HomeMy WebLinkAboutHealth sign off 6/1/23 of Yq TOWN OF YARMOUTH
HEALTH DEPARTMENT RECEIVED
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PERMIT APPLICATION SIGN OFF TRANSMITTAL 414010 2023
To be completed by Applicant: HEALTH DEPT,
Building Site Location: (' T Cat 1 Yn U)v - W` /IC IV\ O r`l MI\ Or)-6
Proposed Improvement: /V euJ 1'1 d vi S
Applicant: ��IArrrv'S Tel.No.:6 fZ—`ja l—n1133
Address:1k ,..5 -r brat.% 3?.,5dmw'w,t 1 e MR- Date Filed: 51 ciI (3
"If you would like e-mail notification of sign of please provide a-mail address:3A -n r.5 a I/(9 C. `C' Pit Y 1-€T
Owner Name:'3 PrTreS cT-'<_
Owner Address:VO ,S ICE h vaw\ S ,5com ory`1 it ki- Owner Tel.No.:10
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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)—
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' �ya� (c . DATE: C ( J-3
PLEASE NOTE
COMMENTS/CONDITIONS: