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Home My WebLink About0156 OLDHAM ROAD - Health/ -- � � _ Sao - ia�' i I �I i �I 1 ®� SMEA6 KEEPING YOU ORGANIZED No.10334 2-153L MADE IN USA GET ORGANIZED AT SMEAD.COM t THE COMMONWEALTH.OF MASSACHUSETTS BOAR® OF HEALTH .............OF...RAI��.s..1....!Ct�J..-� .._-'......................... I Appl r a#ion f nr'Dispos al Works Tonstrudion ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at, , t •�' Location•Address -- •. or........................................................ t-No. s.. :err1j=5kfr �-_j h .��as�:.Z513.��4 j,.9 . „�— Owner ress a ...... . .. ... ... ...... t 1 fG�&[st er Address tt Type of Building Size Lot.... feet U Dwelling—No. of Bedrooms.___._ ..............Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ��.._...... No. of persons a Other—Type g ................: p . Showers (� — Cafeteria ( ) dOther fixtures ----------------------------•--•---•-•--------------._.......-•-----•----------------•-------------------------•--------------:....---•--•---•-------. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'ca.pacity............gallons Length---------------- Width................ Diameter................. Depth................ x Disposal Trench—No..................... Width.............._..... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) _._ _a Percolation Test Results Performed by...-- 6t _ __ .1��. ------------ Date....... a Test Pit No. LA...Z....minutes per inch epth of Test Pit.................... Depth to-ground water........................ 44 Test Pit No. 2:5-r..�-...minutes per inch Depth of Test Pit.................... Depth to ground water........................ t------------------- -- ----------------•............................. ------....-......................................................... � --- .Description of Soil-c �--- A ...... ----..... .. -------------------------------------------------------------------------------------------------------------------------------- -•---•-------------------------------------•-----------•-----------------•-------------...-----------------•-----------------------•-----------••-----------------....--------------------------••••---- 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 TI'L LE 5 of the State Sanitary Code—The undersi ned further agrees not to place the system in operation until a Certificate of Compliance has n ' ued by t bo ealth. Sign •. . ----- ---- .............. .•-----------•----------------- • Application Approved By......... .... ! ...µ....................... Date�`` j � Date Application Disapproved for the following reasons:.............................................................................................................. _ h ------------------------------------------------*---------------------------------*----------- ----------.---------------------------------------- -------------------------------------------------------------------- ---------- Date i PermitNo......................................................... Issued....................................................... ill Date .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .--------.OF... C............................ Appliration for Disposal Works Tonstrurtion Vamit Application is hereby made.for a Permit to Construct (4 or Repair an Individual Sewage Disposal V System at* 41&....... CA I' , f ----------- T7............ ------- Location-Address or Lat N OOV W O b caner t e e f .. .o.af- W ..................... Snsiaailer Address i tl� Type of Building Size Lot__:Art-0.00-Sq. feet U Dwelling—No. of Bedrooms____ ..................................Expansio Attic Garbage Grinder PL4 Other—Type of Building ......... No. of persons....... ............. Showers (4?.o) Cafeteria Other fixtures ............... ................... ................I..................................................................................... Design Flow...........................................gallons per person per day. .-Total daily flow......I ._.__..._____._..___:___________gallons. gallons Length................ Width..�.............. Diameter............ Depth................ 1:4 Septic Tank—Liquid capacity....... Disposal Trench—No. .................... Width.._ Total Length total leaching area ft. �4 b a .ng .......... ........... Seepage Pit No..................... Diameter._.._____ ....:_,Depth below inlet........ .'....'Total,,1eaehingarea.: sq. ft. Z Other Distribution box Dosing tank Q 0-4 Percolation Test ResuLts Performed by.-:=.../V# 4_(,&44------_---- Date.......7 14 Test Pit No. 1. .Z___.minutes per inch Depth of Test,Pit.................... Depth to ground water_______________________. (i, Test Pit No. 246'-..-.4—....minutes per inch Depth of Test Pit..................... Depth to ground water...________------------ .....p................. -------*----------- ......... ........ ......."P I Of Soil.Q:7 ............I......-------------------................Y7....... K .. ... .. .. . .. 0 D -1-7------ .....e......v----_----------------- ........................................................................................................................... ...............................................................--------..................................... .............................................. ------------I.................. 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 T I T 111 5 of the State Sanitary Code— The dearsined further agrees not to place the system in 'c'un 0 0 r operation until a Certificate of Compliance has b6en ed by the-b r, ealth. ign .. ...... ................ ......... -4.. .......................... ............................... 2 Dat,;gd Application Approved By......... ........................... ... ............ ............ Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued.................................... ................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... ...:......OF............. !.... ............................................. �Q, Qpwrtifiratr of Tompliattre 41 TO, CE IFY Th4, the individual Sewage Disposal System—constructed (4ror Repaired .................................................. . ................ ..........by....... -- --- ------- _,4 ..... .......... In %_ at__........ . ..... . ....... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Co cribed in the -de as des 7 2?_ application for Disposal Works Construction Permit No_—_Z.&_ -------------------- dated---- -------------------At ------_-- THE .'ISSUANCE 00 THIS�CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.....__... !.�5 Inspector.. ............. In ............................................. THE COMMONWEALTH OF-MASSACHUSETTS BOARD OFZjHEA4TH ........ . ....OF............. ...... ........ ................................... N......... FEE...10............ i lip 0 0 e trudion rrutit l— Permission hereby granted -•-• n�.......�_,. ........�A�?Zlne 2�17 hereby1Z..................... ................ 0 0 to Cons w_� Ir Rep it n Individual Smagg Disposal Sy No.. &- ------------- Street -------- ............................ • as shown on the application for Disposal Works Construction P&rAeX0.__.. ---aated.....77?�:_ �......... ................. Board of Health DATE............... --------- ...................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS LOCATION SEWAGE PERMIT NO. -37,C V1LLAGE INSTA LLER'S NAIVE & ADDRESS 0 U I'L D E R OR OWNER .DA T E P E 9 M I T ISSU E D DATE COMPLIANCE ISSUED r `G�� / `�� . d� '`�\ '`� .* ��,� � �, os'' �. F f �. 4 } E X.P/•NSy' /0 er b Pr T M ,• r iaK ' Q O M s r/C + /K N i — N m Rys y I. r fig; 3 i"TF.•4 t � _ Y d {y 0 #�I I y. ..IV k.: P q �� i ` � _ i e •,y 3 § l �f'r., Alp • s '. ) / 1,� -r � ;I~ � .T ��. � ��'° . ``��CN M� ,� `4 R08ERi . g • i'.tip P , ` ' - U' BV NIIti1�M4 ♦ 14t: No.221�t s, ONA LEGEND -ErXi:ST1NG SPOT ELEVATION 0,C CERTI I - , L QT�l} >, Ef'$T1MG CONTOUR — :. = 0 L a T =' t49 L'f 0l99 ,r t INls*'l [Z S.PO,T, ELEVAT.IO:N h0 ( ` CONTOUR - . 0 -. DsTE� t/fL..L,� � = r� OVE® i BOARD OF HEALTH a s , if A►` $. AGENT S+CA( E �. REOGE ENGIN£EPING CO INC C y L I E N? �Nv; %z. a + ... �:.:. .._. f - I CERTIFY THAT THE lt0. P . s o . EREd� REGISTERED) ,JOB NO. 8005/ BUILDING SHOWN ON 2s CIIIL LAND A ,» CONFORMS TO THE ZONIt � ' , DR. BY BfNEER4 SURVEYORS — OF BARNST BLE ,, MAS w . 1 43i C'�.N9AIN ST 712 MAIN ST CH BY _n_R ._._._ //�G p �� • . �'ARM.Ot,T'H, MASS. HYANNIS, MAC : ? F •SHEET__/. OF _ DATE- REG. LA40 8. ,. �.. � 'sad ::P:,; .;,9 .::. ,.a .; w ., •.f ,-,..q r .4 .., - - 3aeF ..fez.: y ,...» d � ' /Y D'7"E �:/�' E'/'i�"N�',�':7,'I�✓,E.SEi�T/'C T.4� ,10, rt:ga F(,,, �. LeACH/NCi PIT ARE /�'IORE THA ;V 1Z"BEi0JN MALL ®.F 7. 7"p GR.4 NC.t' :TF. COMER E AN EXTi�'A CONC !'TE H, . •. . - E�, f o ,-Cov�Rs . t'.4 V y CAS 7- /R'�O/Y G o!/CaFt :SheA L L l3E CJ S EO ., e.•. {�B' f�Fri�FT�;` F:/N .bR/VEJVA y':'' F' C O 1✓ER A ADO N D i CLEAN S &AC. 4=/L L F;js `a LAYER IRON P/PE" U. o' c o OF 11B,—.y " a� IN.O/TCN GAL. 1 • a •. e • s e'a o o P--m FT. SEPT1C TANK D/sT, o�h 1 , . • • ..,;, � .; 4 YYASHFD. STYJNE Pox v.P D . I I oEFfECT/VE ' ° � 3�4•,_. / �2., ' o ° � 1 •'O�PTN ° ° ° °�� o ' - ' '1•t%4SNED STO.t!E . • _�.,. - . . .1 1.•: • • 0 • e /;a -O o - • < .„. _ e v 4 c e • el;. e ; • o • e'e ~ p o P t�--- PREG45 T 5' .EPAGE I MVCIT7 eCEVATIONS . • v ► o eee • • • e �'' e ' ®; o P/7OR EQU/V. f/NYERT AT BUILDING �! c FT. ( FT PlAm r. I _ — --� hNL ET SEPT/C T.4 NK C� FT, _ . FT` O/AM "' C(SEE rKaZll-47 oiv�� '�UTLE_T SEPTIC TANK c 6-3 FT. _ INLET D/ST,R/49UZ/oN BOX 9 `'' FT` HC7ION GROUND' M/,ATER TABLE ' Oc/TLETD/STR/B[/TiON,BOX y.S;9 FT. INLET LEACH/NG /�/T �S�FT SEl�1/i4G� ".l3IS/QOaSA L. SSYSTEM: 'Y 1.EACfH11V P/T BULATION DES/G/Y CR7TER/R. SCALE : %¢;. � /'-o" �;, v/MENs/oN A � AT O/IENS/ON 8 G FT. NUMBER OF BEDROOMS 3 DIrwIENS/ON C_ >=T.�'"is/• GAROAGEP/SPOSAL UN>T SDI L_ LOG 't TaTAL E3T/M.4TED FLOH/ 3 3 2 GAL. DAY SOlL TEST edtl' SOIL TEST2 SOIL TEST NUMBER Oow .:.EACNlN4 P/TS_... �' / �FL--t 6 .a r .0A OF�SO/L '.TEST :. S/DE L.CACH7NG PER,P/T . � ,S FT.. ' t I Q U 3 RESULTS_h//TNESSED BY R P B c)Al:! (< T 60TTOM 4ArW4CH/NG PER ,tT L O A ; 1L TOTAL LEACH//VG AREA �' Sv�� 5 0`�4 fCOLAT/ON:RATE#/ L G S S M/NeILNCH SQ,: FT. "',e AWNCo4A7-/ON RATE1l�2 RESERVE LEACHING AeQEA . 2. b SQ.' FT. .r u 0:5T %A/v,7� P. MEN%��'J u E�UNfKIS ti I L.e MT yo.22162 EL®REPASE ENG /MMR/NG C /NG. + �sS'ONALE "33NO.MA/NST. pawl B �a r I1rO a7�BUNp. °te�:� t�NTE tr HYA .7,, s,0 VA vmm,77I,A"Xv. i4• LE`'Y': j400 2 Z1 .7 f