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Home My WebLink About0026 GALAHAD CIRCLE - Health 26 Galahad Circle Osterville A = 145 — 069 i a LO CAT ION SEWAGE PERMIT NO. L L E ,2 = d69 1 STA LLER'S NAME i ADDRESS B U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED3p` 7 , r � g 1 �� r w4 THE COMMONWEALTH OF MAS�ACHUSETTS BOAR® OF HE TH 4,t..........OF.... .. ApplirFation for Dhipvii al Works Towitrnrtion Vantit Application is hereby made for a Permit to Construct ( " or Repair ( ) an Individual Sewage Disposal Sysjt5at..... .. L %, ...... .............................................................. -- ocation-Ad or Lot No. O Addres ............... ............ ......•• ......... ........................................ Installer Address UType of Building Size Lot....e Sr, ...Sq. feet Dwelling—No. of Bedrooms__.________. Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures _._ ________________._____ W Design Flow......57 3______________________________gallons per person per day. Total daily flow____........._...... 9.d._..........gallons. WSeptic Tank—Liquid*capacit/6-"—g—a Ions Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Widt ................... T tal Length..__.._.____.__ .. T,PO leaching area....................sq. ft. Seepage Pit ............ . tal leaching area..................sq. ft. Z Other Distribution box ( ) Dosing to ( O�• �/-�- 23-7�r- '~ Percolation Test Results Performed by_____-.. ............. ......{� �.____ Date..... -. ...�.�:........ W ,_l Test Pit No. I........:.......minutes per inch Depth of Test Pit_._....__________.__ Depth to ground water........................ Grq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water________._______________ O Description of Soil_...-_ 'o--off--S�..IZ........... W 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 TLH1E 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 J Signe � � -s----- . . ••.••• ••. _. Date Application Approved B ,....... . ----•---•----------• ....I'-` --- -?- `------ D ate Application Disapproved for the following reasons---------------------------------------------------------------------------------•--------------•------....•..... ................................................J........................................................................................................................................................ �© Date Permit No......................................................... Issued----- ................................................ Date No. ..... _ Fimii. .. J ............... THE COMMONWEALTH OF MA�SACHUSETTS w BOARD OF HEA TH ..- .....OF... ...... .................................................... Applira#ion for Disposal Works CTonitrnriion Prrutit Applicatiori is hereby made for a Permit to Construct (4 j o Repair ( ) an Individual Sewage Disposal Sys ..... ......... ...._. - -.�-.--------- ............. __.._ .............................................. l/ �rocahon Ad or t No. . - O- rr �dj Addresses ............... i - !....... ......C. ��..LeC.Cf__.............. ---------------------------- •.. -- ........................................ - Installer � � Address � UType of Building Size Lot_._� ! -:___...Sq. feet Dwelling—No. of Bedrooms............ ...........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building No, of persons............................ Showers p-1 yp g ............................ p ( ) — Cafeteria ( ) W Other fixtures -a .+¢-- ---------- -------------- d W Design Flow...... ......................... per person per day. Total daily flow__:_____.______.__. A—! ............gallons. WSeptic Tank Liquidt�capaciV.49 a9lons Length................ Width................ Diameter. ........ Depth................ x Disposal Trench Lt"24 No_____________________ Wid .................... Total Length............. --- leaching area....................sq. ft. Seepage Pit No.. /G�-_. . *Dia ............ .__ ta) lea hingarea__________________sq. ft. / Z Other Distribution box ( ) . Dosing.taryl�c ( D "� 3`" -. Percolation Test Results Perfrmed by.__._.`_ t ._r .lo! .__. Date......................................... a Test Pit No. 1................ minutcs 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........................ ( f / Descriptionof Soil -- ........ ------... d't'! x .................................................. .......• ---•----••--•...............•---•. .L.................. .+.......__......................._...._...._____.._..._..__....___..............................._. U ------------------- ...._. .........._•...............:--------------------..__._................_......__.....................___..__.................----....._.._._......_......._......................._...................... 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 TITLE 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 o health. ... igne -:.e -fir!: -�`�`1� Application Approved BY /r-------•- i�F'1j.�6 -�- --- Date Application Disapproved for the following reasons----------------•----•--•-•-•--------•--------------.......................................................... .................................. .............................................................................................................................. ---------•-----•------•------•----'•--•--- Date Permit No............................ Issued--•-- d - 7,g, -- ------------------------- ------- `, Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (Irdifiratr of Tomplt anrr THIS IS TO CERTIFY, t the ividual Se-•age Disposal System constructed or Repaired ( ) b XF = - --•-•----•-••-----•... er at......rf1"3 - has been mstalled�'-4,accordance with the provisions of T ` of The State Sanitary Cod as esc ' m the application for Disposal Works Construction Permit No -._._.._� '............... da.ted....._..__._.____........_...._...._......_._... THE ISSUAdd-0 OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A A GUARANTEE THAT THE SYSTEM WILL.FUNCTION SATISFACTORY. '------ .DATE.:. ' ._.. Inspector.... . ............•.---.. ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT No............ ��'...... FEE._�2.................... Difillos a1 1vorkii .T"anstrurtion r • . Permission is h Y granted--- ••--.---'` ---..... . •.... --• ....c............................... to Construct r Repair ( an Individual.Sewa e Dis sale Sy r ............ re 3-.b.. as sh wn on the application for Disposal Works Construction P . t No /, .... Dated..__. ------•--------•------'- 2c2 Board of Heal IIIIIIJJJJJJ .�..�� DATE. . . ---•--. --•-••••••••.........................••--........... FORM 1255 HOBBS & WARREN, INC.. PUBLISHt-RS - - ;4 �,�t i.1G t_� t✓o.�n t�..�! - 3 �st�tzo c�a� io 1 , z.9 Dat t_� FLow _ Ito 4 3 = 133d G-P-V. } t 1EPl'tC T�1►C = 330� lS0 % • �S G.P.D j ; i � � } ': .1 �" USA- t DOCI SA.L . _ IT 1��0 SF 2.S �1S G.P.D. BOOT— OAtA AZeA,c rz O ST-. 1 N s� �ES G ,ToTA 2 •, • 1(. 5 } i �, l•. • 7-OT-6 L- tea►L--( FL0V-1 - 330 6.P.D. : PE12G0LQTIOLi tzAT'E : to,1w Sm I W"oiz �SFs `' ZLII / - 4 Y a I �y t n J� � � .. y•' r 9 . i r r RICHARD ALA. j �,• } BAXTER v> Flo No. 48. .a JO >4 s ,r ?ypq � 00 p 1 WAL TEST i . Tm. 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