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Home My WebLink About0153 OCEAN AVENUE - Health Aft Dui IN 5 M EAD KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT10% Certified Fiber sourcing POST-CONSUMER wwwsfiprogremorg sr+012w1 MADE W USA QFT ARGANIZEED AT SM�AD.CQI�I FEs.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T.o n.......................OF.............B.ar.ns t-ab-Le------..................................... Appliration for Uhipvii al Workii Towitrurfiou Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (XX) an Individual Sewage Disposal System at: 1` 153 Ocean Ave: Craiaville ................__......_----------------•-.--••••-- ----.....--------..........-•----........---------•---------•----------........_...------•-----... Location-Address or Lot No. .........L a h e x_._-_•-•........F r a n c i s Owner Address a ......... :.P:Mac.QMb.eX..-•-•••......•-•........................................................ ----••-•-•--•---••--•----•--•---•--•...............•-•-••.........•••-••••-•-......._.......•-•--- Installer Address Type of Building Size Lot_____.-.•........... .....Sq. feet Dwelling�No. of Bedrooms................. .........................Expansion Attic ( ) Garbage Grinder ( ) `k Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ..............•-•......-•--•.•.• ... ;4• '`� W_�� k+ Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Wrt Septic 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........................................ 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........................ P4 ._..--•••••••----•.............•---•-•-----••••••-----••-•-•••-•-•---................._._..--•---••......_._........................••-------••--------_•--- 0 Description of Soil........................................................................................................................................................................ U ---•-••---••-•••••-•---•-•---•---••-•----•-•--•-•••••--•-••-••-•-••••-••-----•--•.......Sand &._.Gl. ve1 -------------------------............................................ W U Nature of Repairs or Alterations—Answer when applicable................L:nl-0_DQ---Leal_loxl---tank----------------------------- ----------------------------------------------------------------------------------------------------•--•-•-••••-•-••......_-1.00.0---.gaLLon...lP_ach."g...pi.t; --. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f'1T!•14^ the provisions of'TT LE 5 of the State Sanitary Code—The ndersigned further agre not to place the system in operation until a Certificate of Compliance has be n issued y t b d of health i 9 6 88`.' Signed .. ------... '---------•-• l- �^ Date Application Approved By.................. ••••••• I^ . ... Date Application Disapproved for the following reasons:.............................................................................................................. .....................................•----------------------...-----------------......-----•----------------------------•------- -----------------------------------------------------------L,......... u Date PermitNo........ .'.. ----------------------- Issued....................................................... Date Q ,tom 6,TOWN OF BARNSTABLE LOCATION �id/ jF G SEWAGE VILLA.GSZ ASSESSOR'S MAP & LOT 22j 6D? INSTALLER'S NAME & PHONE NO..� P SEPTIC TANK CAPACITY 1004!5> LEACHING FACILITY:(type) c, (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: ..DATE COMPLIANCE ISSUED_ 10 VARIANCE GRANTED: Yes No c/ r� I t I . 1 1 , y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -•---- ------------------OF..................................... . Appiirttt u for Disposal Works Tonstrurtiou Prrmit Application is hereby L e for a Permit to Construct ( ) or Repair (XX) an Individual Sewage Disposal System at: •--- 153 Ocean Ave::._. r l a i lla..........--'-----' ---------------------•--'----"-'----'-----'-'•-----------------'-'............'--•'-'--•"------. ,Location-Address •--•--...or Lot No. !_..............................--------------------------------------------- .....-•-------------------•--••-- - -------------- ------------------- -------- -'"`f Owner -----•--------•------------•---_Address f Installer Address Type of Buildin ' Size Lot............................Sq. feet �--� Dwelling—No. of Bedrooms................3.........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ....... W Design Flow.....:.....................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tarik 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.......................................................................... Date........................................ 1 Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water..................... f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---------__-___-----__-_ 0 a .-•••------------------------••••----•-----•-------•-••-••-•-----•--••-----•---•----•---......---•--'-----•---•-......-'•---............................... Description of Soil....................................................................................................................................................................... x V ..........................................................................................Sand: ... .._Gravel ....------...........----......................._._._.__._......_.__..__.. W U Nature of Repairs or Alterations—Answer when applicable_---------------1-100^__.'1a l l on...z:%1? •`_._..___._._...........___. ------------------------------------------------------------------------------------•----•-------------------------------1---1 f}...... -_-z 11 nr� ----' t:._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTi.a. p 5 of the State Sanitary•Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued,,by the board of health! I'll, ; Sign(d. ?t= !/e?y :_'- _J�%!;f,' �?.r',irlt,�l==°•f................. Date Application Approved B - Date Application Disapproved for the following reasons-.....-......-.........-............................... -------------------------------------------- -------------- Date Permit No...... = s y Issued----------------------------------------------'-•-••--- D-._- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............T•o.wn...............OF............P�arnstable ....................................... Trrtifirab of TwOmp ittttrle THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (KX)C by....J...P..Ma r a mh a r....-•--..... Installer at-----U:-... - has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........ --:----57..f.9.. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector...................... , -------------------••--'--'---"---•-•- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH g8 Jc— y Town.......:...OF...................Barnstable............... $ 20.00 No.. ........... . ..... FEE........................ Disposal Marko 0-51instnuliutt unit Permission is hereby granted............J.p.Macomber ,,�"'Into Construct ( ) or Repair (XX)C an Individual Sewage Disposal System at,No.-j 153 Ocean Ave. Crai ville- ---- ----------------------------------------------------------•-•-------' ---- .--------------------------------------- ------• ----------------------------------------------........... Street �6 y as shown on the application for Disposal Works Construction Permit No..............sy..... Dated.......................................... _ - _ Board of Health DATE .<- •- -- I. ---------------------•-••-•--•--.... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS