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Home My WebLink About0075 WIANNO CIRCLE - Health w7� McLn n o i i �76 6 L O CATION N S EVOrdE PERMIT NO. fc�d°► � C VILLAGE I N S T A l l E R'S N.A M�-� i ADDRESS JOHN A. I70 BACKHOE SERVICE ee 1wSoWnstable, Mass. 02668 11UILDEIt OR OWNER 51&11i r-� DATE PERMIT ISSUED -2 3— F'3 DATE COMPLIANCE ISSUED ��.�� y� hhO CI %de f Fini THE COMMONWEALTH OF MASSACHUSETTS B®ARD.10F HEALTH �.w ev...................oF....�1 iP �( ��,�5'e......................................... ApplirFatiou for Dispwi al Works Towitraurtiun Orrutit Application is hereby made for a Permit to Construct (k) or Repair ( ) an Individual Sewage Disposal System at: /�i✓ O ��i....._.......... ......._....� eS� ._.... o .Ld%.........................................................•--- / Location-4Vress or Lot No. r..................................... ........ v� ,/1!cQ�S` ! °�.s Owner Address �f �` _... ✓. ............................... (�i�}�l✓1/ ....3 r.-----......1 Installer Address Type of Building Size Lot1L__`l4__�___.._._Sq. feet Dwelling—No. of Bedrooms.__o.2v..................................Expansion Attic ( ) Garbage Grinder Other—Type e of Building ,��i ....... No. of ersons____________________________ Showers Cafeteria Pa.� YP g ---- - - P ( ) — ( ) Other fixtures _.._._._.. W Design Flow.............................................gallons per person per day. Total daily flow............................................. 1:4 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........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_______________________. z ---------------------------- ........................................ ............................................................. ./..''�Description of Soil___,11YE.4____, f},nsl ...1� .._STnN __, ....pF_T'........... 4 x 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 m h provisions of l I L Li; of he a Sanitary — h undersignedfurther h t e p 5 t State Sa to y Code Theagrees not to place the system in operation until a Certificate of Compliance has been i ued by the 1,oard of health. Signed --------------• 1 ate Application Approved BY-----, --1 ---. . -- - --------------------------------- z� L' ------------ Date Application Disapproved for the following reasons----------....................................................................................................... •-----,--•----•---- ......................................... -----•...----•-. ------... --••-•-•------- Date PermitNo......................................................... Issued_....................................................... Date AL No.. ...7b F�$......7.. .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` w ��. .. ...................OF... 7- -C---......................................... Appliratiou for Ropnoul Wark.5 Tonitrnrtion lirrutit. Application is hereby made for a Permit to Construct (>t) or Repair ( ) an Individual Sewage Disposal System at: i RNA (� ' --.. ��... ... ...... ................................... ..... o T, id ..--------.._._......_..-•-•-•-------•-•-•-----............•--- Location-Address or Lot No. ...07aQ .._ 'w./y'. ..!`f�Ifc......•.................:............. sa G,cE T. 'L .c� f!!Ln...--/�'CGL? Owner Address Installer Address Type of Building Size Lot _l _.............Sq. feet U Dwelling—No. of Bedrooms___�...................... .Expansion Attic ( ) Garbage Grinder (Midi n.C ... ...... No. of persons............................ Showers — Cafeteria Other—Type of Building ... '' p ( ) ( ) Other fixtures . cc�.. 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------------------•--••------------------------------...........---.....----.........................----.........--- --------= - O Description of Soil_._/"/ D-----5-d,,4 ---_...e, F... Tt�^�. .... 9 .............,44./ !-----��Z. �� ,,c ...` 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 TIT! : 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ;�su " d�by the, oard of health. r7 Signed---------------- �w'`_..'�-------- �'�.--�_. /. 7= /at Application Approved By........1. A y ' _ y �' - == '' • --••-•------------•------•----•-- Z- _— e Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------•-•-- ......---•---------------•--••------------------•-•---------------------------------..........---------------••----•-•--•--------......•--....._..--------•-------------•-•----•------------------.----- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... W-Entifirat a of Toutpliattrr THIS I 0 CF.R TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........... ............................................-------••-----•--..._...................•--•-•---•---•-•--•--------••---....---............•-•--•. Install at. �/ `"="fit=fit"''Y '» -,J Z has been installed in accordance with the provisions of TITLE 5 of ThS State Sanitary Code as described in the application for Disposal Works Construction Permit No...!�? .......... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE/CONST AS A GUARANTEE THAT THE SYSTEM WIL FU CTION SATISFACTORY. DATE.....°�..°� ---....-•....................................•...... Inspector. ........-----.._.................----............-----•---••.•-•-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No. ................................OF................................_. FEE---�e .Ax'' ...ram: ---... ......�............. i o l orko Tonoirttr ion rrutit Permission is ereby granted............... ...` .. ,. -----------------------•------------------------.............---•--•.....---•--••-••----- to Construct or Repair (f) an In iuidual Sewage Disposal System atNo.. `�; G�1,./.at°" ........ r t_..." ------------------------------------------------------------ Street as shown on the application for Disposal Works Construction Permit No...................... Dated.......................................... -- B •r of Health DATE .'..a ..........-----••-----•-•-•--•--------- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS �ESIGI.I 5tw6Le FAMtI_ ( uo GAP-BAGE GwNDGP- DA►t_Y F%.OW : Ito X 3= 3306.Pp SEPTIC, TANK 330x15o'/• =1495°u P. 0- t.4• q�•�- usE 1 o oo GAL. G3 d8 I ot5Po5At_ PIT v51c IvoAL. 5%DG.WALL AREA 2 1'j05.F v. o 15o 5.F x 2.5 a .375 G,Pq _ p TD R-F-As o 4F. BOT M A ., 5a S.F x I•o a 1` .�i.p 'ToTA�. t76.S16N • .4.2 G.P Q. .� � 'ToTAI•. DA I t_�{ FLOW x 330 C?o , PE2COLAT►ON RATEi I��IN 2MIN O�LESS 0 ° N IPML 'T I b _ _ l 4. &Y l � „ of oo�vd S M RICHARD `,�`�, ALAN N� A. �, i.� W. �., \1 ► 11 a a d C.) HAXTER io JONES v 1^ Nc.21048 f t«{, fd 25100 , ♦ Q/STf� pQ a r 4/gTC Hp SUR��' 1AL 141� �/ a 9S - Top FNDf100.0 NoLE I I-'Zq-AL (� 'LoAM looms INv. Z SCPTIC. (000 ��( BaX �•d .TANK � Mbm GAS.. 94 LEAcu SAJP. PIT INV.. IN . So„�a WITH STb�►� q 314.1 WAsut:D I 6'ro Hp MbO, CawrIPIG0 pLoT . PLAN X446 PRUFIL� LoC4-cloN C�'STEtz�/ILc.l3 8� NO SGAI_6 Scp.t_E 1L VATS Ih306L lfo IIJa�-�- R•tV 1%- 3-(3l-- i ('' pLP•hJ REP626NGE I C E RT t F Y 'T VAAT T H E 1 oot)(ZZ'1 o IJ 5No ww N6.RCzo►.1 GOMPL,?S YJITN'T NE S 1 c�LIN LOr 05 I A► o 56'T5ACK R.6 0%9-EM6NT� r µE ' -towt., or- -g4"'5TA.'BLG AND IS C.AIJ'-') Couer G� 3 LOCP.TED •WIT91 T .E FI. op P AlN twr E �►Jn• 12-�-BZ BA.KTEiZe WYE INC. i R.EGI s-TT_-V_Er IANoSu�YPsYoe'S 'Tuts PL&M l fl NOT g�SBp ca AW osrE2vILL& • �5• I tA E;N-V 5ueVc--Y �-rHE oF�'SETS Suouo _ e . c:.s� INC LEI.. t-IN�'� lAPPLlr_AI`I'� —j1L✓Ia 4" �11.✓f/�