HomeMy WebLinkAbout2023 Sign off Transmittal - Dormer TOWN OF YARMOUTH
HEALTH DEPARTMENT
r
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: / '
Building Site Location: v� M
1 c(�e(J S
J
17
Proposed rovement: p C re c�e !I n1/l ,5 C+C C�(>
'f 17e /ijf / M€c1/Q C ii✓- on ir5 N66r Crecv 0 /) fioor Spac2,
Applicant: .Q� Tel. No.: U _4 -�-% i/
Address: Old /�
60b U/l�f ���GP ICt'- Date Filed: 'd„�
**If you would like e-mail notification of sign off,please provide e-mail address: 5 p CG V rcc 1 .fe II^ (1icp'I
Owner Name: p,me it
n M Cy
Owner Address: / "l(;c,L e J Owner Tel. No.: 5n 2k710 736
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.
7 �y Please submit three (3) copies of plans, to include:
ilk C'�L.tivtitz (1.) Site Plan showing existing buildings, water line location,
and septic system location;
FEB 3 2023 (2.) Floor plan labeling ALL rooms within building
HEALTH DEPT. (all existing and proposed)—
Note:Floor plans not required for decks, sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
ith fee.
REVIEWED BY: DATE: AE11 3
PLEASE NOTE
COMMENTS/CONDITIONS: \
v S e � ✓ti a. v� DN. 1�e f c,c 1 6 G vu yU
ly,
' \ 11
..,
!........
—1 •-t•Dj-- 5,
-4 r;
' I
0.
9 ,
-IL
I . III , •
•
, .
1:=1,
-/
. ,
1—.4-- '
.... • _ . t.-.,
,
,
-,...,
It.....
1
)11i •
. ,
0,
I ,
t i
I
fr ,__ ; .--. _
i 1
'53 r
..... s.!
-4 r f` m CD'I 111
r fte. -•--/') III cr-2 @
..› /ft •
4
(---.)
11-4
f -
T-L
Tf�j:tz,Qq Mv, Post 7
AIJU". 1*-�
I --Eyll '151r( < 15
awnw: �Lw cc)t4sf
C. 0—
-'C -
------- owl
4*
5 k f-) t Q <; (`rs A-(,A-Tc- 4—
0�'N�MW OR
P;%VA,OV.q.---ZLH'� LjuLr.
Accurate Remodeling .-AUM24ti sdM Dea-,Ma— . -Ot4.5
Thomas Telford rI #-E4GF--' 61-12.6;'r
ow",
ceu.s0s-280-9211
Email-
Toneaccurweremod*lJngograoaco-
Websit---
Accurate-remodeling.bushwss-ske
Ostervine, MA 02655
AnmnmaupAL 3EMM
774W,"
0
?� 2 MI=WAYnMVLN
DESIM