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Home My WebLink AboutApp-Permit-ComplianceNo. 6PQ1 C -i5;--&43 &Ll>l -16-0® 34/2 FEE COMMONWEALT14 Of M ASS C14USETTS AAI f Board o Health, rAAMOIM!# , MA. ('fAPPLICATION F®I, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Constructy,) Repair( ) Upgrade( ) Abandon() - M Complete System ❑ Individual Components U^, is c .t -7A Location Lot 6, Virginia Street. W.Y. Owner's Name Habitat For Humanity Map/Parcel# Portion of 36, parcels 65 & 66 Address 411 Main Street Yarmouth Port Lot# 6 Telephone# 508-362-3559 Installer's Name P�Jq COlJ AC?UP'S' INC. Designer's Name The BSC Group, Inc. Address P 0, 80)( 7751 EAs-i DeVivis 62J.,Y' Address 349 Route 28, Wesy Yarmouth Telephone# 6—be - 3es-Sc1 13 1 Telephone# 508-778-8919 Type of Building Residential Dwelling - No. of Bedrooms 3 Other - Type of Building Other Fixtures Design Flow (min. required) 330 gpd Calculated design flow _ Plan: Date 12-12-14 Number of sheets 1 Title Septic System Design Plan, Lot 6 Virginia Street, Lot Size 12,349 sq. ft. Garbage grinder Mne No. of persons Showers ( ), Cafeteria ( ) Design flow provided Revision Date West Yarmouth 340 gpd Description ofSoil(s) See Plan Soil Evaluator Form No. Name of Soil Evaluator Kieran Healy Date of Evaluation 10-8-14 DESCRIPTION OF REPAIRS OR ALTERATIONS Complete new 3 bedroom septic system The undersigned agrees to' the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to pl t e ation until a Certificate of Compliance has been issued by the Board of Health. Signed�T Date Inspections No. 80(4VC-15"( d` 3 � FEE 3 100aOD -51d 11;111 ®M[NI®N�I,TI� ®� SS HUSETTS d -- W e VED Board of Health,Y AEP QUT + , MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑ Complete System The undersigned hereby certify -that the Sewage Disposal System; ConstructeRepaired ( )> Upgraded ( ), Abandoned ( ) by: P" CONT ( 77)kS WC -0 at Lot 6, Virginia Street` has been installecYiffatc' rdanee wiffilthe pfovisions 9.E3.10 CMR 15.00 (Title 5) and th proved design plans/as-built plans relating to application No. /V �dBated �.1 ` �2% I S Approved Design Flow (gpd) Installer �l9mi� k—,!�'I cl)oWeu( Designer: &S C cwzo leo Inspector: Al Date: -The.issuance of this permit shall not be construed as a guar tee at the system will function as designed. No. 60 DC -1 -A• (` 3 p14.'r. / FEE O, 00 COMMONWEALT14 OF MASSACHUSETTS W41 V6D Board of Health, VtAMO 0111 , MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct Repair( ) Upgrade ( ) Abandon( ) an individual sewage disposal system at Lot 6 74 Vle6 INIA STX2OEW- as described in the application for Disposal System Construction Permit No., dated/ - J �10 Provided: Construction shall be completed within this -of the date of this peri All local conditions must be met. Form 1255 Rev. 5/96 A.M. Sulkin Co. Chadestown. MA Dat / Board of Health %' No.:BOHDC-IS-6143 � Commonwealth of Massachusetts Fee $o.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#: 036.66.7 411 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: 508-896-6601 5083855993 Type of Building:Dwelling Lot Size:6,970.00 Sq.Ft. Dwelling-No.of Bedrooms:3 Garbage Grinder: Other Type of Building: No.of persons: Showers: Other Fixtures: Plan Date: 12/21/2015 Number of Sheets: 1 Cafeteria: _ Tit1e:SITE&SEWAGE DISPOSAL SYSTEM PLAN LOT 6(7A)VIRGINIA Revision Date: STREET Design Flow(min.required):330 gpd Calculated design flow:330 gpd Design flow provided:336 gpd . Description of Soils:SEE PLAN Soil 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 PRECAST H-20 LEACH CHAMBERS W/STONE:30'X 9.83'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 nlace in ooeration until a Certificate of Comoliance has been issued bv the Board of Heakh. Signed Date Inspections Commonwealth of Massachusetts Board of Health, Yarmouth, MA Fee DISPOSAL SYSTEM CONSTRUCTION PERMIT $o.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 HIJMAI�IITY OF CAPE COD INC 411 ROUTE 6A SUITE 6 YARMOUTH PORT,MA 02675 Location:7A VIRGINIA ST, WEST YARMOUTH;MA 02673 Disposal System Construction Permit No.: BOHDC-15-6143,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 PRECAST H-20 LEACH CHAMBERS W/STONE:30'X 9.83'X 2' 2. BOH TO INSPECT SOIL REMOVAL � � Bruce G. Mu y, PH, R.S., CHO/Amy L.von Hone, R.S.,CHO ealth 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 $o.00 Description of Work:Complete System The undersigned hereby certify that the Sewage Disposal System; New Construction by:PKM CONTRACTORS,INC. at: 7A 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-15-6143,dated Ol/04/2016. Installer:PKM CONTRACTORS,INC. Address:P.O.BOX 175 EAST DENNIS,MA 02641 Inspector: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 PRECAST H-20 LEACH CHAMBERS W/STONE: 30'X 9.83'X 2' 2.BOH TO INSPECT SOIL REMOVAL G� Bruce G. M hy, 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. BO H_Disposal_Construction_CofC.rpt