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HomeMy WebLinkAbout0236 NOTTINGHAM DRIVE - Health (2) rn kam be"c No.. qe, Fss.. . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALT Appliration for Disposal Works Tnnitrnrttun ramit 01 Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at OL --• D._.1................... ............, • •--- Loc�d..-Addres or Lot o. �A SCLX Owner / - Address a DSO.yam: ------------------•-----------•----•---•------ {4 Installer Address U Type of Building Size Lot__/J_0-00._Sq. feet Dwelling—No. of Bedrooms....... ..............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixres •••••-•--••-•••-•-•----••-----•-•••---------------•---...••••----•-••-----•---•------•------------•--•••-------••-••---••--•-------•-•--•--•----•----- W Design Flow............. _________________gallons per person per day. Total daily flow.........)k ......................gallons. WSeptic Tank—Liquid capacit 0.0M_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--------------------------- /�6 ........... r/� W r*� 1 �,_ -`___Date------- .-. .. Test Pit No. lo"-55____minutes per inch Depth of Test Pit_._I o5__. ..___ Depth to ground water_.___ ___._ c�C - (_, Test Pit No. _ ._minutes per inch Depth of Test Pit____________________ Depth to ground water._____'.__ __... R+ --------•-- .................. -•.......... --------------- •-----•--------- O Description of Soil_._______Q_._____� ._ c_S�4.Y�9�__ �1__(!� .� r _- x V -•••-••-•••--•----•--•-------•----•._...-••----------------••---••......••-••-----•.........---••-•---•••-----•-•-----•-••••--••••--•-•-----•-•---•--••--•----•-•••-------•-•••---••---•---•--••---•••- W x --••••••••••----...•--------••-•-••----••-----••--•-•-••••••--••••••••-•-••-•--------••----•••••....------••••--------------------•--••--••••••-•--•-•---•-•---•--••------•-.._..-•-•••--------..._..._. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... c ---------•-------------------------------•-----------------------------------------------._........----•------------------------------------------------------------------._.--------•-•--••-------•--• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed-- �� � (--- ---------•-- t �- -a Date Application Approved By........... -• .............. .----•-----------------------••_-••••-- 7— g� Date Application Disapproved for the ollowing reasons---------------•------------...__...-------------------------•---------------•--•----------------•------...------ -----....................................................................................................•-•------------------•--•--------••---•----•••-•-•---•--•••-••--•-•-••----•--••-•-•----••----- Date PermitNo. --� ........................... Issued•....................................................... Date No................I. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE LTI-I .C��c•t)r' 3 OF.. -.. -.. .................... Applir�tt lau, for park C�u�t r�tr inru rruti# a Application is hereby made for a Permit to Construct (,.- or Repair ( } an Individual Sewage Disposal System at ----_. .��.°.�wf Z.�!. r .....?- -----••-- - '!' '�"sal/ �'_�'-: s � �........... Lo�gtion-Add e or Lot o. . s.__ ........1-5.ox.... __.._���___-- �° , .v+. .'.......--• W �, Owner / ,Address ,-7 - , 2 1 *"..4- .0 I TIJ--------------------------••. ..............--••-------= `h'? a.. Installer Address Type of Building Size Lot_Z17 00 ----Sq. feet Dwelling—No. of Bedrooms____....._ _______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—,Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' her fixtures- -------------------------------•-- Desi Flow_______ Other WDesign ..___�.._::�t____.................gallons per person per day. Total daily flow......... ___.....................gallons. WSeptic Tank—Liquid:capacit)�, ?.42__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..................s . ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by___................................._________________ _ !4 ......... Date.............. .....______ Test Pit No. lAeJ..5 _! ._.__.minutes per inch Depth of Test Pit____-_� __ ___._ Depth to ground water_.__ GT4 Test Pit No. ,-( :_ ._minutes per inch Depth of Test Pit ......... Depth to ground water_......__�_ - ----------------------- --------- ---•-•-----••---•-----------------------------------------------------------•-••_-•------------•----------------------- O Description of Soil.......... _.- !__� e1- '_._._1 �_l i�.= __-�. ' _ x U -•...••••-••••-••------••--...•------------------------------------------------------------------------------•---------------------•----•---------------••-•........................................... 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 TITI LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed ,� r �. ..x -----._...•--------------- 109 r �,,^ Application Approved By---------- u -plc! _-------••-•-•----------------- Dat -•----• Date Application Disapproved for the ollowing reasons:----------•-------------------------•------------------•-------------•--------................................. i ..................................-•------------------------------------------------------••----...._...._:::..__...._...-•-----•---------------------------------------------------------••••---------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 11 v ...................OF.... < ....�' ";Rx .....:................-........ Tntifiratr of Tompli ttu jHW IS TO C - TIFY, T a the Individual Sewage Disposal System constructed Jo J or Repaired ( ) ----•----------------------------•.•••... at... Q = ��' •'•-E� —xis �iInstalle1.K! .---•---••----------•-------•--' has been installed in accordance wil°h'the provisions of TITLE ✓3 S__6 _�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 CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. _U, DATE......... � -•---•-•-------------------------------------- Inspector........... •----•------------------------.._............--------------------....... THE COMMONWEALTH OF MASSACHUSETTS ~. BOARD OF HEALTH ».:q .../1�.��.d.4�'�'�!.................. �5 �✓`1'�..__..._..._........._.........__. A] 3FEE. Disposal Works Tunas iuu Uprrutit Permission is hereby granted---- f_ :`:.1r' 1.: ° to Construct o e�air ( ) 4n Indiv al Sewage Disposal System atNo. t?_t /e! : a _._ ................................................... ........................................................... treet cc as shown on the application for Disposal Works Construction Per it No.-'_'5S_ 3 Dated------- �J. $..?......... --------------- --•----- -------------...... DATE.__... �• � Board of Health •-- ` ••- FORM 1255 A. M. SULKIN INC., BOSTON- _ \ - 7 O p �2pc p ! Q 6S 7 4 Y� N r. i 16 171 }. 15 11Ij` t. L /L7 0 r lit/I D .7. QE;<PAW S(0 0)' .� •�. Z. 2scvnE• � A��. /oo .0 73'S 7 /., / - IJ F Mgss, A C . - _ Bi 1 9 GIs 6 �> R08ERTo�FSSIONAt�a�` LEGEND F BRUCE ;�: c�nR�o© EX.1 '6'IN0 SNOT ELEVATION GAO. i" CERTIFIED PLOT PLAN _EXISTIht® CONTOUR -- 0 — PMISHED SPOT ELEVATION H �,.u�j,� �v7 /7 nlo-�-'-r�,,✓r.r;/AP F$�ISHIED CONTOUR 0 r �<<�✓t. . '� NOTB,. The- location of any .existing underground sewerage, w`ells',. or other utilities shown on this plan is approx- IN U:mat6only as determined from records and'/or verbal` inMA formation. The contractor is responsible for the S �� '�'�"�"��' , S` • r, verification of the existing locations `in the field. SCALE, / rt� DATE + F �k .DREDGE ENGINEERING Co IN C2�c-'✓3'`�/�'� CLIENT._,,.._,_..w_ I CERTIFY THAT THE PROPOSED EGI3TERE REaiSTEREO r J08 N0. g�7 6 BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING LAWS x�. ENO NITER RV DR.BY+',�. OF BARNSTABLE MA5 712 MAIN STREET CN. BY+. ' E HYANNI,S, MASS.. 2 -- ISHEET:'L OF DATE REG. LAND SURVEYOR th Is • •Z •,Y 11 '� ra. $ nx; �.L �• 1�.,� 1•.� '1 V " CIO 0 Z yG'i,9FQ ayy y n k n' c M O sita NZ �► y 1► 0 .10 ;�.� 0. 0 th F to lb ''' y is ,� `� n► ^+ cam; aQ � �, . � :-�,�;: � '� l� y � � "� ��� ��,. a °�e� • � �'+ y -� is fi� � 4 th Now m. . .a.^.:-a. rol*, . ,n"".� •;�.^''""'""'tM si.•'mu-�3*:i�.'n•'.:�'.f.�W',:. :'?'��/...".r-"-.,?i'•'��,.,,.- ._".n""n'.',°'.'T"'.��.'..... .-, ,*- - .:i n z t {�! 61 6.1 t 1� . 1 n \