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HomeMy WebLinkAbout0036 POPONESSETT ROAD - Health 36 Poponessett Road Cotuit A = 035 006 l I Aug-15-02 09 : 54 P .02 T+� 00 _- 6�', A Ql I �"� it tr KLr � � I is � �S � �• I I BETSY'S OFFI9K I � (� ' Ili �,-- '•- � u� I ! � I � I ,l IT � I � , I I � i T RAGE 7FFICE -� t�.IJl�sr.; - - - - i -• - --- Y � _ , t, MASTER BEDROQM .N Aug-15-02 09: 54 P _01 ARGI" lI-TEGH, 6 5choo! street A550.C1ATE5 cotuit, ma 02635 tel:(50a) 420.5535 architectural dFSign fax:(508) 420.5304 X T / 5.M_15..5....1.0..N_GOVER 5 H EST DATE: �L DL NAME: FIRM / COMPANY: REGAI,DING: _ �C2(J0L� _ TRANSMITTED BY: T1�'1nMlf TOTAL NUMBER OF PAGE5 INCLUDING COVER SHEET: COMMENT; / 5FECIA(_ IN51-RUCTIONS: IF YOU DO NOT RECEIVE AM OF THE PA>E-5, FlEA5E NOTIFY U�:-).!MMF[)lATFl_Y. TOWN OF B11"RVSTABLE SEWAGE # 061 -11�, VILLAGE C-2 7UI% ASSESSOR'S MAP & LOT.a �3a' ��� INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) /% (size) cam.; �70tJ - NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER DU/-Z/�/6 BUILDER OR OWNER DATE PERMIT ISSUED: Zz/ �2 DATE .COMPLIANCE ISSUED: 3 VARIANCE GRANTED: Yes No 3 A Q f ' TOWN 077 BAFANSTABLE ' LOCATION (d �'�����SE WAGE # VILLAGE ��j ASSESSOR'S MAP & LOTl33,5=®0,C INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 4 QV LEACHING FACILITY:(type) (size) w NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER dl.Jv BUILDER OR WNE .✓f3�!�' � U� ,y DATE PERMIT ISSUED: ]PATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No Nw x a,GGED €, - 94 6eel.. x a y r 7 +t.,t. N+M,.��Z �"` ,� .vx � tR�i .'k �, � -aY� a 5 s xi r �,•h t. .f,t x'P+y� x•�' hH, V! ,x , K. '`4•' �p.nS'y Tci.r+�g NSF, New" P x f r !� '(S�� t` -C`�,�� � ©.Sa .t '6+'�4 4 t 3' n[i nr ' r .� , / Fes'I t x�, !-���:��1 df. r!S'fl�'W���",OIi�' t i.{'��r -+' +.,5 �442�x& A�`2� � "�•tt �•- �� '� ry y`k r �� = r a" { r iX a e ✓ }� � ; r §� },1 33 5,Z7 r , Ga k A. [2 P i rs C�7�.7�, /�+1s; ) t���♦ ,V �. /.Jr7 f '�$ry�yy s' ct.}2`�rV:�ap�lE���j '� Ik�s i4.�t 'x�.�T: 1 } °S _ �L? a`�g, ' ht �q• ,l J3 A �.�Pt"y.�`v�:h t F � r n�`i,. i a�;�r� ���'r�'�.fL`'k''�� �f< Wcy�,� 2, s a 1 R a; ,5.1,4-d�yY!a�jr�'+'r�'"44��� a Sjj !•x��.ww ^��g�� {� ;��fisa .�,h i .. 2tP }v.>, s t ,{ ,, _p� � }E+'�>"t N* � Y 4 4;, i t•,#5 a �,; y�,. . 1'gCyc:. " ,sq ��6�;Rsir t<a, . _SSESSORS P"PP NO: 35, -,._._..".._.`_ Fps. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..----------_.........OF............�Ja�-�5.��J�� Appliratiou for Disposal Works Tono rnr#ion Pautit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at -------------- Lo on-Address or Lot No. ......�. Y-.2..s... e Q�ks....._. xda �.�_f__3 .._.. s �.e Owner Add ess ..--•- Installer I Address Type of Building Size Lot...lq-'^•VD... ....Sq. feet Dwelling—No. of Bedrooms_____... ..............Expansion Attic (YJO) Garbage Grinder 040.) aOther—Type of Building ............................ No. of persons_--------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures -----------------------------------••-••-•••. W Design Flow.............1/®...................____gallons per person per da�. Total daily flow.........3.5.0......................--gallons. 0: Septic Tank—Liquid capacity.I.QOO-.gallons Length.. Width..__._Q tilJNDiameter__.:-........ Depth.. �Q....Ii�Q Disposal Trench—No- -------------------- Width........ a--0 ° �1�,eWth..__-___.-i....._.. Total leaching area....._.__.._..______sq. ft. p Seepage Pit No.....__I__.__-______ Diameter_______•. _ ___"'."Depth ew inlet.....4.•._._._.._ Total leaching area.2.4z3f 1_.sq. ft. Z Other Distribution box (/ ) Dosing tank '-' Percolation Test Results Performed by.. Date..... ........... Test Pit No. 1 t.2.......minutes per inch Depth of Test Pit._ii6......... Depth to ground water.....A11 ............ 44 Test Pit No. 2._&1^-_-_minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -•••-------•---•---••-•-••-••---•-•---•••-•--•-•---•••-----•-••....•--•---------•---•--......-•-•--......................................................... 0 Description of Soil........... .............Ft LL -------•---------------•-----•....-----••-------•••-••--••............................................................. U --•••••-•••------••------•-•--•--......7a•"-- tik........• .....Y.. s�LO ------..Pk ................•---•---•-------------------------•--•-••---- W x ............... ------------•...••••--...-------•--••--••-•••-------•--•---••---•...----•-•••-•••-•----••-•-••••--------•--•-----•--•-•--•---••-•--•...-•••••----•••-•---••-•-••---••-•••-----------•- V Nature of Repairs or Alterations—Answer when applicable_________________________•-__-______________---___---_---_____________-_-_-__---_-•-------•_--. --------------------------------------------------------------------------------------••---......------------•-----------------=----------------------...--------..................................... Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with the provisions of'TTL: y g g p y`�of the State Sanitary Code—The undersigned further agrees not to lace the system in- operation until a Certificate of Compliance / en issue by th d of health. Signed f ---- --- --- --- Application Approved By--••--• --• .��•... . -..... . .---•---•-=� J e ......... Date Application Disapproved for the f ollowin easons:--••-•-••••••----•---------------------------------------------------------------------------------------------- -------•-•------•-------•----••-•---•-•••....._..•---•--------------•----•----•-•••----------•-•---•-•-•.••------------------•----•-•----•-•••-•-----•••-•---••-••-•••••-••--••-••-----••-•-----•------- �y 2 1 / Date Permit No... L �...� /✓. Issued 1'��6 ....• ......................•--•-•---- Date r— No. - - FEE.............�..:,d......„. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ............. Applirat ou for Dijpntial Modw Towitrurtiou Urrmi Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ` �-c i f? �..!.l '?�.5�.7- ----- -------- -•----•--- ..... .. Loot on-Address or No. . M� Owner W .. : 17.... J?`'`s&------c���r�cj,.11l:l_�:iE^c�%.�c�fn_.f..�'��.-=------• Type of Building Inscauer ess . SizderLot.._�V`?U�---M--•--Sq. feet U Dwelling—No. of Bedrooms......... .. _E -..............Expansion Attic (40) Garbage Grinder (No-) P4 cer-- Y �Ie o Otl T ) f Buildin r :.---:-- .:-_-_-- ---- No. of persons...................... ..... showers Cafeteria ( ) � aOther fixtures ........... ------------------------------•---........__._.._.._.. ._ -•-.•' .........-•----•-•-•--•-••• Design I%w.............�.1_U.....__..._. ..gallons per person per day. Total daily.flo��......... .__..___.____.gallons. W Septic Tank—Liquid capacity.i4`lQ_-gal Ions Length_._ =G Width------!� R/u"Diameter__.:.-: _..__ Depth..'E''� x kL Disposal Trench—:�o. ................... Width___ T.otaLLenkgth.__._.._.._..I....... Total leaching area_.___.........._.sq. ft. °p Seepage Pit No.......1_......._._ Diameter........ epth UAW mlet......4........... Total leaching area.2.4>1�_7._sq. ft. Z Other Distribution box (•' ) Dosing tank ( ) %' / '-' Percolation Test Results Performed by.:_4��.-l�s.tt'14fs1.+�..�___.►"gLwuU�►..�iL� , �`: Date.....!v-`-t�•4 G-t--4...--•---.. '_lj Test Pit No. ______-ininutes-per inch Depth of Test Pit..k7.k......... Depth to ground water.....YJ ............ Test Pit No. 2---&1A....minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ......-..................................................................................................................................................... DDescription of Soil-----------C2 - ••-•••.... '[......--• .._..--••---•...... ............-----•---••-=-•---•--------------.........---...---•---•-----•--• W ...-•----•••••-••.............. s—Answer when applicable..........._____________________________________....._.__.:..__._......_................_...... U Nature of Repairs or Alteration Agreement The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with the provision mTs Of l 1LE ` 5 O> the State Sanitary Code—The undersigned further agrees not to puce the system in operation until a Certificate of Compliance ha ( issue y the of health. "Signed....l.. M— __.. . `` Date Application Approved B J---. .............. ................� `......-. .... Date Application Disapproved for the following asons:............................................................................................................... ----------------•---•................................................. Date Permit No.-- ... 1_..-..�� Issued.... J` Y6.................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --� O F.............. .................................. U .B.................. ... Tatif iratr of (gomptiaorle . TH I T CERTIE', That the Individual Sewage Disposal System constructed (x) or Repaired ( ) f . Gc.��-�-....................................... .._...-- •--•---- --...... ........... Y... (� i �Inst ler has been instailed in ccordance with the provisions of TI TIE 5 of The State Sanitary Code as described in the application for Disposal World Construction Permit No. ''._____{.�G}y- -•--------•-• dated...... ... .... .. . ..� 0._ PI 1 L _ , CC . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE H YI•IE SYSTEM WILL .UNCTION SATISFACTORY. � DATE.... L '. •....................... Inspector..-•-- ! Ij...�. ...-----.......................... THE'COMMONWEALTH OF MASSACHUSETTS ` \\ BOARD OF HEALTH .343:........ .OF....... FEE ` ioo1 or�oogYoa� ion gut Permission is hereby granted..------( ._... _ :(_:.: = � - ------•---------------- ... to. Constrf t or Repair ( ) an Individual Sewage fDisposal Sys _ Street as shown on the application for Disposal Works Construction Permit No3�••—�.I� D`ated�d ����� k%,t .._.... . � I301i4'OI ri28lYf��` ; , DATE...'`: r..: _13 ...---------•------.....-•••--•---•••--_.... , FORM 1255 HO,BBS & WARREN, INC., PUBLISHERS , .r P�014 t P 1 PE TO &E 4 K .TM✓- Z4,76 INV_2-f S/ d° a , TQV �Ex15T) zqt 2448 i pe T+ P p .. , 5 x FILL. x X 3 4 to i a j Slane MEP, I `r`' 7 1 C 1 1 `' SgNp Y , f v .may t ;''4"t•.a a u`+ �' �;? PR�SEI�I'r' AT S 17 1000 , D o uG C A 5 N, c•4MER' Eti/G/�/E'E� A/A VC Y 4-/Tit/& -QGEAJ T Z AAJ A. -'SPEAK BAN - BACK HoC SEVAGE _ �.._a...� ...._.._..�._,.,,_�,..., PSG ATE • .c %.�liv, iwG.4i t 777 aI a _. �st�ac _ O 2 Z 000 Xx i�. ZZ ��eosEO �. 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