HomeMy WebLinkAbout2023 Sign off Transmittal - Shed .0t;:TA* TOWN OF YARMOUTH
s�{ HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: ,''''4 /# 51L '12 DV( ...
Proposed Improvement: 4—t; 4' 6°hie,0
Applicant: AI A ,f'-(H ifoZ1 ut'l l.?_ce Tel. No.: 5 0 8 'g to 5— `,
Address: G l Lae ,t,! ��- '/fin. , ,fi Date Filed: "trh.!./„
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: )i 1.!_1 r»'Ai La l LC a£ , e�OJ�,/
Owner Address: 34' 41 A 1/I<' , n (f Owner Tel.No.: 576 6 3( 474
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:
RECEIVED (1.) Site Plan showing existing buildings, water line location,
and septic system location;
MAY 0 3 2023 (2.) Floor plan labeling ALL rooms within building
(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.
REVIEWED BY: C�v+ �, DATE: S -
PLEASE NOTE
COMMENTS/CONDITIONS:
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. .,. •1{er The Gilooly Residence
:Do,cr,a. .,,:- 34 Marsh Side Drive,Yarmouthport
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i — _ Scale:Pilip L.J8Cheney 508-394-1373
9/29/2022
il Rev.3/29/23