HomeMy WebLinkAbout0009 SIMMONS POND CIRCLE - Health 9 Simmons Pond Circle
289- 176,,-- Hyannis
Lot 12
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LOCATION S L�W-A C9 P1y� T NU
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� INSTA LLER'S NAME & ADDRESS
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� D A T E PERMIT ISSUED
DATE COMPLIANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
------------
Appliratiun for Uiupu,ial Work,5 Tonstrnr#iun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at , '
s�......... .2.......... - -
Location-Ad ss G or Lot No. JZ Y_.
....... � z.Zo.j..............d- X07...... ...........J :..........
��..-•__-,/
ner Addre s
a .. ......... ...... — :.. -- .............................
................. ••....
Installer Address
d Type of Building Size Lot_..- �d.S.___Sq. feet
U Dwelling—No. of Bedrooms.............. ----. -----Expansion Attic ( ) Garbage Grinder ( )
►�
Other—Type T e of Building No. of persons............................ Showers —
ts� YP g -----••-•--•-•-•--------•--• P ( ) Cafeteria ( )
Q' Other fixtures .----------••......-•••••-•--••. .
W Design Flow............................................gallons per person per day. Total daily flow...............��...7...d...........gallons.
WSeptic Tank—Liquid capacity/#!Agallons Length................ Width................ Diameter----.---.--..... Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.....-. �q. ft._
Seepage Pit No.................._ Diameter..........--.--..... Depth below inlet.................... Total leaching area... ...-Sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Res Its Performed by...........ccyc............................................ Date.... CS
aTest Pit No. 1 .. .......minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. _.`1.......minutes per inch Depth of Test Pit.................... Depth to ground water.........................
-----------------------------------------------------------------------------------------------••............................................................
O Description of Soil.....__.; ..
x Wig,.` �'
u - . .
W
VNature of Repairs or Alterations—Answer when applicable...............................................................................................
' ----••--••••--•-••••--•-••--•--•---••-•••••-•••••••--•-••-•-•-----•••-•---•••--•••••...............e...........-••••••••••••••-••-••-•--••••.......---•-••••-•-•••••••-••-•......-•-........._..._..-•--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITLE4 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue the boar Ith. ,
-
Signed.. -- -"a J
Date
Application Approved BY------------------'' Y--- _. _.......•••-••-•---•-----•......-••----•-------
Date
Application Disap ved fort e f l wing r sons.......•---••--•• =------------•----....------........---------------------------------- ...........--------
Date ------
Permso................... ....................... Issued.......................................................
Date
f.
...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF............ ...� .........:: ...............
.r....._....
Apli iratiun for Mipwial Workii Tunutrnrtiun Prruat
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Se age Disposal
System at,
'� -- -
.--------- ------------ --
a ,
Location Address r or Lot No
* / pp�^ �^
nery Address
W ........... ..�..l.�i. ..... �! ._._...._._...._....._.....
F-i P
Installer Address
UType of Building Size Lot.___O T.0 cl d....Sq. feet
Dwelling—No. of Bedrooms.............. ,.................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures ------------------------------------------------------•••.....-•-.........._..------••--•--••----•••-•--•----------•----..............x:.
W Design Flow.............................................gallons per person per day. Total daily flow............._a.-3_6-...........gallons.
WSeptic Tank—Liquid capacity/09:0.gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area------ G i.:.:,,,,sq' ft.
Seepage Pit No---------- ------ Diameter.................... Depth below inlet.................... Total leaching area.._, e-�sq. ft.
z Other Distribution box ( ) Dosing tank
Percolation Test Res Its Performed b C-CIC............................................ Date..
Test Pit No. l,,r��f_..._..minutes per inch Depth of Test Pit..................::Depth to ground water.............:..........
44 Test Pit No. minutes per inch Depth of Test Pit.................... Depth to ground water---- ..................
a
Description of Soil ,. .... •-• ............................
(� ,. ............................. _....•---•-.....--------_..
W
x ------------- = ;
U Nature of Repairs or Alterations—Answer when applicable`........................................................`
---- -•-- ------------•....--•-----•-•--•--•-•----•--•---••••••••-•--•--•-•-••--.......•••-•--•••---•--••-••-•-•.......-•-•----•------•------•--••1..�•--•--••-•-•--•-•-.......::--••---..._;
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 issue the boar Ith.
Date
Application Approved BY •� .....................................................
Date
Application Disapp r ved for he f 1 wing�r ,
-----------------.---•- -•-•--•-•------------------...----------------.................
-----•••-- f:�-""'--- /7 --- ------------ ----------------•----...------------.... ...------ ----•-----......
Date
Perms o.. ------------------------•---....... Issued...................................:.................
---
Date
THE COMMONWEALTH OF MASSACHUSETTS.
BOARD OF HEALTH
....................... ................OF...... r .....:............ .., ...............
Trrtif iratr of Tompliatme
THIS IS TO CERTIFY,�That the IndividY 'Sewage Disposal Sy co rl�tr d ( ) QT Repaired
by------------- --• _tmxry �,...�..
Installer -"
at......................................................................................................................................................................................................
has been installed in accordance with the provisions of T '' a1'rl 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.
DATE.......... � ' � ............................
`r`.....------=
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
3 ....................jl............OF.............. � .............--•---•--••• .....
No. ............:.. FEE-..-•-..................
uiupuual lalprko &ndration rrnt't ,
Permission is hereby granted......
• -•-- - • -- --- ... ''.
to Construct (' ) or Repair ( ) an Individual Sewage ispos System
atNo..............•-••---•--•--•-•-...---•-•--••-•---•--•----.......... ......... =
Street
as shown on the application for Disposal Works Construction Permit No..................... Dated........_......._.........................
kN'.
----•-------------------•---•...............-•-•-- .'t...--•-•••--•-.....----•-•-•-•------•---.........--
(' Board of Health
DATE ".. ......�.�P_�-------•-------•-••
FORM 1255 A. M. SULKIN, INC., BOSTON
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S /M NIoNS POVb yC�l2cGF_ t
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y $ �
.o 9ro.Y /S,000 SF. �1 0
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GATcN
BASIN
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$aj• B ��< SN OF
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BRU.CE
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STY�1�
G LE END
EXISTING SPOT ELEVATION 0 +0 CERTIFIED PLOT PLAN
EXISTING CONTOUR — 0 --- LoT 12 SjMMow (�ow0 C,iR�LR
RINISHED SPOT ELEVATION Zo,NGDa W y19N (Vis PART
_FINISHED CONTOUR.. 0 -
/o, I N' -
APPROVED BOARD OF .HEALTH /ao'w/orA
E DATE AGENT SCALE,. " v yp- DATE' 311
c LAAAY
:LDI�EDef ENB/NEERINe CQ /N CLIENT ` �cKu4� i CERTIFY THAT THE
EG►ISTERE REGISTNlED JOB N0. 9 yv 2 3 BUILDING ' SHOWN ' ON THtS ILL
CIVIL LAND CONFORMS TO THE ZO-NING LAWS
EN8 fER YEYO DR.BY �E OF BARNSTAB E. MAS
712 MA-1 N STREET CH. 8Y� c�?P.w 3 3e g ;w
MYANN I S,: MASS. -SHEET! OF ?.;. ATE REG. LAND SURVEYOR.
ZO FT.. MIN.. N07E• /F E/T/NER 7We SEPTIC TAX i+C OR
all LEi4CIN/iY.G Al/T ARE' MORE- TNA/V /I"BF40*V'
/G PT. WiN .rrRAOE, 4 ?4",VIAMETER CONCRETE G'OiOER i
4'PVC PIPE SX^LL BF 9.P006/y7- TO 4RAOAF.(-AN ,-XTRA
�75 CONCRErR' M/N. P/TGH /'HEAVY CAST IRON C0V4=M SIOL1.4LL DE USED
a.. . COYE/eS .P FT JF/N OR/✓E.WA)e
IiI 2'R MiN. CONCRALTE
4 A 1 Q of Ca ►DER
i- CLEAN SANG
�. . . BAC,tC.=ILL
CAST - Z*LAYFR
i IRON P/PE o 0 0 a • e
-
b M/A/:P/TGN /000 - GAL.. •. 1 • • • • • 1 s •
%4 pro l"r.' SEPTIC ' TANK D/ST. 's v e . .. • • • 1 • , ; WA SHED 570NE
BOX n • 1 $ r • • •• + •�•- s'
n • 1 •F..fFECT/✓E + • ► 314 - �2
• ' • •: OEPTJN • • • ' • o o WASNED STONE
/SB-S �tx 2•S:EPo . �f7/ ► e. • • s • • •• + p t•p PRECAST 5A=.AV AGE
INY.CRT ELEYATlQA/8 • ►• r • 1 • • • • • + s* p P/7 DR EQIJ/V.
INYERT AT Ol//LDI/VG' 95.0 FT. ds
6 FT:D/AM.
eac�+ucs CAPA4Ct y c s4q 6N C(SEE 7AW4V 4T)0N� i
SEPTIC TANK y.S FT �-
DtITL.ET SEPT/C TANK AFT. '
/IVLET D/STR/BUT/O/V BOX gY,FT. SECT/G/V OF GROUND y�TER -ZAALE i
O(JTLETD/STK!®[PT'/ON 6QX 9Y-z_ FT.
/,yLE Acw/NG PIT 9Y.o. FT S�J�V�IGE OISPO�TA L SYSTEM
Tit 4WL. OT/G/V
LEACHING P/T
DES/GX CR/TEI�/A JCA L E : %4" a /�-Q" D/rfE/NS/ON A�'S XT.
D/rI.ENSloN 8 FT. !
NUMBER OF EEORoO/►fS _ D/MANS/ON C FT. iW/w
G.4R45AGE-P/SRO-MJ-uw/r LOG
TOTAL ES'rfAZ-tTED FLOW 3 3 v GAL.�DAY SOIL. TEST 0/ SO/L TEST02 Sa�L TEST
XUMBER a,='LE,aCN/Nz ,o/TS / fECEY. •� -ELEK PATE OF Solt TEST
S/OE LEACH/NC, PER P/T /8S S,3'q �turpuS RESC/LTS iV/T/VE55ED BY y/���� �S�%
BOTTOM LE6ICN/NG
AERCOLAT/ON RRTER#/ Z- !�►// ..Y 1NCh3
t 7'OTi44 LEACHING AREA` Z4o7 SQ.,FT. PERCOL,4T/ON RATE 2 MJN:�ING !
I RESER{�ELEACNlN6AREA ZG 7S4. FT.
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JOB ND. $y02 3 SNEA-r 2 OP` �-