HomeMy WebLinkAbout2023 Sign off Transmittal - Garage Conversion ..o .'YA r TOWN OF YARMOUTH
Tic' HEALTH DEPARTMENT
''��e���`' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: `- \
Building Site Location: I t i ' ,ccIA.: -ce4_ R.c. W C. r Ye4ix.✓h 6 JAA"
Proposed Improvement: 0-0a•1 GILT' St^tile_ AA-rettCp 9tg0r.. /K.
0-c 4 / Z5A4 -)r-o n ern
Applicant: Z c -c -4,i ( j _ Tel. No.: 617 93 9—d///p
Address: II 4k. 'Lek,(uLA._ Date Filed: 2-2/-23
**If you would like e-mail notification of sign off,please provide e-mail address:
Owner Name: tieKi`/tLry 8Ug,IGte--
Owner Address: /( 44 e.44C_. Owner Tel. No.: 6/773 9- ///U
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.
it , Please submit three (3) copies of plans, to include:
, `t'' Site Plan showing existing buildings, water line location,
y <91, O, and septic system location;
<,7-( ,) 042.) Floor plan labeling ALL rooms within building
/, (all existing and proposed)—
Note:Floor plans not required for decks, sheds, windows, roofing;
Q' If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: Crw-hz. ( DATE: 'o2a'r2 3
PLEASE NOTE
COMMENTS/CONDITIONS:
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