Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutApplicaiton Sign Off 5/18/23 0N 'Y'Ai:e TOWN OF YARMOUTH
.1t-',' * -tell
HEALTH DEPARTMENT
,"' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: q j W A5 4 i E1fl f i . W. y-r•ri-t.E` *h . r'-k A
Proposed Improvement: P d d yq. 15(S
77� 311• 60 64f
Applicant: D .r-t-a'& 12- t 5 C.: .OD Tel.No.:S.Q2.
Address: 9 5 LL., As tf,t N ti n y Date Filed: 9- / (1 z 3
"If you would like e-mail notification of sign off,please provide e-mail address:
,
Owner Name: 1 I v-- P.-..A IA
7 I P c u. 0
Owner Address: ./ZO Co bb L€Sk.Olv F Rd Owner Tel.No.:7 7C 5 3 Lt"(6 C 6 y
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: � � - DATE: S r t -
PLEASE NOTE
COMMENTS/CONDITIONS:
6
cr C-,
NJ
_ .'s,,,,,„..._,i,.:,. .:„., „.,
1,,,,,
,..,....,.1„...„.. : , .. I
, i 1 ,
1,---2 N
rn
c..
—
1
CN
A,
-- O (c _
O 3
Q c)
); 0 4
i
-1 W 1----____-1
I DECK b
12'4" x 11'5"
.
1 1 ICI
.-Al _1 k+ -- _--
KITCHEN
18'0" x 11'2" "0 © n / r'-
d ¢ x BEDROOM
DINING ROOM ° °o " 12'0" x 11'2"
MIME
-
I HALL ...
a 7'8„ x3'1„
Imum
�/J
,� LIVING ROOM PRIMARY BEDROOM 18'2" x 116 16'7" x 116
„
s
, le I I
. mayi I
j
.11 . II
=no
PO-CH ,
•'4„ x 2,.,,