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Home My WebLink About0151 MAIN STREET (COTUIT) - Health _ .151 Akain Stree$ 009-008 t Cotuit 1 it I LO CAT ION �� SEWAGf PERMIT NO. VILLACE INSTALLER'S NAME i ADDRESS 9119 f U I l D E R OR OWN ER DATE PERMIT ISSUED 9r 17., �� DATE COMPLIANCE ISSUED IL i 1 6 \ I l A� / �r THE COMMONWEALTH OF MASSACHUSETTS B®AR® F HE L 01 ............. -.....0F.................... ................. . _. ApplirFa#ion for Uiiipwi al Workii Tomitrnrtinn ramit Y Application is hereby made for a Permit to Construct ( ) or Repair ( Lir1 dividual Sewage Disposal System at ................__.......... ...................... ... ................. . ------ ..........••--••......-•..._..............-•---•-•... .. .................. ation-Ad o Lot Y .... ..............-----.........- :...... �._._._.... .............. ............................................-- --•-•------•-- W � OwnerC ./! _ -'7 Ad(..css...'! 6 �-1 ✓ `` Installer Address QT of Building Size Lot___.........................Sq. feet UDwelling—No. of Bedrooms...................................:........Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............._.............. Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------•--• . W Design Flow............................................gallons per person per day. Total daily flow........:__.____..__.._.______._._..........gallons. WSeptic Tank—Liquid capacity............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.......................................................................... Date_..._.....__...........-----.._....�_:� aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water---_•----•___-__•-_.`. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P+ --•••-•••----••-----------•-•----•••••-••---•••--•--•--•-•••••-••-•-••-••-----•-••---•-•-•-••.....................•-------•--------------------.........•••-- 0 Description of Soil------------------•--...-----------...-•---------------------......---.....---------------------------•-----------•---------------------------------------------••--• x U ••--••••-------•-•......•-•----•-------•-•---•-•••--•-•-•-••--......-•-••-•--•--•••--•---•••••-•-••••....•-•----•--•---..................................----•.......................................... W ---•••-------- ---------•- •-----------------.._._....---------------------------•--•--•- ...-•--•---------•••----- .....--•=........... .. Repairs- ' - -- ---:- ...... . . .• - -----------------------•----•-------------•-•••••••......................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage isposal System in accordance with the provisions of TITLE 5 of the State Sanitary C de he u de i ned f zer agrees not to place t syst M in operation until a Certificate of Compliance has bee is d by t e a d of th. �, Signed. -• •• ......•••• ............................................ .............. •... ........ Dat Application Approved By 'f -......---. ........................... , .................. Date Application Disapproved for the following reasons----------------•••-•••••---•••-••--••-•-••:-----------------------------------•-----------------------••-_..._ ------------------------------------------------•--------------------------------------......••••------......-•-••-•••-••-•-----•••------------•-•---•---------•-••-----•----•-----•----------••-•_.._. Date PermitNo......................................................... Issued_........................ ------------------- Date si No.. = Fmc............................ THE COMMONWEALTH OF MASSACHUSETTS B 0 A RD -0 F....... ...... ............................ ................. ----------*---------------- Appliration for 0hiposal Works Tomtrurtion frrmit Application is hereby made for a Permit to Construct or Repair L.)-=r—rndividual Sewage Disposal. System at 'zo ............................................ ................. ------------- ---------------------------------------- .. .... • ............. ............. ----------....... .............V------------ ------------------------ Owner Ad?'ess �_l .... .. ... ......................... . ...... ................... ............................................. ................................................... PQ . Installer Address 14 T of Building U j Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow.......................I......................gallons per person per,day. Total daily flow............................................gallons. f:4 Septic Tank—Liquid capacity............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. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........ ................. Date. ....................................... --------------------------------*---------------- Test Pit No. I................minutesperinch Depth of Test Pit.__.__._........._.. Depth to ground water.._....._........_.._._. ;T4 Test Pit No. 2................minutes per inch Depth of Test Pit............._...... Depth to ground water____._..........._..____ ......................................................................................................................................................... 0 Description of Soil.......................................................................................................................................................................... W U ....................................................................................................................................................................................................... ............................................................................................................................................. ....... ............ ............................. U Nature of Repairs oy Alterations,—Answer when applicabl y,. -- ----------- .... ................. . .. . ............................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual ewage her System in accordance with. the provisions of T IT LE- -5 of the State Sanitary C de he U de I ' ed f/�.Iier agrees not to place thysyst7n in I operation until a Certificate of Compliance has bee iss by t of th. 1A71<FZ- Signed - .............. ......................7--------------------- 7------------- -----/ D ate Application Approved BY--- ..... ..... . ..... a tt e ........... Application Disapproved for the following reasons:......... .................................................................................................... ........................................................................................................................................................................................ ............ Date PermitNo.......................................................... IssuedL....................................................... Date THE COMMONWEALTH.OF MASSACHUSETTS BOARD ,48F HEA;LH /��yC ' OF...... ..................................................... ............. (9rdifiratr of Tautpliana THIS IS TO CERTIFY,"ha he Ind u I... rage'RiAosal System constructed or Repaired ....... ..... . .......I ....................................................................................... by................................—------------ . ......� ---------7------- ler at.............................. ...............................f--/........ . ....................................................................................................... has been installed in accordance with the provisions of TITLE �Iof The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__.....e.?......5�-P......... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUO) A GUARANTEE THAT THE SYSTEM WILL U "TION SATISFACTORY. DATE....._ ......7...................................................... Inspector------- ............ T -----------------------------------------------........ THE COMMONWEALTH OF MASSACHUSETTS BOARD LJ,fflF HEAI 'V ............7;� .....OF........ ........................................................................ 'oe No...,:TA.157...... FEE.... ............... D tiff isposal V. rk. m5v trurtkin 0 pit Permission is hereby granted...... ................................... . ............................................................... to Construct Z�or air (P-7 an In' Hu e g� D al S 4 ,,A ya tsa!II.Satem at No....... L4-.......... ........... ....................................................1, Street as shown on the application for Disposal Works Construction Permit No..................... Dated......__..._....:_.__.................... ...........I.................................. Boaxf-ofHealth DATE............................................................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS LOCATION SEWACf PERMIT NA.` VILLAGl INSTALLER'S NAME A .49DRESS 9 U ILL D E A OR OWNER DATE . PERMIT ISSUED 9_ ly_ � DAT E. COMPLIANCE ISSUED . h l