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Home My WebLink AboutApp-Permit-ComplianceIJ�Irt" T+ E/C�S TVFI�^cNV. 'v L —•—v, . ,yvt —Q II L KJ FEE $67'0 0 r6rCOMMONWFAEM ®F'MIASSACHU* SETTS 84DO / (jV61,e4l,, oard of Health, �69:MO VN , MA. �} APPLICATION FOR DISPOSAL SYSTEM[ CONSTRUCTION PERMIT plication for a Permit to Construct( ) Repairk) Upgrade( ) Abandon() -\;411_' omplete System ❑ Individual Components Location o l% Owner's Name ap/Parcel# 3 / %7 Address Lot# '(APe Cob %,p-neSdCs Telephone# Installer's Name Designer's Name Address w GO Address/7 Telephone# S o 7 - 2g Telephone# p�P•- 3d�J - - 3 y�� Type of Building s S' :a �� ®� %fr ��w eze Lot Size off ; .f a4 sq. ft. Dwelling - No. of Bedrooms 2 Garbage grinder ( ) Other -Type of Building No. of persons Showers ( ) , Cafeteria ( ) Other Fixtures Design Flow (min, required) 1 © gpd Calculated design flow 3 _,?g9 Design flow provided gpd Plan: Date Number of sheets % Revision Date Title 7,5F7 662 Z4� /sr Description of Soil(s) ,-IcKez�rco!g 9vrar� Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS �/'�C � a i � �i .+t/4 .'j y •�G i� r�� % �tc�5=O / L'�' e r c � S7�cv.�� .r�,� l�t� r�ii .�im� The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed �' y-- �� DateU) N j't. 1 F' �e.G' No. /��10��ONWEAI.114 j)L/'7_3% FEE OF M ASSAC14USETTS c �z � z7 � q Board of Health, �,�eJ.A0ta3-} CERTIFICATE Of COMPLIANCE Description of Work: ❑ Individual Componeni(s) (.Complete System 1r / The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired O, Upgraded ( ), Abandoned ( ) by: at�� //f V j C. has been install&?h*11Vco{dancA t1�the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 14 -, V"D dated Approved Design Flow (gpd) Installer r , Designer: L� llag`, Inspector: 1; i Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. / �Qe�9 c.6c-16-73 No. Li ('i I'f j) C �1 - C) �� U( ! Ci>9�COD C�C �51�� FEE COMIM ON ITR OF M ASSACRUSETTS ro\., 2¢�GQ1 Board of Health, \AA2Mr) krt"Ft , MA• DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair(;) Upgrade ( ) Abandon ( ) an individual sewage disposal system at c ... rte, i. /.. !., as described in the application for Disposal System Construction Permit No.iired Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. Form 1255 Rev. 5/96 A.M. Sulkin Co. Chadeslown, MA Date(? Board of Health l'-�,1 �J Y �/,�`,��ii i" � J-�1�� Y ,, / �✓�ri�/ � / -%o � ,G'�' � No.:BOHDC-15-4473 Commonwealth of Massachusetts Fee . sss.00 Board of Health, Yarmouth, MA APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERNIIT Application for a Permit to:Upgrade-Complete System Location: 38 HOLLY LN, SOUTH YARMOUTH, MA 02664 Owner: M[JRPHY JOHN W Map/Parcel#: 033.178 GIRARD KAREN E 6 F2ANKLIN DR TYNGSBORO,MA 01879 Phone: Septic System Instalier Designer CAPE COD SEPTIC BASS RIVER ENGINEERING 350 ROUTE 28 WEST YARMOUTH, MA P.O.BOX 1163 02673 EAST DENNIS,MA 02641 Phone: 508-385-3426 Type of Building:Dwelling Lot Size:8,276.00 Acres Dwelliog-Na of Bedrooms:2 Garbage Grinder: Other Type of Building: No.of persons: Showers: Other Fiatures: Plsn Date:08/OS/2014 Number of Sheets: 1 Cafeterie: TitIe:SIT"E PLAN 38 Revision Date:08/29/2014 Design Flow(mio.required):220 gpd Calculated desigu Oow:220 gpd Design flow provided:357 gpd DescripNoo of Soi1s:SEE PLAN Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluatioo:07/31/2014 , THOMAS MCLELLAN,P.E. DESCRIPT[ON OF REPAIRS OR ALTERATIONS:SEPTIC D[SPOSAL-REPAIR-PROPOSED 1500 GAL SEPTTC TANK, 1000 GAL , PUMP CHAMBER,DBOX,9 CULTEC C4 DRAIN PANELS W/OUT STONE:24'X 12'X 3" The undersignetl agtees to insfall the above described Individual Sewage Disposal System in accordance wkh fhe provisions of TITLE 6 and furfher aarees not to olace In ooerotlon untli a CertHicate of Comollance has heen Isaued W the 8oard of Fleakh. Signed Date Inspections Commonwealth of Massachusetts • Board of Health, Yarmouth, MA F� DISPOSAL SYSTEM CONSTRUCTION PERMIT 555.00 Permission is herby granted to; CAPE COD SEPTIC SERVICES, 350 ROUTE 28,WEST YARMOUTH, MA 02673 To perform:Upgrade an individual sewage disposal system. Owner: IviIJRPHY 70HN W GIRARD KAREN E 6 FRANKI,IN DR TYNGSBORQ MA 01879 Location:38 HOLLY LN,SOUTH YARMOUTH,MA 02664 Disposal System Construction Permit No.: BOHDC-154473,Dated:September 21,2015 Provided:Construction shall be completed wi[hin six months of the date of[his permit. All local condi[ions mus[be met. CONDITIONS: ��. 1. SEPTIC DISPOSAL-REPAIR-PROPOSED 1500 GAL SEPTIC TANK, 1000 GAL PUMP CHAMBER, DBOX, 9 CULTEC C4 DRAIN PANELS W/OUT STONE: 24'X 12'X 3" � 2. BOH TO INSPECT SOIL REMOVAL 3. ELECTRICAL PERMIT REQUIRED G� �' Bruce G. rph , MPH, R.S.,CHO/Amy L.von Hone, R.S., CHO , Health Direc[or/Assistant Health Director � ✓ The issuaoce of this permit shail not be construed as a guarantee t6at t6e system will funMion as designed. ' No.: SEPTIC soHDc-�a-o��2 Commonwealth of Massachusetts Fee � sss.00 Board of Health, Yarmouth, MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to:Upgrade-Complete System � Location: 38 HOLLY LN, SOUTH YARMOUTH, MA 02664 � f . Narqe: Map/Parcel#:033.178 i VI S LL AM TRS A d ss: IN BARBARA 38 HOLLY LN � � e: Septic System Installer \* ' � Name: NEIGHBORHOOD WASTE WATER SERVICES A�dIRBl1TE 28 WEST YARMOUTH, � MA 02673 Phone: 5087752820 Type of Building:Dwelling j Lot Size:0.20 sq.ft. Dwelling-No.of BMrooms:2 Garbage Grinder: Other Type of Buildiog: No.of persons: Showers: Cafeterie: Other Fiatures: Plao Dah:08/OS/2014 Number of Sheets: 1 Tit1e:SI1'E PLAN 38 HOLLY LANE Revision Date:08/29/2014 Desigo Flow(min.required):220 gpd Calculahd design 11ow:220 Desigo flow provided:357 gpd gpd Description otSoils:SEE PLAN Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation:07/31/2014 THOMAS MCLELLAN,PE DESCRIPTION OF REPAIRS OR ALTERATIONS: 1500 GAL SEPTIC TANK 1000 GAL PUMP CHAMBER DBOX 9 CULTEC C4 DRAIN PANELS W/OUT STONE: 24'X12'X3" 7he untlerai8ned agrees to insfall the above describetl Intlivitlual Sewage Disposal System in accordance wMh the provisio�n of TITLE 5 and fuRher aprees not W place in operotlon uMll a CertHieab of Complianee has been isauetl by the Board of Health. Signed Date Inspections � Commonwealth of Massachusetts �' Board of Health, Yarmouth, MA. F88 DISPOSAL SYSTEM CONSTRUCTION PERMIT sss.00 Pertnission is herby granted to;PAUL MARTIN Address: 350 ROUT'E 28 \ WEST YARMOUTH,MA 02673 ; To perfortn:Upgrade an individual sewage disposal system. r � � 11 Owner. VINES WILLIAM 7RS . ` VINES BARBARA j 38 HOLLY LN � SOUTH YARMOUTH,MA 02664-5217 i Location: 38 HOLLY LN,SOUTH YARMOUTH,MA 026 Disposal System Construction Permit No.: SEPTIC BO C 14011 ,Dat : September 02,2014 Provided:Construction shall be completed within s' �mon[hs of the is permit. All local condi[ions must be met. Conditions � Board ofHealth Agent to Inspect Soil emoy'al 1 S00 gal Septic Tank, 1000 gal Pump Ch ber, D ox, 9 Cultec C4 Drain Panels w/Stone:24'x 12'x 3" Bru G. urphy,MPH, R.S., CHO/Amy L.von Hone, R.S.,CHO Health Director/Assistant Health Director The issuance of this permit shall not be construed as a guarantee that the system will function as designed.