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HomeMy WebLinkAbout0110 EAST OSTERVILLE ROAD - Health JIF1,1,0 Ea"st Osterville Road Ostervilletk 'A= 122:- 058' ` yi `4 .�4 r No.7 .......... .. M P2 - 0,54f `............ THE COMMONWEALTH OF MASSACHUSETTS I f BOARD A�'HEA T �1 -.OF......... ................ Appliratinn -for IN-4plaiitt1 orkii Tutu trurtiou' permit Application is hereby'made for a Permit to Construct ( or Repair ( ) an Individual -Sewage Disposal Syst a �.. � C/� J Location ddress j-or Lot No- - G O Ad - Installer Address d Type of Building Size Lot...... feet V Dwelling—No. of Bedrooms----------- - ____-__-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ___._ ••-•-•--------------------------•-------••--•---•-------__.---.---__--_------•----------------------------------•------- W Design Flow----------6.—'_Q......... .............gallons per person per day. Total daily flow......._..._.___.�j a_®--.-.-_-.,_-gallons. P; Septic Tank—Liquid capacity/Ale—a—lions Length---------------- Width---------------- Diameter-------......... Depth.._._:.__.-.--. Disposal Trench—No_____________________lVidth--------------- otal Length----- _._____ otal leaching area--------------------sq. ft. Seepage Pit No.._� o / To 1 leachin area.73_9_.$r'sq. ft. Z Other Distribution box ( Dosing tank '-' Percolation Test Results Performed by------- - ---------------------------------------------------------------- Date------------------------------•--.----- aTest Pit No. 1................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water...--------__-.--..__. GI Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ •-•• ----------- { /- 4.� O Description of Soil---- !� L�� liG .'. x 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 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 b the oard o health. igned- ' -... . --------- -------� �f!' J Application Approved By---------- ;- -- ...... -•-- . . . ......... --------------- ----•� ,..date`-?------ Date Application Disapproved for the following reasons-------------------------------------------- ......................... ......... -------- ----------------- -----------------------•------------.........._........-=--------------------------------•---•-------•--•-----•-•-••-' ----------------------------------------------------------------------------- Date Permit No... Issued 9.... ....... .....7------_-----_-••- Date LO,CATI N J' SEWAGE PERMIT N0. VILLAGE °INSTA LLER'S NAME ADDRESS B UILDER OR OWNER DATE PERMIT. ISSUED DATE COMPLIANCE ISSUED d17 �``. 33 �6 ' DESIGN DATA ngle Family - 3 Bedrooms 5G, No Garbage Grinder � Daily Flow = 110 x 3 = 330 GPD CO Septic .i ank = 330 x 150% = 495 GPD J , Use 1000 Gal. a, e X A• N Disposal Pit - 1000 Gal . f/Vo• sy 9. # p Sidewall -a"a= 150 B. F. ' P„- 150 S, :: 2.5 = 375 GPD Bottom Area = 50 S. F. s7 ` 50 S.F. x 1 .0 = 50 GPD 1 04 Total Design = 425 GPD Total Daily Flow = 330 GPD Perc Test - lit in 2 min. or less OL/2 14 of AV FOLHARD A. _j. �1"R hI0 ?�()49• I D SlltC�" a.'irAt��k� 4G.So r�L /N✓. --4 /NY. 97, Zo 55 7 e /Nt/egg oa Z +.F 7/LGIT7 J SE,o r!c Th'N/� iQ a O o a D o u5,o• b'orTdM C>=tZTtFt D PI.c::>T' p>1 G x 70nlE PRO o-/L L bCA T I o t�.l 84 as GCAI el,.5-177 I CMVTlr-Y T�4A7 T14GFOUNDA710N5jAa-,,jQ Pt-AQ QZ—Ira akkc& Nt'- � L'sfJ CCaMPL�I a �,l/1 TF-1 ThtE 51 D'l _t..i►-�� Lc) -1- of A,tiJa SET�CIC Qe4�1r;ENc�w1Ty o1= TNF >_. �. 3 2 Z Z 5 i"3 "fowQ atr t3A1<:ni S'TABLE. ,i©S TtRv # DA'i C z1-Z-7 6",-- l+ . CZGG15it3Zta t_A►JU SU��JEYo�S Tt-{IS QLA1-1 IS UOT e>A.Se'0 0�4 A.W OSTE2VILLG o �rCASS. IEJSi�'tJ�EN"=" ��U2V� { ;� Tl1� Uh�'•y�_T'S• Zr!-1oWW APPt_lC_At,:.IT C,gPE yyiDLs Z7L'V1�L, k,JOT IBG U'>Cn TO DC-:TCLMIwL 1_CGT LIWLS C7)l No........... .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT N ....OF...... '/��` .�: . .�.�/` •r i.. ...s Applirtttion far JRripotial Evrks Tomitrurtiott Prruift Application is .hereby'made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal Sy' stern at .......... .........................................z��A Z.......................... ....................f Locati�ddress lr or Lot No. _________________________ f• O n - - - ._. ,. .. r Installer // Address UType of Building �i' Size Lot................:...........Sq. feet Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ....___ No. of ersons_-------------------------- a g ------------•-----� P ---------------------Showers ( ) — Cafeteria ( ) Other fixtures ---- ''` -------------_---_-------- ----------- ----------- Desl n Flow__________ ____ _______________________gallons per et-son per day. Total daily flow...._.____..__._73_6__U__--..----- . W •g ._._ P P P Y• Y .gallons. 9 Septic Tank—Liquid capacity!�'t'� ions Length................ Width---------------- Diameter._. ----- Depth---------------- xDisposal Trench—No_ __________________J Vidtli-------------- Total Length______....._. otal leaching area--------------------sq. ft. Seepage Pit No--- �1 + _ at S i -_-___-_: n. &pth—%U61 l t�' r y.......... To al leachin area-__�_l_--?r''sq. ft. Z Other Distribution box ( r9 Dosing tank ( ) 61 jPC,0I' — P—z4,,77 Percolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- a Test Pit No. I................minutes per inch Depth of Test Pit------------.------- Depth to ground water..-._-._--.-..-_.-_--. f� Test Pit No. 2____•-_--_•-____minutes per inch Depth of Test Pit-------------------- Depth to ground water...--------------------- ------------------- - -- O;: Description of Soil- ". . ------_49 " "'. _e. - --T Wit: Gl' x V -------------------------------------------------------------------------------------------------------------------------------- --------- ---•--------- W vNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------- ----------------------------------------------------_'a. --__ ---_.__ . :------_--__-.--.-----_.-._-_ --------------------------------------------------- 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 o Compliance has been issued by the board of health. / Signed/— �J��rr •Y�s f � -----. ... e `. ' Application Approved BY..... ;;�• - -- ----------- +-7-7...... Date. Application Disapproved for whe following reasons=-------------------------------------- '.. --•----•-•--••••--------•.--•--•••---...----•._.......---••-•--•----.._...--•••------•--•--•••-•-•-•-•--•---------------•-••----.....---•-------••-•----•--•-------------------••---•------------•.---•- Date Permit No.......................................................... Issued.----- Y-- 7 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .�!r�.�-rt�. OF....../ .�i,/�r,yr �y ✓':<�r ' &rtifirtttr Of f�0mvIitttur THIS IS TO CERTIFY Tihat e Individual Sewage Disposal System constructed (f or Repaired ( ) by. ,r F- r.._ ------ __ stiller at 'Y 1�! - .....Z '� -- ?'•----/-,! ,: ------ -------- � ...... has been installed in accordance with the provisions of A is XI o The State Sanitary Code as described in the application for Disposal Works Construction Permit No--- �___-__-._-_. dated......Q ....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.' DATEInspector---- .-----•-••------•---- ----------- .................................. THE COMMONWEALTH OF MASSACHUSETTS ,� �� � ✓ BOARD F "i H E A L •i2%4' ' '✓ . Wit... -..OF..............-- - --------------------------------•----------------......... < No..........�e.7.... FEE Permission is h y granted..... ` -+:.r-s '' 3� „•' ''' d to Construct ( or Repair O an Individua twage D•_ 'sal S 1E­e3V;Z1 — --- t r Street as shown on the application for Disposal Works Construction Pe No__ _AA� ed_._�r ".j_ '7 -_--------------------- ............ lth o DATE ( `` 7 ----------- -- - FORM 1255 HOBBS.& WARREN. INC., PUBLISHERS -