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No.:BOHDC-14-0041
. Commonwealth of Massachusetts F�
555.00
Board of Health, Yarmouth, MA.
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to:Upgrade-
, Locafion:43 SUMMER ST,YARMOUTH PORT, MA 02675 Owner
Map/ParceUl: 11321 � Name: I
MARTIN, HELEN ��
Address:
34 GOLFERS CIRCLE SOUTH YARMOUTH, MA
02664
Phone: �
Septic System Installer i
Name:
ELIIS BROTHERS CONSTRUCTION
Address:
P.O. BOX 59 YARMOUTHPORT, MA ,
02675
Phone:
5083626237
Type of Building:Dwelling Lot Size:0.28 sq.ft. �
DwelGog-No.of Bedrooms:3 Garbage Grinder: '�.
i
Other Type of Building:Main House(2 Bedrooms) No.of persons: Showers: Gfeteria: '
Cottage Q Bedroom) '
I
Other Fixtures:
Plao Date:06/27/2014 Number of Shcets: 1
Tit1e:PROPOSED SEPTIC DESIGN 43-45 SUMMER STREET Revision Date:
Desigo Flow(min.required):330 gpd Calculated design ilow:330 Design Flow provided:351 gpd
gpd
Descriptioo of Soi1s:SEE PLAN
Soil Evaluator Form No.: Name of Soil Evaluator: Date of Evsluation:06/26/2014 ��.
ROBIN WILCOX,PLS '��
DESCRIPTION OF REPAIRS OR ALTERAT[ONS:2000 GAL TWO COMPARTMENT SEPTIC TANK
DBOX �
4 HIGH CAPACITY INF[LTRATORS W/STONE: '
� 36'X ll'X 10"
The undersipned agrees to insfall the above described Individual 8ewage Disposal System in accordance wkh the provisions
M TITLE 5 and further apreas nM W place in operatlon untll a Certifieate of Comnliance has been Issued by the Boartl W Heallh.
Signed Date
Inspections I
I
� Commonwealth of Massachusetts ;
� Board of Health, Yarmouth, MA. Fee
DISPOSAL SYSTEM CONSTRUCTION PERMIT $55.00
Permission is herby granted to;REID C.ELLIS Address:P.O.BOX 59
YARMOUTHPORT,MA 02675
To perform:Upgrade an individual sewage disposal system.
Owner: MARTTN,fiELEN �'�
34 GOLFERS CIRCLE
SOUTH YARMOUTH,MA 02664 '�
Location:43 SUMMER ST,YARMOUTH PORT,MA 02675
Disposal System Construction Permit No.: BOHDC-140041 ,Dated: August 08,2014 ',
Provided: ConsWction shall be completed within six months of the date of this permi[. All local wnditions must be met. ',
Conditions
Marn House (2 Bedrooms)
Cottage(1 Bedroom)
2000 ga[Two Compartment Septic Tank, DBox, 4 High Capacity Infi[trators w/Stone:36'x 11'x 10"
� �C
i
Bruce G. rp , MPH, R.S.,CHO/Amy L.von Hone, R.S.,CHO (
Health Director/AssistaM Health Diredor
The issuance of t6is permit shall not be construed as a guarantee that t6e system will function as designed. ;
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