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Home My WebLink About0232 SKUNKNET ROAD - Health 232 Skunknet Road _ Centerville A= 171 - 013 TOWN OF BARNSTABLE p� LOCATION ►�1AGE 9-9 " Y-7 VILLAGE C� � :8`-�r ASSESSOR'S MAP & LOT /73 )0-r j3 INSTALLER'S NAME & PHONE NO.I kILL &L� (` ` `2 0/ Q SEPTIC TANK CAPACITY /00C) LEACHING FACILITY:(type) AW)CI.1 (size) MOO NO.OF BEDROOMS PRIVATE WELL ORdM C WATER BUILDER OR OWNER Zz:t Gc) COrJ C ,-12 yG 7`i U�3 DATE_PERMIT ISSUED: _ DATE COLIPLIANCE ISSUED: _/U-C iTARIANCE GRANTED: Yes No �' 1 �- • �� 3� �� g �C l�Z� � � �' �� '��' --4) No..... Fx$..... f '... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH OLi- ...•--- ...... ......................OF............................. - ApplirFatiuu for Dhipasal Workii Tomitrurtiuu Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .. ............� n KV,.Z,f; -------------------------------- - Locatio - ddress or v o r A dress :4u.�.... c�Qs. d ------------------------------------------ �-x�- ----�__` .... s��r�c�c�rC Installer Address d Type of Building Size Lot............................ feet U Dwelling—No. of Bedrooms..........�-•---•--•------------------Expansion Attic (� Garbage Grinder ( ) Other—T e of Building a Other—Type g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtur s -•-• - ... --------------------•-------..-----•---- ............................................................. W Design Flow.......... __ ________________________gallons per person per day. Total daily flow..____.___._��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--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 04 Test Pit No. L_______________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------___:-___-_____-_-- Description of Soil.................................... 4 - - - - - - -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- UNature 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 T IE 5 of the State Sanitary Code The undersigned fur` r agrees not to place the system in operation until a Certificate of Compliance has been • su d by e b gf healt Signed........ _ .. � �_ _ ...........S..__..__. Date Application Approved By---------- •----Z--'"`--�-tf-�Avk---- ------------------------------- --•------ Date Application Disapproved for the following reasons:-----••------••---------------••----.._...--•--------------•------------------------------------••---•--------- ---•-•--------------•---------------------------•--•---------•----------------------••-----------•-------••-----•--•----------•-------•--•-••••-•---••••-•-------•---•---•-----•-•-------•---•-•-------- Date PermitNo. Lf .......................... Issued....................................................... Datd No...... Fss.....7................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...............---.....................----- ApplirFativat for Dispavi ai Works Tuaastratrtivaa ,,merit ' Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: _..._ ...f................................... ......................................... Locati yddres�s r / � / �j1� � ,/ ,/ " �� PU/ rl/C�IS/ C� WG�OuJ �L+,c'n/or CC�r /e..............•-. Or -- f...... ............ ........ dress ...................--------•------------- /_ Z_� -. ... - Installer Address UType of Building �j Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms___..._...n�.............................Expansion Attic (✓ Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) = Cafeteria ( ) Otherfixtu s -•--•••-------•----••--••-••••-•--------•-••-•------•••--•-•------••-••--•---•-••-----------•---...•••---------------------•---•------••------------- w Design Flow............. ........_ _.....__gallons per person per day. Total dam flow____-___-_-_-114 __......__..••......gallons. WSeptic Tank—Liquid*capacity 2V..gallons Length............ Width.._5_..____..... 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fro Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_-__•_---_-..______-___. ai ®----- Descriptionof Soil ------------------------------------------•-----•--------------------------------------------•---•--------------------•-•-------•.....----_---•-- x 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 provisions of 1 T:..;•. 5 of the State Sanitary Cod The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been - su de 1 of health. Signed............=••----------•... .................................... ................................ Application A ) Date PP Approved BY .. -.------•--------------------------------- ------.... •--y •- Date Application Disapproved for the following reasons:............................................................................................................... .........--•--•--•------------•-•----•---------------••----......-----•--•....••.._......----------•------------•---........-•••----••••-----------.................... ............................... q Dato PermitNo......... l "t-7-_-------_------------- Issued---------------------------------.......__...---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f C/ l/ OF ........................ %Trrfif iratr of TuutpliFaatrr THIS IS T C'ER( IFY, at the Individ a Sewage Disposal System constructed (�d^or Repaired ( ) by. � -�- �' ------------ Installer 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......... _ __`__ _.7____.._.._ dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................... - . .. ................................. Inspector................. ................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT . NO.... . +•.:..... FEE..............W.......... Disposal ur s Quinstrud rrutit ermission is hereby granted............... C_ *< p.i�.� t onstruct ( ) or Repair ( ) an Individual Se rage Disposal Sy temNo ---- ------- ---- --------- ------------........................................................................ Street C 1 as shown on the application for Disposal Works Construction Permit No.....C: __7_ Dated.......................................... .................................................------•------•-------••----........................... Board of Health DATE...................................................................._........... ,FORM 1255 HOBBS & WARREN. INC., PUBLISHERS � f 1 �l E4.,,VA 1"/ON TD P OL` ro4,N o/1 T/ON r1 qpvc . OR �,. R . /VIlN. DISTR-;eYVTIVN Qpal i INV 1000 ' f SFF'Tic 7-A N h" � ,fury,i /n+y � _ =� � � ( �_•'�''� ��+�. + __. 1 YS TE M 17,E TA IL NO TES" _ , t� �r { ., i. _SfvTrc SYSTEM SN..�LG fp�lFd•�M TO TMf /►��J.sflCNr/1ETrS �'N1J/,�p♦:,� FNTAL � _ CVpE T/TLE TNf NfAL7-H 8F- !-" VZA T/0IVJ' 0A- TA/ ' 7—,0WN O F Ej'T!G TANAa A�ST•c 1,P t/7 AAID LE OeH PiT TD �'£ CCIF RE/N��.PCE1� NOT T U r�,' r�r,� fr�nlc,r�t- 7-F y-- rp �D/1l�/N� . GR�rvfr.v�4r y 6 r �N F�' TH � S F✓r-f G TA N!f U!P G f A C .<,+/!1/� f'J 7- A P,E M d,P 6 T fr A N .2 q " B f PCCU! fHT TO O—RAke , f ( i j PLAN t k I DE.5 I u,"-N COM P U TA- TI D/YS j/(` r 4 4 .s/ �! �l: �r E.� (.t'�I �'i F��` !JF t�•� j `_ 1 �y-s, .�."!.+- .f i F,- r /M:�;`f;+ t r� ''.�}':,..e tl S E P T/C TA ivy' ; e�!�` G.� v, x r 5�' -pF AC vL a9 T!O/v RA TZ : _. .�e► !N./ANC N. ' :.,.. .� �u� A-e..L Klil S, � G�p T T OM A►�'E A _ — -- --=/{l r. V. F. 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