Loading...
HomeMy WebLinkAbout0042 CARRIE LEE'S WAY - Health (2) ya Ca rrte Lee,'s li � , (e,� j< 791 � Fes$...` .! ................ No.............-_ ---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. �i-^S ............................................. 747 1141):7...........OF........ M1I t� ,� ftrtt Ilan for Uhiputi al Worko Tonotrnrtion ibrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: �� � s lr� , ..........................e ........ ... ._.. ...................Addr----- -.--................. ....................................2 fDTL 1C ' -oration-Address or Lot No. e77 Owner Address W .. .........................Inst ---•-•-•----......••-•-•.............•..... {e"G•'---'LVQ�Q...................... Installer Ad Tess i dType of Building /� Size Lot �':.........�'._..Sq. fee U Dwelling—No. of Bedrooms......_°3•---•-----------------•_----__-Expansion Attic ((/ Garbage Grinder Other—T e of Building ... No. of persons............................ Showers — Cafeteria a Other fixtures ........................... . V.;. ----- ---•-------------•--•--------- W Design Flow.............*,A .................gallons per person per days. Total daily flow._........ � ...._._____._...__.gallo ns. 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.__.,.+,f............. Depth below inlet... .............. Total leaching area.�.�.......sq. ft. Z Other Distribution box (/) Dosing tank o y� _ J Percolation Test Results Performed b �- .!_._..-:..?V _%�a.' ...... ______________ Date_.. !_- ._._.___... Y a aTest Pit No. 1....rd.......minutes per inch Depth of Test Pit_____ ___________ Depth to ground water.......... (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ . ' ---••- f. ZZ 0 Description of Soil ' . -� ->11 � ---••••S• -�-.................................................. -- V •••••--•-••••-•-••••••••-•--•------••••...••-••-----•---••-••------••••••-••-••-•••--•--••-••••-•-••......•••--••-•--••-•-•••••••••-•-•-•••..._..._..•--•-------•••••-----•-•-------•-•••......-•...--•• ----------------------------- --------------------------------------------s-----------•------------:..•---------------•-----------.._..------------------------•--•-----------------••••....--••--_.... 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 TIT1 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b tn issued by th 5-oar o health. G� Signed_ ... ..._ ►_... .............. " .Z. Date Application Approved BY.......................... ... .... --G -•--------------••-•-•-••--•-- D ate,'- Application Disapproved for the following reasons:................................................................................................................. -•-------- --------------------------------------- •--------------•---------�-------------••-------•--- -----------•--------------------------� `•---------- ----------------------------------•--- Date PermitNo._.....-•----•-•................••-••----.-........•..... Issued.:-., --•-�_�....... --••- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH .............. ..............OF................ ........ ��................................ rrigfictttr of Tlampli anrr T I TOICIFY, That the Individual Sewage Disposal System constructed ( or Repairedby �i � ..._ ..... .. ........... ...•----------------------•------•-----•----•-•-----•--•-----------...-----....------.......-•-------•----------•-- ------------------------•--•-------- In 1 at-- .. I�� / has been installed in accordance with the provisions of r of The State Sanitary Code as described in the application for Disposal Works Construction Permit N ................ dated___- F................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION^ SATISFACTORY. ,✓� DATE--•-•-..T.....� r'...................................... Inspector....-- Oat NO........ ....... FEE...�.�.........._ THE GOMMOt4WEALTH OF MASSACHUSETTS BOARD OF HE LTH Applirtt#iun for Diupugttl Warks Tunu#rnr#iun 11amit Application is hereby made for a Permit to Construct ( or Repair ( } an Individual Sewage Disposal System at: .........._r �!L':1 ........... 'e:.,S �Q �o�. r,?,..� ��, try lit /.� 4. ... .... .-•a ion-Address or Lot No.�/� �Ds � Y:c° � oZd R /� `� °� `fi r_......,('/�`.YS-fv r+_/ �1s ............. /............. --•--•• ---•--...........•............. ...._ !� Owner Addres�!X� Y W 4.ya.Y4 ............ ......................................... {.-. .. ...•-�dc�.S� ... h"� Installer Address .� 10 �J .S Type of Building Size Lott.......................... q. feet Dwelling—No. of Bedrooms.._..._3..............................Expansion Attic s Garbage Grinder Y00 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d _ ... Other fixtures ..---------•---••--•---••---------------•----•-••-----.............................. Design Flow........... e .................gallons per person er day. Total daily flow____---__.,_._ __�_.-................_...gallons. WSeptic Tank—Liquid capacity C�gallons Length._. .,vr_7 Width.....6....... Diameter................ Depth..,;-_0 x Disposal Trench—No..................... Width...7............... Total Length..........._...___ Total leaching area....................sq. ft. Seepage Pit No........I......... Diameter..../,�------------- Depth below inlet_4.............. Total leaching area.R.01.....sq. ft. Z Other Distribution box (�)' Dosing tank '~ Percolation Test Results Performed by..._/-�. ._ .:AJt=...... ....../-__L.............. Date... ? .!7, 7 ----------- Test Pit No. I....G7-------minutes per inch Depth of Test Pit__.._4........_. Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ tx ......----•---•---....----••............•------••-•.-- O Description of Soil �..``Q '� 5 ✓ -S._.. ,,,J �.. -- ...... . x U ......---•••-•••------•----------------------••-........•----•......-----•--------••---•••---•••-•-•-----•---------••----•...__............-----••---•-•----------•...----•-•------•••-•-----•----•••-_.. 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 T I T 7 is 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n issued by th oar health. Q a., Signed . -•---• h -t --b....-------- 1..." -7 ._.... Date Application A roved B _... _. ---------------••---•-••-................ -•••----•-•-`.,,4" Date Application Disapproved for the following reasons-----------------------------•-------------------....._...__...------------------•---------------------------••-- -------------------------•-•-----.....-----•-------•-----•----•--•--------•------•---...----•---------------------------.......--•------•-------•-----••----•-----•----• ............................... Date PermitNo......................................................... Issued:..................................................... Date THE COMMONWEALTH OF MASSACHUSETTSM f BOARD OF EALTH .........:;?.......................OF................ ....... 1 ................................. �ler#ifirtt#�e of f�unt�rltttnrr . ��.. TH a I TO CE IFY, That the Individual Sewage Disposal System°'constructed ( or Repaired ( ) by f= �..... . -- -•---•----------•••-----......................... -----•---------•-------••---------••......•-•-•-•-•--...--•- lU1 Ins le at � .�•- � -d has been installed in accordance with the provisions of ) 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N�._.,,2'a�-�/................ dated....�.f f-"--_7.�=_..t............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. .. 7� DATE•• ...1 .............•... Inspector.......fo.-:. .................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH ... ........................OF._.....:....... . /><-��. 2S r7....... .... - � No......................... FEE....... .......... �iu�u 1 ur �'-'-�un�#ri�n lerntt� Permissions kereby granted. •------..... to Con true ( ) or Repai� ) an Indivi 1 Sewa a Disp al S�tstem at No�.- U ..r-....�?:.��-......��':.... _4K -;e. ��� - ........................ Street as shown on the application for Disposal Works Construction Permit N. ___ �__._...;. _ Dated.._�l'` ...`. _.__...._. -----•--------------- Board of Health DATE..... ---~Ap....... D4.:--•---•-----•--•-......-----•-••-...... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 19 .:s s1440w-r7 4�-)7 PZ427 //Zei 4.v t/7 Q. C,Ile 4 . 8�C 3 le � Y8 17 Cv.y s r>rc vc /o•y .�o, e��6 ��y.Ff. •2 /3� �� 6 N C'Qw 5 Th vc 7-1 r1 / /7 d z 9 " /0_ l D _,�•/�, %X p ¢/v Ft 4 >i".!!� 077 / „ ,1 1 �Q i 1 do 1�1 4 77 t / X/0 rou 7, W a c' y a 1 E 7-n / 77 /9 c k ! s'1 c± A E T7S V -r7 6112/7 ,., �wC� f i i �1 . bb 0 7 2 e.oa • �,� E J v, t $ �N w,;• l� -f" Q*M*J?� \ D /( 4 ff FRANK =.:L FRANK Q CONERY "`� CCNVERY No. 6232 Q Ap No. a73 0 ONAL 00 04 PL-AN1 of LAND I E N -re:,? V /& MlllcsS. Z©` G O ' .Z G " /o 8 t• /p' /�' e J OWNFD NY FRANK CCNIERY 5 TRENTON ST. HYANNIS. MASS. 02601 wNstsTwjwm t'�+c."ma a LAND SURW'frP SCALE 1 IN -s,o rr- 711,eb f3