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HomeMy WebLinkAbout2019 May 28 - Sign Off Transmittal, Plan - Deck at TOWN OF YARMOUTH - :1 ter HEALTH DEPARTMENT �• ,I, ' `-• PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: I 6v4) -t) -(in k L IV Proposed Improvement: kck of 6a�.E or (17(,..1/4-1.4.,-.7) J ' b Lt. 10 . 6 // Lor Applicant: K,-/In )".-jr3c-k- Tel. No.: 171 q300 ) 7 Address: �>�l�- Date Filed: slay/1 **lfyou would like e-mail notification of sign off please provide e-mail address: Owner Name: ' �'�� 6"--Alr Owner Address: I " `O `t..,,K C t✓ Owner Tel. No.: SA 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 j (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: i� DATE: 'c----/,aal 1 PLEASE NOTE COMMENTSICONDITlONS: 12 L 1 /La - (-e )ick C v C ✓' S-we ,c- L t ei . /0 d. lz-coA0L'i i i 1 l A 0 EXISTING CESSPOOLS LOCATION TAKEN FROM RECORD AS—BUILT DATED 6/7/07 TO BE PUMPED, FILLED WITH SAND AND ABANDONED, OR, REMOVED. Benchmark Set Left cor. bulkhead EL.=100.00 (Assumed; MAY; 2 8 2019 TH DEPT. I V; fait valid for REPAIR OF SEPTIC SYSTEM LY, due to State and Local septic variances. rd of Health review and approval is required any future additions/renovatious/alteradlW to, age facilities and/or structures/ Yarmouth PROVED ,czW�c OWNER OR RECORD ROBERT RHODES ET AL 22 GLENVIEW AVENUE AUBURN, MA 01501 I- CD V.=!jO VU= / 0. I / �I I/2 5TY. /WD; FRM. T_0 -F. = 101 .( I -I- 0 1 E-1-T_r__1 ' l i l I I I TOP OFD LOADED L ;71'.I N I r -I -t -r -I 1 1 1 1 1 99I 1 _L..li Z X919, TP co O 0) Q N � UTILITY POLE GUY WIRE W W- 99 S� APN 58-394 10,000±SF 81 .59' 531 04820" E 9 9) 19> EDGE OF .3� 'slj '6'j PAVEMENT 805 -0 -LINK LANE 9] R 0 J;1 9] ; /0, . 19> v 66" LEGEND — — ag — — EXISTING CONTOUR x 100.98 EXISTING SPOT GRADE 99 PROPOSED CONTOUR 99 PROPOSED SPOT GRADE W EXISTING WATER SERVICE G EXISTING GAS SERVICE / G. H. W. OVERHEAD WIRES mo TEST PIT R. BENCHMARK ml 0 LOCUS MAP NOT TO SCALE nvl C) V 53104,5 GENERAL NOTES; N O 99 102.E 1' ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL CzSEP 2 20 8 BOARD OF HEALTH AND THE DESIGN ENGINEER. 2 ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS >_ HEALTH DEPT. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: a —310 CMR 15.405(1)(b,t -- PROPOSED 1) A 1' variance, S.A.S. to cellar wall, for a 19' setback. BE BACKFILLED PRIOR / SEPTIC TANK TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 1 fi'S O >>, 4. THERE ARE NO WELLS LOCATED ' WITHIN 150' OF THE PROPOSED S.A.S. 0 99.68 5. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON 'SHALL BE REPORTED TO THE DESIGN _J ' n a 9 38 ENGINEER BEFORE CONSTRUCTION CONTINUES. 6. ALL ELEVATIONS BASED ON ASSUMED DATUM. z 7. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF I- CD V.=!jO VU= / 0. I / �I I/2 5TY. /WD; FRM. T_0 -F. = 101 .( I -I- 0 1 E-1-T_r__1 ' l i l I I I TOP OFD LOADED L ;71'.I N I r -I -t -r -I 1 1 1 1 1 99I 1 _L..li Z X919, TP co O 0) Q N � UTILITY POLE GUY WIRE W W- 99 S� APN 58-394 10,000±SF 81 .59' 531 04820" E 9 9) 19> EDGE OF .3� 'slj '6'j PAVEMENT 805 -0 -LINK LANE 9] R 0 J;1 9] ; /0, . 19> v 66" LEGEND — — ag — — EXISTING CONTOUR x 100.98 EXISTING SPOT GRADE 99 PROPOSED CONTOUR 99 PROPOSED SPOT GRADE W EXISTING WATER SERVICE G EXISTING GAS SERVICE / G. H. W. OVERHEAD WIRES mo TEST PIT R. BENCHMARK ml 0 LOCUS MAP NOT TO SCALE nvl C) V GENERAL NOTES; N O �c��adr� 1' ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL CzSEP 2 20 8 BOARD OF HEALTH AND THE DESIGN ENGINEER. 2 ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS >_ HEALTH DEPT. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: —310 CMR 15.405(1)(b,t 1) A 1' variance, S.A.S. to cellar wall, for a 19' setback. BE BACKFILLED PRIOR 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 4. THERE ARE NO WELLS LOCATED ' WITHIN 150' OF THE PROPOSED S.A.S. 0 5. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON 'SHALL BE REPORTED TO THE DESIGN _J ' n ENGINEER BEFORE CONSTRUCTION CONTINUES. 6. ALL ELEVATIONS BASED ON ASSUMED DATUM. z 7. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. OFM 8. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. Assq� 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED o TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. RICH ARDtiG s J. �', 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE HOOD THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 0 35031 o CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS S H S IN TLAND AND EPL E WITHATH CLEANDFILOLRAS SPECIFIED INS131E0 CMR255HE (3).255(3) 12. ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED BURIED SEPTIC SYSTEM COMPONENTS THAT MAY EXIST ON THE PROPERTY. Mgssq�yG o PETER T. McENTEE CIVIL No. 35109 n�^RfGI SiER`�p..S`�� PROPOSED SEPTIC SYSTEM UPGRADE PLAN 1 BOB—O—LINK LANE, WEST YARMOUTH, MA Prepared for: B & B Excavation, 14 Teaberry Ln., Forestdale, MA 02644 Engineering by: Surveying by: SCALE DRAWN JOB. NO. Engineering Works HOOD 5URVEY GROUP 1 "=20' P.T.M. 222-08 12 West Crossfield Road 18 Route 6A DATE CHECKED SHEET NO. Forestdale, MA 02644 Sandwich, MA 02563 9/18/08 (508) 477-5313 (508) 888-1090 P.T.M. 1 Of 2