HomeMy WebLinkAbout2016 Jan 27 - Sign Off Transmittal Sheet, Plot Plan, Floor Plans, T5 Insp. Pages _ _
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�'�"'���`'��� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: ��.. M��, C��C� �t�,. �OLt� yQ,l� VI��f t��L.?
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Proposed Improvement: C G�C X �� C f1.
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Applicant: � C� � Tel.No.:�,���-�q�-n��,�
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�lddress: 01't,�l, �V . y � �O Date Filed: 1 �7 r�'
**Ifyou would like e-mail notafication ofsign off,please provide e-mail address:
Owner Name: ��V L ��,Q�.r 0 C�C�l`f �-�.(,'
� �K 4umer Addres�7�o�, ���.�.�l. �,, �Q.���� Owner Tel.No.: ��3 "�('o ' �Q ��1
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�" .� '��ri`� `' RESIDEN�IAL AND/OR COMMERCIAL BUILDING ; , , �
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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,
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� ' "�w and septic system location; ,'
(2.) Floa�plan labeling ALL rooms within building
(a�l egisting and proposed)�
Note�loor plans not required for decks,sheds, windows, roofing;
(3.) ` If necessary, Title 5 application signed by licensed installer
.. with:�ee.
.......................................................................:.......................... ............. ...:.........�.:.::..........:.
....................................................................................................................................................................................................................
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REVIEWED BY: DATE: �7 � G+
PLEASE NOTE �
COMMENTS/CONDITIONS: 2 �
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1. LOCUS IS A.IA. 25. PARCE� 144. FB 31-55 f
2 LOCUS iS lN FIOQD ZONE AE (EL 11} ON FiRM DATED JUIY 1&, 2014. �
3. OFFSETS SHOWN ARE TO THE CORNERBOARDS ON EXISTiNG �
BUILDINGS. QR TO FQUNdATidN ON NEW GONSTi2UG'RON.
NQTE:'fFiiS IS A SITE PLAN SURVEY
�OT COVE�AGE BY TNIS QFFICE AND NOT A GOM—
� PIETE PROPERTY UNE SURVEY.
n EXiSTING HOUSE 970tS.F. BLQCK MATH CLOSES WITH BIOCK
a EXIST{NG SHED 127tS,F. 1EN FEET DEEPER, AS SHOWN HERE,
� EXlS71NG DEGKs 325tS.F. SIDE lOT I.INES ARE �RAFTED ON PLAN
PROPOSEO ADDITION 544 5.F. 800K 148, FG. 79 AS 206.71' aEEP. f
a TQl'Al 1966tS,F,
lOT COVERAGE=1966tS.F./18,270#S.F.=10.8� '
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0 0 18.270#S:F. S;Fl4U5£ � .•------- SYSTEM FROM�C f
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N ETTLES :
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HEALTH DEPT. CB/DH. FND.
CBfDISG. FND.
1 CERIIFY THAT THE LOCA S SHOWN ON TFlIS PLAN PLQT PL.AN
UVERE��+1�1c D I E ! ON 1 f & 1/26/16:
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� ���,��� FtVE SHAMRaCKS, LLC
��.�� ��������'.� L.OT 6. 82 MATTAGHEE ROAD. S0. YARMOUTH, MA
���4s � FEBRUARY t, 2a16 SCALE: 1"=40•
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' �'������1��� RONALD J. C/lDItUC. PLS, RS, P.C.
.�����U�`��c� PROFESSfONlU. LANQ SURVEYOR dc REqS7ERED SANlTA�AN
P.O BOX 258
NIE�7 YARMAQtJTH, MA OZ673
� � � i �+ 02016 BY R.J. CAWLIAC �508� 775-97�
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� � COMMONWEALTH OF MASSACHUSETTS
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EXECUTIVE OFFICE �F ENVIRONMENTAL AFFAIRS
� DEPARTMENT OF ENVIRONMENTAL PROTECTION
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TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPQSAL SYSTEM FORM
PART A
CERTIFICATI4N
Property Address: 82 Mattachee Road
South Yarmouth MA Q2664 G°3 G �.�^'' }� n �,� � p
Owner's Narue: 8arry Netiles
Owner's Address: 27 Brusl�Hil1 Road D E C 2 2 2006
Sherbarne MA 0177d
Date of[nspection: November 9,2006 Job#06-288 HEALTH DEPT•
Name of Inspector: PATR[CK M.O'COHNELL
Compan Name: SEPTIC INSPECTION SERVICE .
Y S CO.
Mailing Address: 189 CAMMETT ROAD J t A�
MARSTONS MILLS MA 02648 • l�,V
. Te[ephone Number: 508-42&1779 . • • ��/ "
� CERTIFICATION STATEMENT
, I csrtify that 1 have personally inspected the sewage disposal system at this address and that the information reported
betow is true,accorate and complete as of the time of the inspection.The inspection was performed based oa my
` training and experience in the proper funcEioa and maintenance of on site sewage dispasal systtms.I am a D�t��i=1ljti
approved system inspector pursuant to Sect(on 15.340 of Tit[e 5(310 CMR 15.040). The system: `, P �t OF/,�,q i����
.
_X_ Passes � •• .� .�'Z:
ConditionaUy Passes _� ' • T„� K •-N�
Nteds Further Evaluation by the L.ocal ppmving Authoriry = M . s-�-i=
Fails � t 0' � :��
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Inspector's Signature: Date: 11/9/06 ''�.�T������coQ�`�
���i�F5!�lSP�G����O�
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The system inspector shall submit a copy of this inspectian report to the Approving Authoriry(Board of Health or
DEP)within 30 days af completing this inspection.If the system is a shared systerr�or has a design flow of 10,000
gpd or greater�ihe inspector and the system owner sha1)snbmit the report to the appropriate regional office of the
DEP.The origina)should be sent to the system owner and copies sent to the buyer,if applicable,and the approving
authority.
Notrs and Comments: Leaching system has no standiag water,pump and alarrn are properly[unction�n&
"*�*This report only describes conditions at the time oi inspection and under the conditions oi use at that
time.This inspectiun does not address how the system wiU periorm in the fnture under the same or different
conditions of use.
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Page6of11
, OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION ;
Property Address:82 Mattachee Road,South Yarmouth
Owner. Barry Nettles
Date of Inspection: November 9,2006
FLOW CONDIT[ONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms{actuat): 2
DES[GN flow based on 310 CMR 15.243(for example: 110 gpd x#of bedrooms):330
Namber of cunent residents:0
Does residence have a garbage grinder(yes or no):No
Is laundry oa a separate sewage systom(yes or no):No [if yes separate inspection r�qvirerlJ �
Laundry system inspected(yes or no):
Seasonal use:(yes or no):No
Water meter readings,if available(last 2 years asage(gpd)): Two years total:57,040 gal.=78 gpd.
Sump pump(yes or no}: No
Last date of occupancy: Weekend ase
COMMERCIAWINDUSTRIAL
I Type of establishment:
Design flow{based on 3l Q CMR 15.203):� �epd
- Basis af design flow(seats/persons/sqft,etc.):
. Grease trap present(yes or no):_
Industrial waste hotding tank present(y�s or no):^
• Non-sanitary waste discharged to the Title 5 system{yes or ao):_
_ Water meter readings,ifavailable:
I..asi date ot'occupancy/use:
OTHER(describe):
GENERAL tNFORMA'fION
Pumpiag Records: Tank has never been pumped
Source of information: Owner
Was system pumped as part of the inspection(yes or no): No
If yos.volume pumped: gallons--How was quantity pumped deiermined?
Reason for pumping:
TYPE OF SYST�M
X_Septic tank,distribution box,soil absorption system
Single cesspoo[
Overflow cssspool
_Privy
Shazed system(yes or no)(if yes,attach previQus inspection records,if any)
InnovativelAltemative technology.Attach a wpy of the current operation and maintenance contraci(to be
obtained from system owner)
�Tight tank _Attach a copy of the DEP approval
____Other(describe):
Approximate age of a11 components,date instalted('sf known)and source of information: .
Compliance date:6R6/04
Were sewage odors detected when arriving at the site(yes or no): No
SPR wall w/ continous header
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9'-5 1 /2"
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SCALE:
as noted
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SHEET:
Floor Plan shear wall # 2
Foundation
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SN-2: 1/2" cdx outside & 1/2"
(MB on inside. solid block all plywood
seams (this section). Nailing is
standard 4" o/c maximum for all joints
and edges.
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SY�I-2
asphalt shingles to match
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1 3l4" x 11 7/8" Y-L 2.0 3100s
existing, 1 /2" ply, 2 x 10
continuous ridge w/ 2xb collar ties, (2) rafters @ 16" oc, H2.5
Front Elevation
13/4" x 5 1/2 " Ivl header over round
window. balloon frame this gable end
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clips to plates, R-40 open
cell foam insul.
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and double king studs for headers
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5 pitch
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105" to bottom of window
m psi
Exterior walls: match
existing wall height, W.C.
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siding, housewrap, 1/2"
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APA wall, continuous header
ply, R-21 f.g. insul. 2 x 6
studs @ 16" oc, vapor
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see foundation detail
DATE:
12/17/2015
SCALE:
section
as noted
SHEET:
Rear Elevation
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WINDOW SCHEDULE
Right Elevation
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existing roof to overlay
on to addition, match
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existing roofing
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5N-1: 1/2" cdx outside & 1/2" 67V IB on inside.
solid block all plywood seams (this section). >
Nailing is standard 6" o/c maximum for all Q ojoints
5Y�1-1 and edges.
DATE:
existing deck iz�i��zoi5
SCALE:
as noted
Left section / Elevation SHEET:
Pg-4
CALL QTY. MANUFACTURE DESCRIPTION ROUGH OPENING note
OUT
Q3 Harvey classic 2442 2' 6"x4'9 1/2" egress
Q3 Harvey Gassic 2646 (2) mulled
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t Harvey classic 2646 (2) mulled
Harvey round
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6066 slider
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2 x 4 pt sleepers @ 16" o/c
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w/ rigid foam insulation
between for first two bays,
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3/4" pt sub floor
4 1/2" concrete floor slab on
2x6 TREATED PLATE
w/ sill seal
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compacted sub grade w/ vapor
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barrior and 6x6 mesh. floor slab to
be. 3500 psi w/ 3/8" - 3/4" blend
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5/8" x 12" anchor bolts w/ 1/
4" x 3" steel plates. space
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bolts 24" o/c plus corner
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bolts w/ in 12" of all outside
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and inside corners. ensure
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min. of 2 bolts per each wall
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panel section
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24" #5, drill and dowel @ 24" o/c1.
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continous #5 top and
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bottom bar
2" ridgid foam insulation 3
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8" x ?" CONCRETE
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bottom of footing @ grade
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# 5 @ 24" o/c
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10" x 18"
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DATE:
iti
Addon
Foundation
12/17/2015
SCALE:
as noted
SHEET:
Pg -5