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HomeMy WebLinkAbout0469 ELLIOTT ROAD - Health i —9 Elliott Road ` Centerville A= 227 — 115 mpendafte.Y' OESS040 42101/3 ORA 10% P4 Y FEa.........L .......`......... , THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ----...f��....................OF....... ........_..... ._.......... ApplirFation for DiBpm al Works Ton rnrtian 1hrutit �S¢'* Application is hereby made for a Permit to Construct (-<or Repair ( ) an Individual Sewage Disposal System at: AF—_— ...... i T ..�.. . ................................ --•-------------------------------. �--. t�.....---------------....----------•---•--•---- .....--•--.-....__. �� —^--•-••-..-----Low�catio�aaress 1� ...1,., or Lot No. b i 1-7 0 w�� � •----------------------•-------... ................................ _4.l:aca. Owner Address W Installer Address dType of Building y Size Lot--_�'?+_24c....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (WA) Garbage Grinder (Lio) Other—Type of Building .......fib........... No. of persons......! ------------ Showers (a-IA) — Cafeteria (&OA) 04 Other fixtures -------------!?f A........... _._ .__ W Design Flow..........!..!.9.........................gallons per person per day. Total daily flow---__.. .'�..a__a._...___..._......_.....gallons. 1:4 Septic Tank�Liquid capacity_!5�t..gallons Length._B.!.�e'.. Width..�0''_.. Diameter---!�1.P-_..... Depth..!i�..Q"'... Disposal Trench—No. .--."IA........ Width--- !a_-_-___-. Total Length.__H! .__.._.. Total leaching area_._.-�fr4_._-..sq. ft. Seepage Pit No----- _. ._.. Diameter------ Depth below inlet................ Total leaching area_An�_.....sq. ft. Z Other Distribution box (V< Dosing tank (wk� 0'- 1--3-14-7 aPercolation Test Results Performed by------ .......................... Date-------. -.'_" .:_ ......... Test Pit No. 1.4.°------minutes per inch Depth of Test Pit......i-2-.�...... Depth to ground water..!-A�-tE........ (s, Test Pit No. 2..._.........minutes per inch Depth of Test Pit__-_-_!?......... Depth to ground water..447E ........ -•-•-----•----------------•--•-----••---...-----•----•---------...-•----------.............................................................................. O Description of Soil....7 ......i.........4=n� �__�,�a _ U . • -• .... ..•------•••-•--- -•---- _-'----_� ------" ----- `c v.� {�...ir`�...`..... • U Nature of Repairs or Alterations—Answer when applicable.--__-_-+3.1.p`.......................:....................................................... Pimi- F)te� era =&Z 3 -►54s •----------------------------------------------------------------------------------•---•••-----•--••--•-•...----••-------•-----•-•---••---•----•...---•---••-•---•-•-•-•••--•••--•--•-•......••-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TT 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beeby e board of health. l / Signed7/4 ?!'��...➢EvEtGO/'+�+•r ✓ 7F � Da Application Approved By ---•-•--•...........................•--•---•-- 6 ate Application Disapproved for the f of w ng reasons:-------•-------•----•-----------------------------------------------------•--•---- -------- •------------- --------------•------......................---------------------••--•-----------•----------•-------------•-----•---•------•--••-••-•----•----•---•-•••------•-•-•----•----•-••------••••--•-•--•••------ ' Date PermitNo........ ..r'?` ..................... Issued..........................................------....... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ... .. ..... .......OF..........................--•..........------ ...... Appliration for Bhiposal Works Tunstrnrtinn 1Crrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: r •-----------------•----.....................--•---...•.....---------....._••---•••--•---•••.••-••- --•-•--•--•-••-------..__.....---•----•-••------•........-------•---•-•---•---•--...........--•••- Locat:on-Address or Lot No. ......................_.......................................................................... ................................................................................................. W I Owner Address Ins tall_er Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ -__-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—N?o- -------------------- Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--- ---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_--_----------_-..._-.-. L=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.___--_____-___•-._.-__- W •.....................•••-••---•--•-----........----•-•--•••--•......_....-•-•-•-•••------•------•-•......................................................... 0 Description of Soil........................................................................................................................................................................ U ---•------------------------------------------------------------•----•----•---------•-----....-----------•--------•----•--•-•-------------•------------------------------------------------•••---..•••. W ----- ------------- ----------------•---------------------.......---------------------------------------------------------------•--------------•---------------------------------------------••••-•-- U Nature 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 T?Tt. p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been;ispued b the and of health. Signe 0 � Dvf[gplr+�c.�+r � �> ti- D to Application Approved By... ••.•.......� 6 �� ate Application Disapproved for the f o o ing reasons:----•---------••-•--•--•---•--••----------------------•---••----------------------- ----------------- . ------------------------------------------------------•------..........-----------.......--•--•--....---------------------------------------------------------------.................................. Date Permit No....../? _-! . ........................ Date THE COMMONWEALTH OF MASSACHUSETTS '� '\ BOARD OF HEALTH ........1... `J ...................OF......I.— --..! ................................................................... �nrtif iratr of Tnmplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } by-•------•-----•-•-----------------•-----•-•-------.-----------•------------------•--------------•-------•--••---------------------------.---.----•---•----------------•- I r has been inst.11led in accordance with the provisions of TIT-I.E.' 7ff°�'jj e State Sanitary Coe as described described in the application for Disposal Works Constriction Permit �'o.__.� _ _1.11............... dated.... . ..�._ . _ ._:____._.....__.___. f THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................. :'_. :- ............................ Inspector--------------------- -•-----------------------•------------------- - —� � THE COMMONWEALTH OF MASSACHUSETTS G• BOARD OF HEALTH IZ� �...©`^�.:........................OF..... ............................................................. 1\I o.. ........ FEE............i.V `� Disposal Vorkg Tannstrnrtion rrmit Permission is hereby granted............................................................. ------..... to Construct, /�) or Repair ( ) an Individja ,.. ewage Dispo Sys ter/Jw.at i�o............ ..... --- •--- .... ............r L Street (� qq as shown on the application for Disposal Works Construction Per 't No?_.-�2.L_..... D ted. � 6./a... ................ -----------------I'd�A4 L447-`'Z.............----- --•-------••--- r Board of Health DAZE................../._ I_K........ 7 FORM 1255 HOBBS & WARREN.. INC.. PUBLISHERS L _ \ � TOWN OF BARNSTABLE LOCATION �` �.. $`- -- VILLAGEFN �u ASSESSOR'S MAP Cz LOT INSTALLER'S NAME & PHONE NO. " SEPTIC TANK CAPACITY LEACHING FACILITY:(type))� � NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER R OWNER — ' DATE PERMIT ISSUED: .� DATE COMPLIANCE ISSUED• cy VARIANCE GRANTED: Yes r I No �. I i \1 AlNo c i 4 ((� TOWN OF BARNSTABLE ' LOCATION ��° /3 moo, f�.a SEWAGE #g7— VILLAGE Cc�2v79WIte r ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 2MC-gowtEy SEPTIC TANK CAPACITY LiEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATERv BUILDER R OWNER -,DA,J IPmA y74 4macneve) DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �- -►: _ �l o � i � ``� Sys � , � � M � �; � u ,1 ,� � � J 3 � ' � n � � � � � � � O0 � � � I � 1l1� IJ � l �s � Q � � � � � � � No.... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH .. . OF. C T.—-T,� ................................... Appliratinn -for Bi,ipusttl Vorks Tomitrurtion Punift Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: "I �' --�..... ---.�. -►�- 0f-----......................................................... )D,ocation-Ad 'erss or Lot No. ------ -------------------•-------------........---•----------------•-----------•-------.------•---.---- oWn -�� -•--•---••-•------------•-••....._-••_._....address a ---• . .............. stall.r Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------------------------------ W Design Flow--------------------------------------------gallons per person per day. Total daily flow-------------------------------------------.gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width................ Diameter_-..._..-..._--- Depth.___.._.--_--- x Disposal Trench—No_____________________ Width.................... Total Length--_____-_-.-____--_ Total leaching area-------------.------sq. ft. Seepage Pit No..................... Diameter•_-_-___-__...______ Depth below inlet.................... Total leaching area-------.----------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-, Percolation Test Results Performed by-------------------------------------------------------------------------- Date....................................... Test Pit No. 1................minutes per in Depth of "Pest Pit.................... Depth to ground water..-------------.--.-___. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_:.__.__--____-._..-_... --------•------------------------------•--....-•-----•-•-------------------------------•-----------...-•---•--•-----...--•-•-------.....----------------- 0 Description of Soil------------------------------------------------------------------------------------------------------------------------- --------...----------------------------------- x c., -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- x - ------ -------------- ---------------=---- ------------------------------------------------------------- --------- -- ----- ----- - ------- - - U N/ae of Re airs o tions— er wh n applicabl •_. . .._ :�...Ament: , The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issued§y the board o4hea 17 - t�, d Date Application Approved BY . • -•---••--- Date Application Disapproved for the following reasons:.----------•------------------------------------•-------------•----•--•--------•------------------•------------- -----•••.....•--••----•••••-•-----•-•-----•-•----•---•---•----------------•••-•--•-•--•-•-••••••--- / Date Permit No......................................................... Issued...1�_.............................................. l...� Date No..-- -- • t A F�$. .................._ THE COMMONWEALTH OF ASSACHUSETTS Nt i BOARD F H"EALTH -- ..OF.. . - .............................. Appliratinn -for 131�ipugal Works Tonfitrurtinn Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ^y - wo— PM. .-`..� �^ ``"--'� ...01q -Ad e3s or Lot No. •------0--//--�'-a- q" Own Address a •••... .-----• �'' '-•-•-•• --•--••-••-----•--•••• ••••. ., staller Address d Type of Building Size Lot______________________..._.Sq. feet Dwelling—No. of Bedrooms_______________________________________:.;_Expansion Attic (` ) v Garbage Grinder ( ) 11 P-1 Other—Type of Building ............................ No. of persons--__--_- ................... Showers ( ) — Cafeteria ( ) Q' Other fixtures -----------`-!t---------------------------------------- WDesign Flow_________________________..................'gallons per person per day: Total daily floe.%....................................._.gallons. WSeptic Tank-Liquid capacity--_________gallons Length................ Width---------------- Diarn:eter--------_-...... Depth---_______--- x Disposal Trench—No_--------------s_.___ Widtli::_ -----------Total'Length---------------- Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter -------------------^_.Depth below inlet--------------- Total leaching area------------------Sq. ft. Z Other Distribution box ( ) Dosmg tank ( ) », '~ Percolation Test Results Performed by Date___________________________.___.. - Test Pit No. L_______________minutes per Inch Depth of' sx Pit .......... Depth to ground water--_-___-____-_-__-__. . (� Test Pit No. 2................minutes per inch ='bepth of Test Pit-------------------- Depth to ground water._-__-_,-_.__-.-____.-. •----- ,•.:_.,_ '.................................................................................................. 41 ---------=----------------------------- .•.-' O Description of Soil---------------------------------------------------"........................................ ----------------------------__-___ w '\".ram."'^ .___________________________________________________________________________________________ ,_-_.__....._..__..___._._____........._.........._........__.....___._._.._.____________.---. U _ _ _________ _ ________ _ ____________________________________________ _ _._._____ ______ ___ _ ..._ UNatu e of Re irs or . tions— er w n applicabl . -_ -__"•7__- ___ __.___ _Q-..... _...: --- -- —------------------------------------- A reement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article YI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issued the board of h j Sig. !�--' "d I� �----------- ---- ----------------------- Date� ��-- Application Approved By---- - - --- --- .............. ----- ----- r- -------------- Date ~' Application Disapproved for the following reasons:-_... -;-------------------------- ............................ .. . r k M ..•. e:D Permit No........................................................ Issued......................... ............- •----------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ........74rvh.............. .......................................................... Tprtifiratr of f omplinnrr TH& IS ZV CE Y, That the Ind• Sewage Disposal System constructed ( )' or Repaired ( ) by....... = w Installer at....... •- •--- ,, ------` ---- . --•--- ---- ----• •-------- ----- ------ ---- . •• ----- ---• -----......----- has been installed in accordance with the provisions of Attic I f The State Sanitary ode as escrib in he application for Disposal Works Construction Permit No.- --- ___________________ dated-...�.�. r � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �~ Inspector DATE...............1 ............. --•----• ------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH 0 ........... ..:.° �........- No.... ... ....... FEE•- ••----••---_.... %spwi Warr n ntrurtinn rntit Permission is hereby granted,,--. .• L ... ..--:..�............... ... ••---•-••-•---....... ........ ....... to Constr tom( or R r ( ividu 1 e a'e' i po.a, 1, e at No. '.±..... � � ------- --------- Street as shown on the application for Disposal WorkslConstruction,.Pe -, No ated .Z "' '" 4 --- -__ .--_----,-,,---_-— Boar of ealth DATE.....)_l ......... ------ - --------- ------------------ FORM 1255 HOBBS & WARR,EN. INC..; PUBLISHERS LO Q-T-10K--1 IaC;E—PERMIT t�1-O.. ' 1 - - =T- -- - - -- -►J-- -E-�A D-DR E-S-S - -1-1.D- R --1J-L� A D-D R F S S �l�►T-ESE-Rtu�l�1-SSUED — _ � 1 A I . " . . � y .:.'. -.-. .... _ _ I ... a �,�^, _ rl . . n � V 1 c � .. .. � �� � � ' . . � .=x , � . � 0 � . . DESIGN DATA STRUCTURE 4tr`�cl t- >t�,Ly L��v �, �_,r.►<; DESIGN FLOW Ei_Ty_r�c Njc--) c�r•l . � k D _.? D `3E )ZcxCa V- r.P. D. SEPTIC TANK J LEACHING RATES : SIDE AREA = ." GPD/SF BOTTOM AREA I . . GPD/SF a LEACHING FACILITY K.EA r _—------ - AQE c (-�� .x N- 221a 'S.�. - L.4 _-- 1'\�2� :��1�> PLAN REFERENCE : -44 s-LYI _ WEI A';° I � �� ASSESSORS LOT NO. i LOT , lb ll,B f4 o �2i 9i `41- NOTE ..., , � ,, •�,� � ; , , -,..,._ I. ALL MATERIALS AND CONSTRUCTION METHODS i --- ?_! . ,,r TO CONFORM WITH COMM. OF MASS . TITLE SZ 1 4 '! ��►�, r�R_1 Lp � (1 (���, � y 5 .�__�--=5 !�.._----f�_.�c:� •, ��� ENVIRONMENTAL CODE — .Now. l" yy- 1 7 '.. aim / PS T: AST Tom"' // `, \, _ .. o ✓ �g `\ zr.xr_r rszxP =sue '1+lN �_! `:�• _ o �,,_ Wv ATErb - T W -x C ` -i_ V,� ZA L1M t1'S LLT' i Pi Ate1 G c. �.-�1)0 �, 1SS.79 4, pipe_ � '°" ti __ 'fit N(-JTF _.�O�nJP.f VV�i���_ ,�,tiA.;L-:'�i?,L,'� c� � !T'� ' � •i-- ''y '!� C .� .�-.- - 17,74 a.N l L 5 J� r��3 �5:11 L l"5T S . /R)Be. - 22 24 -.----___._.. PAVE. 11 �P�SN Of A9NsJ, P�lN pF Mqs DAVID G �y C J c C. N �o JOH PF/ } LIN T'e' o ! f H 'v - �' -os.29976 � S o j ` (ricrUPitafGISTER��J a r Fss�� `EDGY S ✓ AL LAND z ; ` ti /ki I5J PLAN SCALE SOIL OBSERVATION PITS . >z�sE�_ i' >_ f✓ � ' _. �` TEST PIT N0. TEST PIT NO. _.�_ -- ---- - �-• �� `' ' ELEV. 4- ES ELEV. i � DATE OF TEST _._ - -- - _ �' ENGINEER +L B.O.H. AGENT EXCAVATOR Ft 2o, F �' .._ — r+ - _ --! - ----- - ---- ---- - - - - — ----EANnv PERC RATE IN T.P NO. AT /v FT. = MIN./ IN . 20 ' --+ )7. (7 '`' fl _.�. ft',r 1 hlCtit�r•t i T_ L,CJ T �� -IN l= s LID-7 R.,DA 1) I ----- CENT V 1 L i -:-_.Af`'0_j E L L I S & T H U L I N INC. tom' I ► !G, , LAND SURVEYORS AND CIVIL ENGINEERS f L7 O I G 2Cr --- - - ---- --_- - - - 1✓L _ � EAST SANDWICH, MASS. SECTION THRU SEPTIC SYSTEM _ SCALE I " _ D H O R I Z. _ ` V E RT. `Y art As 1