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Home My WebLink About0017 EBENEZER ROAD - Health 17 EBENEZ_ER_ ROAD Centerville A = 147 — 077 S M EAD KEEPING YOU ORGANIZED No. 12534 2-153LOR (SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT10% Certified Fiber Sourcing POST-CONSUMER® www.sflprogram.org SFI-01m MADE IN USA GET ORGANIZED AT SMEAD.COM ... ........... THE CbMMONWEALTH OF MASSACHUSETTS B.0 A R H - ---------------- 0 Fy. ,Are_ _A�.� ....................................... 17 �irttfilan fvr' `Biiivviial Workii Tomitrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at* ------_---------------_- ......... .............................. .. ............ ----------------------- ------------ L ti Address or Lot No. e7_ .......................... ...... Ab�............ ..................1.) .................;40....LIZA....... - Own ................ 5X .. ......... ... ........ ............. ..................................... Installer Address Pq 17 -0 Type of Building ...... .0.7/1-M.Sq. feet .0 Dwelling—No. of Bedrooms----------j-_-----_-------_-_-- Exp io Attic eize Lot. Garbage Grinder ( ) ans 04 Other—Type of Building ............................ No. of persons__...z.................. Showers Cafeteria ( ) P4 Other fixtures--—----------------------- W Design Flow____________________ _____________________gallons per person per day. Total daily flow------------ ..15- . ....11---------------- 1:4 Septic Tank—Liquid capacity/O.P.P.gallons Length________________ Width_______-_-_____- Diameter-1. ....... Depth_.__.L-2....... Disposal Trench—No...................... Width...._.......______.. Total Length..__._____.......__. Total leaching area-_________ --sq. ft. Seepage Pit No....../_---------- Diameter------1..�....... Depth below inlet...�_.,-5.......... Total leaching area sq ft. z Other Distribution box Dosing tank Percolation Test Results Performed by...... ....... Date--- W. ............. 0, / - Test Pit No. 1.24�----minutesperinch Depth of Test Pit..... Depth to ground water......e"V40Pt__4;57 Test Pit No. 2................minutes per inch Depth of Test Pit_.___........_._._.. Depth to ground water_-_________-____-_______ ..................................................................................................... ..... ---- -- ------------- ------- .. ......................................................................... O Description of Soil.--....... .... .. ..... U4. ........................ ------ .................................... .................................. ---------------- .....nzt, - - -- - ---- -------------I................................................... -------------I .... ------- Alterations—Answer when applicable U Nature of Repairs or --------------- - -- - -------------------------------------------------------.............. ........................................................................................................................................................................................................ Agreement: The. undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'THE, 5 of the State Sanitary Code— The undersigned further agre of to place the system in I- operation until a Certificate of Compliance has been issued by he board A hea_kh. SiV--- --------- -- ....... ... .. Date Application Approved By.... . . ..... .................... ...... "------ ......... Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date FE.B ..:................ } THE COMMONWEALTH OF MASSACHUSETTS BOARD--.Of! !—fE .LTH Appliration for Uhipati al Mirk i Tnnitrn.rthin 11amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 1 - - ................4 ......••.... ................... ............................... --------------------.-------------- ............ -•'^ f �' Location Address orV LotNo. i .. O W ..,. . +.} 6 wner �. ; ................... . . . Ad..... Installer Address ol +' dType of Building ` ize Lot.....--_•_-__•_ -K-'�-_-Sq. feet V Dwelling—No. of Bedrooms.......... _••-----------------------Expansionn,Attic (� Garbage Grinder ( ) Other—Type of Building ----------- --------------- No. of persons.......(a--•----___________ Showers (/�) — Cafeteria ( ) a Other fixtures •-••••............. ___________________..._.....__...._..._._._..___._.._..___..__..._......%"'P�. ................------------- -ell Design Flow...................Syry: ...............gallons per person per day. Total daily flow.._...._.__:..... gallo WSeptic Tank—Liquid capacityZ gallons Length................ Width................ Diameter_-__9....... Depth......6_.----. x Disposal Trench—No. _:..,•.............. Width.................... Total Length.................... Total leaching area...___ sq. ft. -_ Diameter____________________ Depth below inlet.................... Total leaching area.-_�_X_; '._.sq. ft. Seepage Pit No._.___�.._______ z Other Distribution box (. �) '" Dosing tank,.( a Percolation Test Resins Performed b - - "�'" j �f`'" -_• / '�j Y -- n . Date-5.........• Date Test Pit No. 1 Y-_---minutes per inch Depth of Test Pit------- ------.. Depth to ground water_._.....'IV� LT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ...• ••• ••---•.....•---•-••-----••-------•--•-•--._......••••........0.....••••..---•- D Description of Soil ' �t'n M. �_ _--------•----- Ze V�i r —'/ �i'kr*'.s"i 5 ......, '�..•• -----•-------------•-----•-----•-----------------•---------------•---- ............................................. UNature of Repairs or Alterations—Answer when applicable--------------------- _____________________________________________________________________ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of AITi y g g p y 5 of the State Sanitary Code— The undersigned further a ree� of to lace the system in operation until a Certificate of Compliance has been issued by the board of health. j J Signed._? ..!.. T��j� ��?`' �,w�,,+ �� --- d---- Date Application Approved BY----------- - .:/1 '............................ --- -- te�---''�----- Da Application Disapproved for the following reasons---------------------------------•-----------------------------•----------•----------------------•--•-•--•------- ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS j BOARQ�O'F HEALTH � . ; II &rtifirtt#le of Tomplianrr THINS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b �'�?f � .................................. •; r Installers r. at has been installed in accordance with the provisions of TITLE of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..- /��._ .5.!�............. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........................................................••••-•-•-----•••-_.... Inspector................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD,,O --) HEALTH, , Nol..Z . , FEE........................ Difivalip,11 Workn Tnnotrnrtwu pamit Permission,Whereby granted..... t••-----� •-----•-•-••-••--•-•••--------••--•••---•--•--••.......••••...............•-•---•--•-•--- to Constr c ( )ion Repair ( Individual Sewa Dispoa�I atNo....... .............................. -•-- a. WA.................................................................. Street as shown on the application for Disposal Works Construction—lj'ermit No......•.._.._......e. Dated.......................................... -Board of Health DATE - -.....r.......... ...................•------............__ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS H St T•sP L, . 39 3A �Y OLD lot in Ti BUNIKI c No.22162�0��1 ��plew�t F`310NA\-�a6 wg /C, vW LEGEND � �;►� CERTIFIED PLOT PLAN- EXISTING SPOT ELEVATION OxO .�o �' EXISTING CONTOUR --- 0 e� e,► FINISHED SPOT ELEVATION FINISHED CONTOUR 0 —�— 'IN APPROVED BOARD OF HEALTH SAAAS tAALjl,.WAS3* DATE AGENT SCALE$ / m DATE16: S LDREDGE ENGINEERING CO. IN CLIENT �� I CERTIFY` THAT THE P1tOPOSEO Y' EOISTERE REGISTERED JOB N0. BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAW$ 1 \ENGINEER4 Y R DR.BY _' OF BARNSTABLE, MASS.. 712 MAIN ST. CH. BY, HYANNIS, MASS. SHEET OF DATE REG. LAND SURVEYOR IV07E /F E/TNER TNESEP7 TANk DR � - - ---- �L.Er4CH//vG PIT ARE /rJORE , THA."✓ /2"BELOW /O PT. Al"Al. :TRADES A 24"O/AM ETER G'ONC'A'ETE COVER 4"PVC PIPE StIALL BE BROUG/4rT TO 4,TA0E.�A/✓ EXTRA CO/VCRCTE i JiE,4Vy CAST /RO/Y COVER SAIA4L 13E USED .� /OO.O M/N, PITCH -� CoYERS r IJ=/Al ;DR/VEN/AY' yg IaFiQ FT 2 A :o: 7 M/N. ONCRE TE GRAOE. Cc).►�ER. CLEAN .SANG •� L/QUID LEVEL '' �� . . . . . ,'a - - •". • • . . z LAYER `. CAST IRON PIPE i JOG!/ o o a /r�.ro o Q� //a p.3181 Ii MIN.P/TCN GAL. • I • • • • • • • a o a + %4"PE/+ I'T SEPTIC TANK X o ob , • . . . . • • ,ob d• WASHED STY>NE :. ' P o � • •EFFECT%✓E • i 314. o I4�r45HE0/ iY STOE I • P r � • DEPTH • • • • • o O to • • • 10• 1 oe • 1 • • • • • • • a, • • • • • • • • • • p y PRECAS T SEEPAGE !JVIVBR'T CLEYAT/oNS F/ s'f- d :e• r • • • • • • • • paw o r P/T OR E4L//V. /NYERT AT Ott/LD/NG 97.G FT 6 FT D/AM. T INLET SEPTIC' TANK o1 G,r FT• C SEE 7�9BUL.4T1ON� D<JTLET SEPTIC TANK Q6' FT, f-_ INLET D/STR/B!/TION BOX 'G FT. GROuIVD W,4TER TABLE SECT/ON O x" OUTLETD/STR/B!/T/ON BOX FT INLET LEACHING /P/T �'� FT. SELVAGE DISPOSAL SYSTEM LEACH//VG I0/T 'Ti4BULATID/V -SCALE DESIGN CR/TEl41A : %s = / -o DJMENs/OJV A 3 FT. t M D/Al,ENS/ON 8 FT. I1/l/MQER OF 6EORO0AfS 3 D/MENS/ON C _FT.�"* GiaReAGEO/sPosAL uvlr_. SO/L LOG TOTAL EJT/MA'T'EG SOIL TEST _G.4L.1DAY SOIL TEST At/ SOIL TEST#2 NUMBER OF 40ACNlNG P/T.$_ / FLEY. 94C.0 ELEY, pATE OF SOIL .TEST Iva 5/ r S/OE LEACHING P.ER P/T / 9 SQ FT. D- 1 RESULTS It/ITNESSED BY •` / 6GTTOM LEACHING pER P/T 78 so* /CT. �a14 P S4�s PEitCOLATI.ON RATE jo/ !E-Ir Ml/vj//NCH TOTAL LEACH//VG AREA ��t�SQ. FT. PW#VCOLi4T/ON RATE 02 //Cy RESESRI!ELEAC'f/ING AREA66 SQ. FT. G �' G rc M e OBER P. l � :N+Ka ELOREDGE E/VG/N6V1?/Al1G CO,/NG. ['f % No.22162 O l V. Li 7/2 MA/N ST. No G/tovND L{/,4TER E/VCOlJNTE�EO HYIt NN/S /'�13'S. Fs10w4L�N�' j� G/�O[J/VO Lv.�►TE.Q AT ELE✓. _ .JOB /VD_ G SHEET�.4F P LOCATION SEWAGE PERMIT NO. see cow' • VIIIAGE 1 ST L ER'S N E R ADDRESS B U I L D E R OR OWNER s Ll� e DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED e S 40 1 LOCATION ` SEWAGE PERMIT NO. VILLAGE I ST LA ER'S N E i ADDRESS BUILDER OR OWNER 6 s DATE PERMIT ISSUED DATE COMPLIANCE ISSUED � � � fb �� ry U� 5 _: _ J