HomeMy WebLinkAbout1178 SANTUIT-NEWTOWN ROAD - Health mcc�s i o n s era �'��S � �:c���;
35
LOCATION nn,j - — 5EWQCaE PERMIT UO.
_Lot 27 _Newtown Rd — Santuit — — — —
VILLAGE — — - - - - - - -
INSTQLLER'S U&ME ADDRESS
Robert B Our Co Harwich Mass
BUILDER 'S 1J-&► F— ADDRESS
— —David Tellegen Dennis Mass —
DATE PERNA T ISSUED 10/8/75— — — —'
DATE COMPLI WACE ISSUED : 10/9/75
A
-3 ,9" �
... .... FRic ....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......T.OWN I............-----OF.............BARNS.TA LE -
Apphratinaa,.'fnr Uiipuiittl Workii Tonstrurtion Prrmit
Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal
System at:
Lot 27 Sandwich Newton 'Road, .Santuit
--•---------•---------------------------------------------------------.........................
I,o lion-Address or Lot No.
William E. Co `�i 0ep•ot••_St.e-,-•-Dennisport,___I ass.
w Robert B. Our Owner Great Western RAd;r�s N. Harwich
. .... .......... ........
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms----------3--------------------------------Expansion Attic (x ) Garbage Grinder ( )
Other—Type of Building .QW e.l1_i.0.t]____ No. of persons...........!.............. Showers ( ) — Cafeteria ( )
Otherfixtures ............................................................................................................... -------------------------------------
w Design Flow..........50.............................gallons per person per day. Total daily flow---------- 00__._________.____.___--.gallons.
WSeptic Tank—Liquid capacity1_.i_QQCkallons Length................ Width:-_-__-.---._.. Diameter................ Depth.--._-_-_------
x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No........I----------- Diameter___6.... _.•8-. Depth below inlet____________________ Total leaching area...-_._-____._____sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed bY-------.......-..................................... ..................... Date---------------------------------------
Test Pit No. 1................minutes per inch Depth of Test Pit._.__...-___.______- Depth to ground water...___.--.__.__.__._----
rX4 Test Pit No. 2................minutes pqr inch Depth of Test Pit Dept to groundl r------------------------
----------------- �c , .x �...
O Description of Soil 6 � y /—' Y� -------------
x
w -
V 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 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 issue oard o ea
Sigd ... . = •-•-- ------------ • ---,-•..._...............---
A Application Approved B �'�' '�' i�'o-�" Date
PP PP Y '". .. v -'3 ' '-- --------------------- '5�---- ------- -- --
Date
Application Disapproved for the following reasons----------------- •------- ......................................-•----•-••----••-•-----.......----•-. ----•-•---•-----------------•._...--•------
Date
Permit No-------------------------------•- - Issued.--- -
-- ---- ------------.......
Date
------------- --
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T 0M N._ _.... ..........OF ...........9.A.R N 5 T A3 4.F............................................
Appliration -fur 4iupuuttl Work,6 Towitrurtiun Vrrnift
Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal
System at:
Lot r27 SandwichNewton Road, Santuit
----------•--------------•----•-------------.....------------------------.....-••--....---••••--
o ation-Address or Lot No.
tUilliam E. Co d Depot St.._.....Dennispart: <<�ass
. .....-. --•--••-•---••-• ......•------•--------•---••-••-------•------------------ • •• ...................Owner ddress
W Robert 9. IJur great 'Oestern R& N Harwich
-----------------------------•-•- ••--•-••.....•••--•••••---•--••---••-••-••-•--•-•••-••-.••••. ---------------------------------................ .......
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms---------;--_-____•___.__-__ ._ -Expansion Attic (x ) Garbage Grinder ( )
P.,., Other—Type of Building PA_q.j l .n.9_____ No. of persons___________________________ Showers ( ) — Cafeteria ( )
PaOther fixtures ......................................................
W Design Flow..........55.0----------------_-------------gallons per person per day. Total daily flow.........300------_-----__-__-----_---gallons.
WSeptic Tank—Liquid capaciJ- Ugallons Length................ Width------..-------- Diameter---------------- Depth-.-.__--_-.-----
x Disposal Trench—No._.................. Width.................... Total Length.................... Total leaching area-.._-__--.__.-____--sq. ft.
Seepage Pit No.......1............ Diameter... --- Depth below inlet____________________ Total leaching area._-_--._-----____-sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by-----------------_- .................................................... Date-----_---------------------------------
a Test Pit No. 1----------------minutes per inch Depth of Test Pit------------------ Depth to ground water.--.----_-_--.---------.
�Lq Test Pit No. 2................minutes per inch Depth of Test Pit........... Dept t ground w er-_---.---_---_--_.-_---.
P4 •...............Q---------�
O _oDescri ---
Description of Soil___________________________________ _
x $ lam-l� ---=-------.._.
7
W ._...._.... rv� -•--•-----------------------•-------------- -------------•-.---•------ -
------------------------- ----------- ------......................................................... --------•----------•------------•------------------------------------- ..........................
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 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 oard of health.
-------------------------------
Dat
Application Approved By-----
Date
Application Disapproved for the following reasons----------- ---- -----------------------------------------------------------------------------------------------
•-••••••-•••-••••••••••-•••-•••••-------------------------------------------------------•--------------------------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD Q HEALTH
....... . ..... I.......OF......... . .... ..........................................
.........................................
4withthe
tifiratr of fguntpiianr
THI .I T CEIFYIndividual Sewage Disposal System constructed ( or Repaired ( )
--------- ••• -•-•••-•-•••...... -••••••----- ................--------- .................................
Instal
-----
has be n installed in accordantprovisions of A LssfSThe State Sanitary C de as deperibed in the
application for Disposal Works Construction Permit No._-_..............._5--_--... '/...._._. dated--�d-"/._.__�---_�ZVV�--
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.......................................................................... Inspector----------------_-•-..............................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALTH
s �
.......... ...... .....OF.----- .....- ..454 ----------------------------------.......... l� ..�.
No.......� - .. FEE` ...........
r T mi fiun rrmit C
Permission's rreby granted------------ ---1 -•-- ---•---•-- ------------------------------- .........................................
to Consttp.&ct k or Rep ' ( ) an�Ln vidual S g- Disposal;.ystem
at No(Y ? �`s '--- ------------SALE � d, ------
treet
as shown on the application for Disposal Works Construction Pe I o...... ....... .... 1 �.�.�`...._.._.................
-------------
='
------------•--------------•-•-•-------- .., Board f ealth
DATE---- -��------�-`- _.
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
dr �d
( - aoa 00
t All,
„46 7'
117a 3 }� Ei art1
44,
-� 11
` OrrisT NC, `
.c?06. 77 2C
LOB- 28
S/L.L 6G.E✓.._---�--�'f_L T ABO i/E �'O.aD
PLAN �EF� ENCE': t3tr/NG 4.47
_#27 q,5 �5/-/0A1,Aj 4'/ i::t,Nv A300K
IV I �•1 Re-45Y CEvT,�FY'7'14A T ThAE EX/ST
WRED
/A/& FO.t/n/DA Y/ON GOC.4 T/Q,v !S Q 7ZPM-
= TAYLOR
���r�r ��' ��� THE 8C,/[.D/N� SET$•QCX.8E.�t�i.C��M�t/7
CQOttV' 04V
- 4 7
,. 8 WIZ. "SF yA2MO 07W.OPT l.4.