Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0321 WEST BAY ROAD - Health
321 West Bay'Road Ostervlle t VI J b' TOWN OF BARNSTABLE VOCATION SEWAGE # VILLAGE fj ?���( ASSESSOR'S MAP & LOT/Af- INSTALLER'S NAME PHONE NO. C-_-%AeC �t4wl�j� l SEPTIC TANK CAPACITY �/77� r LEACHING FACILITY:(type) 1:16LL) (size) NO. OF BEDROOMS PRIVATE WELL OR , BL CIBL CI WAT BUILDER OR OWNER isb DATE PERMIT ISSUED: ' -- 'r1` DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes NO j oil p � Q c Scrb • i�A� 't� t��Lr tI No....7Y FEs.....3...Q........ HE COMMONWEALTH OF MASSACHUSETTS AA BOARD OF HEALTH OWN OF BARNSTABLE Ap.plirFa#iun for Ditipu3Fal Morkii Tomitrur#tun ramit Application is hereby made for a Permit to Construct ( ) or Repair (N) an Individual Sewage Disposal System at: ......... 2� Cs ! ` ea 0r2.1l i tom, .................. ................. ..---•••-••-••----•-.....---•--•------••-•----••••-•.........._•-•------------•••......--....••-- ©x o�,c-l.._Coca ion-Addr�-2� CA�-�N G7 sA0_..,jvj )� t No.02®(O 2. •. -- ...... -•-• •-•-•....................•- Owner Add s ------.CAP.�:..1 INN—.0----------------------------------------•....--- ----....o... ���d- . ���� ----- 9 Installer Address c� (t _ UType of Building �Pe�QTw�Eta-1-5 Size Lot..o(Se-______________ q t Dwelling—No. of Bedrooms-------1?-_------------------------------Expansion Attic jlk(:� Garbage Grinder (P� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria Q' Other fixtures ------------------------------- -- d -------------------------------•---------•... ---------- W Design Flow......5s._._-_--__----__--_•-______-gallons per person per day. Total daily flow..._�32-0_________________________gallons. WSeptic Tank—Liquid capacitv.g _gallons Length................ Width--_-__-_-__-_-_ Diameter.-.-_._--.._-.._ Depth................ x Disposal Trench—No. .................... Width-----ZQ__-_-_._ Total Length.__9.�........ Total leaching area.-A.7.7_.__._sq. ft. Seepage Pit No---------_----------- Diameter------------:------- Depth below inlet___-.._______-_-.-__ Total leaching area..................sq. ft. Z Other Distribution box (Ye$ Dosing tank (>\d Percolation Test Results Performed by------ .. q_&-L am................';. Date....V!F-6._3.;..Nwe?..... Test Pit No. I... -z.-.____minutes per inch Depth of Test Pit------6----....... Depth to ground water..... A........... f14 Test Pit No. 2... Z_._....minutes per inch Depth of Test Pit__._,__ `____-__. Depth to ground water...... il......_... O Description of Soil------ �'- = .. Lo S o sso t t- 1.5 --e5 IM/ i4 i- x W ---- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------••-- UNature of Repairs or Alterations—Answer when applicable............................._._.__...................._................._...................__. --------•----------------------------------------------------------------------------------------------------------------------•----------------.............-----------•------......--.........._..--•- Agreement: s The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Com lia e issued b, the boa d of health. qq Signed ....- ------. � .G .. Dace ApplicationApproved By ----------------- - - ------ ----- - -----------------------------.::---------------------..:..----- ��`... .3.-..9..� Application Disapproved for the fo lowing reasons: . ................................. --- ..................................._.........------------------------------- ------------------ ----------- -------------- ------------------------ ------------- ---- --------------------------- ----------------......--------------------------- .............. =---------------------- Permit No. . Y Issued ce Date 7 0...F N FEB ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH J " TOWN OF BARNSTABLE Appliration for Ehinpmiat Works Towitrurtion lirrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ............................................R - ---------7----------•'......'-••. -------------------------------------------------------------------------------------------------- /, (_00Lo\ation-Addrqsj Z ICAA Tr _ 0 or Lot No. C\4j c? s- Owner kdd ------- .......... ................................................. ....... f __1'".r_!.A�M..t.!�:..L...... .........or" 73��' Installer "Address..... - CQ ji�'\e F . ..S ' Sit Type of Building 4, Z VAJ-r S Size Lot------G... ............. ef&e Dwelling— No. of Bedrooms-------!_�-............................_.Expansion Attic Garbage Grinder 1.4 Pk Other—Type of Building ---------------------------- No. of persons------------------------i--/_ Showers Cafeteria 114 Other fixtures ---------- ------------------------------------------------------------------------------------------------------------------------------------------- < c Design Flow...... �57..............................gallons per person per day. Total daily flow....). --------------------_--g-allons. W ....... 04 Septic Tank—Liquid capaicity.2'? gallons Length---------------- Width.....----------- Diameter--.............. Depth........_....... Disposal Trench—No. .................... Width.._.ZtQ-------- Total Length.... .. ........ Total leaching areal.(.Z.-......sq. f t. Seepage Pit No--------------------- Diameter....--.:-........... Depth below inlet.._..._.._.......... Total leaching area..................sq. f t. Z Other Distribution box NO Dosing tank c)�Percolation Test Results Performed by-----Gj�---M,-ZA..KAq.F_-__A.yJC.................... Date--- ...\ 04 Test Pit No. I...4�:� minutes per inch Depth of Test Pit-_----;5_r......... Depth to ground water..--� ........... 1-� 44 Test Pit No. 2...49:-------minutes per inch Depth of Test Pit-------i$.......... Depth to ground water......4,_[........... P4 .............................................................................................................................................................. o Description of Soil------. .....Lc-'k.'"..A S 0 ........... ... ............................................. . ..... .. . ................................... ----------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------*-----------*------**---- ............................................................................ -------------------------I................................................................................................. U Nature of Repairs or Alterations—Answer when applicable----------- ......... ..................................................................... • ...............................................................................................................................................................I........................................ Agreement: _ ,..—3 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Codez. The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beegl,issiTed by the boar]of health. Signed --------- - -- -------------- 11_".:------- - ---- ---------- ---------------------------- Dwe ApplicationApproved By .................. .� ------------------------------------------------------------------ ---- f9..........':�....... ce Application Disapproved for the 0 owing reasons: -------------------------__4-------------------------------------------------------------------------------------------------------- ------------------ D ------------- ----------- ---------------- --------------------------------------------- ----------*--- ----------------*---------------------- m Permit ........... /.................. Issued ------------------------Dui,............................... ----- -—————————————---------——————————————————— —————————— ——————————---— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF'HEALTH. TOWN OF BARNSTABLE 01'ertifirate of Compliance THIS IS TO CERTIFY, That the. Individual Sewage Disposal System constructed or Repaired by ..................................r. ---------:---------------------------------------------------- ----------------------------------------------------------------------------------------------------- Instal ler a t ... - -------& ---- ....... c..................................................................... ------------------- D----------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No- ------- dated .................... --------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- InspectorCl: ............... ------- ........................................ --- -V ------------------------- ------------------------ ----------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE -. .... Mipm at Works Tongtrurtion ramit Permission is hereby granted............. . .................. ......................................................... or Repair an It '�Vjge Disposal System tic) Construct ( i��ivi'duall' Sew at No. .............................. ......................... --------- --------------------------------------- Street as shown on the application for Disposal Works Construction Permit No_t?�Ul__ Dated......... .................................K.r............................................................. (i Board of Health DATE....................._i..........................�[........................ FORM 38808 HOBBS&WARREN.INC.,PUBLISHERS BAXTER & . 9 INC. Professional Land Surveyors and Civil Engineers 812 Main Street •Osterville, Massachusetts 02655 Tel. (508) 428-9131 FAX(508) 428-3750 WILLIAM C.NYE, P.L.S. President PETER SULLIVAN,P.E.-Vice President-Engineering RICHARD A. BAXTER, P.L.S.-Vice President June 2 , 1994 Board of Health Town of Barnstable 367 Main Street Hyannis , Ma 02655 Re: Septic System Repair - 321 West Bay ' Road , Osterville Dear Board : I As per the terms of your per mit _Baxter & Nye has provided ongoing inspection of the sep.tic , system repair at 321 West Bay Road . Based : can this inspection we certify .that to this point the system has• been installed inaccordance with the plan of record with respect to all •civil engineering requirements . As you know we can not certify .the electrical and plumbing aspects of this project.. If you have any questions please feel free to call . Very truly yours , r & N Inc ' eter Sullivan , P.V. P. Engineering cc : Oxbow Corp . - OF 41, 9 .° PETER : SULLIVAN No. 29733 AL MEMBERS OF CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS/AMERICAN CONGRESS ON SURVEYING AND MAPPING MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS Tit rV F ca 50 d� suw� vi M V° iL 00 C I I co 1.9 Qa �i a ;4- Ll + F T L)+ C � 40 m � P � s i J ,r U ,L0 T ICkN S,EWA� E PERMIT NA. dll GE a INST IIER' NAME i gADDRESS 0 U I I D E It R OWNER DATE PERMIT ISSUED �y DAT E COMPLIANCE ISSUED Y � i r .........11-rV V THE COMMONWEALTH.OF MASSACHUSETTS BOAR® OF HEALTHAIV .-- OF !�/�1/�........... ApplirFa#ion for UhiposFal Works Toustrnrtion Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal Sys�txm`at: - ......................................................... .. --.... ... . A�....16 .I�_... . . . .cati ddr or Lot No-- ----- .. ... .n�---- -------------------------- .........._•................................. - W r Address •---•--.--•-.- ........ ....................................•-- ••---•----••--•— alley Address Type of Building Size Lot............................Sq. feet U DwellingNo. of Bedrooms....................... ___._Ex Expansion Attic a — ________________ p ( ) Garbage Grinder ( ) a. Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ---------------------------------------•----•-•------- ---------•-_-•-•-••----- WDesign Flow............................................gallons per person per day. Total daily flow..............................._............gallons. j. . Septic Tank—Liquid capacity............gallons Length________________ Width................ Diameter................ Depth................ W 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 ( ) 1-4 Percolation Test Results Performed by........................................................................... Date...........,............................ a Test Pit No. 1................minutes..per inch Depth of Test Pit.................... Depth to ground water......................... (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ . 0 Description of Soil......................................................................................................................................................................... x W x ---•---------------------------------------•---------•--------------•------------------•-•----------•-----------------..------------------------------------..__.....-•-------------------------------- 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 iITLi:, 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. Signe ........ Application Approved By....... `7 Date Date Application Disapproved for the following reasons:-______•__ ..................................................................................................... Date PermitNo--------------------------------------------------------- Issued.....-._.:.f.......................................... _ !,a Date a� q � No.- ..._..��.... Fes$... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH LYL�1. ..............OF............ t'+ .................................................... ApplirFation for Bhip s a1 WarkS Tonstrnr#ion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( *) an Individual;Sewage Disposal System at: ...... ,.., ._. .. �C. . .................... -- --.........-----..... ....... ••Location.-Address .• or Lot No. Owner Address W .. � aller Address U TypeDwelling Building No. of Bed Size Lot___._ Sq. feet of a rooms____________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers (. ) — Cafeteria ( ) dOther fixtures --------•----------------------------------•---------------••-•-----------•--•--••••--------••--•... W Design Flow...................................._.......gallons per person per day. Total daily flow__________:_____________._____.__..._______.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.......................................................................... Date.........a , Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground,'water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground-water..._._.................. w �'y _________________________________________________________________________------- _................... ........................................................ _ Descriptionof Soil. .....---••--.......--•--------•---------------------------------------------•-------------------••......----••----•••--.._.. U ............................................................................................................................................................................0...._._...................._ 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 L I TE 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. . Signe .......................................... Date Application Approved'By------.- ..... =' `� --`---..._.. Date Application Disapproved for the following reasons:-----•------•---------•-----•-------------•---•---------------------------------•---------------•------......--• ..................................................................- -•------------•----------------------- -------------------•-------••--•--•----•-•-•-•-------•------•--•-••-----•-----....-•-- Date Permit No........ .. Issued_....................................................... Date THE'COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... � ✓��1.....O F..............: ...C'(, ! ......................................... (115rrtifiratr of Toutplitanrr THI VS3 TO IFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by.._•----• 1 ,...... .. ..................................•-- ----• ............................................................... j/'���A, Ins er r .has been installed in accordance with the provisions of T 5 of The State Sanitary Code as;-descri ed in the application for.Disposal.Works Construction Permit No.. ` -- r_................. dated_...: `__, "' THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM ILL FUNCTION SATISFACTORY. + DATE.. •--•...:.::.........•...... Ins pector.....:-.....------.... -----------------------•----- .......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �........OF........... .......�/j. ._• ......._......._._............_._.:..... ,�./..• FEE..'s ............... � irk �an�f�or�imrn rrmi� Permission is hereby grante -•-- . 1---------------------------------•-------....----.....--••....---.......I............... to Construct (. ) .or Repair ( : an Individual ewag�os Syst ` �f at No. -A--- � ,'� "� "---�•-./4'----._..... - Street as shown on the application for Disposal Works Construction Per No._____ .- ;ted__.__ ... .................... ,s DATE_ 7� v � Board of Health FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - 0CATION SEWAGE PERMIT NO. ZDQa, VILLAG " I . � s I , I H S T A LLER'S NAME 6 ADDRESS Soo' Z-6--e R U I L D E R OR WNER Ak DATE PERMIT ISSUED .� DAT E COMPLIANCE ISSUED 9 X f No.. - ....... Fss.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD O?f HEALTH d ..............OF....................................... ApptirFation for Bilipas al nrki Tnnitrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (L--�an Individual Sewage Disposal Systemat: '�_ _ ...-..---------------------- ------------•---------•-....._...._.......-- ------------........------............--•- L�cat' n•Address or Lot No. Owner Address................................ Install Address a, Type of BuildirV. Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building ............................ No. of persons.............---.---.------. Showers ( ) — Cafeteria ( ) Ga" Other fixtures --------------- --------------- . W *Design Flow............................................gallons per person per day. Total"-daily flow............................................gallons. 0< Septic Tank—Liquid"capacity------------gallons Length................ Width.......----.---. Diameter................ Depth................ W Disposal Trench—No. ..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No--------------------- Diameter.............--..--. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................=................................................. Date........................................ Test Pit No. 1-.--_---------minutes per inch Depth of Test Pit.................... Depth to ground water.---.................... Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................---- a -•••-•-•----------------------•-••••-•-•---•-------•-•..... O Description of Soil. =: .�....=.••.. . ------•--•-•••.... -••--•...---- -----•••• -------•.-•-------- --•--•-•--------- x e 1. U ----••------- -------------••-•--------------••-••--------•-----------••-•••--••-•-•--....-•-•••-•-------••- ...... ••.....-- •••---...- ....._... U Nature of Repairs or Alterations—Answer when applicable.-._---_-----41/-0------- --- ------ ---=--------c�. ..... - .... .............................................-........................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI1 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by/the board of health. .7................................. ........ Da e Application Approved By.. -•�Q... ............................ ' 6� Date Application Disapproved for the following reasons:---•---•------------•------•-----•----------------------------------------------------------------------------•- ---------------- ------------------- ----•-•-•---•-------------•---•---...--------....---------••.....••---•-•-•--•••---••---•--------•------- 1•• --�-----••-•-----•---••-••-................ Permit No......................................................... Issued--.-------.�_ ..--`-_��----•-.Dam...... Date i No................... Fizz............0................. THE COMMONWEALTH OF MASSACHUSETTS BOARD- 0 HEALTH --------------- ..................OF...... .... Appliration for Dhipwial Workii Tonstrurtion ramit Application is hereby made for a Permit to Construct- or Repair (1.&�h Individual Sewage Disposal System at C�s 0 ------- -------- ............................. .................................................................................................. ;;H ,a; .-Address or Lot No. Aa 1) VS Address ............................. .............Owner------------------------------------------- --------------------------------------------------------------------- ..........�_A*�........... :!�45 _4 ....... ��l .................................. .................................................................................................. Install t Address Type of Building,: Size Lot-------------..............Sq. feet Dwelling—l"No. of Bedrooms............................................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons___._____._______._.___.___. Showers Cafeteria Otherfixtures -----------------------------------------.............................................................................................................. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length________________ Width______-_.._.-_-- Diameter---------------- Depth____________.... Disposal Trench—No. .................... Width.................... Total Length_-____.._______.._._ Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter._______._-...__.... Depth below inlet______.______._._._. Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) 04 Percolation Test Results Performed by-.......................................................................... Date........................................ 0.4 Test Pit No. I_...............minutes per inch Depth of Test Pit..____________..____ Depth to ground water_._.__.____.___.__._.__. rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.__....__._._______- Depth to ground water.____.__.______..__.___. P4 .............................................................. ...*"*---------------"------------------------------------------------------------------ 0 Description of et... ...n 1..... . W C: .-4.4rjEZ........................................................................................... U .............................................................................. ............................. -C.... -71............................................................... ................. ............................................................................................ I -------------- U Nature of.Repairs or Alterations—Answer when applicable-______-- ` lzq;�.......... ............................................................................................................................. ---------- ------------------------------------- ------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I TIE 5 of the-State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued byl-he board of health. " .................... =__ .............................. ...... ign Application Approved By------- .... ... .. f 7 .......... Date Application Disapproved for the following reasons:................................................................................................................ .....................................................................................................................................................................................I................ ate PermitNo......................................................... Issued_..__..._.._..------------------------------------------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 77� OF...................... .. ............................t......................................... rtifiratr of Tompliaurr THC R�TO C� ARTIFY, That the Individual Sewage Disposal System constru&ed or Repaired (44 by C�-4w' 'c"0 ................................................ ....................................................................................;...................................... -stall_/5� ...........��/,...........Installer ----_--_ ................................................. has been installed in accordance w: ith the provisions of T(Tkv 5 of The State Sanitary C de as described in the application for Disposal Works Construction Permit No. ....... dated__ ---—--- .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FgNCTION SATISFACTORY. Y ,5 - DATE--------------------......—...1........7 ..................................... Inspector..... ....................................... /------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................................OF ...................................................... 0 N ......................... ........... Aim Vunfit -"Permission is hereby granted. = =0........A...................... .......... .................................................... o to Const!2ct ) or R a ewage DispV�t6n, Rep #,Y,'an Individ S 4 '2 at No. .. . ...A..........L.....i._. ............................ -- -------------------------------- ----------------- ------------------------ Street 7 as shown on the application for Disposal Works Construction -- ---.......................... ...... 42 / e . .- ..1W-4,e....................... DATE.....7 _�. ..Z Board of Health ...................................... FORM 1255 HOBES & WARREN. INC.. PUBLISHERS LOCATION ' SEWOC;E PERMIT UO. ILLp - - - - - - - - - ���u l( !h1 TILL ER•5 U&ME ADDRESS BUILDERS tJ &MF- ADDRESS DNTE PER"VT 155UED ' �-/�7Q TE COMPLI &MCE ISSUED 4 f S pa U aA- No`� (A�o Fua ......�--.---- .................. THE COMMONWEALTH OF-MASSACHUSETTS BOARD-OF HEALTH AVVIiratinn for Bigposal Works TouBtrnrtion Vrrutit Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 3:)-_ / Lu - I Z/ - ----------------------------------- .-- ................................................. --•••-•------•--------------.._..•------_--•---------•--••----•-•--•-•-•......•----- o n-Address or Lot No. G CC2/P .mac' l ------•-•--•-•- - '�" l--•---•---•----•- •-- a Owner Address •---•-•--•-------•.......................... --------------- ' � Instiller Address Q Type of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building --.__-__-_-_ p ( ) ( )_.________.____ No. of persons............................ Showers — Cafeteria Q' Other fixtures Q ---------------------------------------------------------------------------------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................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-------------------------------------------------------------------------- Date-------------------------------------... Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water..---_._._-__.._-----.-. �rq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-..-..-_____---_---.... ------------ - O Description of Soilo-O.O.-W--- 9-- --------�..`'`� ------------------------------------------------------- ------- ------ ----- ------------------- x ----------------------- --------------------------------------------------------------------------------------------------- ---------- U LN re of Repairs or Alt rations—Answer whe licable. �?c- /a ---•-----.-- --- _.... ----•------------------- .............. - •------•- -----------------------------•--•-•----------•--•------.-.-•----•------------•-•---------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b n issued by the board ealth. Si e . :-- ••........ �-�a��----_ ---•�.--- ------- at Application Approved BY .. �' --- --_- ------ Application Disapproved for the following reasons----- --------------------------------------------------------------------•--------------•-•---•----------------- .......--•......................•---------•-•••--••---------•-•-•---•......-•-------•--•-•---•-•---.........------------......._.....--•------------------:..------------......------......--------.•---- Date PermitNo.......................................................... Issued........................................................ Date r J No. .... Frees.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARDOF HEALTH ............................................................ Appliration -for Biq otittl Workii Tottistrurtion Prrutit Application is hereby`made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: nee --- `' +� L n-Addre� � � 7 or Lot No. .................................................... -—ViL--•-•--•--•-.................... )G/"''r W� a,a. _aWae AddressOwer Ins ller Address UType of Building Size Lot--.-__----------------_---Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Gal Other—Type of Building ---------------------------- No. of persons...__-__.--_------._.-___-._ Showers ( ) — Cafeteria ( ) QOther fixtures -•--•--------------------=------_----------------_-------------.---------------------.--•----------------------•- W Design Flow--------------------------------------------gallons per person per day. Total daily flow---------------------------------------.....gallons. iSeptic Tack—Liquid capacity-----.__--..gallons Length---------------- Width-__--......._.. Diameter.........-..---. Depth.--.------.-.... r ,. x Disposal Trench—No. .:------------------ Width--------------------- Total Length.................... Total leaching area--------------------sq.'ft. 3 Seepage Pit No-----------_-------- Diameter-_--_-_•_--___-_-- Depth below inlet.................... Total leaching area----.-_------_---sq. tt. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY-------------------------------------------------------------------------- .Date-----•------------•---------•--------- Test Pit No. 1________________minutes per inch Depth of "Pest Pit................•... Depth to ground water........................ 44 Test Pit No. Z......----------minutes per inch Depth of Test Pit..------______ : Depth to ground water----- �:::_-_-----..--. -_ O Description of Soil,=':, _ ...-- / -------------------------- ------ -- ................. x --------------------------------------------------------------------- UW ---------------------- ------------------------------------------------------------------------------------------ ------------- N re of P. psirs or Alt rations—Answer whe licable...� sue?+ ., , k;_--------------------- y - ------ --- -----------------------------------------------------------------------------------------------------•------------ 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 b n issued by the�boardhealth. Si e LEA!t ,e � �� 7 11 Application Approved BY /lat ate Application Disapproved for the following reasons: ------------ ------------------------ ----------------------------------------------------- --------------------------- Date PermitNo......................................................... Issued............................................. Date THE COMMONWEALTH OF'MASSACHUSETTS BOARD OF HEALTH ( n _ . .............. OF........... .''t'r`.. ...". , Tatif irate of 0.1,11mplianrr �IS,IS TO/CEERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (G. b Y ...... ----•--------------------------•................................................. at----- - --•--• • .- --- -•-------------•-•--•--•-•--••----•-----------------------•--•---•---•-------••----•------......---------•-•.........----•---••--- has bee'Q installed in accordance with the provisions of -AXIM XI o The State Sanitary ode as described in the application for Disposal Works Construction Permit'`No — � �.-_--G .....--•-•-- -------•-----•-•--- dated._r _�.. ._*'_ .. --•---•----- TiIE ISSUANCE OF THIS CERTIRCATE SHALL NOT BE CONSTRUE® AS GUAR A TEE THAT THE SYSTEM,,,WILL FUNCTION SATISFACTORY. DATE --1..13.-----?-�n------------------- --------------••-•---- Inspector..- - ... --- THE COMMONWEALTH OF MASSACHUSETTS BOAR - OF HEAL � � ` , •U No �... FEE..... ............... Bi1i:V , l or IT r�trti�tt rr tit Permissionis hereby grant —--------------`'Z:-- ------ ------------------•-----_............................................................... dito Consu ( r ep it (� ._ idual S Disposal System ,q Street as shown on'the application for Disposal Works Construction P t No. Dated_ ._:. -_.. ...' f --- -- --- DATE... /73- ••--••-•--------••-•--•---_.... oard of Health FORM 1255 HOB8S & WARREN. INC.. PUBLISHERS - F y r tir..'.w+w,,.n...www'.,tuvlrwra+�.Yx�1r.. 3e.ti,:.r1�nY.WO:Mw.p+.au�.,.;:.w,..-4•.��rW F. n..:rN..wuna.;:aw.ni..WN.aar...Ywa rcwe:we.W.lrtnr.M.roah,a,n:e.;waWl�x++^r•ewlumc.•nm' .a:rmneM'Mw*w+x+n I Y' �r",\ xi 6T1►V►Cx r�71 2.-r-.a�"""e v coP-A / ,?Aet-rm is.rLT"s PCaBf�"r -5 i JK,. Zis t''�'i;t7..PJdM APB{?'c' M E"`i"'S IN)1 O �A+'�►�'•�r�.. l�X'�t VJ,3%•'�",�"._ i 'I "a O LP .- •.�- _. _ __ �t'�i'1LI.NF"� I�C' i/a �, ,, K �,_� �i c,vc6 P'12ot:'kI e, �- // � C ���• ,► j + -ti3(�E► , I "`"""' --�� � �� � V "A�- ls+ t ' '�a T� �F" 0 i� - _ -TAM'- Et•A� '�'�5rrSCo 5 (es+x ) w Th't 2 hA i i W � �0' �� �_�`_ �\ ,"� Z'S�ti.:��, �Ju �:.r•.tG°=, t��. ��.�x �� F't�t•.•� t' ''�F��t..`t`ty� ��� 'pc�'c' k+'t I�tC EAt1 P '�7 g" ; '�►�j •.'�',.�, •F i a 1 t�`-r � �>�D�c�M �,� �T� -�M�-.�..._ � � '` 'L �. :x.ap � ;,,._,_ Q ( `�e �:.:� rr, •--� \1 P. ! 701� urs,r'taAt`.r ! c t-^ P. F_X e,T't < '; 1, k5s�st�.o :.5 At ti 1 G� 1�a"r' R -L'C�O_ LA,,spA - 13 (w�cLll,d) rANAMLr3t'+� ,- Z"s's...Z.C` ©(:�tG�c i.. !/t�o � \ \\ r.tc,r� bE-r t+�t t.. P:�Y.r_.+.s.,r !. I '7 ,(n ; � �, �... �ti•A�:1� C��• � '1:,,� 1�\J � c,'�'t C. ` P,ct.•,11� � � I.�l.,157 1 C±i ti�C.LA'\A.1 •`� :.,C:Y�.A.S 4..L #••»!t �.:. >D(:.A Z� �CCJO� C' �+ d 0 T"� A►-+O QL:NA+1"tE 0 •�-"'M.j4"NQ, 5 �N iE, Ta TaLS � Prr,MOF_16 0a-V A-tJ0 1"hLt_4t-''� W 1T"A } I d 4 I C> Mk1trG+hL- A �e ! L 5, Le�c�'r��Y»e of , 7�LrTr �ar,D Ev1sn�G. L.i�r�cewyMa r9��ctv6'. "� �Hc,wra t rrtti�a Pt, i-i A-Q. s>APSlr_a�errr,r" ;t_ ((3 o ca '; 5 � �6. --..,� _.__ -,_._. -.._ p ,, � 1 Gvr•,+�r•!?!.R c I^r�.+j"... •T'o Cc�,h-+F :?,,,,t L nc_n 'P,r,f•.,�.�. µ)1 Sl-1 d t Lw- s r1•��'� I°I'N b G- c� v,t.1T'i±'-(:L c,e. p Q rc'��? -r-� ec.a•n.�T.Rv c T,c7 r,,.f "rflr-ate. A r-�i'� w�ur; P G+l�.M A.��-Z2. To f�� v.�stT�:f?. P L�r�i= �'r r-.Y U w t'�'�Q_ -n�,r't -r t l~,c�,.�D t na G.. ,4 L..c_ c t r' � �� - = I _�1 ; r-• ¢3 .,„y !^��.a e-'t`GZ a-h�c_�� c.*,.t.�Mf t�': ■". w r t_L_ t�,�T N't A�,� f"l o�,A L P M--f nn�}.�'r- u w r C_ T A+•..f�'"�. '/i•�1L"'� W t TT-Y Es�,'�sf'�:C'S� TCS _ _...._.._..�.�.._......_.._...�...,_.._,._..._..,...___..__.....a.M, - �_...�.....,._.,._.L_� �'.``.•...�......---._._.,..._. . ... ._.__ _w_..._.... ...T`-',.--.;..��,_J__..__.�;1'� I~u � TL.- e._cx..��- r�i^-� . �'��It,:.>,..2 eNG,.Yti,��f? �...•• t �.] . v r +� q 8 � � `7, SF`-O I`7G• T7r h-1 a:. 1\na Cy P u r^-1 P c rl A.ti,I Na,�:�L �1 1 Y..4 ��a.� ,ci.� A �r N`r .�h' cc,ww'(?�z-�.- �-�--, F� t~�"':•.d�::u_..Y r I.+i`i..,F' r•' . • Tr /-C�C.",�-�;: ' t � Drat-t'Ytir rOG"(r�4t MIJ��T :5v(':.Kn }� T'r't�s lG c�DE�Ci T� a.IJ l+G"a lr � Tn / 4- Gs 4- w PtJNtD c4-r^�N_c_Cl Ax.A n` rr, , K; -rc, Cx.�l„ i7-e..A P,�a P't w- MA Y,.rFAcn.�Lt�i2'� nn��� 1 �, .^ nY+�' MlJ> 1 8. A PPRo-at + '' rar 13n4�, rr,st A•. ,.� .T"t:�u '•4 1 • �` ' , @ix 1*.T-t H _, Me, G ,4p L_�_.P"'ha i1 "5'ty'"}'T+ G+�. 1 . - 'e1�i. P'°'1�^"•i,.-1: 1.•r."f ft Tl r^.n..a f;-H M� i ", .,•, ^-t Y ,a-. G'•��, •.•r. ¢:�,[�- c f IC.A-nt' RnQwIGL� N FuGRa - M�C ��LLAt-t�, , �+.�,r• � Y+c DELI N C r Tl cy" / LQOC.�+'+TllC:* a bA 71-- L7'1 - I-1 "14 i L CN►C A'P1 o►.,Y ', fas h'Q M•!L7"If f'i.LS A''351C'�."�G,Q S. Aw/t-A + I G. P I.L. 1 t L. � N J F l C'ta,+.+/4 0 b L E'�w Y�--, � •f'"d. ) ,� ��j� �"�''''"•� ����� fi��, �, 1 >��<� rat�a�N � �g� �L- - t 1 .�. �^•,'I_!;': `rry,'s_�'i"P•i d A..4 E_E" t "') is iJ A �4-7 ,'�• �,Y'� t ! i�YSI:+R u:+/y�'�'•{ V u A.JI b:l t A.� CJ� 1�AX'T'�1� ��. p Cw !C 1 I 3 q+r�( -_e4,.lri:� C "1�{t� 1 ',/A:tt ►J �3.t A ST ..I � _ r4 II�IV£ Tx« __.. _ __ nPa,yc f 17r�54 -� - r WV `1 _7 � t=wt Ci-' +� F �' .._r\ �'�'' I iw ^I.S I r ,,,..•.-„,,,, r f � Iv, �� "�'.� Co AL'� • t 1f�,\�/ »v �'G Nv In,a Cj I I 'l ";✓ �...{3�!°a is /� _._� _.._ +.. °,�.ScXJ CS+lLu.J'J�,- -_ _____....,_ _ ____. ...- _.._.- - __—__-___ — - __.. cS L�xa�'L-..�1�l� G�Q.•�.,i w.,Gs.r.ir� r"�i� ,�.., r . s � M A Q�a1 3 In 1'1''v I jj �, .,, t /G•�r'i r.�-''_a•-/At't'1G'!i.# �1..d E::''!„1....} /y ' -TT A F_l _ t P u/vti p c t I A M o,a 69_ r, A cc-C, --_,.— �_�_. _ �' I E.:� �^'> r ` '�' ,,,.. :� �_,•- e ..1 r!,4 T � � -- � � W r�.'i'�r - l�t _ _ � PUMP ��-t f`,/Vl f a�-I'=- j•C:_r:7�.s p j�'�y q,�, `,� Jai \�T6:1+ .3, "r°�3 ( 2... 4e -* ....'wr �. s 71 (o -7 C + !oO< i ���14,f j/ e, ' : Lai t , •T Tc ac-A LE _ _ f�v7t hXC. S �:�cat\? , �7 --'"..y^` «�a y` ``^ • �. i JY^, � �e�.Ca 1..�' "' ` l'� vt.� C� I`I I � 'a c C.�,•t O P,..t t C).C3� ,w. l � ` S r `�"r _� — _-- _-- -- ✓ �` ` I `�i la T"ti{G C �l C- F- vC.l i 17T k lr ' 13 S tL 1.t '.:.* a w u. �R 1 Lt..«�.,++ .,w ^.wr------ ------'�-'.______.__._.._...____..__.—..___._�._.__.._..__,._._ _..�--_• -__----""_ -'_ ' "rF- ` �••'� 1 `w..+Y••+... �� ,,..1 mow+ 9,Q_C.t t,.,4 ls.L LC�2 o Y iar C. ��E 6 a�c 't�C��h..0 9 ,CVU, � ��w *�"�} �°•.��:, 1 t-outz_ Fcc i o� r a A'r a 2_ t^L eyec v R E U 1�.t r ca , ter c c.. tZ U 12 G > 3 74 , �� UF �.'."` � 1�•i©'�'erp f T(R^ rE'�J r`sc I G r t < '9er Y .,. M SULL!';A J y 1L-s �icr �i G. Y i r t.,; A N�. 2�733 i' `w t �. C � 1 ti_'_�.. 1 �ec'1 " � , C"'"' � �... F'ra ( Gor '�,��s ', �! i.� t�' �^'rS7�a`C `�� 1, �`p...^"i�C,r'C.t r'�:���.'�,.. G bd�g,��...: �d�`+.�: � a� i �� 1 ; C r � i 6 � ,�\ 1�•���;+ O"L' I z'� '`�+a�," I'� �.. �* 1•.`'er`'F.t E-� `,-"•-" ,rr�'' jag t £ w tt TM rt f] k : :' �-t ?V— `fi t�`+,7br y I