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HomeMy WebLinkAbout0028 DUNASKIN ROAD - Health (3) 28 bVR ask(n Ave, ZZg - 016 TOWN OF BARNSTABLE LOCATION vkQ4q(i.vA-vA /-'/ RAC SEWAGE # - 60 VILLAGE gCI-Ire)( '1111-Ie ASSESSOR'S MAP & LOT ,12g, 0/j, INSTALLER'S NAME & PHONE NO. l / lm h C a m eeR fi 5d SEPTIC TANK CAPACITY G 6 LEACHING FACILITY:(type) r (size) 1 o c� NO. OF BEDROOMS,PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER fv DATE PERMIT ISSUED: ��- - 1 _3 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No Li r q ����w�l � � �T ° � � ,�, 1 \� 3 TOWN OF BARNSTABLE LOCATION C v.v A,7 k_lit/ .C? SEWAGE # VILLAGE, (Q ASSESSOR'S MAP 6z LOT JZ INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) la,, NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: 2 r f - DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ssf v;,� �"'� ! ,�,, i \ / �1 f � 6! 6 i cr�� r© ti�w Fss..........1.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � M � TOWN OF BARNSTABLE Apphrativit for Diripwial Warlui C ontitrurtin rust ' e Application is hereby made for a Permit to Constr itct ( or Repair (g,�an Individual Sewage Disposal System at: Aym Li tion- 4 dress Lot No. .............................................. 0,ncr Add c � --------- v°� = S ice -- ° ���'�'...� � _ _.._ ................I..,�i Installer Address UType of Building Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms-_..__7--------------------------------Expansion Attic ( ) Garbage Grinder ( �) aOther—Type of Building ____________________________ No. of persons..........------------------ Showers ( ) — Cafeteria ( ) Other ---------------------------------------•--••--•----------------------------------------..........--�-�.---:-------•--••--•-•-----............__.. W Design Flow.............._______.-..._._.____.___._gallons per person per day. Total daily flow-_____-.___.:___ .......................gallons. �: Septic Tank�Liquid capacity./.67wgallons Length______ Width--�_-------- Diameter................ Depth................ Disposal Trench--No_ ____________________ Width.................... Total Length-------- Total leaching area....................sq. ft. 3 Seepage Pit No--------/.......... Diameter____ Depth below inlet......._......... Total leaching area..........._......sq. ft. Z 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........................ r4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ............... -------------------- •---- --------------------------- ------------- -----__---------•------- •---•.... -••-••-••••...... -------•---•---- -----•-- 0 Description of Soil........................................................................................................................................................................ W ------------------------------------------------------- -------------•--..._..--------- •------------------------------------------•--•------------------- •...._..-------•.....-------------•-•-•-- U Nature of Repairs or Alterations—Answer when applicable._ �ut� .1 t-`___._ .... �a t -..... ------------------------------------------------------------------------------ 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 C tificate of Co has be issue. b the b,.and of health. Signed ........... . ..... ...... c....-.... -f0. . Due Application Approved By ............... .. ...... .. �?....... .. .-. ......- - - .. .. ... ........ .......--- .........-...-.-.�[e..--..-...--...... Application Disapproved for the following reaso ................ ....... .................q.. .. .....�. . ................... .....-............................ 0_2 Permit No. Issued ......_.......... -....... . Da e...... U re JZ' C) THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE -IY-92 Apphratiou for. Diripwial Wor1w Tutuitrurtion , ' amit Application is hereby made for a Permit to Construct d or Repair (Vran Individual Sewage Disposal System at: VK ...................... ... ............................................................................................. Location-lAddress or Lot No. ................ .. ......... ............... .......... .....1............. ......................Address..............cl V-) IA� ....... ......... Owner Ad t OTI C ..... ..... .....?.......................,.................................. ...........................................I....................................r................. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-------7---------------------------------Expansion Attic Garbage Grinder 04 Other—Type of Building ____________________________ No. of persons._.-________--_____--__._... Showers Cafeteria Other fixtures ....................... Design Flow....... ...................gallons per person per day. Total daily flow..____ 5�(Q.......................gallons. IY4 Septic Tank-r"-Liquid capacitv./ArK.gallons Length---77---- Width.__ ........ Diameter................ Depth....._.......... Disposal Trench--No- .................... Width........_._......... .Total Length.-..____.._......... Total leaching area....................sq. f t. Seepage Pit No---------/------- Diameter._-_Z(7.1------ Depth below inlet...j.��.."......... Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tank ( ) I 0* Percolation Test Results Performed by.......................................................................... Date........................................ 1.4 1.4 Test Pit No. I................minutes per inch * Depth of Test Pit._______-_--,-__-. Depth to ground water........____.._......... 0-4 44 Test Pit No. 2................minutes per inch Depth of Test Pit__.______...__...... Depth to ground water__....._._.........._... 9 ................................................................................................I............................................................ 0 Description of Soil........................................................................................................................................................................ WI............................................................. .........................................:.............................................................................................. U ............... ......................................................................................................._............................................................................... U Nature of Repairs or Alterations—Answer when applicable-------- ........................... .......................... ......................... .......... ...4i. ....C"C'.4'.-�,-.<-/'-A--e ..... . ...................... .......................... ................................................... 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 C , tificate of Compliance has been issued by the bpard of health. ..... - ---- ...... ..........I... ....Signed ................................. e ........ ..............6;C'e.................. A ........... ...... ............................... Application Approved By .../........... .......... w��...... .................I.3�.te.................. Application Disapproved for the following reasons.. ......................................................................................................................................... ................................................. ........... .......... ..........D.a-e.................. - ---------------------- ................ .................... ..................... Permit No. .....V �77- ----------- ------------------ Issued ... THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE (9ex#if ra e of CfomplianoE THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( �) by ........................................ 6a r1r.0 .u��. Sttw��i'�.;�� ..�"" ^> at ...............................................................r._... _�M. ....... _.!r�la k �`-�Kl r� dt-�t i ny. P---------------------:...._....................-.... has been installed in accordance with the provisions of TITLE �gf,The St ,te E,y onmental Code as described in ti the application for Disposal Works Construction Permit No. .. r dated ..-...._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................. . -_-.......1.. ..." __........ - Inspector - _. ..L. ._� -- ..._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No. TOWN OF BARNSTABLE �/ /1 � FEE..�...... . Permission is hereby granted_... <l7 4 -- -- ----------------------- --------- ------------- --------- to Construct ( ) or Repair �Z_) an Individual Sewage Disposal System PPcet P - aN. Dat^d: o /�' e as shown on the a licati n for Disposal Works Construction P�lrm�rt No.__,,r}�' �/t j -/1 _-/�'l./__/.��f v C !I / li7�Vl/ ---------------------•-- ------•-- ------------ / Board of'Hlalth��` DATE............. ;� u-! 9/ �. ----.................. FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS NOZ Fps.. _ 5 THE COMMONWEALTH OF MASSACHUSETTS L BOARD OF HEALTH -------.. -T.own..................OF..........Bar.GIs.t-abl.e-----.-._..._.-.------------_-............�`... Appliratiun for Diupuual Works Toustrurtiun ranfit Application is hereby made for a Permit to Construct ( ) or Repair (XX) an Individual Sewage Disposal System at: ........... Il AvP_...GerLt:exvi-lls........... .............................................. ot ............................... ............._....... Location-Address orNo •.......... .....loli.11ia ............................... ..........--.......................................................... -......---........- .. Owner Address W ---..Z._P...MELC.ombP_r...Jr....------------------------------------------ -------------•-•----................................... ................................. Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling-X-No. of Bedrooms........... .............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures -............................................................. = W Design Flow............................................gallons per person per day. Total daily flow............................................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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------------------- ............................................................................................................ ------------ --- 0 Description of Soil..........................Gansi---&-Gra_Ye1--•-------------------------------------•-----------------•-•-•--------------••-•-•-----•.....-----•••... x V .....•-••-••-•--•----•-•••-•••-•••••-•-•--•--••.....-•-•-•--•-•-.........••••-•-••-•......-•---••--••-••-•--•--•--•---••••-••------•-•••---•-•----•-••-•-••••----••--•-••......---••-•--••----•-•-••---- W VNature of Repairs or Alterations—Answer when applicable._-____......................................................................................... .. r .. 1--leaching---pit --•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' sued by t bo d of h h. c Signed- - .8 .. as� Application Approved By....... . -•-- ..... t1-- " ._.. . --•--• Date Application Disapproved for the following reaso ................................................................................................................ .................................. Date PermitNo.._. ..._..__v.... -- Issued....................................................... Date No..(J-i................ Fmc..$..... ,, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................0 F.......... .............................................. Appliration for Uhipoiial Workii Tiamitrurtban Vamit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ?.......... ........... .................................................................................................. Location-Address or Lot No. .......... i.-;:,m... • ..r............................... .................................................................................................. Owner Address .......... ......................................... .................................................................................................. Installer Address U Type of Building Size Lot............................Sq. feet Dwelling7'—, No. of Bedrooms..........23.............................Expansion Attic Garbage Grinder Other—Type of Building ............................ No, of persons............................ Showers Cafeteria P-1 Other fixtures ...................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width......._.__..... Diameter____......_..___ Depth_....__......... Disposal Trench—No. .................... Width..........._._...... Total Length_......_.._......... Total leaching area....................sq. f t, Seepage Pit No..................... Diameter.................... Depth below inlet.................._. Total leaching area..................sq. f t. Z 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-_-----_________---_.__. 44 Test Pit No. 2................minutes per inch Depth of Test Pit_._..........___.... Depth to ground water-_-_____........_..____. P4 ............................................................................................................................................................. 0 Description of Soil........... swv:� & Gravel. T.... . . . ... ..............I...a........................................................................................................ --------------**.....................*-----------------------------------*­--------------------------------------------------------------------------------- ....................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable_.....................................I ............. .................................. U .......... ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITS 5 of the State Sanitary Code— The undersigned further agrees not to place the system in A operation until a Certificate of Compliance has been ssued/bb 'th,eboard of 141th. Signed.......... . ......................... ?.............. _�4 77 Application Approved By.. A d �a .......... ..... ....... ............... 7 A . ..... . ... Ali Date Application Disapproved for the following real ........................................................................................ ...................... ...............................................................................................I..................................................................... ---------------------------------- Permit No.. .................. Issued_...........................................Date....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trr#if raft of Tomptiaurr THIS IS TO CERTIFY That the Individual stem Sewage Disposal S- constructed or Repaired k' g P �' ( ) P ( ) by...... ...J r'------------------------------••-•-----••--.....•----•-•------------•--•----•------•---------•----................•---................-•-- ^8 Duxl,.'.stdr? Nve Cf'ritervi le, Installer at........................................................................................................................................-----•-------------------•----.............................. has been installed in accordance with the provisions of "'I"I'; 5 f - e State Sanitary C�e s d0sc�ed in the application for Disposal Works Construction Permit No.-_:: z _ __ ____________ da.ted_...._ __. .__ __ __________•_----_--- THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUE® AS A GUARAPITEE�THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................0 ..�...., .......................... Inspector........----------- ... 3 y THE, COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T1 own „►No -----•... ,................................................... Disposal Works Tongtfurtion ramit .. .. ......'.E.C.......cc i �. Permission is hereby granted-- = :-:.: ....................................... to Construct ( ) or Repair (`� ) an Individual Sewage Disposal System at No . . ...........W v . Street as shown on the application for Disposal Works Constructio Permit N ).....---- �1._ Dated----- � • �y•. /DATE. 13'o rd o Health /- - FORM 1255 HOBBS & WARREN. INC., PUBLISHERS