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Home My WebLink About0076 WHIDAH WAY - Health WOj C -rvikm 0 SMEAD No.2-153LY UPC 12934 smead.com • Made 6n USA it WaoV SUSTAINABLE FORESTRY INITIATIVE 1 CartiRed FdWSoilft fl w.n.r.afiu,o0raa�aro I +i //® / o c� NO.__. ff'��l..._ �lo F �.................._ `25 THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEA TH Sys �aC-4d o`.?.............OF..... .:... i ----_.-..-..---------.-- Appliration for Uispwial Works Tonotrur#iun j1prmit Application is hereby made for a Permit to Co struct (C-)-o/r Repair ( ) an Individual Sewage Disposal Sy stem . t: -- - . :.....G �� .. .�.. .......... .............L�l7.. 1�...................................... y, L t o Addr s- r Lot No r 1 ....._ . '�.._C 1>�: ......... � f................ . ._.. __ ._.( _....Q r !�� A..S).L-..(-� ......._ Owner Address Installer Address Type of Building Size Lot... Oj!P�`.. ..Sq. feet Dwelling No. of Bedrooms_.__.._ Expansion Attic k2d) Garbage Grinder (►�� g— ............ Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 04 Other fixtures ......................... •---•-----------------------...---•----•---.............-----•-----....---...------•-----------.....---------•----•--•.•---- W Design Flow.._......_�: ....................gallons per person per day. Total daily flow.&..!-.........................gallons. W Septic Tank—Liquid capacityj6M.gallons Length................ Width................ Diameter._._-________ - Depth................ x Disposal Trench—No- -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No---------_-------_ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing t ) .^ '-' Percolation Test Results S Performed by._..�' ._ 1 e_.,r! �lai��l _C'%/ .__ _ Date...... -'� Test Pit No. l �s._.....minutes per inch Depth o� est Pit.`..J De to ground water.... fi Test Pit No.,?&_O- 1 .minutes per inch Depth of Test Pit.....r............. Depth to ground water. 04 Descri tion of Soil .....F__ �_ ��!? ..e SCI.,6,5 ---••------------------------•----•----------....-------- �^ w ------------------------•-- y�-.l. ' ............. 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 TIHE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the bow of health. Signed......G„Z��.. .........-•-- ........� ..�:2... ..S (/ Date ApplicationApproved By.................................................................................................. Date Application Disapproved for the following reasons--------------------------------------------------------•------•---------------------------------------•-------- ------•......................................•----•---•..._...-------•------•------•-----•..._......-•---I--.............------------•••---------...----------•-----------------•-------.._...._._...---- / Date Permit No.---- ._ _ l'_ .ta................. Issued_....................................... .. ----------- Date VJA -�ov5e. S E W AGE PERMIT NQ�1A �JLOCATIO r P® 26 VILLAGE 1� I N S T A LLER'S NAME i ADDRESS ��. Q c ► sco ll �, 50In y1Igf5+0lh s "Aa��S S UILDE R OR OWNER 6 r2.,ev% �kv --<- DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r Ll �3 3� 2A 3� P THE COMMONWEALTH OF MASSACHUSETTS BOARD JQF HEA TH .............OF..... .. ... .-----............----- Appliratiun for Disposal Works Tons#rurtion Frrmi# Application is hereby made for a Permit to Co struct Repair ( ) an Individual Sewage Disposal syt t . ' ....._ ..» P .. ....... ..... ... ............. ----.---. Lo t n Addrejf +- rLot NoJ ] . O ner Address {. . ., -�.---•-----•-•-•--•-----•---••- ^ mot!. ------ --.. c:? . ..._... ---------- Installer Address r U Type of Building Size Lot__cPOA:�A.'_G?..Sq. feet �. Dwelling—No. of Bedrooms........ .................................Expansion Attic kVe) Garbage Grinder a`4 Other—T e of Building No. of persons......................... Showers YP g -----------•---•----•-----•• P --• ( ) — Cafeteria-( ) dOther fixtures ...........................................................................................--------------........_....._._ • . _ W Design Flow____.._.... .....................gallons per person per day. Total daily flow _ 0.._......._.__......._..._gallons. WSeptic Tank—Liquid*capacityJOC.O.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 t ) r^ a Percolation Test Results Performed by. _ ' f ` ._. ��r y'�'1 "�" �%`r :. Date....... _ -. Test Pit No. l/�` ....minutes per inch Depth of"Test Pit.. _J'_.. DelWid ground water_.._ . .. 44 Test Pit No.Z&n._A_minutes per inch Depth of Test Pit.....fC`�_____.. Depth to ground water. a. ... ----••---••--•---••--......................................................... Description of Soil._.... r s yz??�e'�'7 '�- / r T r,_ ------------------------------------�-� ........`!r-----........� ..._��...�- .�� ------------------.......-------._._._..._.....------------•----....------. W Nature of Repairs or Alterations—Answer e livable-------------' .. --- U P PP -----------------------•------------.......:.............--••-----------•••...... ------------------------------••---•------•---•--•-•-----•----------.........---------•---•-----•--•-----•-----.._..-•---------------...---.........---•----.....................--•............•-•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—.The undersigned further.agrees not to place the system in operation until a Certificate of Compliance has been issued by the boarthof health. Signed_.... -�------------- Date ApplicationApplication Approved BY.................................................................................................. ........................................ Date Application Disapproved for the following reasons:......................................................•-______.____•-_•__•__•-_____......_..._............--- •------•--.....-----•---•--•••...............•----•----------•---•--------•••---••-•--•-•--••......_._....:---•---••----....---------------------•........--•------------..._....-----....--•---...._____ DatePermit No......e,.r, . !' ----------_-- Issued....................................................._ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH ...............OF.... ,!7, .. 1:: :.C................................... Trrtif utttr of Toutphaurr T IS TO RTIFY, Thati the Individual Sewage Disposal System constructed (j.,)-or Repaired ( ) b �..� .! :._. .i.5 ...f- Y ..................................• =:.....:..... ...:... ....... ._............. --.... .................._ at. / ✓.G.It.SCi _`+rrS__.:.Ins*�.C`"i ( +r /,'�✓� ------... _ 7__. tt':.G 1'f.s:'--------------••-•-----•----------.... .-----.....------••- has been installed in accordance with the provisions- f TITLE 5 of Th State Sanitary Code as described in the application for Disposal Works Construction Permit No.__, _. ............. dated.............. .............................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL FUNCTION SATISFACTORY. DATE........ . �T� .................................................. Inspector-------•-----/�......-•-•---•--------------------•-------............----•-•---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAj..TIj 12 ........... No.......�............... Fn...._.5�....c, ........... Disposal or" ns#r ion rrrmit Permission is herebygranted...-I— ... ...... „ ct li to Construct ( r Repa ( ) an I divldual wage isp'' �y em atNo..............................•••__�'-' .. "' • --- ............._..................... ----•--..._•••........... Street �+ d 12 30 l as shown on the application for Disposal Works Construction Permit No.E.U.4.. . ated.._! ...... ;/..... _......T .......................................... ....-- .......................... - L Board of Heayh DATE.............. _ �_-ees` ........................ FORM 1255 .,A. M fSULKIN, INC.. BOSTON� t , ,. ...... a...�. ay..+ rt ; )_O 7 :� 3 } lu kb y{f n rt A S76 31. • - y r 1 4 a � I k w y ^ ZONE 7e D C•d2G. i , t r r r r+ .►` :. fib! �QV /N "` �'2. 7{V//,0 j'H. } `3ti p o R s��e✓ -,0 t aRS 1'1 SETS cr< S V VL �J ° Soan3 Z,p C7v s.+F}. �3y,. iR/s t . N P,L[iEf2T c r A �,` MOR `£ z ti dX . s sq o No. 10951 <j �41as C/r.IlyL j ROBERT F r B. �F. LEGEND o Q� . } .EXWTINA SPOT ELEVATION OAO 9 ►�o. isELDREDGE 67 .EXIBTINS;.CONTOUR --� O — �""�ss�'°FGISTcQ`�°�4 CERTIFIED PLOT PLAN xs °-1FIMt!lNED'.: •SPO.T ELEVATION i i��w'�,�' Xl SHED:-',CON'TO:UR.-..,~ 0 .. .. ->- Lo T „p ,'N Tt, The ],ocation of any` existing un r Ao,und sewerage, s. ; or other utilities,. shown on this' plan,is approx- IN 7Evi5dEO io/s �8S f itmate .only as,,,determined from recoxds and/or .verbal SAM I-S IA �, Z `nforat on,. he contractor is responsible for the � x, R E f/NSF-,� `I /�,�&'•.� ' 4ue a icatxop'•of -the existing.-;locations in, the field. gCALE� / r� 40 DATE d r &PRED.CE ENG/NEE'RlAlf cot IN C41ENT I CERTIFY. THAT THE PROPOSED_' REOI9TERE0 K. 6'309l BUILDING SHOWN ON THIS PLAN IEtQI$.TERE JOB N --- -- CONFORMS TO THE ZONING LAWS :} CIVIL 4y -'LAN �:N T ER R ---`-- OF BARNSTABLE , MAS t . 3. � � T ,rTi2°'MAIN STREET;. CH. 8Y l� 3 8S' ? =MYA�JNI`S, MASS., $NEET.:�. OF Z A E REG. LAND SURVEYOR t{, t F 7'NE"SE?T �� .. : y • .e : * � f _ � , ,[� � .., ��T�l� x, ore RIOT /.F ?, n LFi4c ,ilnrG �iT'AIlE�.JyOR�. 4-MAI/ !2"BFLOlti1 !O FT !"J!NrrRI1 DE, 24'p� �9aE.TER' CO/yCRET� COi��! �--= S,�,j.�lt O►i="`BaOuGryT, T-o -IRAoE.�,-tiN FXr e q ? J' 4 ;PYC /PE G�NC.tI`TE h+EA3Yy C!'1 5T.IRON CD{/ER SHALL 8E USEd W. P/TGN IFIN DR/YEWA)e r jet, SZrS corERS �! �8� 'FR,FT 3." M cooeZ r ; r _ /2 MIN F,L ° i �Q D IA. - t * -- '� pKG /PF t 'TO D O (jL. :0 SEPTIC TANfC DIST. • • ,� • •• t ;.� ,•- '• • e �t OtPTt,/ ' t � • • �_o "31'ASNEh,STa.t'E BOX = _� �� _ .• a :. °. e + �. • • • �'•�1 �� o PRECAS T SEE A6f i //f�Y&ol r,4EY.�TIONS Pr7- c��A c�-TY S¢� �A4-1APi4 Y • �•• • i • .+ • . . +"• �� L !s R l.VY,EIRT AT Ol//LD/N S G _ 4y D/�1J�� T FT. : INLET .SEPTIC :TANK 4913 FT, F7. O/A!M• i C(SEE Ts.BULA r�oiv� Ot/YLET SEPTIC TANK INLET DISTR/BYlJON 80X �•9 FT SECT/ON OF :GROIJND ACA7Z. TitdLE a2WZ&7-10/SrRAI&!T/ON BOX 4 g 7 fY /1V4ET LEACNIM42 PIT 48.SFT SEWAGE P SOASAL SYSTEM ?A&V TIDN LEACH/NG PIT JCAL viwfEnrsJow A 3 FTE-: fs_ : /=D� D.ES/GN CRJTERI�S D/�fHvs/oN a 6 FT, wv�aER of BEoxOOMs 3 D�ME1vSioN G FT. jni. !ARdAGEG/sPOMlJ- uw1`r Mv1✓E SOIL LOG TGZAL &-ST1A%A'reD FLOW .330 G.4L,IAOAY SO/L TEST ,*l SOIL 7EST02: SO/1- TEST VUAf&" 0,- 4lrACMISC P/rS [ -. Sn•3 EL&rb OATF OF SOIL TEST &'/ 51DE 4,-ACHIN6 PER.R/T ,S42. -P RESULTS ly/TNESSED $Y pM GF7�/L-O ,107T'Ohl LZ4CH1N0 A>4LCR Lv fi M o PE/t COLAT1OlV RATE _ c� 707AL LEACK(NG AREA 2C'fo stp FT. �ri35D rL PPXcoi-A r/oAe RA7,.r A T1f��/MIX.�INCR ?ESEMk LEA C,,NI/V6 AREA �-(' � $G. fT / 2 +"� S,n-I✓ram SDlL72_�.5T Fiisr� GOT ;;;14- yVHI.`"A PALEL NO- 10951 s �c/urLF No 5Qz r s �' ImLOREDGE Eh /N6�JP/ILL /AEG. € ,38.3 7t2 MAIN ST., NY.tNNl9, MA-�S. = S ® IYaGROUND yY,4Tt`R 1rJNC0UNTEREO LL/El/T�REEN$�IER jr ISMO L Ar-P. .yVsl TER -A7' ELZY: J08 /A .:3 ►ES T—•Zw Z ._ _