HomeMy WebLinkAbout0065 JAMES OTIS ROAD - Health (2) �o�J�,A'ICS Of-i s Rod. C,�4�
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No.... . FRis ....30.06
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
Appliration for Diopotittl Works Tonotrnr#ion ramit
Application is hereby,made fora Permit to Construct ( ) or Repair (X� an Individual Sewage Disposal
System at:
6_5 James Otis Road Centex ; ,,,_„•_„-
........ -- .• - -•---••-•-------------------•----•--.....------•--•--................................-----------•.
Scott C O S t e 110
Location-Address or Lot No.
............... — .... -- ....--------------•---............................... ----------------------------------------------
-- ..........-^
W J.P.Macomber Jr. Owner Address
- ---------•----....-•--••-•--•-----•-......-------•-• -•-.......----------------..........,------•••................._.....................•-------•••-.
a ....................•••-•----••••--•-•••---
Installer Address
dType of Building Size Lot............................Sq. feet
DwellingX No. of Bedrooms._.____._________________________________Expansion Attic ( ) Garbage Grinder ( )
`4 Other—T e of Building .... No. of persons............................ Showers — Cafeteria
G, Other fixtures -----------------------------------•-•---••---
WDesign 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........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fT Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P ----------------------------------------•---------------•--•---•---•--.............................---•---------------••-----..............................
Descriptionof Soil------•---- -------•-------------•------------------------------•------------------------------------------------
x Sand--.. Grave 1
W
UNature of Repairs or Alterations—Answer when a licable_______________________________________________________________________________________________
1-1��J0 gallon leaching Pit'
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 beels issu d by the oar of health.
Signed -- �J 1/15/9
- -- - ----�---`���. .. ... ...... ...�.......-.................... .......---Dare
Application Approved By ............. .. .... .. ....... ^ f..'l-� - ------
Application
Application Disapproved for the followin reasons- --------------------------------------------------------------------------------------------------------------------------------------
------------------------------ . . . ---- ---------- ------------.-----
Q - Dare
Permit.No- ----------------L f ........................... Issued .. ........................................----------------
Dace
Fzic
�o.00
is ,
THE COMMONWEALTH OF MASSACHUSETTS
`BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disposal Works Tonstrn.rtiun Frrmit
Application is hereby made for a Permit to Construct ( ) or Repair (X}. an Individual Sewage Disposal
System at:
..Rnad .......... ..................................................................................................
-I �+ Location-Address or Lot No.
eSC Ot� awslallu).......................................................... ........•-•...........----......---_...._......_._._............_.
Owner Address
J...P_t Ma c omb e r..J>r_�.
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling X No. of Bedrooms..............3........................... Attic ( ) Garbage Grinder ( )
a Other—T e of Building No. of persons............................ Showers
Pk YP g --------•----•-•--•--------- P ( = 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 (' )
a Percolation Test Results Performed by.................................... ---•-•------•-----------•-•-•------- Date........................................
11
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--_�.---__---____.__---
r%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground`water...-__-.................
---•----•----------------------•---•--.........--•---------•---.....------------....------. ...._......------------'-'--•---------•--I...............----
P
Descriptionof Soil-----------------------------------------------------•---------'--•----------•-------------------------•-----------------•-•=------••---•------.
W k
Sand & Gravel ............
;____...-_-_ _
---------------------------------------------------------------------------------------------------------------------------------------------------•---------"-------------------------------•--------
U Nature of Repairs or Alterations—Answer when applicable.......................................................................:.....................
-•------•_-•-------------------------------------------------••••••--------------1-10 J J--ga llon---leaching... i 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 has ben issued by the board of health.
~? 15/91
Signed ... ...�e% .. -- ........ .................. ........ ./1 D�e
Application Approved BY -------------------- , . .......... .
Date
Application Disapproved for the fo lowin easons: ----------------------------------------------------------------------------------------------------------------------- ---- ------
9
.....................................:.................................... ......""""..................---..-------
D.
Permit No. ................. - ` Issued ------------------------------------------------------ e------
�.
` Date
THE COMMONWEALTH OF MASSACHUSETTS
I
BOARD OF HEALTH .
TOWN OF BARNSTABLE
C�ex#i�irtt#e �£ C�nm}�it�xrc�c�e
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired K XX)
by......J...P.,.Ma combs.r..Jr-e...... ...........................................................................................................................................................................
1wraller
at .---h5-- JD mes---.O.tts-----Roa.d....Ceraterld l e---------------------------------------------------------------------------------------------------------------
has been installed in accordance with the provisions of TITLE 5 of Ahe State Environmental Code as described in
the application for Disposal Works Construction Permit No. ................ ........../... dated ....... .-.------------.----..-.......----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C 7STREDV-A S A GUA NTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
/ /✓� ....-f................................................................ Inspector ....----...........
DATE.................. �. �...------.............-.....-........-. ...............................
f'
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No......G!....1.��.: FEE..... ---��J,,.
Disposal Works 00Munstrnrttiati ramit
Permission is hereby granted...----. ]'.......
...... .................................................................
to Construct (, ) or Repair (X)� an Individual Sewage Disposal System
at No....6 5..r7A:r p-aa..Qb1.G...P(a,9:d_..a er I t e,r 1I.1.1.a e..._.-------•-----------------------------------------------------•------•-•-•-----...............--
Street q
as shown on the application for Disposal Works Construction Permit No. 1:.,� _.. Dated..........................................
............................... -r -----------------•-------•---•-------:---•----
DATE............. .....................................
Board of Health
FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS