HomeMy WebLinkAboutBLD-22-004958 health sign off B LD Z2- 6.ov2s? RECEIVED
TOWN OF YARMOUTH APR 15022
HEALTH DEPARTMENT
.; �.*' LNG DEPARTMENT
' � PERMIT APPLICATION SIGN OFF TRANSMITTAL .) ` , 4L__---- —
To he completed by Applicant: P
Building Site Location: > 1�,� V P``�
Proposed Im rovement: eth A A/f,•a a ? tea, f- 71"d .i} U/V 1?-1--
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Applicant: f..oy e (3 „,4itrl Tel. No.: 5 o8 -3 le.`?
Address: 3 a i , , rz n t✓ Ar Date Filed: 3 /`/ - 2Z.
**If you would like e-mail notification of sign off,please provide e-mail address: tVeu,t00% Sei✓,%do5 '/-i4;/-coyl
Owner Name: PA,/ G'c.,i/her Jo
Owner Address: ra 13 OJ 7 ,444, 69z.6 3 Z Owner Tel. No.: Sae'718 loop
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;
MAR 14 2022 (2.) Floor plan labeling ALL rooms within building
(all existing and proposed) —
HEALT°H DEPT, Note: Floor plans not required for decks, sheds, windows, roofing;
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(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: DATE: ! — / C f.—d.
PLEASE NOTE
COMMENTS/CONDITIONS:
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