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HomeMy WebLinkAbout0295 AMES WAY - Health 4M � es wl Y Cenfyi(It 17o - 01 { 5 M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR OSFOU,6ST Y LE MIN.RECYCLED INIVE CONTENT10%a® Certified Fiber Sourcing POST-CONSUMER wwwxfiprogram.org SF 012M MADE IN USA GET ORGANIZED AT SMEAD.COM I •--•• FRs.`.......`.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di-sposal Works TUmitrnr#iun Frrutit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: Locati n/-Addres/s or Lot No. c!SJ._._...... ............ --------�'-•:_r .......... . .............. Owner Address Installer Address Type of Building Size Lot.. .DDD _-�---Sq. feet Dwelling—No. of Bedrooms............. _______�.................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures -------------------------------- -- - - . W Design Flow...............: .............--..gallons per person per day. Total daily flow.___........._.._�_�__�__G.........._._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.._...�4._._.._ Depth below inlet.......___.____ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation 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........................ a -------------- -------•------•-•----------------••---•------------•----•----------•••••••-•-••----••••-------•••-•--••-••.....----------...........-------- 0 Description of Soil....... ........ !t. _..._... W UNaturp of Repairs or Alterations—Answer when applicable....eF �..X_.. �!�1..i57.. -------���----------- "'®------ Pro P ---- 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 further agrees not to place the system in operation until a Certificate of Compliant as been issued by the board of health. Sined ...... --- ---------- .11............ . -- . --- .........---------------- Application Approved By ... Q -------------------------------- f 3 �gto ................ ........................... Dace Application Disapproved for the following reasons: .------------- ------------------------------------------------------------ ----------.................................... --------------------------------------------------------- ------ -- --....................................------------------- --------------------.............------------------------------------ ---------- --------------------- - V` 2 Date PermitNo- ----------------------------------------------------------------- Issued ......................................... -- ------------------ Date 4:•" Na �..�.2....... Fps... � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Elisp' oral Works Tonstrurtinn rantit Application is hereby made for a Permit to Construct ( ) or Repair (� an Individual Sewage Disposal System at: .......c ,9S�__/ is�l S -1��'=�r ............................... ............................................... ----........................................... Location-Address or Lot No. /sue)------... .,95`...... -5 C� :...----- ...... t Owner Address ,Wa ----....0 �Jl �L0777-----•-�6��ls :----------��-�-- �c4,Y......, ?Q yi12,�?>1�.,- ....... 114 Installer Address , Q Type of Building Size Lot.- DO/).=Sq. feet U Dwelling—No. of Bedrooms__...•..............,.3.•....•..__..__..Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) G I 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 ( ) Percolation Test Results Performed by.................... .................................................... Date........................................ a" Test Pit No. (................minutes per inch Depth of Test Pit.................... Depth to ground water_-___-_____-_-__•---_-.. (i Test Pit No. 2..._............minutes per inch__Depth of Test Pit.................... Depth to ground water........................ a •-•---•-••---••--------•-----••--•--•-••-•••.....................................................-•--•----------••••----•-•.._..........---•---••--------- O Description of Soil......./-)-- .....----�-C- ........Z-_,2 Ce-�__Q__'/C...---- - / = 14'r ...,s4-,��-..... x w ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•••......---•••- V Nature of Repairs or Alterations—Answer when applicable..e�AY.4 LJ,rc-_.-O°..A�E'.1 ..�T. !�..__�aC ,�-! t _12i.7 r 7,��A� y d ---•--.�• o2�f1®---... Q ..p(T_.....!_i /—\S ............................... 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 Certificate of Compliance hasbeen issued by the board of health. Signed- 1 ............. G, ....... �' 4--- - �^ � Date Application Approved .... Q / ..........................................---------•-------------------....----------- `� .................. Datc Application Disapproved for the following reasons- ---------------------------------•---------. ----...........................................___----------_-. .. k \. Permit No.. ------9/ 1- 2—-- ------------------------------------- Issued ----------------------------......... ............................. � Date r THE COMMONWEALTH OF MASSACHUSETTS I , BOARD OF HEALTH TOWN OF BARNSTABLE 4 Cfez#ifirate of QTfI aplinure THIS IS TO CERTIFY h the Individual Sewage Disposal System constructed ( ) or Repaired ( ) �JI�BGDS77 COX,.5-72plJ6_Tll by.....-...... ---------------------------- ------------------•.....-------------------------- -----Installer at - ...... ..../�J�fS -- .-------���Qd/LLB---------------------------- - ---------- 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. ..... ..�.. ...:z...................... dated ......../... -/�..t......-.- -.-.--.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR TEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ,e ........---------------------.................. Inspector ...... ---•--------...........................-•---............------ ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No......................... FEE�.�K,./............ Disposal Marks Tuns#rur#inn Prrntit cow n�•c� vc�o Permission is hereby granted......... ...... ....... ........ ............ ................. to Construct ( ) or Repair *(�) an Individual Sewage Disposstem atNo........ . ' ---...................... ��/GG�.....................----................................ Street as shown on the application for Disposal Works Construction Permit No`�,�_:.Z......... Dated....1._ .�Z�..................... / n ............................................................., ......................................... DATE.-------•-l!l--- --/--................................................ Board of Health FORM 36508 HOBBS✓4 WARREN.INC..PUBLISHERS �. U7- 33 TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE C��t)/aE ASSESSOR'S MAP & LOT ZZ42 INSTALLER'S NAME & PHONE NO. CxaAJ5- SEPTIC TANK CAPACITY LEACHING FACILITYAtype) ��- � (size) <��, Z� NO. OF BEDROOMS PRIVATE WELL PiTRi_i BUILDER OR OWNER 46&-,pd0tj ©ee--IE�nj DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No e 711' 56 r a I 15�-- 07'` i:95f) -- LOCATION SEWAGE PERMIT NO. 29r2 o f WIR `9 H51c a 4 S VILLAGE ce;;11e-,4- 11%411 INSTA LLER'S NAME i ADDRESS JOHN A. AALTO .BACKHOE SERVICE West Barnstable,, Mass. 02668 B U I L D E R OR OWNER DA-T E PERMIT ISSUED DATE COMPLIANCE ISSUED " : �� � ,6 �,u 6 '�� D �y _ ._. . 4 No....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _81­4C............................. ........OF.......6W.R.U.S.T 4 Appliration for Dh4paua1' lVarks Toutitrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ; - CAf . ................ .........a-2----------- i;n-A#djessor .................................... ..........; 7,.... .............................. 0 ner Add q 1.4.................. ................................................. .......... /r42 ............................. Installer Address Type of Building Size Lot..... . ------Sq. feet U Dwelling—No. of Bedrooms....._.._.9. ............................Expansion Attic Q") Garbage Grinder (No) Other—Type of Building ............ No. of persons............................ Showers Cafeteria 04 Other fixtures ................................. ------------------------------------------------*------------------------------**------------------- Design Flow............/40......................gallons pe per day. Total daily flow____--_-::92_a 0................gallons. W e., I /9 Septic Tank—Liquid capacity,/Qon..gallons Length6_2�...... Width..9fA.". Diameter-__--__--____- Depth..S'_.� '..... Disposal Trench—No..._...... ..._. Width.................... Total Length................... Total leaching area....................sq. ft. Seepage Pit No......../.....;,,Piameter-----jC9 ... ..... Depth below inlet..ALI.......... Total leaching area..0'2_0.03 ..sq. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed by..._. "-.0.-N.1V..6&>............T:........... Date.... Test Pit No. l..4.;Zt_minutes per inch Depth of Test Pit....ZV......... Depth to ground water..,0j_a.A/,6"._.. Test Pit No. 2................minutes per inch Depth. of Test Pit..._._.............. Depth to ground water_._...................__ ............................................................................................................................................................ 0 Description of Soil...... ......... 62-"9/,v -YA?�Lam.......... ................................ W ............................ ..................................... ........... -1 em",&�.V..!nr— .,o - U .9.9_5�e. .........._5;e9w.,�............................................. W .............................................................................................................................................................................................. U Nature 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'LI'i1.E 5 of the State Sanitary Code—The under igned urther agrees not to place the system in operation until a Certificate of Compliance has b n i ued by t e b o ealth. A Sig ... ... . ............. ..................... /at Application Approved By..... . ......... . ........................... ....... / Date Application Disapproved for the following e ons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo........................................................ Issued....................................................... Date N ....... FRIC.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TO W.IV............0 F....... Appliration for Dispasal Works Tonstrurtion Prrutit Application is.hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ................. 1.1,Z............................................. E"o'c"atio­n_-Address ..........or Lot No. ................................................................................................ .................................................................................................. Owner Address ,4 .......................................................................... ...................... .................................................................................................. Installer Address Type of Building Size Lot.15.316.4.....Sq. feet 1-1 U Dwelling—No. of Bedrooms..........9.............................Expansion Attic (00) Garbage Grinder (NO) a Other—Type of Building ...hJ/'A........... No. of persons............................ Showers Cafeteria Other fixtures ................................. ----------- Design Flow............//_0......................gallons per pers-on per day. Total daily flow.........-' _0...............gal Ions. 9 Septic Tank—Liquid*capacity./6iw..gallons Length5!�__..4L". Width.'/.2A.0". Diameter................ Depth..S_�....' Disposal Trench—No..................... Width..............._.... Total Length.._................. Total leaching area-----------------...sq. ft. Seepage Pit No........i Z........ Diameter.._._.C9........ Depth below inlet... ........ Total leaching.area..4R.0�.sq. ft. Z Other Distribution box ( IT Dosing tank ( ) 0-4 Percolation Test Results Performed by.........!m.......C.0-A)-A)-.6R-X....................... Date....ZI 9.. 1.4 � Test Pit No. L.4.9---minutesperincti, Depth of Test Pit._.ZP........ Depth to ground Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... ............................................................................................................................................................ 0 Description of Soil...... ........4fle9lY...... ........ . ............................................................ ...................................... ...........Z4, U ...........47".PpAe ?_>............................................ ........................................................................................................................................................_.............................................. . t4 U Nature 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 TAILTLE 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. Sig ................................................................. .......................... D t .. Application Approved By...... ----- ----------- ... .. . www Date ..... 7 Application Disapproved for the following reasons:-.................. ............................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.... ........ ............................Tprtifirate of Toutphatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer. at.........................................................................................­*---------*----------------------------------------- has been installed in accordance with the provisions of T, 5 of The State Sanitary Code as �Iescribed in the application for Disposal Works Construction Permit No.__ -----47-V................ dated- .7f-------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON UED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. Inspmtor_�....... ................................................. DATE...................to--=::.k................... ------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .....................................OF...................................................................................... N ........ FEE........................ Disposal Work.5 TRomitrudion 'j"Prrmit Permissionis hereby granted.............................................................................................................................................. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo ,.­;...................................................:.:........................................................ Street as shown on the application for Disposal Works Construction P it N L. Dated...Z.—/4L. ............ ---------------- /DATE................................................................................ Bo d of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 1 r TES HOL.E NO 2C� , 19 lE3 40. l 7. IAAUL 1`'°! iA -Ay - T N< PlfC i oR — L07. 3 3 l ELEV /9 .o J . PROP 33" L� { LUG" � LOT � 3 .t ss' 34- / MA'DIUM -CQt q,r ,' EXIST iNC� -- 3�"¢ O 26 FoUN D A!'i' ON 041 io" 1,j�0 TEST a Et� Y. 7 � I - O SEPTIC. M(?L 7 A N tC N D !c_.:/4 71-9 Ir Pl c 0 Lf tv'T F R r-ID �9a d s p15T Jy+S s' i30X �� TOC.c.1N IA JA TER J� A`v'i';C..A !='G 4 �6RYE LCAC,H �q�o Go-t ` 3 /� 5.00 ' / -41//U/A4uti7 j3 u/LD/nrG .S ETl3�1 C� e�Q v/,� ME�lJT,S S C,4 L E / = 30 F20/v 7- 7z�17� P2 0 a0 SED SE P T/C 5 Y5 TAM CONS T2 UC T/OAJ SHAG-Z- C0/i1F02M TO MASS . DES/GA/ FLOW GAL/DAY ENV/,e OAJM L-AJ TAL COOS. T/TL • L-LA C// )2.4 TE G a. M/n/. //i/GA/ TOFF OF (JL A T/O/VS G D L E ACf-/ A,0 A O' 2 0.00 S "0,1= S7-OAJE O•_DO /MpEl2✓),OUS CO✓E,.2 MANHOLE CO✓EI2 TO EX TEND TO TO .a2E VEA./T .�/A/C--S W/ TN/A/ / OF G/A//SHE-D (3)0ADL=- �2o�ti /n/F/LT2.aT/nrG J I S TOnJE/O d , 2¢.,V_O✓G-/Z$ I I D 1:5 7. //.f i//✓j U/LJ _ 3OX Z/-Wwc 0J/Ee OAJ I p/TGr�/ A— FL-Ow LANE .— N .b,TGf/ p/T. /D"M/n/ /41, )4*/r00T 2 Mini �i rc Al -✓- ' /�f 2 D/A. Mint �4 Fa o r ' n C LSD s+ C3 WASHEO Y - /A/!/EIZ r S To n/E �t �/o Q_ / GALLON/ /A/VEZ7- i <l�C l /NVF2T CA AAG / TY � ELEV ' A20UN0 i E�-)7 c TA .8 o710A4 a)r-7 CLVA 7-n 7-1 7-) /N VE2T /n/vEAZr /V0 GA)L5A6E G,L/ND,F-P- SITE PLAAJ ��, ✓ I �`'-E� �.-� 6 � > L0 <17-i 0ti C EN1,7 kVI LEA, t,jA 5, SEpT/C TANK 0/� TT2/ 5UT/ON 80X OUTLETS AND LEACi�//ti/G A-/T TO f3E OF ,2E/n/F0.2GED C-OAJCTZETE t ~ OOn1G2�T� STLE.vG77✓ 3000 P5/ M/n/. -& - --- - ' jam. _ #�- , ODOO *' ,�. `4., .:kv", {, .":/7" ;, y .{^ _ � r�J/ 0" t7lc'/ ✓'� Lv.l'Y' /�/�T TO L �',4✓��> O✓E,G. 5''S7-E/-7 UnJLE�5Z> A/- 20 f'� 1 i�Y 7*t Z7E.S'/v/`/ L�J4D/A/c� /S fSET3ACK ; R % � n ry ,.Y ?TO L N r ai "A � - — ---- - ------ j ii F2 A �F��G O✓mil L-