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Home My WebLink About0298 CAP'N LIJAH'S ROAD - Health (2) 193 �l�f jq2 O Y 4 I._e.a V No......1—i••9------ r FEB...hl...................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® F HE LT QOF......... �tPl/l .............................. p Appliration for Uhivaoal Works Toustru"dion lirrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: --- -•-•............. _ t .�.. ...z�........ r _...--. -- - Address /� Lot No. ............. .... -• ...................................•.... (� ......................................................._..._.. ...- •^ •. Ow r Address Installe Address UType of''Building iy Size Lot.. .�. .7:..Sq. feet Dwelling—No. of Bedrooms............................................Expansion ttic-�-� Garbage Grinder-—j— '4 Other T e of Building No. of ersons._..._. Showers — W yP g ---------------------------- P ----------------- ( ) Cafeteria ( ) Pa Other fixtur s W Design Flow.............. .. ... 71 o®---•----gallons per person per day. Total daily flow............. _Q .................gallons. WSeptic Tank—Liquid ca acity..... __..gallons Length.__��__.--...... Width................ Diameter................ Depth................ x Disposal Trench—No. Width.................... Total Length.................... Total leaching area....................sq. ft Seepage Pit No./DO.4... rheter.................... Depth below inlet.................... Total leaching area..................sq. ft.. Z Other Distribution box (J� Dosing tank ( )- d- 27 '-' Percolation Test Resul s Performed b .............. Date._a.-. �.-.1.7.._...... Test Pit No. 1. .:�r.....minutes per inch Depth of Test Pit................... Depth to ground water..................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �'` �� j Description of Soil-------• ` Or,y1�.. y -----•- °� ........... -- -.�---•------ W UNature 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 Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu by the boar - igned -----_-••-•------ .............. 7 Date Application Approved By........ .....J 2.-'---'-� 7Z ° Date Application Disapproved for the following reasons:.................•-•-•••.... -----------•-----------------------•-------------------------•--•--•--- .................................•--......---•-------------••-------------------•------.........••----...._......_..-•---•---•--•--•••-•-•••••--••••----------••--••---•-••--•--•----••...•-••••••••.._.. Date Permit-No......................................................... Issued_ ..............................................7� . Date q ff THE COMMONWEALTH OF MASSACHUSETTS BOAR® �` I-iEA T t ........---OF........ .... 1 Applir€ation for Disposal Worko Tomitrurtiun rumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage,Disposai tstem-•-- t •".` . -- -------------- - .. ............. ................ ............ ......r--- ...... .. - Address ."' Lot No. ..................... .... — .__. �. er Address " ` ,-a . -------------------------•------- Install Address Q Type of`Building Size Lot_j .................Sq. feet aDwelling—No. of Bedrooms......... ............................Expansion Attic*`*" —" Garbage Grinder p-, Other,—Type of Building ............................. No. of persons.......-_.._..._......... Showers ( ) — Cafeteria ( ) G I Other fix�,es ---•=--------------------------- Q .,,�3 ------------------------------------------------------------------------gig ---------------•--------------------- w Design Flow.....................7elm 0._.___._gallons per personpeF, day. Total daily flow...........�✓-.0.._r�.'_..................gallons. W Septic Tank—,Liquid'ca,� clty gallons Length................ Width.,............... Diameter---------------- Depth................ x Disposal Trench 'Vo ..'Width ----- Total Length . Total leaching area....................sq. ft. Seepage Pit No '�4� ____ eter.................. Depth below inlet_ 1 leaching area..................sq. ft. Z Other Distribution box (� Dosing tank ( . )" 7'! Percolation Test Resu s Performed by; .._ .,.._. 1A� ...: ........: Date._ _:._`. 7 .......... ,4 Test Pit No. 1 _..:�'_.......mmutes p t er inch Depth of Test Pi ........ ...... Depth to:ground water..................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ o l Description of Soil �N Ow O tt w `,T`` .z -, --- ....V. r - - w UNature 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 TIT?.1 5 of..the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate*of Compliance has been issurpd by the.boar . �< Application Approved By.......... . ••• ...... ........................ r-'" Y Date Application Disapproved for the following.reasons:.:............................................--...-------•••.............................. ---......_..-- .........................:••-------------•••--•---•-•••-•---•-_.. ......--------•-.... -------...-----------------------------------------......--------- ---- -------------•--- Date Permit No--=...................................................... Issued----- ::... - Date ;.,.THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f ......... ..... OF.:........ ...:..:.: St .+............... Tn#ifiratr of Toutplianrr THI S T E,. FY,. at theme Individual Sewage Disposal System constructed ( or Repaired ( ) by _ -•- _----- Ins at '"._ �s - •-- f� -------?1�/ -----------------------------------•-•--••-•---_----- has,been installed in accordance with tlief'provisions of 4TI y r of The State Sanitary C.o e as described in the application,for Disposal Works'Construction Perini Y PP P t No` dated.. f -y-�- 7-...-------------- THE ISSUANCE OF`THIS', CERTIFICATE'`SWALI:'NOTiBE:CONSTRIIEb AS GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY DATE------...---,-7•-- Y inspector .. . ............ x: THE COMMONWEALTH OF MASSACHUSETTS BOARD LOFHE LT......... „ .............O F..... .. .. `...... w: ........... No.....��d.: ...... FEE._��.------•-•--- i �t 1 rk rrn a #i,att anti# Permission is Y g ,ereb ranted_.., . to Construgi 40 ) or R wage is al Ste at No." �` U ` ` ................................, .Z,. �-----------------•---- ... Street as shown on the application for Disposal Works Construction P- No.__..' _ ' �Y 7.7 Dated . --..._..._.. 00, ',...... ....:.. . Board of,Health DATE-•----•----• •. ... s ` -----• - ....---••- ---• -FORM 1255•HOBBS-& WARREN. .INC., PUBLISHERS- - - , 24•d T r r C°j G SOP` 0 o tio 145 �10 j40 197 S•h• .0 - 2 S 7-1 ¢1-3 rEsr PIT wZ /.�Tfi�E Tom 4•� Tri/,E t oUiUO�T/oiv /S' OF AVf �-" �- O T9 iOW S G }r = THO)"s 5G jw G�r�oSiTE T.�L- Save-!�/�t/EST.�,t�LY €. E. THOMAS E.KELLEY CO.- g 2426Q 1,) �LE�/�T/o�1J5 ,Sr�u//v .Q•PE ENGINEERS—SURVEYORS C GiST�P� T�P� 346 LONG POND DRIVE SURIJ �FrS/ONAIF Ti5/E 7a� o,% �pv�J TJLalJ �`OUTH YARMOUTH, NIASS. v�EOr 02664 ,4T ELEd, 2�ao .45� 3J T,yE ,SEA-✓r4GF sysT�� CERTIFIED PLOT PLAN syow,� oti Tl/%s ,Ceor �A,v LOCATION C�,vim e.,,�� fa� ... y is .a P,Po�os�0 SYS .►7 SCALE ��-. .r. . . DATE ,4i�p mE5 ivoT Erg"sT •4S PLAN REFERENCE - .�!:.�a•`Jo �'v of 77�5 GJ4T� /. .. . • ,ol.4�tJ B,r 277 �G.�B. j' 1 CERTIFY THAT THE ... .��`'� !°'r?�v SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. �� ook C tf DATE 12e V:77. . PETITIONER. oZ�3Z a EGISTERED LAND SURVEY R r L. TOP OF FOUNDAT•'�Y CONCRETE COVER CONCRETE COVERS 4 CAST IRON 10°htAX. 10"bSAX:� PIPE (OR 401ORANGEBURG(OR EQUIV.) EQUIV.)_ MIN. PIPE- MIN. LEACH PITCH 1/4'PER. PITCH 1/4 PER.FT. PIT .. PRECAST °•' LEACHING e EL 2oRoo INVERTDI INVERT P • W gr� PIT OR I SEPTIC TANK ENVERT3:. EQUIV. BOX EL/BaoCo � �.e INVERT /Oo0 „• GAL. INVERT �� 0: 3 EL. �/883 INVERT ww �• ;:�; /4��T0I1/2� E : .. WASHED STONE /vo ` •' PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM . . : NO SCALE . rt SOIL LOG WITNESSED BY : DATE �',3p'-77• TIME. B:i5,�2'Z/•77 v� /�v�i� / BOARD OF HEALTH TEST HOLE 1 TEST HOLE 2 �T�/o�QS• �: c��Y• Cam.. ENGINEER "✓��,�,.,, DESIGN DATA : WOOM NUMBER OF BEDROOMS �eE� TOTAL ESTIMATED FLOW . . 3.3,! . GALLONS/DAY 42" 130TTOM LEACHING AREA 78:�7 o SQ.FT. /PIT / �a8• So ...Q , �y�• w,�,•�: _ Me-�+�^^ SIDE LEACHING AREA . . . .. SQ.FT./ PIT • S4ND pt E . GARBAGE DISPOSAL ../-)Q ._(50% AREA INCREASE) V SAND 2�7op TOTAL LEACHING AREA SQ.FT w PERCOLATION RATE . . . ! /'`!n. . . . . . MIN/INCH LEACHING AREA PER PERCOLATION RATE'.S-Z:: . SQ.FT. P WATER ENCOUNTERED NUMBER OF LEACHING PITS . . .aN. r. . . .. . APPROVED _ .. . . . . . . . . BOARD OF HEALTH y zi : ' : '• DATE --- Ieep— AGENT OR INSPECTOR O F o•Z� THOMAS Z-F-s .�• S',q,�� o CAEL ar (4 THOr4AS E KELLEY CO. �� r A$ ,%_, 0 `o T/�:•-" ' ' ENGINEERS-SURVEYOR >9OG/STEM �E✓t> �/ii�G.E� `�, SS. 346 LONG POND DRIVE �FSS/ONAI.�a�\ PETITIONER .z , Z . SOUTH YARMOUTH,'D4AS