HomeMy WebLinkAbout0011 VERMEER COURT - Health t t v eeR-
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Lb C �T ON � SEWAGE PERMIT NO.
VILLAGE
I TkkLER'S N ME & ADDRESS
® U I L D E R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED 81r9 J;Z
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No....l3'5.....,5r FRis ...................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
� d`--.........OF.......................I/ 5../;y ......................
ApplirFation for Uhipaii ai 10orkii Tomitra.rtion thrmit
Application is hereby made for a Permit to Construct (. or Repair ( ) an Individual Sewage Disposal
System at: �// - - 1 �—
:.... .1�.1......---•--•----•............... `'�t2t ......------•----...-------•-D--a�S /- -
ocationor Lot.No.
Owner Address
Installer Ad
dType of Building Size Lot..... _ _�: ..Sq. feet
aDwelling—No. of Bedrooms ...-•------- -------•---------Expansion Attic Garbage Grinder (/
p., Other—Type of Building ................................................. No. of persons............................ Showers ( ) — Cafeteria ( )
04 Other fixtures --------------- ---------------
W Design Flow.................5.�............gallons per person per day. Total daily flow.................lt_3.._0...___..._gallons
.
fx Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter-_-............. Dept
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 ( ) dAr
�-e-- w Date............
=
Percolation Test Res Its Performed by......................... ...� ...... , ..._._ _.._.
Test Pit No. 1.�S.�...minutes per inch Depth of Test Pit________ _____ ____ Depth to ground water......./
(s, Test Pit No. 2......'Y___...minutes per inch Depth of Test Pit...... _ eph to ground water------CA'Gj.)
------------------------•----• . CV • �_
Description of Soil " -------- --- f - - --- -
------------------------•-•-------•--•-•-----•-••-•-••-----------------�'- -----------------------------�1-r�-----52f_ -----
w .............. --�z----
x ------------------------------- --------- '-
c
U Nature of Repairs or Alterations—Answer when applicable______._....:..................................................................................
J
........................................................................................................................................................................................................
Agreement: i
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITI 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue by the board
Vof ;
�z hIgned� --------•--------- --
� � '_-.._--.---
-
APPlication Approved B - Date
rApplication Disapprove a following reasons:---•-••-------------------------•••---•----•-----•-------••••-----•----------------------------••.......--••---
...................••----------------•--•-••-----....----•--•------------------------........-------------••-•------------•-----------------•......-----------•--•-•--------•----------------••........_
Date
PermitNo......................................................... Issued........................................................
Date
04.
-A
x,
.._...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
, pphration for UiipnsFal Works Tomitratrtion Prratit
1-
Application is hereby made for a Permit to Construct ( ')or Repair ( ) an Individual Sewage Disposal
System at: r --7 -:n� z"fi 0_•
Location-Ad ess, or Lot No.
.� Owner Address....
W .................................................s> .......... :..t��*='Pr ...__.....__ ....
Installer �' Address
dType of Building Size Lot...... _:t.0 0 !.Sq. feet
Dwelling—No. of Bedrooms______________________ - Garbage Grinder (_____________________Expansion Attic) !lk-)
p-1 Other—Type of Building ____________________________ No. of persons-........................... Showers ( ) — Cafeteria ( )
0.1 Other fixtures -------------------------.....................................................-------- ---------------•-------•-- __----•---------------_-----
In
W Design Flow__________________�:_..�_._._.___..._gallons per person per day. Total daily flow..____._.____._._'_.r-'_. _________._gallons.
WSeptic Tank—Liquid capacity............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
Percolation Test Results Performed bY.........................� ._._.___fJ..___t.__�...:.. <. Date.............:...............�/......... -
Test Pit No. __.minutes per inch Depth of Test Pit________/____'-2... Depth eto ground water_-_____ �"._,Gr r•-r'--
f=, Test Pit No. 2........kY____minutes per inch Depth of Test Pit.____.t._ ,. -...Depth to ground
water______
•---------------------------• ..-•_.....-_.._---•-•-••--•---
Descriptionof Soil �----...-••--------- -•- ---•---`............s..........................................
U ............................._________________________________________................................................. ___.......................... :'r, ___�`_�...._..... __________ _.______..._. _____
a• P C mot_
..........
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
operation,until a Certificate of Compliance has been issued.by the board of iealth.
Igned_ • •.y
------------
✓, � to
Application Approved By.... •• 4==='=---------------------------------•----..._...._........._....---•-- -----?f--'----------- �'�----------
Date
Application Disapprove for lie following reasons----------------•-•--•---------•----------------------------------_--............................................
..-••--•-----••-••---•••-...••-••-•-•••---•--•-••---••-•••-•••---•-••-••--------•--•-•---•--••-••••••••--••••••••---•--••--••---•-•-------•-••-••-•-•---•--------•-------------•----••••...............
Date
PermitNo......................................................... Issued...................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
05rrtifirFatr of Toutphaurr
THIS IS TO CERTIFY,. That the Individual Sewage Disposal System constructed (r ) or Repaired ( )
by------------------------------------------- ~ '--" ..._�_._.... 1),�'".�_-'- �_! '!`&..............................................................
..___._. ._._
>� Installer
at-----------------------------------------------------"`--'? j =•--• - - = •••- �
has been installed in accordance with the provisions of T�'L ro The State Sanitary Cad as escribed in the
application for Disposal 1Vorks Construction Permit No._t7___.........
_.._.__._. date( .... ._ ...... ....................
THE ISSU o#ACYOF THIS CERTIFICATE SHALL NOT BE CONSTRUED A GUARANTEE THAT THE
SYSTEM �F TION SATISFACTORY.
DATEL...... ................................................ Inspector_------'"- ---------------------•-----.....__......-••-•--••••-------••........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
1 /...%''`• ..- '..O F...........................7'`..4 'd- �!>.-...�....... ` �o
........................... 7
......................
No. .................. FEE.____--__..-------___..
�i���a��a1 �rk� ���t�trttrtuaat �er�tit
Permission is, hereby granted '"*''-?, _-� "_. .. =---`-- ..- ........................................
to Construct (/j or Repair ( ) an Individual Sewage Disposal System
at No.. :_.._..-?`?...__..�l: ;-4 ---- � :3 =?-------•------� ~ ............
i sStze`et .�
as shown on/theaplicatio for Disposal Works Construction Permit No.-_--_-- .� �`_._ Da p--'----�-__�_________-•--.
. . -----------•---...-----•.............•---••--Board of Health
DATE---- --••-••-•--•--•-•--._.._..-•--.._......_._._..__.........
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
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LEGEND OF, CERTIFIED PLOT PLAN
EXISTING SPOT ELEVATION Ox0 �.
EXISTING CONTOUR. --,-:(! ---- . p��• . A09ERT:,yGN L0T 'L '�'Z/y'C%'/??:
FINISHED SPOT . ELEVATION (Q�t �`
a�ucE ., S I C I�' V l �,
FINISHED C 0 N TO U R 0 � _t` ELOREo
IN
' APPROVED-- 130ARD OF `HEALTH �ASINS tAaLgol
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DATE. . AGENT, : 4 SCALEt /" 40 DATE , 5,/31/6'3
LU'f �'DGE 1VGINEERINe_ca lM I CERTIFY THAT THE PROPOSED
.�.._ _ _.. CLIENTS
EGISTE REGISTERED' :2�.- �' BUILDING SHOWN ' ON THIS PLAN
J08 NO:.
CIVIL LAND .. CONFORMS TO THE . ZONING LAWNS
ENGI IEEf"t [SURVEYORDR.BY� OF BARNSTABLE , 'ACAS
712. MAI N STREET .- CH. By' �j �
H YA N N I S,. M A S S.: �`
SHEET_.L.OF::, .�.. DATE. REG. LAND SURVEYOR
it
20 A7. MI/N. IYO?"E /F.E/TNG•R APT/C 7-AMAC OR
._.E�4CN/NG PIT ARE /✓JOKE Th9:'/ /2"BEtOry •
/O /•7 W/N. $,RA GEi 7 CONC.R I TE CGS NEA'
_ SNALL BE BROUGHT TO GRADE. !.-+,v EXT.4.4
GGIVCRCET i 4 oVC /PL t/EAVy CRST /ROA' CORER GL 3E USED ''
M/N- P/TGN
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/4 .Prm fr. SEPTIC TANK , , , . . • , •
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35 3. FT, . -�--
INLET .SEPTIC TANK - C�SE �✓�
OtI740r SEPTIC TANK AFT
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/NLFT D/STR/Bl/T/ON BOX AFT, GR�uNO BITER T,46LE
Ot/TLtQ'TDJsrmla T/OJN mx I`Y T.- F y K,SEGT/ON OF
/1111 ET Lg aCH/�11G P'/T ✓`�ffWAG E L�ISPWA 1. SY.S r.6M `
L ZAC�!/NG �/T n TABUL.�TION
JCALE : �4• . D/MENS/oA, A'
DES/GK CRITERIA DiflExs/a N >$
NUMOEP OF BEDROOMS 3
GAat6AGE o/sPos.�L t/N/r nror✓� ,SO//- LOG
3 3 SOIL `TEST
TOTAL Esr/lVs4'TEv FLOry G. i..IA4V SO/L .TEST A/ SOIL:MST02 l
I' NUM8ER OF 4rACXllV4 P/73 r f^e4&b 2-9•n �•.Ozipr .DATE OF SOIL TEST
S/DE 4XACHJNG PER P/T .fYt fT. 0 ;�- ' ' - RESULTS iV/TNESSED BY `JIZE•✓'`r D 3 1
90TT0/N LrWACI!//VG PER P/T Z6 of h M PERCOLAT/O/1/ RATS I Z-�Ss M!A/�lNIX
TOTAL LEACH//VG ARE�O SQ FT. �_ -�ns o r t AERCO&AT/0N/VA:rF T MI /.lINCIk�
aEsERvEZE4CNl Vd AREA SQ. FT. Z
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1� l kD SUR� 9oFsSONA� \�` �L V ! c 7/2 "AG Ec �iei -yYgNN/S. ASS"
Co No GROUND LYi4TER ENCDuwTER..o CL/ENT:
Q GRO UVO WATER AT EGL.
_ ✓09 NO: �2'� SHEET?GP 'zc..