HomeMy WebLinkAbout2023 Sign off Transmittal - Create office in basement . .
TOWN OF YARMOUTH
HEALTH DEPARTMENT
'�•` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant.
Building Site Location: C, -yi Gr2-ee,;:,;..
Proposed Improvement: ,4QD 2 wAit-s C -s y) TO Fo(t./v( Off'cg-
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Applicant: 0ft./�4. CA- k1 J_N Tel. No.: q-i -.cos ) 01
Address: Pd (seg. Eys--r f�ft-e{,asreA-- fl" i- Date Filed:
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: a RVe L I- 11FtwO COcNC, 8-SA /ivr//<'e- I L ' A
Owner Address: ig 2-Y1 tfrktivieviA Owner Tel. No.: 1-3Z--9 3 22--
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,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
JAN 1 g 2023 (all existing and proposed) —
HEALTH DEPT. l Note: Floor plans not required for decks, sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
- ith fee.
REVIEWED BY: DATE: fr 1 el,?-1, -3
PLE SE NOTE
COMMENTS/CONDITIONS:
fa
MaushopLodge - Basement Room Layout
,
.. __ , _
Existing New Rear Side
__. ) , t
t
Proposed Room Existing Storage Room
11' x14'
z
24' _ ,,,%4,. *
1
\ :
Relocate Existing Door
1\
Replace Existing Door Proposed 2' x 12' Scout storage shelving
30'
3AN 19 2023
HEALTH DEPT. •