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HomeMy WebLinkAbout0086 QUEEN ANNE LANE - Health 86``Quee,riAnn Lane , 022-'.1'1 7 'jw�Cotuit LO> AT ION '` EV A G E PERMIT NO. VILLAGE 1"r 1 o f ) 1 IN�S'TA ,,I ER' NAME ADDRESS t -1IN v B U I'LD E R` OR OWNER DA T E PERMIT ISSUED ©AT E COMPLIANCE ISSUED;• ,� �� �� �� �� ,, � � _�:� 1 � � � , 4� � _ ' /- � �' ��� . : �� THE COMMONWEALTH OF MASSACHUSETTS BOARD HEA �" ........ OF....... . . ........ ........... ._......-.-................... Appliration "fur Bid uuttl Marks Tomitrurtion Vauld Application is hereby made for a Permit to Construct (VO<or Repair ( ) an Individual Sewage Disposal System at �Yy�+ oca6t�ion-A d� O+or Lot No. Ir /• iC%.C- /� ...--1-- ......... off_._.---- � I.._ / ner Address ---- ' -------------- ------------------------------------------- -------- Installer Address U Type of Building Size Lot.l o_*j.._._Sq. felt �-, Dwelling—No. of Bedrooms_-_.T.........._........................Expansion Attic ( ) Garbage Grinder ( �, per, Other—Type of Building ____________________________ No. of persons............................ Showers ( ' ) — Cafeteria ( ) a' Other fixtures ...................................................... w Design Flow..................ff_®!tP...........gallons per person per day. Total daily flow....................XJ -------- WSeptic Tank—Liquid capacity/AMUgailons Length.........:...... Width................ Diameter---------------- De)ih-_-____-__-_-_. 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 ( ) Dosin tank ( ) Percolation Test R u Performed by ���/ ` . _.___,t�' _ � � Date___-.__ _.l'�._- ____-_. Test Pit No. ' s _ _minutes per inch Depth of Test Pit Depth to ground water.*~ zt --------•---,ai f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__-__-___-_____-__-__--" a �y ---------��------------------ // ----------- --- - �y O Description�f Soil �� C� '� ------------ --- U40- - ' >. . 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance"has beepmueo by the boa Vofhe . Si e � -- •- •-- ��%%�� q. to Application Approved BY 6%___ ----{ .. . .. Date Application Disapproved for the following reasons:---•--••-------................................................................................................ Date PermitNo......................................................... Issued........................................................ Date No........... ........... F>t>c... Y..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH, ..............OF........: ., . . .. /� ....,_1�:- -t, ......:........ Avvi rntinn -fur Miivoiitt1 orkii Towitrurtiun Vrrntit Application is hereby`made for a Permit to Construct (/) or Repair ( ) an Individual Sewage Disposal System at: ' /,/, 04r (n Tc'/i7 S AS ..................... --•---••-•--------•---••-----•----------•---••--•-- r �p �/�Location•Address , Lot No. / /T t T/!//`� ` .................. /.� ....... ''`+��r n-//-:� ..,ir...!.........._ ......,�- . �.� .............---•------ W ,,� Owner Address a .....................................•-•----•......------------••----..................-----_•_... .--•••---•-....-•--•-------•-••-•..............................._Y...........-----•••----••.•.•-- Installer ,Address Type of Building Size Lot.. _ ---____Sq. fegt Dwelling—No. of Bedrooms .................................Expansion Attic ( ) Garbage Grinder ( �- Other— Type of Building --------------------------- No. of persons___________________________ Showers — Cafeteria a Other fixtures ......................................................------------------------------------. ...-----------(...._----- (..--)-- W Design Flow.....................Ke719...........gallons per person per day. Total daily flow--------------------- ........gallons. WSeptic Tank—Liquid capacity 444{gallons Length................ Width._.._........_.. Diameter.......... Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area...:� 4_---sq. ft. Seepage Pit No-----_-------------- Diameter.................... Depth below inlet.................... Total leaching area:_-_..____--..--_-sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Re ults Performed by............... . ___. .._......Date.._....... _./✓'..___ ....... - ----------------------------------------- -- Test Pit No. f'r --_-_minutes per inch Depth of "Pest Pit.................... Depth to ground watPr_'f_ (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----------__..._-_._.. "rr----------------------------•..........-------- t.. •----•------------------------ ........................................ DescriptioGn�-9f Soil------�-------------------------------------------~__.----------------•-----------------------------------...------------------------------------------------ U -------------- .._. ►� .1!sra�1 f w x ----------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------- V 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 Article XI 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.----.�i �t'.. r ---,��='- '-=t......------•-•••----•-- ��'/ ' •� . --- - .� - / � �// mate_ Application Approved By ------------�....... �. : f / ---- �'-- -fi---------- ------------ Date '---•---------------------------•-•-•-•-----------------•-----. -------------- Application Disapproved for the following reasons__________________________� ------•---------------•---------•----•-----------•--••--------------•---------------•------------•---•------------------------------•--------------------------•--------------------•---------......... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH- ............................'............OF..............`..................................................................., IT.rrtifirntr of f911nwHattre THIS.-IS TO CERTIFY That the Individual Sewage Disposal System constructed (L) or Repaired ( ) by.. =1 = ------------------------------------------------------- installer,l/ / L• -� at...'dt(r. , ;`mod�c�' /t it ................. ( / v j vt C --------------------------------------- -- ='---------- -----•......----•-••...._........ has been installed in accordance with the provisions of Article. XI of The State Sanitary Code as,described in the application for Disposal Works Construction Permit No._ �._! `f__.._.....-. dated ...:__S_ G___ .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL kUNCTION SATISFACTORY.r - Inspector.....DATE fi _-_-------•- ------------ � � -. THE COMMONWEALTH OF MASSACHL.E—T-S BOARD OF HEALTH OF No.--•-----!� f i FEE /�') Di venial grk �Cn�;an trnrti,aat rrnttt Permission Pereby granted ----------------f-lam -------------- = = to Const uct ( ` ) or Repair ( ) an Indwidual^Sewage Disposal Syste vim. , at No. = P, .,✓c�r r= v . ------------•------------ - ti Street as shown on the application for Disposal Works Construction Permit No..�'-----r......��Dated-------- __ G-- �__._..... !' .. 7� Board of Health / DATE ` ------ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ' Yio � 3 Sol. D` -v m r off' a G4�103 Noo Gal: s + Lo Lecachin9 Pit. d 8$ Test Pit i', Dist. Box \c t ,' Future V .O. 1 �/ 3O'f � 4 Ypansion Se tic zv ��j p{p� n • , TAN V 00 � `L' `J I` o i Atq N. N Bc�,'32'01 a L off- .- . 0 r�i LEGEND sm fir '` EXISTING SPOT ELEVATION 0,0 EXISTING _ _ ;� ` GERTIF,IED PLOT PL`A STING CONTOUR 0 :s # N�a ' FINISHED SPOT ELEVATION L0.0 LOT B QUlt E°ANNE L'N` COTUIT FINISHED CONTOUR -- 0 ':f ;'' __- ` ='- ' APPFZOVED HEALTH BOARD OF IiV' 4 DATE AGENT 1 ;. SCALE: I - 100' DATE : AVG.19)'1916 E DL KEDGE ENGINEERING CO. CLIENT :HARvEY_ . • I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED _ JOB NO ?605_ I- BUILDING SHOWN ON ,THIS P-LAN CIVIL LAND- 4, CONFORMS TO THE ZONING 'AW` ' ENGINEER SURVEYOR_ S DR. BY t R 5_J_ OF BARNST BL E .MA` S. tF 33 .NO MAIN ST 12 MAIN 'ST' CH. BY / ` �,GYt;E oo rd; S0� YARMOUTH MASS. NYANNIS, MASS,: ._.. — _ a SHEElT .OF D REG. 'LAND SURVEYOR ` 20 FT. MIN. IO FT. MIN. '�- T--- CLEAN SAND -- CONCRETE 4 PVC PIPE - --7 Elev. 100' COVERS MIN PITCH _ / _ /— 1/8 PER FT J CONCRETE I � -- - ----,�—Alif 10�� COVER / j l LIQUIDO LEVEL- ' / 10 �, t 1 4 CAST 2 LAYER f i IRON PIPE ° —T OF I/8"- 3/8" 1. _ MIN PITCH_ SEPTIC TANK • WASHED STONE - 1/4 DIST.PER FT ° BBOX ; , e� • . . , , � �, y EFFECTIVE' ' ° �-- 3/4 - I 1/2 '; DEPTH WASHED STONE 'L1 • e ° � > 1 e' e s • • ee ---'- --- PRECAST SEEPAGE lee' • . 1 e e' . • • • off . PIT OR EQUIV. INVERT ELEVATIONS 6 FT. DIA. — J —'— iNVERT AT BUILDING `iT o_FT. _____.__ 10 FT. DI_A_ I C (SEE TABULATION) i INLET SEPTIC TANK FT. - - ---- -- - -------� SECTION OF LE GROUND WATER TAB O.0 T-LET S -_ E.PTIG .TANK . _ g6.�Ft _ - - - - --- -- - -- INLET DISTRIBUTION BOX _9G, FT SEWAGE DISPOSAL SYSTEM OUTLET DISTRIBUTION BOX 9-3 FT. SCALE I%4 l � O" INLET SEEPAGE PIT 96_I_FT TABULATION DESIGN CRITERIA DIMENSION A 3 FT DIMENSION B 6 FT UMBER OF BEDROOMS _.__3 DIMENSION C4FT min. ARBAGE DISPOSAL UNIT ,TOTAL ESTIMATED FLOW 300 GAL./DAY SOIL LOG SOIL TEST NUMBER OF SEEPAGE PITS I _ ELEVATION 99.0 — DATE OF SOIL TEST _emu_- 18 19- G SIDE LEACHING PER PIT _ 1 68 SQ. FT L-.Ir, — RESULTS WITNESSED BY BOTTOM LEACHING PER PIT _?8 SQ, FT PERCOLATION RATE Less +han 2. MiN/INCH TOTAL LEACHING AREA SQ. FT ' 3oi Sand S��bsoil RESERVE LEACHING AREA —?�� SO. FT41. ZV� " '`:` PHILIP �sN LOT 8?-3 QUE ENE ANNE I_N.-COTUIT WEINBERG i No 366 1p ,, tolsT����� I ELDREDGE ENGINEERING CO. INC. <.• `;t`'=C'`,! Fss/ANAL E� 18 Medi�w, Sattc+ 33 NO. MQ1N ST 712 MAIN ST. K; I._�-- SO. YARMOUTH MASS. HYANNIS MASS. JOB NO. 7 r,=.o S I SHEET 2 OF 2. k. C 1 Sv °- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH. .........0 F... ........ �r. .� .b ...... Appliratiou for Dwpasal Works Tonotrur#iun ramit Application is hereby made for a Permit to Construct ( ) or Repair (L—_Ian Individual Sewage Disposal System .... __... ,u . . ...... -- ----------- .. _..._: _.... ......_............._._...._..........__. L c ddre s or Lot No. -••--•-•--•-• a s....... ......................... ..._._M. = ----�V � ... dress.... ... Installer Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—T e of Building No. of persons............................ Showers — Cafeteria aOther 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........................ Test Pit No. 2................minutes per inch Depth of Test Pit.._........._...... Depth to ground water........................ oP .....•• :: f... .:.........------------------------------- Description of oil--••--•--•••........-•-- --------------------•------•-----..................................................... -............--------------------••-•-......--_--•••. x ----------- --------------- ----------------------------......------------------------------------ - - - - - - - -------------...................... 0 Nature of Repairs or Alterations—Answ r w n applicable__________ _____ ��_�:: ���.. ...... ........................................................pauet .. . ------••. 1 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in.accordance with the provisions of TIT ' 5 of the State Sanitary Code—.The undersigned further a ees not to place the system in operation until a Certificate of Compliance has be issued b the boa d of health. Signed---= . ..:� . .. ....--- ---- ............... ......l.-.....•---..._.... Date ApplicationApproved BY................................ ...................•-----•••--•---•......• ......... Da t e Application Disapproved for the following reasons:............. < ..:...._.__. ;. .......................... , .............................. ...............•.... .......................................................... Date PermitNo........................................................ Issued....................................................... Date r-- THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR � QUALITY ORIGINAL (S) Im ^ACC DATA r - THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF HEALTH, v , Appliration for Disposal Works Cgonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (L-)-an Individual Sewage Disposal System at. ,# j ................»»... --- -•�-•Location-•Address.........................--•---•-• -..__...--- -.....---........... ..-or Lot No.......................................... ....... f..!..L.� 'l f r. !.............. ............. . .......... ( '....,-.....:_........ .............................................. -•Owner ' I Aci ess Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms................. ......._...........Expansion Attic ( ) Garbage Grinder ( ) 1-, Other—T e of Building No. of persons............................ Showers — Cafeteria A4Other fixtures .....................•-••-..........._......... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WW 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. ft. Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by-•-••-----•............................................................ Date........................................ Test Pit No. I................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........................ x ...................... •. -_... -- • .......-•--•----...___................................................................ 0 Description of Soil...............................I / t ,(_� /i •-----•---•--- • •......----•--•--•.............•--•-•----••---•-----•------•...............-•---------•-••.........-•••--•••_.. 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 TITIS 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�...............................••---•••--•-•-•----•------.`/__..-•••----........ .. Application Approved By.... ..........................................•-•-•-•--•--•----•-.» ....._...... Da t e Date Application Disapproved for the following reasons:............................................................................................................ »» ----------- •...... ------------------------------------------------------------ .------------ .--.---------- ••-•...... -......... .............- -- Date PermitNo...................................................»..» Issued..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Fa J 1 .................OF................. ..! - /................................................ Cgrrtif utttr of ftompliana THIS IS TO CERTIFY, That the Individual Sewage-Disposal System constructed ( ) or'Repaired ( ) - by.................•-•••..... '::.�!.`• '' - •- !:. ..: ..-............. ' .-.......-- -- ......-.......•.... -•---._ ...... ....- •_.. Installer ---- •--••----•-.._......._ --•-•---•---•-•••- ••--••---•-.......----•--•--•-----•••--•-•••-••••-•...................•--•••••-- ----•••-•-_... has been installed in accordance with the provisions of TIT F 5 of The State Sanitary Code as described.in the application for Disposal Works Construction Permit No...... :7...7&f --...._. dated---.------•.................... .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRUED AS A GUARANTEE THAT THE SYSTiM WILL UN TION SATISFACTORY. y ' ATE.....--••- I b ....-... Inspector...... .- •------- .... THE COMMONWEALTH OF MASSACHUSETTS ,r BOARD OF HEALTH 73L .......��.�...).9.........OF.. �,1,�, a ,r ,� ................................ ,t �.-.:ll.? 'No... .. Fas.. -="`� �i��ouul ork� �on� ttrtion rrm' <' Permission is hereby granted._..: r. �' .C , ..»_».. to Construct ( or Repair an Individual Sew Disposal System atNo.. ' -•- .. - ........................................ I--- oard ...... ......... ras shown ort-tl�tzapplication for Disposal Works Construction Permit No..•.�.. ...� `-�'_ Dated..__._` ..�-........:....... -•-•••..............................•. .-• .... .. •---•••of Health : . DATE...---...� .0$_..95--------------------- FORM 1255 A. M. SULKIN, INC., BOSTON