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No.:BOHDC-15-1131
• Commonwealth of Massachusetts Fee
555.00
Board of Health, Yarmouth, MA
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERNIIT
Application for a Permit to:Upgrade-Complete System
Location: 53 COLBURNE PATH,WEST YARMOUTH, MA 02673 Owner:
NIXON AI�INIE F TR
Map/Parcel#: 076.67 THE 2010 ANNIE F NIXON REV 1RUST
61 MAPLE ST UT]IT K
CANTON,MA 02021
Phone:
Septic System Installer Designer
CHASE&MERCHANT SWEETSER ENGINEERING
P.O. BOX 5 DENNISPORT, MA 02639 P.O.BOX 713
Phone: SOUTH DENNIS,MA 02660
(5081385-6900
Type of Building:Dwelling Lot Size:021 Acres
Dwelling-No.of Bedrooms:3 Garbage Grinder:
Other Type of Building: No.otpersons: Showers:
Other Fixtures:
Plsn Date: 12/13/2014 Number of Sheeta: 1 Cafeteria:
Tit1e:PROPOSED SEPTIC DESIGN 53 COLBURNE PATH Revision Date:
Design Flow(min.required):330 gpd Calculated desigo flow:330 gpd Design flow provided:351 gpd
Descriptioo of SoiIs:SEE PLAN
Soil Evaluator Form No.: Name of Soil Evaluator. Date of Evaluation: 12/10/2014
ROBIN WILCOX,PLS
DESCRIPTION OF REPAIRS OR ALTERATIONS:REPAIR- I500 GAL SEPTIC TANK,DBOX,4 HIGH CAPACITY INFILTRATORS
W/STONE:36'X 11'X 10" .
� The unde�signed agreea to Install the above described Individual Sewage Diaposal System In accordance wi[h the provisions of
TITLE 5 and futther aareea not to olate in ooeretlon untll a Certificate of Comolianee has 6een Issued 6v the Bosrd of Heakh.
Signed Date
Inspections
Commonwealth of Massachusetts
Board of Health, Yarmouth, MA FeB
DISPOSAL SYSTEM CONSTRUCTION PERMIT s�•oo
Permission is herby granted to;
CHASE&MERCHANT INC., P.O. BOX 5, DENNISPORT, MA 02639
To perform:Upgrade an individual sewage disposal system.
Owner: NIXON A1VHIE F TR
THE 2010 ANNIE F NIXON REV TRUST
61 MAPLE ST UMT K
CANTON,MA 02021
Location:53 COLBURNE PATH, WEST YARMOUTH,MA 02673
Disposal System Construction Permit No.: BOHDGIS-1131 ,Dated: February 23,2015
Provided: ConsWction shall be completed within six months of the date of this peani[. All local conditions must be met.
Couditions
1. REPAIR-I500 GAL SEPTIC TANK, DBOX, 4 HIGH CAPACITY INFILTRATORS W/STONE: 36'X
ll'X 10"
2. ZONE II M�IXIMLIM 3 BEDROOMS
3. MFC VARIANCES: 1.NO RESERVE AREA 2.SETBACKS
�
Bruce G. M h ,MPH, R.S., CHO/Amy L.von Hone, R.S., CHO
Health Director/Assistant Health Diredor
The issuance of this permit shall not be construed as a guarantee t6at the system will funMion as designed.