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ASSESSORS riAP 22 P^RCEL 116.2
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TITLE 5 SITE PLAN
+73 SILVER LEAF LANEWEST YARMOUTH, MA
STEPHEN NADEAU
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civil choin@rs
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NO OROUNOWATER ENCOUI.ITERED
D(:t; #t7-297 oAI. or.xrf,L r. oJ ! . PE., P.L.s.
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NOTES
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SYSTEM DESIGN:
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NGLE DWELLIN
D E OF ISSUE
j tl
OUPLEX F ILY ING
3. CONDOMINIUM LLING
TO\VN OF \ARMOUI FI
WATER DEPARTMENT
irg Buck lslnnd Road
Itcst Yarm()uth. MA 02671
Tclcq:hone; {5081 771-79.11 ' f;11; l50B) 771'7'tit
ER OF WATER AVAILABILIW
4. COMMERCIAT/INDUSTRIAI
5. OTHER (SPtCTFY)
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R erence: Massachusetts
P se be advices that the
M p:
GJneral laws chapter e0,
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Toiwn of Yarmouth oublic
ilrP
section 54
water supply is available to service address:
1 3ivts,'
a a.- Parcel:l.{.>-
ce of this Letter of A lability is subject to the following provisions / restrictions:
1. The propertv er agrees to cornply with all federal State, and local Laws, Rules and
Regulatio ns as t pertain to the use of the public water supply.
2. The Yarmouth ater Department shall have exclusive rights as to the size, number, type
and location of ll water service lines, fire service or appurtenant items connected to the
water distributi system.
3. The Yarmouth
expense, the i
ater Department reserves the right to require, at the property owner's
ns lation of water mains and appurtenant item5 to meet water demands
requisites with any structure relevant to this Letter of Availability
4. The Le erofA ilabil ity will expire 180 days from the date of issue
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ve read and understand e provisions / testrictions of this Letter of Water Availability
Representetive of Yarmouth Depanment
s Name
'els Signature Wat Signature
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YARMOUTH WATER DEPARTMENT
Residential Service Application
TO BE COMPLETED BY OWNER / AGENT:
Applrcation Date
Contact Name:
3 Phone i Day
Phone / Evening
TO THE YARMOUTH WATER DEPARTMENT:
I hcreby submit an applcation tor a resrdentral watcr seMce to be located at:
Street
I hereby agree to pay all charges for the same and will comply with all federal. State and Local Laws, Rules and Regulations as they
pertain to the use of the Public Water Supply. Should a police road detail be requi.ed, I further agree to pay all costs associated with
police road detiail. The Police Deparlment has the sole authority regarding the need for such a road detail.
Further, I will hold harmless the Town of Yarmouth Water Department, their agents and employees against all claims, damages, losses
and expenses resulting from injury to or destruction of tangible properly including but not limited to shrubs. trees and fencing during the
installatioo. relocation or rehabilitation of any Municipal water service.
Funher. water service excavations will be restored to a rough grade condition. Complete landscaping will be the responsibility of the
property owner or owner's ag€nt at the property own€r's expense.
Yarmouth Water Oepartment policy requires thal a water service over 125 feel in length shall be a minimum of 2 inches in diameter. A
Vadance to Water Service Requirements is available with the approval of t Water Superintendent
Owner / Agent name
Owner / Agent (Type or Print)
Address:
ciry, stare & zip
':b1 \lA s\.
6 D
BILL COST OR WORK TO (TYPE OR PRTNT)
Name \lo^rs.Address
City, Street & Zip
Owner i Agent Signalure
FOR OFFICE USE ONLY:
To Field:
Servrce #
Service lnstaller:
D New Service
Pole #:
Cross Street
Cross Street
Digsafe #:
E Cut and Cap fl Relocation ! Replacement fl Other (specify)
Comments:
H:\WatedYWD Shorlcut OnIy\WVD\YWD Fo'msUO13 Resldential service applicatron'doc
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rur"p*, ).-)- r-ot*, 198.] un,t*, - House#: a3=Silv<r-Leq{ Lo
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YARMOUTH WATER DEPARTMENT
Residential Service Application
'lndividual applications and water services are required for each unit within a dwelling / building.
I, USE
Number of Units
Condo Dwelling'
Duplex Dwelling
Other (specify)
II. APPURTENANCES
Number of Units
\Lawn Sprinkler
Fire Sprinkler
Separate Frre Services
Fire Pump
Swimming Pool
Other (specify)
lll. FIXTURES (how many)
Number of Unats
Sinks
Toilets
Bath Tub / Shower
Garbage Disposal
\,
IV, WATER CONSUMPTION
Sinks
Toilets
Bath Tub / Shower
Garbage Disposal
ARCHITECT / ENGINEER
Architect's Name.
Address:
City, State & Zrp
Phone #:
Average Daily Consumptionthr Peak Hourly Consumption
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Enganeer's Name
Address:
City. State & Zip
Phone #:
H.\Waler\YWD Shortclt Only\YWD\YWO Forms\2013 Residentiat sorvice apptication.doc
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TOWN OF YARMOUTH
1 146 ROUTE 28
SOUTH YARMOUTH, MA 02664
LONGFELLOW DESIGN BUILD
367 MAIN ST
FALI\4OUTH, MA 02540
73 SILVER LEAF LANE
LETTER OF WA
INVOICE
@ Pst0
TOWN OF YARMOUTH lnvoice Date 0311912021 Customer Number 2'1'1135
lnvoice Date
0311912021
lnvoice No.
71 59
Customer Number
211135
lnvoice Total Due
$150.00
Amount Paid
Description Quantity Price UOM Original Bill Adjustment Paid Amount Due
LETTIR OF I{ATER AVAILAEILITY
EACH LITTTR
1C0 $15C .00 IACH 515C.00 $0 c0 50 cc $l51 00
lnvoice Total:Please put lnvoice Number on your check.
Make Checks Payable to: TOWN OF YARMOUTH $150.00
Longfellow Design Build
866 Main Streel
Osterville, MA 02655
50&428-3999
MARTHA'S VI}IEYARO SAVINGS BANK
397 PAL!'ER AVENUE
FALMOUTH, MA 02540
5'"729i,2113
b
32282
$ /5:O.rD\OJPAY TO THE (vfuOBDER OF
0 J DOLLARS (
il JA
Vold.frer 90 daY3
NaJe,ou l"Ja+<r c4(5ti' c4
MEMO
NOI a ?B 2r. r:altl? 2qa5r: t.5 2OOl ?B'F
Due upon receipt
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