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0010 MINTON LANE - Health
lD Yes hi lei rr I I i s m E A 0 .1 No. 10314 2-153L MADE IN USA C T ORGANIZED AT SMC-AD,Cr-M I l L0 CAT 10 SEWAG. E PERMIT NO. VILLAGE INSTA LE 'S NAIVE D0ItFSS 0 6UILDEN OR OWNER DA T E PERMIT ISSUED 12-7 DATE C 0 M P L I A N C E ISSUED �S 6 �q I Nolz.�7�j..::, Fx$............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® Off" HEALTH . ------.....OF................ .............. Appliration for DiopooFal Worko Tonitrn.rtion ramit Application is hereby made for a Permit to Construct (� C/ ' or Repair ( ) an Individual Sewage Disposal System at: ' � ................_--------_.............................................--••-•-------- ----- -.. L 'on Address or Lot No. 640,24 Zoe a r Address ?� g .-•--••--------------------•-•---- Installer 5; Address �� Type of Building Size Lot....' .S..? 'Sq. feet U Dwelling—No. of Bedrooms.... ........................Expansion Attic Gar Age Grinder '4 Other—Type T e of Building No. of persons............................ Showers — P� YP g ------•-•------•------------ P ( ) Cafeteria ( ) a' Other fixtures ---------------•-----•-•--•••--• . W Design Flow............................ --.15—_..gallons per person per day. Total daily flow..............7-;.3.--............gallons. WSeptic Tank—Liquid*capacityI..Cpugallons Length________________ Width................ Diameter................ Depth................ x Disposal Trench—No. ............. Width.................... Total Length..... Total leaching area.......t............sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area......... .....sq. tt. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................... -•-• �... . ate---.•---.�r .--7� lr?l Test Pit No. 1..../,--fV.minutes per inch Depth of Test Pit.......... _Depth to ground water.......P-ox/\e,44 Test Pit No. 2----d .minutes per inch Depth of Tes/t Pit........-�........ Depth to ground water........................ �i{ ___________________________________________ _ I _ .. -- .....A .... Description of Soil..................................................... /C--- '-- ����1 - �-�!!���d�t' - - x �. .. f --••---------•------- 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 TITTLE 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 h S' ........ -•-•••7 hx Application Approved By.... .•••-• ---.----•.............•-------•--......••----•-----------------------••..-•-•-- .................... ....-•.............. Date Application Disapproved fort f o wing reasons-------------•------------------------------------------•--------- ------------------.._..Da.t.e---....._...._ ....................•-•--....----•----------••--•--•-•-•-•--•-------••----....-------•----...------........--•-----•---......---- ---•-------•---•----•-----------•---•----•-----•-'- ......----•----- Date PermitNo------------------•--••............---------------• Issued---•-•-------_...._ �Date------•-•-•-------------------- No..... :_ , .. F�s, ..1C2........._......_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH "' 4414,-� ------......OF................ . .:<-. - .... /: - .._..._.......... � f� +[ ..... razes... Appliratiun for Disposal Works Tontrnrtion Permit Application is hereby made for a Permit to Construct (��) or Repair ( ) an Individual Sewage Disposal System at: '1 -..._...... ........... . ---- - -. Location-Address /J ��y /yy/ (/ or Lot No, "�/ ..y fJ/� ....................................... .G�i qS�/_..�.... 1 J"� _..._.... -...'Fi:..Y ........._._ _�..�...1.. ......... f....�yt......1 Owner Address W ............ .��,3='pa4?.= *...........d_ .:.v✓1 ,.. a Installer UType of Building Size Lot...���/j___<_1.'1- Sq. feet Dwelling—No. of Bedrooms............. Dwelling Attic ( ,,�.. �- Gari age Grinder '04 4 Other—Type of Building ............................ No. of persons............................ Showers — Cafeteria al Other fixtures ...................................................... W Design Flow.............................. :.t _._..gallons per person per day. Total daily flow............. 5.............gallons. IY' Septic Tank—Liquid capacity,a,aoiagallons Length................ Width................ Diameter__.____--___-_ Depth................ Disposal Trench—No..............�_._.. Width.................... Total Length..... Total leaching area......!-............sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by......................... %� :C'r.... .�..�.'L .........�:_..7-__f/v Test Pit No. 1...I-.-t..51-minutes per inch Depth of Test Pit......... . Depth to ground water.......I-_ fs, Test Pit No. 2....4144.-..minutes per inch Depth of Test Pit.................... Depth to ground water:_...................... x ,----------------� -------------•--------------------•--------------------------- •••..... Description of Soil........... . ----•--- ," .. /-�'F7.............. i------------------- W ---------------•-----------•--------------------•--------------- ;./ --•-•------ (� f 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 T ITL ij 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. Si 2 / -+"� Date Application Approved By.........--••• --.......... ... Date Application Disapproved for the f o wing reasons-............................................................................................................... -•---------------------------•---•-------•---•--...........--•-------------•------...----------------...---•--•-•-•-•-•••-•---••--•••••.•-•-•-----•-•-•-•---------------------------------------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH z.... 13.4r..........OF.....................,. . Tnrtifira a of TompliFan r THIS IS TO CERTIFY, That the Individual Sewage Disposal S constructed (*or Repaired ( ) by -j /�°�'', • --...... -- •---------------------- ....-•--•-........ lrnstaller at................................................................. .......C, /.---- 5-----------.All` ---=--------------t`�--�.•--- ........... LI has been installed in accordance with the provisions of TITLE E 5 of The State Sanitary Code a/de �ibed in the application for Disposal Works Construction Permit No.._/� .::.. _-------•----• dated..... �'' , / ....................he THE ISSUANCE F THIS CERTIFICATE SHALL NOT BE CONSTRUED AS GUARANTEE THAT THE SYSTEM Wl ' FU �N SATISFACTORY. DATE.......i,... .........4.------------------------------•--•--------•------- Inspector. ..... ............................................................... THE COMMONWEALTH OF MASSACHUSETTS /BOARD OF HrALTfH� J r .............. .` ��"`.....OF......._...----.........G-✓�+ /`�`.. ff.r ........... No. .... FEE......S. ..... tuusttl Turku �on #rnnr##iun rrutt Ifkj �\ � . Permission is hereby granted................................. r ee!-............. , . ` .. . to Construct SA) or Repair ( ) an Incf ividual 5.qwage Disposal System , --. -------- �= at No............................................. _ _-" " !!-• ,�/'"'" Street as shown on the ppl• tion for Disposal Works Construction Permit No._- ------- Dated.......................................... {/ .......................... ..... .................................................................. DATE----�-- -----............................................................. Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON ly Sd3 03� 3 , : �G6 80' o• h U - G—J/ Q V J 43, Syg S•F ` Lv 7 t NA IC N CA F- 14:�39.S4 o w 14 /5D } / ROnl'Tp C,t, o CERTIFIED PLOT PLAN F.ly �(N AS L-07 Z M!/✓7-i'N L-fit h/E 2 lei ^ /RQE3tRT urr CL` Y12. Z- C— A. E tr o MORSE in s �:� ElftEO N �Notv95�lp try } A'p FG!STEP �� // G}jf '? v _ • ` Jt r "' IONA� A So�°� .. SCALE, ./'=-�10 DATEi 6111 ' sQr.LDREDGE ENGINEERING CO /� . CLIE 7' I .CERTIFY THAT THE PROPOSED r EGISTEFiE : REGISTERED ®ULLDINO ,SHOWN ON THIS PLAN ` CIVIL LAP!>a y -CONFORMS. TO THE, I'ONINQ' LAWS E_NaINEER R Y t` DR,BY+ '� OF.$A NSTABLE MASSY 712. M A'I:N STREET, , if N.YANNI'S, MASS,,{, >JNz SN.EET.�'0� A E l G. 'LAND' SURVEYOR ;f t . /Y07"E = I� E/TNL'R THE SEPTIG TANAr DR 20.FT M/A/• ZZ!ACN/wG P/T AN& /"ORE 7 NA.OV M"6ELON/ /O pr. M/N 1R.4®E,A " w P1A.M ET.�R CO. -VCR COYRJp 4+PYC P/PZ SNA ZZ ®jF ,®JFO&4ArT To ASRA Deb•.Ci4N A"-7-,TA CO~CWJE�rjff HEAYy CA ST/RONC o -TWA LL BE lJSED COWrNS AI/Al- 0/7'GI �•p�FT /F//V DR/VE.W.4 Y g gMjA/. CoNcR�'TE �} a� CC:) CLEAN SAND &AC k L;L � LIQ[I/e Level-CAST I " •'. .••.• z Ls;YFl� r :• I OIV PIPS /O Q ♦ 1 O - C 0 OF /V •�/® A°!/A/.P/T'e=N GAL. D/3T. • dip • • • • . • • e e a •• WASHEFD 57?9/Yes- %'p�A'err SEPTIC rAA'IC • • e • .e r e v • eF EGTrVA " • •+ 314•- ��~ `,:�j •- -.� � •�o • v e o�i e •o � �•o� 1•V.a9SH.E® STORE 7 B o s 4 : e ® ® ® e • • • p •e r PRECAST SEEPAGE •• i iT c^Poo ciT �4 Gd+L IPA 'l or . e • e e e • • e • a o P/T DR E�1U/V. /OVJO',�T AT erd/Ie 01M& /!34-- C FR Orr. --49 . _ . hV.Z ET• .SEPri IOC T.4,VK. (" 3.vir � � FT. O/�8M. v C(3F&TAOU"7 0W,) ®tfTLET SEP?'/C T.�4/1ieK, /03,6 Fr . r-r = i I/Y1-,FT DJ.STRIA0r10JV e®;e I o3-51- F7.' SEC7701#/ OF GROMNO WA rEM 7A LZ - OrjTlErd�' 3•z FT. lM4A-r LEACRIMIS PJ'r to 3 5Fr AESMW CQ/7ERIA - D` /�T.`. le G�s.��AGEo%s�os��c uN®r �o�✓� S®/L L.®G c 3`3 � d - $®®L ���� y G.4L.1aAy So L TES�A/ TO/I- 7ZW770� E QF ZJtACMIAAo AI/73 " L ! -E OP- SOL TESVUbSToTAL ESTIl 7EDLOw 2q/ / S/®E 4CACHIMO AWAt P/T /�� �T. — 3 ..:� I�FSULrs �rTiv�s��® SY X'6 c 4007-rOAI L&rW4C///NCr A>01R PIT 7 W. A ✓ Lo.-^7 COXAT/®M RA j�/ ��S S /pry/IV�IIVCt/ TOTAL LE4CHI.&Cr AR.-A SQ f•7: de svi3sa/L Prieco 4A7-/oN RA:rff AZ T"Al MIMVINCH R,ESERIVE 4P54CIH/N6 AREA b Sq FT. 3 y - l Soil T�57 j�-34 / 7 7 ©�. ROF�E`RT ,: moo? ALe CCU/TC--_";2.y� ORSE No.10951 Q ti Ri- DMIE�4S"W ASNf'// MS VA Cf: IIVC. A� Vf o �isTSvf P``�`�� S 7t2 MAtN s7r, NYANN/9, MASS.FFSS/ONA1 /V®G�Ol1Nd� YYATL�M d�14/COCINTER�O CL/EI6/T:�2�Ei✓� izic�z p.ITE 6 / r3 Gmouwn wA7,iF�P .qr EL JOe3 I1o� 83 2�,f SHE.�T z`Op L { Department of Health,Safety,and Environmental Services Public Health Division Date � 367 Main Street,Ilyannis MA 02601 MANWAKA i6 t► Date Scheduled - r - SJ Time--JJ-4m; Fee Pd. 100 ro Soil Suitability Assessment for Sewage Disposal Performed By: �•�r�1Et_ 1- 03A L-A Witnessed By: .SCzZY ^' �iJ(r- LOCATION & GENERAL INEORMATIO LocationJJress L.07 1 M To N L At V- -1 i Owner's Name A-\q►DL 3jt05 V•�t>�. tN 50, '�i r.►E �T. �H(1t� 1►3t.E (,aoo,7e, S�a�i v. Address ✓W.31�nN. / M,Mtt.L S �pWtJ C/1 cNIT• Assessor's Map/Parcel: l'_?y/-7.X)61 -Tc Engineer's Name. NEW CONSTRUCTION ✓ REPAIR Telephone 0 Lend Use V/'tc A r-s Slopes(%) o— 10 Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line _ ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes do perc tests,locate wetlands In proximity to holes) MIN1Dla LA t�J1_ 11`i -66 , to, 5'2Z� I •1 - •DRf�JtA. C5^ANT-. — W�S,— MAfi�-►v N5 iw�� r ` 1 lS1 a L-6I Z L o�uS oe 01 m J , � i 10k N Parent material(geologic) /Y v ro\:r-3"1 `" pth to Bedrock Depth to Groundwater: Standing Water in Hole: "' Weeping from Pit Face Estimated Seasonal High Groundwater �--- fV/A J.ro G1td�ti,at„/nTEtt 'Fort r�� DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth t soil morales: In. In. o Depth Observed standing in obs.hole: In Groundwater Adjustment ft. Depth to weeping from side of obs.hole: Index Well N___•_._ •Reading Date: Index Well level Adj.factor Adj.Groundwater Level I PERCOLATION TEST DateJ�6 'rlmr 1 Observation 71t 'L Time at 9" Hole N tq r Depth of Pere � Time at 6" Start Pre-soak Time Q a� o`\ i�` ILA`�� Time(9"-6') End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Al Original: Public Health Division Observation Hole Data To Be Completed on Back-----) Copy: Applicant t Hole# �I DEEP OI3Sl;1tVATIQN 110 LOG sou o1cr Soil"fextu►e Soil Color L(-stuI,,Ure-'S`onCs-"o,� ldercs.1)cplh from Soil I lorizun (MunselQ h1oltling (USDA) Surface(in.) O 3� -5 C-\ .rw+) rQvy�oV� 8 L� t��-13g G2. rLl F SANS N 6 UVP N HOLE LOU [dolt [Q other QCIJ 6BSCItVAT Soil Color Soil Soil I lorizon Soil Texture (Munsell) Mottling (Structure,Stones,D''d arcs. Depth from (USDA) Surface(in.) Od vv..C. O-2 6 I VS -�. 2,5 b�� L e w zv b _LAQ0 G 1 2,5 6t) 44t 1 i 10le# _ Color Texture Ul i;l' (�l3SE, RVA,rION 1[OLL LOG sou other Soil Soil Structure,Stones,Doulderes. SoilIlorizon (Munsell) Mollling ( • I)cptlr from (USDA) Surfnce(in.) IIo1e# DEEP 011SCRVATION IIOLC LOGs°II other Soil Texture soil Color Mottling (Structure.Stones,Doulderes. Dcpth from soil Ilorizon (USDA) (Mort • Surfnce(in.) r a�nni nCe at8 M--� / Above SOo year hood boundary No Yes within 500 year boundary No____ Yes — Within 100 year flood boundary No z Yes •-� (UII 0 currin P rvlous IY1lldgtlnl aterial exist in all areas observed throughout the Does at least fou r feet of naturally occurring pervious m �ti area proposed for the soil absorption system7 i? If not,what is the depth of naturally occurring pervious material? �prtlflca ton V (date)I have passed the soil evaluator examination approved by the I certify tllat on De arinrent of Environm ental Protection and that the above nnalysiR 153017forned by me consistent with p the required Ira expertise and experience described i....