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HomeMy WebLinkAbout2022 Sign off transmittal - Finish Basement ,,,.,-'',,k� TOWN OF YARMOUTH � r HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location:3r Ade,j12/s ,� . g k xy.,,,„,..,,* , f, 21,.,6713 Proposed Improvement: A/ eir r77, 6 iex / &,. .,., �,,,,,W4 e c jte / I- r 6- z z '- Applicant: fri 7 4-4 Tel. No.: •ag 2go-4-nS3 Address:3? % c _ h/es,,,..2a�,/' ',li 73 Date Filed: **/fyou would like e-mail notification of sign off please provide e-mail address:ir# (J3 V07,041//62‘p.7 er Owner Name: 1 /s 21- Owner Address:tj# �V��� �� u/{S .�, Owner Tel. No. d�Z .� 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, RECEIVED and septic system location; NOV 16 20Z2 42„)) Floor plan labeling ALL rooms within building (all existing and proposed) - HEAL iH 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: J DATE: (/ /8— -. PLEASE NOTE COMMENTS/CONDITIONS: t11I7 /a- , Cce4cf - Ner1Aci_S icYcc..-- C,/g tea' (/( ZZ. a<t)rt241' _ ........ ,..........____ -ek 12.-..) • ' ' (°-7A ' ,54ol'ic j---'------------1',. f et.- 1___—___----___—_.--- ; ------- —,..--- , - N4C). i --1,-----------1-------- ---,--pgii•Ati I , I-7 . 1 . \ 1 Niz.) ) . -........... VI 1111 1 . 't t F•,difooitA • , . . r --1,..---- • • .,.. i..6) .• () . If, h. . i 0 forvl I c , -t-p. i ' • ho , , -•i ,,,,,- -:". f :73.-- . 1 -NOV 16 2022 .• / #' •:,,,:, 1 . .....a al ,..,,,„f ( .-..4. . . , ..2. HEALTH DFPT '.'i, '.' • I k , )e. K glA p' .,• ' -... . , •. ' .., • \.-- 20cC OW e", 140%,r 1 t — i = (i2 ,..1 --- 9M- r- 0 ,,,,......„Niut. 1 [lull . , CO E-.1 ! ------tia : N : ‘' r•-.3 M cD buil e,, '"''":":frel‘1414 • V - • :1"V)C r '. -0 rs, (!_ij ..... ., °." ' - -V 514\1,,A '1 I (.. if r,tke.L.42,10 0 i . er ,,,k, 1-tet‘cluk . • 10 :137(ker \ Isk it04 .' • , . :/::;'!- i ci ,,, . . 1, 4,...- .1 - clivar,... i, . t.s.4,.-.... , • 2 Y# ) 4. 1 1 . 1 tt,..1 ., P i ...... 1(.Iel," -----1 1 e -\ , . 111 . e •,ock..: ,,.,:i / 61:i •' . .0.-1. 1 . 41\.f A _ _ . . si 4 I _ __ ____ , [ . ,...,,... .: v. . -,), .. .. ....., • ...' .1'..!". .........o+' .? 1 1 to,;/ ,1 0 r. a..,c,?4,•,-;-, • , ....... 1 ., - • ,, • \ 4‘) .„ . ‘ i \ i ........„,, .6* • i/ . ,....... . .. \\\:4...k.k9V'• I NI'''. i ..1'.' • f---- __.!...._____:2_