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Home My WebLink About0008 DEBBIES LANE - Health De 6b,'�,e s L,%, J ASSESSOR'S MAP NO.L71j-®per PARCEL L0CATION � SEWAGE PE It MIT NO. VILLAGE INSTALLER'S NAME i ADDRESS B U I L D E R OR OWN ER DATE PERMIT ISSUED DATE COMPLIANCE ISSUEDId� ___ 5 . � q b� \6 y, „ we\\ y^ T F' l \ �. - k _ THE COMMONWEALTH OF MASSACHUSETTS BOARD"OF LTH -... OF...- . ............. ...................................... Appliratiun for Uispusttl arks Tonstrurtiun ramit Application is hereby made for a Permit to Construct (Vror Repair ( ) an Individual Sewage Disposal Sysxemat_.3 ...aeX. e. .---•-------.._.....------ - ------. ..... --------------------- �' -- Location.Address r Lo -t ... - . .................................................. � . .�:._..... W .... .... . ... ..'..... .._ �..n�-..........._._..._._._............__._.. A ........ `:.Y_.. .l�r." Installer 777 Address Type of Building Size Lot.��__Z�...._...Sq. feet U Dwelling—No. of Bedrooms.__._.__...3...........................Expansion Attic (A14 Garbage Grinder e1) Q' OtOther—T e of Building ............ No. of persons............................ Showers her—Type •g -------------------------•--............._ P ( ) — Cafeteria ( ) Otherfixtur .. ••..-•.............•-••-•-•-•-•••-------•----------•-•---•--------•••--..........--••••---__._..... W Design Flow.............._ ................gallons per person n per day. Total ily AQw........ ®.._".__...._._._........ Ions. WSeptic Tank—Liquid capacit} .gallons LengthtJ-nl..... Width. _. ..... Diameter................ Depth.. ........ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....... _�y...._sq. ft. Seepage Pit No.10A/�.... iameter....,1.7 .... Depth ow inlet--./--.-----.---- Total leaching area. ....... ......sq. ft. Z Other Distribution box (� Dosi ( _ r '-' Percolation Test Results Performed b .. . �L�.....................•--•--•----........ Date--�-d.,�.----••---------•----•-- a Test Pit No. 1................minutes pe n Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes p Depth of Test Pit.................... Depth to ground water........................ a ODescription of Soil........................................................................................................................................................................ W ----------------------------------------•--------------------------------------...-----•--•--......---------•-•---------------------••--••---------.........-----....-•---•--------•--•--------•--..... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•------•-----•-----------•-•------------------------------•------•--.....-----••-----------...................---------------.........................................................0............... 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 sys em in operation until a Certificate of Compliance has en sued b " he board of health. Si .. Fe...............•---•-----•--•------------- --•-----.....-- `5 . . ............_.... Application Approved By---•------•-- .. .. ._.... •--- -••--....... _......._ e ate Application Disapproved for the following reasons:----•--•--------------•-----•--•----.....---...---......-------•------........--------•-•-••---------...-------- ...........................••---•--•------•---................------•-•--------....------.................----•-------....------....----'----------------•-•----------•-•-------•--••------•--- Permit No. - Issued Date--------------------------------- Date ------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H ALTH OF A Appliration for Disposal Works Tonstrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: / r ... :. ............................ ............................................ .............................._...._..... f Location-Address or Lot No. r --------•-•---•........................... •--.-. ---------------_-_-..__...�. .Owner Address i Installer Address Type of Building Size Lot..-?4,_._7eZ).......Sq. feet aDwelling—No. of Bedrooms._y, p ( g (/f�)F'.-:.._..Y.r...........................Ex Expansion Attic �L� Garbage Grinder QI Other—Type of Building .....+ ------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures - -------------------------•--.-.--------------------..._......._... W Design Flow................�<......._.........__gallons per person per day. Total dailyow......... .z ._'_._...._._......__.. Ions. W Septic Tank—Liquid Li uid ca acrt /met_ allons Len th.^.t Y.._.. Width..._.r........ Diameter................ De th__ __._.._. P q P Y g g P x Disposal Trench—No.................... Width.................... Total Length.................... Total leaching area_...................sq. ft. Seepage Pit No.,0_4 7 ..... r iameter....y/. .... Depth ow inlet....-------.---- Total leaching area. la)�...sq. ft. z Other Distribution box ( Dosiffik Percolation Test Results Performed b ..It. Date Aj ................ aTest Pit No. I................minutes per n epth of Test Pit.................... Depth to groun water.....................__. f� Test Pit No. 2................minutes ped Depth of Test Pit.................... Depth to ground water........................ Q+' -------------------------------------------------------------------------------• -•-------------.---.-_..-•--•-•---------.-•-----•------•...... •...... .-••-- Descriptionof Soil........................................................................................................................................................................ x W •--•----•--•----------------••------•-•------------•--•-•------------------....------....••••••-•-•---•-•...--------•--•-----•-•-•----•-------•----.........-•-•--••----------•-----..1..........------ 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 TITIL% 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en sued b he board of health. / f Sign l/ - 5 _ . _. e!.....-- -- ate ApplicationApproved By............ -T.'. ... .................................... -•-••- -----•••- ate Application Disapproved for the following re`eaasons:---•--•-•••------••.................•---•--•--•................-••••--•........................................ .................................•---------------------------------------...----...-----•------•-----...............--------..........-----•--------------------------•---------------------------•--•--- Date Permit No��---------� ------- Issued............................. Date THE COMMONWEALTH OF MASSACHUSETTS BOAR OF H A ...........................OF e",J' *4. „/,1 _ � �pr�i�irtt�r ,af �ian��li�nrr _ CFI ' IS T � ;TI�Y; T e Individual Sewage Disposal System constructed (- .. or Repaired ( ) `r ----- at� .....__. -- ,._... -- -----........... ....... ..... Installer ha- been installed in accordance with the provisions of TITLY, 5 of The State Sanitary Code as described in the application for`Disposal Works Construction Permit No'""` _._ dated._.. J>�,� _THE ISSUANCE OF TINS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAN E THAT THE SYSTEM WILL FU 1 NSA/TISFACTORY. DATE.............................. ... ................ Inspector................................................................................... : THE COMMONWEALTH OF MASSACHUSETTS BOARD. of HE 7L 4 ;r aq ca( Qy -1 ........................OF.. .. NFEE FEE....:. ,.. Permission > eby granted .v_. ._. .-, : ..... _ 1 to Construct >r ) a�%div u Sewag^e r is sal System r Street as shown on the application for Disposal Works Construction Permit No __ Dated.._�. �.. `� ` /fir.. .......... --••- Board of ""---------- -- ............ .-. DATE..--••••-•-•- � 4 .. .................................... 1 � j- FORM j1255 -A. M. SULKIN, INC., BOSTON . i T 8 # IApZ VAIL 210EI f/ IFS ,(xi Q � /cPm' f � � I1 D — of S P V / i fJ i.� SCAIS / 30 jkb 3 rz1sriN6 CawroAeS- /koP#reo CoNrod-ft q JOHN JA,COBI UPPERCAPE ENGINEERING No- 814 n � P.O, BOX 616 E. SANDWICH, MA 0253.7. wr A' �� 362-6281 S.� EL.SzXO. TOP Oil FOUNDAI ION _ CONCRETE COVER ---T--- CONCRETE dOVERS nr''" y'' T7 aT err 7rr ^trr r ,7m. , r 4"CAST IROrJ OR SCHEDULE 40 4 SCHEDU P.V.C. PIPE — LE 40 PV.C.(ONLY) PITCH I/4"PER.FT —_ PIPE - MIN.:' PITCH 1/4"PER.FT LEACTi PIT PRECAS \—INVERT Q -j LEACH I N EL.Sllv.• c ° INVERT INVERT o. �' a•. PIT OR SEPTIC' TANK EL.S/X D9ST. � W �., EOUIV ° INVERT '3` ' 60K ELc'11�'« > EL. /.X.. .. . .. .. GAL - IEQk(o' NVERT. �Wa 3/4"�T0.1.1, r WASHED STONE 3S 6'D.I A. I - 5.� /Z,' DIA.-- i �q PROF! LE OF — /IQ GROUND IVATER TABLE SEWAGE DISPOSAL :SYSTEM NO SCAL[7 SOIL LOG WITNESSED BY DATE TIME. . . . . . . . %' i%' /%i! F 'i? . BOARD OF 'HEALTH ?' TEST HOLE I TEST HOLE 2 //+i ENGINEER ELEV. ELEV. ..SZ.771 l� ,! T-0 r�/L o i9 rn jUP/C n stYa� (49.3 3, DESIGN DATA . NUMBER OF BEDROOMS /y7ed rn e ul SRN TOTAL .ESTIMATED FLOW , GALLONS/DAY BOTTOM. LEACHING AREA �/`3. . SQ.FT. /PIT SIDE LEACHING AREA . . .1�q d . SQ.FT./ PIT' GARBAGE DISPOSAL . . . � . . (50 % AREA INCREASE) TOTAL LEACHING . AREA .o7to•✓ SO.FT r �w i I ! ��. • PERCOLATION . RATE L MIN/INCH 3a.8 I LEACHING AREA PER PERCOLATION RITE . . . . . . . SQ.FT. ..0 . .WATER ENCOUNTERED NUMBER OF LEACHING . PITS 4�✓,G• APPROVED BOARD OF HEALTH DATE . . . ``• ✓ 4 D .,r AGENT OR INSPECTOR �UT. DFM; aJOHN JACOE31 u/.4,C f �% � OPPERCAPE ENGINEERING No. 814 iti` � cy. ! ! �. . . . . . . P.O. BOX 616 `o�� P�� PETITIONER - --- E. SANDWICH, MA 0257 �DQ/rI 'i1//�f 362--6281 . F1