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Home My WebLink About0072 NORTH BAY ROAD - Health 72 North Bay R4V,,� Osterville A 072-029 I _ _ Ass ivo• O C A T ION �� S E AGE PERMIT NO. U 9 VILLAGE f R i T IN TA LLER'S NAME A : ADDRESS I � t GUILDER OR OWNER J DATE PERMIT SUEDkd41 DATE COMPLIANCE ISSUED . &ZZ616 ? 'a c � M o r .I r � 3 s�AF' �q J� s ]3 e� No................_ _ Fss. ................. THE COMMONWEALTH OF MASSACHUSETTS ,�v P Q.ry Q L� -d BOAR® OF HEALTH wlJ ..............OF_ �� Ll�..........------------.....----- Appliration for UhipagFal Works Cnnnitrn.rtiun Famit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at.* (� I ................_ ...---_..�� - !Q y •-!l.....!aP•.....--••-•-- --•--•------•--------------.....••.L�' -- --•-•- �J--g .. ................................ Location-Address! fl or Lot No. ................... ----•---- -------� 5 �. +lT s31d1►xa�? 2001..Sae"-' . l `4 : -....---- Ow a ark/ Address Installer Address Type of Building y Size Lot................ .......Sq--feet— U Dwelling—No. of Bedrooms____.___.J_______________________________Expansion Attic ( ) Garbage Grinder (, ) 'k Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ------------------------------•-- ------ W Design Flow.................. � _.__ ............ per person per day. Total daily flow..........__.------:--------�- .gallons. WSeptic Tank—Liquid capacity.! .gallons Length................ Width._.__._.___.... Diameter__-_.........._. Depth...._._ ....... x Disposal Trench—No.....]............. Width...../Z........ Total Length.....�.�_._____.__..Total leaching area...... 4 sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ►/)7 Dosing tank ( ) '-' Percolation Test Results Performed byeA9T 0 -+1Y .....A._�j 14!6- ('g Date....!ZVl-S,l$Z .a Test Pit No. 1......2 ....minutes per inch Depth of Test Pit.......3....... Depth to ground water.......6.iok rzq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 .................---......................................................................................................................................... 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in opera 'on until a Certificate of Compliance has been issued by the board of health.' Uj etA Date Gf Application pprove ------------------- ~ ! ate Application Disapprong reasons---------------••----...---------------------- -----•----•-------......-----•-------------•-•------.......... .........................•-•-_---••• ..-•-------•----..........------_.... Date PermitNo......................................................... Issued-....................................................... -- --r Date No............... .. = ^. Fps., ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. !..................OF.... -� `.:. .. T `..-1 r . ApplirFa#ion for Vispos al Works Tonstrurtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: (`/t ..............................'_Y`.: T ..: �^`. I............... .............. ..................................................._......___................ :'i ( ....._._....__._................_.L. ._.._ _ .. fffff ..._........ e� Location-Address y p �o r,/Lot Nop.. 'tRrQl`L. 'Q.1:��l�l�Q1�. ......._ ._.�..................r_... a�l[X2.!. �\ 1+7:....U.�1 ...J_L�� . . ..� ��?".: ........ Owner Address w _ as Installer Address d I I.�r !�G UType of Building Size Lot____________________________S-q-feet" Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No. of ersons____________________________ Showers Other—Type g --------•------------------- P ( ) — Cafeteria ( ) P4Other fixtures ----------.---------------------------------•---------------•--•-----------•-•-------•---•--•--•----------•-----•-----------••--•------------------••- W Design Flow..................... ~`?..............gallons per person per day. Total daily flow.............................?'__3Q_gallons. 1:4 Septic Tank—Liquid'capacity__q�v_gallons Length................ Width--- ... Diameter................ Depth................ Disposal Trench—No......j............. Width-----_1_.�:__._.___ Total Length_.___�`' ______..Total leaching area____.__`(`:&sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ✓f Dosing tank ( ) 1 '"' Percolation Test Results Performed bye= ".. ,t..... ...._�::.._____� .......'[� ..1— I '/��` /�f'� a Date-----= ` •---.....�_.. Test Pit No. I_____:K--...minutes per inch Depth of Test Pit-------��.__.___ Depth'to ground water______G.' _... 44 Test Pit No. 2.........._.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ••--------------------------------••----•--•----••-•------------...-•-------------••--•••-•-•------•••---••-•......_..-----••--------•-•..................--- O Description of Soil-----•---•------------•--------------•-•-- --------•-----_-_-- ------ x W •--•-•••---•------------------------------------•-•-------••--•--...-•--•-•--rZ ..............................-......................................................................4.................... 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 of health. ed... ------------------------------------------- --Date -- .................................................... Application pproved __ _-�'� '_ for Date Application Disappro a/following reasons------------------•---•---------------------------------•----------------------••----------•-----....---•-•-•--•- ----------•-•--•-----••---••--. ----------•---•-•------------------•-•-------...--•---•-•--------••---..... Date PermitNo......................................................... Issued....................................................... - Date THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH ................ ...................OF........... :..:':.1' ......................................................... Trdifiratr of TompliFanrr T S CE a"f t�ie_ ividtfa .Sewage Disposalystep constructed ( �or Repaired ( ) ;=by-- _ g ..:.. has been installed in accordance with the provi • ns o T� 5 of The State Sanitary od�as � cribed in the application for Disposal Works Construction Pe it No._-______� _`___��.�__-__._.__ dated__�.. .r!_.____ _____ ____________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. = = Inspector........................................................................•-•-••...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF7HEALT J —w.. ......OF........................ ?............'....._-�_.....__...._..._._..._..._.... f� l% ._ FEE........................ Bi Is:P101 �1 k� %T!70 strnrq' n rrani# Permission is reby granted__._.. ________________ _ ____ ___________ �.__ to Construct C Re ip ( ) "didual! -ewaDist sal Syst atNo...._---•.�-•`. �j_u _ ......... _._............................__________________________________________________ Street as shown on the application for Disposal Wo s C nstruction Per _____________________ Dated.......................................... �j ,,// •----------•--------••--Board-of-. --•------•-•----------------•---_-__---_-__-- DATE_ / v? 7 tT /f Board of Health .............................................................. l FORM 1255 HOBBS & WARREN, INC., PUBLISHERS BAXTER & NYE, INC. Registered Land Surveyors 32 Wianno Avenue/ Osterville, Massachusetts 02655/ Tel*1617i 428-9431 WILLIAM C.NYE,R.L.S. -President RICHARD A.BAXTER,R.L.S.- Vice President l 0y!5,T-02- C4A UO-so2s e E-Ie--VAT10/JS �X ls1'�►J� SSPT-1c_ SYS7UVVl,S I-t..o w �►f=Ru sow G �4 �. o MEMBERS OF CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS A.tIERICA!V CO,VGHESS O.%'SUH4F)'I.VC A:\'N.1IAPPING MASSACHUSETTS ASSOCIATION OF LA.Vl)SURVEYORS ANn CIVIL ENGINEERS P. 12-AA3- ruy W4r, + Mt SG o lQ 4 4)AW ; [[ v i q, ►; � 9 - r Ilk j 4 U pr A : i. sArl� tti1 `��Cam • 14 -54 - t _-s _ �AL.L .." y✓ A S i�lv :sL�'?..ti T^ Z. 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