HomeMy WebLinkAbout0451 SOUTH MAIN STREET - Health (2) �� SokfA lAcUn S�-f,,&4f .
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THE COMMONWEALTH OF MASSACHUSETTS
,--.,BOARD OFHEA TH,
.
. ...... . .. . ..................
. ...... ..........�'___.OF..........
Allphiation for Uiiipaual Workg Tomitrurtion ranfit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
\System at:
& f
............................................ ----- ....................7Z ua
ea i.. d r ,t........ . ....... ......... ............. .......
Owner Ad... ss
....................... ....... ... .... ................ . . ..
..............I......I? ......e�.... ..........
Installer---------------"------- ................... ......... Address
...... .. .
qq
X5. .. .........Sq. feet
Type of-Building Size Lot..a
Dwelling—No. of Bedrooms____.._....1-1.........................Expansion Attic Garbage Grinder
Other—Type of Building ............................ No. of persons............................ Showers Cafeteria
Otherfixtures ...................................................................................................................................................... .
Design Flow............................................gallons per person per day. Total daily flow......................-:1.5 .......gallons.
Septic Tank—Liquid capacity.JVVgallons _Length................ Width.........._..... Diameter.__..........._. Depth.........._.......
Disposal Trench—No. .................... Width.................... Total Length___................. Total leaching area....................sq. f t.
Seepage Pit No...______..--.--_--- Diameter.................... Depth below inlet.................._. Total leaching area..................sq. ft..
Z Other Distribution box Dosing tank
#V_P ................................. Date.......
Percolation Test Results Performed by................ .77......4:? -.& Y/Vi0jr------------
Test Pit No. I ...../--------minutes per inch Depth of Test Pit.................... Depth to ground water.._..........___.._____.
fi Test Pit No. 21............minutes per inch Depth of Test Pit.................... Depth to ground water-_____-----.-__.--_-___-
............................................*................. .......*........................a.............................................................
0 Description of Soil.......................................... -------
........... ......... .... ................. ..................................
................................
....2Mn ............................
U ......................................... ............................................................
------------------------------------------------------------------I-------------------------------------------------------------------K - � Atft%'!..................
fftA MUST stj vliJt;�
U Nature of Repairs or Alterations—Answer when applicalkIT11MANIR .PING!
........................ vvwm Men..................
F. 14.�-
&�&TION AND OFERT1 Y
'A' greement:
W"a L_) _'%ystem in accordance with
The undersigned agrees to install the aforedescribed*1 MA ' e iAisNp'osa1 aidI
the provisions of'T T L:4: 5 oi the State Sanitary Code— The u ersigne�Lfurt�_e,turther agrees not to piace the system in
0
operation until a Certificate of Compliance has been issued by t board o healthi.A.Gam!
......... ..............
Signed......... ....... .................... ..... .............. ... .. ......
Z
............ D
at
Application Approved By.. . ......... ................ .................
ate
Application Disapprove for the following reasons:................................................... ............................................................
....................................le,�.
...............................................................................................................................................
Date
PermitNo............ �.e�..... Issued-----------------------------------.....................
Date
LEVY, ELDREDGE & WAGNER ASSOCIATES, INC.
ENGINEERS-LANDSCAPE ARCHITECTS-PLANNERS
LAND SURVEYORS
889 WEST MAIN STREET
CENTERVILLE,MASSACHUSETTS 02632
(617)775-2244
June 22, 1987
Town of Barnstable
Board of Health
367 Main Street
Hyannis, MA. 02601
Subj : Septic System
Lot 1 South Main St.
Dear Sir:
Please be advised that the Septic System at
subject location was built according to the Proposed
Plot Plan dated November 19,1986 .
Very truly yours,
LE LDREDGE & WAGNER ASSOCIATES
Paul evy, P.E.
PAL/mlw
enc:
1169
88 WAVERLY STREET FRAMINGHAM,MASSACHUSETTS 01701
THE COMMONWEALTH OF MASSACHUSETTS
(_BOARD OF HEA T_
.... ------OF........... ®.................... ...... ...................
Appliration for UinposFal Works Tonotrudion Prrntit
Application is hereby made for a Permit to Construct 41)
or Repair ( ) an Individual Sewage Disposal
System at:
/1
...........•�l T/--•--- �� �c�. L - ....._...
Location dress M1 '�jr �t 1/y�
/
` Owner / �� .� ..- - -•-•-- Ad s - •-- --
W �.�......, : :%-----------------------�................__ � " `�... -- ...'------. _�?lG ,
Installer Address r q f
U Type of Building Size Lot.4 ./-� --- Sq.,feet
Dwelling—No. of-Bedrooms___.•.........�•-.`...........................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( )
P-I Other fixtures ...--•...--------•-------------- -
W Design Flow............................................gallons per person per day. Total daily flow....................t,�d........gallons.
WSeptic Tank—Liquid capacity._.0-V allons 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 ( )
a Percolation Test Results Performed by................ '>.......
1 ✓ ....... 11.y/ ..Date
Test Pit No. 1------
__-_ minutes per inch Depth of Test Pit.................... Depth to ground water........................
f1 Test Pit No. 21! ....minutes per inch Depth of Test Pit.................... Depth to ground water......_--------_........
P4 •----•-••---••---------•-------•---•-------•---•-•--•-•...........-•----•..................•------•-.........................................................
0 Description of Soil-----•---•------------------------------------------------ -------- = A
(xj --------------------------------------------------- �'
•••--•-•-----------------------•----•----------....----------------------------------•--•-•••-••-•-----•-•------------------------•••-•------••••----•-•----•------•-•--•-••-•-----••••---••-.---------
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 i T s E,
}of the State Sanitary Code—The u ersigne further agrees not to place the system in
operation until a Certificate of Compliance has been issued by t board of health.
/r�o
Wined
-- ----^----•-------•. ..... . ..............
Application Approved B =,�. _�_tqk._ .. ---.- ..
(_Q _�1�2
PP PP Y . .... . •--•---..•..... .•.
ate
Application Disapproved for the following reasons:----•-------------------------------------------------------•-••--------------------...-----•----------••---•--.
�'
.,rt-- ,
---------•------------------------------••--••----•----•-•-----•--------------------------------------------------------------------------
Date
PermitNo........... ------ (------- Issued----------------------------------•-----------•--------
Date F"�
N
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.r� .....OF..........I ...................:........�........................
Trrtif irate of TontpliFanrr
THIS IS TO CERTIFY, That the Individual Sew< e o 1 System constructed ,i(�) or Repaired ( )
by - z - - �. ?.•-4P ..........................
In taller
at...... - ------ T
has been installed in accordance with -ie ovi jons of TI T iE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No... ?..l.-S.L1.!........ dated---------f.... ..........
THE ISSUANCE OF-THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............... .'.... '-:_arm-..2............................ Inspector.... . .
•------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
t /. .....OF..------. .......................
. .
�'0..._...... LFEE.........:..............
a ro l /rk. T rqa on
Permission t ereby granted Y 4 --- rr t
... .... ........................
to Construct ( 4,or Repair ( ) aq.1ndividual. Sewage Disposal Svstern
C.N M tz
.
Street P2 1
as shown on the application for Disposal Works Construction Permit No---�P_...!�1D t d............... ......(/..._. ........_.
--:: --------�:-_`- G�:. ---
�-- — -
c Board of Health
DATE......................2!t 2 � -��6•71....-•---------
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS.
1e ��
SO.uT H A IN 5T2EET I
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LEGENDi Y l
EXISTING SPOT ELEVATION 0
PROPOSED SPOT ELEVATION �r
EXISTING CONTOUR ---0— -- sf,��� A�tH o► , °
PROPOSED CONTOUR 0— D`,VID P.
NOTE: THE LOCATION OF ANY UNDERGROUND I' MA;IANo _ RWIN
SEWERAGE, WELLS, OR OTHER UTILITIES SHOWN ON I L CIVIL WILCOX
THIS PLAN IS APPROXIMATE ONLY AS DETERMINEDNo.31115�® � 0.3 41
a1
ROM RECORDS AND/OR VERBAL INFORMATION. .'ohC/ST
HE CONTRACTOR IS RESPONSIBLE FOR THE * Frc:
ERIFICATION OF THE EXISTING LOCATIONS IN
THE FIELD. `^ ANREGISTER
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" i, lllf.H' fkOUt�U-WA1f.R LEVEL COMPUTATION, 3:
1 Lot No. t'
Owner bcKu c.¢ S �: Address:
tYbntractor:t Address: ;
t r
Vl • 1(_
STEP
E ,l Mcasure:-depth to water table . :
7 "` s to ncdr`e5t: Mo ft:
' . . . . . . . . . . .
date
STEP 2 Us ing 'Water-Level Range Zone
and Iridex.Wc1'1 .Map locate_
r site and. determine:
�1 r :
A) Apprb'prrate index well
r B) Water+'level range zone . .
S, EP: .3 Using n►�nt hl y :-report"Cur rent x
� .
ti
Water Resources Conditions" Y s
r determine- current depth to
rthll ,
i w,r t I�r 1 c ve�l 1 or- index we
,
51EP 4 IJ% ing Table -of 'Water-level _ �{
Ad j uI.I ment s for.:i ndex we 11 �<
(SIf 2A� .. current depth to
to ` w.iter I eve l:',for index well
(STEP 3) , '.yid water-level
T41
` zone (STEP 28) determine
4
water level ,.'Idjustment . . ... Y
51CP 5 Cst i1-1a,c (it otti. to high water
z
by subtract ing the water- ;
level ad j ustment- (5T( P 4)
tram mea..urcd depth to water 7Y'�
' 14•vel at sate (STEP 1).. - . . . . . . . . . .
tfi
i
y
r,
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