HomeMy WebLinkAbout2008 Nov 12 - Sign Off Transmittal Sheet, Plans - 3rd Floor Dormer � . �.. ,,..,"��..�.:.. . . .. .. . . . ... .. . '�F�F"".�'n"�"�'F,P�_ ',.,6:.:—'-,.'�.^�..,�.`'",�,-�-�.,^_"-.� ,.� #�-;,�
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,�°��Y`��.o TOWN OF YARMOUTH ,
� y HEALTH DEPARTMENT '
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°"'�""°` �'� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: '�I
Building Site Location: �� �''=-i�����,' ��-� , �t`�������Map No.: ��� Lot No.: '�$ �
Proposed Improvement: 3''� �� DeR�i2 p ��``Tc.�. — j�-�,,,, l3t�"'t Fj
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Applicant:_ l � �„�'✓ �+G�N Gu�^ t3��i,r�sf�6 Te1. No.: ��3 733� yC�� �
Address: g�K ���O 1�"I��-S A�h1S M;,� �?Z�� � Date Filed: 1� ��` �� ;
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**If you would like e-mail notification of sign off,pleuse provide e-mail address: ;
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Owner Name: _ }
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Owner Address: 5���i � Owner Tel. No.: 5�� �i��"��77 �
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RESIDENTIAL AND/OR COMMERCIAL BUILDING i
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HEALTH DEPARTMENT: Deternunes Compliance to State and Town Regulations; i.e., Requirements ;
For Septage Disposal and other Public Health Activities. �
Please submit four 4 co �es of lans to include: �
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(1.) Site Plan showing ezisting buildings, water line location,
and septic system location; ;
(2.) Floor plan labeling ALL rooms within building f
,
- (a�l ezisting and proposed)— I
` Note:F[oor plates not required for decks, sheds, windaws, roofing; �
(3.) If necessary, Title 5 application signed by licensed ins#�ller- �
with fee. I
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REVIEWED BY: DATE: �l �-- � � ' �
ASE NOTE ; ;
C011�IlVIENTS/CONDTTIONS� f '� !
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SECTION - SEWS
1.
TOP OF FON � e
•Q%:OD�
ELEV.
TEST HOLE LOG
lit
Iz - SEPTIC TANK -
5-„O..Box-
x-13'
�.--'.LEACH._
"2„ OF 48TO Ih••
--WASHED STONE
f - �ICOyEt2''T,I '
IN-
OUT 1^!'
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45,16' �
SEPTIC
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TANK
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45,14
ELEV.
ELEV. ddjj'1
ELEV.
ELEV. ELEV.
TES IT • G
TEST DATE 5 S WITNESS DESIGN BEDROOM HOUSE
T.N. • 1 I T.H. 2
ELEV. b ELEV.
PERC RATE �MINIIN. P O DISPOSER {
644,1 FLOW RATE I ID+,5(GALJPAY )
SEPTIC TANK 3W (1.51 1,49`5 oef
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REO'DSEPTIC TANK SIZE gef
WD
TO LEACH FACILITY
AWE SIDE WALL tr 81� - (t 51- 3� G/D.
IM
BOTTOM ._ E1,p) -
TOTAL X00.1 SF'�
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�6/ USE: LEACHING
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d'' EFF VIA, _ +� a EFF. I�Et�ril
WATER ENCOUNTERED
NOTES; (UNLESS OTHERWISE NOTED)
1. DATUM (MSy=TAKEN FROM A QUADRANGLE MAP
2. MUNICIPAL WATERVAILABLE
3. PIPE PITCHI M" PER FOOTk --44
-10 1a
4. DESIGN LOADING FOR ALL PRE -CAST UNITS: AASHO -
S. MIN. GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT.
6. PIPE JOINTS SHALL BE MADE WATERTIGHT
7. CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM. OF MASS.
STATE ENVIRONMENTAL CODE TITLE S
8. Tw.S vo-A -i Fot b� O",_.,
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a. ^i -L 0ki'50rAMLZ MokiZRIAL METKXEEJJ eLr--v. x{5.14'
AUD ELEV, 39,14 "ro E9E MSM ^MD STD
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CONTOURS (pxIROSpTOiSED) --0-0-0-0- APPROVED DATE
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