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HomeMy WebLinkAbout2023 Sign off Transmittal - Finish basement RECEIVED , o TOWN OF YARMOUTH MAY 12 2023 ,� HEALTH DEPARTMENT o. +, HEALTH DEPT. ''^°N`'� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: j 6 K►o IL-c h (Lo^4 t wes T YpeMo.,i h - M A oa c '3 Proposed Improvement: F I AA 1.5 I1 b A Se M Q T Applicant: E S ti c u A o L A ,,.,c`1 ( k0 c... ) Tel. No.: -9 41/ - 3 6 8 8 3- 4 Address: S6 N o 2\h R .0,a 1 w e S\ '/102 Ano,i7 k - M s.O.24 3 Date Filed: 0 s'- f. -a 3 **If you would like e-mail notification of sign off;please provide e-mail address: ES T Ev No F L A�.,4 ,•An c eNivv,.L• �•�/"` Owner Name: E STc Li too C ..•cl\ ..., Owner Address: SG ti eac<C ti Ro rA 47 w e s l yAQMo v I, .M,, Owner Tel. No.:11 1 - 3 6 8 33.2 y 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: +.1_,,, C � DATE: E-'/5 ..2_3 PLEASE NOTE COMMENTS/CONDITIONS: 7 r to 43?N 1 M sr j a v N \!tr romiogal I— �toa.-1 i30d ) 1 n f • or Ir +^ 4 •--_____- 0 3 a 4---- 1 ( 0? F 1- . - 6 ! cil !' Sn1pF 4 0 00 J c?c,ro . s a aJ i>h �_ o— i. co �� .O d 4 E , -11 '� E' of cY 0' U elooA i lJ (t N\\\W s•Vte KT > e F I' o C ti- r `1 �ceeZ Ti % o 44 S _IA gz° t, -,nI Fhf q.- C � I 1 li ri ., , F �tx . . ,: 1. 0- : , I . ......„ 6(3%, • -co 5 G°' o r_ -\.L____ z "s 17 as- ii IS S w z _1 , tO ; • u; w 7Nd (3',/�j , , 1'7�� + + + 4 I I .I i + _.: t " + , I + , , I` 1 1 i 1 I V It 1 I 1 \ i ( II k i 1323X Is'Gh s vi - + p/ 1n Y © 9 03 Po 11) A. C 'kV, t, J . Eli U d55 I Ch d4 FT 6