HomeMy WebLinkAbout2023 Sign Off Transmittal - Inground Pool of 71 ,t TOWN OF YARMOUTH � Ov
HEALTH DEPARTMENT MAR 3 0 2023
Ct.ttV PERMIT APPLICATION SIGN OFF TRANSMITTAL S EEttEALTH DEPT
To be completed by Applicant:
Building Site Location: d' 3 S I S T t(L S C 1 I.. ) )'A IZ t o IA P o QT/ M q Q Z 6 i S
Proposed Improvement: No L (I t(, RUv N ()) 4 6 X 3 Z
Applicant: V I L L I RN LA S I L V A Tel. No.: (5(3 1 ) 9 S - S "1
Address: 31 GENERA(. PATTON Da-,i IF-I WO is , Ma Q 2 C O Date Filed: 2-Zu -Z3
**If you would like e-mail notification of sign off please provide e-mail address: We ru b d%F I 60 t i h„, Min, ,
Owner Name: V ItLiAN DA SIL4a
Owner Address: CENtRAL PAT TON I) g_. 14YANNISt1 026oIOwner Tel.No.: (COD 9SA-gE2S
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
(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: /' c oZ 3
PLEASE NOTE
COMMENTS/CONDITIONS: D
LOCUS
INFORMATION
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