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Home My WebLink AboutApp-Permit-Complianceo. Qtp. �. V J.� 4 � � � e l�Si��' � t--1 l� FEE 10 _Iq 76 COMMONWEALTH OF MASSACHUSETTS ` cs k Board of Health, YaR !nn oTu , MA. ?: APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT �Npication for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) - ❑ Complete System ❑ Individual Components Location 0 (d.. dig Owner's Name Map/Parcel# % , °� Address Lot# Telephone# LW 3&V Z 7- Installer's Name t I Nc! Designer's Name Address E?1 Cin (Z•D Utjrt- 14AS 446 0264 q Address Telephone# M8 -4 -r7 -()j'7-7 Telephone# , Type of Building Dwelling - No. of Bedrooms Other - Type of Building Other Fixtures Lot Size sq. ft. Garbage grinder ( ) No. of persons Showers ( ), Cafeteria ( ) Design Flow (min. required) /ZU gpd Calculated design flow � Plan: Date Number of sheets Title Description of Soil(s) Design flow provided (na 7— gpd Revision Date Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation The undersigned ` further agrees to ej Signed Inspections to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and place the Agem in operation until a Certificate o Compliance has been issued by the Board of Health. �_ Date 15� L7- boy( No. �i¢�C"1 A FEE'." Of MASSACHUSETTS -a f�7 � COMMONWEALTH BI.DF/1-oo59017 aDmour y? 1 Board of Health, %A+10t}"t-B AIA. f ?l140;'1 �V� , jt (App CERTIFICATE OF COMPLIANCE li " ..), - . f ; Description of Work: ZFindividual Component(s) ❑ Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded;(. -r, Abandoned ( ) by: fSo a5 G:x 6AVwnNcv- !t,)C , at S 0% -ID � l IM91 i 1'S 9'D ° has been installoedri'�a cJ�orcance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. Zr� P � dated ! Approved Design FlowiR- pd) Installer A A ��u � [cR 1°-° ` fif .�' �. = c st' Date: - Designer: 7,�k'�G �� r�d�-%�-�'` � . �%' - Inspector: •� , , ,�—� The issuance of this permit shall not be construed as a guarana that the system will function as designed ^C.)OJG�000OOCDOOCO(`.,-�C UUP �.. L^JCp OGOJ. „IiSU(CI C.; V'':C Oma., ."'U �. i. .'J(.:JQ•"'O ..�., i OC�CCfi'JGCOC�:, �:.)u00�JrJUut :;: :'J �C No. 6OWD , - � �.. sq,3 y � �- 7f �il .%% t� _ . FEE S. �. COMMONWEALTH00 Of MASSA HUSETTS Board of Health, VA V -M© 024 , IWA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) RepairkUpgrade') Abandon ( ) an individual sewage disposal system at 01,-D gyflcok5 9-V , as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed wttl& tbx=-vaears_of the date of this permit. l local conditions must be met. Form 1,,255 Rev. 5/96 A.M. Sulkin Co. Charlestown. MA Date. -/f--2 7-/> r/> �Board of Health No.: BOHDC-15-1843 � Commonwealth of Massachusetts Fee 555.00 Board of Health, Yarmouth, MA APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to: Upgrade-Individual Component(s) Locallon: 8 OLD HYANNIS RD, YARMOUTH PORT, MA 02675 Owner: DAIGNEAULT TANYA Map/Parcel#: 104.9.3 8 OLD HYANNIS RD YARMOUTH PORT,MA 02675 Phone: Septic System Installer Designer RON'S EXCAVATING T.DAIGNEAULT,R.S. 81 ECHO ROAD-UNIT 1 MASHPEE, 8 OLD HYANNIS ROAD MA 02649 YARMOUTHPORT,MA 02675 Phone: (5081360-2259 Type of Building:Dwelling Lot Size: 122,839.20 Acces Dwelliug-No.of Bedrooms: 1 Garbage Grinder: Other Type of Building:MAIN HOUSE=4 BEDROOM No.of persons: Showers: ASSECCORY l7NIT=1 BEDROOM Other Fixtures: Plan Date:08/26/2001 Number of Sheets: 1 Cafeteria: TitIe:PROPOSED SEPTIC DESIGN LOT 9 OLD HYANNIS ROAD,YPORT Revision Date:07/21/2014 Design Flow(miarequired): l l0 gpd Calculated design Flow: 110 gpd Design flow provided:660 gpd � Description of Soi1s:SEE PLAN Soil Evaluator Form No.: Name of Soil Evaluator. Date of Evaluation:Ot/25/1999 TANYA DAIGNEAULT,R.S. DESCRiPTION OF REPAIRS OR ALTERATIONS:MINOR UPGRADE-PROPOSED 1500 GAL SEPTIC TANK/PUMP CHAMBER COMBO INTO EXISTING MAIN HOUSE SYSTEM Q500 GAL SEPTIC TANK,DBOX,6-500 GAL PRECAST CIIAMBERS W/STONE = 55'X 12.83'X 2')FOR 1 BEDROOM ACCESSORY DWELLING The undersigned agrees to insfall the above described Individual Sewage Disposal System in accordance with the provisions of TITLE b antl further aareea not to olace in ocention until a Certifitate of Comoliance has been issued hv the Board of Heakh. Signed Date Inspections • Commonwealth of Massachusetts Board of Health, Yarmouth, l�l�y Fee DISPOSAL SYSTEM CONSTRUCTION PERMIT $55.00 Permission is herby granted to; RON'S EXCAVATING INC., 81 ECHO ROAD-UNIT 1, MASHPEE, MA 02649 To perform: Upgrade an individual sewage disposal system. Owner: DAIGNEAULT TANYA 8 OLD HYANNIS RD YARMOUTA PORT,MA 02675 Location: 8 OLD HYANNIS RD,YARMOUTH PORT,MA 02675 Disposal System Construction Permit No.: BOHDC-15-1843,Dated:Apri127,2015 Provided: Construction shall be completed wi[hin six months of the date of this permit. All local conditions must be met. Conditions 1. MINOR UPGRADE-PROPOSED 1500 GAL SEPTIC TANK/PUMP CHAMBER COMBO INTO EXISTING MAIN HOUSE SYSTEM(1 S00 GAL SEPTlC TANK, DBOX, 6-500 GAL PRECAST CHAMBERS W/STONE SYX 12.83'X2)FOR 1 BEDROOMACCESSORYDWELLING 2. ELECTRICAL PERMIT REQUIRED 3. PUMP CHAMBER TO BE WATERTESTED 4. ZONE II M�LYIMUM 12 BEDROOMS PER LOT SIZE-SEPTIC SYSTEMSIZED FOR M�LYIMUM6 BEDROOMS . Bruce G. M h , MPH, R.S., CHO/Amy L. von Hone, R.S.,CHO Health Director/Assistant Health Director . The issuance of this permit shall not be canstrued as a guarantee that the system will Function as designed.