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HomeMy WebLinkAbout2023 Sign Off Transmittal - Front Porch °v- TOWN OF YARMOUTH tri HEALTH DEPARTMENT i PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 1 P)CD C L-' L - . 1A) .'N/calf)DU N \ Proposed Improvement: PO Car) off-s -r \V- OOO f- Ai ' („)U .t ) ik)`c1 Applicant: KF' .1'1•(-) --"N -(1 i,t---, Tel. No.: —EH q30 2z2 1 Address: \ CR, 0 LAL_- l J) . Date Filed: 3 . 1 3 . 23 "If you would like e-mail notification of sign off please provide e-mail address: �l � J ��'/ Qa l I, ( 01 Owner Name: ' Owner Address: \ (ThU U (.-- L vim, Owner Tel. No.: "11H q3 0-2_2g- 1 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 13 2023 (2.) Floor plan labeling ALL rooms within building HEALTH DEPT. (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: . CJ,.,: irk DATE: y - PLEASE NOTE COMMENTS/CONDITIONS: 14 LEGEND R ?J. U `.hpc IuiL' ''' EXISTING CONTOUR 1,„,,,,,r1Willillitl a' O3 a 100 98 EXISTING SPOT GRADEZ3 MAR1JZO —t 99�—PROPOSED CONTOUR ?�� 1: " 0G6r:° s ; 99 J PROPOSED SPOT GRADE jDEPT. —w— EXISTING WATER SERVICE cur 03'' a� , ,HD - -. EXISTING GAS SERVICE LOCUS a+ ,„%�., s, 0.H.W. OVERHEAD WIRES •�� 53 I°48'20"E TEST PIT "Pc �� 4� 99 IO2.6'b' • _.J �.9, rz'.'t p I 6? 4, BENCHMARK �ji J�i' I r �s _l. 1.3.—L~tO'er. `_ ` EXISTING CESSPOOLS a rTTT1 LOCATION TAKEN FROM RECORD J Q I I I LOCUSNOT SCALE AS-BUILT DATED 6/7/07 v7 t-t-t TO BE PUMPED, FILLED WITH SAND • PROPOSED �b,2 TCP 1 'N Q AND ABANDONED, OR, REMOVED. �^ SEPTIC TANK �1�LS1 LOADED Fr jrF1,4 16. O !j, t1�t 1 (Benchmark Set` . ° 99.68y — '-ry� GENERAL NOTES: y�t�� ^ ! t I t 1 t Q a CY/IF. 'Left car. bulkhead ti� `S' `� s��s rw J.�J 1' AUL. LL CHANGES TO THIS PLAN MUST BE A PROVED BY 1 EL.=100.00 (Assumed) #'9,� — 19 V SEP 2 2 2008 Ef ARQ OF HEALTH ANO THE DESIGN ENGINEER. �'. & 6 C0 + \- 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE I EXIST. SE•rfR V ('1 9� /- OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND A E Nv=sNo. w �i HEALTH DEPT. LOCAL RULES AND REGULATIONS EXCEPT AS REQUEST I F+ I I 2 STY. .1 N !11 1) A 1' veria^ce• S.A.S. to ceror wall, fora 19' st 0 8 } L_ ' 1 ((( �J 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKF -CI i_; PROWQE �• F t TO INSPECTION AND APPROVAL BY THE BOARD OF HE tu-so cLEA OUT T.O.r.. t01.00' II UTILITY POLE DESIGN ENGINEER. I GUY WIRE 4. THERE ARE NO WELLS LOCATED WITHIN 150' OF THE i _ -4. W W O 5. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTIOI Permit valid for REPAIR OF SEPTIC SYSTEM ! —r 9 —) FROM THOSE SHOWN HEREON SHALL BE REPORTED 1% OMLY,due to State and Local septic variances. j 9� (� ENGINEER BEFORE CONSTRUCTION CONTINUES. Board of Health review and approval b required z 6. ALL ELEVATIONS BASED ON aSSuesED DATUM. for any future addltbostresoradoanfattuadaO b 7. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE sewage facilities and/or structuratdwell* 9 THE CONTFiACTCR CR OWNER TO NOTIFY THE LOCAL 1 d HEALTH FOR PROPER INSPECTIONS DURING CONSTRUE Yarmouth Meatlt3Deparlsoud s2 11 APN 58-394 1 �`� er yfI' 8. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. APPROVED Se. t0,000tSF rLOp96 �Ep 9. ALL AREAS DISTURBED CURING CONSTRUCTION SHALL ;���Q�(�/� • or RICHARD s TO A CONDITION AGREED UPON BETWEEN OWNER AND , `�� r 9. ♦• + J. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTO �( G Q- n� 9� HOOD - THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOF Y 81.59' _ ��' -66, 0 35031 CONSTRUCTION. J / 53 I°48'20'E •���� II, WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL L ,�!t IN THE AREA BENEATH AND FCR 5 FT. ON ALL S'OE`_ �,• LAM AND REPLACE WITH CLEAN FILL AS SPECIFIED 'N 310 + +s +9 EDGE CF PAVEMENT fis I- �',,. 12. ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCLMEI 9 >x,' �! j SEPTIC SYSTEM COMPONENTS THAT MAY EXIST ON TI- tJ 4 BOB-O-LINK LANE ``* CF. k4ss,� PETER T. yG� PROPOSED SEPTIC SYSTEM UPGRAD ' "`CI 1 BOB—O—LINK LANE, WEST YARMO No. 35109 Prepared for. B & B Excavation, 14 Teoberry Ln., Forest OWNER OR RECORD (\r►'; Ci 1E�`�\ ° Engtneerin9 by: Sv n9 q, SCALE ORAV ROBERT RHODES ET AL ( , : EnglneeringWorks HOOD SURVEY GROUP 1'- T.I 22 GLENv,EW AVENUE V 'i- 20, P.IT West CrossMW Rood 18�yt AUBURN, MA 01501 ��LI46 Fore txt.. MA 02644 Sandwich, Ut 02563 DATE CREW (! 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