HomeMy WebLinkAbout2022 Sign off Transmittal - Partial garage conversion to family room ov'Y-yk, TOWN OF YARMOUTH
1. c HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: � '�J
Building Site Location: 'VY �(P_si- ( yeg fry?Ot. l Y L.- a2b72
Proposed Improvement: (iii ve ri 6)R(I- oP34, Vfil npd,,K. anal/
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Applicant: /9m +�/ Q ,B!`14, Tel. No.: / ),_ray- 0400(e,
Address: )yy Fore g 20( , #ifino,,(1L ; VIA— 024,7? Date Filed: 1\/i .2._
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name:Xrn 0 13
Owner Address: .3c Lf FP r- 4- 20 Owner Tel. No.: /7•:,--5-00— 0006
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,
NOV 2 9 2022 and septic system location;
(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.
Pa
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REVIEWED BY: DATE: JP-02:z.,,
PLEASE NOTE
COMMENTS/CONDITIONS:
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= DINING AREA KITCHEN PRIMARY BEDROOM
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10'3"x 109" 10'4"x 10 I 13 "x 117
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L. LIVING ROOM
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181"x 149'
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rig BEDROOM
10'0"x 13'2" I j
BEDROOM
iv,A 4 11'2"x 133"
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FLOOR 1 1153 44 It
NOV 2 9 2022 TrITAI.1153 04 P
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10'3 13 "x 11'7
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10'0"x 13'2' BEDROOM i
11'2"x 13'3" 1
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CA CM NIERNAL AREA
FLOOR 1.1153 sq R
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urn MIS PIIINCTCM ME orocoximart.sen.4.NW tiAlef
NOV 2 9 2022