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Home My WebLink About0052 WINDLASS LANE - Health 5,a- uj i nc� l cuss 1-a�n� bp4&cvim, l 01 ems] �$....../00 ..................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .................... " "...--------.OF.....26�7.2..........r .................................................... Appliratiou for Uiipuiia1 Works Tomitrurtiou thrutit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at ... iwr�Guess L;�Ir CwT�7zVl,! GZ Co7- I� ..... • ....... •- ............................................... .....----------------------------.... ---...--- /dress or Lot No. -------••--•......•-----•-•---..I..... ...........•••-•-•- ..........--.................................................................. Owner Address 044P777r Installer Address Q Type of Building Size Lot.—�715®4------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------- . W Design Flow................. 7.. ...................gallons per person per day. Total daily flow------.._ 3®....................... 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_____elq_`__..... Depth below inlet....A_........... Total leaching area.._.i�`7.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by----- �✓ -!o-••Lr� �� Date. ....................t----�-��/.. Test Pit No. 1--- "z...minutes per inch Depth of Test Pit--- Depth to ground water------^------------- f=, Test Pit No. 2....L.2'._minutes per inch Depth of Test Pit.... ...... Depth to ground water........................ ..................----------------•i••---..........7.....• -- -----•--->-------/--."....i--G-----•/--`.•-�•-•...... � ------------------ 9 S zO Description of Soil----......o..�.'2�. .....!Vao�4a/► ....�.. v3-sa --------Z C /iiea` ..E. : ........................... -•-••- ............ ..__ _ -------------••----•----------•---- W . ------------------•---------•.•-•---------••------•--•--••---------•--••-•-........-•-••--•-•-•----------•-----••--....-----------•-••---•---•----•----------------•--•••----------•----•------•------. 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 Compliant as been i ed he board of health. Signed ------- -- --- -------- --- ----- -------------------------- ............................ . ...�� ... > _ e Application Approved By J................ vw•1.... ,rr..r••- �........ - ..... are Application Disapproved for the following reasons- -- -------------- -------------------------------- -- --- --------------------- - ---- ------------ --- ............................... ------ Date PermitNo. .......... .'. Issued ........................................................------------ Dace o No................-....... Finc............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............................... Appliratiun for Bitipas al Work.6 Tunutrurtiun Vrrmit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: (cr.e,ita�.755 Lchi✓�' 67, ✓/07 Vi4G6 - - - -•--• ......... ....... --•------•-----•-•..._----••--••----- •-••-•---•---------••--•--......... •-- --.......----- Location-Address or Lot No. •• •- ......................` _rr_.� _......__. v.�c - • ------------------ --- dr ...----....---.....-•-- �., Owner -• Address ----------------•----•-------...........------------•--•------•------ Installer Address d Type of Building Size Lot. -r--1'4_._____Sq. feet aDwelling—No. of Bedrooms...........'-'.............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ..... W Design Flow................"_'......................gallons per person per day. Total daily flow______._.-j_ a...... _................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.____.t�!?...__.___ Depth below inlet___.•........... Total leaching area... .....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by----- �_�12� • �_!✓ G.= / Ti1-./. i r>/ f -'--••__ Date.':---=••- Test Pit No. 1__ 2___minutes per inch Depth of Test Pit___! r' "-..• Depth to ground water_____..--______________ r3, Test Pit No. 2____ __.z'..minutes per inch Depth of Test Pit___1G t `'•••• Depth to ground water..... _."`_______________ ----•---- Description of Soil--------- ` �....ln/t G i� la/�y 1. .._S�/�.......................... 6✓C ?-'/ ,--/—;� fy � E� x ........................../.... � �/�[ E ... .. -- -----.... -- x '--__.••--------------------------------------------------•-•-'----...------•------•-'-----•-••--•--------•----•--------•-----------•-••-•----••----•-•'•--••••-•-•••------•--••-•'•••-..__..._•••-••-- 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 Complianc as been i ed he board of health. Si ned - g ............................. Date .�..... Application Approved By ------------------------------ Dale Application Disapproved for the following reasons- ..................................--................................................................ a ---------------------------------------------- --------------- ---------- -- ------------- ------------------ ----------------- ------------ ------------ ---------- -----------------................... Da[e Permit No. . ---.... ... --------- ---------- Issued .. Date t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - - .................................. C e tifira#e of Tontylianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (t/ ) or Repaired ( ) by------------------------------------------------------------------------------ ----- ---------------------------------------------------------------- -- ------------------ ------------------------- - ------------------ Installer at ....................................... has been installed in accordance with the provisions of TITLE 5 of The Sta ,Environmental Code as described in the application for Disposal Works Construction Permit No. � PP p .-�..'�...-............................. dated ------------................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......... .............. ' , ` Inspec ram...---- ----....- �. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ...................••---..........--........-....--•.-.......... No.•--- ---------•---------- FEE........................ Permissionis hereby granted.............................................................................................................................................. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No. Street Qc� as shown on the application for Disposal `Forks Construction P it No..................... Dated------Z,---;6z--- ..--••-- DATE............ ..- T'--------------------------------- B and of ealth �-�-" ----.• FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - V " OWW OF BARNSTABLE LOCATION GLJ -JD L4S-S L-N SEWAGE # S`�57� VILLAGE ASSESSOR'S MAP & LOT 4NSTALLER'S NAME & PHONE NO. 00�t-4—ejL&77-) ez Qg77 EPTIC TANK CAPACITY o �.EACHING FACILITY:(type) P �� (size) r BEDROOMS PRIVATE WELLR`OR OWNERERMIT ISSUED:COMPLIANCE ISSUED;CE GRANTED: Yes No lad e a F.ILJ�DCATION ,SCALE . DATE'f�, .-*7,/f PLAN REFERENCE . .....?NG . . . . . . . .. . .... . I � / 2.31 i 6 I 4 i 0 O �,ST. Msjr V TDlz/v4--klAy �v NJ Lo T /Z 33 V. EY Z a,e Z -SlleZ-l.5 4v L. . . ..... . . . . . ... . TOP OF FOUNDATION e„ CONCRETE COVER CONCRETE COVERS p3L ,e; 4' CAST IRON 12 MAX. T 12"MAX. "mr""�n'• OR SCHEDULE 40 4"SCHEDULE 40 PVC.(ONLY) P.V.C. PIPE PIPE- MIN. LEACH ' PITCH 1/4"PER.FT PITCH I/4"PER.FT. PIT PRECAST o INVERT o a LEACHING EL.. .�.l7. INVERT INVERT c . Q•i PIT OR SEPTIC TANK DI ST. INVERT EL.39.-�9. . BOX EL39•L7, �_ :i' EQUIV. /can. •, ., GAL. INVERT a o; EL.. P•.��.. INVERT �• w w 0. .,% 3/4"TO I I& EL w o• WASHED STONE ' . 13�— -WDIA. E D I A;!:q PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL. SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE 99!?f- TIME.�!:po 141-1. �`�'W'A?� . 4 y BOARD OF HEALTH TEST HOLE I TEST HOLE 2D�n!.9? , ENGINEER ELEV. .-fq� ?o . . . ELEV. .' /�' �. . WooD woc;nt-oAr7 " s4-spec. T.¢ +�svfi_ss��- � � DESIGN DATA : NUMBER OF BEDROOMS TOTAL ESTIMATED FLOW . .'330. . GALLONS/DAY 9z, ��-S �•3,4d BOTTOM LEACHING AREA . SQ.FT. /PIT/G. RD, G/ts�y�G SIDE LEACHING AREA �g8' ��. SQ,FT./ PIT/47/' Z GARBAGE DISPOSAL No�/�' (ram% AREA INCREASE) 7 TOTAL LEACHING AREA .LG7 on SQ.FT �zD g �z Z7��o PERCOLATION RATE ?S? �? MIN/INCH _ 7,7v _ _ LEACHING AREA PER PERCOLATION RATE .�. SQ.FT/nA.v, !fib. .WATER ENCOUNTERED 6.VG PT/ NUMBER OF LEACHING PITS . . . . . . . . APPROVED . . . . . . . . . . . BOARD OF HEALTH DATE . . . AGENT OR INSPECTOR xz;JR 0v. /t �tV1H Of MA IiY d. ers PETITIONER f �,•,