HomeMy WebLinkAbout2023 Sign off Transmittal - Kitchen Remodel y.0Y!Yilk4, TOWN OF YARMOUTH
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s, ° HEALTH DEPARTMENT
'z.,t r.. PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: ..74c 1`// 14 ?,/ iW _'o '1 'i'9rr/ot.t.1.7
Proposed Improvement: 4 /44o IL_ /1Cc he-i cc e% 7,,lc-/. ` Lee j c1r7 f ''
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Applicant: 14:2c1,'a2/y 9 4//il Tel. No.:-C13,C'6 qs, ,c--42
Address: /29 L''(/I'4E1)4 aR/v-e, it e 1/ Date Filed: J Z� 1 Z
**If you would like e-mail notification of sign off please provide e-mail address: j €i/. . 'TGl L.v74/ C? Kg Ljv 0 . eon,
Owner Name: jur11S Mre.ems itior20 rg t,
Owner Address: .24'S Aly, , 4/; I f2 S illy Owner Tel. No.:20- 6.2,E .2eoe
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,
CFiT4110 and septic system location;
MAR 2 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? c . DATE: 'i`,), - d 2
PLEASE NOTE
COMMENTS/CONDITIONS:
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