Permissions errors after weird Time Machine restored backup
It ends up that you need to use the Mac Finder UI to set the permissions of the whole user home directory and not just the Music directory. I was able to fix the issue using the following steps:

Opening Finder, navigate to my user/home directory (/Mac/Users/MYUSER) and show the &quot;Get Info&quot; pane
Open the &quot;Sharing and Permissions&quot; drop down
Clicking the Lock Icon and entering the User password
Clicking the Gear Icon and selecting &quot;Apply to enclosed items...&quot;

This fixed all permissions issues I saw and iTunes was able to view and play music again.