HomeMy WebLinkAboutApps-Permits-CompliancesDig Safes#: 87311488
Fis...... W..Q.Q—
e THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
goose S ............. TOWN............... F.................. YARMOUTH
.---.....------. --
��" cp Appluttiiun for Disposal Works Tonsirixrtfun Frrmit
Application is hereby made for a Permit to Construct ( ) or Repair /( IQ an Individual Sewage Disposal
System
--- :.:.... GARDINER LANE... W :Y :........... .•-- OT ' Z -c ----•-- -- - �il �Z---------------------...
-..r........---•----•---. .. .....
ROBERT MCDh' KUbfess or Lot No.
_................___.._.............----.................
.................................. ..._.........._.......-----....._..............-----......----.._.......-----•---._...._........
BCK - 778-0444 owner Address
Installer Address
Type of Building Size Lot ............................ Sq. feet
Dwelling —No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other —Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures.......--•--------------------•--•---...-•---•---......--•--•-------------••--------------•-------•---------.............-•-•------•----.._.........--
Design Flow............................................gallons per person per day. Total daily flow ............................................ gallons.
Septic Tank - Liquid' capacity ------------gallons Length ................ Width ................ Diameter ................ Depth ................
Disposal Trench — No ..................... Width .................... Total Length .................... Total leaching area ...................sq. ft.
Seepage Pit No ..................... Diameter.................... Depth below inlet.................... Total leaching area .................sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by .......................................................................... Date ........................................
Test Pit No. I................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...,.....................
Descriptionof Soil ------------------------•---------------------•-----••--------------------------------
--•----•--------•----------------------------------••--••-------------------------•-----------------------....----------------------------------------------------.------
Nature of Repairs or Alterations - Answer when applicabl----- ............................................................
---------------------------------------------------------•..............---•--.....----------------------------.....-•------------•---.............................----------•-----.................----
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 isstfoy the boarMikitIL
S' ed .............. 7/30/87
ApplicationApproved By-------------• ........•--- •-•---•-•-----.....-------------_..... •---------_... .
Date
Application Disapproved for the fol ounng re ons:...............•.__....____.._............._________.__.______............._._.:_...._..:_......_._....._._:...
...................................................8..7..-..
9,��--•--V------------------------._--.------ •------------------------- •-- -----..1-•-30 .....9....................
............
No.............. ......_..._.. Issued D... /.7-__nau...._
THE COMMONWEALTH OF MASSACHUSETTS
,BOARD OF HEALTH
TOWN OF ................. YARMOUTH
.......................................... .............................................................
(Irrxifutttr of (�nm�rlittnrr
Tgg��SS IS CERTIFY, That the Individual Sewage Disposal S7stem constructed ( ) or Repaired (K )
BCiI� -8- 0444
by............... ----- ------............................ .....------------------.........----...--•---......... ...........................----•------._......----
16A GARDINER LANE - W.T. Installer
has been installed in accordance with the provisions of TITLE 5 of The State Sanitar Co a disc ' r n the
application for Disposal Works Construction Permit No .... lrQ.................. dated . ._� , ...........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A A U#ANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY r,
DATE ................. t-'-
------------------------------. f-..- p. .__._........._..
Inspector
r
d
twig bare if: oijii-too
15.00
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN YARMOUTH
........................................... O F...............-..................._...._._....-----....._-....._.._._......_..._.....----
Appliratiun for Disposal Works Tonstrurtinn Vprrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( 1) an Individual Sewage Disposal
System at:
------_-16B GARDINER LANE, -W _Y___________________________ _
ROBERT MCD�3'VtMOTT ess or LDt No.
-----......._..____..-................................ - --
............................ ........................................................ .......................... ...... ....-.....
BCK - 778-0444 owner Address
......................... - - --•- ...--................................. __............... --....---------•--....•--•......_........--•--•-------...----------•-•-------•-•••--..............
Installer Address
Type of Building Size Lot ............................ Sq. feet
Dwelling — No. of Bedrooms -------------------------------------------- Expansion Attic ( ) Garbage Grinder ( )
Other — Type of Building ............................ No. of persons ............................ Showers ( ) — Cafeteria ( )
Otherfixtures..-----•----------------•-----------------------------................-----•----------------------•---•-•---..._.._..._...._..--•----•••-...-----_....
Design Flow..........:.................................gallons per person per day: Total daily flow ............................................ gallons.
Septic Tank — Liquid' ca.pacity___...____._gallons Length ---------------- Width ................ Diameter ................ Depth ................
Disposal Trench — No_ ____________________ Width .................... Total Length .................... Total leaching arm ................... sq. ft.
Seepage Pit No ..................... Diameter ........... _........ Depth below inlet .................... Total leaching area .................. sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by .......................................................................... Date ........................................
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 ........................
---------------------------------•--••-•--•---------------•-------------------•----------------------•---•••-••--••--------•--------••...•-•••-----------__.
Descriptionof Soil----------------------------------------------------------------------•---------....-------------------._...._..--•-----...._...........---------._.........._.._---_..
.-••-----•---------•--••----..._..-•--•--------•-•------•----•------•-------•-------•-----------------•-----•----------•---------•---------------...-----•---•---•------.._........_..-------•-----•-----
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•---.....
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 TIT IS 5 of the State Sanitary Code — he undersi ned further agrees not to place the system in
operation until a Certificate of Compliance has been issue the board o i t
L \I.L-,- a K 7/30/87
........... ----------- V�aZ;j. ----- -
Application Approved By--- ------------------------•---
---•----- Date
Application Disapproved for the following reasons:
.......................
Date
PermitNo................87-'--------------•-------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........TOWN ..-OF.................YARMOUTH
...................................................................................
(Irx#ifiratr of Tom plittnrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (� )
by----- BCK-- - 778-0444
Installer
at_ 16B GARD1iN8R_ LANE W.Y. _._._...---------------------------------------------------------------
been installed in accordance with the provisions of TITLE 5 of The State Sanitaryj
as�/j1��scf' in the
application for Disposal Works Construction Permit No--s7-7`�--- dated.v�-� ID.J.............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED ASS AANTEE THAT THE
SYSTEM WILL FU"TIQN SATISFACTORY. ,/
DATE......................�- • - - ..._...:_. InsP i� -• ---------------------------------------------------------
7 ---•-