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HomeMy WebLinkAbout2023 Sign off Transmittal - Front deck expansion °9A: TOWN OF YARMOUTH ot ;:i y HEALTH DEPARTMENT ' r/ `tea "'' PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEE T To be completed by Applicant: Building Site Location: 2 � to i ` ,yt dr, �. ,4ri,--,0 444 ,/1-(4 eW Proposed Improvement: l'l 0"lel of (.,91.4<j-t-- cieth E k-(e.-v, \ a lA Applicant: a W Si,A oV Tel. No.: co<rCt C3 Wt9 f Address: 1 'yt AA \ U d r r e,� '1M.D fii, �.2(CI(Dat, e Filed: **If you would like e-mail notification of sign off please provide e-mail address: IVD.. ry1 i 1A p V 4 /9/.J_42á' . 60 h..,Owner Name:lD�� JJM DV Owner Address: 9 _ /0 A e V IA) a 01 Owner Tel.No.: G9g 6,(3 (go( 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. 4Please submit three(3) copies of plans, to include: 41.) Site Plan showing existing buildings, water line location and septic system location; ' (a.) 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. (1) //,/ REVIEWED BY: .___._.....__..... D 1:2—A��i Gp6LI j `J COMMENTS/CONDITIONS: PLEASE NOTE MAR 1 0 2023 HEALTH DEPT f . ....; .utit Health Departrik:.t i AAPPROVED 4 Oce/e 4 4'71__ V4�cniK MUST CONFORM TO A L e Date TOWN BYLA REGULATI S f; z_ OU H WATER D f 100.04 EPT 0 A J • " TOWN OF YARMOUTH EVIEWED FOR BUILDING AND ZONING CODE COMPL 'VCE. ERRORS OR OMMISSIONS DO NOT RELIEVE TH E TANK ° PLICANT FROM THE RESPONSIBILITY OF' BUILT C IMPLIANC ' 1 v Z i o EX. v BUILDING OFFI IAL .- 1 m • 36.01 ....AA DWELLING -C = PROPOSED % I/14 FILE r 61x11. ► .„ ® COPY t— LANDING 0 73 NOTICE mew J i8—B as built plan must be 26 STONEY HILL DR. s bmitted to this department YARMOUTH. ;MA P or to foundation Inop©ct(on or lny further construction, �•'Q. 70.00 ;L,IJV L.0 • SEPTIC SYSTEM PLOTTED LANE MAR 1 U 2023 BY OWNER, FROM RBUILDER TOMATION O CONFIRM VIDED PR I V• MA E WS I HEALTH DEPT. CERTIFIED PLOT PLAN MBLU 118-8 I CERIJFY THAT THE IMPROVEMENTS SHOWN �� w o> 4 26 STONEY HILL DR. HAW BEEN LOCATED BY A FIELD SURVEY. �4 stfcy YARMOUTH, MA >� ROBB G�/' DATE: 4-7-2014 J DRAWN: RBS SYKEs I SCALE 1"=30' J08 I. S0e0 No. 35418 t^ DwC. CPP ' NT7 EASTBOUND /l f..�- U y 104 ."1 LAND SURVEYI2NG, INC. !I �' P.O. BOX 44 ROBB SYKES, P. S. DA7E %h�y� / FORESTDALE, MA 02644 /� 508-477-4511 1yr4—a2-S ' Commonwealth of Massachusetts =__ _ iF Title 5 Official Inspection Form r _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 26 Stoney Hill Drive South Yarmouth MA Property Address Schwede Kevin 135 Highland Ave Owner Owner's Name information is Mansfield MA 02048 7/1/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately REAR --a L o a o r..t.., ■ y' p .t:y 3 m .16.s' gl: It.s, ' /tazaol/ gr... al A3 -ay f, g3. as ALI: 3g5 B`+=3.2' NYC MAR 10 2023 HEALTH DEPT. tSnsp.Poc•rev 7/25/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 • o4—s: j 1.0' - Ac N / %7 A Eli kfl .. >4 to 1 R: A Cia 1 ill o a Z cn 43 co ,, a 0 H (A `►-" W CO j .9 w 0-1 ez n Z R1� U Z o 1 u, 1 vim} D 0 E.,-, A 2 .. , d z < cy_ Z ; w iii ci o 1 to Z 1 --1 .. Z f.. -. H 0 `� E1) a a H ca 0 Z Cl)n 14 I , H 1 • c CD O to W H d c4 ►-� � .- H Z H to H .-S o ? [z1 Q Z Z Q ,- 0 Cr) Ca 1-4 0--4 3 �] 1 M BL( 118 "8 a(o S--F-ri n-e i l l D: 1 Ya ni xA4i , VI- i 0 0 .04" , , \ L_1 It Z ..,,—TAk 's 1 \C' \0, \----.40 r" �-1,5� �\ -.1 C�' `\.)' ` G-E- 1,0di1� V 34' 0, 0 �f MAR '1 :3 2023 . 0h-a ;i)RO�'oSED HEALTH DEPT. ki' ' \ LANDINI aXI% \ . \, c \ ,NZ-___ tt 0 1 PR. MAte" €W5 L.-AN6 f