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Home My WebLink About0083 HICKORY HILL CIRCLE - Health 83 Hickory Hill Circle Osterville A= 120-102 / L O CATION SEWAGE PERMIT NO. vlLlacE A-= ? of C�s—, ` tz 11r- I NSTA LLER'S NAME & ADDRESS Li S— ji +S ® U I L 0 E R OR • OWNER N t c 1c J I,�s r-�a ►.�,�s DATE PERMIT ISSUED ® �3 DATE COMPLIANCE ISSUED r 33 91.3457 THE ,COMMONWEALTH OF MASSACHUSETTS BOAR® OF H LTH ......... ........................OF........... ..................... ... AA-4b3Avvftrat�ivu for Elhip al Works Tomitrurtinn thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System al: :. ��. Location-Address or Lot No. .. Owner Address W ...................� • .. ...........,............................ --•----•-••--•-•--•--------•--•-••----................................. Instal Address d Type of Building Size Lot.___............. Sq. feet U Dwelling—No. of Bedrooms................. .......................Expansion Attic ( ) Garbage Grinders( ) `4 Other—T e of Building .............. No. of persons._...___.___........._.._... Showers — Cafeteria P4 , Other fixtures ...................................................... W Design Flow..........................................gallons per person per day. Total daily flow-------------_3.3_0................gallons. GG Septic Tank-Liquid capacity/OWgalIons Length................ Width................ Diameter---------------- Depth................ Dispo&a Trench—No..................... Width.................... Total Length.................... Total leaching area.._._V/9.d_...sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet........._::......... Total leaching area..................sq. ft. Z J Other Distribution box ( ) Dosing tank Percolaron Test Res lilts Performed by .. ' Y!l. ----- Datez= �� --------- Te t Pit No. 10:14ir.minutes __minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ4 Test Pit No. 2 per inch Depth of Test.Pit.................... Depth to ground water........................ a 0 Description of Soil-------•------------•----------•--•--•----••-•...............•----------------------------------------------• -•-•--•-------••-------•--••••--••••••----...........__. x U W UNat. "_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 TIT?1 5 of the State Sanitary Code he undersigned rther agrees not to place,the system in operation until a Cert sate o mpliance has been is by the d of ealth. Sign _7 .....................•---•--. .............. Appl cation,Approved"By.--- --- •GG Date Application Disapproved r e following reasons:................................................................................................................ Permit No..................................................... .. Issued........ tt�777 THE COMMONWEALTH OF MASSACHUSETTS �"(J BOARD OF HEALTH ......................... ..............O F.............. ............:............------------------...._........................... A' plirFaiion for Disposal Works Tonotruriion 1krutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at �- ...... � A�../-•--.... . .�G _.... ..._;1 �.1,! f�r �./ ---------------•-•--•------:.......--.._......................-•---•-- Locatio -Addr r Lot No. .... � et •-• •-----Address a .............................. ................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.................. .... _..._Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria 0.1 Other fixtures -------------------------------------------------------•-•-••. W Design Flow...........................................gallons per person per day. Total daily flow............. ..rg..............gallons. WSeptic Tank—Liquid capacityAgCSrgaIIons Length................ Width---------------- Diameter................ Depth_.--._..._..__.. x Disposal Trench—No. .................... Width.................... Total Length..................... Total leaching area-___*1Td.....sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank`j J"L / � �i� �� aPercolation Test Results Performed by._-.-•_-_.__ A�__n-........ .....x.'e...... Date.............. le _•- a Test 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........................ a ......................................................-...................................................................................................... 0 Description of Soil........................................................................................................................................................................ x 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 TITLZ 5 of the State Sanitary Code— The undersignedturther agrees not to place the system in operation until a fC rtifi a of liance has beAissby the bo d of ealth. Sie ...... ----- Date A lication A roved Bf `" " 'Date--•----------- PP PP :. ..... ......... Application Disapprov f the following reasons:.............................................................................................................. ....................•----•-----•-....--•---••••-•---•-•••---••-••--•--••-.............--••---•••••--•-•-•-•-•----•-----•---------•-••- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH ..........................................OF..................................................................................... %5rdif irat a of TontpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by = ---------- .- --- .,.�'' fI ................................. Z Installer ------- ------ ------------ has been installed in accorda with the provisions of TITLE 5 of The State Sanitary C a escribed in the application for Disposal Wor s Construction Permit ''^_. ' -------------------- dated / _ ---------------------------- THE ISSUANCF OF THIS CERTIFICATE SHALT. NOT BE CONST D A GUARANTEE THAT THE SYSTEM WIL F CTION SATISFACTORY. DATE._.. �t . ..0..---••--•---------------------•-••--------•-•.--•-.. Inspector-• •---•-•.•-• ............•---•-•-•--•-•------------•••--•-----•--•---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r 1 .................................OF..........--- ..._................................_....._........................... Disposal Works Tonotrnr#ion Trani# Permission-is hereby granted -------------------------------------------•---- ------................. .._. to Construct( ) of an Ind' 1dual Sewage Disposal System atNo................... ....... � �e - --------.....-----..........-•--.-------• Street as shown on the application for Disposal `Forks Construction Permit, o :................ ate _ . . ... .................... ............................ --- oard of Health DATE -----------------•---- FORM 1255 11011135 & WARREN, INC., PUBLISHERS ;� �� ;,._ � � _ '� �- �. �d r Y .. 1 �jl►JGLC FAMILY( - 3 BG0ROOM I zo I Wo 3 O • SCo ur D.oe, F.1_'n W .: 11 U X 3 = 3 3 0 6.P i? SEPTIG TANK = 330x15o`/- - -}95G.P• v it G•1 ..._ I. 1' 0t5Po3AL PIT v51= "96 S�D�H/ALL AQ.6L* - 1�j0 S,F J l 'GA2. ��T�;-•�`, :'-- l yo S.F. X 2.5 - 375 G.Pc? BOTTOM AVEA- 5� S.F- x 1• o - 5 o G.p�? , . . ioSr., 44 . ••'TOTA 1.- DESIGN = ,e{2 5 G•P. CD. �' �.eo� �f.✓ -TaTAI- TEA 1 L�{ F1-OW 330 6 Pp .cil!,a ale Q . PE2co�ATlo�l RATE : 1 1N 2MIN o2.LE5i �...._-. ... S - ..�,WILLIAM � 41 1 r N Y E 1,y 3 °1 � r'• 1 0 j S1GkA�E~ p- Io9Z `PEST FGY./9 op FND=q•9.o 6. 97 1 Lod%" 100C.) DUST. 1N $06 So6L `� 5£PT G 95 8 g Q IOoo 1NV• 6�7C qS.G -TANK GAL— 0 ' LEAcu �� ►1�R�u!a.. ._ . ._.. PIT - INV. INV. 95,z U•4 I SA#Jv W171714 r WAS14GD CER.TIFIGC> PLoT P>_AIJ i PRoF1Lr I 1..oCA•T IoN QSTER�/ tLLE WO SCALE SCALE ►u.• VRoPoSE� p t-At�.l REF:EcZEN G� I . � . 1 C•ERTIFY •TNAT TN� FOtlNDAT��N5N01�t�N . . ; NEREON GOMPI-`(5 WIT0714E SI'DEL1I C-- 1�or '�• I ' ) A P 51^T5AC- 2E,Qv1R.l=M�NY� of ,CN�- 7aWN o1= '$A,�NSTAt3�-�ArJD IS RIOT ?LLB N ZVI. ZI 1 •Pc�. t3 S Locp.TED 'WITNI►J TN6 FLoop Pw.IPJ �� N 14 DATE 5!11..,�2 ,� r C• BAxTE2� P•1`(E bN �Z.EG I SZ f�QEU'I,Au D 5 N Q.v EY�eS Tt�15 PLAN 15 NET 5A'76D p►d AN OSTE2VlLl J ��s• I 1w5-q•uMENT 'SuzVf=`( 4-TNc 6POUL;, > No'C 1�G VSE.DTb pET =�l�l�t✓ LpT LIt4p5 APPLlCA►-4-r �Eti1'RY. KAPoLC.HO