HomeMy WebLinkAbout2022 Sign off Transmittal - Interior Renovations /...‹,:;,-_,:,,,,„,,,, TOWN OF YARMOUTH
5 i:',44. 1. HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant.
Building Site Location: p2Q 6 /.Sa u4 Co.,— C1rci.2_. , „n/,,�t Poet- / X67
Proposed Improvement: ;1zs-- tea- '-- - Up Da fr- /..<;4-a.,/ 4-0,4, !'t
Njj'5r /J ei
Applicant: 1C /116, vn/h.,.l— Tel. No.. Y--„/37—4787
q �h 4-- ( Yar-Ai.oc,44, ' Gaol-
Address:
Date Filed: -7 /a Jaz
Address: �q,.y}.� v-�L Cfr�-fit �
**/fyou would like e-mail notification of sign off,please provide e-mail address: v Atil - a
Owner Name: 1-C-aN-, A)C✓3UN�-
Owner Address: owl a! Acc s,4"ei-- 60,,,e. (i r c,(--C--. Owner Tel. No.: S —' 37-47
\/ctrn�wv (- c&r N\A 01-67 S- ”
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,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(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.
/ glie
REVIEWED BY: / DATE:
-�0-,D,L
P EASE NOTE
COMMENTS/CONDITIONS:
1
I°
SCALE:APPROVED BY: - DRAWN BY7?-
(p� Jul •�
DATE: �{ . A�� REVISED
i
t i7'4i 4j4�r�t
-
DRAWING NUMBER
� b-�..�tuC1i��E2.1L"Ota
rKt� Ise j k�
o
i6 Y� R Blau €�a �p —
I;
1
u oL ta"
XloI
. e. tyy,
u _
SCALE:73�,()�q•�` „q APPROVED BY: DRAWN BYy�{�,[}f,pj�
DATE:ryVxGO�// REVISED
2t`(' -kms ��•�ta.-__
DRA�GNNUMBER
OfYJ/
-�a.� �„✓x. was
1,^4
IVV,
SCALE: Y4 ^'C'v APPROVED BY: _ DRAWN BYjSwM
DATE: ZjW JL ?OZZ REYI9ED
ON"
DRgWING. NVM9ER