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2023 Sign off Transmittal - Demo
Egaa11C cif.Y.I. TOWN OF YARMOUTH APR 0 4 2023 c HEALTH DEPARTMENT o _ -3 HEALTH DEPT. �''0 PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant:Building Site Location: /V � ( jed Gi}QiS/' ) i> ii()>/i-k Proposed Improvement: R/}Ze- 61 .-- /s 1.5 hoc ,/s* / v i1 olj CaV-- !/1l-V bee y Applicant: f}-TTA) �,4yt F. E-02 Tel. No.: (i -D?&-'/ -S7'/c Cam/ .41IV /e2A0i , , Address: , /7T.c) 1-) 4, ,n /04- en_ Date Filed: g3 63 **If you would like e-mail nod tification of sign off, l se pr de e-mail ad ess: f M'? �' �a C✓p—S t- 0 -11 £eve/c l ary Owner Name: lam) t PI1 L,liyl Owner Address: 71E-1(16- 5 6:s ./ C, Owner Tel. No.:6tJa ,s-- 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, i w , t ; i )?:i and septic system location; (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 with fee. REVIEWED BY: C,A..c_ DATE: '��` �l APLEASE NOTE COMMENT S/CONDITIONS CiQ 01) I-1 e>-k.. x_c____ "•,--7 C.:- .. N F7 z- rz�w z oo= U) �D w oz� LL- p:2 of �0 0 uj wE ,_ 00 w c" 04 oOa o0 0 N BERRY AVENUE O\ Q m C)J W mw w Z 9 a Z O w N uj O o cf) Q © O wHIGGINS Ld CROWELL ROAD w F- 1 o m Q o, LLI U ° o -�-� }�- Q Q L.LI w 0 w cwn^ u _ II O O NO Co 00 �_ pZ=o ff>U F- Y F- Z Q C� z o U w i O ry O O 00.E o r N x I O) 0 N oo N WIMBLEDON DR LU -� cn Q L� Q QQ L�1 U C/� me L..% Q J— � O v W o FW- -j 0 a o � z� Z z m N W m ui N CV � o c� m wLo 0) c0 O Ln O ! 1 wo��g w�m� W I O1 in 0 z p Z (n U o �o U 0 LLJ z= �� r M N U cn o p Z U 0 Z 0 c() �_ co — Z w O v O J� � p D- Q o l=- Y I I I I I I- I -- I -- I \ W O Z J O N W W Q O O o� Li.. z O d W Z 0 W 0 00 O N W �-. Q W c0 11 v W W 0 O Q O O O Lo O W Ui 00 (00 LL- LL O 0 W U') o N� M N -H 00 U) (f) N Q V) LL O w m m Z NoW� O c�0 w Q �LJ`' 0_ LL x W NN a 1 Xon Ln O O O z O F- O _ z XQ O x Z U o 0_ N L0 o' LL (n W' N — 00 N N N Z Z e a. 0_ W U U Q W 0 Y NLLJ w w U U U U W Z O U V J W W Q W Q Q W W W F- H 0 N OJ U O o: 0_ N Q cn m F- 0 0 > 0 > 0 > 0 V) 0 LL (n Q w w W o' w o' �� �� 0 wo LLI W Z Q o Z o Z o Z Z g Z w Z O W Z Q o Z p a-J -J-J > W UOW� N a o ,> > > i — — — _ � N ♦ ys�,y ♦ 7b,S `yo i D Q V) �J Q Z FU-- O o W W F- 00 U 00 CL o > U) Z z Z 00 Q W W Q Ld Z F- � U W O OW W V)�UQ0 ZLLJ0_d F- V) C) w0a.0 W = Z F- � a O 0ZZ� Z Z Q o O p > U Q O U W J W O W V o = )- W Z F-Uom< 91 0 Z Q O U o LLJ ~ IL > Ld O � O WLLJ o Y�IQ W W F--m�Z LLJ QOQZO_ OQ_�ZQZ CL 0 W d J Ln��U ZLJ D W o F- 0Of�tn H H )-W 2 N O0_F=2 mUOQ:2F- r) Q Z O LLI F- �> Z O OLL. O in N coo M<o J = Z 00 W U U p V)WO z F- U)3: o00_ m 0 of m W 0� Um_ (n0 O Zoe 0 00 O Q JW 0_ W N J ZU o ct -1OZ w- OU) 0 o Z I=00 b U U 4 L6 �y PA, 00 00 ` ` 0 o =)J�>- w0 ` O 2Qp v ® �,6 V%�6o OPo> y CL m U o OS s�J v Li U z Q m ry cn o�i L_L m • M 0 M LLo O I I I O In M O Lo ` N N CLLJ o LL 0- J Ld Z �2 W Q 6 V) V) z O~ uOiFt� OJ, � a. 0 04 o LLI LLJ O d czzo 41, aOZZ \ LL- \ �Ld N N ' 0- m oU r 1� ,\ 0- z i O OJ .O I dJn' _fit 2 ® \ M M o O M 1 a�N \ OLAJ mw � Q jetoQmin ��a� ui \ �I = \ \ LLJ toZII w p =o Z O N ?W\� O . 0 < CL J0Zm J J J J Q Q Q a l7 li lr3 � � Z Z Z Z O O O U U U U O O U O O < u) m m CL �, O p W Wp 0_ LU N Z > O 0 0 � 0' 0- w S N N t= o o 4 N F_ F- LL 0 LL- L- L� LU (n V) N -H Li o . . .,}.I C4 (n 0 0 0 o Z � N W O M 00 ZO ca CQ m Lu � (L Z cli O W W U tL :c LL m w w ui — LL - vi o Lo o rn Lu Z OW Z Q Q l7 O Z z Lu O Z z LU LL cy- w Q m Q Q Q ZO > > 0o U04 O Z Z i— O 'S Q w m ttl N � 2 N U U 3