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Home My WebLink About0181 CAP'N LIJAH'S ROAD - Health (2) Fm eaplo L� ahs, fin} , No _`.107 •---•- r Fps........... .. ........... ASTHE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 1 • -----OF.......................................................................................... ApplirFatiou for Disposal Works Tomitrurtion Errant Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 'en V1 Location-Address or Lot No. p -- �/ Owner Address W — Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms._....-f.................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building F"r.n�+e........ No. of persons ................... Showers = Cafeteria a YP g -------- P ( ) ( ) Q' Other fixtures ................................. W Design Flow..............4 ...................gallons per person per day. Total daily flow--------6_7V®.........................gallons. WSeptic Tank—Liquid capacity/_,'#�a-.gallons Length -4.- Width.!' ___ Diameter---------------- Depth,_I'__�: a. x Disposal Trench—No. .................... Width.................. Total Length.................... Total leaching area............____._._sq. ft. Seepage Pit No.....�.....--... Diameter---------&------- Depth below inlet.......G.'....... Total leaching areali��f.K..sq. ft. Z Other Distribution box ( V� Dosing tank( ) '-� Percolation Test Results Performed by.......................................................................... Date---------------------------------------- aTest Pit No. 1......Z......minutes per inch Depth of Test Pit.................... Depth to ground water-----.---.-------------. fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•------•--------------------------------•--•-••---------•--------------------............................................................................. 0 Description of Soil.......... --•................................................•-•----------------------•----------------•------......................................... W V ..••---•••----••--••-••-•---•--•------•.._..--•--•-------••••-•-•---------------•-----•------------•-......--•-------•--------•-------••-------••-•••......•............................................ ..........................-............................................................................................................................................................................. 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 p p y of health. K o er do u I a Certificate o Compliance as been is ue the oar c �^ Signed••-• .�...- --- ate Appli tion Approved By....... - •`•= ................................. 1/ -------••---7 ate Application Disapproved for the following reasons--------------------•----------------------------------------...--.............................................. i ................•-•-•------------....-----•-••---------------...-•--------------•-.....----••------------......---........ ---------------------------.......-----------------------------------•------ Date Permit No... .................................... Date FimB D19................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF..................................... Appliration for 14sposal Works Tonstrurtion Vanfit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System af: o ..........�....... ------------- ................... .................................................................................................. Lociition-Address J or Lot No. ........ .... 0wher.......................................... Address........................................... ........................................... ------------------------------------------- -------------------------------------------------------------------------------------------------- _�Y,__ -if,s'ja r Address U Type of Building Size Lot............................Sq. feet 1-1 Dwelling—No. of Bedrooms....:r..................................Expansion Attic Garbage Grinder Other—Type of Building .......... No. of persons....Z.................... Showers Cafeteria PL4Other fixtures ...................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow...................I.........................gallons. 04 Septic Tank—Liquid*capacity............gallons Length................ Width__............._ Diameter._.____..._..... Depth....._......._.. Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No..................... Diargeter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 14 Percolation Test Results Performed by......................................................................... Date........................................ 14 Test Pit No. 1................minutes per inch Depth of Test Pit................_.._ Depth to ground water.___.................___. 4 Test Pit No. 2................Minutes per inch Depth of Test Pit.................... Depth to ground water......._._..........____ P4 ........................................................... ----------------------------------------------------------------------------------- 0 Description of Soil.......... .............................................2 .................................................................................................... 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 p� do Of TITIZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in`� T t'o ope 10 11 Certificate of Compliance has been issued by the board of health. Signed.. t Z( ! --------------------- Appli ation Approved By.. . ..... ...... .............. ---------- .................. Date Application Disapproved for the following reasons:..................................................................................................w............ N ............................ ............. •................................................................................................... I • 't Date PermitNo........ ...................................... Issued....----- ................... Date COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................r.................OF............ ......................................................................... (Infifiratr of (Ijautplianu THIS IS TO CERTIR Y,.,Tha0hgqndividua4 Sewage Disposal System constructed or Repaired by---------------------------------------------- ...............rl" ............................................................................................................................... prslaller at...........)—a.il.....1� . ................................................................................................................................. has been installed in accordance with the provisions of TIT1Z_�pf T6'$4te Sanitary Code ap the application for Disposal Works Construction Permit No.........-0......--'..............�'� dated-.---------------- ............................ THE ISSUANCE OF THIS CERTIFICATE SHALL-NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... .................................... . Inspector...... -- ------ -----_-------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Z) to ...........................................OF...................................................................................... ....................... ............. FEE. Permission is hereby granted................... e................................................................................................................... to Construct or Repair an Indi bal S Disposal System 0 fwa e....................J7 .. atN .. ..... t .......I------------------------ ........... ---------------�t Street as shown on the application for Disposal Works Construction Permit No. ........................ p Igo________________----;O� ........................................................................................................ DATE.i......C,,[................? ..................................... Board of Health .... ...... FORM 1255 A. M. SULKIN, INC.. BOSTON 4 a A I Cross-Section NO SCALE Lot 17 Lot 16 15 ,265 s .f. Lot 18 vl/? t Stone 5 Expansiun . 4 - 5 34 S . D-B 47• FC)GO( po = Io98 G.1 ,D 150049.3G.S.T. z3 p --Z4' 47 4 8 i ro��osed -' N GGar. --7 2a•' 47.7 } 16 �> �1 49.4 1y ll'i) 49.0 47.3 CAPT. LIJAH' S itOI�D 7r5 PLAT: :CALL 1"-30 ' j AT , 10/10/84 I 140 WAY Sh IJ t LAN OF LAND 1N CENTERVILLE,I Ii. { for 6 Anthony Pino Beim- lot 17 as shown on a plan for D .D .J . Realty Co. dated April 11,1973 by Charles N. Savery, Inc. . Flan recorded in Book ?74 page 5,in Barnstable Registry of deeds. elevation shmm •are in feet above an assumed datum. Date --------Agent Barnstable Board of Health j All Cape Engineering 49 Harbor Road ;OIL L 1 -3579 Hyannis, Mass. 02601 }/l/84 "it .. __,'on Gifford No '. Otte:- encountered 1 49.3 • ';oll i —�4 7:3 lours `I Nand t. o,,ey41.3 i E FRAN. ,•i FRANA _.. ._._...__... . . . .....- _ ___ _... _ �r _ `-' emu- ' i .../�� e ��t''' -� ��•� 4