HomeMy WebLinkAbout2022 Sign off Transmittal - Rebuild Decks TOWN OF YARMOUTH
HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant:
Building Site Location: -/` L)%- i 04 1S
Proposed Improvement: \Li.' vi w, pi I:KS
Applicant: i kk>(— `1o.) Tel. No.: t I$3 )(.3-5"3411,
Address: 71 AQA.4,.i\4€J c Ei.. (WI 0>t 1 f Date Filed: —� Z.
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1 you would like e-mail notification sign please e-mail address: � 1S YOr3wt,r�- �H4 �
Owner Name: `j14t--A�
Owner Address: 71 I&w11.4A ptit. &1/4.11+r,;e,; NIA 0,-K Owner Tel. No.: r-Irs- ft3 -SW-
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
SEP 2 3 2022 (all existing and proposed) —
HEALTH DEPT. 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: 7— 6 ` -
P EASE NOTE
COMMENTS/CONDITIONS:
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\` ,:a, 4 . JUL 2 0 2022.
n j y\� 4,. \ 99,66
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�T' `\ HEALTH DEPT.
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'( ,Fk + / 100.83 \ .w n.
LOCUS MAP �a,,;� '>� ��
64---- EXISTING CONTOUR �/ Sd. �R. 99`98 • �� m
x 60.98 EXISTING SPOT GRADE x 100.99 00 3o
-W- EXISTING WAT R SVC. ,
EXISTING GAS SERVICE d, LOT 65 FLAGPOLEBIG 100 36 . ��
14,500f S.F
�' TEST PITE WIRES h��ypp �`A r 10 g x 101.05 101 01'' 100.31 100.09 ��
BENCHMARK �` �10 x 101,90 PAVED,
\ DRIVEWAY'
LEGEND \) 00,16 /
•J� 99.06 ISP I - O 101, 46 100.21
EXISTING LEACH PIT GT ♦ x !` 1 ,RAGE •40 , - 0 '
TO BE PUMPED, FILLED ` I` , ,'-• ; 100.23
WITH SAND & ABANDONED 98.35 ♦ I 110 ,' A\ ,. � CBDH 100.24
''-' x 101.58
c'- SEWER/ i:.:i'`e,
� • �`� INV.�1 Q1 10 I` .: e1 ` C-I0
I � ix 00.81
1,97.87 ? 1 i ce, �� a
�., x/ �o• • -� f X/STING , • � a 100.11
1,4 o• I ♦ HOF.=1071) x 1o1.53a
i CO+ 99.35 � T.O.F.=102.51 • =`k
x 1
` 9 .55 0 \ / / ill
0,43 � ~N\.,0 0
_\\ co O�:` 1
ie., .40
-A", Mrti8. ss:1• .
DI TG11 S \ 101.87;. 8 4111pjl �\
•
EXISTING SEPTIC�`ZAI�i�\`\`♦` F` •. • \4lik A00.70 i^♦ x 99.55 `� x TO BE PUMPED, FILLER ` \ ` C 100.2WITH SAND & ABANDONO `\ `\\` 5 �.,` 100.62 k' '
PROPOSED S.A.S.
'�� N. _ �__._.- '5 #� ,' PROPOSED
``�\ `�`�`�` \\! �- i � -� T\ / SEPTIC TANK
` \ \ \ ♦� s it , �\
+IF
Q\` , '\ Ic\\ \,♦ yu • �\ \`�` `r>` , \`♦ se 99,15x '7-\ , \/
99.72 x98,51 \
'YalAM&AMIth Dl !heltt . �`\ y •\\ 99.4. 4)42) yAPPRO C 9 ` ' . C -9 KE tl TENIN 691A\ \\ 4,Z
1°X217411 -
93.45 \ \ , \ \` ' a N` �V
WATERSURF \\ \ \ �� \� a Q 99.36 ,
GENERAL NOTES: s, \, \ \ \\
1. ALL CHANGES TO THIS LAN° MUST BE APPROVED BY THE LOCH tr�\ `\ \-
BOARD OF HEALTH AND THE DESIGN ENGINEER. \\ ....,.
2. ALL WORK AND MATERIA_S SHALL CONFORM TO THE REQUIREMENT9 `\\`\\\
OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE\\ \Y OrI
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: \ \, \ 1 99.51 SEP 2 LC f, r�
-310 CMR 15.405(1)(b): _OCAL UPGRADE APPROVAL \\\DIT �
CH `�1
1) A 2' variance, S.A.S. to cellar wall, for on 18' setback. 94.27 ‘ -LTH IIEPT.
?)(--
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR \
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ' \
DESIGN ENGINEER.
4 FROMANY CTTHOSEONS ENCOUNTERED SHOWN HEREON SHALLI BE REPORTED NG CONSTRUCTION
TTO THE DESIGN 13,
1MOI ;I 98.94 �4`c�\� OF SJ'''t,
ENGINEER BEFORE CONSTRUCTION CONTINUES. i o PETER T. .
5. ALL ELEVATIONS BASED SN AN ASSUMED DATUM. r McENTEE
„:,
6. THE DESIGN ENGINEER I; NOT RESPONSIBLE FOR THE FA LURE OF CIVI1.
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF -u C E'R• p i No. 35109
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. OD
7. WATER SUPPLY PROVIDE) BY TOWN WATER SERVICE. • \
.-� / Eli'
8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED SA.S. �AA�� .
•r!--- 7 1(71'
9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE OWNER OF RECORD
DIRECTED BY THE APPROVING AUTHORITIES. YOUNG, THOMAS
10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 71 ARROWHEAD DRIVE
THE LOCATION OF ALL ®NDERGROUND UTILITIES, PRIOR TO BEGINNING MAP ID: 115-92 YARMOUTH PORT, MA 02675
CONSTRUCTION.
11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS PROPOSED SEPTIC SYSTEM UPGRADE PLAN
IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 71 ARROWHEAD DRIVE, YARMOUTH PORT, MA
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
INSPECTED BY DESIGN :NGINEER PRIOR TO BACKFILL. Prepared for: B & B Excavation, 14 Teaberry Ln, Forestda$e, MA 02644
13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND Engineers: Surveyors: SCALE DRAWN Job Na
NOT CONSIDERED TO B: A PROPERTY LINE SURVEY. Engineffling Works,Inc. JCEngineerbegInc. 1"-20' P.T.M. 174-22
14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC 12 West Crossfiefd Road 2854 Cranberry Hwy.
SYSTEM COMPONENTS P OT SHOWN ON THE PLAN. Forestdois, MA 02644 E.Worsham, MA 02538 DATE CHECKED SHEET NO.
15. THE PROPERTY LIES WI-HIN A STATE REGULATED ZONE II. (508) 477-5313 (508) 273-0377 7/17/22 P.T.M. 1 of 2