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HomeMy WebLinkAbout2022 Sign Off Transmittal - Sun Room TOWN OF YARMOUTH �, HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: —5C6 tL/O6 t t?i r9 Proposed Improvement: /a / x �� / S v 4/ k Cj 0 A-1 )1/4 C 4 /7 71 17 2)647-62 ' /9Re-)51 "14 o SoovU 7 6e 5 Applicant: .54'mt". Tel. No.: Address: Date Filed: `.0)-‘6-2 **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: "f9-vi Owner Address: SO k/ Uv d Owner Tel. No.9789r 0068 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. REVIEWED BY: DATE: ` 1 PLEASE NOTE COMMENTS/CONDITIONS: • • •y /oo.00 , f /o/ Loa .Fr: 43, t • N 7.3f f L� b 42.eV.7ap of 1 . • d .. p '44 E" Resriiva - i LoT 'c 4'b$49130 I, C 3t'j 43./3 41.89 74'1.'4w way x,.41. . r v CA 7> •ev s eo/9-27) -.41'*A toe' el. • • • • CERTIFIED PLOT PLAN . - • • LDCATiON •Soc.rt/ ,!/,9.eh0(.7-Afi Ms)ss SCALE./'r 3c,' DATE Dec<2. /580 PLAN REFERENCE . e7A/C - 40 r "L .Sfec).bY'! 0 A t 6!r• X/ I CERTIFY THAT THE 4`?! !" Q fp�•!�•gvo�►/. 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INVE IN . •:' PIT OR SEPTIC TANK DIST. ., /-f- EQUIV. . . EL..•. �� w f.. .•• INVART SOX .• �_ ,',� �. EL.. ... J,. GAL. - INVE !NV RTJ;-' w,a _, I.••••• 3/4 TO IU WASH ED �Q ' :- = let:. •�: Ir r• STONE !. /�• ,, 4, 6'DIA. ''-- r............., .1171 PROFILE . OF GROUND::WATER TABLE.. SEWAGE;':: DISPOSAL SYSTEM ' • ' ,` NO SCALE;.1 . • . -1;;:; ..fitttt---' :fir' • ...al,' r SOL LOG ;: WITNESSED BY : DATE ..O%�9.79. TI ME.Zi.. o Pin . . ,pi9�6.' ,e4figiff0.4 . BOARD OF HEALTH . •1 TEST HOLE I TEST HOLE 2- ,N . 4.50 ig 1. . .'ENGINEER "`• _ .. , ELEV.. . . . ELEV.... / S �3 4.•. : DESIGN DATA ' _ — 4 84 art.. :. _ � ,► . - ! _ NUMBER OF BEDROOMS . .. • • • rte. ; I . 1... ' ` ESTIMATED FLOW ..2%61g.4:5:2?. ; GALLONS/DAY BOTTOTOTALM LEACHING AREA . v ... SQ FT./PIT /e6.4)/44 :1.. /j746:/yid/tADt .- SIDE',-LEACHING AREA . . /88s' . SQ.fT./PIT. ' GARBAGE DISPOSAL ./Z ..(3O% AREA'INCREASE) s /' TOTAL'.LEACHING AREA•: 74�!? ) •:SQ.n ��ww ,• PERCOLATION RATET/'14)• 2. - �•>r�r• �. ! MIN/1NCN • LEACHING AREA PER PERCOLATION 'RATE. -Q SQ.FT.• 4/P.WATER ENCOUNTERED • 1 •; ' NUMBER OF LEACHING PITS".1:2r.P/•rI.efYT APPROVED . .. . . . . . . . . . . BOARD OF EALTH '..-1/S".-6 M '�`�•AY/•�. • DATE. a i. .' . .c ''. +firf • . . • AGENT OR INS CTOR "ter` • /v/�� .‘V7:41. 2 R..4:i 4. s 4 : ��rangEER _5 Tt.TDITAE E. ORS. \SIF 42"e T .G1� .Cl�G�l7 I�i1.J.�/ � :!�,IIr , 346 LONG POND DRIVE :: r• •i9•,. 0�' ONAL PETITIONER : Q�d .'Y'. • �i.;;SOVrHXARttoVTH.bt�►ss• s^: p. .. . M 2664 :-;/,670a Commonwealth of Massachusetts N=*-= =_p Title 5 Official Inspection Form _. . Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i- % SO (n100d 4) Property Address (/��� Owner Owners Name V 48114 information is ` required for every Q( a* �� �v��rs6 � page. City/Town State Zip Code Date of Insp ion D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view o sewage disposal system, including ties to at least two permanent reference landmarks enchmarks. Locate all wells within 100 feet. Locate where public water supply enters the bui ' g. Check one of the boxes below: hand-sketch in the area below ❑ drawing attached separately ,/i--ci j). 6_„1/.., 0 -,-,...,_ T � 3 — -1)-10,/- G,ic, i J- (Ai/ /1.4- 3+-0.'1-'1- 1.4- 4 / -30 g/ -tea g/A-A- Rte A-4- 3_c ad--- ( 3a " (0,,,,--- /t3 _3 dvP,---/t3 -3a3 - a$ t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 16 of 18 DRAINING L15T T1 TITLE SHEET T2 5PEGIFIGATI0N5 A-1 FIRST FLOOR PLAN AND 5GHE ULES A-2 ELEVATIONS A-3 BUILDING SECTIONS 5-1 FOUNDATION PLAN FIRST FLOOR FRAMING PLAN ROOF FRAMING PLAN GENERAL NOTES 1, THESE DRAWINGS AND ALL A5PECT50F THE PROJECT SHALL COMPLY NITH THE IRC 2015 AND 180 -MA AMENDMENTS TO THE IBC A5 WELL AS ANY TOWN AMENDMENTS OF BI- LAPS, LIFE SAFETY, PLUMBI NO ANDS CTRIC CODES. IF ANY CON FLICTS IS FOUND, NOTIFY THE ARCHITECT IMMEDIATELY. 2. THE GENERAL CONTRACTOR SHALL BE RESPONSIBLE FOR SECURING L PERMITS N ECESSARY FOR THE COMPLETION OF WORK. S. THE GENERAL CONTRACTOR SHALL BE RESPONSIBLE FOR THE CONST UCTION OF THE DIMENSIONAL REQUIREM ENTS BETWEEN THE WORK OF REQUIRED TRADESISUBCONTRACTORS. 4. THE GENERAL CONTRACTORSHALLVERIFY EXISTING CONDITIONS PRI RTO STARTING WORK INCLUDING ALL DIMENSIONS,GRADE, PROPERTY LINES,EXISTING BUILDINGS, AND NEW WORK. THE CONTRA TOR SHALL LAYOUT IN THE FIELD THE ENTIRE WORK TO BE PERFORMED TO VERIFY DIMENSIONAL RELATIONSHIPS. THE ARCHITEC SHALL BE NOTIFIED OF ANY VARIATIONS FROM INFORMATION PROVIDED IN THE DRAWINGS. 5, CONTRACTOR SHALL BE RESPON51BLE FOR ANY VARIATIONS OR DEVIA IONS FROM THE PLANS WITHOUT WRITTEN CONFIRMATION FROM THE ARCHITECT: THE CONTRACTOR MUST SUBMIT AND PROPOSED CHANG S IN WRITING AND PROVIDE ADEQUATE TIME FOR REVIEW BY THE ARCHITECT FOR THE PROPOSED CHANGES OR REQUE5T5 FOR ADDITI AL INFORMATION. 6, CONTRACTOR SHALL PROVIDE ANY ITEMS REQUIRED BY CODE OR THE ROPER INSTALLATION,FUNCTION, OR COMPLETION OF AN A55EMBLY REOARDLE55 IF SAID ITEMS IS SHOWN OR NOT. SUBCONTRACTORS 5 L INFORM THE GEN ERAL CONTRACTOR OF THE REQUIREMENTS FOR THE WORK REQUI RED BY OTHER TRADES PRIOR TO SUBMITTAL O FINAL BIDS. 1, THE ARCHITECT CANNOT ACCEPT RESPONSIBILITY FOR THE SPECIFIC UANTITIES OR QUALITIES LISTED HEREIN, IT IS THE RESPONSIBILITY OF THE CONTRACTOR TO REVIEW THESE CONSTRUCTION DOCUMENTS kND CONFIRM THE SUITABILITY OF THE HOUSE FOR PARTICULAR BUILDING SITE. B. IN ADDITION TO THE ITEMS LISTED THE OWNER SHOULD SELECT FINIS MATERIAL55UCH AS COLOR AND TYPES OP PAINTS, STAINS, TILE, CABINETS, COUNTERTOPS AND LIGHT AND PLUMBING FIXTURES, ALSO 0 BE CONSIDERED ARE THE HEATIN6I60001,16 SYSTEMS, WIRING, PLUMBING AND EXTERIOR SITE WORK. R. CONTRACTOR SHALL PROVIDE ADEQUATE BRACING OR OTHE"ISIE 5L PPORT ALL PORTIONS OF THE STRUCTURE UNTIL ALL MEMBERS HAVE BEEN PERMANENTLY CONNECTED TOGETHER. PLUMBING DIAGRAMS C IR DRAWINGS SHALL BE PROVIDED BY THE PLUMBING CONTRACTOR. HEATING/COOLING DUCT DIAGRAMS OR DRAWINGB SHALL BE PROVIDE7 BY THE HEATING/COOLING CONTRACTOR. HEATL0550RENERGY CALCULATIONS SHALL BE PROVIDED BY THE HEATING/COOLING CONTRACTOR OR THE PROFE55IONAL AS REQUIRED BY THE BUILDING OFFICIAL, TRUSS DESIGN, ENGINEERING AND PLANS SHALL BE BY THE RUSSMANUFACTURER, 10, ANY SPECIFIC CONNECTOR$ OR STRUCTURAL ELEMENTS MAY BE SUB FITUTEDWITH WRITTEN PERMISSION BY THE STRUCTURAL ENGINEER. 50 WOOD Iq �,OUTH YARMOUTH, M, FU <m o�Ef Z- o, AD N - a o Lu k SSACHUSETTS m Z Lu N N h FU <m o�Ef o, =s r N - a o m Z Z Y w N o 0 o d FU