HomeMy WebLinkAbout0319 TANGLEWOOD DRIVE - Health 319 TanglewOd Drive �
Osterville
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LOCATION SEWAGE PERMIT NO.
VILLAGE
I N S T A LLER'S NAME i ADDRESS f
d GUILDER OR OWNER
DATE PERMIT ISSUEDA Ir:c
DATE COMPLIANCE ISSUED 57— 2 175
9
JO
No FEB
THE'COMMONWEALTH OF MASSACHUSETTS
BOARD OF - HEALTH
...................OF.....OA4MBLS...------.-------------:................----------
Appliration for Disposal I'Varks Tonstrudion rrrmft
Application is hereby made fora-Permit to Construct -or Repair an Individual Sewage Disposal
Syibm at:
2-.o A
u............. ....U............................................................
Lot Lwk�pn Address
....................................................................... ........... .............. ..........
'I
0 ddress
.......... ...................I..... ...... ..
Installer Address
Type of Building 3 Size Lot__15.99....... ....Sq. feet
U Bedrooms...........................................:Expansion
Dwelling—No. of Bedr ,Attic Garbage Grinder
Other—Type of Building .........................I--- No. of persons....;------------------------ Showers Cafeteria
P4Other fixtures ....:................................................... ------------ ........................................................
..........................gallons per-person per day. Total daily flow........ -1-0........................gallons.
Design Flow..........
0
Septic Tank—Liq'uid'capacityj.00b..gallons Length:.&.. 16'b.. Width...4.20.• Diameter................ Depth_5.�_-.-,L...
Disposal Trench—No..................... Width.................... Total Length................... Total leaching area................:...sq. ft.
Seipage Pit,No.......I--------�_.. Diameter'.7J.0......... Depth below,
inlet......6.!........ Total leaching area2-42Z).-sq. ft.
Other Distribution box Dosing tank
Percolation Test Results Performed by.....Z_ .:....... ;./& .............; Date.... ........
Test Pit No. I...15n7r-....minutes per inch Depth of Test-Pit.../Z........_. Depth to ground water.7.-44.,.........
Test Pit No. 2....47......minutes per inch , Depth of Test Pit 4.'.......: Depth to ground water7.....J.Z........
....................................................................................... ..................................................................
0 Description of Soil......4_1.......Q::3L........76f.4..506SDI-�M........ ....s..�0.ZA .. ...,. . ......
............... ...... ......................
-------------
----------- .........................................
..............................................................................................*----------------:-----------
U Nature of Repairs or Alterations—Answer when applicable ------------
....................�j..........X..........PW.M40.............................
...........................................................................................................................................................................--------------
Agreement:
The undersigned agrees to install the aforedes'cribed--Individual Sewage Disposal System in accordance with
the provisions of TITLE LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
sued 6 5b rd of health.
operation until a Certificate of Compliance ha*beesu
Y,
`Td UAJ C()-,-.-�
gned..... . ........ ...... ...............................................
... .. ........ .. ........ ..
-L 4e
Applicatio) Approved By...... . ............ ............ . .............................. ----------- ----- ---------------
Date
Application Disapproved for the following'reasons-..............................................................................................................-
........................................................................................................................................................................................................
Date
Permit No............Q.Jie...... ....................... Issued.......... ............
Date
���`�- ''"';�":J'"�` -F.
%
THE COMMONWEALTH OF MASSACHUSETTS W --
BOARD OF HEALTH w '�
vlJ.ti f A2AJSrA6L_C
----.....OF............ -- _
- Appl ration for 11isnns�tl larks Tonstrur#iun rrmi a x
Application is'hereby made for a Permit to Construct (y) or Repair ( ) an Individual Sewage Disposal
System at
--- -...
L ation- dress or Lot,No
A�ht sine S
/.........
.._. ...� .t.tl.,..........:
Owner r ddress
:._ .•.
Installer Address
Type of Building - Size Lot....S.vU.f v Sq. feet
Dwelling—No. of Bedrooms._.: ................Expansion Attic ( ) Garbage Grinder
a -
p,. Other—Type of Building ....... ......... ....... No. of persons............................ Showers ( ) - Cafeteria ( )
Other fixtures .. ......_-•--•-
---•
W ;.Design Flow..........OfU......................._-_:gallons per person per day. Total daily flow....: 3:1(2............... .......gallons.
WSeptic Tank—Liquid capacity .00. _.gallons Length..f..',�''.. Width. Diameter...: ..I....... Depth 5, �:
x Disposal Trench No ..................... Width ........... Total Length....... ...........Total leaching area.: .....sq. ft.
Seepage,,Pit,,No.......j.. ......... Diameter :._.0 Depth below inlet......4........... Total leaching area_ O._ZLsq. ft.
` Z Other Distr lution box ( yJ5 Dosing tank ( )
'-' Percolation Test Results Performed by.-... J ...... l......_ .... ..._. Date
aTest Pit No. 1...LZ....minutes'per inch Depth of Test Pit /4........... Depth to ground water ?..14
Test Pit No. 2...e<Z.....minutes per inch Depth of Test Pit....:Z.I......... Depth to ground water'?_.....t.Z...........
R+' ---•-----•...................................... .........................................................
0 Description of Soil_:: ! �),. ...... _t.te±`' =-...... rL . .... =1 4�L.:: /�'�: ....................
x
------.A.Z....L�= -1 'ie Cep...�i+� -------------- �1..:_...Lt:�.. ...fl:. ��!1JL......---------
W --•-••-•••••......•..... ----------------- •-----. ...-----.. ...
r x
U Nature of Repairs or Alterations—Answer when applicable....................jJ...0.....................r .....................
-----•......----•-• ...................••-•_:...;--------------------------.............---...---•--.._..---•••......••....._... ...........----••......•• ------..............----••
Agreement
. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLL 5 of the'�.State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha bee�n(sued)�h bard of health.
�' ned� / �,,t�,o., ------_.... •-•--_•... ........... .... -
APplicatio APProved BY_T.x `, Jam''---...".lJ... ... f-------��.+.---
�# Date
.�Avvlica.tion Disapproved for the.following reasons:-----•----------------------------------------•------------------------- ....................................
...... ................•---- •. •-•-•---•-----... •-•-........-••----••- ..... ..................•••••. ............•••••.........- . .............
Date
Permit No.._----- ( .... Issued........... .- ! �`l,e ...................-
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....:.........:.............OF....................................................................................
1 .
(Infifirate of Toutphatta
4ins
T C TIFY, That e Individual Sewage Disposal. System" constructed ,(.�) or Repaired ( )
by .--••-• c .::: : ....
has bed in accordance with the provisions of TITLE 5 of The State Sanitary Code,as,described in the
application for Disposal Works Construction Permit No.: _s: _.f._ ............. dated,_ �. ,i '-----_.-.•-•----_-:----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY
DAT _...... ... Inspector-•--$......•.... ..... .... ... `._..... 3 '�� -
�
t �
THE COMMONWEALTH OF MASSACHUSETTS
BOARD', OF HEALTH
%G OF:.:.:..... .. E ?
No............. - F E.... •••.
�is�r�s nrk�. ��ans#rn�#Uan rrntt�
Permission is hereby granted-......_..T ..................... �............:�..
to Construct ( ) or Repair-( ) at Individual Sew age is osal S st 1 S
= -
_ _ _-- Dated
as shown on the application for Disposal Works Construction Perm• No�K'__._._JS��_ .<
Board of Health
DATE . :.......................
LOCATION
S E W A G E PE ItMIT Mt?
VILLAGE _
"i
INSYALLER'S NAME i ADDRESS
8UILDER OR OW' ER . f
a DATE PERMIT ISSUED, A
o �.
DATE COMPLIANCE ISSUED .57-, `� � - 95
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