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HomeMy WebLinkAboutBOH Sign off LIPS -023-o ssga t 'Ak, TOWN OF YARMOUTH �`'c HEALTH DEPARTMENT P D PERMIT APPLICATION SIGN OFF TRANSMITTAL itE14AY 2 3 2023 To be completed by Applicant: BUILDING DEPARTMENT Building Site Location: .31 �/ o'car/l'✓e, ��iti y0 tJd j0 ti , n - - - Proposed Improvement: h,,You'd V 1 h y/ go/ 705 Oct 49 ri Applicant: (./ea,IAA rul `-,S I-,'h poo(s -s, ,-,V;ce5 Tel.No.: 5°P 2 /_ O of Address: 4/ $jSSAti Z! ya,, ii CJ m/¢ 02 Date Filed: O�2043 **If you would like e-mail notification of sign off please provide e-mail address: 11 p h6 64 e son ry la vd504 n(V Owner Name: v 1 / le �i1(Q Ve i Ya op CoVt Owner Address: ✓1 g1l 5 o j4 ve, Sv fN 01©U'-1 , ittA Owner Tel.No.:50g 36 y /cs-z 02i 7-3 � • 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. RECEIVED Please submit three (3) copies of plans, to include: APR U (1.) Site Plan showing existing buildings,water line location, 2023 and septic system location; HEALTH D (2.) Floor plan labeling ALL rooms within building EP7; (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: 0_,Y. �, ‘f-e -_l DATE: 5_�_3 - PLEASE NOTE COMMENTS/CONDITIONS: N