HomeMy WebLinkAbout2023 Sign off Transmittal -Finish Basement k,„ TOWN OF YARMOUTH
:-T4itA
HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant: ff
Building Site Location: 1 SV 4,1, 1 fl1>\ , l� �lJ Y lyDU l'�`� m6
Proposed Improvement: 6'/ r I S f of e4 Je dY��n �-- (�D (�
} l7 coL,-citp 'op t S II11<
TL' -t- 4 �-,a $.oci-wt
Applicant: o NI5 l(xO Or,_ 7CZ/3 Tel. No.:J Off' 3-co ez‘io
Address: 7 SU LL i Vl3,N 4 i (/v rS 4e,YrDIIjk Date Filed: 12 ,S 1I0Z
1 �
**/fyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: VD )'5 166 Dr-So U2o
Owner Address: / S U L 4,`1 (16 lv f Owner Tel. No.: 5D 3 O
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;
DEC 05 2022 -(2.) Floor plan labeling ALL rooms within building
HEAL
(all existing and proposed) —
Note: oor plans not required ed for decks, sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: P.. /
DATE: IcX '� - e)` 2
PLEASE NOTE
COMMENTS/CO ITIONS:
5 c vh ea- ida v Sf cf. ‹-S / cv ,,
C-i-c,-42_TO Rc !t-I 04_ t Ft r ST Flco4
(�e
3 (led v.
a�z fl c ✓
..1 t: I i S 4 1.4
el 1 ' iW
I 1i 1
[ HHa 1 7
w
4;61 Iti j 1 til
r
---- t
c -j N ''�
t........... iiiih.-•
...fa .73
fir
. UV it:As I
N
N
a
l
L�,
4V'al i L...1 1-.J C
-)-- . )(2--,-,,actac-N-AA,
i
0 0
0 O
o
o 3
ti * ' % et el) , -2tocC z
NJ C 0
di) 0 vi' vfooy /a a R
CD kAl-c9bVicit 40 ..,/d L 1 I 1 , .--i"
Z --
0 , _ 4 N, Aik •
fir
\-.4 ' s/i'
• lam, ) f 1
- C-14_r) (>4-4 _) V r _IS, 7 1 I)
Lf:::\ '.
v,'fin I s ,,I,. 1 -I"ssi -I--Th
•T�
W
Y J
ti
2 4 F
co
4,0
/) .30
cJ
1 I