Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
App-Permit-Compliance
No. COMMONWEALTH Of MASSAC14USETTS FEE �c x-00 6?19,S� Board of Health, Y ij f 4 D org , AM. If APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgrade( bandon( ) - Complete System ❑ Individual Components Location Np Foo V Owner's Name Map/Parcel# 5 Address Q Na+ -v grooK Rey Lot# - Telephone# S of - c029 Installer's Name ��" �� c© � Designer's Name 'S�ekjz I I fA R S Address - 0 - 5 (��� Address b . 04aNN )� Telephone# O 52C Telephone# % Type of Building 1 Dwelling - No. of Bedrooms Other - Type of Building _ �� No. of persons Other Fixtures Design Flow (min. required) gpd Calculated design flow C� Plan: Date a( cf Number of sheets Title Description of Soil(s) P Soil Evaluator Form No. _ Lot Size sq. ft. Garbage grinder ( ) Showers ( ), Cafeteria ( ) Design flow provided �3z-;96 gpd Revision Date Name of Soil Evaluator AM -9 I/0A 0fJ'( Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS �` n i -kc -'Ll C pan n ci -s,N, or 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 pla a tem ation until a Certificate of Com fiance een issued by the Board of Health. d SigneLJj'Z . Date 1 Inspections No.. 60" (S"2 -'40(o �P FEE e"1� •QO COMMONWEALT14 OF MASSACHUSETTS tA &-,0-1s- -#00( 78 5 Board of Health, A -R- ' o tai , MA. CERTIFICATE Of COMPLIANCE Description of Work: 0 Individual Component(s) 0 Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired (Upgraded ( ), Abandoned ( ) by: r -r 2, , 6h{�.at Rt-ov K GP 'l -AR MOVIVA has been installed i �,cco�da c� witdth provisions of 31 Q CMR 15.00 (Title 5) and th proved design plans/as-built plans relating to application No. �:' '� dated -- / . Approved Design Flow (gpd) Installer f" fs2_( 5"1� 1 b' N 2 �Z_ 00 12- - /1 I --_ Designer: S'T' Vt:�- S Inspector: // 1` / Date: - r The issuance of this permit shall not be construed as a guara�nt�ee that the system will function as designed. i ,:C V'�.. 1': �:•.J(?-... 1. ti, .(.-1,;!:�'Ur'.L`LVG!...i':�1:-.il.tivC(C�•-J;71)C�c�:JOC::JUl7tiC)GC:cic`.:,JU:iOI)O•}CJ.•7 C�C:>OgfiC iO C'�'. �i.C: (: ,U.:O�IJ lu J:l J� �J-1U.U:)UJ:J`1.0_J._::.'J'7 Ji).n (J��n12n_C!')C::Q (_'. No. P76kk -Z l�(�� .UIJr tr 1 6o4 60. FEE COMMONWEAL114 OF MASSACHUSETTS CA4 00(078 Board of Health, ) ad M0Urr* , MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereblygranted to; Construct( ) Repair(perUpgrade( ) Abandon( ) an individual sewage disposal system at i 1 N ow I� MO/ Z U' as described in the application for ,Disposal System Construction Permit No. �� ~ , dated 6- Provided: Construction shall be completed within tof l e date of this permit, 1 local condi 'o must be met. I Form 1255 Rev. 5/96 A.M. Sulkin Co. Charlestown, MA Date G/ Y ! rr Boar of Health" - No.: BOHDC-15-2406 � Commonwealth of Massachusetts Fee $55.00 Board of Health, Yarmouth, MA APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to:Upgrade-Complete System Location: 8 SNOW BROOK RD,WEST YARMOUTH, MA 02673 Owner: WHITING ELIN E TR Map/Parcel#: 058.125 DTA REALTY TRUST 8 SNOW BROOK RD WEST YARMOUTH,MA 02673 Phone: Septic System Installer Designer ROBERT B.OUR STEPHEN HAAS,PE P.O. BOX 1539 HARWICH, MA 02643 P.O.BOX 16 Phone: SOUTH DENNIS,MA 02660 (5081362-8132 Type of Building:Dwelling Lot Size:8,712.00 Acres Dwelling-No.of Bedrooms:3 Garbage Grinder: Other Type of Building: No.of persons: Showers: Other Fixtures: Plan Date:OS/26/2015 Number of Sheets: 1 Cafeteria: Tit1e:SEPTIC SYSTEM DESIGN 8 SNOW BROOK ROAD Revision Date: Design Flow(min.required):330 gpd Calculated design flow:330 gpd Design flow provided:394 gpd Description of Soi1s:SEE PLAN Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation:OS/06/2015 STEPHEN HAAS,PE ' DESCRIPTION OF REPAIRS OR ALTERATIONS:REPAIR-PROPOSED 1500 GAL SEPTIC TANK,DBOX, 18 HIGH CAPACITY INFILTRATORS W/OUT STONE:37.5'X 8.5'X 11" 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 ulace in ooeration until a Certificate of Comoliance has 6een issued bv the Board of Neakh. Signed Date Inspections �. Commonwealth of Massachusetts Board of Health, Yarmouth, MA Fee DISPOSAL SYSTEM CONSTRUCTION PERMIT $55.00 Permission is herby granted to; ROBERT B. OUR COMPANY INC., P.O. BOX 1539, HARWICH, MA 02643 To perform:Upgrade an individual sewage disposal system. Owner: WHITING ELIN E TR DTA REALTY TRUST 8 SNOW BROOK RD WEST YARMOUTH,MA 02673 Location: 8 SNOW BROOK RD,WEST YARMOUTH,MA 02673 Disposal System Construction Permit No.: BOHDC-15-2406,Dated:June 12,2015 Provided: Construction shall be completed within six months of the date of this permit. All local conditions must be met. Conditions 1. REPAIR-PROPOSED I500 GAL SEPTIC TANK, DBOX, 18 HIGH CAPACITY INFILTRATORS W/OUT STONE: 37.5'X 8.5'X 11" 2. MFC VARIANCE: 1. FOUNDATION SETBACK Bruce G. M hy,MP , R.S., CHO/Amy L.von Hone, R.S., CHO Health Director/Assistant Health Director The issuance of this permit shali not be construed as a guarantee that the system will function as designed. � , Commonwealth of Massachusetts Board of Health, Yarmouth, MA Fee CERTIFICATE OF COMPLIANCE sss.00 Description of Work:Complete System The undersigned hereby certify that the Sewage Disposal System; Upgraded ' by:ROBERT B.OUR COMPANY INC. at: 8 SNOW BROOK RD,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.: BOHDGIS-2406,dated 06/26/2015. ; Installer:ROBERT B. OUR COMPANY INC. Address:P.O.BOX 1539 HARWICH,MA 02643 Inspector:AMY VON HONE,R.S. Designer: STEPHEN HAAS,PE Conditions 1.REPAIR-PROPOSED 1500 GAL SEPTIC TANK,DBOX, 18 HIGH CAPACITY INFILTRATORS W/OUT STONE:37.5'X 8.5'X 11° 2.MFC VARIANCE: 1.FOUNDATION SETBACK (� Bruce G. Mu y, PH, 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 guarant e that the system will function as designed. BOH_Disposal_Construction_CofC.rpt , !