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6°V/4/ o/ No. tl . ....
I \ ' Application fo a Permit to Build
'� e
\t R, EI_ ASED BY Fee st accompany this application
N N I N B ARD)----, lee.4..4. •
TE 7 / ` 'a • ' Yarmouth ..77,:t.) l[19 "
j"? to /61,1/P - •
TO THE BOARD OF SELECTMEN . •
The undersigned hereby applies for a permit to build, according to the following specifications:
1. Name of Owner —7—X0 AveP Ae v • i'-c, Address j . /774,wJc. /kg- , r/p. re 44;
, 2. Name of Architect(if any)
3. Name of Builder iAfM,4r •�,
4, Precinct No 3 Lot No.. " Z Plan: Name or No, A K, 43. It2
•
6. Name of Street .1\ .yj �]T• ,9 , ,
6: Purpose of Building 3w/11/f
7i Material At
8: Estimated cost of building 30 C'vO N r /a.
Ji- I,
2 C+ ell
9. Dwelling fr 6.0
10. Cottage /✓e ,Y
11. Heat . /IT/✓( •� . S . e 1nt�
far"
12. Basement it:/ti SL wot. I P,e♦ v ^
.1.4.---- io iD
•
°y 13. Garage •_ • j .0 a,` t/ ;1�. 7
E. fR
14. Store 1.
U
16. Shop
16. No. of stories •../
17. Is there to be a Store to the Power storey._ "? • •
18. Size of Lot. No. of feet front 4 No, of feet rear No. of feet deep
19. Size of.building. No. of feet front' No, of feet side;' No. of feet rear
20. Distance from nearest building: •Front. ft.; side ' ' ft.; side ft.; rear
21. Distance back from line or street, from rear lot line , side line :
Show by diagram the location of propsed building with relation distances,from adjoining lots side, ,. .
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F OFY'gR TOWN OF YARMOUTH.
Aok
1 ': c WATER DEPARTMENT i' "
W11T[R.COMMI[[ION[R[ . OT WI1T[R COM UNION [R[ M[[Tt [VERY MONOAV 4 tt �
� ATT>b P W AT YNION [TR[ET OFFIC[ ( Y
FREDERICK J. THACNER r 'sy`
ROGER G. EDWARDS JR t . } ,
THOMAS E. IZEtLEY +x �� � 3 .
rt
;. '1 Date. � ay 12,1980
f I` .
PAUL WILSON It 41111���
t r
1n 14 1 _ i IJ `
Name; Thomas Grew Incorp. ` "
Address; 6 Atlantic Ave.^ South Yarmouth Ma 02664
TO WHOM U MAY CONCERN.
Please be advised that Town water'is available on Lot or Lots !I X1.?t��X4 '
(Street) Forrest Road ".'' 1 , as shown on Assessor's Sheet 43
Very truly yours,
` Paul A.�Wilson= �
^' Superintendent
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.M, ELEV. ' Ira.,S
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TEST LI O LC-#Z I' Z5.5 - 26.1
Dor.
ELEV.= Z5.4
— Lo--r- 2
. 13,Co. 29s. �
I C,rema,n,ng9
2r! '0e. 30 ,
ZEw - -Zl.&
EZY UO'NT eD °c9S e
0 DISTANCE AS CERTIFIED &5vn9 rerna/nater ole
I HEREBY CERTIFY THAT THE BUILDING Laf� z-Ra. 19a,P9./27 SITE PLAN
SHOWN ON THIS PLAN IS LOCATED ON THE • <^ ' /970 tenon . [_O j 2 - FOeCS r 204b
GROUND AS SHOWN HEREON&THAT IT LOCUS:
CONFORM TO THE ZONING BY LAWS OF THE road >4 tn. 5,) S01/77-/ VAtNIOurW, ,'/HSS.
TOWN OF
WHEN CONSTRUCTED. DATE REF: Plan BODE /9B, Ai, /27
down cape engineering PREPARED FOR:
7NoM4S G2CW /A/C.
CIVIL ENGINEERS
LAND SURVEYORS
REG.LAND SURVEYOR ,
Yarmouth&Orleans,MA SCALE /" ez 30. 3/3//80
DATE 630-O/O
'',S�EOTION SEWAGE tNFET Z of a
4
-SEPTIC TANK- -"D"BOX - -LEACHI We -n esic-14
TOP OF FON
\ 2$.00
(MSL)* -"2"OF II8TO4 "
\\Y NOTE: WASHED STONE
1� REMOVE ANY UNSUITABLE MATERIAL FOR A DISTANCE
OF 10 FT.AROUND ENTIRE LEACH INCr rRF_,ICH
AND REPLACE WITH CLEAN COARSE SAND.
o� ..--.---'-0.-...,... ..
_ e 4_
%4/FTpl_{_h(O,eae> .{ 4, pr peach o.00s) —�19.s9
OUT• I _- \
IZIt IN 1000 OUT• 6, IN• OUT 2
1 G
\--
ELEV.
IN .� /
ZO.SO / ' SEPTIC / t
20.25 TANK 20.00 19_le9 Z'
ELEV. ELEV. ELEV. //1 F
III Ig,Bi / igi0 ELEV.
/ ELEV. ELEV. I ZC' -I /,
/
EL.=I3.4 E. 4.772.'k w�I I'L59
. NOTE: F$oll•on+ T:0.12 "( ` OF I/4"-14z^
BRING ALL COVERS TO WITHIN I WASHED STONE
1 FT.OF FINISH GRADE. (below IJI pe
TEST HOLE LOG
John Jaltcki •far James McDonn_Id– rep.
TEST BY Down Cape 6ngr. Yarmou+i Sd. of I- �rl1I+I,1
TEST DATE2G/(90o WITNESS DESIGN BEDROOM HOUSE
T.H. # 1 T.H. # 2
_yG • ,. ELEV. O• ELEV.=2S.4
NAr+1.P16IAJ - .0 a DISPOSER DISPOSER
FII 12" 24.4 PERC RATE MIN/IN.
24" 23.4 FLOW RATE 220 (GAL./DAY) Z20
Lo&rn 4 SEPTIC TANK 220 ]c ((.S)= 3 30
Subco1I REQ'D SEPTIC TANK SIZE 1000
Cie • Mcchurn LEACH FACILITY
d SIDE WALL 2o',c21g 2 K (2,S ) = Zoo G/D.
BOTTOM 20'K 22 x ( 1.0 ) - 4o G/D_.�.
TOTAL IZOf
S. . = 24o JJ�"1"f
144' 3.4 USE: C OLEACHING TeEl.io 1h
Zlona K Z'wide. x Z'deep (bestow ppm.)
�� 24::WATER ENCOUNTERED
NOTES: (UNLESS OTHERWISE NOTED)
a U.S.G.S. 6.M?k 28P0 G 10 p+{'f __ .�tHBet.0A M4 , A. OF Ale
1.DATUM(MSL)-TAKEN F OM ri restest!! A]- ,4 ,p,
2.MUNICIPAL WATER_I _AVAILABLE ,+�4 •P i.
3.PIPE PITCH:IA"PER FOOT &Carr• W41E2E.1-10TE:0 4-, JAMES �C- // . JAMES�`z; Lc
4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO• I"(—IC -44 '1 — H. °+ Io H. "' I.
.5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. C BOWMAN u IS' BOWMAN
6.PIPE JOINTS SHALL BE MADE WATER TIGHT 2103B/f ``+ .p 24040 0
7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. I „1 'Pe. F• `4Ii" �GrST E�`�t
STATE ENVIRONMENTAL CODE TITLES N. T/ •Oj• +�. . O
�•SS/ONAL F. SU R_....-
REG.
�REG.PROFESSIONAL ENGINEER
) ) 77 / - BOARD OF HEALTH
CONTOURS (EXISTING) _ � 1'�2MouTH
(PROPOSED)-0-0-0-0- APPROVED DATE c.-
IMA
i BUILDING PERMIT REVIEW : ,.
' APPLICANT? 1i ,91',23.4;:'P • !�?G'L.J Vic:; ` BLDG PERMIT NO: •
-
LOCATION OF 'PROPERTY Z:. 'Fwf< 7ed, DATE FILED- ••
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE •PROCEDURES AN- iNDINIDUAL. - .... r;-:
MUST FOLLOW IN ORDER TO 'OBTAIN• A PERMIT TO BUILD OR ALTER A .BUILDING. -�THE 'BUILDING'-:.--2, .4.-
-DEPARTMENT 'WILL' CHECK.ON -THE: FOLLOWING: (A)' CONSERVANCY DISTRICTS; (B):•-t. HISTORICAL•• .;
- DISTRICTS (C) FLOOD PLAINS'.ZONING,• ANO WILL BE RESPONSIBLE FOR 'ASSISTING TME.<`_z : .- ` .• -
APPLICANT _THROUGH•THE FOLLOWING AGENCIES
.2: :.
1 . RESIDENTIAL BUILDING- r
A) CHECK WITH THE HEALTH DEPARTMENY IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGE ' .
DISPOSAL:'
B) CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERSONANY TYPE OF WETLANDS
• - EXAMPLES:_ STREAMS, PONDS, RIVERS, OCEAN, BAY, BOGS, MARSH,. ETC: ' -i.
C) CHECK WITH~PLANNING BOARD FOR LOTRELEASE: - _
`a_ s. ..
2. 'COMMERCIAL-BUILDING :' '- - t;
: A) ENGINEERING -DEPARTMENT—FOR.-PARKING AND DRAINAGE REQUIREMENTS,. TOPOGR PHY SITE -
- "- PLAN REVIEW` .
B) CONSERVATION COMMITTEE-IF LOT BORDERS ANY TYPE OF WETLANDS -
C) PLANNING BOARD TO -SEE IF. LOT COMPLIES WITH ZONING BY-LAWS.
D). BOARD OF:. HEALTHrFOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. •
EXAMPLES: - SAUNA BATHS, SWIMMING POOLS, RESTAURANTS, ETC. •
-E) FIRE DEPARTMENT FDR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE _
DETECTORS). : .
REVIEWED BY •
- . = - � i r ,-r 3 t';.
1 ENGINEERING DEPARTMENT:..t YES1 • DOES NOT APPLY SIGNATURE_- tt -r DATE W':•
2. CONSERVATION COMMITTEE:. YES DOESNOT APPLY r' SIGNATURE 1 .Jr k\Zi - DATE S'041
3. PLANNING BOARD YES DOES NOT APPLY-_SIGNATURE " y DATE -
4 BOARD OF HEALTH • YES DOES NOT APPLY • SIGNATURE:.c •,', , "li')t,tPMA DATEt
5. FIRE DEPARTMENT: _ _ YES_DOESNOT APPLY_SIGNATURE DATE
COMMENTS:
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C: �c9S<-jy 7Ctt -
—Q DISTANCE AS CERTIFIED age,;-,y ��ina/nde/' 4T.,. .
HEREBY CERTIFY THAT THE BUILDING �� �'/ 1 9. /Z71 SITE PLAN -
' SHOWN ON THIS PLAN IS LOCATED ON TEES ( ' �0 [s.P�q '
GROUND AS SHOWN HEREON&THAT IT - LOCUS: LQ/ - FOeCST ,, ,, , .
TOWN OFT`1q.2ZM 3 1, AWSOF THE roc- ±.., Al"
/,.,11.2Acy ,' ._.
GJ, SOUTH YF1 t/✓/pL/TN MSU S S
CONF
WHEN CONSTRUCTED. DATE 6/S//�80 c OJA'LA N '
• r r 3 926348 REEF: /��Q/7 �GO/� /9B, / !). /2'�.''.` ','..
'cyylown cape engioreering `� ,� PREPARED FOR: 7NoM�S G�'EW, /t/C•
CIVIL ENGINEERS , �'9,,�s61$ � _ '�
7 LANDSURVEVORS "1 s,,� .�
REG. E.�>• a OR ,_ • //
.Y rrtauth&OI •ans,MA SCALA,/• — Or 6 DATE
I ��-O/O