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HomeMy WebLinkAbout0033 TOMAHAWK DRIVE - Health 33 ToMa lwk Dr Cerxurvitle qo - o I SMEAD No.2.153LY UPC 12934 smaad.com • Made In USA SUSTAINABLE FORESTRY INITIATIVE CWe�d Ww�ourcLiq A r MAP . 3,Y7 A No.- � . .. FRs...... .... . .... APPROVED THE COMMONWEALTH OF MASSACHUSETTS e �' BOARD OF HEALTH S Dub TOWN OF BARNSTABLE Apphratiou for Ali►ipwial World, Tontitrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (< an Individual Sewage Disposal System a Location-Address or Lot No. ... cab .S'4v#+nn...................................................... Owncr Add reJL s J = YA ...................... Installer Address UType of Building Size Lot...........................Sq. feet �..� Dwelling— No. of Bedrooms............3...........................Expansion Attic ( ) Garbage Grinder ( j aOther—Type of Building ---------------------------- No. of persons-_-___--_-___-_-__. Showers ( ) Cafeteria dOther 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 ( ) ..4 Percolation Test Results Performed by.......................................................................... Date........................................ 1 a Test Pit No. I................mmutes per Inch Depth of Test Pit.................... Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ -----------------------------------•----•-------------------------•---------........------............................----•-•---•-•--........................ ODescription of Soil....................................................................................................................................................................... V ................................•••----•---••-•-•-••--------...---•----------•••----••---•---•-•--••------•--------••••••-•••-••----•---•--•------•----------•--••••---•-----...--•.............--•----- UW --------------------------•-----------------•-••----------•------ Nature of Repairs or Alterations—Answer when applicable-- W1 -0�l_.--..L_'___.1 Q_d-_--•-_ t l..__._ �._......... ....... r --------..-"--- L.P...100.j------.W.�.....a-----. 60)n_�g............................................................................... 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 Compliance has been issued byLhe board of health. Signed .. ... .. 1 Dare ' / ..�..... ........ .............. ....... ..................�'.. -- /I ApplicationApproved By ...................(Jac. ...... .................................................................... ..... ..- Dare �-1..-..��.�f Application Disapproved for the following reasons: .......... . ........ . . . ..... . ................................ . ................ --/.. ....... ... ....................................... ... ...... -------.---------------------- ----------------- ............ ......................... . ----------- *......... Dare PermitNo. ............ .. .:-.......�...5.6.............. Issued ............................ . .............................. Dace �� u^-w•>,.-�t- �.+. r:_ „-,_ - .�--:-r-•.�-:.y--:v., ter: - L�cJ-__. � —. „_...._ _ �. _ __ __ ___-.. -. ____ - ~�J SIC. Par. No.._. .............. Faa. _5C1 i THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF HEALTH t//.�_� /� TOWN OF BARNSTABLE Appliratiou for D4,pwial Works Tomitrurtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal ' System a Location-:Address Or Lot No. ---------------------- ........................................................ Ow er Address t (s1 t �A�IICD 50_... a i it t' ...... ....................../(� _, Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No, of Bedrooms............a-_____________________-____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. 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. 1----------------minutes per inch Depth of Test Pit-_-___________._____ Depth to ground water........................ L? Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •...•••••..............•-----•-••-----•---••-.--••••-•---•-••-••-•••-------•••--._....--------.....----•-----•••..._..------------•--- DDescription of Soil............................................•------------•----------------------------......------------------•--------------------------------•-•----•........__----•- W UNature of Repairs or Alterations—Answer when applicable_n fA( /_------I.o.e �"4/ � -•- - --------- --------- --------- -------•--• Agreement: �I 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 Compliance has been issued by the board of health. Signed -.-- ---------- �./ 1.- ' mot.............. ........ y��v" -e/ '��� ........1/. ApprovedBY .... �.� •� L..... ........................................................... ......V-.-., Dace Application Disapproved for the following reasons: .................. ... . -- -.........................---.. ---...............----...--............... . .................... ............................................... . ......................................--........... ......... .........._........... ................................ Permit No. .. ------ g6.. ....... Issued .............................. ...................... Dace...-.. Dare I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tex#ifirate of Tontyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired O' b .t..6......... - ✓U. -L>.----------- �— / t�..rlie i at .........��a��.........../.a .hAG �..---...._ 1..------._..........tom / �1� _......----------------------------------------- - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ........................------_..-............ dated ....... ............................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.DATE.......... �.... Inspector ....�..- .... ..I...r..........�...... .........1...... ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c� TOWN OF BARNSTABLE FEE---.....�.�.>...-... Disposal Workii Tunutrutiun '"rrutit Permission is hereby granted---------- 1.8----- 6mf L4............................................................................................... to Construct ( ) oar Repair (✓) an Individual Sewage D' System s ------------........................ street as shown on the application for Disposal Works Construction Permit No. !_l��___ Dated..........._............................... ----------------- ... �..._ ----•------------------ L Board of Health DATE .._..__..-_�.. ---------------------------- n r FORM 36508 HOBBS d WARREN,INC.,PUBL SHERS /060 - 413 - /0 0 0 TOWN OF BARNSTABLE LOCATIONS 3 To wK SEWAGE VILLAGE�GnYeXVl*1M— ASSESSOR'S MAP & LOT /� 0/'7 Ale INSTALLER'S NAME & PHONE NO.,4-� ✓f CgACL) �m /�yP'��S�ita, � /%tA SEPTIC TANK CAPACITY LDAO �a!/or.S LEACHING FACILITYAtype) 1,aao d ol. le gl A'l(size) 6 X 6 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER —&,)03 s alum Ah DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: Cam- — P5/ VARIANCE GRANTED: Yes No ��! y�nofy �9 .,1��/ ;. , � ���� )�� 1,g�y `s� JCL 4� �� C� TOWN OF BARNSTABLE LOCATION 33 Tomahawk Dtc. SEWAGE # OLD VILLAGE Centenvif-te ASSESSOR'S MAP & LOT 190- 17 Senv�ce by ASB Canca INSTALLER'S NAME & PHONE NO. 350 Main S W. yarcmauh SEPTIC TANK CAPACITY 2, 000 Gats. LEACHING FACILITY:(type) C ez s pa o2�s ( 2 ) (size) 6 x 8 NO. OF BEDROOMS 2X�( KX,X(�(1� PUBLIC WATER X OWNER Robert 9 Madeteine Schuman DATE PERMIT ISSUED: Cez spoats pumped 7/ 1 1 190 DATE COMPLIANCE ISSUED: Conditi,on,Good VARIANCE GRANTED: Yes No �,� ilk).�^. _) i •� .' � r , - � ...t iv.l; - ------ N g I k C Cat r . ..�� •� �, PuN'llull'kl Ylnl� � rrm utuer:nu u.l•ul . ti � , ' ' tdmculuu rtrtt,uu �irr��ii�irr�r��� ,, � �.I.t.rlr• 1', �' !,r,, .�. .,•. ���..