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HomeMy WebLinkAbout0019 DEEPWOOD CIRCLE - Health I q ��eP.woad �� Gc/� �eh�'�ry� J1� � Sq - 013"� oq J � TOWN OF BARNSTAB�E c LOCATION Omc)a tdaA) _SEWAGE #/49 VILLAGE ���, , .-. ASSESSOR'S MAP & LOT 9 4, � INSTALLER'S NAME & PHONE NO. � SEPTIC TANK CAPACITY I ®V LEACHING FACILITY:(type) ( Xx L,c,"` (size) p-3/.5,}o•.c. NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: �" < DATE COMPLIANCE ISSUED: '��✓ `mom VARIANCE GRANTED: Yes No s /00 o w la, 4 -�:- ILO<�- I-�' F(-,, 'ATION SEWAGE PERMIT NO. VILLAGE I 1 �— l ug 0-5 INSTA LLER'S NAME a ADDRESS S U I L D E R OR OWNER 40 DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED J ell �q No...._.. ✓'� FRs.......-............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di-npinial Works Tomitriirtiun remit Application is hereby made for a Permit to Construct ( ) or Repair ( (J—.an Individual Sewage Disposal System at: d,��C�QC.�S (-------- ------ -------------.. Locatio Addr s �_ Lod o �Q J ' •.._ ................................................. 161"X _j ( f_0 6AZILP �-e I — � s : Installe Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons--------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------------------•----•------------------------------------- W Design Flow------`�5 7...........................gallons per person per day. Total daily flow...? _ ....................... WSeptic Tank—Liquid capacitv............gallons Length---------------- Width---------------- Diameter---------------- Depth.............. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No......I.------------- Diameter.._..1.0-1...... Depth below inlet--- Total Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-.___-.------__--.-- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fx ..............................................•------•----•----------......-----••---•----••----•--•......................................................... 0 Description of Soil........................................................................................................................................................................ W U ...................................................-•---------------------•-------------••---•------------•---------•-------••-----•------•------•--•••-•-----------••-----•---•-•---••......--•----•--- W UNature of Repairs or Alterati s—Answer when applicable. :: ... 060 ��T 0 4,5 ......Z3�--••••---------•--•----•ezca s T.--�c Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned furth r agrees not to place the system in operation until a Certificate of Complia d by the board of lth. Application Approved .. -----...�...- --------........... ..._......_....._.. - "......... iL Dace ��7 Application Disapproved for the following rea,rons: ........._..._...............................................: ................ . . ..............................................................------------ ------------- ---------------------------------------------------------------- ........................................ Dace Permit No. ................... Issued------------------------------------------- ---- ace - I (oq o( If) t vV No.................. Fims....... ...... J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE A liration for Uhn wia�� }� 1 Wurltii Cnowitrurtton Vrruttt Application is hereby made for a Permit to Construct ( ) or Repair ( _an Individual Sewage Disposal System at: / „ ............Iq.....j .: Q.r�,-cO ��i ,!. �Locatio�l�i\dds t �Mo��ior ......................_.....--------- ------- ._.._.._..-------•••-•......--•----------•------ •-•--------------------•-----.._..._.........A ............................................... Q I /� �Oavner ,r7/. Ad'ress -----••�-•-�----_-- W aj) Ct► t J' \ t�C----c..-- ---- -(/Z--v Address ��•-- - ................ , Installs UType of Building .z Size Lot............................Sq. feet Dwelling—No. of Bedrooms-----=f?: .................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures ---------------- -------•----...---..__._....---•-----------.....----------------------..._...........----••••----•---•-----•---••••----...._.. w Design Flow.......5_,�_> ------------------------------ per person per day. Total daily flow---.`M_�-7___0.......................gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter..---.---------- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area_........._.._.._...sq. ft. Seepage Pit No......I-------------- Diameter---_.�_(�.�.__.__ Depth below inlet... t.............. Total leaching area..................sq. ft. Z 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Q,' ...................... .......................... -•----•-•-----•-•------•------------•--------••••-........................................................ 0 Description of Soil....................................................................................................................................................................... x �., w VNature of Rep irs or Alterati ns—Answer when applicable.:�1A­G?7aA_��_..-1 OCR �`� �: 06 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia e_hes+een- sued by the board of dlth. Signed ........... ... `�..-----..... Dare Application Approved CBy..............�--- --- .-..... - ..........._... - - ........ � Dare Application Disapproved for the following reasons- -------------------------------------------1........................................................................................... ........................---------------.............---...---------...--------------...-----...------.....---------------------------.._................._.---------------------------------....-....---. ...----..------------------------------- /� Dare Permit No. .G,�...--a .................1./ Issued "'.. .'.�" ---------��.� Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE T.Ertifiratle IIf Tontlatiance THIS IS TOl CE TIFY, Th t thvl'ndividual Sewage Di pposal System constructed ( ) or Repaired ( 4--j__._... by ----------------------- -Q-.,f l�- r'---- C _ ---`----------- - .-----------...'-------------------------------------------- at ................... - -�........ ...�,u_C�(�C':� -'_.�l f�c` ,{ C `�/�..-1.1-- _---------------------------------------------------- has been installed in accordajcce with the provisions of TITI_E_5 of The St at Environmental Coe as described in the application for Disposal Works Construction Permit No. _. dated J THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ,/�' DATE....... """....,/��"/....................................... Inspector ---- f. /" .. /Z- -� - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.. FEE ..................... /�>aa�����r#'. n �erutit Permission is hereby granted................. �.. .....-E... �-- G - -_] - G� to Construct ( ) or Repair ( ) an Indivi..a Sewage Disposal System / _....__...............................r...._ ....._....____ .._..t.......................... Street as shown on the application for Disposal titTorls Construction Permit Nd.' Dated___ .... r--r..✓�' -- ...•--•-----------rC.= --- ..--•- Board of Health DATE......... -------�------------------------ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS Fxs.. ......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ....773�✓iv.....................0 F.. � s r�9 B_�o App iration for Dhipaiial Warkii Toutitrurtiou ramit Application is hereby made for a Permit to Construct �_l or Repair ( ) an Individual Sewage Disposal System at: ................C G c1...... �'�:� QQ ................................... ......... T �y. ......T:�..................................... __.... Location-Address / or Lot No. //A Owner Address Installer Address Type of Building Size Lot.._/�.cl/�.._.._...Sq. feet Dwelling—No. of Bedrooms___..._.....................................Expansion Attic Garbage Grinder k-01) 04 Other—Type of Building ............ No. of persons---------- Showers ( ) — Cafeteria ( ) Other fixtures --------------------------------__ W Design Flow..........................Z1�...........gallons per person per day. Total daily flow--------------- .a ........................ WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No----------------_-- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (—) Dosing tank ( ) Percolation Test Results Performed by------ %C __._..t3. .......................................... Date.......�.-ls-........................... Test Pit No. I........_-2_....minutes per inch Depth of Test Pit----_/__;--........ Depth to ground water.._.�._.ti011-P Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.-_-______-____--____-. R+ ----------------------------------------------------------------------------•--------------------------------------- -------------------------- -----•--- O Description of Soil-----------------.0..'�........_Go 9:,"? __3` .5'0-,0ZU/L.__.-__--- --- .....-•------ --------••----•••---••••-••••--•----......--••••----------------- ti W UNature of Repairs or Alterations—Answer when applicable............................................................................................... _ •---------------------------•--------------•---------------•----------------------------------------------------------------------------------------------------------------------------------.....--_.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisio of TITL: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation it a Certificate of Compliance has been issued by the board of health. ................................ -�-��.-.�:�........ /Datee )cation Approved BY -•---• --- ...................................................... l `�-�� ' Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- ..........................................---•------•---•-••-------------•••---•------------••............----•---•:•-•--••----•--•-•---•-•-----•-•-------•-----------••-•-•---••----------------------- Date Lg n rmit No............ ..�� Issued... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...7G.......'v...................._OF...�-�7/i. Appliratiou for Uhgpaiia1 Murkfi Tamitrurtiun Kermit Application is hereby made for a Permit to Construct (__) or Repair ( ) an Individual Sewage Disposal System at: ...... PP C...... (a ('57 .-•-•---------------------••-------••----------------............... Location-Address or Lot No. Z147 62" �. .. act.c</�:..........T!.....r------------•.......... ..........._-...........:7 P�::'....�-----.............................................. --- - / Owner ...Addr457 ess......................••---•--............. Installer Address d Type of Building Size Lot----.. .........Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (,'15 Garbage Grinder (Nd C14 Other—Type of Building ............ No. of persons.._..._..3.............. Showers ( ) — Cafeteria ( ) a Other fixtures -----------••-••-•-•--••......•. W Design Flow........................... ...........gallons per person per day. Total daily flow................33 c gallons. WSeptic Tank—Liquid*capacity------------gallons Length................ Width-----------_---- Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box Dosing tank ( ) `-' Percolation Test Results Performed by.....:Z.n<A......0 lI/?�'t............................... Date....... s:..._.... W a Test Pit No. 1........�--.-minutes per inch Depth of Test Pit..__ �__:...... Depth to ground water____�``____- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •••••••••--•----••---•••-----•-----------•-••••.............•--- ----------=---•-----.--.---..-----------------------------------••---------------.----- O Description of Soil..................62..-0.......... .li--'-9 ' S 4e so I e- ........................ --------------------•---••••••••-•---•--------•---•---•••-•--••••----..........•••--- 'r�i o7-%_�- &lPA , S--2-L-_-) U --•••-••-•-••••••---•--•••-•------•-•--•--••-•-•-•-••-••---•--•-•--•-•--•-•--•-•----••..............••---•-••---------••••••----•••-•-•••---•---•-•----•••--••••............-••----•---... W • UNature of Repairs or Alterations—Answer when applicable.............................................................................................. .............. Agreement: The unde agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions iL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in gpe on un > a ertificate of Compliance has been issued by the board of health. ----.— .. .. ......................................................... \ / .. ................................ � Date Application Approved By. ....y- ... _ ........... . .` �� Date Application Disapproved for the following reasons:--•-------------•-••--•---•--------------••------...-------------•--------------------•-----••............--.... ------•----------------------•-•-•-------•--•------•---•-•--•-------------------------......---------------•--••--------•--•----•---•---•-------•-----------------------••-•---•-•---.................. No-------------------- '... - Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............................OF..................................................................................... �rrtif iratr of Tampliana THJS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by........... -•--1.g�:(......- ---------------------------------------- -------------------------------------------------•---•------------------------------.........--------..........-- at. L\ I taller ' o j !j .... �n�v_..L< has been installed in accordance with the provisions of 11_m E j of The State Sanitary Code d scribed in the application for Disposal Works Construction Permit No... :�_�G �' � •---------- dated__- -/ _- -- THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONST UEID AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............. ---------•-2---..... ................................. , Inspector.................e------- •- �--.�......._......_._....._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.............:.... NO.....:.................. FEE........................ Permissionis hereby granted. ............................................................ .................................................... to Construct 0/1 or Repair ( ) Indi idual S wage Dispos System at No. -I ?� � ..........................................Q- ....S _, ` y�-••-------••----------• -------------------- reet ----- r as shown on the application for Disposal Works Construction Permit_N ___________________ Dated-_____ _:_:`��.................... •-"`"-""' '• Board of Health l " � -- � DATE. ------•••••• < , --"FORM 1255 HOBBS & WARREN,'INC.. PUBLISHERS 4S. p S 1 G 1.1 `,I►�Gt.c-. 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