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HomeMy WebLinkAbout0015 LAKESIDE DRIVE EAST - Health 15L` <eslde- U. za C)b LOCATION SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME A ADDRESS 0 U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED L M�� �-_ g'y�� � � �s�� � � � ' �3 a S i/o� ,, a ����� ��� � Q'�' Q` No.. a.1. '4.�::.. .� FEB. THE COMMONWEALTH OF MASSAA SETTS BOARD OF HEALTH ............. r� ....-----.OF..............." -- Appliration for Uiopoii al Morkii Tonotrurtion JIrrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal ...-t - .......................................... Location-Adress WOw er Address - d` a70 D1 �7T-C--•-----•••••------------- ---•--•••-•-•••-----...-•--------•......*j vwlc _..----......-----........_. Install r Address UType of Building Size Lot..../-f 9�66.....Sq. feet Dwelling—No. of Bedrooms______________ .........................Expansion Attic ( ) Garbage Grinder ( �} Other W —T e of Building g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------------------------------------••-------•-•----•--------- ----•------•-•-----•--•--•-••--••-•-----...••-----.......__.. W Design Flow..............:J .....................gallons per person/eor 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__- -D._______ Total leaching area... Z Other Distribution box ( PT Dosing nk ( ) a Percolation Test Results Performed by.-__ �1 Xl til_ /Ili siV...l___________________ Date_.__!N!�__ � _/�$ ..-.. Test Pit No. 1.---_---�'--minutes per inch Depth of Test Pit---1' ___-___ Depth to ground water Q1L�__ 1fJx/� rX. Test Pit No. 2................minutes per inch Depth of Test Pit......_............. Depth to ground water......................... a ----------------------------------•--•-----------------------•---------___-_-----------•-------------____-__---------------•----------•-••----•--••---- O Description of Soil....... e�_�" � .......... ....... L---` •_ ei x ••--------•--------•- ....................................................../ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- --------------------------------•-------------------------------------------------------------------------------------------------------------------------------------------------------••••••••....--•- Agreement: . The undersigned agrees to install fo e escr' d I ' idual Sewage Disposal System in accordance with the provisions of iITL 5 of the State a o der ' d further agrees not to place the system in op.eratir until a Certifi of Complian e a b e is ed b bo d f heal h. r- ig e --•--•_-- -•-- •------- - -- • ----- ---•-••---• .................... Date Apication Approved By-••••-••-------- ............. .:..........................................-_-- --------- Date Application Disapproved for the following reasons:---•----•-------------------------------------------------•------•--•-------------------------•-••-••-----•---•- ---------------------•-------------------.....-._..-----------------------•-------------....-•-----------...---------------------------------------------------------------...--------...----•--•----_--- Date PermitNo......................................................... Issued_....................................................... Date T T No... ..c... ...... F�$.. .'..... THE COMMONWEALTH OF,MASSACHUSETTS BOARD OF HEALTH . .........,.OF................. .........64� L " Appliratiun for Disposal Works Tuntitrurtion "permit ' Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ,+ Location-Address /. or No.. sue" L.e ' L.r r ft, DN er Address - /J4'a! .................. ..........................................2--���3�A�i .............---•----........ Installer Address ,� � Type of Building Size Lot_._ . ....C-� ....S feet q Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder Other—a Type of Building g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures . W Design Flow...............6_5......................gallons per person er day. Total daily flow............... ...................gallons.. WSeptic Tank—Liquid capacity....._-.....gallons Length.......::..... Width... Diameter................ Depth.... Disposal Trench—No ................ Width_.._..�.._.._...... Total Length..__.... F.... Total leaching area... � .......sq.-ft. Seepage Pit No.... Diameter.._ . }........ Depth below inlet.. . .: Total leaching area.. Z Other Distribution box (` Dosing_lank aPercolation Test Results - Performed by... ................... Date.... �;?e ' 1 Test Pit \�o. 1................minutes per inch Depth of Test Pit__l ¢F..... Depth to ground waterA/K:t":�..: I c w7z7-..''e.e 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----•---------------------- --------- -•--------------........ O Description of Soil (�.. G"� r ,�.�...........�"..� !. .._. > .�sr�. ---' �_' / rd x ,� v ...C7124-- : ------ -------- -------- --------------------------------------------- x ----------•------------------•---------•-'--•--•----•------•-•------•'------•---•-•---------...•'----------......--------••--•-----......--•---••-------••-------------•--•••......•--••._...---•------- U Nature of Repairs or Alterations—Answer when applicable............................................................................... -•--•--------------•--'•-•---...---•-•--•---•--------••--•-•-•---•-•--••----.._.....................---...-•---•--•------'•-•-•--•-••---.....•-•--••--•------.......................................... Agreement: The undersigned agrees to install fo edescr' d I ividual Sewage Disposal System in accordance with the provisions of TTLEE 5 of the State a?iitan` o --_-�nderftd further agrees not to place the system in operation until a Certificate of Compliar>ce b e ed by boa health. ; € �. a .r1L...r' .. 4 d ,c Sage` ....... •. .t .................... .._. t Date A lication Approved B �..=- -- v�.y_ ....... :...: PP PP Y ....`.- ....................................' Date Application Disapproved for the following reasons-............................................................................................................... .......-•-----------•-----•-•---------------•---•--•------'-•----------••-•----•-•----•----•-------•-------------------•-•--'---'------•----•------'-'•---•--•---'-••'----•--------'-•--------•-•--..... Date PermitNo...................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , ..........................................OF �. C�Wrtifiratr of Toutplianrr THIS I$ TO CERTIFY, That. the Indjmdual Sewage Disposal System constructed ) or Repaired y..._. --------------•---------_------;--1------...-••••-... f.. .------------...... . --..........--------------... ^, l ti Installer'^ / has been installed in accordance with the provisions of TI`IZ 5 of The State Sanitary Code a . described in the application for Disposal Works Construction Permit No---`�s_-.-__15!�...___...... dated........ .................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE YSTEM W L UNCTI TISFACTORY. 1 DATE... .. . . ..........1.<1.41.11.315 Inspector ------ N FE p E NI/NdcY,Cr#E COMMONWEALTH OF MASSACHUSETTS sT v P.E>Rv�S� BOARD OF HEALTH Gdt3S-v (R�c7f�,,1 ..............O F.............. ....................... No.gc�...--9.....•• FEE........................ isposal orkv Tonotrurtion �erntit Permissio hereby granted......._.. 0*1 ��...A-�.....T?`/p.01E: to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst l f ..:. � .......................................... Street as shown on the application'"for Disposal Works Construction Permit No`�!_..�`� ._ Dated.... J�_" ......= -....,--• ._ "_-_--------`A.`„. 19 I Board of-Health 1, DATE................................... ......................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS , r .RRROW engineering inc. civil engineers& land surveyors December 6, 1985 Town of Barnstable Board of. Health Town Hall Hyannis ,Massachusetts 02601 Re:Lot 217 Lakeside Drive Centerville,Ma. Dear Members of The Board: I hereby certify that the leaching pits servicing the above referenced residence were installed ,both in location and grade, as shown on the plan entitled: "Exhibit A - Proposed Dwelling Location & Proposed Sewage Disposal System - Lot 217 Lakeside Drive,Centerville(Barnstable) Ma." Applicant : Francis X.Collins, 52 Crest Road, Framingham,Ma. , 01701;Engneer: Arrow Engineering Inc. , 60 East Falmouth Highway,E.Falmouth,Ma. 02536 . Dated:Sept .20 , 1984 . Respectfully, ARRO IN RING C. obe t E.R ymon ,P. 60 east falmouth highway, east falmouth, ma. 02536 (617) 540-0354 t•.►OT>~S -_... Eiev= 4 S x6 „ �►..t=v=4 a xd (o �OA�t/1- - ---- ---T ,� ��--ALL Etit�. 9FLr•. " SEA. 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