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Home My WebLink About0037 CARLETON LANE - Health F,3f7 OdrleA /7 6m 09 No.............r.. )qb ~ o?-3 Fmc.............. ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. o._s�-' C 1X.....OF........... Appliraataon for Disposal Works Tonstrnrtton merit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: � ................_. . .._.......1 ..:..... ._.. . ........... . ._,�.......--•----------------------------------•------•--------------•._............_.............. L Address or Lot No. • _ ..... .......... . ...... ^- wner Address a ............•.. . . ......... ..s'-=•_�................. _.........------•....._........__..._....... ---••-•----..........................•..... � i Installer Address Type of Building Size Lot.... ......Sq. feet U Dwelling—No. of Bedrooms....................................Expansion Attic ( ) Garbage Grinder (M) Other—T e of Building ............... No, of ersons................_----------- Showers a YP g --------•---- ------------------------P ( ) — Cafeteria ( ) Otherfixtures ...._....--••-•......--• ••••••...-----•--------•--•-----..._......._.... W Design Flow............................................gallons per person per day. Total daily flow........... WSeptic Tank—Liquid capacity-/tl�'gallons Length.�._4....... Width-__-'®... Diameter________________ Depth...... x Disposal Trench—No. .................... Width_.._r.__...__.__._. Total Length---5'__l...... Total leaching area...........T'Z.sq. ft. Seepage Pit No---------l---------- Diameter..._ 0...a.... Depth below inlet.................... Total leaching area_...............sq. ft. Z Other Distribution box J) Dosing tank ( ) s '~ Percolation Test Results Performed by________ _______ ° .__.___ Date..__ __.._.•..__Z_/ l� ay, ----- --- a Test Pit No. 1..._ ..__._minutes per inch Dep h of Test Pit......./.:_...____ Depth to groun water........................ 44 Test Pit No. 2.:..............minutes per inch Depth of Test Pit.................... Depth to ground water........................ Pr �c --•---•---••--------- - -------------------------------- .Description of Soil-••••-•---•-............5 ------• • ....................... ' ---••---••----•-•--------••-••................... . 0 U ��-- — 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 iITLi: 5 of the State Sanitary Code he dersigned further agrees not to place the system in operation until a Certificate of Compliance has b e oard of heal . �. Signed......... ..........................F ................................ Date Application Approved By......,-`_ ��1 .. Gl_ > ................•- � -�-—---------- / Date Application Disapproved for the following reasons:•---------------------------•--•----•-------•--...----------•-------------------•-----------••-••----•-......... .............................•-•-----•--•----•--------•------.._..---------------.•...------..........._..__....--•---............................................................... .................. Date Permit No........1��''��...................................... Issued.... .......................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TE-1 ._..... . ": �.......o F............. .:. - '. a't ....................... Applirntion for Dispuiial Workii Ton.strnrtinn Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at $ -y...r.::j J 9j ` �� •'� P�� `=..-L'r . .-Loca om-�Address �� a or Lot No. • � .. ~ ..�.. ------------•----•••••........ --•-----7--- •------• .•.......... O Owner Address Installer Address d Type of uilding j Size Lot... _ . .__ -------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (sic+ ) Pk Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --------------------------------------------------------------------_-- ------------------------ _---............................................ W Design Flow............................................gallons per person,per day. Total daily flow----- --: _ ..__..-._____.:...........gallons., WSeptic Tank—Liquid capacity .".gallons Length_x._..''........ WidtlL_2_J... 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-( ) - �`Y � ,- ►-� , a Percolation Test Results Performed by.................................................. ........... ......:...•_•__._____•----,<.___-_________... Date---;'f�_�___ _._ --.:.._°.._.. a Test Pit No. I.......�.......mmutes per inch Depth of Test Pit.....(Z_�`........ Depth to ground water------------............ f r Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Descriptionof Soil---------•------------- ----------f--- .................................................'lfs� -(M1 M `. f� y ...t.___.__ ______.__ ........................................................�...........--••_•___ .......................... F�'4f f ... x ................................................ � -------- �--_-`-----_-__ --M _---' •. ' )�+ . -- ---- *•�.f .__ f __ ...____.1___________________________t__!..._!......_.___.__.....__.......__....._._._............................ 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 iIT?.w, 5 of the State Sanitary Codef—fThe idersigned further agrees not to place the system in operation until a Certificate of Compliance has beerioissued,?by t e board of healthi Slgl}e _. ; .._..f Date A lication Approved B ........ -......... ( :.... �J....:T__7--- Application Disapproved for the following reasons----------------------------------=----------------------------------------------••............................. ....................................................................................................................-•--•----•-•------ ----•--••-•--------•----•--•-•-•••----••------------•-....------ y Date PermitNo......................................................... Issued....................................................... Date t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... --........O F........... ....................................................................... �rrtifiratr of fanntlilittnre T ISnTO CE"FY,,Tthedividual Sewage Disposal System constructed ( or Repairedby.•. ---- ... --------------------------------------------------•-------_.... Iler at.------. o ........................................................... has been installed in accordance with the provisions of T o he 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 WILL FUNCTION SATISFACTORY. �f DATE------�-1-=-•,�-'..�--r-............................................... Inspector.....------------------- -•--•--•----------•--•--- THE COMMONWEALTH OF MASSACHUSETTS r. BOARD O HEALTH 47 d' ...................f............OF........... ................----................................. f '. No......................... r .t FEE.---•-..--.G!J ..... Disposal Vorhb Topotrudilan rrntit Permission }s hereby granted........----................................. to Construct X or Re air an Individual Sewage i osal System at No...._....46.1!!7.-----' •--•-- e 0t!� LT�iec-----•---�1d` Street "q as shown�On the application 1br.Disposal Works Construction Permit No..................... Dated.......w < :.............. r, r s /,f Board 4 Health DATE /- /-----FORM 1255 HOQSS.& WARREN, INC., PUBLISHERS -•--• - .i i R"r •i°"` r^ tr "`''Pf,� ••r•^ tr4 rt+y+. . 7 SOIL L06 , • i \xxdfi,�UICW�\V�n7- M ar/,/Svc.ti.�wVi iy0.1/}�r�vx /OI Z f 2•,.PEASTONE .—LOAM a FILL 12• MAX. 4 d T 6 oV��i. 411C.1. DIST. Box I° ° °• °o °.� 1 I S °2d'MtN. ° { 1000 I° °, °• 1000— GAL. d o°I 1 GAL. (� O'° PRECAST OR ° ° p SEPTIC 6'10 0�°�, BLOCK °° ° u � M TANK SEEPAGE' PIT Il I J o 20, MINIMUM o °'• °° ° ° ° FOUNDATION $ 9 L I %z" WASHED STONE o�� i. �/ SCALE: It' ELEVATION SKETCH r= 10' MO. RATQd4&Mo6 �'..»•...�.��! a SCALE: I' = 4 ' TEST BY : TOWN INSPECTOR ��G �••/u,�T IC,o✓ BACKHOE OPERATOR • —2—424rC+'C�Y {j/Y>tse:77 J- 1 TEST MADE ON : �� i Z. i 9 7-7 41 too I �. ` - - � G�9.Gz ov 141•S N Cv`ax . ve sLty c, N o Pot h oo: roo _ 101.0 ys',. 2 •-,104.._ ''1�ST®IAVol 'o.--1v4 '•3' . -..s .. rd i t 1.^.:�.� `'_•�° �.5,� `"' Gam.,,,_ �\i � ; ll e 1 `"�.. �- ~-,��' a....� �.,�.•ir'° •�� ,.ter. ...�. .>!,�.`-�� - ^ + �� ti� —� •ter i- .N /.2 q. sz 1 OF I a � RENWICK tiN B. • 4 CHAPMAN cn I APPROVED BY BOARD OF HEALTH LQ pNo.,276540 J DATE 19_ ��rsrlr¢�� i �SrONAL . _' ..' 102—" fCXtS"��dt�L9 ��,rE.�do►R�oi�1 10o Ell E.LE`•t• ELEVATION SCHEDULE ' 6�R0P08E0 8iTf PLAN ' 1. INV, AT FOUNDATION - 8EC1A8L SVS'P[�1� ®[E818q ; 2. 1 NV. INTO SEPTIC TANK = IN 3. 1 NV. OUT OF SEPTIC TANK = Ott or 4. INV. INTO DISTRIBUTION BOX SCALE: 1"=V401 *4Zv'.'�L.g.• . 19'�"? C— 5. I NV. OUT OF DISTRIBUTION BOX = 6. INV INTO SEEPAGE PIT CAPE COD SURVEY CONSULTANTS g ROUTE 132 Z BOTTOM OF PIT = `�• HYANNIS,MASS. c w °1w A DIVISION BOSTON SURVEY CONSULTANTS, INC. B. BOTTOM OF STONE LAYER L t d