Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Apps-Permits-Compliances
Fmc lz� ..... . ...... . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF YARMOUTH - Appliration for Disposal Works Tonstrurtion jhrmit Application is hereby made for a Permit to Construct System at: ..... P-PA8 Location - Address Owxr ... ......................... -- ------------------------------------ Installer Type of Building ) or Repair ( ) an Individual Sewage Disposal ............. .. ................... miae-Lo. or Lot No. ........... p / Address _.. . .............. Address Size Lot ............................ Sq. feet Dwelling — No. of Bedrooms.._...... . ............................Expansion Attic ( ) Garbage Grinder (Kj� Other—Type of Building ...!6 : 1 ......... No. of persons ............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------------------------------------------------------------------------------------------------------ Design Flow ................. /1.0 ................... gallons per person per day. Total daily flow ............... 3.3-o ................... gallons. Septic Tank —Liquid capacity../Poo..gallons Length .... 7.'M4.= Width._.............. Diameter ................ Depth ................. Disposal Trench — No . ....... Z ......... Width......: -7. I Total Length ...... Total leaching area ..... /SJ_'.ojf..sq'. ft. .... ... rA Seepage Pit No ..................... Diameter..........__.__.._.. I5e-pth below inlet_................... Total leaching area .................. sq. ft. Other Distribution box ( vj' Dosing tank ( ) Percolation Test Results Performed by....... . ..... A.Z ..... Date ..... . Test Pit No. ....minutes per inch Depth of Test Pit ..... ?Ayr ..... Depth to ground water ...... 4.Z7 Test Pit No. 2 ................minutes per inch Depth of Test Pit.__........_____._.. Depth to ground water.._.._.......__.....___. ................................................. ? ................................................. ... F ..................................................... Description of Soil .................... 0."=Zy� .... ----....------------......----------- •-•--•------------- .......................I ------------ ................... ................................................... _ ............................................... ------ ------------------------------------------------------ Nature of Repairs or Alterations — Answer when applicable ...... SE W ... C .. P - - -------------------------------- ......................................................................................................................................................... - ------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T LZ 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 oWiealth. ---- ------ Signe ................. C . . . ...... ...... .......................... ... . ... . ............. - 4-- r '?: _- Application Approved By .. ... . .... .. .............. .......... . ... ........... ........... ....... 3 - -------------- .. . . ..... ...... . Application Disapproved for, the following reasons: ............ . . - -- ----------- . .......................... ....................................... ...................................................................................................................................................... ......................................... 'C --y C — Ll I , /'�� 7�......--•---. Date PermitNo. ...jL2 ............................................... Issued ... 3 . ........... ....... Date ----------------------------------------------- --------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN of YARMOUTH ,/^ Tntifiratr of, Toutphatta THIS IS TO CERTIFY, That the Individual ewageDiigsall System constructed( )or Repaired (4,.)0'* by-------------------------------------------------------------------- . ................................................................ . Installer at................................................................ Y.? lel .... I 14 -Ad --------------------- the has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as descri ... i - for Disposal Works Construction Permit No._..q 4/1 S— ated k application q ( ............................ d o .. ........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE ;�S�TRUED S GUARAbITEE THAT THE SYSTEM WILL FUCTI N SATISFACTORY. DATE .............. �v J ............................ --- -------------------------------- Inspec 7r, ------- f .. ..................................... Noll~6_ Fm$......I S 01" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF YARMOUTH Appliration for Disposal Works Tonstrurtiun f rrmit Application is hereby made for a. Permit to Construct System at Location -- Address j .......................-•--------------------------.... Installer Type of Building ) or Repair K) an Individual Sewage Disposal .............................P. s.._ .... /...!f................... ---•-•-- or Lot No. ............... �............. ! ;Y�1" M.4.t�Ikf. /�1�.. o z.s. .... Add r ss - �.. - `�..�.: ..........fit? ... ........-•-......... Address Size Lo ............. 1 -meet DwellingX No. of Bedrooms ......................... ,3 ............... Expansion Attic ( ) Garbage GrinderA(l©) Other — Type of Building ............................ No. of persons ............................ Showers ( ) — Cafeteria ( ) Otherfixtures..------•---•-----•-----•------•---•-----•-•-•--------.......•-•-•-•---------------•---...--------..................--•-••-•••--...................... Design Flow...........//Q//Q ....................... per person per day. Total daily flow ............... 33W. ...............gallons. Septic Tank — Liquid ' capacity/®Of..gallons + Length ��----. Width_ -B... Diameter ................ Depth ................ Disposal Trench 9- No. ...... 2-......... Width.,2. ?..AATotal Length_e?j0._o1FA. Total leaching area/' .. sq. ft.0,4 "`- Seepage Pit No..................r Diameter .................... Depth below inlet .................... Total leaching area .................. sq. ft. Other Distribution box (✓) Dosing tank Percolation Test Results Performed by1ISEl1 t _,14i11:...P- .... e/ X... Dat4.1 ra j . j «q.Z Test Pit No. 1 e _ ...minutes per inch Depth of Test Pit.e..y ......... Depth to ground water... 6a ........... Test Pit No. 2................minutes per inch Depth of Test Pit .................... Depth to ground water..................... A �c--••-•------t.------u....................................•--...........•-•-•••-- �� - . !! ,,.....-•----•-_-.... ............._............ Description of Soil_._. ----M.. .f..._.._.T�P..._..�?eVb...S S J.__._ `- __....,��!�I l 'D ................ ---------------------------------------------------------------------•----------•------•--•----.----------•----.........--'--•-••-•--•----..._........----•-----•--•-•-------•---...-----•------..:i:.. -------------------------------------------------------------------------------------------------------------------•-----• .... .................. Nature of Repairs or Alterations — Answer when applicable.—s-ko.... �-!9N..1-.........."" .. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 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 hgtlth. Signed- --• - •--••- - --- �-- --- -•---•--•............. . ---- Application Approved By---•---- -•-----•- :....-•--•---------•----•-- v....-- •. --- ------ ate Application Disapproved for the following reasons:--------•-----•----•---......-•-•-------•••................••-----•-- ....... --••--•----•---•-------------- . --••.................................................. ..... .._..........................................------------------........-----••.....•-••..-----••---•................................... .r— � / �j� Date Permit No.._31 . / --....... Issued ....1 .. n .L ... ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN of YARMOUTH (arrtifiratr of Toutplittnrr THIS IS TO CE TIFY, That the I}�,dividual Sewage D' posal System constructed ( ) or Repaired VI) ....... ....1i rSs� �? ...,c..... `� 111 ,�..---.-C. 71Q.K KIP/;.' '.......................................................... at....... Sof C/ + �-//- r-�••=- • , ?7C�0'L� ._/I --."I................................... ......' .....---...._._ has been installed in accordance with Ze provisions of TIT of' he Sate Sanitary Cod s Qscr' the application for Disposal Works Construction Permit No .......... dated_... . . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR TE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................'-----•---............................•--........_.. Inspector.....................................................................................