HomeMy WebLinkAboutApp-Permit-ComplianceNo. ' el-I5-4pd31 I '002)2 FEE �
6�Y' 1141
COMMONWEALT14 Of M ASSAC14USETTS
�' (f Board of Health, Yho 01A , MA.
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to ConstructVj Repair( ) Upgrade( ) Abandon() - '❑ Complete System ❑ Individual Components
Location
Owner's Name
Map/Parcel# 7�� Lo
Addressjo
Lot#
Telephone#
-,546 -
Installer's Name f
Designer's Name
BSC r
Address N
Address 314 9
P -+e2 k MC)
Telephone#4 , I
Telephone#
-7 b
Type of Building
Dwelling - No. of Bedroo
Other - Type of Building
No. of persons
Lot Size
sq. ft.
_ Garbage grinder( )
Showers ( ), Cafeteria ( )
Other Fixtures
Design Flow (min. �nd) gpd Calculated design flow Design flow provided gpd
Plan: Date & L f) Number of sheets Revision Date
Title
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation 1 "' Z `- I'
DESCRIPTION OF REPAIRS OR ALTERATIONS �J� 1600 q a,l H 1 O A C'e Q. C,> H 1 e key i31 R26
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agre n t to placeto operation until a Certificate of Com
Signed plifance has been issued by the Board of Health.
Date
Inspections
t
No. Vy 0 DC -15- (�0 031 . , FEE $ 5'5, DU
/ 7 -7 COMMONWEALTH OF MASSACHUSETTS
—44 316-7
Description of Work:
The undersiened het
by: )I
at
has been insta
Installer V/
Board`of iledUh; � N1 C� �-(}-; , MA.
c'ERhhcATE.0 tCOMPLIANCE
❑ Individual Compon�nt(s)-12--Complete'System
by certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgrad ), Abandoned ( )
./ i -. r /-� i. , ,,-%
Designer:
The issuance of—this_nernut_sh
No.
vgith thi�prov1srods of310CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
dated /Z /y Approved Design Flow (gpd)
Inspector:
Date: /'-1 S
Lot -be construedAka_* raWee_that the system will function as designed.,
+ t j ex 4-0 00 FEE
COMMONWEALTH Of MASSACHUSETTS c, 3l b7
Board of Health, MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construe Repair( ) UpgradelfAbandon( ) an individual sewage disposal system
at 3 6 �� a-C�-� as described in the application for
Disposal System Construction Permit No. 7?dated
Provided: Construction shall be complete/d wtthit%tet /wears o the dte of this permit/. �All`local
�conditions must be met.
Form 1255 Rev. 5/96 A.M. Sulkin Co. Charlestown, MA DatO' I—" / / �—Board of ealth
Id /5 ale, 1 (�Y%.> / x4 Y r,I /1 /,- /,, / ,1 I/��4,1/ 61,
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No.:BOHDGIS-6031
Commonwealth of Massachusetts Fee -
$55.00
Board of Health, Yarmouth, MA
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT `
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Application for a Permit to:New Construction-Complete System '
Location: 30 CREST CIR,WEST YARMOUTH, MA 02673 Owner: !
NAHILL KATHRYN M '
Map/Parcel#: 022.48 152 BROAD MEADOW RD
NEEDHAM,MA 02492 I
Phone:
Septic System Installer Designer
B&B EXCAVATION BSC GROUP,INC.
14 TEABERRY LANE FORESTDALE, 349 ROUTE 28,UNIT D
MA 02644 WEST YARMOUTH,MA 02673
Phone: 508-778-8919
7815401322
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Type of Building:Dwelling Lot Size: 10,890.00 Sq.Ft.
i
Dwelling-No.of Bedrooms:3 Garbage Grinder: i
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Other Type of Building: No.of persons: Showers:
Other Fixtures:
;
Plan Date:06/23/2015 Number of S6eets: 1 Cafeteria• „
Tit1e:SEPTIC SYSTEM DESIGN 30 CREST CIRCLE Revision Date:07/28/2015
Design Flow(min.required):330 gpd Calculated design flow:330 gpd Design flow provided:355 gpd
Description of Soils:SEE PLAN
Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation:04/21/2011
RONALD J.CADILLAC,RS
DESCRIPTION OF REPAIRS OR ALTERATIONS:SEPTIC DISPOSAL-NEW CONSTRUCTION-PROPOSED I500 GAL SEPTIC
TANK,DBOX,3-500 GAL PRECAST CHAMBERS W/STONE 3'ENDS,1.5'SIDES:38'X 7.83'X 2'
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 and further aarees not to olace in ooeration until a Certificate of Comoliance has been issued bv the Board of Health.
Signed Date
Inspections �
i
Commonwealth of Massachusetts '
Board of Health, Yarmouth, MA Fee
DISPOSAL SYSTEM CONSTRUCTION PERMIT $ss.00
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Permission is herby granted to;
B&B EXCAVATION, 14 TEABERRY LANE, FORESTDALE, MA 02644
r
To perform:New Construction an individual sewage disposal system. I
Owner: NAHILL KATHRYN M �
152 BROAD MEADOW RD
NEEDHAM,MA 02492
Location:30 CREST CIR,WEST YARMOUTH,MA 02673
Disposal System Construction Permit No.: BOHDC-15-6031 ,Dated:December Ol,2015
Provided: Construction shall be completed within six months of the date of this permit. All local conditions must be met.
CONDITIONS:
1. SEPTIC DISPOSAL-NEW CONSTRUCTION-PROPOSED 1500 GAL SEPTIC TANK, DBOX,3-500 GAL
PRECAST CHAMBERS W/STONE 3' ENDS, 1.5'SIDES: 38'X 7.83'X 2'
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2. BOH TO CONFIRM SOILS PRIOR TO INSTALLATION I,
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3. FOUNDATION VARIANCE APPROVED I
C1! �%( i
Bruce G. Murphy P , R.S., CHO/Amy L.von Hone, R.S.,CHO ;
H th Director/Assistant Health Director i
The issuance of this permit shall not be construed as a guarantee that the system will function as designed. ;
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Commonwealth of Massachusetts I
Board of Health, Yarmouth, MA Fee i
CERTIFICATE OF COMPLIANCE $55.00 (
Description of Work:Complete System
The undersigned hereby certify that the Sewage Disposal System; New Construction
by:B&B EXCAVATION
at:30 CREST CIR,WEST YARMOUTH,MA 02673
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-15-6031,dated 12/15/2015.
Installer:B&B EXCAVATION
Address:l4 TEABERRY LANE FORESTDALE,MA Inspector:AMY VON HONE,R.S.
02644
Designer:BSC GROUP,INC.
Conditions
1.SEPTIC DISPOSAL-NEW CONSTRUCTION-PROPOSED 1500 GAL SEPTIC TANK,DBOX,
3-500 GAL PRECAST CHAMBERS W/STONE 3' ENDS,1.5'SIDES:38'X 7.83'X 2'
2.BOH TO CONFIRM SOILS PRIOR TO INSTALLATION '
3.FOUNDATION VARIANCE APPROVED
Bruce G.,bCurp ,MPH, R.S.,CHO/Amy L.von Hone, R.S.,CHO '
�j Health Director/Assistant Health Director
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
BOH_Disposal_Construction_CofC.rpt
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