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HomeMy WebLinkAbout0054 MARASPIN ROAD - Health _ 54 Mara spin Road able -076 No....... F�s.... (�..............._ THE COMMONWEALTH OF MASSACHUSETTS 5 i1 BOARD O t-BEALTH 1 ....,:............. Zqq 07 (o Appliratiuu -fur :41,s uiitt1 Workii Tutuitrurtiou Urruift Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at ........... , Location• ddress ams" - or Lot No. --•..........-••--- .......................... Owner dd ress a � -------- ................... Installer Address d Type of Building Size Lot___________________________eqf U Dwelling—No. of Bedrooms------------ ,..-----------------------Expansion Attic ( ) `'6 t Garbage Grinder ( - ) Other—Type of Building ____________________________ No. of persons---------------------------- Showers Cafeteria ( ) Q' Other fixtures • --•---------- - d ----------------------•- --------•-------------------------------------•-_--•--- W Design Flow-------------- 0._.._. .gallons per person per day. Total daily,•flow._..._.._• _ . __._.._...-...__.gallons. WSeptic Tank "Liquid capacity---d6-__-gallons. Length................ Width_' Diameter----------.----- Depth.___---__--- x Disposal Trench 2-No. tal 2° ---- Total leaching area____________________sq. ft. 3 Seepage Pit No-_----------------- Diameter.................... Depth below inlet___.__.___'..__,...... Total leaching area_____-__________-sq. ft. z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by------ ---------------------------------------- - '7. ` Date------------------------------ ------ a 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__.__-___-_---.-__--.__. a+' ••---------•--------------------••-•------------------••--•-••-•-----•----•----•------------•--•--•-.......................................................... 0 Description of SoiW_M� �. x W -------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------- 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. g �� Date Application Approved By------ �� ...... •7� -Y-D/ate ' Application Disapproved for the following reasons------------ ------------------------------------------------------------------------------ --------------------- ----•••------•--••---•--•--•-•---------------•---•--•----•-•---•-----__...•••-••---••-•---•------••------•-•-------------------------- ---------------------------------------------------------------•- Date PermitNo......................................................... Issued........................................................ Date No. ----•••••. FEa._.. Q.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH 1.� 00 't oF. - Appliratinu -fur Uiunuittl Vork,6 Ton trurtion Vrrm t Application is hereby made for a Permit to Construct ( ) or Repair ( ). an Individual Sewage Disposal System at* t1l�ext ---.•-�vc�..4_. '............................................. ......... Location:Address ------------......__.-_-.. Lot No:----------------------- Owner Address W Installer Address Type of Building Size Lot--------------------I_--___ q. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers (' ) — Cafeteria ( ) Pa Other fixtures d - ---------------------------------------------- -- -, 0 g ..� ...................gallons per person per day. Total daily flow......................................... ..................gallons. W Design Flow.............. 1:4 Septic T ink 77�4iquid capacitv_44�#-�_gallons F�'Length................ Width--------- ..... Diameter................ Depth................ Disposal T~;, c �No. _.__ P_Q, . Width:`� ........ Total leaching area--------------------sq. ft. Ti :��t `Dtal ��� Seepagedli No-------------------- `DiametetY ..............: Depth below inlet.................... Total leaching area---------------__.sq. It. z Other Diiribution box;( ) ',%Dosing tank ( ) Percolation Test Results Performed bY---------------------------------------------------------------------------- Date---------------------------------------- ,� Test Pit No. I................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........................ -------------------- -----------------------------------------------------------------------•-••-••..................................I------------_-------- ODescription of Soil 3; ........................................................ ---------------------------------------------- K w= �f :.:........................... a W �? u Z --------------------------- ------------------`-----------------------�-'---------------------------------------------------------------------------------------------------...........---------------- U Nature of Repairs or A,jteriations—Ari wer when applicable------------------------------------------------------------------------------------.------------ --------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the afbredescribed 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. r, ate D Application Approved B -. � ---�at� --y ,. f PP PP 6 Y k Application Disapproved for'the following reasons:.......------------------------------------------------------------------ -------- •....••---••-••••.....------•---•-----•------------------------•-----....--- •••---•-=--••-••---•-•-•--•---------------•---••--...........--•---------............._.....---•----•-••---•--. Date Permit No.-•-••-••••••--••••---='................................. Issued.............. Date t ' A { g..X THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH,• 5 4 ........... r1owtet.........OF....:. }` .: ............ ftr Orrtif iratr of woutphanrr Tyy IS TO CkR -t the Individual Sewage Disposal Svftem constructed '(G "r Repaired ( ) by... ;�� ............................ :_:.. ,'=-------------•••••- -------------- , In- aller ---- has been installed in accordance.wi the provisions of Article XI of The State Sanitary Code as described in the ` application for Disposal Works Construction Permit No..................:...................... dated................................................ THE MUA_AN OF THIS CERTIFICATE SHALL. RIOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector---------------+------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No..... .. ........... FEE--/Q............ �i�nu ttl urk� �� tr tiugt�yrrutit Permission is reby granted. -.____ -kc_ __ to Construct or Rep ) an Indivi U4 Sewa i osal at No. d� 1 '�� l0 s �i�9� �Y 'r. /��� Street 4 as shown on the application for Disposal Works Construction PoQt N _ _ ___-_ -__ Dateda___. .__._ __ --• - Board of Health , DATE.... v ------- FORM 1255 HOBBS & WARREN. INC.. PUBIISHERS 1� V� CA l I 4 Y, 7 LOCATION o SEV/ AGE PERMIT NO. Lot 10 MARASPIN ROAD 74-172 VILLAGE - -- BARNSTABLE INSTALLER'S NAME i ADDRESS Kevin Hickey 8 UIL ®E R OR OWNER Royal Acres Realty Trust DATE PERMIT ISSUED 4-29-74 DATE COMPLIANCE ISSUED 9/30/74 iL . y® i