HomeMy WebLinkAbout2022 Sign off Transmittal - Deck with steps JN2.',k,,. TOWN OF YARMOUTH
4,1, c HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant.
Building Site Location: I'g I fI.I..C_/{. Ian ' d I fir v a
Proposed Improvement: Tb e' c. 1< io di\ S
Applicant: LI,kairt (>,,►iLu_K 41 La;c..7 (1- s>kS 78/d(5. Tel. No.. -3-7)g"g(o ' -' D-
Address: l //C(th&n i4-e.,r) I"' 'y
-RC�, I lit , 1. tA--to1 ..1, Date Filed: OZ I )-
**Ifyou would like e-mail notification of sign off, please provide e-mail address:
Owner Name: /---►SC,L_ , ' WI tire--Th /kUil
Owner Address: i &kQk _1_-S IfLrV1 R416-,
1�A-8 Owner Tel. No. (C r y�i i
L/..J...f.... (=U-Mt-A..T7.1
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,
FU�a 1 6 2022 and septic system location;
HEALTH rEPT (2.) Floor plan labeling ALL rooms within building
L______
(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.
,n
REVIEWED BY: /6DATE: .
PLEASE NOTE
COMMENTS/CONDITIONS:
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