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HomeMy WebLinkAboutApp-Permit-ComplianceNo.0�_ l 9-7N85 85 kJ Lo7k- k- ! 5 — 0o (7 3 FEE COMMONWEALTH LTH ®F MASSACHUSETTS 3275 Board of Health, ymolo Ulm , MA. : APPLICATION FOR DISPOSAL SYSKM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgradef Abandon( ) - ;11Complete System ❑ Individual Components Location ?j t goNdC 5-r Owner's Name W k-L.l A04 + A4,4A4 �,�`L8UejQ Map/Parcel# 8 (67 AaD_ Address 31 qo'qQ6 j -r 50oot NAPM Lot# Telephone# Installer's Name CAPGw -5 O,-a0k(5-6 LLC- Designer's Name G peto l s,,,- Addressl V S;e q 10 � - ���� Address Lt 0 N 1,� C. W!R Telephone# 0 S 5-5 Telephone# Type of Building R_G5LbGQ- l A -L- Lot Size (3,+40+ sq. ft. Dwelling - No. of Bedrooms 9-1 Garbage grinder ( ) Other - Type of Building No. of persons Showers ( ), Cafeteria ( ) Other Fixtures 33U rafN Design Flow (min. required) ?� z i.� e: ,j gpd Calculated design flow Design flow provided ��s� �- gpd Plan: Date Number of sheets Revision Date Title 3 ( q_oV.:6 57e +C 60y77-4 YAR -k j)Lm-A Description of Soil(s) Al GP 10&A 5nLzeJ+) 9Z)- j, 't n ev Soil Evaluator Form No. Name of Soil Evaluator M% P/ 1K 6&Iti L- Date of Evaluation G " 3 -2015 The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed—Q Date ✓ o� �.� Inspections No. FEEs"..�,t1� COMMONWEALTH Of MASSACHUS TS Board of Health, Y&9jjQLrR4 MA.2 CERTIFICATE ©F COMPLIANCE lk.,V,e VY'Oon of Work: ❑ Individual Component(s) Complete System he undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded {Abandoned ( ) by: CA f & u.) i 4/ E QVTP.riVJrS-5 :L--.. .. _ at has been installed in accord ap-,ce with tFle -provisions of 310 CMR 15.00 (Title 5) application No. dated Approved Design Flo Installer Designer: -TC GJOESJOESUL -=C+ Inspector: The issuance of this permit shall not be construed as a guara the system will function as designed. 6 n c o')" o o �.o �.o o n n au wor--,coo(,000-o ac, o Q, ;: ao o o o 6 Q o o nbo. No. 00C "15- 2.-q 85 4.. 4ya IT) (5- FEE t_55 0 /:-)- f COMMONWEALTH Of MASSACHUSETTS C*4 3L 7 5J Board of Health, Y6 j= 10 U -M , MA. DISPOSAL SYSTLM CONSTRUCTION PERMIT Permission is herebygranted to; Construct( ) Repair( ) Upgrade(-j'__'Abandon( ) an individual sewage disposal system at 31 UdyCi5 S mprr / as described in the application for Disposal System Construction Permit No. A� /.>- 9 , dated 7-7-/<7 Provided: Construction shall be completed withinthsea�s-of�date of this pe it All local conditions must be met. Form 1255 Rev. 5/96 A.M.SulkinCo. Chadestovn,MA Date % 7 � Board of Health No.:BOHDC-15-2485 Commonwealth of Massachusetts Fee , ass.00 Board of Health, Yarmouth, MA APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to:Upgrade-Complete System Location: 31 JOYCE ST, SOUTH YARMOUTH,MA 02664 Owner: KILBURN C WILLIAM Map/Parcel#: 078222 . KILBURN MARY G 31 JOYCE ST SOUTH YARMOUTH,MA 02664 Phone: Septic System Installer Designer CAPEWIDE JC ENGINEERING.INC. 153 COMMERCIAL STREET 2854 CRANBERRY HIGHWAY MASHPEE, MA 02649 EAST WAREHAM,MA 02538 Phone: 508-273-0377 Type o[Building:Dwelling Lot Size: 13,504.00 Acres Dwelling-No.of Bedrooms:2 Garbage Grinder. Other Type of Building: No.otpersons: Showers: Other Fixtur¢s: Plan Date:06/16/2015 Number of Sheets: 1 Cafeteria: Tit1e:PROPOSED SEPTIC SYSTEM UPGRADE 31 JOYCE STREET Revision Date: Design Flow(roin.required):220 gpd Calculated design flow:220 gpd Design flow provided:3552 gpd Description of SoiIs:SEE PLAN Soil Evaluator Form No.: Name of Soil Evaluaror: Date of Evaluation:06/032015 MICHAEL PIMENTAL,EIT • DESCRIPTION OF REPAIRS OR ALTERATIONS:REPAIR-PROPOSED I500 GAL SEPTTC TANK,DBOX,20 ADS ARC36 STANDARD UNITS W/OUT STONE:25'X 11.5'X 7" � The untlersignetl agrees to insWll the above tlescribetl Intlivitlual Sewage Disposal System In accordance with the provisions of TITLE 5 and furfher aarees not to olace in ooeration until a Certificate of Comoliance has heen issued bv the 8oard of Health. Signed Date Inspections Commonwealth of Massachusetts , Board of Health, Yarmouth, MA Fee DISPOSAL SYSTEM CONSTRUCTION PERMIT ass.00 Permission is herby granted to; CAPEWIDE ENTERPRISES, LLC, 153 COMMERCIAL STREET, MASHPEE, MA 02649 To perform:Upgrade an individual sewage disposal system. Ow�ec KILBURN C WILLIAM KILBURN MARY G 31 JOYCE ST SOUTH YARMOUTH,MA 02664 Location:31 JOYCE ST,SOUTH YARMOUTH,MA 02664 Disposal System Construction Permit No.: BOHDC-15-2485,Dated:July 07,2015 Provided:Construction shall be completed within six months of the date of this permit. All loca]conditions must be met. Conditions 1. REPAIR-PROPOSED I500 GAL SEPTIC TANK, DBOX, 20 ADS ARC36 STANDARD UNITS W/OUT STONE:25'X I1.5'X 7" 2. ZONE II MAXIMUM 2 BEDROOM ��� Bru G. urphy,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. Commonwealth of Massachusetts Board of Health, Yarmouth, MA F� CERTIFICATE OF COMPLIANCE E55.00 Description of Work:Complete System The undersigned hereby certify that the Sewage Disposal System; Upgraded by: CAPEWIDE ENTERPRISES,LLC at:31 JOYCE ST,SOUTH YARMOUTH,MA 02664 Has been installed in accordance with the provisions of 310 CMR 15.00(Title 5)and the approved design plans or as-built plans relating to application No.: BOHDC-15-2485,dated 07p6/2015. Installer.CAPEWIDE ENTERPRISES,LLC Address:153 COMMERCIAL STREET MASHPEE,MA Inspector:AMY VON HONE,R.S. 02649 Designer:JC ENGINEERING,INC. Conditions 1.REPAIR-PROPOSED 1500 GAL SEPTIC TANK,DBOX,20 ADS ARC36 STANDARD UNITS W/OUT STONE: 25' X I1.5'X 7" 2.ZONE II MAXIMUM 2 BEDROOM �`�� � Bruce G. u y,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 that the system will function as designed. BOH_Disposal_Construction_CofC.rpt