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HomeMy WebLinkAbout0043 LAZARUS LOVELL ROAD - Health ►`7 1 - I i i (iiMODNWEALTH MASSACHUSETTS _ BOARD OF HEALTH " .......... Q. /..1 ...........oF. f 21 ---------- -....... Appliratiou for R-spaii al vrl Cnayat rttr inrt• erattt# Application is hereby made for a Permit to o struct ( or Repair ( ) an Indivi ua Disposal S stem at* �Y" t� . 71. ... Location-Address ....... `r_��.. ..._..>J1 ........ .. t �.... ... _.... �_.... .............. . w r• ------•-------------------------Address W ,: 9 �� ............ ............................................ Installer Address � Type of Building Size Lot___5_,QQ®___________Sq. et U Dwelling—No. of Bed rooms....... --------------------------------Expansion Attic A() Garbage Grinder 40) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ................................... W Design Flow...........il`__. .........................gallons per person per dray. Total daily flew__:_.__3 ........................gallons. fr WSeptic Tank—Liquid capacity-Imo?gallons Length-6 .... Width. -1.6'. Diameter.-- Depth.... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------I----_T__ Diameter------- Depth below inlet..._-__......... Total leaching area. .17....sq. ft. Z Other Distribution box l75 Dosin tank ({J 0 ~' Percolation Test Results Performed by.- A1.�IMR-t... .................. Date........................................ aTest Pit No. 1---A--------minutes per inch Depth of Test Pit.... ........... Depth to ground water_--�� (i Test Pit No. 2.... --------minutes per inch Depth of Test Pit.....�.1........... Depth to ground water. �_� C©V"r � Description of Soil '.� Lp � �? (- -2.'.�`2.. .0.�!�19� -� a -- D 5-------------------------------------------------------- ------------------- U ...................................... -,_' .._"_ A��1, _s4_...h..L...li Cx '_ S.7 ---V1......-•------------.............. 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Com lia eenp'ssuedbe board of h a t . Signe .- ----- �3 ApplicationApproved Bye....... .... .............. ....... .... ....................................................................... ................Date ..-.... ...... Application Disapproved for the following reasons: ............................ --- ...------------------------------------------------------------------------------------------- .. . . .. . . ............................................................................................................ .. . ........... .... . ........Permit No. .... .......... Date • ..... . . ....�..... .............. Issued ..... .........V-------------- Dace '4 %%YTOWN OF BARNSTABLE LOCATIPJi ��2 J�l/S �ovtL �,iQ,g�,rze SEWAGE # VILLAGE c2aat2c2tA ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. AW4 brl ,eo.*,,Zk1c .T s-S 7e A� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) f-ieoo ��/ 3` s�.o.¢ (size) 1 NO. OF BEDROOMS ' PR+V T-� r "'' PUBLIC WATER f BUILDER OR OWNER C eO(i Pel^rr C6,k ! DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No IA l® 1 [� � 7 ` , G - -7 e 37 � �a 1-71 C, Fss.............................. r THE COMVAONWEALTH OF MASSACHUSETTS BOARD OF HEALTH PY TA , pplira#ion for Uiopooal Workg Tonitrnrtion nuti# Application is hereby made for a Permit to Construct (K,) or Repair ( ) an Individual Sewage Disposal System at: /�{ l:Qt �7 S 7,tA`c ��JCt1u -1MI) I lam_ ar•NOJ �av c ��E r�,ns l a_ Q:4,/(L( '..... •• _......... --�• . ..................... .... -•-- •..... Location•Address . or Lot No. e.C.USt_� a �C��j-A.,,..? ,t A, -q ` c_�ttc,��;l_%� 1��._�_ 'a ............................................... ..............- -•-- -- ... .. • . Owner Address W Installer Address Type of Building Size Lot..I..S-....CDO........Sq. feet U Dwelling—No. of Bedrooms.._......3................................Expansion Attic (��C) Garbage Grinder ) '4 Other—Type of Building No. of persons............................. Showers — Cafeteria 04 d Other fixtures ------------------------- ...............................................................------------.. � . W Design Flow..._.......: 7.'�? .......................gallons per person per clay. Total daily fipw............ WSeptic Tank—Liquid capacity.)Pgallons Length ... Width.A::il.(S. Diameter-- ..... Depth_._e._' �r x Disposal Trench—No. .................... Width.................... Total Length........... Total leaching area-______-------------Sq. ft. Seepage Pit No..........I---------- Diameter--------J�..... Depth below inlet...(_............ Total leaching arean.1.7----sq. ft. Z Other Distribution box (pia; Dosing tank (6)) '-' Percolation Test Results Performed by.J-25AV:►�l?I- I,�_f-c=, �Q ............... Date.......................... Test Pit No. 1.... ........minutes per inch Depth of Test Pit L........... Depth to ground water_. --- _.1- r---- - LL, Test Pit No. 2....Z-.----_-_minutes per inch Depth of Test Pit.....Lk........... Depth to ground water. P4 .............--------------- ---..............----•-----...---•-•-•---•......T. . . .............................................................. O Description of Soil..... ..:'_...._.._... vAr�1`1- to� U _Z V 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance-has'been issued by-the board of health. - Signed r......................................................... ----------- . -------------------------- Application Approved By Application Disapproved for the following reasons: ................................. ........ . .... . . ............................................................................................................. Date Permit No. ................................------------- Issued -... = '`°`/ � � Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF ` f'ia s..15 -.�--................ - Tvdiftxttte of C�omplin'u're THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by - ---------------------------------------------------------------------------------------------•-----------------------------......................................................... Installer,I at --------Lt,D -..-` ----- .!?r . ....V. �:1 - t YU.S... .+ �� ? �... '- t C,r..- -b (--c— has been installed in accordance with the provisions of TITL of The tate Environmental Code as described in the application for Disposal Works Construction Permit No. ,�- '�.. �'......-- dated . �---- -,-�--�V _!:.��`:. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................... ....... . . ............$ `�3 '� Inspector ............ THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH F''EE� kc:z Diopsal Vorkv Tono#rur#iott amit Permissionis hereby granted.............................................................................................................................................. to Construct (Y,,) or Reppairr an..Ilidividual Sutra e Dis osal stem V-' at No..--•-••-------- L ..- -- .'_..... t= V- C t l��t tN 1'?�z2l��VS...L......l_..... V�?P4 75_�E►.t.C'(Z_U/((,�. � Street _ as shown on the application for Disposal Works Construction Permit hl ea 4 Board of Health DATE........................... •.....—----- -------•--------•-•---------------•---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS i c } c)2- 2DB �JE=SI l>IJ 1�ATA 5146LE FMILY 3 BET, Mir 1�0. GAP�AtsE G1zr�1�E>Z SEPI't c TA�V- 33ox cscav=A S Foe. DlSpoSAI. P1T 11�G0 6C�ll.�.orys W4 mri.3 6TOLAF- ���N V► E�f 5IDEW4LL AREA =A5Z ��:. :... 'eoTToM A(ZeA 1 13. AL-L co Nt poKA C 09 TOTAL v&516W = SAS, 6fp- TCT'AL DAILY ,ATI ON QATE. 1►.►..rf�2 11�1 Ltd �l +� i c LOADS s HALL n EW N ZD tA OF .►° PETER SUWVAN C. No. 29733 i0 l�. low C v . VL NAL� ' .. o �oA2.0 06'T1EA l.'IN '�E'QQ�.. 17uNi.►1►.1.(� .. ... "l M&` 14 0992 �---v- T Sr 'P-�897 cc Risees To all 4CLE . . . FCC 52,5 TF ML 48,a Z V. DUST. At- v,e O 100t�: Box a9 Sr�rrc pith. . �,�' •o M 1N, a.. ..SA1�lfl (Z p bOMt 6 WA49m . CTR-AV�I. -TONE 17 k �AZCCL Z�3 C Zr(T--I© PST' Fa ��Elop� ` 'PtZv�l�-- N >•oT 273 i LcaTlot'4 ; LAggeusLOvru,f SCALVE tlKMK►µS o se-n�- a ELU,8 �V �GAIr� �SI�OTED DATA; �t�`C 18,1992 "I:oVfATE�. ?P-0sa PLAN IzERFC ,u1Jl��,lgg3 1 CEZOFY 'T IC' TEE .tEl.O�ta C� , %c)vrW HEzeotJ • coM'P.L 5 WITA -n1�- 51DEUtJ 3b6 �G•C Zl Or is Mo. o; : T "mwm �+JD ►5 l�V.�[�1-0� Its t.. '.'[�f� �CJ�z-A l�J XTF•z It NYE INC PL'D'F�SS/ar,1dL. LAIJ'b Su�.v�yotzs 79K R-A W I S Nor i3A5© oN AN Pa - t t� EEQ Z:"i 1 L C-iJ61 IA ER-56u A44D TOE . OWF eTs 44po D uC T3E : 0 5'T=2vIL-S MA/5-4 APPLIC uScfi .T'o �STQBI-IS(� �.Ptz�E¢.Ty -; l.i Nc-S . . .. , . . . , �E����►�TIAL�oMicvcg���5'i"�2�c.T'o '2C s+t�.�i ZoF2 ' ; f 5SES5,De5 MAP l.-lj l F�,e-c E L— 1 SGo 5v x��eJ t61� o� Flo: 273 c,6 6E-T S %5.�92 (-8 SET" 5.is•9'2 PETERSULLIVAN no. 29733 49 9 ThF 'L t�ROt?r5 Sm Q u F N -71 ' i NO 61 .wmv, I�IO� IV 1 ij ht ° f Al l 3 4 , .,a t , y f i r l tr rye A 7.1 t �M06LE GC mob&M9MT s I—o 2 z LA'?a9-u5 LOY ELI•- /° .3eALFY lENAVt1US e_u6Yo �x�r �• NYC 119C