HomeMy WebLinkAbout2023 Sign Off Transmittal - Farmers Porch off-Yak' TOWN OF YARMOUTH
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y HEALTH DEPARTMENT
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'r• 11•`' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: A4 L1 \'' e K O L i(. Q&. CL3
Proposed Im rove ent: 4W4 c -PD rwt.QAiS Olr'�(,� d )( 3 "1 l -o r C�
\ate s� 1
Applicant: S a kAck ` k9 U G C_j StOWVS Tel. No.:5 V S (9 (4 S(P
Address: a S ot &tea ikpakya teei NEVUS�V� Date Filed: 3 l,HN a 3
**If you would like e-mail notification of sign off please provide e-mail address: 1 C (� s(� (Q( 2 S el-
Owner Names_\OAkkv Q, `t--Dlil V\ \Co 01(s —
Owner Address: c9- - k x C ctviA,0504. Owner Tel. N o.: Lt,- a
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;
MAR 2 8 2023 (2.) Floor plan labeling ALL rooms within building
(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: C,,• -o DATE: /' oW.' et,
PLEASE NOTE
COMMENTS/CONDITIONS:
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GENERAL NOTES:
/. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION /
/
OF THE SEWAGE DISPOSAL SYSTEM ONLY. R I
2. ALL CONSTRUCTION METHODS AND MATERIALS AND 1 L/V YY -
MAINTENANCE OF THE SEPTIC SYSTEM SHALL
COOKORN TO NASD. D.E.P. TITLE S AND LOCAL jft
BOARD OF HEALTH REGULATIONS.
S. ALL SEPTIC SYSTEM~momLOCATED UNDER n �'
•
AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER {� `i , '/'
THAN 4' IN DEPTH SHALL BE CAPABLE OF WITH- D
STANDING 0-70 WHEEL LOADS.
A. ALL SEWER PIPE SHALL SE SCHEDULE 40 PVC OR C�E y /
APPROVED EQUAL. /- -,��
5. SEPTIC TANK AND D•BOX SHALL BE REIV000CEO i---
PRECAST CONCRETE OK APPROVED POLYETHYLENE, '
BOTH SHALL BE WATERTIIXIT. 0-BOX SHALL BE WATER / - /
TESTED FOR LEVEL IMEN THERE IS MORE THAN ONE
OUTLET. •
' Permit calld for REPAIR OP SEPTIC'SYSTEM •
6. BEFORE CONSTRUCTION CALL 'PIO-SAFE'.
OM 1, due to State end Local septic ,.
I-BBB-DIN-SAFE AND THE LOCAL WATER DEPT. BOwld of Health rtvIewdJdRS ISO epproYal I� ,I
FOR LOCATION OF UNDERGROUND UTILITIES. for rally Wore addltfB TIdI rtttnSisllcr.I,, - to
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sn.aEe facilltlef O0NOMICht►e✓derMOK.
7. EXISTINO CESSPOOL TO BE PUMPED DRY AND Yarmouth Health Department
BACKFILLED.
• APP OVED
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Name DBm.
LOT /5
GARAGE EA,:,,,,,,,J BEDRoOy 00Ffi me
• CLEAN OUT { �
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. W �IAIRV�a"-J,1
lor
NEW I 7/
aFrSEPTICC T TANKM
o MAR 2 8 2023
""3WeJAJ - -:`'' _` HEALTH DEPT.
...ADO RISE D.,. `CESSPOOL
a.A.,
QW EXISTING RsT..,.,y....4.4. ...� '0
LEACH PIT N I
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aIT ___--_. �� 040 L5.
0.13
p153 0
BLUE RO CK RO AD
ar '
SKETCH PLAN OF SEPT/C SYSTEM •
744 CLUE ROCK ROAD. MAP /0/. PARCEL /72 .
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0n _a ci L SOUTH YARMOVTM. MA,
N!, plt ri?c PREPARED FOR'
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CIVII N-, AL ICE CORE/V
�, Nn,3546t L •
SCALE' 1'- 70' NOVEMB£R 14. 2008
'oc 4',df.IYO t�.LC
f�J'WI t ��-^ EAGLE SURVEYING , I NC
_ 023 IROure OA
j!'; ,/ YOrMmUtOpOrt, MA. 02070
riiiOW �` 000) J02-0t22
(GOO) 432-0223
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