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HomeMy WebLinkAbout2023 Sign off Trasmittal - Garage conversion into Family Rm A ..��.,'� TOWN OF YARMOUTH a. r HEALTH DEPARTMENT '�• '� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: e� Building Site Location: !A 1.,� yl 1- . ycy-froll-pc. (-J- . ...Improvement:L it40 • -r✓ls cti p 2Il6 ' sec IL-0-0 Applicant: //k7 ,eyi �yy _ /Iaive4V7 Tel. No.: 46' ( 1c Address: Q ),Y-/vL_.. 1- i `� Date Filed: VZ6/Z3 **lfyou would like e-mail notification of sign off please provide e-mail address: kUL 4/Q4WW)G U'C�7 /1t f f• Owner Name: Sit I—!it'll') Owner Address: IA 064 u ` 5-74( Owner Tel. No.: r Zs./_ g-ic 1 7 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: c4 (1.) Site Plan showing existing buildings, water line location, ti �� , and septic system location; p (2.) Floorplan labelingALL rooms within building y )F,0T ?`� (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: L ?-77 A 3 PLEASE NOTE COMMENTS/CONDITIONS: ��� t1 �r�l/) ? �3�•�c�e �' I kelp fw Ect t 6 ftocrw— s �w `� S c aSeJ cr‘v i A. UaviusA.- -.'7.,0‘.1 , yormcdit-k- pri ,-- I r •••••••••• ••••••••.................•••••7,,„„,... ....D.. • w.---..-....-a.,...... .........-.. A dr- i •J 1 etn -ti 1 47)fir4 cA I •,-,. ; 717- I • . • ir • 1 •i . ,...;,,i'l• "*. 1‘ , < \4 1 , • /*NO.' 1 -,, t..,44•%, A %.. , . 44,,, . i , 1 J i ss„..c..) _ sa- c-. • Wivic../cki —: -- ._ .,..\... dy'! c. 1 1 rretikt. t 1 i ) JAN 2 6 2023 Zcc, . oe-cvt 0-- HEALTH DEPT. j Catt44-- .2XF /46LJO 1 I ':).) . ._ 1 7- ki) I q 31( '-' . ,• (-Citie- aell'Ac ? i ()eql°4:4'504e ICO.• t'''.'". rfuloic. *Th-e. LAy?rf.x.6-1 ier .4.- .HA..v:i tk i i V.i_________4(__.........C.laThe.,..... ..r— , • trcott- i'v) 1,),,,t., \ 4, 1 zxcf",5 ca. o cicSR ( itie‘ ,,i tr.,k)o- • a_ ciaAk-e.._ Owl 6 eVole,.114\e/ - "4 .5 . / (...,.... (F1 • • \‘''' ., \........,- 1 \ik - ' 1 7 r C r E.. 76',L.,, TETT ' , 1..,-.. / d4 a,,ite„ IA\ cA,_ 1 -,--- 4 . 1 1 C*6 -_ .,. , .1 L''' : ,;'_•,.:‘. _E- j' -r-4- a JAN 2 6 2023 i HEALTH DEPT. 6s) f 1 e AAia—i: k + $iro •,74, (.3 •- 1 . ►44o s e_____-. 014,,,,,,,,, / 1•11. 111 1 1 ! (I,k C .•""! v I) 'k..3)t.r, ... °I , \ e3 / it:-,e-• \ 0 1 ' 1 i 1 , 1 1 .............. I 1 i..... , , $.... , ! --,-- I JAN 2 ti 2023 I HEAL.„-L, 'i-7 DEp7- 1 1 1 1 t I ) 1 , ...................._...... Yr....