HomeMy WebLinkAboutHealth sign off 5/8/23 of_YAa TOWN OF YARMOUTH
r
02 c HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: r0 hS
Proposed Improvement: T 't o)1-}i an O f Of We/Li rr
Applicant: QlS IV-�L �1CCatraktr) `� )(v�G� r1 Tel.No.: •62 333 Il In;3
Address: Lib eKeri ,L ln,S rnn bZLeuU Date Filed: 5J3-103
"if you would like e-mail notification of sign off please provide e-mail address: nl-))e rce G�/O!rk_Compa n Le,S.C oh/1
Owner Name: YU CQ 07- I i ci c LL.c
Owner Address:/ tY'Qr iac Owner Tel.No.:C003 -
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
(all existing and proposed)-
MA`( 0 5 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: � oCL�.� DATE:
PLEASE NOTE
COMMENTS/CONDITIONS: