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Home My WebLink About0128 GUNSTOCK ROAD - Health (A r � la i //or i ®t 9s- 9 . P MIT N0• LOCATION S ACE E C v n nc VILLAGE Z to 4!�k7( S. I N S T A LL R'S NAME & A," MESS ® c�c r BUILDER OR 0 NER DATE PERMIT ISSUED Zja 2/ ' DATE C0IAPLIANCE ISSUED 11113191 f � ck<" Ct j use 1 N C_ o .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................OF......... ... —---------__----- Appliration for Uhipatial Workii Toastrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at . . ..... .. .......... +'laa4 ..............4.... .................................................................. ............. .. ... ....... . ..... ............ ... Eocen-Ad ........................ or Lot No. ..... .. ........ .................................. .................................................................... Own Address .......... .............................................................................. 1 s taller Address 9; Size Lot-/_,.......1V-V..........Sq. feet Type of Building S- U Dwelling—No. of Bedrooms.............. ..........................Expansion Attic Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) P4 Other fixture�—----------------------------------------------------I--------------------------------------------------------- .................................. Design Flow.................. gallons per person per d?y. Total dall ;flow......... ..............gallons. gallons Leogth.-Zo----- N -------- Diameter---Z!5�---- Depth._.:___.._____.. 1:4 Septic Tank—Liquid capacity Y1_- Disposal Trench—No. _/............ Width.../0-------- Total Length-------------------- Total leaching area--------------_---sq. f t. Seepage Pit No.__-____/.......... Diameter-42---------- Depth below inlet......$.............. Total leaching area-,7.F,6......sq. f t. Z Other Distribution box Dosing tan a ....... ......... Percolation Test Results Performed by...... Date---.,.. e-- ->— Test Pit No. I-----___ minutes per inch Depth of Test Pit.................... Depth to ground water_____________-_____----- (.T4 Test Pit No. 2......f-.._2-Tmnutes per inch Depth of Test Pit____________________ Depth to ground water_:_________.._..__.___. .................................... ...........................................Y...........;r........................................................... 0 Description of Soil.................0.........2........ ..... --------- );�c- --------------------------------------------------------- V ......................................................... ........ ..... - ------eegz U w-n.'A..................................14-------------------- --------- .......................... .................................................................................................................LV.............. Nature of Repairs or Alterations—Answer when applicable.__________U --- - ---------------"�9777---------------------- .......................................................................-............................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLI-1 Ti,71, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issujpd by, the boa- f health. '7-o? S ................ .... .. ...... ...... Date Application Approved By...... .............................. ------ ---SJ..... Date Application Disapproved for the following reasons:................................................................................................................ .........................................................................................................I............................................................................................... Date PermitNo......................................................... Issued-....................................................... Date N ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD 0 H kT H ........ .. ................. ........OF................... ......... .............. .................... Appliration for Uhiplaiial Workii Tomuurtion 11amit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Sy -.. ...... stem at- 01 .. f ./.......... --•-----•---- n Ad or Lot No. 'o - .......... ............... ................... . ............................................................................................. Own Address ---------- .... .. ............. ................................................................................................. ... . ... .'.._._.---Own ........ ....................... Installer?stja I�Ife r Address Type of Building r Size Lot............................Sq. feet U. Dwelling—No. of Bedrooms............................................Expansion Attic G/,v er (e 44 Other—Type of Building .......................3.. No. of persons.........................._,.Showers Cafeteria ( OtherPNt5=1 I------------------------------------------------------------------------------------------------------------------------------------------------------- Design Flow.......... .......i................ --gallons per person per day. Total daily flow--------- .....................gallons. W Septic Tank—Liquid .Lej.igth--- Width-----4�------ Diameter--- Depth................ Liquid capacity/ ...... Disposal Trench—No Width -------- Total Length.................... Total leaching area....................sq. f t. 7Diameter......_.._::.__.___. Depth below inlet....... ......... Total leaching area../.5.;.�6.....sq. f t. Seepage Pit No_____________________ Z Other Distribution box Dosing t 0-4 ank Percolation Test L Results, Performed by------/cZ A ............................................. Date....._....__...._...................._.. '!L- - --M Test Pit No. I-___-- --- ormeminutes per inch Depth of Test Pit.................... Depth to ground wqte�r--- -- — . Test Pit No. 2................minutes per inch Depth of Test Pit:__.....__.._.___... Depth to ground water..._....__.........._... ............................................................................................................................................................. 0 Description of Soil....................................................................................................................................................................... ..................................................... �'W---'�;':------ . ............... ....... ..... -------- W z-e--?................5;�... �-' V 7 ..................................................:4: � 4:�.. ......e�.......... "..- ------------ _7......... .Sri U Nature of Repairs or Alterations—Answer when applic-ab"1`e.'—'-�--'/ ........ ................. ................................................................................................................... ........................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewa.-e Disposal System in accordance with the provisions of TLITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been isstWd bbyothe bo of health. 7...... ................. .........................Date ApplicationApproved By............................. ............................... . ................... ... Date Application Disapproved for the following reasons:.............................................................................................................. .................................................................................................................w................................................................................. Date PermitNo......................................................... Issued-........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A X-6& ---k— F. .........................................0 ..........�1 ....................... ................ Trrtifiratr of Tomptialarr THIS IS ERTIFY That the Indivi ual Sewage Disposal System constructed (4-11)"Or Repaired .................S�..... .2 - by.................— Z4..'b................................................................................................... .......... �ller�n at......................................... -----------------------------------------------------------------------------------------------------------....................................... has been installed in accordance with the provisions of TT-9"-LEP-' Z',of The State Sanitary 'Code as described in the 5 application for Disposal Works Construction Permit No ;/................ dated---......................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFIACTIPRY. SR DATE................................................. -t......... Inspector................. f Ae 1................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.......... ...... .. ............ No......................... FEE----�r.----............. R01111fi vrToniNo To d , PermissionLiehereby granted............ ........................................................... to Construct 4or/ ,Repair a, IndiviAual,,Sewage Disposal System,- V) atNo.............'Z.............................................................................................................................................................................. . Street as shown on the application for Disposal Works Construction Permit No..................... Dated.__:-_____:____..__._..................... ......... ........................................ Bo rd of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS a y! (S p s 1 i f I.,Yi � . 1 .. _ z r' i f.'vre✓S� J t. �iA, 1 Vk �, 1S !1 ;r ti� .. �.�\r �,� �`R1r��Ptlq�� G�•��LLl .. '� _ - i' i. r , ,,15 � ,'�� ,e Y ,. ,j�� '>1{ a _ ,� \ 1c✓'i is ..,� # $9 \ ,::,[ �, _' s 'F� �� /_ \S �'*a //' ♦\�� /pt��rs.� q I t I _s, n°s.FMj Y 1 1 ! v f a a 4 1 LEGEND ;r , fi ►$TINtB' 1SPOT ELEVATION Ox0 CERTIFIED PLOT, 'i w * TIN0 CONTOUR 0 Ir MED. SPOT ELEVATION $ L�; MY CON TO U R 0 . I Rl AP� OV0:1 BOARD OF .HEALTH '. O>CI,TE AGENT SCALE: / J- ` Def ENGINEERING CO. IN CLIENT I CERTIFY THAT :'THE {5 b r� 8•tSTERE REGISTER JOB N0. 4 BUILDING` SHOWN ., ON �-,,Hf �t 14 ,CIVIL LAND CONFORMS TO'"°TME ZO�INi$ �l 4 t3fP1EER SURVEYOR DR-BY= ,�t� , . OF—BARN A8 p 712 MAIN:ST. CH. BY= u HYANNIS, MASS. SlETL OF �» - _ -. _.. .•ill .,.,�.. r�p. .r ,.: -.,� k;as., ;:P :. • "?"-4 y� ;��dAPraw 3�y.�r_ � .-'k'C7_ ''Y P' :�Y .4'r: - M.;t..-:�,�"Y.. VF v 1 d ' / n y S�l�4ZL 8 .�Q�tdllfMY TO Q t erg , ®r Lloo . 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