HomeMy WebLinkAbout2021 Sign off Transmittal - Bathroom Addition l
•
A.Y 4. TOWN OF YARMOUTH
cr HEALTH DEPARTMENT
!,,„,t• PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: 9 7d71:no /;:
r- f c/(Proposed Improvement: rzti '`h, k---0 )Y\ CL11,c - Vi t--- /0 )4/ d
c0, 5 /cc 4 .
Applicant: RaJ Tel. No.:4;-)7 - -2S /U
Address: / 75 r�iU'r. y _T`=( 1C el /V C'ke...7-42.,L Date Filed: /%1,1/�?ri2/
**/fyou would like e-mail notification of sign off please provide e-mail address:
Owner Name: _Co-yv i -Cc--.-G- ( /1ZGi2'f
Owner Address: /v c .. l 1 ' WCC Owner Tel. No.. 77‘/` a777) —
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
(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.
,I 1
REVIEWED BY: v�I, 4— ;�� DATE: // O��
PLEASE NOTE
COMM NTS/C NDITION,: !
A-c �oc C • 4 t--r,� tt.-(c -- p—e ,f 4,, ei
New ''► t-.. irc (L. fl l.d ►v. t, y
ec,L> fa( ary Re L I/ /.4‘ al.
ELEVATION
40.35 ooi
OF FpUNDP�\� 4
PLAN
SCALE: I in = 20 ft
PRINT ON It x 17 in PAPER
FOR PROPER SCALE
moo,
THIS IS A
COLOR
R
PLAN
USE COLOR PLAN ONLY
FOR INSTALLATION
FULL DETAIL IS BEST
VIEWED IN
FULL COLOR
C41
j3p8 PL s_---- �— 40
\ )\11
E�STING SOIL
ABSORPTION i 40 \
SYSTEM
\Pk
1a"L a
+ N
3 FdG
39
0 F"
/ 0
MINIMAL
GRADING
Oy/ PROPOSED
STONE
RKING LOT lI O `tr eJ2
I
AREA / AREA = 17391 sf t
/ PLAN BOOK 104 PAGE 107 '
v ASSR MAP 79 PCL 141
\ /
O�0146
F�FNT
LEGEND
SEPTIC COMPONENTS
EXISTING
1500 OAL
SEPTIC TANK
RELOCATED`""'_
1500 0 A
SEPTIC TANK'
DISTRIBUTION BOX 0
TEST PIT wim
CLEAN OUT
TO GRADE
Uj11ILITIE
WATER LINE
WATER GATE
GAS LINE
GAS GATE 0
OVERHEAD Y
UTILITY
POLE
DRAIN
40
8 ,� k 4 5 $� � 0.
w ro
�± '7r
a A: a
G3[9GGoMgD
NOV 2 9 2021
HEALTH DEPT,
YARMOUTH, MA
NOTES
Oo TES
ABANDON EXISTING SEWER LINE AND
PLUMB ALL FLOW INCLUDING FLOW
FROM THE PROPOSED ADDITION INTO
A NEW SEWER AS SHOWN ON PLAN.
EXISTING 1500 GALLON SEPTIC TANK
MAY BE REUSED IF ALLOWED BY HEALTH
DEPARTMENT AND IF IT IS IN SOUND
STRUCTURAL CONDITION. IF REUSED,
EXISTING TANK MUST MEET ALL CURRENT
SPECIFICATIONS.
IF EXISTING 1500 GALLON SEPTIC TANK
IS ABANDONED IN PLACE, IT MUST HAVE
A DRAIN HOLE PUNCHED IN THE BOTTOM
AND BE FILLED WITH SAND. IT MAY BE
REMOVED AS AN ALTERNATIVE.
DAVID
D.
No. 1093
FOR SURVEYOR'S CERTIFICATION REFER TO 'SEWAGE DISPOSAL
SYSTEM PLAN' DATED 9/12/2014 SIGNED AND STAMPED BY ROBB
SYKES PLS ON FILE WITH THE YARMOUTH HEALTH DEPARTMENT.
THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM
DEPICTED ON IT, FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING
PLACEMENT OF ADDITIONS, SHEDS. FENCES OF SWIMMING POOLS. OWNER
SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR.
SEPTIC TANK
REPLACEMENT PLAN
ANNDD SERVE
ADDIIT ON LUNG
CAROL HART
P. 0 1265 YARMOUTH, MA
WEST CHATHAM, MA PROPERTY ADDRESS
02669 onrE NOVEMBER 29, 20