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HomeMy WebLinkAbout2021 Sign off Transmittal - Pool & Pool House ,, TOWN OF YARMOUTH )- HEALTH DEPARTMENT . ���"t.4,1t`./ • PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET - To be completed by Applicant. - Building Site Location s\Ql\ � 1tg-- VQ¢ 02-6:--) ` Proposed Improvement: Applicant: c>?s,A.3s)No____iim_ss-;L Tel. No.:1-114 1-1 O7O i,?O) Address: 2-7 j 6, rc \ lk.3.A .ady_..1? -- \Au 0 2-6 7. Date Filed: O7 fJ/tf **If you would like e-mail notification of sign off please provide e-mail address:.b D ,a-1Y\ Owner Name: f4 \-\ cet,..SSc, �= --- — -- -- — -- — — Owner Address: g 7 l .)ei, r,A ___ith - Owner Tel. No.:`7`11Ak4.7O)7 ` .....c .., 0 2, 6 -76 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, _a.�= and septic system location; (2.) Floor plan labeling ALL rooms within building JUL 1 6 2021 (all existing and proposed) — HEFA,I.TH DEPT Note: Floor plans not required for decks, sheds, windows, roofing; ° (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: DATE: 7A- ( s --- , PLEASE NOTE CQMMENTS/CONDITIONS: - 9 v " a i_------------� � 1 _ I I 1 I I CL d NO1103S to w. �, a-2< I W w 0 1 I I coa I I I Z s R {,.o o ,, I d N011035 r- •- co N Z I I I I l <• I L--- __ J I I I I I co I I I I I N cn M co 4 —� U. 0 I I I g � W -�. I ,.° I o�© LO p ,w- ti ..::. 0 I o a i I 1 I Z r U. _ Z J I I I _ - au'I IAW Q WPM- z (� :.. Cl) o p i I 00 ClqI a �- N I „-,z I a z I Q 0 M I z°� I '' I p .� Z oo I I U CC a� ' I W I = r u. a I I co w Q W v WHao c ( N I CT! - I �'••4. I � p C 91 � I I L—_-— — — — — — — — -----_ -- ---__J 8 —j 0L LD ` w o p J a. p ow--_---- - - - - - -_ - -- — — — — — _------ o a tw.� aa,oz W w W D t- M T— c9 c? wa zV co Z 0 W W cr-d w w 0 J 0 0 a_ w Z U Y U C� ID 0 Q w J W I-- U- W W CO r J 0 a CL Z 0 w .i W F- uj CO J 0 CL