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Home My WebLink About0009 HANNAH CIRCLE - Health f C4,./cf •� - C9 C)3 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEA TH ......._. .................OF........--- f _...____--_____----- Appliration for Dispas al Workii Tnnitrnrtinn Vamit Application is hereby,made for a Permit to Construct: (4( or Repair ( ) an Individual Sewage Disposal System at., �! l �. .(--_..t. �_ -_ . ...--_�.. �� ---.....---• --- /vJJ4. Loc o ss �F = -- -•---- ....................�. f�j/ Owner - dr ss W ...........................0,- �4�ie-- .�--------------..._-...-------- .....C'-.1 �r 5- ------- � -...._... a Instal r Address Type of Building Size Lot....../L01. Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (t'� Other—Type e of Building _______________ No. of ersons_______.__..___.__________.. Showers — Cafeteria f-4 YP g ------------- P ( ) ( ) a Other fixtures ........................................... W Design Flow______________________________________ gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liqutd capacity ga]Ions L6n ............. Width................ Diameter---------------- Depth................ x Disposal Trench—No :J________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------I/.....:__' Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( )' Dosing tank ( ) Percolation Test Results Performed by_________________________________________________________________________ Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit..................._ Depth to ground water........................ r3 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ d -DeschPtion of Soil____________ ........................... ------------------- ----•----••-•.-=--•------•--- x 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 TITLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has buss b e•_- e lth. Signed................................... ..... .......................•-----------_._ ............................... Application Approved B '� o G��6//�%a�� Date Application Disapproved for the following reasons_________________________________________•---------------------•---------------------------.....-_---_........__ --•-•...............................•--•--.-.._..._.__..--.p...........------------•--•-------......--•--•---•-------------•-------•--•-------------------------/------------------•---.....----- D - Permit No.-_- ''.X1........................... Issued......... Date No................_....... Fizz.................._.... THE COMMONWEALTH OF MASSACHUSETTS BOARD .OF HEALTH OF.............. G1.�'' ' Appliration for Disposal Works Tnnstrnrtinn Prrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at• �� f / ............ !:� = -�•? i, /..%�-i f ..........................................� { s , !_. ., �K_ :.:.. �, / ----- a^ Location""A�fddr�ess or Lot—No.Y' ............... �r �/l,/�'�,f(•F-' ,1 t `r•-�LI/�,r7/,- )_i ... t ............................T / './✓ /',/�" ..:.C. ................._._ rr ---- •- Owner J Address We f- rl' ... Installer Address d Type of Building Size Lot........A'_11 Sq. feet Dwelling—No. of Bedrooms............ ........................Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P 1 Other fixtures ------------------------•------• . W Design Flow....................................'.:___gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity-/5 Ions 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.......................................................................... Date........................................ W Test Pit No. 1................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........................ -------------------------- O . Description of Soil-----•--•---..... .....1...% �r�'r��'' -� .-----•- ..............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 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 issued�Oy�t,1f boaf ofghealth. ,f Signed - -----•-•=-- ......................................... .......................... Date ApplicationApproved BY.................................................................................................. ........................................ Date Application Disapproved for the following reasons:-•----•--------•----•-------•--•----------------------------•--------------------...---••.......-----•••.------ •••-------••-----•-----•-•....................•-------••••-•••----•-----------•-••-------......----••••-•..--•••----.......•••-•-••------•-•-----•-••-----------•----•--•----•---•---....•••-••••--•----- Date PermitNo..................................•---.......--------•-.. Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH, V-17V Trrtifirab of Toutplianu THISTO CERTIF Tat the Individual Sewage DisposalSystem constructed 4'- � S ge p ( ) o Repaired ( ) by �" °r '� f .-...-------•---•---•---- ------ ;-- ,w.... . - _ , ---_---------44.... -:. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No............ $f!_/r1/---------- dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.........................-------•-•••--.......... Inspector............... ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH--��gg--� ....... .........OF...................� �`rt N ............. FEE......: .. Disposal Vorb T11notrndion Upamit Permission is hereby granted... --- --------------------Ya-x •----•--•-•---••----........•-••--------..........••-••.........------......_ to Construct ( ) or Repair (X) an Individual Sewage Disposal System atNo......................•••----•----------•••--•----------•---.......--•-•---------------------•-.••---•••---------••---•------•-•------............---•---•----•........------........----...... Street q as shown on the application for Disposal Works Construction Permit No.l.. .... .... Dated.......................................... .......................... ...... ..r- ----------.----•--------.-------•------------••----- / � Board of Health DATE L =-�••t y-•---------------- �J FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS TO O BARNSTABLE �f �r..r. 77 L�11CS&0 I� �rJ SEWAGE VILLAGE !� ASSESSOR'S MAP LOT /— INSTALLER'S NAME & PHONE NO. ` i SEPTIC TANK CAPACITY /5� 7ZX� n ,s LEACHING FACILITY:(type) .� 7' C �3 (size) �r NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER' I BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No i_..> r h DESIGN DATA 4F 2 SINGLE FAMILY - 3 BEDROOM GARBAGE DISPOSAL Pi:� DAILY FLOW = 110 x 5 = 4cl 5 G.P. D. I L �,-r- i A SEPTIC TANK = 3� x Zoo'l0 : 4-6o3 G.PD. USE GAL. TANK =4c9! 1At. "A+-1 DISPOSAL PIT — USE ------- 1000 GAL. SIDEWALL AREA = 1110 S.F S.F. x 2 . 5 G. P. D. MAP 2t - Pc[.. 3-s BOTTOM AREA = 113 S.F. S.F. x 1 . 0 = 13 G.P.D. TOTAL DESIGN = G.P. D. � OF TOTAL DAILY FLOW = 495'G.PD. ��lttioc �'4 a� 0 9sy y � PETER 5, PERCOLATION RATE S 1" IN 2 MIN. OR LE aC 4' SULLIVAN { •S H No. 29733 09 .,5 a 9874 �OA /STfsR Q� FSS�ONAL TEST HOLE p- I5�8 - s�.o F. G, z F G. TOP FND.-- sa.s �r . } !! .• Lo,�M 4►t P,V C.) . SCHE0.40 ` ., . 1 NV. = 54,o 1500 INV. •••% G )-faoo fu./. DIST. fruv INv. •: Pry 5375 ••� GAf � oi• 53.0 �X `'''.25 + •� LEYre-H P)TLA p v� wrnt 6l ct�rtr1 : 3/4n r¢ ,�Z S2.5 Lp rn s.r,-.o s�� ,1'• o pi 4�.5 d a 11' EL= 4 4.f lj d N fro wAr�� N I s EL - �'G.o ' He w .1t<2 I CEGZ-nF-f THAT THE PRoPcre0 Sflow� HEeEoi cornDt_tC':5 wfT-H 74r= srbt_z - I--�T 3 I A Towt t aF r3.t¢u�sr.�P PLYN f��tc 4�4 PflG� 4� I .ALE. A t-.b t5 t Jc5T L c�cA i fl r W l Ti-f1!-.i 1-:H f_ -FLcx�aP -ntt5 P(- t-j vs �n-ra-tE S Sr-foci�i� �ro-r L31= ��e� 70 C i QManrB ►.oT c ra.ES, r4PALIGA7.tT ArQef-ri�Llr_D �Et1LT✓ ( f�j$ � s 3 IL A A.ALb R:T. 14 - 9'S N\ES 4I LL- ., TLfjY!^, \ ti r Pit n+ ICU i Y PiT f 1 7 .a LtoT 3 t. A ol 47 r Q7 A G1j loll 9 1 PETER SULLIVAN No. 29733 n �S'IIONAL Y al SL( (rj8 DESIGN DATA 2 S.1NGL.E FAMILY - 3 BEDROOM GARBAGE DISPOSAL rF�Q�oF DAILY FLOW = 110 x 3 = 4-1 s G.P. D. SEPTIC TANK = 33=1 x 2ooc70 : 4-6o G.PD. USE GAL. TANK - :HA A c 1 L--E-: DISPOSAL PIT — USE =+-4c 1000 GAL. I5'3I4 SIDEWALL AREA = 'I'" S. F ;,,1� 6 pGL a_s S.F. x 2 . 5 = G. P. D. BOTTOM AREA = 113 S.F. S.F x 1.0. = 113 G.P.D. TOTAL DESIGN = rotes G.PD. tloF �i �t% OF �, q TOTAL DAILY F LOW = 49 5 G.P D. PETER 0 PERCOLATION RATE o 1" IN 2 MIN. OR LE ka JoH ; U SULLIVANa ii o S � No. 29133 eh 9874 0 • & � ^15SEq� ci`S�a 0�.��-#STU- IONAL TEST HOLE P- ISnfi G. G. _ ss s t �: TOP FNDe= sa.s 41-4 4�� SCHE0:40 P.V.C.) '•'• INV. = 54.ca -noc i I SOO ;A t_. INV. •% . INS/. D 1ST. PvINv- LA Z- o oio b3.o �' •• LErW-H P)T 0� wIT-H 2 INV A. MEO • o v e eo ' a0 11' EL= 44.1 ' Q) I'r, M A , J cJ N H o W A T-e7 rJ N G%.Ij I c�2TF-f T+-Ir17 Tl-IE P(toPc�e� �o�.�wAAllo�..� Srlowu t IE�E��i C�MDL1� wT�I ME sID - �—oT 3 I A 1.1�...!E A r.l p s ET('..�C..K K_��u 1 QE M E H'P•i o f "TYI� Puy-,._, f'-Ic 4-7 4 PAGa 4► TOWI-� bF"" �3rtiQ�•��If�"�.�LG Af-� IS hloT Lo�A i�fl W I.Ta-Yl lit Tel C'Lt��D i� II LA (n/ ( i DA�i G : 02^Is 94_ tl L.-AI-A0 Sv�lE—�oQ3 r_4 S evE.-e A O -rt-F C- Gar - E T"S Srfd�r_V� 11oT (?>I= - JSEc7 T �2 o' CC; ,.•NIr-+B Lcnx L.,�,ES. �APPLIG>��.IT AP.=t-heL.A" II l,c-Al AR-cH 14 - 9 S j L.oT 22A s M Coll i eR PATTfOp � \ ` M Cd ' 1T ` PIT 0, �, 272 62, e / co. Q ^� D 54.9 Tf�!nN P r 1 POF ETER c�5, �NDr /�a o SULLIVAN N ! _ N0. 29133 Q ^O " , $0, @ v ,�� s415a ,gyp �►alr- !