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Home My WebLink About0007 NARROWS WAY - Health 224 OLD OYSTER RD, COTUIT� 1 A= 021-113 1, h f • I I j -- ,� �� yf c�n� � _. .......................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® O H E %��---.......O F........ . .............. <°..... ... � � ... � Application for Disposal nrk nntrn.r#inn f rrntit Application is hereby lm/ade f(o�r a Permit to Construct ) or Repair ( ) an Individual Sewage D' posal /00, _ System at; Q � �1 �zy..-.........�. ...._;.. ............--••-•_.__•..... ••-••••.•. ----. ..............----- Loc io - �r or Lot o. `.. u� .... •............... ...ram................_..... ^� Ad r �) W ---// ,.� •...........................•------•••••••-• ................................................. . .... .. Installer Addres U Type of Building Size Lot._._ ..._... '._Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (�}-- `� Other—T e of Building ..... No. of pe.rsons............................ Showers — Cafeteria Q' Other fixtures ........................................................ W Design Flow..................................p. ...gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.lgallons Length................ Width................ Diameter................ Depth................ xDisposal Trench—No..................... IAidth.................... 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit______-_-..__.--__-_ Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------------------------........................................................................................................................ ODescription of Soil.................................-----------------------•--------••--------•----------------------------------------------------------------------- •---------- U ---••••----------•-----•--------------------------------------•-------------------•----------•----•-------•--•---•-------------------------------------------•----------..................-------•...... W --•---•-••-------------------------------------•--------•-•---------•-----•-•.....---•-----•-•--------------------------..........-•-----------------•---------------•---....__.._.........-•--•-....--- VNature 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 iIT?,% i of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the o h I Signed--•-- . .. . =- • - - ---- --------------------- ------- •... / _.... - D e f Application Approved BY........... ��- -ems Date Application Disapproved for the following reasons---------------••----------------------------•-•-------••---•--•--------------------------------•-----........._ .......... --••.....................•---••--•----•----------•-••---------•----------------•-•---•--------------------•...--•---------------......................................................... q e� Date Permit No....1..L = 1 ........._.... Issued....................................................... Date �, No. .----•-•1-----�'....y _ � �� Fps........................... THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEAL�H 1� ...........OF.......... ....... • .... Application/is hereby made for a Permit to Construct or or Repair ( ) an Individual Sewage Disposal System at; .n «, .... l r f Location-Addre(s�s }✓' f.3> °*f1 F.S ae{� /i �-' or • x f �i 7 ' .✓ Fi f'r ! }. .'.... .....................E-_ P ............L._. ....... _._ n t "d tit Address + ✓f j r y j P . .. 7"Installer Address ` f --- d Type of Building x- Size Lot_____s.. ..:.:f.:::....Sq. feet U Dwelling—No. of Bedrooms ^ " .Ex Expansion Attic Garbage Grinder = P ( ) g ( --..)- `� Other—Type T e of Building ............... No. of ersons.......--.--................ Showers a YP g ------------- P ( ) — Cafeteria ( ) Pa Other fixtures --------•-••-•-•--......-•-•--•. . 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. ................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........................ a -•-••••-•••-••-•--•-•-•••-•-••-••--....••-•••••-•••••••••••••--.....•••......................•--••••......................................................... 0 Description 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 TITI.i 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. ApplicationApproved BY----......b......••• 1-••..................•--•-----•-••............_...._.................. ........................................ Date Application Disapproved for the following reasons-------------•-•--•-----•-------------------------------•----...-•-------•-•---------------------------•••..... ..........................••••--•--••••-•••-••••••-•••-•••-•-............-•••--•••-----•-•---••••••-••••.••-••••-•-•••••-•-••••••--•••-••-•••--•-•--•-••-•----•-•-------•••----••-••---•---•-•••--•-•-- q PermitNo._•./..5_._...•-......--�---••-----------•-.. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT ........ r��Z::.............O F........ ................... ............................... �pr#ifirate of Toutpliattrr THIS[ TO ERTIFY, That the Individual Sewage Disposal System constructed C ) or Repaired ( ) by................. .................... .......................................... ----------------------------------------------------------------•----...... CT ---................................................................................................ has been installed in accordance with the provisions of TI W_5/Qf Tho,State Sanitary Code as described in the application for Disposal Works Construction Permit No----------------------------------------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FIJNCTJ9�N SATIVACTORY. L��a �� DATE.......:.'..... ............... .......-------••-•--•-•----- Inspector =------------......-......---•-•-........---....._.. THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ............. FEE FEE........................ Disposal Permission is hereby granted........................................ ---•--------------•-•-------------•-------•-------.......-•---...........................----- to Construct ( `,17or Repair,( ) an4ndividua1-5ewage Disposal Sryaep,* (_ atNo.................................................................... . .... � Street as shown on the application for Disposal Works Construction nut No.--....�4Boardo ted.......................................... _ ••--- .._ .-- // / � Q ealth DATE. ..1.--- ."`-%' /-' ------------- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 1 p�S16 +- VATS 'S t EE'T 1 r= 2 FAM IL-( F3E�� r�� pLA I-1. oIJ 'BAGK. 1�4�fzl�" 5A0P3Ae-,s. 17A4L-� PLOW aLD a'✓S"i�R �aA,D S zrn G7�N�'T ' 33 0 �(i /s o G C D A u5F- 15oo GAL. b 1...1=AC411.1G TWd - 4", 40�, 2 � TEF--ucr+1=5 w 1. C-c>mp . k\ •� 4r-ru6AroN. AMA 8E1.�'D• V_ 3 3 o GFD 4 o-7 4 `jF 4 5.7./ (o Co`l dPp uG�.T►oN ARFJ� �E516 N S1'c;[---WALL AIzeA' 3S2 S F FINISH GRADE' rT'oM AAA = 3 2 c s F 2.OF 1 8' - 1 2" STONE MAY BE REPLACED WITH IF ENCOUNTERED REMOVE = INSITU MATERIAL T / i. �--I/LSp UNSUITABLE MATERIAL TO INSURE THE n 4�PERF SCHED 40 PVC t ( L SDEWALL AREA OF SYSTEM IS INCLE - �(,/��Tl� 5'�'`Iv/IIVG.t� 710MCMRM15.OD-�15.293 FILL P� T Y OF J/4' SOIL Cl bS� I Oi s 4 s 14• 1c:TER , SU`1.1VAN DETALL LEACH FAaUTy t�l;• /�� END SECTION 1 N. T' S. EN61IJe1=Q.: �•�`fTT=Q'T H`/� 1�G� �,✓^ ,ti\ i r EX G A,^TOE F.G. =.so.o ;. .TK• s5.s' {^TOLE- E L -- I $'MAVIM JM a IM- s'z — L.onM 2Lrjk 1Ml lu 4e.1S 49 n 4 4aiS I�.UO El 4 1.5 807( dPIr a' Q J UJ N .� • . rn f TA►Y. 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