The URL can be used to link to this page

Home My WebLink About0014 HILLSIDE DRIVE - Health y t4IlIsfs� Dr rtATerV i 1It SMEA® KEEPING YOU ORGANIZED No. 12534 2-153LOR OSUSTA r'E FOR I MIN.RECYCLED INITIATIVE CONTENT9oy soti POSTCONSUMER tempo MADE IN USA GET ORGANIZED AT SMEAD.00J1 I { THE COMMONWEALTH OF MASSACHUSETTS c BOARD OF HEALTH .............. ...............OF........AE;" ,5.'--<►'//49� -----.......--•---------------•---- Alip iration fnr Ditipa5 tl Works, Tutt Ugrthitt ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: a ,' ................---------...------..4// . - .......--•...... ..........-•�20_9...t9.............................................................. - Loc tion-Address or Lot NNo..,== ........� ..... ........*o.. .... ....f �a.�.✓ rs!s�l�... Owner ?� 1dre�ss/•!� .. ................................ Installer Address Type of Building Size Lot......A ._ Z_1...•..Sq. feet Dwelling L2No. of Bedrooms__.__ T" .......•...............Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) Cafeteria ( ) Other fixtures __________________________________ W Design Flow.............................. _..__gallons per person per day. Total daily flow................ ...........gallons. WSeptic Tank—Liquid capacity../e _gallons Length---------------- Width................ Diameter--------------•- Depth................ x Disposal Trench—No. .................... Width......z1.I......... Total.Length......b�........ Total leaching area..__.,1.VK.....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........................................ 1_4 ,.a Test Pit No. I........ ? .minutes per inch Depth of Test Pit_____? __________ Depth to ground water_______.__-•_-------___- ( Test Pit No. 2........�_._minutes per inch Depth of Test Pit.....7.......... Depth to ground water........................ Description of Soil.......... ` a. J,7 - r= - a. _ _ _ ......... ----------- x U Nature of Repairs or Alterations—Answer when applicable _.c r. � �_ ........ V e A.._ -••••---••-••••-----------------•---••-••••-•••--••------------•--••--•--•-•-•-•--••....._..-••-•-••----•--••••---•--•---•--••-----•-•••••--•-----••-••...•------•--•---•----•--------••......_....••-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 1? y g g p• y of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certi f ompliance has been issued by the board of health. Signed_.__.. _• t.: . 0 Dat Application Ap rov y........ Date Application Disapproved for the following reasons--------------------------------------------------------------------------------------.......................... ...........................•----------------------------------•-----•----••----------.......------------.---•-•--•--------------------------•---•--------------•----...-••----••------------•--•----•••- Date PermitNo......................................................... Issued.................................................. Date y3Z -s/7i - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... JN...........OF.....: ....... .�N.S.75r-...... .c��.�tr�i#tilt f itr �t��tD1,�F�� '.�lark� Cn��r�r�tun rrntt� Application is hereby,made for a Permit to 'Const.uct ( or Repair ( ) an Individual Sewage Disposal System at i Loc n-Address /;r s•^— or--- r � �D r p n d s Installer Address 1 �� UType of Buildingw� �® Size Lot____ _,_____0 ______Sq. feet ,-.., Dw —elling No. of Bedrooms____.__.__!__________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther`Type of Building'____________________________ No. of persons__.._.._____________._______ Showers ( ) — Cafeteria ( ) d >; =Other fixtures �-----------------•-----------------------------------------------------------------------•-___---- Design Flow_____________x___1_____.__•. _ ___'gahons per person per day. Total daily flow...._..___._..______`�.�............................................gallons. W , 1:4 Septic,,Tank—Liquid capacity / `ygallons Length................ Width__ _ Diameter---------------- Depth................ Disposal Trench :�Io Width`__ _______, Total Length_.____��._.,____ Total leaching area-----ILK----sq. ft. Seepage PIt,N.o ...{ Diameter.................... Depth below inlet.................... Total leaching area'_................sq. ft. z Other Distribution box ( ) Dosing tank a Percolation Test Results Performed,by. ......................:....•---------------------------------------- Date- ---- •---`---•----------------- T x� . z., Test Pit No. 1_____ . __minutess per inch Depth of Test Pit___=_�K......... Depth to ground water________________________ 44 Test Pit No 2______ ._._minutes per inch? Depth of Test Pit------ _________ Depth to ground water________________________ ..�_____________ _. ._...___ _ D 4 t �� ,� sue ; fflFt7rlr� l�:° 7/ Descr>pption,of�Soll -----•---•••••.•••---•••. -••••• ----••-- .......................................... U ___ +_ '.. ._ .Id ` ._W r'I�k _- •�`-•-..�l,Ctsfv+.,.M --' _ 7'r-..•• 7 --____ f U Nature of Repairs or Alterations flnswer when applicable...__`. _ : ............ ------ ........ --- -•--- •-- • -•••- •-•••••-------•-----•--------•------••-•--••• .........._ Agreement: Thy ,>jnderslgnedp-agrees to install the, aforedescribed .Individual Sewage Disposal System in accordance with the provisions of T: t S of the State_Sanitary Code- The undersigned-furtl:e'r agrees riot`to place•tl e�'systtem in operation until*a Ce A.—'kt(,of,Compliance has been issued by the board of health. y d - a.^� �I I� �r9.lY(Gr g t� Y < APPlication Approved'BY -w� � ' { , Date Application Disapprgved fortthe folloiuivcg''reasons------- ;...................-------------------------------------------------------------------`----------- v 1 t'x t Date PermitNo -------- •--••--...-•-•-•----._.it Issued....................................................... Date r' t - ;. I= 'THE�OMMONVCEALTH OF MASSACHUSETTS @0.kRD OF 'HEALTH a ... b OF. - t......................................................... t= THIS IS'TO C TI Y, That th r, m vldu ge Disposal System constructed ( ) or Repaired` ( ) by.... _...__... ... Install at Z-.^- 1/ -----------------•••------ has been installed in accordance with the provisions of. TITLE' r of The State Sanitary:"Code as des r bed in the ` application for Disposal Works Construction Permit No _____ ____ dated----------_____________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION.SATISFACTORY. _ DATE.......--•----------------------•----...........---...__._......---•---•-----_._ Inspector........................................................ •----•---------.....•-•- THE COMMONWEALTH OF MASSACHUSETTS ' A BOARD OF ALl ..............................OF..................................................................................... �d No......................... FEE......... ............. _ tt�tFll It rrlltt Permission rol reby granted.................. ---------_-•-•• ..........� .............................................. to Construct ( Repair ( ) a ndividrial S� age Di os System .4 k atNo. - .rs. . ._------• `'------------- 'Street = Street as shown on the application for Disposal Works Construction Permit No_____________________ Dated.......................................... Health DATE............................................................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - p al.✓c e .ems . . .S� E r NNV am/ Ft t �1� 56�+ v�lAwZ> sag VJ Ta--sAL 271 OF h4 �O x .• y �1 As39C Q i f � WILLLLIAM yG� saq CEQTIFIE[DC. pLbT Pi-.Q1J NYE N No' 19334 - L O GA T 1 O tJ �EiS/T� ✓/GL,� 41 ST R�FEIz� ►.tc.E 1 GE+RTIF`( THAT T14r-- r^c0K1Dh-,n00 5u0r4j►J I ti.I�Q 0►�1 Coyv�PL�(S W ITN TWG 51 VE.U►••.w& v1RE FITS OF -r►-1C— IAIDE ,Se-rtf AC-4 -ToWU OF (3A�rJSTA31_E A�.1D IS f`idT 1N 4I�(E' IUc..LoG'A'C�p •: W l•TI-•,111.,� FL� i bAT� 0 3 3 �'' REGIS(TJZED L..�Wo 5uevtYo�zs ; I 0STEIZV%LL.6 o MaSS� THIS D 4-A►-� I S W OT bAS ev N A.� SvZV�`f Tt�� UF�SaF�"S Sidol�LD APpLIf.A.►JT ,�? ,4��c'e �GL./.. ✓� X O " ' /' i o s�rc,Y• , i iA sa.��razY sys4 11 -4 ,s� -707-, ,' 271 B//45r i X, OF blgsJgy , ` / WILLIAM G C. oo CEQTIPIEI: PLOT PL- QlJ io NYIE ,p No. 19334 O L OC A T 10 C��/T ,�✓/G 4 41, yoI S-r�v��°� � - T HAT THE_ ►�l DtsnO 5 G-lotiu u Pt A►,1 R t=�E tZE N GE �. sy i 1 TC6RTiF�( INF�G.ot� Ga!MPI.�lS W ITN THE 51DE.t_1►-�� ,cT u 12 E E"TS AI.lD ,SET�CIG R EQ ToyvUFL •LOCGAT t> _ B A XT E � I DATA 0 3 3 _ QE C.I S rz-2ED lam.4-1 0 6U I'V c`{�O�zS OS'TE. Z\/IL.� o Mass. ., . 1 T H l 5 C7 L-A U I S L.!OT gA5 EMW ►� p W G tIJS1��J�E►JT StJ2V�`f �, T1ar= OFFS+:=TS SldowLD AP Lim GA.►�1 T ,� ,Q.E c,�'�GL1, � 1. De:TGP_m LO LION " a �3 SEWAGE PERMIT NO. Hill side Dr.. 83_g /-VILLAGE Centerville INSTA LLER'S NAME i ADDRESS DeLu,-e Excavation Queen Ann Rd Harwich Ma 02645 e U I L D E R OR OWNER �. Arthur Williams ' DATE PERMIT ISSUED 4pDATE COMPLIANCE ISSUED �2e, `C V' .. .. .f' I�� .....�......r_.._.__..,."'_" i� .!� �� 3Z . �3. � LL F�� AV 40 ---------w ,� ,, p 7- Iti c.� r.. p k r)Ia,. + �! '2 F .ti A C>V E A�.t� S U IN a Ca G A.a.. t.. 4 a. J , / �. ^ / `� ` 1 r ----` --- -- q3 z s.n 3 16 S C,3 N !►.A � 't"a E 'i --J TANK_ �� ` f M E t i OVA I � f�ray a � �' W�T t 1 �'*?� ��# T u�Ali; '+JA`o l'E.i.1 � { , • � ----`------- S TU N£�. A..�.. l+t G,�,l�tx `�; O F �� I c L P �• f t R c>�> � �'' � .�;�.. ,- i w^5��.v a��st•c�+��. �a*+-t-�,� � r' '�° 't' `• 4'Cp� F-L.oit W A7 — -: -= tAN--- �t - 5 A•�.N� O 1p TA c... r - .r ►�,O �A.Ql3i°ti GEC �o�1 rJ A�/� �1 .V 'D. TA is< x 3 SQX 15'f/a°411 t_4rNc.ta Lwts, ', 2 71-ow IkvFUss<n- 8crr T G rn ACE A - Z .S t< 48 Z G .P D N �4 0 S NCi v °N N L—»R�C,P� =�_c�rat Fti:,�{ `v+r T�; T `� S►D�t^� ti _ t){ cRE.0 LIPID �V4�,�.'E-yQ) '! wr GIAN! N r c '` � .tilt E. •� N �k?�..' ..