HomeMy WebLinkAboutBOHDC-14-0039 PERMIT APPLICATIONFee
$55.00
Commonwealth of Massachusetts
Board of Health, Yarmouth, MA.
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to: Upgrade - Complete System
No.: BOHDC-14-0039
Location: 79 BERRY AVE, WEST YARMOUTH, MA 02673
Map/Parcel#:
Lot#:
Owner
Name:
STEVENS JAY
Address:
79 BERRY AVE WEST YARMOUTH, MA 02673
Phone:
Septic System Installer
Name:
CHASE & MERCHANT INC
Address:
P.O. BOX 5 DENNIS PORT, MA 02639
Phone:
5083982116
Type of Building: Dwelling Lot Size: 0.18 sq. ft.
Dwelling - No. of Bedrooms: 2 Garbage Grinder:
Other Type of Building: No. of persons: Showers: Cafeteria:
Other Fixtures:
Plan Date: 04/17/2014
Title:PROPOSED SEPTIC DESIGN 79 BERRY AVENUE Revision Date:
Number of Sheets: 1
Design Flow (min.required): 330 gpd Design flow provided: 351 gpdCalculated design flow: 330
gpd
Description of Soils:SEE PLAN
Soil Evaluator Form No.: Name of Soil Evaluator:
ROBIN WILCOX
Date of Evaluation: 04/17/2014
DESCRIPTION OF REPAIRS OR ALTERATIONS: 1500 GAL SEPTIC TANK
DBOX
4 HIGH CAPACITY INFILTRATORS W/ STONE 11'X36'X10"
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions
of TITLE 5 and further agrees not to place in operation until a Certificate of Compliance has been issued by the Board of Health.
Inspections
Signed Date