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Home My WebLink About0093 MELBOURNE ROAD - Health 93' Melbourse Rosa Hyannis A==268 - 250 I LOCATION SEWAGE PERMIT NO. , VILLAGE INSTALLER'S NAME i ADDRESS W" iL 11-10 col es O UIL0ER OR OWNER e ZGO DATE PERMIT ISSUED DAT E COPAPLIANCE ISSUED o Mouj"c f or v ®e No. 2 ....'....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -ate ..........................................OF.........................................---.....----..................................... ApplirFatilln for Uhgpoii al Workii Towitrurtion thrmit APPlication is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System s . ..::....................•••....•--•- ---- - -- oc ' -Addres t or Lo ,[' / rb!.,f-- L1.. ................... L.4! l...k�''l' -. :......-� �.Z1._:�!�!'. Owner Ad r Installer Address Type of Building Size Lot__A.P.A_Q.........Sq. feet Dwelling—No. of Bedrooms__ ____ ______________ ___________•Expansion Attic (/Yo) Garbage Grinder - P4 Other—Type of Building _ ..... -�----_.-•- No. of persons......s -............... Showers (/;) —'Cafeteria ( ) dOther fixtures .......... ................................... 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. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground'water...................... fX Test Pit No. 2................minutes per.inch Depth of Test Pit.................... Depth to ground water........................ a' •-•••-•.._--••••••------•----•-•-•••••-••-••••••-••-••••-•-•---••.......................••••••--•-......._...•-••••-•--•........•--••...-••-•-......---•--•-- 0 Description of Soil..................................................................................................=..................................................................... V --------------------- ••------------- ••••--------------- ------------------ •------------------------------------- •-••--------------------------------------------------------------- ------------- W V Nature of Repairs or Alterations—Answer when applicable.:___........................................................................................... y 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 bee red ed by the a d of health. -e- ----V........ ----(--------------------------- Application Approved By.... ..... _ __. ..._ .._.._ld.-.� a'2-- Dat ---- -----•-------- - Date Application Disapproved or t e following reasons:-----•--------------------------------------------------------•------------=................--a•-.............. ..............•------------........---------•---•--•-----•----------------•------•------------------------•-••••----••••••---••-••-------•-•-----••••••-••-••---•••-•......----•-----•••••-••--•--...... Date PermitNo......................................................... Issued_...................................................... Date No. FxB .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................. . ......OF........................................ Applirtition for R-4posal Workii Towitrurtion 1hrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal S stem at, 4) .......... -- -----------------------------------------------------................... -------- ocC-Addre 4., ----------------- --- --- Owner d ......................................................... .......d. kX........AZa...,r..c............................. Installer Address U Type of Building Size LoV.A.!5.a P.........Sq. feet Dwelling—No. of Bedroom,s ..............................Expansion Attic QYe') Garbage Grinder Cafeteria Other—Type of Building No. of persons.......1�2................ Showers P4 Other fixtures ................................................ Design Flow....................................::......gallons per person per day. Total daily flow...........................................gallons. 1:4 Septic Tank—Liquid capacity--------...gallons Length................ Width.......____..... Diameter__-_.......__._. Depth....... Disposal Trench—No. .................... Width......__....._...... Total Length__....._............' Total leaching area...................sq. ft. Seepage Pit No_____________________ Diameter.._..........__..._. Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.__.__.........._... Depth to ground water____................_-_. f14 Test Pit No. 2................minutes per linch Depth of Test Pit._-_.__......._.._.. Depth to ground water......_____._......._... 9 ............................................................................................................................................................. 0 Description of Soil........................................................................................................................................................................ U .......................................................................................................................................................................................................... ....................................................................................................................................................................................................... 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 T I T LZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in�. operation until a Certificate of Compliance has bee n5'*� ' ued by the of health. igne,. W ,------ ..... /.lo....................... ..... --------- .... ---- ------------ "-4,- 14`�- V-4— ApplicationApproved By----- .... . .. ............................................................................ ........................................ Date Application Disapproved or t e following reasons:................................................................................................................ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------r------------------ Date PermitNo........................................................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD� PF HE L H ......... ......OF...... ... ......... ....................... . .........Trilifiratr of Tompliana HE�kl. T OT ' s TQ ICERTIFY, That the Individual Sewage Disposal System constructed or Repaired by..Z......I ------------------------------------ --------------------------"........*--------------------------------------------------- at.... .......... ........ ------k �e� Installer has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code ap/descided in the application for Disposal Works Construction Permit ..4................. dated---- ---—------*------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BECONSTRU AS A GUARANTEE THAT THE SYSTEM ffl, �NCTION SATISFACTORY. TRU DATE..... ......................................................... Inspector..-- ... ........................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOAR D�O F HEAL t...........................OF... . .. . ........ .. ................................. FEE...j.- ............. Bispa V� it i ar*v ToMtration V rut Permission is ereby granted.. ---------------------------------------*--------------------- .................... to ConktrjgP or Repair 1� a divilual Sea posal System ...... ..... at No..7.. .5 .. .... ..... .................. .................................................... Street as shown on the application for Disposal Works Construction Permit No_ .. Dated................... ........ ... ... ....... ................................ . ... ------------------------------------------------- DATE.... ------*................ ------------ .....�.ard of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS z ___ ---- - ,,50 u Gat. 5eP7 is Tsti✓K V I i M Q OQ 2 Sr' ' Q 2z PROPL �} � Q• S 2 2S' �)•s jNOFIy 0ti IG3 � Lv ' 22, — — - -- - zo 't , �o suc��` V { M -- 72.9 oLt Zo N/067 n/99°/e'3 S i , �`r- S3 -ri3P tea, ftss-v'ij t D T,&Al c /UU .L) LEGEND OF CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION Ox0 EXISTING CONTOUR --- 0 ' o A T FINISHED SPOT ELEVATION WE FINISHED CONTOUR 0---- A MOOS 1,0 APPROVED , BOARD OF HEALTH �o�FS�IST&� � A TAS L 4 o S�ONAL DATE AGENT SCALE& / /_- 30 DATE& `' 3/ 7-. LDRED6E ENt?INEERINS Ca IM �sr N CI.OEMT________ I CERTIFY THAT THE PROP08E0 Fr i BUILDING SHOWN ON THIS PLAN EGISTERL REGISTED OB NO..�--- CIVIL LAND ER OR.BY& . CONFORMS TO THE ZONING LAWS ; N t E R Y OF BARNSTA!LE, 'MASS. 712 MAIN STREET . CH. BY& �' H.YA N N I S,. M A 3 3. �,2 , 8. SHEET-•L •F DATE REG. LAND SURVEYOR NOTE /F E/TNER 7"NE SFPT/C T.4,,V/< p,Q ZEAC/•//.,vG P/T ARE MORE 7iNo9.1/ /2"BELON/ �O M♦,v $RA OEM A 24"O/mil W E TER CONC',P.E 77.47 CO f�ER SWALL BE a g0eJGNT TO 4,TA0E.�c+,✓ EX7.PA CONCPETiff 4"PYC P/PE /•/ER V y CA S 7- /R0/Y C O V—`M S EO EL-Ell �04Z M/N• P/TCN /F/N DR/VElt/AY COYERS �9"pF,Q FT. a a !�_ GJtAOE COVER G'L E,4N .SANG LQ[//D LEVEL :, �• J/f ! 4 g .{ z 2'LAYER /?ON P/Pg • e o a o o OF :¢ MJN.P/TC/tl !Soo G.4L. • e + • . . . . . • • • D/s WA SHED 5727NE P*: SEPTIC TANK , d + • • • • • • • , ' • , BOX I • $ , r • • • + .•r • 34 ♦ , EFFECT/VL • • yyA3XE0 STD!VE o 0 ~` x ! • • . • • • • . • p • PREC AST SEEPAGE i l a8•S 4-1► G D • a. ••v lNYC ' �"lE�•�TIONS 76•5 x i . o = 78 6/D a �. + • • • • . • + a o P/7 OR EQU/V. /NYERT.AT BUILDING /0/Z FT PIT CAPAC�T--( '. 549 G / D 6 D/AM. INLET .SEP'r/C T�NVK I o7.0 FT G�Q8 G49 = +_ F7 PM. D/ , C SEETABUL.aTION, _ _®/JTLET.SEPTIC TANK AFT 50"7 p ice. ' 1 . INLET D/STR/BIITJON BOX /O G A SECT/ON OF GROuNO ltr�ITER TA9L, ouTL�To/sTR�evrio/v eoX /o 0 4 .4=r SEWAGE /SP05A Z SYSTEM INLET LEACH/-Na PIT 100.Z FT. TABI�iLAT10N LEACf///VG p/T DIMENSION A 3 FT. o. 6CALE �4 DES/G/V CRITERIA ��Gd� -r?do/ o/M.E�rs/o�/ 8 6 FT• NUMBER OF®EDROOMS 3 D/HENS/ON C 4- FT. /'I^f GARa vGED/SPO•S,9L UNIT YES tt a SO/L LOG TOTAL EST/MKTEG FLOWG.4L.�DAY SO/L.TEST A/ $o/L TEST#2 SD/L ?"EST ,VUMBER'OF !,EACH/NG P/TS -/ �^ELEK 2-. /^-ELFK /o!' / DATE OF SOIL TEST �/ 7/43 S/pE LCACH/NG PER P/T /�� Sjt PT: O _ Z ' f O 9oTTOMLF�ICN/NGPERP/T '"7� $Q. Fr' ,r.-°,� y; L��: 'Y'' p PERCOLAT/ON MATE / '�`= MI/V�//NCH TOTAL LEACH/NG AREA Z(o SQ FT. SA Nt7/ - S•�// / AEhCOL/47/0N RA7"E2 MI NV/NCH RESERIiE 4EAC"N//V6 AREA 2 b SQ. FT. i ter _ /•� ' 'Z� - //G OF M S G G-e:'i� /✓ _q ^f r c - n c (NQF•M `�?' Jac . ,F i,.,�,i�-/ L-DT ' At yc o � SA,✓n . A,,,v 0 P/C-`-S 7- N YA iv'A`/5 P-0.Z T- i A TV v /�1/)YiSVRSE v; M74 Q No.10951�O c�sTE�� ELOREDGE ENGINEERING CO,/NC. 90 �G�ST6P ��` Np SURVF' CL. 92•Z rL 9 U, l 7/2 MA//Y ST. , /�rYgNN/S, MASS, R �FSS/ONE%- NOGROUN�7 LVATER E/VCOUNTL�REO CL/EA/T:CUSTrz1��`c DRTE � a R GM U/VO WATER AT ELE—V _ JOB NO. F l l c S SHEET Z.OF