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Home My WebLink About0069 ABBEY GATE - Health - 69 AbbeydGatc - _ Cotuit 021.- 019 S LOCATION �-+ SEWA G E PERMIT NO. VILLAGE C:70 Zv` Al 14 I N S T A LLER'S NAME S ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 7oP ��C� �� /�J Cs S G 9 �`� �� 3� — -�1 .� :: ,. . "'..Yew" w\4_�. . y ��M'�.h�t ... t .�MY �. 'uSA�J _ P a � � �}��e..:ra- f "Ito.............. ......... F.Rs.... 1 ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...._... Tom...........OF..........6., -------------------••......-- Appliration for Diipnaal Works Tomitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System a ' .., ✓ .......................•-...... .............. ......�...... �" .:... - ._...... •------------ Location:Address ` or Lot �'Mi& / Jyry�/� / p Address . .... -------------------------- +? A .�f k� .�----.----------....- .-........... � Installer .` Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.__...._..�............................Expansion Attic (y( ) Garbage Grinder ( ) WOther-Type of Building . _ ........... No. of persons......-A................. Showers (% ) — Cafeteria ( ) a' Other fixtures ...................................................... ----------------------------------------------------- -------------------- W Design Flow...........3.2.6.....................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/6_64..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. Other Distribution box Dosing to -6, � Percolation Test Resul� Performed by._...... L /..0- _.__. 4......................... Date...... � .' ....... ,4 Test Pit No. 1.7--------minutes per inch Depth of Test Pit.................... Depth to ground water--_-_-_____-_-__-______- G Test Pit No. 2................min}}tes per inch Depth of Test Pit.................... Depth to ground_water................_---____ ---- -------------_---...-- .. Description of Soil_ ........ ......................... 1.. ` x w 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 operation until a Certificate of Compliance has bee i ued by thlboa , heal-h, Signed.•. ............. ...... -•-••...----------------. { Date Application Approved By-------.. .... .. .......° . -•-! ! Y Date Application Disapproved for the following reasons:-----•-----------------•-•-••-------•------------------•-----------------------•---------------------.........__ ......................................................•----•--------•----•••--------------•------------•---.........---•--•--•------------------------•--••---•••---•------------•--------•------------ Date 7c� Permit No......................................................... Issued_..: _.......----------------....._....--•--••..._•-- Date N ------- ....._....... FE$... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE A TH ' -----.... !1...........OF......... ..... •---x................ Appliratiun for Disposal Works Tonotratrtion ramit Application is hereby made for a Permit to Construct ( ) or. Repair ( ) an Individual Sewage Disposal System af " Mi '` as .._.. -� Location-Address or Lot+ Imo, ---------------------------- �� t��!�?.� ' ..........?.a t�r,r�,v!�1� ..�...�� f Owner ddress ,. W x' r ..... kwk_ j_ e'~: il'�. .............................. Installer Address d Type of Building Size Lot................ _.Sq feet U Dwelling No. of Bedrooms__--_ .Expansion Attic Garbage G der, ) PL4 Other—Type of Building P d ........... No. of persons f ................. Showers (e — Cafeteria ( ) d Othe"r fixtures -----------•---------------------------•---------•--••---------...........__.._..----- =4 W Design Flow..........«.. ....................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacit_4A6.4L_gallons Length.............•.• Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width—................. Total Length.................... Total leaching area....................sq. ft. __---- � ....................... Depth belo inle "°� Seepage,Pit No_____________ _ Diameera. __..._.. Total leaching area.. ___.._.._sq: ft. Z Other Distribution box.( ) Dosing to -lip A— ( ) * } aPercolation Test Res ul s Performed by-__.... :_ ... !1 _ ........................... Date... ............... ...... a Test Pit No. 1/1..........minutes per inch Depth of Test Pit.................... Depth tb:ground water................ f% Test Pit No. 2....... .nuriptes per inch Depth of Test Pit.................... Depth to ground water........................ A , O Description of Soill 4-��°' "-- -�:1. ..1!1 .7�...---Jf_�s>I+ . ........ .. ..............................1 . V ............................................................................. _..._. •-------- W ----•-------------------------------•-- -----------------•--------•----- ----=----------------------------------- 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 T.fT11 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of:Compliance has be i ued by the bo hea Signed ..... 30!�/J--I Date Application Approved BY ace = . ---� ...... .........•-•_..__ ... ....••-------D -------_-•---- Application Disapproved for the following reasons:-------•---------------------------------------------•--------------------•------------••--•--•-......•---.._.._ .....................•-------------...........----••---------•-----•-•----------------.................................................................................... :.... w Date Ith PermitNo..........................................................' Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF LHEALT .........OF.. ... ... .:..... Trrfiflratr of ToutpliFatta THIS IS TO C RT Y, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) Installer �,,�t,� at has been instalee n accordance with the provision j of Tbfe State Sanitary Code as describej in the application for Disposal Works Construction Permit No. . ............... dated _.._..�'` /, '« .7. THE:ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM. WILL FUNCTION SATISFACTORY. DATE...............................-•---------------.---.---------•------•---------- Inspector...................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... ! OF.............. "" z ............... No.......... �.... FEE... .S.......... iuo 1 or u4rlion rrntit Permission is ereby granted....' ... = ".-1------------------------ :.. to Con ct ( ) or epalr ) an Indio ewage Dis P 17 Stree as shown on the application for Disposal Works Construction Pert No.._._ ___. Dated.__._.._ :ri .................... = t. . . ... ' 2 2 78. Board o Health DATE.:........:.:...........••--------------,......------- -•------ ----•----• •' . : I FORM 1255 HOBBS & WARREN. INC., PUBLISHERS - - ZD YT �v i�o N - - - - GX/Stlnq grocrr-,off prof; ie �^ _.__- -o—o-o--o- Pr•oPnsGc! groci.-�c� Prof', i. c �e- E , = /o (_..-. 7� ! /�� S G,q L � SG OEM rr,;nlmc�rr7 pGr f^oot > waS t/� , f n E_i S 'o �' of r----' t � -- - • �p'chi a 8 oX ' ter— -J v f `t/4 - /DOO 6A4. 54e 'T/G -7,9A/&' wa5 "1e- 5 'El, 011 T,-, 4 3 ?8 7•C-5 r Rti /Gf�/9�E'G Fi9i�ec3ANK5, l � G. P n-1/A./1, ./C -,i oATuM M.S,�t pearr7stab G N 6Llthc0 P1' T6- S 7- H O B ! 7-E S T H O e- E cl�, ,orC T.q ry G vSE- : �O GA TA /,� A � l�. �.E r9 G f-/ F'i T 12 ELF. 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