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2022 Sign off Transmittal - Finish Basement
--Y TOWN OF YARMOUTH HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant. Building Site Location: /`� 23t' (tert-/ jA /2d7/ Proposed Improvement: 7 9 gel j9J T-7*/. / ,(3i t/ ,7Y / �7PI7 ' / / 4/q Applicant: a MD/i�• /it ie©/�f// 1W Tel. No.: �C)X / S/ Address: J e' 4W/i fe,A /9.0ll/l/('tf Date Filed. //07,2 **If you would like e-mail notification of sign off please provide e-mail address: / Owner Name: /e/(.,// �'I�ULLCJ Owner Address: /_. c /3 5 O tC /WOwner Tel. No.: rj) /51 ,3_3 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: RECEIVED (1.) Site Plan showing existing buildings, water line location, and septic system location; NOV 15 2022 (2.) Floor plan labeling ALL rooms within building HEALTH DEPT (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. REVIEWED BY: DATE: i! /c7 PLEASE NOTE COMMENTS/CONDITIONS: ( ‘ , (, r 1 1. ---- X I W ' : .....___ . cl, • - f.T.,1 - .) cyi \ -7 7T,' . 11 il) C\ -,.. )•,."-- -e.,_ \`‘',.. t.'ssk. ' ),) to --t • ----'' 7.,... • ••••• ''N.. ..7` , ci\ ! t i 111 t1/4 j,, ..._ 0 1 \ Z x c • — ,i, • '., ?b -,..,.17„, 4.11"., . \ • - , - ..---'.- , NI /C i\t‘,„, fo),1, N\r r.,- , -N. • -7-1-- ''''-:.) 1..._, 1 I. • . \ 4\- -R x. c,‘ .-y: .$) '' , ': ----•--, C3.-, ' I iS.%. .Ns -"••••„,.. i •,, , ' ; I . \••• (4.• Na I 1, •>'" ' 1 j , t..... ..,, c) , 1 / . • 114 tE' .N4 1 i •-*CN.. ...., , • ! ' '-'• '' - • K c•$. - i 4•;-'.4, i (1.0 I ' . t';' f\s)-- ‘:. , ---,-,.. • i (..) "! / , •:,:-. ,ct . 1 1 / , . 'I.' ril , •-.. I • ' * ---...--...---....... . 1............................-.--J..., 1 . i I '4 NOV 15 .2022' HEALTH DEPT. • .k .._—._...---..—. __ .. >,..1 - ----\,,,,;711 r": '' . r-,,j .. ••-•-• rr\ • \ - I t., ,t... fta , rt--i ,-,,..... ..,.,, 1`\ ' . 1 -4. s. r..^$ r. ). ,...,„ \ *.N 3 • \ - .., V6 ...... .-.4 . r--, -4-. .\\ ' c- - " t•,, -, .(- • C:. "••-\ Nj c--- , "---.. -1 CM 0 111