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Home My WebLink About0209 ANSEL HOWLAND ROAD - Health �9�anrcJ° MovtaA d llle r7f -- 1.39 SMEADp KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE MIN.RECYCLED FORESTRY INITIATIVE CONTENTIO4 CertlgeOFiherSourcing POST-CONSUMER www.sfipragrem.org SFW12W MADE IN USA GET ORGANIZED AT SMEAD.COM 1 P L O CATION �__,, SEWAGE PERMIT NO. Lot 4 Ansel Howland 83-357 VILLAGE �s�e INSTALLER'S NAME & ADDRESS Robert B. Our Co. Inc. Great Western Rd.. North Harwich BUILDER OR OWNER Alan Small— .5126Z83 DATE PERMIT ISSUED /26/83 DAT E C0MPL1,ANCE ISSUED ®,a Lot 4-Ansel Howbind NcK a� 1.6 6 �a �r • No...S'f•-3 ,� Fps ..`.`.................... THE COMMONWEALTH OF MASSACHUSETTS � BOAR® F -�-�iE�]�L��`,T�I ...........OF... .......................... App iration for Di-gVus al Workii T.lnitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or /Repair ( ) an Individual Sewage Disposal Syst t: - - ...... .21._.... ... l ! ✓ C�v . -- Loca'on-Address or Z.o j Owner Address W •---...-••-- ' ` �- ------------- -•-----•- ._._._..__.� ! Z/ s�-�? ...........................•--•--•-.................--- Installer Address d Type of Building Size Lot------ _/?%-d Sq. feet Dwelling—No. of Bedrooms____________________________________________Expansion Attic (,A)J Garbage Grinder (/-I),> Other—T e of Building No. of persons____________________________ Showers — Cafeteria a' Other fixtures -_ ...._._ � -------------------•----------------•-----....----------------------------------------•-- W Design Flow.......... -..'_______________gallons per person per day. Total daily flow____._._. --- *.____rJ_._._.__.._.____gallons. 14 Septic Tank—Liquid capacity_t_2�gallons Length................ Width................ Diameter..._...._._____. Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....C2 _,.Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2.........._.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ GY -•••--------•--•••--••--•---••-•---•---------•-••.............................................•-•---......................................................... ODescription of Soil........................................................................................................................................................................ x V ••---•--------•-•-•••---•-••---•-------------•-----------------••--•------•-•-•----......•----••-------------•--•-•----•--•-•••---•---••...•---•-•---•-----•-------•-----------..........-•----------••- ------------------------------------------------------------------------------------•.-•---------...-------------------------------------•----•----------•--........................................ 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 L LZ 5 of the State Sanitary Code—The undersigns further agrees not to place the system in operation until a Certificate of Compliance has been issued by the b and f health. - at Application Approved By......... Er.✓i....._.....-••--------------••--•--.._......_........_..__.... �L. . .. ate Application Disapproved f or�he f .lowing reasons-----------------------•------------•-----------------------••-----------------------------••----...•-•-••-.._... ---------------------•---•-------....------------------------...----------....----------------------...._--••-•••-._._.....••------- -- ---- ------------•--••------- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................O F..........................................--.............................................. Applirtation for Disposal Works Toustrurtion Prratit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: S ................____.............................................................................. ..................................................................•............................... Location-Address or Lot No. •---^••-•-----......................................•--------._..................•.............. ..................-•-••-••-••••.................................................................. -Owner Address W -•--••........_..••••----••-•---•••--•- Instal.er Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) __...._..... No. of persons............................ Showers — Cafeteria pa•, Other—Type of Building ________________ p ( ) ( ) a Other fixtures -----------------------------------------••-•- 111 W Design Flow____________________________________________gallons per person per 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.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••••-•-•-•-•--------------•-••--••••-•-•-...........•••--•--••••••••-•-••-••._-_.---•---------------... --------- ---------------------------------------------- 0 Description of Soil.............•-•-------........--------...--•------------------•-------•--------------------------------------------._._._._...--•--------------••--•-••-----...-•-•--•- x V ------------------------------ ----------------------- ..._......---------------- -------------------------------------------- ------- .._.__._....--------------------- --------------------- --•--------------------------------•------.--......------._._...--------•--•--•--------•--------••-•-----------------------------•--------•----•---..-------•-•---=---•--------•-•-......---•._.._...... 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 iiml 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 health. i ate,1' ow�',, .............................................. .........__.�Application Approved BY-- -'==`-'=.:................ �----%'��reasons:Application Disapproved fog --------------------•--------•-•--•----._.....-----•--------------------------------•------------------....-----------------------------------------------............................................. Date PermitNo......................................................... Issued_...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................-...................-.............................................. TrrtifirFatr of TompliFanrr THII IS T�. CERTIFY, That the Individual Sewage Dis osal System constructed or Repaired ( ) by !� ?,^ -/` C11.. f �--- -----•.............•----------••---..............----...................--•--•--•-...---- �f "Install at `' jF •---- ..... �x __�. ___....-...,1 '' 'P re" _:::: r J �- has been installed in accordance with the provisions of h > of The State Sanitary Cale s de bed in the application for Disposal Works Construction Permit No .. .......... dated_Y-_- ................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BYCONS E® AS A UARANTEE THAT THE SYSTEM WIL F NCTION SATISFACTORY. DATE.. Lf... .. ._.•--_-•---------------------------•----•----------•-.-- Inspect .........._.......... ....................._........:. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No..':.�.... .....s.. FEE.f-•-••............. 19ispos al Works Tuonotrnrtion unfit Permission is hereb granted ------=' =' -----.----•-----------------------•----------..-..................... ,�.. to Construct (;�; epa r ( ap/Indly 'ual Se e asp al Sy em at No.. f� -•----.--add ,�t� •` ;e `°�� ` r .. J Street shown on the appl> on for Disposal Works ConsY ucf tion Perm Now..____.._. . at ......%__.: ., ...... .......................................... .v..... ...._._.. ........_._....... �.............. � y � Board'" Health DATE-••----....1-.. ... ---- ................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS i 1; i i 5IW6LC- FAAILY - :3 BEpRooM I I 1 WO GARBAGE 6Q'w06P- , I nn►L Flow/ 110x 3 = 33oG.PI? 1 j Y � •SEF> I,G TAtiK = 330xl3c>% = ,49/;G.P. q U54=• I000 GAL. D%5Po5AL Prr u5E t000 GAL. 150 5.F X 2.5 3?5 G.Po �E.tcH �.o• BOTTOM AREA= �0 =.. .��p 'TOTAL.. p s,516N r ,4.2 5 ToTAt- pA► Ft-0W = 3306Po �ld'� 1 ooc� 33'� o it j PE2Go�ATION RATE = VAIN VAIN 0t`LE55 ? eX I _ . f oP itt aF As s. . •��P��N Mgs,�c } 8 5,0 3. ��• ALAN tiG �v` RICHARD �yGv, W. , I 1 A. o JONES 'r SAXTER No.24048 4,yo su1904, I'�`l1' ` 'GZ l00• S T4P FWD ` IIIGI��Q ye loon Sv`3Soit_ D 15T. G z� Bu�c INJ. SsP?�G gB.a , (opo Iu�(, �•La TANK .. .S.e^ra� GAS" 58 v LEAcu C-•oeAVf4-. PIT INV.. INV. WIT14 4/E17' 6Tv N 6 /Z � i CER.TIFtGG PL-�T PLAN N W4T PROFI L.� �•8.O L O L A 7 I c N G G t�T' �v l�:l.._iC•'I N o� .5 CP.LE I p�./�►r� RE�E QEN GE 1 1 teEP.TIFY THAT 'TNE Fo0rJDlkr�0P4 SNowtj NER6o►J GOAPLYS WITP"THE 51 oELIN E oT, � A W D SET eAG K R.6 Q 1 t2.E M E N'1"� o f 't 1�E .� /j� ?� fo W N O F= BAZN5-rk'SL.9-- A Nv ►l�, K107- LOGP.T D •WITNIW T1A'6 I Loop PL,60W i DAT 1r \� pal-p �u.� BA%TEIzg Wys INC. ' REG I SZ E.Q6V'1-A►10 5 u 2.Y E�(of�5 Tu15 PLo.N 15 NaT E3n5Ep ob AW osrE2.Vl1_LE• - MP6s- IN,STRUtAF-- -r 5ueVey �--TVAa 01=F'SETS SucuLD ' Na-t pE 'v9ED'co pE'TtEzRlAINE L.c•r VINE.�j APPt-ICANT A, �j,/V��\��--i`IJ�, .