HomeMy WebLinkAbout0037 SIMMONS POND CIRCLE - Health 37 SIMMONS POND CIRCLE
HYANNIS
, A= 289 - 173
AsBuilt Page 1 of 1
LOCATION , SEWAGE PERMIT NO.
VILLAGE -'
INSTALLER'/S NAME 1Z ADDRESS
I R UILDER OR OWNER
r
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
http://issgl2/intranet/propdata/prebuilt.aspx?mappar=289173&seq=1 10/15/2018
LUCATION SEWAGE PERMIT NO.
VILLAGE
INSTA L/L/ ER'S NNAME a ADDRESS
/
1 e U I L D E R OR OWN ER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUEDZ2-/
i
� � '1
: .
� � �
� � �
o
� -
U � _`� �,.
� �.
I^` �;•
V
\^`�
_ ,_� ^
l_
No.... -- U -( ( � 3o Fns..... ®..........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
�� ... ...................OF.-.........-..•/G 'l.=.......................
, .:.....4.?
App irFation for Disposal Works Tonstrurtinn jimnit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
............ ..... .......X..............
••• Locationn- ddress� or Lot o. P ,p
/ p /.. ..
Owne Address
W //�..� F ............. ..............�L.����1... .y✓C:•-- 7.....................................................................
Installe Address ��
Type of Building \ Size Lot_V7__ _ 0__Sq. feet
Dwelling—No. of Bedrooms..__ _ 3 Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures -_--------_----_----- -•-••---••-•---•-•--
Design Flow............................................gallons per person per day. Total daily flow............_. '_ ................gallons.
WSeptic Tank=Liquid capacity/ llons 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.
Z Other Distribution box ( ) Dosing tank / � � )
'-' Percolation Test Results Performed by............ ,C�-�_.._ __r(��_._-�..... � _____ -.
--- _ Date.____ _____
0.4 Test Pit No. 1 in es per inch Depth of Test Pit____________________ Depth to ground water____ ti__.
- }�
Test Pit No. 2.___ ` ?_ _r iin � er inch Depth of Test Pit____________________ Depth to ground water_--______.____________-�
a •--••-------- --...•---••------•------••--•-------
0 Description of Soi--•------------------------------- ---- •---
(xj -----------------------------
•-------------
•--------
?' : ...---••••----- �C�-----SZ--- 777e------ .................
----•-------------------------------------------------------------------------------------------------------•••-•-•--------••------•-----•-- ...............
0 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 TITS 5 of the State Sanitary Code— The undersigned further agrees not to pla e the syst in
__o%atLe ntil a Cer • cate of ,&o , liance has been issued byAhe board of t
�j��iat/i6n'._�kpvroved
Signed ----- .. ------- ---- ----- --••-- at
By---••-•. ----•-- . -- •---•---•--------------•----• ."
Date
Application Disapproved for.t e following reasons:.......................................------------•-•----------•=------•----••----•--------•--._......-•---••-
.................•--••--••---•---•---•-•......_.......--•---•-----•---•-------------•--••....--------•--•---...._...---•------•-------•--•-----•----------------------------•-•-••--•---•-•••--•----•---
Date
Permit No..- - Issued_ _....-------•-----
Dat
I
No.- s•^ FEic ..... —
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
W"O`P .......ZZ..............OF............... GG�f '1..---..._---.._ ----...__..
Application is hereby made 'for:a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
system-at:
-• -- -
Location- ress or Lot No.
/ Owner Address
Install Address
feet
Type of Building Size Lot__ .._..L/. q.�7�� _____._._S
V Dwelling—No. of Bedrooms............... .,Expansion Attic ( ) Garbage Grinder ( )
~ Other—T e of Building ..___.. No. of persons____________________________ Showers — Cafeteria
CWOther fixtures ----------------------------•--- • ...............................................................
W Design Flow............................................gallons per person per day. Total daily flow.......... ___ . .......gallons.
WSeptic Tank—Liquid ca acitY ! 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 Resu s Performed b ........ ' _ __. .___✓C___C__Ct`v%__._. Date__.___l� �f
Y
Test Pit No. 1._. f, .__ es per inch Depth ofTest it____________________ Depth to ground water......
_ �,
f3, Test Pit No. 2___. `" inutes per inch. Depth of`Test, Pit____________________ Depth to ground water................
---------------------......................................................¢---------•--•--•-----•---•••---•----•••-----•-----______________----
O Description of Soil------------ ....................
-
........ ...........a......................Z.............................
--------------------------------•---•--------•-•--•----------••------------•----•-------------------_------------------------___---------------•-------------------------------------•------------•--
V 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—Th rsigned further agrees not to place the syst m in
o� ati ntil a Cer.••sate of o liance has been issu e bo i alth.
Signed.......... .. .... ......... - ..... ---------•_._
Date
XAp-�i`c iori proved BY---------- ----•------•---
Application Disapproved for the reds:_. _:
---•------------------•---------•-----------------•----•-.,..a-•------ -•-
................................................................................. -••--•---------•-----.....----------.........-'---------•-------------------•-------•----------------•------------------'Date--•--...--•---
PermitNo........................................................ Issued_.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................................O F................................................................................._...
Trr#ifirtt#r of Tomplianq
THIS IS�TR,,TI��FY��rrThat the Individual Sewage Dis osal Sys,�tems constructed ( ) or Repaired ( )
by rl(1.. < �. _,1,; _` -
Installer
at.. - ----------•-•-•- .00_,_:—0_.. x = c' "' ............C.s'"r
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.......................................__ dated_.--------......................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. 17
DATE.......... ...-.: Z....�g ........................................ Inspector......... ........................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF............................................................._.......................
No.. FEE........................
Dilivoliaf No ni#nutivit ramit
Permission is hereby granted....-------• -----=---- . --••--- / i.._...._ �._ c. _.
to Construct ( ) or=;Repair ( ) an Individual Sewage Disposal S tem
atNo...............................................................................................................................................................................................
Street _Z!5 ,-?" 73 _ )
as shown on the application for Disposal Works Construction Permit _N.o,.,_i'.___________ Dated.__! .... ..................
t Board of Health
DATE a, ¢/gs-
....
FORM 1255 A. M. SULKIN, INC., BOSTON
n`9 C Al s PdA14
o �
014,
l
pv
S&/W
p < // SAGS
N
I Vim/ R
I/ �b g X `9B'
G
jy N /
OQ
/ a
,vi .
0
t .
EJ �10 �
c, ,
�,_
P G tiI p� P OF
47�a \ L '
c' RSE sy
No.10951, b
�0 G/STEM
LEGEND FST/ONALE��
EXISTING SPOT ELEVATION _ Ox'0 CERTIFIED PLOT PLAN a
EXISTING CONTOUR 0 - - `
FINISHED SPOT ELEVATION 0.0 r au5 -!`�
FINISHED CONTOUR 0
APPROVED = BOARD OF HEALTH '�, l;
DATE: AGENT 9�v s�'`-' SCALE- "-' '�c�.' DATE _ // 66
V REDGE ENGINEERING CO. IN
_ CLIENT I . CERTIFY' THAT THE PROPOSED
EGISTERE RfGISTBRED J0B N0. D2,3 BUILDING SHOWN ON. THIS PLAN
CIVIL_ LAND." CONFORMS TO THE ZONING LAWS
EIVGPNEER SURVEYOR' OF BARIdStABLE , M. �rt
712 MAIN STREET CH. BY,
HYANN.I S, 'MASS L 2, 7 _ :-- — r
..
SHEET. OF .. TE REG: LAND SURVEYOR
No re = /F EfTi'ACR THE.SFPT/C rANfiC D�
z0 PT. M//o/ i.-ACHinrG P/r ARE MOIl4ff TNAJV /2p8E1.0IV
ET.FA' G°®NC'.�° 7"� CO� R
SJ4►ALL �.� �PD�G�O7 710 4SMA DW.�A V 4XTFeA y
CONCR&TE 4 PYC PIPE -iEAYy CAST/eo/Y COYEaR SHALL 8.E US'E17
f9lN. A/TGH
2 N/,V.
_ O
� of Cc) VER CL L::AN SAND
LIC9WD LE'1/EL
' 2LAYER
pYC� P/PE . a o o QF /o -3Id•
�✓jiv.PlrCM� GAL. D/ST • t . • • • •. . a • WASM£-D SMNE
'R�"R� SEPTIC TAONK o , t ♦ • . e . t t , • • i
. .
o t • DER7-W s t • • s• H�i4SHfA .STBXE
v 6 ® /ai?EC.45T.SEDGE' I
ho = 1 /3 ► a� • t o e e e s t • ;� ee n
v o t o e. e e • .; o PIT OR 4ViJIV, t
i�iT e�i�,a cf�-y 4�o G�L�v�F y � o a , �L 90,(11 ;F
hVk&JVT AT'00140/MCv 7 r'' :FT.
� /z � o/.�l�i+. C
dv7LeT PT/C`7A NR 6 3 Fr. w
9 p ,SECT't®M of G�ol1N® dxi�TAB i%IIld.E'l"4Pl1TR/40!!7P/0h/ BDat
E9tli2E'r0l0 S J IAL r/Q/N 9 $.
JS ' �G� L7/c� s�L .' Y.�� J�'
-r L. 0
L CHI*VCr `TB /V
/d8l!/. ebb�JWT t`
1JE d6N. CMI7E-M1 6 D/M St®at, : _ "..
NIJIN1� OF
caA �=®I.a/�.SrL uAtIY nod
TdTi4L T/f "EA .4040 1 3 3 y /oaf SAlL. TEST, / SodL 7�S7" 2. 3'®J�. ?i 3�".
NIIVAfas 'Ow 10ACMINC Plr� ATE AF.S®/L TEST /
SINE 1 .��i9I1/G:P PIT t S - PT. .rr
O —3 RESUL.TS P/lTNE�Lsd► �� 14
QOT rCX^f ` CtJINCr AER PIY. r! 3 .�Q• fsT. v / TRC42s0Tf®N AA70jol ass M/ V INCh►
TDML dCH//YGROA 1 2 g;SQ.. IF7 Sv�< s 1.A7"/®I9I/�o �9 -rFr,4 niM1 N /NCs!"
R.ESERYE LA954CAI A✓G AREA zC�¢SQ. F T. _ 3 ' /I 2— o
x "7 - �:4!� OF A3`�\ Nl� a cow Sz Ld 7 l g l l/mot ONS yJN? Ci ;
f i.'
A R �� �7 / - ��' f'✓ �°��S - �'.
MORSE w��t_sw
x
No.10951 7r/° . '
.cIVl( .� •... Y ` , N-1 F .:
,R PpF GiSTE v��� y .L_ �sfiF� Li
a 1r' •/�f
V». ��:�i' `_ ., _ SSlGhkl�'? .� .: .• �d3`; ��� '" 'N'�C/cCv�.s4 � 7rEs �I' 6/
J •�• +x•.atr v ,<,.......1....._.,_�,:.w,...a.bw. ,4, .+..,_,,.�,. a...k.ru .,..r.,.: ,u+ :. .- ». .s.., r w...,.k� ?-..w-.., _ _