HomeMy WebLinkAbout0149 MILNE ROAD - Health 149 MILNE ROAD
_ _ Osterville
THE COMMONWEALTH OF MASSACHUSETTS
BQARD OF HEALTH
Application is hereby made for a Permit 914strqCt or Repair an Individual Sewage Disposal
System at: / 7
Owne Address
PC
------------------------------
Z Other Distribution box Dosing tank
........................X--------_--------------_ ...
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.
te
Application Disapproved for the following reasons:-----------------------------------------7........................................ ......................
-------------'--------'-----'----'-----------'--------'--'-----------'—'-----'--
Date
Pernub '--_
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1
No.. ....
THE COMMONWEALTH OF MASSACHUSETTS:
BOARD—OF HEALTH
_. -OF_..........................::.......
A s firtt i �t fir i u�tti ork� 'Cn t1i Ur i�� Pr
Application is hereby made for a Permit,to Construct ( ) or .Repair ( ) `,an' Individual Sewage Disposal
System at ,r
Location Address ` {t I y
f
f Owner Address
r
Ir sta er - „ Address
Type of Building Size Size Lot............................Sq. feet .
—{ Dwelling--No. of Bedrooms__ '__-__ -------------------------Expansion Attic ( ) Garbage Grinder ( )
p`-, Other=Type.of. Building p ( ) ( )--------------------•--.._.. No. of persons _______-- --_---_-_--- Showers — Cafeteria
a' Other.fixtures _-_ _-__.
W Design Flow_.... � _t. {._._.___.gallons'per person per day. Total daily flow...... _I'!_ " ............._-gallons. "
04 1 Sep tic Tank Liquid capacity'�� :_gallons Length________________ Width ._._ ---------- lliameter_____. Depth
W Disposal Trench—No_ _________________ Width-------------------- Total Length....:._...---------- Total leaching area--------------. .._sq. ft.
' x
Seepage Pit No., `.__ ! r''t�',Diameter.___ _: _ _____ Depth belowa inlet_._:_• Total leaching area....__________sq. ft;
z Other Distribution box ( ) Dosing tank
aPercolation Test Results Performed by - -----------_-------------------------- ------•-- Date_- --------------------------- -
Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water--------------------------
Test Pit No. 2----------------minutes per inch Depth of Pest Pit____________________ Depth to ground water-_._..._.__________. .
t_. O Description of Soil---- -- ---- ........................ .....................t<. �- p `
V -------------------------•----......------•------•-•--..._--•-•-•-•-------------•---------------•=-•---•--••-----••----------------•---•-••-•-------------------------------------------- -------------
----------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 been issued by the board,of health
St vied _27 td s/�JI
r ;:a . d �
Date
APPllcatton Approved BY - ! r '� g -- ---a- �. F` .y r t ate.
R
r.
i. .
Application Disapproved for the following reasons:.....................•-••--•--•--••--••• .........................................
.....................-----•----.....---•-••---••--------•-••--•-••••--
Date
PermitNo........................................................ Issued--- ------------------ .................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
a.... `^i.......'OF....... .�s ' w .�
Tpr#ifirca#p of Toutpiiaurr
S S TO C•E' TIFY That the Individual Sewage Disposal System cons ed ( or Repaired ( )
by -• ' ......... ' �i�sta�iC
-- -- . ------------------------ "
- ---------------- ----- ---- --------
at- ......l
has been installed in accordance with the provisions of :Article Xh,.of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No....__..._1_�-__/��_.__._...._. dated________________________________________________
THE ISSU NCE F THIS CERTIFICATE SHALL, NOT BE CONS UE® AS A GUARANTEE THAT THE
SYSTEM W L FU �T�ON ANTI FACTORY
ll
'DATE-- - ;Inspector . .
THE COMMONWEALTH OF MASSACHUSETTS
f BOARD O�� HEALTHY s.
r ....:.t... ......OF
�t� t�t�Fi rk� �i i �tG ti�Bt rrImif
Permission ts,h reby granted �--�1' - -r ..................
-----
to Consto-----ruct or Re i ( ) �{I d'- ',al Sewage`Dis,o. Sys em7,,� j ..........................,r
1 �
f)S et$ '^ l / t 7
as shown on the application for Disposal Works Construction Per it�No. t..� E. Dd�`_ / /
. 77
--- l
..•v �, Boar of Health
DATE.................../---------- ----- ------=------------•-------- r
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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CHARGES N. SAVERY INCORPORATED
712 MAIN ST. HYANNIS , MASS.
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PLAN ' OF LAND
IN
osTE;RVIL.LE. B AR. N ST AB LF... MASS.
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P F,T E,R, C R. O N }_N
SNOWING LOCATION OF EXCAVATION FOR, PROPOSED DWELLING
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SEE. PLAN R.F-COR.DED PL NX Boole- Z54 PAVE. 53
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