HomeMy WebLinkAboutApp-Permit-ComplianceNo. 604.DC-1(o'71 3 FEE k'Z;'1C0
lb- 60 COMMONWEALTH LTH ®F MASSACHUSETTS Ck,-46,3 �
Board of Health, YA2-.moo- 4 , MA•
APPLICATION FOR DISPOSAL SYSTLI CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade ) Abandon( - ❑ Complete SystemJdindividual Components
Location 5o Pawew-sLane,
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Owner's Name JY
n t Me )ari 1 e Ts n
Map/Parcel# 1
42-& I3
Address
Cl o and llir JJE04)14
Lot#
Telephone#
5-00 . 30• Q-'Iq(9
Installer's Name J
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Designer's Name
m 0 /ge/ JI
Address f boy'
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No.:BOHDGI6-7839
r Commonwealth of Massachusetts Fee
$55.00
Board of Health, Yarmouth, MA
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to:Upgrade-Individual Component(s)
Location: 50 POWERS LN,WEST YARMOUTH, MA 02673 Owner:
TSENG FRANKLIN
Map/Parcel#:015.14 TSENG MELANIE L
37 INDIAN MEMORIAL DR
SOUTH YARMOUTH,MA 02664
Phone:
Septic System Installer Designer
P.J.NYBERG INC. JM O'REILLY&ASSOCIATES INC.
P.O. BOX 2009 DENNIS, MA 02638 P.O.BOX 1773
Phone: BREWSTER,MA 02631
5083858832 508-896-6601
Type of Building:Dwelling Lot Size:8,712.00 Sq.Ft.
Dwelling-No.of Bedrooms:3 Garbage Grinder:
Other Type of Building: No.of persons: Showers:
Other Fixtures:
Plan Date:09/17/2015 Number of Sheets: 1 Cafeteria:
Tit1e:SITE&SEWAGE DISPOSAL SYSTEM PLAN 50 POWERS LANE Revision Date:
Design Flow(min.required):330 gpd Calculated design flow:330 gpd Design flow provided:373 gpd
Description of Soi1s:SEE PRIOR PLAN 03/26/1987
Soil Evaluator Form No.: Name of Soi►Evaluator: Date of Evaluation:
DESCRIPTION OF REPAIRS OR ALTERATIONS:SEPTIC DISPOSAL-MINOR REPAIR-PROPOSED 1500 GAL SEPTIC TANK AND
DBOX TO EXISTING 2 FLOWDIFFUSORS W/3'STONE TO ACCOMMODATE AN ADDITION(LIVING ROOM AND POOL ROOM)
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 6een issued bv the Board of Health.
Signed Date
Inspections
Commonwealth of Massachusetts
; ' Board of Health, Yarmouth, MA Fee
DISPOSAL SYSTEM CONSTRUCTION PERMIT $55.00
Permission is herby granted to;
P.J. NYBERG INC., P.O. BOX 2009, DENNIS, MA 02638
To perform:Upgrade an individual sewage disposal system.
Owner: TSENG FRANKLIN
TSENG MELANIE L
37 INDIAN MEMORIAL DR
SOUTH YARMOUTH,MA 02664
Location: 50 POWERS LN,WEST YARMOUTH,MA 02673
Disposal System Construction Permit No.: BOHDC-16-7839,Dated:January O5,2016
Provided:Construction shall be completed within six months of the date of this permit. All local conditions must be met.
CONDITIONS:
1 SEPTIC DISPOSAL-MINOR REPAIR-PROPOSED 1500 GAL SEPTIC TANK AND DBOX TO EXISTING 2
FLOWDIFFUSORS W/3'STONE TO ACCOMMODATE AN ADDITION(LIVING ROOM AND POOL ROOM)
2. PLUMBING PERMIT REQUIRED
�
Bru G. Murphy, 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.
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