HomeMy WebLinkAboutApp-Permit-ComplianceNo...THE COMMONWEALTH OF MASSA HUSETTS
BOARD OF HEALTH
............. ........T.olan.-.....O F..........Y armnuth......-----•------.....---------.....-------•------•------
App iration for Dispntial Works Tnngtrurtion Urrutit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
53 Rhine Road
Lot 11 iM Ia P - £3
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Locati n - Address or t No.
German Hill Estates Associates/Barnstable Holding Co. 100 W. train Street Hyannis, MA 0260
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Owner Address So. Chatham, MA 02659
T.W. Nickerson
Installer dress 9,489t
Type of Building Size Lot ...................... ....Sq feet
Dwelling— No. of Bedrooms -------------------------------------------- Expansion Attic ( ) Garbage Grinder ( )
Other —Type of Building Single FamilWo. of persons ............................ Showers ( ) — Cafeteria ( )
Otherfixtures-----------------------------_--•--••--•-••.•-•-•--------------•---•---•------•------•----••....2 ....................................
Design Flow. ............110 ----•.....:=.....------.gallons per�per day. Total daily flow.........._..220___-_-_______.._______..gallons.
Septic Tank — Liquid capacity 1000_ gallons Length__$.._ -6..... Width. 4 -10 Diameter_-.-'-.__-_. Depth- -0
Disposal Trench — No ..................... Width .................... Total Length-___................ Total leaching area ..-_....----..._..._sq. ft.
Seepage Pit No .......... 1.-------- Diameter..... 101-....... Depth below inlet _._......6r-...-_ Total leaching area•267..1_..._sq. ft.
Other Distribution box (X) Dosing tank ( ) D. Mason of Yarmouth Board of Health
Percolation Test Results Performed by -_Flaherty_ _ Associates, Inc. Date•-_-_--•2�l/90
14.5 None 0 sreved
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 ........................
...... .......• p ----------••--------••--... Qf,y ...
- _ - - --- � ace
Description of Soil--------'--- '-•-------------i�- ---- ii---------------•--------...-------•--..--- ��--------- ��---------- -- ---•------------ - -- #----•---
of Silt T P if1 0---36 To & Subsoil 3b 174 Fine to Medium S�n Tr
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Nature of Repairs or Alterations — Answer when applicable ----------------------------------------------------- yt{ERTy�„
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Agreement : A '�
The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sy &
the provisions of TIT1E 5 of the State Sanitary Code — The undersigned further agrees not
operation until a Certificate of Compliance has been issued by the board of health.
Sign -•--•-=4( ,,.4----
Application Approved By.. •----------------..............................................
Application Disapproved for the following reasons:.... ------•----------------------------•-------------------------------------------------•-•--•---.....----•---
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_Date
Permit No ........ � 0-- ------------------ Issued .... --- . --•-•-
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
l.�-sem..•(�} �11(..�ly �--�
.......................................... OF ..........Y�') ....................................................................
Tntifirtttr laf (outpliatta
THIS ,TOS CERTI fY! T U oche Individual aewage Disposal System constructed 0�) or Repaired ( )
by �i�u.....----•--- i { =
j \. , Instal ._) t
`�- IV
r_
at........... ---------------------------------------------•--------------•---•------------•-------•-•-----------------------------------
has been installed in accordance with the provisions of T�7 ;ice 5 of�The State Sanitary Co� �de�c�,j in the
application for Disposal Works Construction Permit No.__-..-' _'- __-- .�_`' ...•....._... da.ted------------ --------- /.---............_...
THE ISSUANCE OV --THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A/GUARANTEE THAT THE
SYSTEM 3NIL� FUN T10 • SATISFACTORY.
DATE. f .-••-----• ------------------------------- Inspector ..---- ...--•--•-• ... 1 ...................................