HomeMy WebLinkAbout2023 Sign off Transmittal - New Staircase with landing p'` Yq , TOWN OF YARMOUTH
'' ° HEALTH DEPARTMENT
'' t`� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: /S 2 A W/6/1 N,1/4 I ) S ac t j Irv',v
Proposed Improvement: II Q V, S i-p j rL ' _ t�/i 4 fv,0" c (fir» �4 12.4e. /L
.� c-l x)o De-c-1, TZ-D ` u AJO
Applicant: pi,a.m. r 2 ;1t 4;..i IS/ .A Tel. No.: l �' PO ? ?71 -.
Address: ( 5 Lc>Sl& Ak/ 5-r , Qe7 , g2,d O)-3 (00 Date Filed:
**If you would like e-mail notification of sign off please provide e-mail address: 1e.4.....)5 ill t N �6) No j wl4 I L' con/7
Owner Name: Rj dp b� PA I;I„ z S-T-
Dc..)-X r`tom,
Owner Address: `,t n-e/L a-t..2_,✓L/ LN VOwner Tel. No.: ('{ ( (j �-�)-)-5
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,
— EI `pULD and septic system location;
(2.) Floor plan labeling ALL rooms within building
MAY 1 2 2023 (all existing and proposed) —
HEALTH DEPT. Note:Floor plans not required for decks, sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: DATE: 7i6
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PLEASE NOTE
COMMENTS/CONDITIONS:
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