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Home My WebLink About0110 CONTENT LANE - Health 110 Content Lane Cotuit; A = 040 — 030 - - - — -- - - - - - -- - - - -- --- - - - LO CAT.10N 1,za vl� � SEWAGE PERMIT NO. ..VI.LLAGE r. 67Lzr 0 /y b — d 30 +U N S T A L L E R'S NAME i AADf\It,E Wro BAcKHQE SERVICE, 150 Walnut Street .West Barnstable, Mass„02668 s I U1LDE R OR OWNER DATE PERMIT ISSUED DAT E COIl JL I A H C E ISSUED nn �� `ran �� t � ,. i� \ a�\._ 31.E ; %% � , i � ��•�� .., No.._ 0 -0 30 THE COMMONWEALTH OF MASSACHUSETTS Cola` BOARD OF HEALTH ..............................................OF... OVA Co� VVIlration for Klispviial Works Tow4rurtivit ranfif Application is hereby made for a Permit to Construct (�or Repair an Individu Swage Disposal System, at.,. .... .............�b.�...... .. ............ ......... ........... .......................... L ocation lion- Mess 1 No. e4 C, Z�. ............................ ............... ....... .... .......... Owner SS— �MW...A9,A.7.2>......................................................... .... ....... Installer Address . .!4 Type of Building Size Lot. . U ........0.P....0..........Sq. feet Dwelling—No. of Bedrooms...... .....3...........................Expansion Attic Garbage Grinder ( ) Other—Type of Building ..................... ...... No. of persons............................ Showers Cafeteria ( ) Otherfixtures ------------------- -------------------------------------------------------------------- ------------------------------------------------------------- Design Flow______.__.__S *_______________________gallons per personigr day. Total-daily-Pow.........33.0--------------_-2,11pps. ......... ........... P4 Septic Tank Liquid capacit3MOO..gallons Length..i ---4...... Width.-Y/ .... Diameter________________ I ....?..... Disposal Trench—No_ ____________________ Width...................... Total Length.................... Total leaching area_._ sq. f t. Seepage Pit No........Z---------- Diameter.....6. ........ Depth below inlet....I............. Total leaching ......sq. f t. r Z Other Distribution box (all Dosing tank"'( g Percolation Test Results Performed by..//,0_S..... ........ Date _!P................. ------------------ Test Pit No. I......Z.....minutes per inch Depth of Test Pit_.._., ,.__..___ Depth to ground G14 Test Pit No. 2................minutes per inch Depth of Test Pit._-...._______._____ Depth to ground water........................ ...................................................................................... I 0 --------- DescriptjonOf)Soil__7.................•.� ...... ........ ..............................................I...................................... .............. U ........ 0. .. ....... . ...... ................................................................................... ..................................................................................................................................................................................................... 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'TTLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss J by the bo rd of health. Sign ... . ...... .... . . ..... .................. (. ............ Date Application Approved By........ . . .............. . . 'a-01----------------------- ...... Date Application Disapproved for the following reasons:.................../................................................................ ................ ........................................................................................................I-------------------------------------------------------------------- ------------------------- "'ate Permit No. Issued_...2�........—,P4 ................0..................... Date No.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ?ej.ovxt�...............OF.... .��2 Application is hereby made for a Permit to Construct V) or Repair an Individual kSwage Disposal System at: ....... ... .............. g' J!�. ......... 8 �gky ........ . ................................................. •. ........... ........................ Location-Address . 4-_1 r Lot No f I ................... .. ... .... .... ld�..... ........ Owner .........................aLre;.* ........................................................ ..... Installer Address M 54 ........Sq. feet -�4 Type of Building Size Lot..X'�o U Dwelling—No. of Bedrooms_____ _____ ____________________________Expansion Attic Garbage Grinder Other 7-Type of Building ............................ No. of persons_.:._._._..___.__._.___.____ Showers Cafeteria a1 ': I . Otherfixtures ............................................ ............................................... .......................................................... Design Flow....;........ ........................gallons per person per day. Total daily flow--- 3-Ac. ................ Ions. ------------------------- W . . - -01 IY4 Septic Tank—Liquid ca acityl"Ch P..gallons Length---d?...1k...... Width__y1..'*/1�.'._ Diameter________________ DepthA... I P Disposal Trench—No .................... Width___ ..._________._. Total Length...................... Total leaching area...................sq. ft. Seepage Pit No---------I----------- Diameter...../0�........... Depth below inlet.....er.......... Total leaching area.2W.....sq. ft. Other Distribution box Dosing tank ........... .......... ................ Date-.: Percolation Test Results Performed Test Pit No. I.......;5 -minutes per inch Depth of Test Pit....../,Z....... Depth to ground water______:.::_`:__.__ :.. 44 Test Pit No. 2................minutes per inch Depth of Test Pit_____...________.___ Depth to ground water------------------------ P4 --------*-------a.;.... :--t--- - .................... 0 .21 -:x.,-----..S--Z---------------------------------------------------------------- Descrit' of p jpn Soil-------- ;............ ........ __N---------------------------------------------------------------------*....... ... . ........ U .............'75.'u..b................................................................................... ....................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ..............................................................."..'............ .................................................................................................I................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT L1 _ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in I- operation until a Certificate of Compliance has been issued by the board of health. Sign . ...................... .... 5.... ............. ------- Date Application A proved By........ . ....................... .....ll�n p .. ........... . . ..1010- 'bate Application Disapproved for the following reasons:....................7---------------------------------------------*................................ .................T...................................................................................................................................................................................... Date Permit No..................................................... Issued......... .............................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH g r,- ..............OF...... _N.3 ...................... T rfifiratr of Tomplitturr T IS S TO CEIFY, at the Individual Sewage Disposal System constructed or Repaired by... e .. ........... ....... ................ ........................................... .......................... . ... staller ................... .............. has been installed in accordance ith the provisions of 1 5 of The State Sanitary Code as described in the application,}for•I)isposal Works Construction Permit No._ .........474----------- date.d_....A/.................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONgVED AS A GUARANTEE THAT THE SYSTEM WILL FU TION SATISFACTORY., s ........... ............................................ DAT17.............. ..................................... Inspector---............ ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NoQ..........71)- ...............T.40..... .......0 F............OW. ............................................. FEE........................ Permission • eby granted__._... ....... .............................................. to Constr or Repair Indiv*al Sewa Dispos t at No.. Ly'y .. - as shown on the application for Disposal Works tion P No .........L. Dated__` ` ......... ..... Construction .......... ..... ....... . ..... ....................... oar .0 He DATE..............- ------------------------------------------------------------------ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS c��t�►.� va-r,o.. , Udtt_�( Clow � li0 � '3 t 33o G•P�D. � (rjb vc3 St 'tc Tl�tittC = 330,E ISO % * 495 6.Pv. USA- t ooc� 6/4t✓. `� I- �ISPoSAL PIT k-KE- loco G,A•, ToTAI. -pESiGIJ = 425 G•P.D. �` TbTA t- C%w L_-( fz Lc> v = 330 6.PD. PFWCDL&TIC)Q 06TE ' IU 2MtIW* OR 2S t� r t�'"� ,'"`� ,,.CCU' {4• iV , `Q� ° �+� 7 1,�" 4d�+ '� .,,k•lJytifi r .��.. �'I /� III !�'{� LA-we ° Top 17w0 o 1coo.a .� �rnn -7,� n t1Jv. too<> S��S4lL. 4rpp� DKT IW. GAL. r "BOY, 9d(. SC-pnc (o' . Z tuv t rAWW. (boo �wK tw. 'J- GAt_- q4.�, gbc1� :. 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