HomeMy WebLinkAbout2023 Sign off Transmittal - Deck TOWN OF YARMOUTH
4oTe,
t HEALTH DEPARTMENT
`'-"="` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 2 7 Pe bole /,3Caeh lt)ai.
Proposed Improvement: (a/Is—kid ce G!'e CSC p>11 czar-r- e I ha(..?
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Applicant: L/50- -e 5' e kg° /e Y�3
Tel. No.:
Address: `37 Pebble bead lo Date Filed:
**If you would like e-mail notification of sign off please provide e-mail address: J/Cf l4 n q erdQ`e ��jyt�i/• e elk)
Owner Name: Lisa( b iLi .r-d u'
Owner Address: 37 Pebble C (Ch idcty Owner Tel. No.: 30 8- 3e
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,
G°5 Liu v u and septic system location;
MAR 2 4 2023 (2.) Floor plan labeling ALL rooms within building
(all existing and proposed)—
HEALTH D E PT Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: 7& DATE: //-,,/
PLEASE NOTE
COMMENTS/CONDITIONS:
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