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HomeMy WebLinkAbout2023 Sign off Transmittal - Permit after the fact - Deck 4f-- ' k, TOWN OF YARMOUTH W HEALTH DEPARTMENT =�-`` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: �� ) t_ Building Site Location: IQ7 4 V VAT \A,I atxxxkif, 'i2� ��,A(I„. ( k1 �V(p Proposed Improvement:_ 't 5 k-', De--r - c,Jc,s ,(ln\ ?et„ \.mac b Y (e S'k re-si l e11-k, 4.-8 it, 6,2 lrc•..t.c�� i7e I re\t� c)(? e s 7c : 6v 41 , ,t. i."—sPe cJ6� J `.J Applicant: \J(A.(4..`ke--- A bC -VNa.wt Tel. No.: 5-ot(- 27-� -- CO39 Address: q(c) I-( e ��fyy,,,K `tt„, t 6C Date Filed: 5 1 l t (Z3 **Ifyou would like e-mail notification of sign off lease provide e-mail address:14 eo. Lr'eA.V\c3..YI\ 12e, o�akc,,1,( r Owner Name: C J c�c 4.. --- 1 VVN- �I Owner Address: q G LI Wes-V- �,eiv ov: c Owner Tel. No.: 5� ' Z i 3-- Ca 3 9 \kW\dsk4. ()f.-, M A' 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 G' v2OWED (all existing and proposed)— NAY 1 1 2023 Note: Floor plans not required for decks,sheds, windows,roofing; (3.) If necessary, Title 5 application signed by licensed installer HEALTH DEPT with fee. REVIEWED BY: /a/m.6o DATE: /s '' 23 PLEASE NOTE COMMENTS/CONDITIONS: 1 OJ 0 � a 4''"-or,.....„ 1„ N N N s - ' w 2 Z iii o -Mt K''. °'a $ -3 `'� o w Z Z ' ,�a`y??r v n M Jai og p (n J a Q Q m N ��o:ir��' V)-o ., Merl/ o ix midi w -1 n K1 Q 01 CTJ Et leti LY °3 ag ,I UQUD )- Dwz g Sic z< cc - ¢ " _ • W cn n �n o� r m /fV( N O� Arz �- cc 4`�� `Ni d O [=i �� Z napis w 1� i 4 Ci w 40,8�A'I i �=• 1 RFaN CO 4 a t' 9 N o Ei rn . U Q ` a.N U, Z w , , Q Q _ '- 22 .a w w .pC .,� 23 a w � a p {�• � d�a _ __�/ 24 2� (1)CO > . a % d — �26 cc 25 21 \ \' 8 28 5 - �� "� 29 -- £'S0! — �0+. 'S1 :2E3 g — ter — — ------- .----`,----_ ------- - t -ei za o 4,........„ i __,\_..,,,.... ,...,OhEr6.11 111111 71 --r 11"2111 � .aLt° IAY m .Ir o L£ .0Z£ ��� �R' in 3 (02 / J W Ow . �7 / ro W 1 • _ °' i Q .N a v M / & r x g a o�4 . / f a" e P Oco s I w J�- Al U 3 .'' r 53 dw° 01 I i 1'i x b+� 0 44 1 a� I t°5\ \3g f o \I r 0 ce,-" � Ot, ( e !�� I zy = g N. �-1 �,b£, oz—— r oo, / Issas ~.oss� ___ tio" cp —i 349.£t.60N �, i/ z3 J Oboe Hinowe,e,, IS 344 z eri866 1 ' • 1