HomeMy WebLinkAboutApp-Permit-ComplianceNo. J6a4-Dc-15 - 2.L483 8(-07P, -15 - o 0 (b3 o 9
COMMONWEALTH Of MASSACHUSETTS
Board of Health, Q1„ -,q , MA. �% 6y,
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APPLICATI®N FOR DISPOSAL SYSTEM[ CONSTRUCTI®N PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) - ❑ Complete System .WdIr vidual Components
Location 'g A M,c*Jb 616'
Owner's Name 5C qw A
Map/Parcel# S9/ 1 r7d
Address o's /{ "Out> Auc- Sr A3*Oun7(
Lot#
Telephone#
Installer's Name �p� GIJ 1 QlSCS WQ_
Designer's Name -,TQ, �� fzl1.� G TA.De„
Address 153 1\4A,5tWC*-
Address aloo54 Q&0±09N Httq G. WAWWWA
Telephone#
Telephone# 5 G - '73 ...
Type of Building RVS l D e�-Ir A'L, Lot Size 1 o' 'col sq. ft.
Dwelling - No. of Bedrooms Garbage grinder ( )
Other - Type of Building No. of persons Showers ( ), Cafeteria ( )
Other Fixtures
Design Flow (min. required) 330 gpd
Plan:
Title
Desc1
Soil I
Calculated design flow Design flow provided A73 gpd
Date of Evaluation G ” 3 acxS
DESCRIPTION OF REPAIRS ORALTERATIONS U}�-: C-XISTt 0Gt 1006 C-
44�J SCR1 L- ` << TO
NeW D-60( "iy (Al) ARC. �3j3fpbw-Fos�5 Cru A Fid C wi:-nE�ATtprJ
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 Date '� ��
No. �4� j..� �% FEE a
- Z
COMMONWEALTH Of M ASSACHUSETTS �
Vic7�.�oiSv �2
/ `'
Board of Health, yAjg^0UT14
CERTIFICATE OF COMPLIANCE
Description of Work: It Individual Component(s) ❑ Complete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded A-bandoned ( )
by. C VC-- }w� (vC �"A. &s L
at
has been installedm c_or a ce with the rovisions o 10 CMR 15.00 (Title 5) and thea proved design plans/as-built plans relating to
application No. � ` ' , dated / Approved Design Flow '37:5 (gpd)
Installer CApE Uj O r 0.LS L.L.C. cp pe1,
Designer: aC C-061 ASMI&6 I'QC. Inspector: �� '� Date:
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
r ....! :'•. rn ',i r -fir--. T,: Y. �s'OOno _)C):`JOC �u'.: c)U;J O::rC �..trl ; )."•.:(
No.6 ovVYcs 115 Z-'7,9FEE 4 5,
7 COMMONWEALTH Of MASSACHUSETTS
Board of Health, YA QVTA , MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is herebygranted to; Construct( ) Repair( ) Upgrad4- r� bandon( ) an individual sewage disposal system
at (2:8 RM l USD *015 as described in the application for
Disposal System Construction Permit No. �� �, dated / . --
lipaoff / 74
Provided: Construction shall be completed within the d to of this pertrtit l local con id s must be met.
Form 1255 Rev. 5/96 A.M. Sulkin Co. ChadeMown, MA Date / / �� Board of Health
No.: BOHDC-15-2483
Commonwealth of Massachusetts FeB �
$55.00
Board of Aealth, Yarmouth, MA
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to: Upgrade-Individual Component(s)
Location: 68 RAYMOND AVE, SOUTH YARMOUTH, MA 02664 Owner:
TAYLORSTEPHEN W
Map/Parcel#: 089.170 TAYI.OR CATfiERINE 1
68 RAYMOND AVE
SOUTH YARMOUTH,M.4 02664-1948
Phone:
Septic System Installer Designer
CAPEWIDE JC ENGINEERING,INC.
153 COMMERCIAL STREET 2854 CRANBERRY HIGHWAY
MASHPEE,MA 02649 EAST WAREHAM,MA 02538
Phone: 508-273-0377
Type of Building:Dwelling Lot Size: 1Q019.00 Acres
Dwelling-No.of Bedrooms:3 Garbage Grinder:
Other Type of Buiiding: No.of persons: Showers:
Other Fiatures:
Plan Date:06/15/2015 Number of Sheets: 1
Cafeteria:
Title:PROPOSED SEPTIC SYSTEM UPGRADE 68 RAYMOND AVEN[JE Revision Date:
Design Flow(min.required):330 gpd Calculated design Dow:330 gpd Design ilow provided:373 gpd
Description of Soi1s:SEE PLAN
Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation:06/03/2015
MICHAEL PIMENTAL,EIT
DESCRIPTION OF REPAIRS OR ALTERATIONS:REPAIR-EXISTING 1000 GAL SEPTIC TANK,DBOX,21 ARC 36 CHAMBERS
W/OUT STONE:35'X 8.6'X 7"
The undersignetl agrees to install the above tlescribed Individual Sewage Disposal5ystem in accordance wkh the provisions of '
TITLE 5 and further aarees not to olace in ooeration until a CerdFlcate of Comoliance has heen issued hv the Board of Heakh.
Signed Date
Inspections
�
Commonwealth of Massachusetts
Board of Health, Yarmouth, MA FeB
DISPOSAL SYSTEM CONSTRUCTION PERMIT E55.00
Permission is herby granted to;
CAPEWIDE ENTERPRISES, LLC, 153 COMMERCIAL STREET, MASHPEE, MA 02649
To perform:Upgrade an individual sewage disposal system.
Owner. TAYLOR STEP}IEN W
TAYLOR CATHERINE J
68 RAYMOND AVE
SOUTH YARMOUTH,MA 02664-1948
Location:68 RAYMOND AVE, SOUTH YARMOUTH,MA 02664
Disposal System Construction Permit No.: BOHDC-1S2483,Dated:July 07,2015
Provided:Construction shall be completed within six months of the date of this permit. All local wnditions must be met.
Conditions
1. REPAIR-EXISTING 1000 GAL SEPTIC TANK, DBOX, 21 ARC 36 CHAMBERS W/OUT STONE: 35'
X8.6'X7"
2. MFC VARIANCEAPPROVED: a. SETBACKS
�V�
Bruce G. urp ,MPH, R.S., CHO/Amy L.von Hone, R.S., CHO
Health Director f Assistant Health Director
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Commonwealth of Massachusetts
Board of Health, Yarmouth, MA F�
CERTIFICATE OF COMPLIANCE sss.oa
Description of Work: Individual Component(s)
The undersigned hereby certify that the Sewage Disposal System; Upgraded
by:CAPEWIDE ENTERPRISES,LLC
at:68 RAYMOND AVE,SOUTH YARMOUTH,MA 02664
Has been installed in accordance with the provisions of 310 CMR 15.00(Title 5)and the approved
design plans or as-built plans relating to application No.: BOHDC-IS-2483,dated 07/13/2015.
Installer.CAPEWIDE ENTERPRISES,LLC
Address:153 COMMERCIAL STREET MASHPEE,MA Inspector:AMY VON HONE,R.S.
02649
Designer:JC ENGINEERING,INC.
CondiHons
1.REPAIR-EXISTING 1000 GAL SEPTIC TANK,DBOX,21 ARC 36 CHAMBERS W/OUT
STONE:35'X 8.6' X 7"
2.MFC VARIANCE APPROVED:a.SETBACKS ! � // ,
C/L�c
Bruce G. M hy, PH, R.S., CHO/Amy L.von Hone, R.S.,CHO
Health Director/Assistant Health Director
The issuance oFt6is permit s6a11 not be coostrued as a guarantee that the system will funMion as designed.
BOH_Disposal_Construction_CofC.rpt