Loading...
HomeMy WebLinkAbout2022 Sign off Transmittal - Rebuild and extend deck o Y/A4, TOWN OF YARMOUTH o; , .,7. c HEALTH DEPARTMENT 4'.fN``g PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: // 7)/(CDmbe 4z)f. Yaw-it/1417g (r'f Proposed Improvement: R2-hvIld c�ixf,e-ka � a y ., fp 50 Applicant: Pain Lja cobs Tel. No.: -771i--357-6 es-. Address: P(2 6 O X 3K`( Mr-flu& f Dri'I ✓"VI- 0.?-Cv 7S Date Filed: V9/011,a-,1_, **If you would like e-mail notification of sign off,please provide e-mail address: Pa-is Golf 76 y ef.A.00 . c owl. Owner Name: -D;,,,,„,e_Seyt-,( Owner Address: / f Mac OA&-r Dr- T -Act- Owner Tel. No.: 56g-77e-73 8,1 RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e.,Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, 11,;r and septic system location; (2.) Floor plan labeling ALL rooms within building HEALTH DEPT. (all existing and proposed) — Note:Floor plans not required for decks,sheds, windows,roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: - - 1/7 -.. DATE: 7 la PLEASE NOTE COMMENTS/CONDITIONS: , 1. 3 U ►n c. ekl C 5 cr'�c-4--. 4-6-1JC- S c 1/ 64/ $-e- 1-4-4e(./- L.i '1 s" My WebLink More LASERFICHE Yarmouth Street Index M MACOMBER DR 0011 M. ' 4 / 5 Lit width 4 Metadata A I I IVe Entry Properties Modified 4/2. 1 PM Created 8/7/ -;___444.4 AM • arlPath War SEWAGE PERMIT NO., ? _WATER TABLE L� IndE 2LOCATION NO. STREET 2idr /1/4 !j/ D R\i MA( ..... INSTALLERS NAME & ADDRESS ,Z1 136. j%14 'w'r t As-E Buil DATE PERMIT IssUED J0'17/7 144•0.:•{., ., DATE OF INSTALLATION ///per Template 3 DRAWING OF INSTALLATION ON BACK J 4 Yarmouth Street li Oa, OM ,,, Fields -r^' 4 Map-Block 136, 1011Number Street 001 5 RECEIVED 111% Number Street MA( HEALTH DEPT. Name Document Sepi ` vl . __ J7ffe Category SEP 0 7 2022 Department Hea HEALTH DEPT H®H® ® I • f _ . o • � G F c I c), m m n _ m Fi m ~' I , m m © moi JoI5V -) ,e ,Qt 1 i ?