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Home My WebLink About0039 SOUTH PRECINCT ROAD - Health (2) 3�1 Sow PAtCArldCaJ . FRis THE COMMONWEALTH OF MASSACHUUSETTS BOARD OF HEALTH 11Lf I/Y OF..........� ! _ . ............................. Appliration for Disposal Works Tonotrudiun 1hrutit Application is hereby made for a-Permit to Construct ( ) or Repair ( ) an` Individual Sewage Disposal ste �115 -0 &4 I-P -........�� - •_... - ............................ ......._. Location-Address or ««- ....... _... ..C. �.�..y-•-•.......................•--•- ��X,( f�. .,...��e.9.��! _. 1��f ....� �U� f�G, Owner Address W .....Q .... ............................. :. 1 !'J. .C.f. .............-----------------.......--•-•-- N w .._ - Installer Address Type of Building Size Lot....l.� 142-�_...Sq. feet Dwelling—No. of Bedrooms.................................... __........��............... .........:_..Expansion Attic ('� Garbage Grinder ( ) Other—T e ;of BuildingW�p PTO. of persons............______________ Showers — Cafeteria G4 Other fixtures ...........................................••-•--• ......._ ..;�. W Design Flow.................7.4....................gallons per.person per(day. Total daily flow.__.......a2-m.0-....................galls. WSeptic Tank—Liquid capacity-/>.GD-gallons Length-__..&.(P.. Width..., ��b.._ Diameter................ Depth....�_A" x Disposal Trench—No.N-Ld......-_. Width.................... Total Length................... Total leaching area....................sq. ft. 3 Seepage Pit No.......�............ Diameter........._.UK. Depth below inlet.......... ...... Total leaching area._�0-_6...sq. ft. Z Other Distribution box ( ) Dosing ( ) '0-4Percolation Test Res is Performed by.... 6 _. ... IC,.: ._." ...CZ&5,/ Date_... a Test Pit No. 1. .____minutes per inch Depth of Test Pit.......__.__P...... Depth to ground water.....A.......... f=, Test Pit No. 2.0 4?`!._..minutes per inch Depth of Test Pit..._.t.?n_-_.... Depth to ground water_____________.--...__.._ a - - �:-4-.C.................... ............ •------ ........................................................................... -------- rr O Description of Soil............. U A_�..... b --------------•-- -•b-•---•---- .......S..L} _N..Q-----._.......----........--•--------.._......._..--------------------•-- 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 b issued by the board of health ' Signed.. &:!: .. �c/L e�_r ��L � � ate Application Approved By. ,_.R.� ................................................ . ......... '/'`�� ate Application Disapproved for the f ollo%ving reasons:-__•-__•______•-_..._-•...................••___....._•_•-_-•___-___----_-_........__....._.....--_______.«..« ....-•...............................•--------....-.....---------------.........---...---------------.._...----.....-------------------•---...--•-------....•-------------------------------•----_...__ Date PermitNo.......................................«........-«.... Issued....................................................... Date tom .;/� , �, �• _ � ��. ' � � � -- - `R 'j No.. 1.11.,7 '' Fps. ._...._.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH....... )......!.tk. !✓l1..----.........OF..........:,/. -1P ,- Cit/�'.__. Appl ration for Biopoottl Works Tonstrudivit Famit Application is hereby made for a Permit to Construct ( ") or Repair ( ) an Individual Sewage Disposal -, s Co yste>�Jat• ��- �5 1 f Location-Address t or Lots r, .......................................... f� ........... ... .��_. . :. .� Cr-..I.....- •-- •-• - ._.... 1� �'r/..9 .r..!.,�P �'!.. 1<. )//r5 e f:�,�J/c"/ Owner d dress j- .. .... W ►,�J [� ............................................ ••••...••-••---...y_1'j -: .�..�..r, ................ Installer Address Type of Building Size Lot..__/......2S.....Sq. feet aDwelling—No. of Bedrooms........... ............................Expansion Attic (_ "� Garbage Grinder ( ) aOther—Type of Building ......h?Jko)1 _.F[eAn 41o. of persons___________ ____________ Showers ( ) — Cafeteria ( ) Other fixtures . W Design Flow................. ............-......gallons per person per(day. Total daily flow.......... ,2.:-a_..._____......_.._gallons. WSeptic Tank—Liquid capaf ity.�l.LOP.gallons Length_____s�4"__6_. Width._.Y fib..__ Diameter................ Depth....S_. x Disposal Trench—No. �.!.A......... Width.................... Total Length.................._..Total leaching area...................sq. ft. Seepage Pit No........ ........... Diameter.__......_Jc.:?r__ Depth below inlet.........e7...... Total leaching area w:-Z26...sq. ft. Z Other Distribution box ( ) Dosin tank ( ) Percolation Test Results Performed by....-,�!...�2__-1 144,e.:Jt.1-.. I ✓LI L?�r; a1 C/ Date.... !? .... /_�s__.._.__.. Test Pit No. L_�P_r_�:.....minutes per inch Depth of Test Pit_ .-_. L....... Depth to ground water____ ._ ........ 44 Test Pit No. 297 .fi".___minutes per inch Depth of Test Pit...... ......... Depth to ground water...:___..•:_............. GL' a ° '.-•------••-----•-=-- ........................•--...._...-•--•----•••••-- - -- -•------- ........ --------- O Description of Soil.............n — .1- �.•-{t.A.m.-----�;-------•�' WZ:;11-r........-•••.... ..�b. _L_ 7........................................................................... U ................................................. -..::._.1 _.......!!;:.:E?-1:�.�.a'C•`t•`-"=--•-•--. __ :._tK_..51---•------------•-----•--•--------------•---•------...---•-•----.._...... W . x --•--•---•- ••- •------------•--------------------------------------------••-• -------------------------------------- ••---------------------------- 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 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. _ Signed.... �_�/-!C_ Application Approved By-- `�'�.�e...... .............................................. - Date Application Disapproved for the following reasons:............................................................................................................... _ ............. -•--------•--••--••..............•--------•-------•------------•--------....•-••--------.....-•------...---•----------------••---•---.....-----•--•--•----•----------•-•-----•-••••-••••- - Date ; PermitNo................................................ Issued-....................................................._ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF............:.:..... .. (Irrfifiratr of fwomp-Haurr v. THIS IS T�jCERTIFY, Th the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by-•••-••---- --.. ....... .............................................•--•--..._.....----._........------._....-•---------.....----•-•--------.....-•-----•--- at................alh1G .- .5---._......._- .__...J=, .L��C InstallerJLGS _a_./lt fAcCi.................................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.___S/ _.` _______________ dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. s ---=-:•..••.- �� ,� Inspector........ ..bS-J-•...................... DATE THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEALTH .- � ` s -OF........... No.. ! Disposal Works Tono#rur#ion rrutit Permission is ereby granted_.__. �_ to Construct ( ) or Repair ( ) an Individd al Sewage Disposal System o Street' as shown on the application for Disposal Works Construction Permit No........ Dated........................;.__.............. . � DATE_ and of Health J ---.............-----•--------•--•-•-- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �'. rl ti t . Ay Al •- _ 1 .. TA i✓rG moo. r`\ YAo✓tr o O T r,G 1 0 r KTCs I n, - X < v M. 4eAcH. pi T N T Z 5 V sp#A o Gi BUNiYifS �A\ P No.22162 t4 n . bd,9t-, GISIrt / 4elp.t� LEGEND CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION ®x0 EXISTING CONTOUR --- 0 RIJ FINISHED SPOT ELEVATION ' Cam—TE: �?�/,�6 FINISHED COAOTQUR ---- O APPROVED BOARD of HEALTH DATE AGENT SCALE` �� rn ' DATES L DREDGE ENGINEERING acEy,�,� CLIENT I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB tNO. $//O`� BUILDING SHOWN ON THIS -PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS DR E I R RVEY .BY l OF BARNSTAB E, WASS 712 MAIN ST. CH. BY R�B HYANNIS MASS. 2 T F - . E SHET_I 0 D TE REG. LAND SURVEYOR a�, e c i:., .,at` �t^}-'s + ✓ .d ri �q. a° `r .,.; '4 ,°r,>"t '' .x�r r°^- a s a .:':mw f., t 3 e r ..>* - ... M/N. � , /1(07F ,�: TAN/C O T { G 2O'.D! : ./0 P7: /N/N.. R A RE MORrEf� TfrlAJV /2 Low-:.. E f r D� �>. AM E.T.E�' GONCR�T,� '�'D!/ER .. 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