HomeMy WebLinkAboutApp-Permit-ComplianceNo.;�a._��
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN....--....OF..........YARMQUTH----------------------------------------------------
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AvAration -for Rovosal Works Tomitrnrtion Vrrutit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
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Skyline Drive ---•--------------•---- Lot. 18 ......... m�P '. ......
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Location - Address or Lot No.
.....J, Alpe-rt...Bass_tt-----------------------------------•-------- Lyman:Lane=-.? .S9ut?..Yarmouth..............
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Application Disapproved for the following reasons: -_
Owner
ddress
_James__Henderson South Yarmout`�h
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nstaller Address
Type of Building Size Lot_-..�3970..-__--• _Sq. feet
Dwelling —No. of Bedrooms -------------- __3._.._._ ---__--_______--__Expansion Attic ( ) Garbage Grinder ( )
Other — Type of Building _____________________------- No. of persons ............................ Showers ( ) — Cafeteria ( )
Other fixtures
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Design Flow ........................... ................gallons per person per day. Total daily flow --------------------------- 3-3-0 _--.. gallons.
Septic Tank — Liquid capacitv1 Q �_O_.gallons Length 8___ 6'� _._. Width_ 4 IO... Diameter ___.____ Deptll_5-' 4_"
FIO`nT DiffLtSOido........... 2....... Width .... 8__'_--_•___-__- Total Length ...... 12......... Total leaching area____ 39.2 -------- sq. ft.
Seepage Pit No --------------------- Diameter .................... Depth below inlet .................... Total leaching area ------------------ sq. ft.
Other Distribution box (X ) Dosing tank ( )
Percolation Test Results Performed by -Cap_ ___Cod -__S. r ay...Consul antdDate-__Rom- —__26_,_.__19.7..6
Test Pit No. 1 -------- 2 ----- minutes er inch Depth of Test Pit --------- 8...___... Depth to ground water._._______C_____-_-_--
Test Pit No. 2 -__----•-__-•___minutes per inch Depth of Test Pit ...... 10.1 ...... Depth to ground
water____. --____8.'---------
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Nature of Repairs or Alterations —Answer when applicable -------------------------------------------- Q_ ._.______..a.__.-_____._
__CHAPMAN_
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a p 1Vo. 27654
Agreement:
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The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sys
the provisions of Article XI of the State Sanitary Code — The undersigned further agrees not t 0 E tem in
operation until a Certificate of Compliance has b,, ' sued by the b rd of health.
Signed. -s/
Application Approved By -------------------- Date
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Permit No .............. -------
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Date
Issued ----------------------------
Date