HomeMy WebLinkAboutApp-Permit-ComplianceNo. {trTTyC' 3'LJ { /�11�. ��' "� �L �""�-4 % FEE ��V
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COMMONWEALT14 Of MASSAC14USETTS
Board of Health, yA N&K0 i tyk, MA. 602 &ZI
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTI®N PERMIT
Application for a Permit to Construct( ) Repait Q() Upgrade( ) Abandon() - ElComplete System 0 individual Components
Location S?— t:�I- 820
Owner's Name -,�,U9L1 (p ((j
Map/Parcel#
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Address f7xcv<
Lot#
Installer's Name
e;i'-K^AIV E -P x,
Telephone# ',7 4 15`5 U7 Lf -
Designer's Name QAw A SPGAb<A Al
Address 1-5
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Address ,5' 3W-Vc L�rA-� co
Telephone#
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Telephone# pg 5 2 �S6
Type of Building 051 W N1f A L Lot Size 10t b OO sq. ft.
Dwelling - No. of Bedrooms (3) 2 EYuT ► A1C Garbage grinder ( )
Other - Type of Building
No. of persons Showers ( ), Cafeteria (
Other Fixtures
Design Flow (min. required) gpd Calculated design flow STr Design flow provided gpd
Plan: Date/. 0,2 Number of sheets Revision Date
Title ► �v��e r�(= PJ2uP05tD coNS41tuLT/uN 4iz- , L1P7%f1Cnk- OArD , 30, urAXIIL, h
Description of Soil(s) M L-5) F-tAJC -Cy�
Soil Evaluator Form No.
Name of Soil Evaluator
Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS SAS C-OAJS?3,r F- 4 31350 (P pl cnz"y-1 f'a2
C l/,l'tS u-( T17 3, S- —(QAAf OA,, S? rX AM,) 1, EIV -03
The unde ' e es to ins Vescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agre tonot oplace peration until a Certificate of Compliance has been issued by the Board of Health.
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Signed �ir� Dat l� f - 2 O �J
Inspections
No. 6014
IDC"w 1 ✓"`551 -7).a�"� FEE. 4 t�li�]- �
COMMONWEALTH OF MASSACHUSETT t
Board of Health, AaMOOTA
CERTIFICATE Of COMPLIANCE _ � r I �or�
Description of Work: ❑ Individual Component(s) ❑ Complete System 64 y ,
The undersigned hereby certify that the Sage Disposal System; Constructed), Repaired ( ), Upgraded ( ), Abandoned ( )
hy; �%Fi ✓iF % GL //'�/ir'I�', �.: e thiou A, 57PgAkMAO CONSIV-Ua7W
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at
has been
with
applicatimn No. 1�; -2 q - !l-
, dated
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of 310 CMR 15.00 (Title 5) and�thee app roved design plans/as-built plans relating to
Approved Design Flow5�(gpd)
Inspector:
Date: // r
The issuance of this permit shall not be construed as a guarantWthat the system will function as designed.
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FEE 0�
COMMONWEALTH Of MASSACHUSETTS -' 7® `a
Board of Health, 7A,9�M6Q1VV , MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct(. Repair( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system
at i^C%tf "% �1 �s h rte' /��� c� as described in the application for
Disposal System Construction Permit No. --�'�, dated//- 6 n7-.
Provided: Construction shall be completed withinree e s of the date of this p rmit. All local conditions must be met.
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Form 1255 Rev. 5/96 A.M. Sulkin Co. Charlestown, MA Date f � Board of Health ll C�
No.:BOHDC-15-5517
� 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: 32 SWIFT BROOK RD, SOUTH YARMOUTH, MA 02664 Owner:
GIORGIO JOHN B TRS
Map/Parcel#: 067.229 GIORGIO FAMILY TRUST
32 SWIFT BROOK RD
SOUTH YARMOUTH,MA 02664
Phone:
Septic System Installer Designer
DAN A.SPEAKMAN DAN A. SPEAKMAN CONSTRUCTION
15 SPEAK WAY HARWICH, MA 02645 15 SPEAK WAY
Phone: NORTH HARWICH,MA
5084325565 508-432-5565
Type of Building:Dwelling Lot Size: 10,019.00 Sq.Ft.
Dwelling-No.of Bedrooms:2 Garbage Grinder:
Other Type of Building: No.of persons: Showers:
Other Fia�tures:
Plan Date: 10/29/2015 Number of Sheets• 1 Cafeteria•
Tit1e:SITE PLAN OF PROPOSED CONSTRUCTION 32 SWIFT BROOK ROAD Revision Date:
_ Design Flow(min.required):220 gpd Calculated design flow:220 gpd Design flow provided:354.4 gpd
Description of Soi1s:SEE PLAN
Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation: 10/29/2015
� JUDITH GIOGIO,R.S.
DESCRIPTION OF REPAIRS OR ALTERATIONS:SEPTIC DISPOSAL-REPAIR-EXISTING 1000 GAL SEPTIC TANK,PROPOSED
DBOX,4-3050 INFILTRATOR iJIVITS W/STONE 3'SIDES, 1'ENDS
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�lace in ooeration until a Certificate of Comoliance has been issued bv the Board of Health.
Signed Date
Inspections
t
� Commonwealth of Massachusetts
;
Board of Health, Yarmouth, MA Fee
� DISPOSAL SYSTEM CONSTRUCTION PERMIT $55.00
Permission is herby granted to;
DAN A. SPEAKMAN CONSTRUCTION, 15 SPEAK WAY, HARWICH, MA 02645
To perform:Upgrade an individual sewage disposal system.
Owner: GIORGIO JOHN B TRS
GIORGIO FAMILY TRUST
32 SWIFT BROOK RD
SOUTH YARMOUTH,MA 02664
Location:32 SWIFT BROOK RD, SOUTH YARMOUTH,MA 02664
Disposal System Construction Permit No.: BOHDGIS-5517,Dated:November 06,2015
Provided:Construction shall be completed within six months of the date of this permit. All local conditions must be met.
CONDITIONS:
1. SEPTIC DISPOSAL-REPAIR-EXISTING 1000 GAL SEPTIC TANK, PROPOSED DBOX,4-3050
INFILTRATOR UNITS W/STONE 3'SIDES, 1'ENDS
2.ZONE II MAXIMUM 2 BEDROOMS
Bruce G. M phy,MPH, R.S., CHO/Am L.von Hone, R.S.,CHO
Heatth Director/Assistant Health Director
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.