HomeMy WebLinkAbout2022 Sign off Transmittal - After fact Deck permit - ;
de.'YAM TOWN OF YARMOUTH
,44 �r HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
-- •c ) j U,-' }2 r-u i \ L • it- r\, .
Building Site Location: � � .J,
Proposed Improvement: F\t \ N ,- `C- IN(- \ �� C K \l l-.; (LM 1 --t-
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Applicant: " J74kir1(\'\El- ') ' -\-- ti fAl v4--„) Tel. No.:Sc) 9_ -34 LI — ( 1 Z_.
Address: 7. (7) (1\r'( h h ' n 11- '1 S L 1-\ , t- r r S "' ' ) f Date Filed: I It" 1 / 2 0-2
**If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: % \-) (-) i ''- t' (IQ r-r) / r` ‘ C L) k i V\A '..
Owner Address: 2 s --C`\'`�` C c ` ( L , Owner Tel. No.:7-7`( - e i cdo -Z 5 t f
C en- A--r Y / , \\ ,C ) (v\A </Z G .) Z
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.
C` ���� - Please submit three (3) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
APR U 4 2022 and septic system location;
HEALTH DEPT. (2.) Floor plan labeling ALL rooms within building
(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: 42 DATE: ��_ �—�I
I 1
PLEASE NOTE
COMMENTS/CONDITIONS:
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
1.411( ;;111114._:jSubsurface Sewage Disposal Syste Form -Not for Voluntary sessments
P �ti
0411 foo4e- led
Property Address /01ff e-S
Owner Owners Name
information is every SO
ON y/ n Liv /p//.2-/02/
-ecuied for eve 7lVwr
page. City/Town State Zip Code Date of Insn
D. System 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 enchma-ks. Locate all wells within 100 feet. Locate where public water Supply enters
the build. . Check one of the boxes below:
land-sketch in the area below
`I drawing attached separately
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HEALTH DEPT.
t5insp.roc•rev.7282018 title 5 Ofical lispecuon FormsuOs.rface sewage Ds
S poral System•Pape 16 of 18
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P.T. RAILING
APR 4.1017
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DECK
EX. BULKHEAD
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HEALTH DEPT
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- I.. GAS METER
36" PT: RAILING
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ICE. & WATER$HIELD
GALV.
JOIST HANGERS
2'-0".- SIMPSON OR EQUAL
PT DECKING -TIP.
POST CASE
---P.T. 2x6 ® 16" O.C.
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2-P.L 2xB .JOISTS
�. P. T. 2x8 LEDGER BD.
BOLT TO RIM W/I• DIA. GALV. LAG
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2-P.T. 2x8 GIRT
SECURE TO JOISTS
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-P.T-2x8 ® 16" O.C.
' 2-P.T. 2x8 GIRT BELOW
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DECK PLAN
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DATE
ISSUED"
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04/02/2022
'REVISIONS:
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P.T.-2x8 LEDGER
I1iIIi11II
BD.
--'-
BOLTTORIM
/1" DIA.
I - - GALV. LAG 801
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TS ® 16" O.C.
FRAMING PLAN
.DRAWN BY.
SCALE:1 4 =1 -0
-
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PROJECT #:
DRAWING NO.:
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REMOVAL NOTE
A PARTIAL 5' AROUND REMOVAL. IS SHOWN AT SOUTH-
EAST END OF LEACHING. INVERT OF PROPOSED
LEACHING IS, ONLY 2" INTO B LAYER`.1F YOU ARE
INTO GOOD SAND AT 40" YOU ARE OK. WITHOUT DIG.
IF NOT YOU MAY CALL FOR VERTIFICATION OF 4'
UNDER SYSTEM BY R.J. CADILLAC OR (HEALTH AGENT
AND LOWER SYSTEM AND GRADES TO AVOID REMOVAL.
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�29.0
?9.2 29.6
29.3
29.9
29.9 <u REPL
28.3 ORANGES
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---,'50.2 1 30.3 x x 28.5
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x 30.6
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- X 30 �x.�2g 7 26,.E 15�' ,� 25.7 2,5
x
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29.2�v. ! BENCH MARK -
29.6 �j`22o SET FLUSH=25.
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BENCH MARK --TOP S.E. CORNER
CONC. BULKHEAD- 30.00 ASSIGNED
x 1-0,2
x 51 �� 11 28).9 N
ETT
THIS PLAN IS A 'VALID
AN ORIGINAL RED, STA
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LEGEND
RONALD
JAMES
Z CADIL,
5
13IDi ow[RD
`TH
9 -
TEST HOLE LOCATION, NUMBER
FERC TEST LOCATION
APR 0 4 2022
-----W-
WATER LINE MARKINGS
G
GAS LINE MARKINGS (IF SHOWN)
HEALTH DEPT
' ---OE-
OVERHEAD ELECTRIIC WIRES (IF SHOWN) :
u 9.
# 11.0
EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT)
EXISTING CONTOUR
----
PROPOSED CONTOUR
>
UTILITY POLE (IF SHOWN)
U---
OVERHEAD UTILITIES (IF SHOWN)
4K.
TREE (IF SHOWN, NOT ALL SHOWN)
(D.
EXISTING SEPTIC COVER
El
EXISTING DRAINAGE CATCHBASIN
RONALD
JAMES
Z CADIL,
5