No preview available
HomeMy WebLinkAbout2023 Sign off Transmittal -3 walls in basement for weight room .di,:Y TOWN OF YARMOUTH _ . c. HEALTH DEPARTMENT T ' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant:Q I Building Site Location: I 0 + • , :ye- P.c7 . S • CA'- nit.o . t k )42 Proposed Improveme t: .3 LL)C 44-7-- I J a-_-. .51-7 raom . Applicant: CJ �Q.I�cVR.3:S Tel. No.: —1-1 4- 83 (P Q3 6 3 Address: g Q.. .2 I • IZcl . S 1 71 Ze_F..iled: -3 I **If you would like e-mail notification of sign off please provide e-mail address: a--b b e a a-1 8' 1 -i -P Owner Name: 0.D i - C vvt &ine 7 Owner Address: Owner Tel. No.: 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: LL (1.) Site Plan showing existing buildings, water line location, and septic system location; MAR 2 U Z023 (2.) Floor plan labeling ALL rooms within building HEALTH DEPT. (all existing and proposed)- Note:Floor plan::not required for decks,sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: �Gm.r C.)Q4,,.____. DATE: L4 J G/.. / ? `J PLEASE NOTE COMMENTS/CONDITIONS: l( W (60i4 41q N O 1% C\ i 1 t 4 i11 ig _ 4 ___________________ ___________ ,.) - ---- ) ?_-_ _. _ _ t o :______ ______ ___/ _____ r___ --4 ---t _ __ _ � ____, ________ _ _____ , _ c-__ _ , )_,, _. _ - v, o� " vi <_ ,,, . O \r c j ..\ _1 .\ -\ 3 3 1 Nrr ri M rn — N (NAct-c �- a t --1 I 4 '4 A fl m . 60 i °°-4- ‘ . . -- ct- r m og LI N. ri m y fD I ' i o q3 a 1 o.fD o m m m c m m c*s cu ELT e 'ic;4 :emu a no 0 1u�r -^'� r3 18 , v: 1 3 'g Oil LL88 ayeidwaL Mawy asn spue3 amedas oo we umn pima)Raj ® r'1 W!id/woY bane o;op =IX spJe3 ssawsne ma5P3 uea,� .►LL88 Aa3/V