HomeMy WebLinkAbout0058 PINEVIEW DRIVE - Health / \
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�uLo fq� � � SEWAGE PERMIT �A.
VILLAGE
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INSTA LLER'S NAME A -ADDRESS
® U1LDI R OR OWNER
1 /?- 09 PL2 (�
DATE PERMIT ISSUED � p
DA.T E COG9PLIANCE ISSUED
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No.................. ........ R F 2 ........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Town Barnstable
Appliration for Disposal Works Tongtrurtiun Vvr
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
;System at:
Lot 16 , Pineview Dr. , Cotuit, Ma
...................... ................................................. ----......•-••----------•......---••-•---------- ...-----.........----•--............______--
Cedar Acres R�'a°j'fVAVnSt 24 Great Pond ) °t;°So. Yarmouth, Ma
......................-.......................................................................... .....................................................-..........................................
.
W Cedar Acres Real�VeLTrust 24 Great Pond DYdress So. Yarmouth, .Ma.
..........................................................:....................................... ---•--•--•------------..._....-•--•----•-•--------------..........----•----•----•••-••-•---•---_..
Pq Installer Address
Type of Building 3 Size Lot20_L000...........Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
a Other—Type T e of Building No. of ersons____________________________ Showers
a yP g ---------------------------• P ( ) — Cafeteria ( )
dOthertures -•-•----•------ -------•--•••-••---------•-...•-----•.----•-•-------•---••---•--------------------------•.._.......----- -•-•-_-----
W Design Flow.............. .........................gallons per person per day. Total daily flow....... 330
-•--•-___-_••_ gallons.
WSeptic Tank—Liquid capacity._lf).DQ�allons Length................ Width................ Diameter................ Depth................ f
x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. r
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation. Test Results Performed by.-_N?ormaD--_GrossmanP.E. 9/17/82
..................................................... Date__-•-........................................
Test Pit No. 1.2............minutes per inch Depth of Test Pit----- �Depth to ground water.......none
0� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Ri •---•-----------------------------------••----•----------.....-----...._..------•------•---•--•_.............................................................
0 Description of Soil____Q.'.'.-u."_..l.Qa m.....8_°_-30°•__subsoil, 30"_-150" sand
x ---------------------------------------------------•-•••-------........
v .__..•..-•-•---•-----------•-----•--••.....--•-----....---••--•--------------------••-------------------...------------•••-•------
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 iILIPLE 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 d bytheb al heth
Signe -------- -..
1�3......
Application Approved By_ „�� Date
Date
Application Disapproved for the following reasons---------------•--•---------------------•--------------------•------------------------------•----------••-••-••--
.........-•------------------------•-•••----•------...--------••-••-------------•------.....------....•-_.-._...-••------•----•••-•----•-•-----------••------•------------------------------•----•-•-•-•-
Date
PermitNo......................................................... Issued_.......................................................
Date
No.- z ......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........Town... ...............OF....BarestaY..le...-----..........--------------------...........-----
Appliratiun for Disposal Works Toustrurtion "truth
Application is hereby made for a Permit to Construct (If) or Repair ( ) an Individual Sewage Disposal
System at:
.Lot 16.r<._P review Dr otu t r...Ma.... -•----------------------------------------------------•--•--------•-•-----•---.......:
......_ ...... ......... ._..........
Location-Address or Lot No.
.Cedar Acres Realty Trust 24 Great Pond. Dr. , So. .Yarmouth, Ma
-- ---•----•------------- ......
owner Address
W dar Acres Rea Tru$t 24...Great Pond Dr. , So. Yarmouth, Ma.
a ....................... ..• . ..............-------•••-•--•------......------.....................--•---
Installer Address
U Type of Building 3 Size Lot.24}., Q.p.Q_..........Sq. feet
,.� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building ............. No. of ersons................:........... Showers —
� YP g --------------- P ( ) Cafeteria ( )
Otherfixtures ------------•---•-------------------------------------.-------•---•------......-----------------------•.....------------.........----............-----
W Design Flow.............. 5-.-.-----.-_------..___gallons per person per day. Total daily flow..........�34.........................gallons.
W x Septic
Liquid capacity._�() l' ns Length Width__....------_-- Diameter................ Depth................
Disposal T enchNoW dth - 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...140r.Men...Gr.0ssManp_..F,.................. Date-----9-/X7/&2---------------
Test Pit No. L.y............minutes per inch Depth of Test Pit.....J.2.!:.6!`Depth to ground water.........1101l.e._.
44 Test Pit No. 2................minutes per'inch Depth of Test Pit.................... Depth to ground water........................
--------------------------------- -----------------------•-•---..........------------------..................................................................
0 Description of Soil....B 1 42!---- oa�P!}, �'„�'�4'' $�i� 0 .�, 3�-"--3.5A°t sarid•----------------------------------------------
x
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
�'iT rl:^
the provisions of '� .LE, 5 of the State Sanitary Code— The undersigned farther agrees not to place the system in
operation until a Certificate of Compliance has been issued by the boa_rd oflh6AII.
Signed.X I.A.-------:..: ....................•------•---...........
Date
ApplicationApproved By.................................................................................................. ........................................
Date
Application Disapproved for the following reasons:..............................................................................................................
•-•-------•---•----------•--•----•-------------------------------•--......-----------•-•---•-----...-••--I--------...---..._...._.._._.._._....------------.......---------------------------------------
Date
PermitNo......................................................... Issued---------........_..................----•-------------.
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barnstable
.....................................OF.....................................................................................
Trrfifi #r of TolutpliFanrr
THIS IS TO CERTIFY tie Ind: al Sewage Disposal System constructed ( ) or Repaired ( )
by / s.--------------------------•-•---•--•-.•. ......................................................
f7 Installer
at ... P--- �p�\� ---- ...
- , ._......
has been installed in accordance with tl e rove I §'of TI he State SanitaryCode as described in the
application for Disposal NK ork's.,Construction Permit No....... ............. dated.-..............................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEI4-WILL FUNCTION SAT SFA TO RY.
DATE........... /
Inspector
-------- .............................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barnstable
......O F..........................................................................
No.........��. Y��� FEE......... T......
Disposal Works T-FaInstrurtion- Upumit
Permission is hereby granted..Ceds3r...AcreS...Realtyt...Trust.................................................................�.---
to Construct (X) or Repair ( ) an Individual Sewage Disposal System
at No..L-4t--16.._..Pineuiew..Dr_,--Catuit.,...Mass.-.........................................................................................
Street
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
.� - _
DATE. � B rrl�of ealth•
------------------- •-- - �. --........
FORM 1255 HOBBS & WARREN. INC:. PUBLISHERS
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