HomeMy WebLinkAbout2022 Sign off Transmittal - Create Egress window in Basment Yak TOWN OF YARMOUTH
;-4441. <, HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
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Building Site Location: l/ / (�[�� /� XiTCY) a ,g ; ' '4
Proposed Improvement: a-iwell -eX�e� �7 1�i,J-t' G1/i/1e uJ /72 Q/7
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Applicant: 13//}[ �DU(4,J eakiiATel. No.( 06 9P/— 2c
Address: % U% /C(%t�� •� /M.if Date Filed: c%Z_%r c2
**If you would like e-mail notification of sign off please provide e-mail address: hy OD TAP- ( pia r I"
Owner Name: - , ✓>J /� O DOL
Owner Address: � V &'k 64`a/7/►'k) /"l/J Owner Tel. No.:(5-0e0AF2$v7J
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:
Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) —
i Note: Floor plans not required for decks, sheds, windows, roofing;
If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: (--jerv
DATE: g -cAcc -
PLEASE NOTE
COMMENTS/CON TIONS:
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ROOM
W.I.C. 14'7" x 5'11" W.I.C.
8'1" x 510" 8'9" x 5'11"
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