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Home My WebLink AboutApp-Permit-ComplianceNo. U Y C -K--07 f -� /Y/V C j'1 N" % J ©V �.� % FEE COMMONWEALTH Of MASSACHUSETTS Board of Health, Y 19g-i�1 MA. APPLICATION FOR DISPOSAL SYSTEM[ CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgrad�d Abandon() - omplete System ❑ Individual Components Location a y v,A%eN Owner's Name2Wb j o i e c, Map/Parcel# /00 Address Lot# ` Telephone# Installer's Names G,s N Designer's Name AddressL Address 1 Zo W44 Telephone# 5 Telephone# SPE3 -q27 _ S� 313 Type of Building { eS <<� e,3 tC. 1 Lot Size /2,��_ sq. ft. Dwelling - No. of Bedrooms 1-( Garbage grinder ( ) Other -Type of Building No. of persons Showers ( ), Cafeteria ( ) Other Fixtures A Design Flow (min. required) N 4 a gpd Calculated design flow 4 SS''i. ° f Design flow provided 4_51 , pd Plan: Date /D % 1=0 Biu Number of sheets 1r2— Revision Date Title Description of Soil (s) _ Soil Evaluator Form No. Name of Soil Evaluator DESCRIPTION OF REPAIRS OR ALTERATIONS (mr, Ire, Date of Evaluation The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further ees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signe �''�— Date Ziv ht- Inspections •.r ^-cam... -.:.. � ,-. -.�._.,-.. .:.;'r r..r. :, ..: -:_ . -._ .. .. ,. �-t....._ ^..¢ �.: .. . ac -u- �..,.... ,_ ._ .:_r.._. -..n. �+,t�: _ .�_ -�;• _�... .. ._. .. _ _-... _- ...... - :. No.90 ID C -144 -71 (0 %r®MM®NI,TII OF MSSC1IUSETTS Board of Health,OUT74 , MA. CERTIFICATE Of COMPLIANCE `Description of Work: ❑ Individual Component(s) ''' E(Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired (''), Upgraded ( ), Abandoned O by:riuGS 1`'i 4ow �J (y C at r ` has been installed inn�acco dal ce with the rovis'ons f�j�10 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. �' P ,dated % ��T Approved Desigig Flow `/ Installer ca A 1- & C i �Cy f-fM Designer: n,.. r. w s 7 W n L( c< InDate: Inspector: - The issuance of this permitshall not be construed`as a guaran ee that the system will fdncfion as designed. F " [�ii�:' R" No. QN "I� �I Ij rr FEES ti 1 \� ! _ COMMONWEAET14 Of MASSA, HUSETTS' ch X3-70� > : Board of Health, y1O MA. I�I��S�E S�YS��EM`�®NS�U�TI®NPER�IIT Permission is hereby granted to; Cstruct( �';_ Repair(;LTpgrade( ) Abandon (—) anindivdual sewage disposal system at 1 Y�u� trdC �' ^�; v ` � as desc -bed in the application for Disposal' ystem Construcuoxt P.erinit No. ,mac ted UL, U7/b Provided: Ogstructi shall be C rn ete with r1• -t rs Qf the date of this permit. l local conditions ust be meta �' p ,v � �� p Form 1255 Rev. 5/96 A.M.8066 C Chadestown MA D*R e'' '" . / oard of Health �i No.: BOHDC-14-0716 Commonwealth of Massachusetts F� sss.00 Board of Health, Yarmouth, MA APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Applicatioo For a Permit to:Upgrade-Complete System Location: 21 PUTTING GREEN CIR, SOUTH YARMOUTH, MA 02664 Owner: Map/Parcel#: 100.102 BABINEAU CAROL ANN TR CAROL ANN BABINEAU TRUST 21 PUTTING GREEN CIR Phone: SepHc System Installer Designer DOUGLAS A.BROWN ENGINEERING WORKS,INC. P.O. BOX 145 CENTERVILLE, MA 12 WEST CROSSFIELD ROAD 02632 FORESTDALE,MA 02644 Phone: (5081477-5313 Type of Building:Dwelling . Lot Size:0.28 Acres Dwelling-No.of Bedrooms:4 Garbage Grinder. � OtherType of Building: No.of persons: Showers: Other Fixtures: Plan Date: ]0/20/2014 Number of Sheets:2 Cafeteria: TitIe:PROPOSED SEPTIC SYSTEM UPGRADE PLAN 21 PUTTING GREEN Revision Dah: CIRCLE Design Flow(min.required):440 gpd Calculated design flow:440 gpd Design flow provided:454.4 gpd Descripfion of Soi1s:SEE PLAN Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evaluation:08/20/2014 PETER MCENTEE,PE DESCRIPTION OF REPAIRS OR ALTERATIONS:REPAIR- I500 GAL SEPT[C TANK,DBOX,3-500 GAL PRECAST CHAMBERS W/STONE IN"L"CONFIGIJRATION ' The undersigned agrees to install the above describetl Intlivitlual Sewage Disposal System in accordance wRh the provislons of TITLE 6 and further aarees not to olace in ooention until a Certfficafe of Comoliance has heen Issued hv the Board of Neakh. Signed Date Inspections ' Commonwealth of Massachusetts Board of Health, Yarmouth, MA F� ; DISPOSAL SYSTEM CONSTRUCTION PERMIT 555.00 Permission is herby granted to; I DOUGLAS A. BROWN INC., P.O. BOX 145, CENTERVILLE, MA 02632 iTo perform:Upgrade an individual sewage disposal system. Owner. BABINEAU CAROL ANN TR � � CAROL ANN BABINEAU TRUST 2l PUTTING GREEN CIR SO YARMOUTH,MA 02664 Location:21 PUTTING GREEN CIR, SOUTH YARMOUTH,MA 02664 Disposal System Construction Permit No.: BOHDC-14-0716,Dated:December 16,2014 � Provided: Construction shall be wmpleted within six months of the date of this permit. All bcal conditions must be met. Conditions 1. REPAIR-I500 GAL SEPTIC TANK, DBOX, 3-500 GAL PRECAST CHAMBERS W/STONE IN"L" CONFIGURATION 2. ZONE li MAXIM(JM 4 BEDROOM i � 3. MFC VAR/ANCES 1. SETBACKS 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.