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HomeMy WebLinkAbout0018 WILCOX LANE - Health Cox one, 4er✓i I I-e, S M E A D No. 2-153LY UPC 12934 smead.com • Made in USA aRccrct" =, SUSTAINABLE FORESTRY INITIATIVE CerdfiedRbwSOumbo �n.nu SiDrogralRorO . , 2.No._ ,1i~J D.G Fxs......U4 ........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...............TOWN------- .......OF............4;.BA-RNS_TABL_E�_ ,. -------------- ------------ , pplirFation for Di-4paa al Works T amitrurtion Prruat Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: ' ----•- -Wilcox Lane � � � � ----2 , ocation-Address or Lot No. Bui tweaa- Homes 1061 Route 6A,Brewster,MA 02631 ......................-........ ---------....._........_. -- ..........-----.......----------------•----------....................................... Ow er Address O' •-- ........................ .......................••..................................•...................................... Installer Address Type of.Building Size Lot-----15,-2 38------Sq. feet Dwelling—No. of Bedrooms...............TWA ---------------------Expansion Attic ( ) Garbage Grinder ( ) a` Other—T e of Buildin q yp g ____________________________ No. of persons............................ Showers ( ) Cafeteria ( ) dOther fixtures -----------------------------------•-------•-------------------••--------••-••--- Desi nFlow 55 2-20----------•-••---------•-------•-- W g ........................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity...l00Pllons Length......... Width...4.'.10"Diameter-------...... Depth... ��... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.__------1.-______-- Diameter...........6'.__. Depth below inlet........ Total leaching area.20.0.,,kaq. ft. z Other Distribution box (X ) Dosing tank ( ) Percolation Test Results Performed by........_Paul- A. Brognade--......_._ Date.....6/1-2•�85............... _2 minutes per inch Depth of Test Pit ___.. ..... Depth to ground water__RQn-e......... 14 Test Pit No. 1_.._.< ___ - 13-'5" fs, Test Pit No. 2__............minutes per inch Depth of Test Pit...... 3 ' 5_11. Depth to ground water....NOTI'e_••-..--- ---•-••--------------------------••••------------••--•-----••------•----•---••......--.......------.•-------._....---•-----------•---------------•---------- O Description of Soil.....1 ) 0 - 18" Loam & Subsoil, l8" - 78" Coarse sandy...gray_el--- x w/many__--cobbles, 78" 162" Medium to coarse sand, ( 2) 0 - 18" Loam.-- W & subsoil, l8" - 72" Coarse sandy gravel w/some cobbles, 72" - 162" U Nature of Repairs or Alterations—Answer when applicable.________ _______ Medium to coarse.. sand_. -- -------- ------------ - - - - -------------------------------------------------------------------------------------------------------------•--------------------------------------------------------------------------..........------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of A :LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance _ has been i sued by the board of healt Signed '�... ---•--•- - '- - •- --•------..-•---------- ----- -�17....1.1...... ` �Application Approved By---•• J Mtn Date Date Application Disapproved for the following reasons-----------------------------•--------------------------•----................................................... --------------------•----.....------....----..._...------------•---------------------•---------------------•-----------••-•-----•-----•------------•••---------•-•-•-•....----•------•-•----•-••-•--•--- q Date Permit No......5?7 -1 9'------------------------- Issued--------•-------•----------------•---------------------- Da-- TORN F BAR STABLE or M LOCATION SEWAGE # VILLAGliZ ASSESSOR'S MAP & LOT 8070 \ a SAS 12d7 INSTALLERS NAME PHONE NO. SEPTIC TANK CAPACITY (��� LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER p ' BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED- VARIANCE GRANTED: Yes No . a6 5 •'jh. 101 Merritt 7, Norwalk,Connecticut 06851 203-852-1222 Merrill Lynch Relocation Management Inc. e � C r ITI W ti` w ' 7� d r , No........................ Fas.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------- -----TOWN................OF................ ARNSTABLB :F Appliration for Eispoaal Vorkfi Tonstrnrtion rrrntit Application is hereby made for a Permit to Construct (X ) or Repair ( } an Individual Sewage Disposal System at: Wilcox Lane 2 ................-........--...................................................................... ---•......----••----•-••--•-•----••-•----•----------••---•.....•-----•--•------••......--------•-- ocation-Address or Lot No..Bui twetl Homes 1061 Route 6A,Brewster,MA 02631 •--•.................•.......... . _____________________.. ...••--•---•---•--•---••--•-----......---•-...........-----•------•-•.......------........ -•-••--- / Owner Address � Installer Address Q Type of Building Size Lot.... i 238 ' Sq. feet Dwelling—No. of Bedrooms............... .............TW�.._----------___.__--Expansion Attic ( ) Garbage Grinder ( ) aOther Type of. Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtur ••---•-•-•------•--•-----------•------•-•-•--•------•-•----••-------•-----•••--- ----•-........--•-•---•-- 5 220--------•------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.....OD2allons Length... Width..A 1.0 n Diameter-_---........ Depth.. 1.4r.-"---. x Disposal Trench—NTo. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...........62.".... Depth below inlet......6.!........ Total leaching area..2Q0...4aq. ft. Z Other Distribution box (X ) Dosing tank ( ) Percolation Test Results Performed by.........Paul---A_•...$4©gI1dG'{e................... Date.....60.11VIB5............... a Test Pit No. 1___- - ___minutes per inch Depth of Test Pit 13. 5_"_ Depth to ground water___N9111@.._.._.. f� Test Pit No. 2__ ...........minutes per inch Depth of Test Pit----- ... ". Depth to ground water....HoM.0________. Rai O Description of Soil.... Loam & Subaoi1�18" 78"_ Coarse---sandy...g�CB_V_el--- x w/many cobbles _?8" 162" Medium to coarse__......................d, 2_)- 0-•---1$"-••Loam_-. W & subsoil,l8" - 72" Coarse sandy gravel w%som _ cobles, 72" -,_162" UNature of Repairs or Alterations—Answer when applicable_-__.--_ -__ MOARm.._t0 eoarse...Band.... --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTL 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 issued by the board of heal h. Signed.-•-AR-43.... ....... - - ........................... -----7y�-1....9.)-------- Date APPlicationApproved By................................................................................................... Date Application Disapproved for the following reasons---------------------------------------------------------------------------..................................... -•...................•-----...-------•-------------•---------------•-------------•--------.....-------------•-•--....._...•••-----•-----•-•••-•-•-••-•---•--••......--••-•------. Date PermitNo......................................................... Issued....................................................... THE COMMONWEALTH O,E.�MASSACHUSETTS BOARD OF HEALTH ...................TOWN..........OF........4ARNSTABLE............................................. TwWrtifiratr of Tomplianrr THIS_W TO CERTIFY,�-That the Individual Sewage Disposal System constructed ( ) or Repaired ( } b_ .ff_nr' _.. l�`'e��� -------------•------------------•--------...----------------------------....--...----------......-------•--------------- Installer at has been installed in accordance with the provisions of TI T IE 5 of The State Sanitary Code as•described in the application for Disposal Works Construction Permit No......................................... dated------------------------------------------------ THE ISSUANCE OF THI CERTIFICATE SHALL NOT BE CONSTR AS A GUARANTEE THAT THE L SYSTEM WILL F �10 TIS ACTORY. x DATE------- . .... ................................. Inspector..--•-- %.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............TOWN..........OF...-------- BARNSTABLE . FEE........................ Disposal Vork.5 Tonstr ion amit Permission is hereby granted••--= :.. � % t :T� ----...-----•----------------------------------------------•-----•----. to Construct ( ) or Repair ) an Ial Sewage Disposal System at No................ � � G_!2!� --------------------------••--- �lZ /7 �' street as shown on the application for Disposal Works Construction Permit No...................• Dated.........7_..._......._._............ ., c -------------------------------------------- �-7 � � Board of Health == DATE----------- -------{- --_----•-------------------- {j FORM 1255 HOBBS WARREN. INC., PUBLISHERS l ToP lrouNgRTl4N s Lt..• lca».c ' MIN. Z� FIN1SriL'D C F.R'DE RI*it;ts 'ra WITHIN I.&' &r F!N• C.IRR� �,p' QF GdVEiZ E o , > o 0 0' • t.0 f"11l+ COVV_Pk- T. PIT No• I T. PIY NA. Z Alf l ol• G. I yo .f� t�I.1 ---r-r •�_� a n.__; ,. Z�' GoYE R OF CL. 144•4p, o' EL. 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