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No.:BOHDC-14-0427
' Commonwealth of Massachusetts Fee
ass.00
Board of Health, Yarmouth, MA. ,
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERNIIT
Application for a Permit to:Upgrade-
Location: 19 TAM-O-SHANTER WAY, SOUTH YARMOUTH, MA Owner �
lviap/Parce�: 080.89 Name: ;
LERSCH RICHARD H '��..
Address: '..
LERSCH RAMONA M 19 TAM O SHANTER WAY
Phone:
Sepdc System Installer
Name:
CAPE EXCAVATING SERVICE ��
Address:
13 CHARLENE LANE EAST
HARWICH, MA 02645 ..
Phone: ����
5084328198 �
Type of Building:Dwelling Lot Size:026 sq.ft. �
Dweiling-No.of Bedrooms:2 � Garbage Grinder: I
Other Type of Buildiog: No.of persons: Showers: Cafeteria: I
Other Fiztures: ,
Plan Date:08/24/2014 Number of Sheets: 1
Tit1e:PROPOSED SEPTTC DESIGN FOR 19 TAM-O-SHANTER WAY Revision Date:
Design Flow(min.requircd):330 gpd Calculated design flow:330 Desigo flow provided:35t gpd
gpd
Descrip6on of SoiLs:SEE PLAN
. Soil Evaluator Form No.: Name of Soil Evaluator. Date of Evaluation:08/13/2014
� ROBIN WILCOX,PLS
, DESCRIPTION OF REPAIRS OR ALTERATIONS: 1500 GAL SEP17C TANK
DBOX
4 HIGH CAPACITY INFILTRATORS W/STONE:36'X 11'X 10" I
The undersigned agrees to insfalllhe above described Intlividual Sewage Disposal System in accoManee wkh the provisions �
of TITLE 5 and turther aprees not to place in operetlon untll a CertHkafe of Compliance has been issuetl by the Board of Health.
Signed Date
Inspections .
Commonwealth of Massachusetts
Board of Health, Yarmouth, MA. F�
DISPOSAL SYSTEM CONSTRUCTIdN PERMIT s55.°° ,
�
Parmission is herby granted to;FETER HORGAN Address: 13 CHARLENE LANE
EAST HARWICH,MA 02645 i
To perform: Upgrade an individual sewage disposal system. �
Ow�r. LERSCH RICHARU A
LERSCH RAMONA M
t4 TAM O SHANTER WAY
Sp YARMOU'IH,MA 02664 �
Lacation: 14 TAM-O-SI3ANT8R WAY,SQUTH YARMOUTH,MA 426b4
Disposal System Construction Permit No.:B4HDC-14-0427,Dated:Qctober OS,2014
Provided:ConsUuction shall be campleted within six months of[he date of this permit. All loaal conditions must be met.
i
Conditions
2. 1 SOD gat Septic Tank, 1}&ax, 4 High Capacity Infittrators wl Stone: 36'x I I'x IO"
�
8r�ce .PA tphy,MPH, R.S.,CH6 t Amy l.vo»Ha�e,R.S.,CHO (
Health Directpr/Assistant Heatth Diredor '
,i
The issuance of this permit shall not be construed as a guaraotee that the system wil!function as designed, (
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