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HomeMy WebLinkAbout0010 DOGWOOD LANE - Health / �aTv i r Lltproz L0CAT OR SEWAGE PERMIT I30. - / . .. VILLAGE INSTA LLER'S RAKE & ADDRESS ® U I L D E 0 OR OWNER -7T e,0Al A1 :!�--rl01�l DATE PERMIT ISSUED DATE COMPLIANCE ISSUED , 4Y St.*33, , T 3® 9 --------------- - ice! Fimic d................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........Town.... ............._0F.....-..-Ba-r-.ns Kahle--....---...-..---.-..........-..-............. A liratiun for Disposal Works Tonstrurttun rnmit Application is hereby made for a Permit to Construct (X ) iRepair ( ) an Individual Sewage Disposal System at: rcoad (-��_ f0 N ......Ls� ...7. ................ - ----- -��- 'o Lot I Theo Construb.9tT&�d t-d 24 Great Pond o5r.N,o. So. Yarmouth, Mass. ......................-........................Owner A-- --•-----......----•--••--•---•-............• •-•••--•••--..._•-•••--•...._......_........._--ddress---._.........--•-......................--_...-- W Installer Address Type of Building Size Lot__2A-,6&5-__:______Sq. feet U Dwelling—No. of Bedrooms.........3_................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of'Building Buildin No. of ersons____________________________ Showers � yP g ---------------------------- P ( ) — Cafeteria ( ) Otherfixtures ---------------------------------•--.....-------------------...------------------------------------------.....-----_..... _......---• W Design Flow.................5 .....................gallons per person per day. Total daily flow---_._..33.0_...........................gallons. WSeptic Tank—Liquid*capacity_10Q10.gallons Length................ Width................ Diameter................ Depth................ 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 ( ) aPercolation Test Results Performed by............ Date_____ 2 a Test Pit No. I........2_.....minutes per inch Depth of Test Pit...... 2:1....... Depth to ground water________________________ (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W -- - --•-------...-•---...---•-----------•-••.......--•-----•-•...................•---•_•--......................................................... Description of Soil--- 0-.-2 4•..._Sub O],I s... - Q...Medium--aand.................................. x V .---------------------------•-----------------------.....----------------------------•----.....------....-----------------------._....-----------.._...-_..----------..........-------.....-----•-----•-- 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 TiI�.;,. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed by th o of 1 alth. or Application Approved By..... .....Q .. ... C- Y l ' Date Application Disapproved the ollowing reasons--------------------------------------------------------------------------------------•-----=--------.....------ .........................•----------._....-----------------------------•---------...----•-------.....-•---------------...--------------------------------------------------------------------------•---- Date PermitNo......................................................... Issued....................................................... Date a NoIj Fimic..... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town.....................OF.........Barnotab.le__-_..................................... Appliration for Disposal Works. Tunstrurtion Vrrmit Application is hereby made for a Permit to Construct (X ) or Repair an Individual Sewage Disposal System at: .......Wt.-1.4 L......................................................................... ....Pinav-LeW--- ...39a....................... Theo Cons trU1dtjbjjd1Cb. 24 Great Pond'rdf.','- So. Yarmouth,, Mass. ........ --------- ................................................Owner........................................... .............................................Address ................................7---------- .......... ......... Installer Address Type of Building Size Lot..20.,.6j65.........Sq. feet Dwelling'—No. of Bedrooms.__.......3.................... .Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures .......................................................... ............ ....................................................... Design Flow..................55 ..........................gallons per person per day. Total daily flow.........33.0...........................gallons. Septic Tank—Liquid'capacity.!QQQgallons Length................ Width................ Diameter._.____..._..... Depth................ Disposal Trench—No..................... Width......_............. Total Length..............._.... Total leaching area.....................sq. ft. Seepage Pit No..................... Diameter..........__.__....: Depth below inlet.................... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by._..........ATQZIIt$T1...GrV.S.90JAZI... Date....-_ ...19.82 Test Pit No. I........ .....minutes per inch Depth of Test Pit.-----11........ Depth to ground water........_____.......,__. Test Pit No. 2................minutes per inch Depth of Test Pit..._............._.. Depth to ground water....................___. .............................................................*............".­'­......­­........*..... . ....... .­*....­------"...*.....*----------------------- 0 Description of Soil........9"--24" subsoil, 240-144" fine to medium...PAad........ .......................................................................................................... .......................... ....................... .............................................................................................I.......................... ......................................................... ....................................................................................................................................................................................................... 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'TTL, 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 Z............................................................................... ......... ---------- ate ApplicationApproved By----.. . ................................................................. .... ..;r- W -------------- ------------- X Application Disapproved fp� the I'lollowing reasons:...........................................................................................Date..................... ......................................................................................................................................................................................................... Date PermitNo......................................................... IssuedL....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - Town Barnstable ..........................................OF.................................................................................... Tntifiratr of Toutpliancr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by...........gn.,&............................11 77...........................^......................... ......................................................................... Instalf;;7-1— .......................at............................................ Adf� ....A - "FU7........................................../-------�'r'i-------------------- has been installed in accordance with the provisions of TITLE of The State Sanitary Code as de! gibed in the 4, application for Disposal Works Construction Permit ............... dated--/;----------;. ... ................ THE ISSU NC OF THIS CERTIFICATE SHALL NOT BE CONS D AS A GUARANTEE THAT THE SYSTEM we L�F I'm% ON SATISFACTORY. we V DATE.... mr................................................... Inspector. ............................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable .....................I............I.......OF....................................................... ......................... Not......7 ...7....... FEE........................ Disposal Works k".31nstruction "PIMutit Permission is hereby granted..........Th.e.o...Cons-truc-t-iono............................................................. ......... ............................... ....... to Construct or Repair an Individual �ewage Disposal System at No....It J ,. Pineview Dr. , Cotuit, Ma. .................................................................................................*... ............... ................ Street as shown on the application for Disposal Works Construction Permit t ated ................ ......................... .. .. ........................................................... DATE................................................................................ .7 of Health FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS -. ., _ - i r I - 2 to'-�" �E .1EIZAL NOT�g I ---- I --__4 (D--ALL ELE/1.1-..V0 '5 4�ow•k) AeE MeaQ SEA. LEdeL 'S'uz3Sa,L S'u13.Sb/L --- - - bA-se o oi,j u <c ,v. e, 5 • Exa,-nu• I Pv,QZ-- I j-L 4�/O.I-III I1I1.L.I.1 1 I"�4I I IL;,_I.� I II I..L-I L�"AL.�,L..1 I;.-L.,I I. I,xI I1-4 0 jI o.*5(M L 0 0L^wI_-,�I7-L-" z�I 0�IL. Za-- PtTcc-1 ALt l t�a ES A M Itil tM U of t/b'�Fc�cJT Z5- • 26-a - -r �- n Uwtt.ESS CTNE2'`a3isE 3WECaF1ED. 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