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Home My WebLink AboutApp-Permit-Compliance6Q)TR —I (a —00 3�4 t FEE F HQI 00 f ia -/1)/�� rOM[M ONT ITTII ®1C MACCArIIUS�TTS cel �� fBoard o Health, d , MA. t. r APPLICATION FOR DISPOSAL SYSTEM[ CONSTRUCTION PERMIT x Aplication fora Permit to C nstruct(g) Repair( ) Upgrade( ) Abandon( - CA Complete System O Individual Components -7$ Location Lot 3, Virginia Street Owner's Name Habitat for Humanity Map/Parcel# Map 36, Portions of lot 65 & 66 Address 411 Main Street, Yarmouth Port Lot# 3 Telephone# 508-362-3559 Installer's Name Pco -. Designer's Name The BSC Group, Inc. Address pro ► 60K 7,7 (E,, DC � d� � Address 349 Rt 28, West Yarmouth, MA Telephone# �.. g Telephone# 508-778-8919 Type of Building Residential Dwelling - No. of Bedrooms Three ( 3 Other - Type of Building Other Fixtures Lot Size 9313 sq. ft. Garbage grinder (Npne No. of persons Showers ( ), Cafeteria ( ) Design Flow (min. required) 330 gpd Calculated design flow Design flow provided 343 gpd Plan: Date 12-12-2014 Number of sheets 1 Revision Date Title Septic System Design Plan, Lot 3, Virginia Street, West Yarmouth, MA Description of Soil (s) See Plan Soil Evaluator Form No. Name of Soil Evaluator Kieran Healy Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS Install Complete new septic system 10-8-2014 The undersigned agrees to ' the above de 'bed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and furthers to not to pl o tion until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections 5— co-� 1150 / — No. 011K3," 1 l a (1..14(0 A� fiE <P #0 ®d � COMMONWEALTH Of MASSACHUSETTS Board of Health, Y&eJ 1QVTI+ , MA. CERTIFICATE OF COMPLIANCE Description of Work: 0 Individual Component(s) KI Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded ( ), Abandoned ( ) by: Co PJ C at Lot 3, Vir ina Street, West Yarmouth NotJS # 713 has been installed m acc r nce ith Ac/pflLons of 31 .CMR 15.00 (Title 5) and t e approved design plans/as-built plans relating to application No. f � * / , dated of Design Flow (gpd) Installer T Trz-lcy, V- - sk(--Jou a� /I i ,�1 Designer: V,:;G 6V4) 1 P Inspector:r Vf.al("L Date: The issuance of this permit shall not be construed as a guarant Athat the system will function as designed.. _. a•.; �: C._ t.; �: t' -on, o{ ,ccr QC. .-_t=.0 No. eo4k-yC.-iS"(Aq(a FEE COMMON LTH OF MASSACHUSETTS Board of Health, OVA DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct(,,<Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at Lot 3, Virgina Street, West Yarmouth, MA (W0%)5E*!'D as described in the application for Disposal System Construction Permit No. X7 , dated /2— l�vlf�C'` Provided: Construction shall be completed within �r o !� the date of this permit. All local condito , s must be met. PC-' Form 1255 Rev. 5/96 A.M. Sulkin Co. Chadestown, MA Date O �- %� 7 1 \tsoard of ealth 4- No.:BOHDC-15-6146 Commonwealth of Massachusetts Fee . $110.00 Board of Health, Yarmouth, MA APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to:New Construction-Complete System Location: 7 VIRGINIA ST,WEST YARMOUTH, MA 02673 Owner: HABITAT FOR HUMAIVITY OF CAPE COD INC Map/Parcel#: 036.66.3 411 ROUTE 6A SUITE 6 YARMOUTH PORT,MA 02675 Phone: Septic System Installer Designer PKM CONTRACTORS, JM O'REILLY&ASSOCIATES INC. P.O. BOX 175 EAST DENNIS, MA P.O.BOX 1773 02641 BREWSTER,MA 02631 Phone: 5083855993 508-896-6601 Type of Building:Dwelling Lot Size:7,405.00 Sq.Ft. Dwelling-No.of Bedrooms:3 Garbage Grinder: Other Type of Building: No.of persoos: Showers: Ot6er Fixtures: Plan Date: 12/21/2015 Number of Sheets• 1 � Cafeteria: Tit1e:SITE&SEWAGE DISPOSAL SYSTEM DESIGN LOT 3(7D)VIRGINIA Revision Date: STREET . : Design Flow(min.required):330 gpd Calculated design flow:330 gpd Design flow provided:338 gpd ' Description of Soi1s:SEE PLAN � Soii Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation: 10/08/2014 • KIERAN HEALY,P.L.S. DESCRIPTION OF REPAIRS OR ALTERATIONS:SEPTIC DISPOSAL-NEW-PROPOSED 1500 GAL PLASTIC SEPTIC TANK,H-20 DBOX,3-500 GAL H-20 PRECAST CHANBERS W/STONE:36'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 $110.00 Permission is herby granted to; PKM CONTRACTORS, INC., P.O. BOX 175, EAST DENNIS, MA 02641 To perform:New Construction an individual sewage disposal system. Owner: HABITAT FOR HUMA1vITY OF CAPE COD INC 411 ROUT'E 6A SUITE 6 YARMOUTH PORT,MA 02675 Location:7D VIRGINIA ST,WEST YARMOUTH,MA 02673 Disposal System Construction Permit No.: BOHDC-15-6146,Dated:December 23,2015 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-PROPOSED 1500 GAL PLASTIC SEPTIC TANK, H-20 DBOX,3-500 GAL H-20 PRECAST CHAMBERS W/STONE:36'X 7.83'X 2' 2. BOH TO INSPECT SOIL REMOVAL V �.�'"/ G `�� Bruce G. Murp , MPH, R.S., CHO/Amy L.von Hone, R.S.,CHO alth Director/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 Fee CERTIFICATE OF COMPLIANCE s��o.00 Description of Work:Complete System The undersigned hereby certify that the Sewage Disposal System; New Construction by:PKM CONTRACTORS,INC. at:7D VIRGINIA ST,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-15-6146,dated Ol/04/2016. Installer:PKM CONTRACTORS,INC. Address:P.O.BOX 175 EAST DENNIS,MA 02641 Inspectar:AMY VON HONE,R.S. Designer:JM O'REILLY&ASSOCIATES INC. Conditions 1.SEPTIC DISPOSAL-NEW-PROPOSED 1500 GAL PLASTIC SEPTIC TANK,H-20 DBOX,3- 500 GAL H-20 PRECAST CHAMBERS W/STONE:36'X 7.83'X 2' 2.BOH TO INSPECT SOIL REMOVAL U� Bruce G. Murp , H, 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. BO H_Disposal_Construction_CofC.rpt i I