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HomeMy WebLinkAbout0045 EMERALD LANE - Health p1 yj 147 zi LOCAT�N SEWAGE PERMIT NO. A07VILLAGE INSTA LLER'S NAME & ADDRESS B U I,l D E R OR OWNER � � � �✓ L�Tri� ��trS�' EdR �, I DATE PERMIT ISSUED DATE COMPLIANCE ISSUED *►/, 7� `/ ; h S I�f/c 0'f �• S T R`. No. < •• - Fizu ........... r THE COMMONWEALTH OF MASSACHUSETTS i BOARD HEALTH U..� ._._OF......... -...a,.1 .4................................................. Apphration -for Biiivuiitt1 Vorkii Tutuitrurtion Vrrmft Application is hereby'made for a Permit to Construct (VI or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. - -------------------------------------- Owner Address a 1� .............i--•------------------------------------------------------ --------- ---------------S A'°z ig Installer Address d Type of Building 0-XP Size Lot... Sq. feet U Dwelling—No. of Bedrooms---------3................................Expansion Attic ( ) Garbage Grinder (/Yo) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _________________________________ _ W Design Flow............................................gallons per person per day. Total daily flow____._.__.__._:____....__._________-___-----gallons, W Septic Tauk4--Liquid capacity. !p�t__gallons Length_______q...... Width___..`-_._.. Di, gmeter__-_�-.'---____ Depth.-�__'_--_--.. x Disposal Trench—No_ ____________________ Width_.______...____-____ Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.......J............ Diameter........ _____ Depth below i let__._.__/___ _.___ Total leaching trea__ _av 0 sq. ft. Z Other Distribution box ( ) Dosing tank ( ) �, �G� - .�� �� 77 '-. Percolation Test Results Performed by------- ------------- .................................................... Date--------------------------------------.. `_l� 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__-_-__-___--__-____--- ................... - Description of Soil (� �f.__CPA C' ,/`fie-- ----------- Tom : . = W ��------- •-- f ,� l� � ---- ---------------------------------------- -------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- VNature 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 Article XI 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. .1 t ned_-__,j _ Date Application Approved BY fir,=4--.7.-------------- Date Application Disapproved for the following reasons:--------------------------------------------------------------------------------------------:•-------••-------- --•-••-•--••••---.._._..•--•---------•••-•--••-------------•••••-•.... •-----------___-•-•----------•----•--------------------------•--•-•---------------•---------------------...••--•-•------•--•----- Date PermitNo........................................................ Issued........................................................ Date NT ;771 t,. v J Finc ............. 1� k THE COMMONWEALTH OF MASSACHUSETTS BOARD 9HEALTH .........OF....... . .��s fir iva fir i � i ork.i Tott.15tritrtion Wrufit Application is hereby'made,for a Permit to Construct (v-1 or Repair ( ) an Individual Sewage Disposal System at: f / //� ........................11 ---- + "` Location-Address or Lot No. v 1��-'!S.�`lc s/.• ° ' '....................... .........612-A--90..... nil ................................ Owner Address w crr Installer Address Q Type of Building G A Size Lot_.�•il_�. ------.Sq. feet U-, Dwelling—No. of Bedrooms--------- -------------•------__---_._ -.-Expan sion Attic ( ) Garbage Grinder (IY() aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures ---------- --------------------------------------------------------------- W Design Flow----------------------__-- ---------------gallons per person per day. Total daily flow............................................gallons. P4 Septic Tr:nk 4---Liquid capacity_/4l _o-gallons Length-------f------ Width---:S____.... Diameter_--�:-___--_ Depth_s_- x• Disposal Trench—No.----- ........... Width-------------------- Total Length-------------------- Total leaching area...............----_sq. ft. 3 Seepage Pit No------- ------------ Diameter--_--- _-------- Depth below i let--___-_!.__._- _._ Total leaching area_;..u.G____sq. ft. z Other Distribution box ( ) Dosing tank 77 Percolation Test Results Performed by------------.............................................................. Date---------------------------------------. ,4 Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water................---___-- 44 Test Pit No. 2................minutes per inch Depth of Test Pit-----_--_--__-_ Depth to ground water------------------------ ------------n; 0 Description of Soil----...- G �PF .'.--.. ""-• --.. 4-. L- ----- - ------------ -- w / -- / -- ------------- ------------------ --- x ------------------- --------------- --- ---------------- --- --- -------------------- ----- ------------------------------------------------ - U Nature of Repairs or Alterations—Answer won.applicable--------------------------------------------------;---------------------------------------------- --------------------------------------------------------------------------------------•--•---•---•-------•-------•-•---------------------------------------------------------------------------------- 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„ndi to place the system in operation until a Certificate of Compliance has been issued by the board of health. - f f • 4 gned- `r:r �L.. - ---------------•-- ,. Date Application Approved BY `!' = ✓'`-i ` e Application Disapproved for the following -reasons:........-------------: !---_-_-__ -----------------------------V ------•------- ---•--•-----------•••----••-----•--••---•-----------------------------------------------------------•--•---------------•-----------•--•-----------•-------•------•--•------•--------------------------- Date PermitNo.......................................................... Issued.............................. .................... Date ! THE COMMONWEALTH OF MASSACHUSETTS BOARD OF UEALTH ,.y.� . -._Trrtif irate of 0111mVliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (V) or Repaired ( ) rrr Installer at------- -----------�U--(s........ --•-•- .A_±r t? ------ If t t c ------•-•---•----------------•-•••••-••------._--_-___--------•------ has been installed in accordance with the provisions of i XI of The State Sanitary Code as described in the P application for Dis isal Works Construction Permit N .� ..: 7-------------- dated---- !_*Ft-7-----_--______- AN f Ti HE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE -.SYSTEM WILL FUNCTION_,SATISFACTORY. DATE.•.-,,�._U�r-I.....� ` P ................... ---4�4�-—----- ....................................... i i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ALTH I, ....... ...... .:...OF................. - ..-- .-.-..-----------------------.-.-.. No.-----�-- .. FEE_.-_�S._`......�M'C`� i� �tti irk Tonfitrurtion rrrmit Permission is hereby granted-------- -----------------------------•--...-..-...--•-------------------------------------- to Construct (vj or Repair ( ) an Individual Sewage Disposal System atNo...... ........A4-=-... -l_j_l_L.-S............................. - --------------------------------------------- ----- --------- Street as shown on the application for Disposal Works Construction Pe No...-. ... :..�. - ated-- :- --_------------------------- Board of IIealth DATE ------------------------------------------------ FORM 1.255 HOBBS & WARREN. INC.. PUBLISHERS a �' .i ♦(r:t i,Y re e, Y Al nw zyy r 3t �1u1 r41j• T: ;t �, t a'. t.�-+ t.. v •:SSF n'":# 5 r �it r� .1�'� �,s^a r `,4 t , J 3 +.w•r!^. , F r '•:� s` ! , o,l t*.4r(t a. m{y 1 , �. x r t _ ,, - + z 't y '*• r'YhiY+x tu• . f GJ V r ttni3+ ,t 54�M.. S t Y / � • rs +r af. ff t �t Yt ti rth t,, . - .. l\ ia•j ,� 1i t^ �kN{ p N t r.F�"� t.T z. sPy k R S; al Vi t 7qY` 1 ' 4 i-m la f IHEREB f f a r •N C tc ,k a: � ',( �'st � •i �, 1 ,p..I C:`r.k y tf: r�fi�� -✓'y'�'�v. t r a sT�ucTUREYSHOEN Nl tl�R�oN wasELOCATED, PLAN' OF LAND Ek STRUCTURE 2 r 3 Y N} , +• BY: AN ACTUAL FIELD SURVEY ON , ON w/z/r 1977 AND CONFORMS TO HE ZONING BY- LAW OF THE TOWN OF It' ry� / MASSACIIUSE�'•�TS. :I N �j/?7BNSTA�GC /7: fj /� t � / � -'1Y1�� '.'''C .. ./�C�'!�..'.��•y! l��i=�fi�`.S%©/t/.s / GAL-s '4� M/'�SS ' REGISTERED LAND SURVEYOR ! y � OF SCALE ' I - y o • 4 fi { � / Jr '1`a r P 64q 1 di,k,t DATE:' o JAMES H. WISWELL CAPE COD,SURVE.Y ,.CONSULTAN'TS ,° ', ` I ,�NO.11029 a A DIVISION OF,: BOSTON SURVEY CONSULTANTS,iNC 1 ��S7E�yp� ROUTE 132 ,t HYNNNIS, MASS Kt t a `fs� r r 1 t •'i: i} T€s«3 tv l.°,rya�,c f b Sl l .t \°, i f$i.., , � t�Rof 1"0.s, (i ,'M1 t 4�'�?'ef' �r 1 h ; � ��rlt. 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