HomeMy WebLinkAbout2020 Jan 28 - Sign Off Transmittal, Floor Plans, Infoot.Y?�rr TOWN OF YARMOUTH
° HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be compleled by Applicant:
Building Site Location: C L� �✓� f5 2 V(;
Proposed Improvement: ' �?v,�t
Applicant: t " ' l`
Address: 6 C.v v,- rn e�, f tri
rU rm') 02"6v
""Ifyou would like a -mail nolificallon ofsign off, please provide e-mail
Owner Name -12")- ^r
Tel. Nolel e,I/`/- �S
Filed:Z6^' uw
Owner Address: �' C " �In SU 0 "- t r .v. r r y Owner Tel. N074?/ 1:511/ 75 L'
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: 1 Robert Autenzio us; i.e., Requirements
1 auTs Project Estimator ies.
.; Landscape
.zllL—Service & Supplies, LTD. lelude:
® Asphalt Paving 917 Main Street M water line location,
IN Disposal & Recycling Wilmington, MA 01887
® Excavation 978-658-7285
® Facilities Service Provider Fax: 978-658-7288 M n building
M Installations bob@paulslandscape.com
® Maintenance
Quality & Dependability Since 1985 '.(/S, fUl/2(ZOiVS, P00 (q
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(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: _ _DATE:
PLEASE NOTE
COMMENTS/CONDITIONS: / y
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Date
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Notes eyq 6-- Project Notes
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ex., ..! Application for a Permit to Build
LOT RELEASED BY. ofreC't'o14, (///06 +M r/ 14r
PLANNING OARD. wee must accompany
o�this application
,BATE Yarmouth »..»....
DISPOSAL INSTALLER ✓� K. f vtiaffifiid f;.fri
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TO THE BOARD OF SELECTMEN /0 S s' 2.3 ' .
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The undersigned hereby applies for a permit to build, according to the following specifications:. �(
1. Name of Owner G . P -r-soP 0 P1 Address i OD I l O Tc- Sr. h-x� C K q
2. Name of Architect (if any) • - •
3. Name of Builder / 1 4-11 99-()e)vt/Sr. 0`1+,/i e-.�-E IVmJl S i I J ka
4. Precinct Not, Lot No. g(0 Plan: Name or No. o/6 0,6
5. Name of Street m plots' c r - Girl'
6. Purpose of Building t M --5
7. Material Wryob , g GI"..'#4 47vd r!
1%7 nook; ".' . / =:;cI/.
8. Estimated cost of building 401#2171 '7,f9
80. Dwelling v $.4 / 9 9s- •
10. Cottage ��. 9 7.73- 3 gb-p ar o o.+s
a Heat t / �;a,( C!`ii+�c c ° / �r�& r-7i S 4‘41.Basement a c i°".'.� / Pee K ! S n r 4,Z.o t£
1 paec/S g)4/(1' O J GLft
Garage i wt. o c c-u P 144 z r o cs /.. fct x-,.( Ace K
14. Store -14..." / 7'i / - P x/ el -1)6'c K
15. Shop 144,
18. No. of stories Z
17. Is there to be a Store in the lower storey
18. Size of Lot. No. of feet front ........6.1................. No.of feet rear ..15Y-.........»». No. of feet deep J.e.S...»..
19. Size of building. No. of feet front ....._:".02......._... No. of feet side ... No. of feet rear ••• ,4.-
20.
20. Distance from nearest building: Front ...--....-..... ft.; side...........»-..„..ft.; side ft.; rear»...»......»..».
/ /
21. Distance back from line or street.................... from rear lot line » ..T..„..»..»., side line C,/... /( ' „.
Show by diagram the location of propsed building with relation !stances room adjoining lots, on reve side.
Namd”C/11 �.`..Y.�S.Y (4)fP ». tea.
Address:R.CIL .. E t x,vis.....&.e 0264/ Z 5I
Vision Government Solutions Page 1 of 3
6 COMPASS DR
Location 6 COMPASS DR Mblu 19/75///
Acct# 825 Owner AUTENZIO ROBERT P JR
Assessment $723,400 PID 825
Building Count 1
Current Value
Assessment
1 _. Valuation Year Improvements Land Total
2019 $223,700 E $499,700 $723,400
Owner of Record
Owner AUTENZIO ROBERT P JR Sale Price $717,500
Care Of Certificate
Address 23 MILAN AVE Book&Page 32593/252
WOBURN, MA 01801 Sale Date 12/31/2019
Instrument 00
Qualified Q
Ownership History
Ownership History
Owner Sale Price Certificate Book&Page Instrument Sale Date
AUTENZIO ROBERT P JR $717,500 32593/252 00 12/31/2019
TSOUMAS STEPHANIE C TR $0 1 11409/0015 1 05/06/1998
[TSOUMASGEORGEP $01 /0
Future Owners
Ownership History
Owner Sale Price Certificate Book&Page Instrument Sale Date
AUTENZIO ROBERT P JR $717,500 32593/252 00 /31/2019
Building Information
Building 1 : Section 1
Year Built: 1977
Living Area: 2,184 Building Photo
Replacement Cost: $271,385
Building Percent 80
Good:
http://gis.vgsi.com/yarmouthma/Parcel.aspx?Pid=825 1/14/2020
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1 . & - M ��
Commonwealth RECEIVED
of Massachusetts PA'55
p1 '
Title 5 Official Inspection Form oEc u,a#gf8
-.: Subsurface Sewage Disposal System Form-Not for Voluntary Assessme
�f
6 Compass Drive HEALTH DEPT,
Properly Address
Stephanie Brackett i F
Owner Owner's Name ,j,� i
L1-
inronnatlon b South Yarmouth
red for every City/Town MA 02664 11-8-18
Slate Zip Code Date of Inspection
Inspection results must be submitted on this form.Inspection forms may not be altered in any
way.Please see completeness checklist at the end of the form.
#tiN 1(;Ipi 744
n ao t o °n A. Inspector Information
17.:"..°' :-A:A:11::INN.
on the computer,use onlythe tab James D.Sears
key to move your Name or Inspector a ; SEARS
cursor..do *: •
•co
"use the a Capewide Enterprises . c, o *z
key. Company Name IsIsu urs`.Rr1r��,.;, ...4.$
153 Commercial Street iNS4, \������
�' Company Address
Mashpee MA 02649
City/Town State Zip Code
I A/I 508-477-8877 S1623
Telephone Number License Number
B. Certification
I certify that:I am a DEP approved system Inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000);I have personaNy inspected the sewage disposal system at the property address
listed above;the information reported below is true, accurate and complete as of the time of my
Inspection;and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage csposal systems.After conducting this inspection I have determined
that the system:
1, ❑ Passes ��t��-�- a2,(�
2. ►_. Conditionally Penne 661 3--D �A, -00.4, t 1 o1 2�
,, ivi_4( .fi
3. ❑ Needs Further Evaluation by the Local Approving Authority if I- ' U
4. 0 Fails *c°1 e�,I
.� 11-8-18roir
pector's Signatu a Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of
10.000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate
regional office of the DEP.The original form should be sent to the system owner and copies sent to
the buyer,if applicable,and the approving authority.
Please note:This report only describes conditions at the time of inspection and under the
conditions of use at that time.This inspection does not address how the system will perform
In the future under the same or different Conditions of use.
Snap deo•rev.swans
Title 5 Olrkl.l Inspecson Form.Subsurface Sewage Disposal System•Pagel of 18
, F
Commonwealth of Massachusetts
►� _w ' Title 5 Official Inspection Form
fl Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
L.. 6 Compass Drive
Properly Address
Stephanie Brackett
Owner Owner's Name
informadlwr is South Yarmouth MA 02664 11-8-18
required for every
page. Cityrrown State Zlp Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
NA
Number of bedrooms(design): Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440
Description:
1000 Gal.Tank D Box and three chamber's.
Number of current residents: 2
Does residence have a garbage grinder? 0 Yes ® No
Does residence have a water treatment unit? 0 Yes ® No
If yes, discharges to:
Is laundry on a separate sewage system?(Include laundry system inspection
0 Yes ® No
information in this report.)
Laundry system inspected? 0 Yes ® No
Seasonal use?
❑ Yes ® No
Water meter readings, if available(last 2 years usage(gpd)): 2016.36,000Gals
201 i-39,000Gal's
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: Present
Data
.
0. 2018 08:09 HP Fax page 34
1 Commonwealth of Massachusetts
:, Title 5 Official Inspection Form
�L.J Subsurface Swage Disposal System Form-Not for Voluntary Assessments 44
,; 6 Compass Drive
Property Address
Stephanie Brackett
Owner Owner's Nine
info ill South Yarmouth • MA 02664 . 12- 048
WfM, City/Town , State Zip Code Cate of Inspection
D. Systein Information (cont)
• 14. Sketch Of Sewage Disposal System:
Provide a view of the sewage disposal system,including ties to at least two permanent reference
landmarks or benchmarks.Locate all wells within 100 feet. Locale where public water supply enters
the building.Check one of the boxes below: _
hand-sketch in the area below
drawing attached separately
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Vision Government Solutions Page 3 of 3
Extra Features
r".____w. Extra Features Legend
Code
[ Description Size Value Bldg#
{ 1 FPL3 12 STORY CHIM 1.00 UNITS $2,200[ 1
EOS 1 End Outs Shwr 1.00 UNITS(1 $0 1
I FPO €EXTRA FPL OPEN 1.00 UNITS( $600€ 1
Land
Land Use Land Line Valuation
Use Code 1012 Size(Acres) 0.2
Description OCEAN FRONT Frontage 0
Zone Depth 0
Neighborhood 0070 Assessed Value $499,700
Alt Land Appr No
Category
Outbuildings
I Outbuildings Legend
Code Description Sub Code Sub Description Size Value Bldg#
DCK1 1 DOCKS RES TYPE ; 152.00 S.F.i $3,800 1
Valuation History
Assessment
I Valuation Year Improvements Land Total
12020
H
$223,700; $499,700; $723,400
12019 $205,3001 $499,7001 $705,0001
12018 $205,3001 $474,7001 $680,000
(c)2020 Vision Government Solutions,Inc.All rights reserved.
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