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Home My WebLink About0145 KNOTTY PINE LANE - Health (2) /q5- A ne 4 - 1� 1 _ � � No........ FEs.....� ............... ,l p THEBOARD oFH E rs AL u H �- �/��3 l . .......------OF.......... .... ... .. ....v. ..... . ......-----................-- Applira#ion -for DiiiVusal Worho Tomitr anion Pr pit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal y stem at: Locat' ddr s or Lot No. OwaOr Address W � Installer Address ff UType of Building Size Lot-----------_ Sq. feet Dwelling—No. of Bedrooms------------- _-__.Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Pa Other fir es -------------------------------- W Design Flow-_-_-___-__- _______________•__-._-_•--gallons per person per day. Total daily flow_-_.__--_----�-e--- ---.------_--gallons. WSeptic Tank—Liquid capacil ns Length----------------- Width------. Diameter------_-_--.- Depth----------_ -- x Disposal Trench—No. ...... .____ Widtli_______ __________ Total rigth_.......____....__._ Total aching area._.__..-__._.-.._.__sq. ft. 3 Seepage Pit No--------------------- D pt �� o leaching area.-`�e2sq. ft. z Other Distribution box ( tank ( aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------. Test Pit No. 1----------------minutes per inch Depth of Test Pit--------------------•Depth to ground water-.------.__--._-_.-.---. riq Test Pit No. 2............:...minutes per inch Depth of Test Pit-------------------- Depth to ground water.......---__.-_.____-.-. P+ ------------------------------•-------•---------•---------------•--------------------------------------------------••----------•----------------------•----- 0 Description of Soil-------------- ............................. •----•----•---------------------••-------- ---------------------------- x01 V ------------------------------ --- --- ---------- •••. ---------------------------------------------------- -------------- ---------- --_--------- --- ----------------------------- ---------- ----- ------------------------------------------------------------------------- ------------------------------ U Nature of Repairs or Alterations—Answer when a licable.-._--_--_--------------------------------------------•.--_---_-_.-------.-.-__._.-_..._... ------------------------------------------------------------------------------------------------------- --------•------ ----•---------------------- ---------•-------------------------•-- ------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—T e undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n issue yhe bo of lth.gned.- �. • -------- ----�--� -../V?X. ae Application Approved By----- - .-- ---- -- -- ----- -- --� .• ..... ....... �� ate • Application Disapproved for the following reasons:..................................... ------------------------------------------------------------------ ...... --....-•--•...........•-----•----•-------••-•---------------•---•---------•---•---•----•---•-•-•--•--•-------------•---•--..........-•---•---------------•-----------------------------•----------.----- ' 22 ��// Date Permit No......................................................... Issued....ar . /7 f=_-- ate....... Date THE COMMONWEALTH OF MASSACHUSETTS ---'' BOARD 5 HEAL f:H - / /- 1-13 .........OF........... ....:... Appliratinn---for Ditipoiial Works Towitrurtion Vrruift Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at:` + '',' /� �4 ...9.Z d.�_ ......... / Locatioe-✓Addr s / or Lot No. Ow Address U e of Building Size Lot---- S Installer Address Type g g —?---------------------------Expansion Attic ( ) Garbage��Sq. feet Dwelling No. of Bedrooms.............. ge Grinder ( ) Other—Type of Building ._- ----------------------- No. of persons......................... Showers a g __________________�-- _.-- -• S ( ) — Cafeteria ( ) dOther fixes -••-------------------••••. --------...------------ ------------------•_---- ------------------------------------- W Design Flow............. ... ._._•....:.........gallons per person per day. Total daily flow..........__...j-e ..........gallons. Septic Tank—Liquid capacity,,/,,,r wj�fg 11 ns Length---------------- Widtli................ Diameter--...___-_--._ Depth-----..-__.._... x Disposal Trench—No......./......... Width....... ------- Total L ngth------------- ---- Total 1 aching area..--- ---------------sq. ft. Seepage Pit No--------------------- - t f:._-_._1� wept e' 1 -_ _-_ _�o leaching area._.? sq. ft. z Other Distribution box ( G� ~;osing tank Percolation Test.Results Performed bY-----------;g40_"-..........-............................................ Date---------------------------------------- ,� Test Pit No. 1----------------minutes per mclf'`"-Depth of "Pest Pit.................... Depth to ground water---------.-_....__-.__- h�•I Test Pit No. 2......_.........minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ --------------------------------------------------------------------------------------------------------------•------------------------•---•---------•-----•--••--------•----------•---•-•--•--------------•---------------•---------•------------------------ O Description of Soil------- i�----...........•- ......• •----------------------------------------------- x -------------------------------------------------------------------------------- - ------/liccable ------------------------------------------------------------------------- -------------------------- V Nature of Repairs or Alterations—Answer when ap ...----.................................................................. ...................... ----•----------------------------------------------- ----------------------------------•------•------------.-----------------------•------•-••---•--------•---------------------------------------•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 'it provisions of ArticlejXI of the State Sanitary Code—The undersigned further agrees not to place the system in pperatioW,' ntil a Certificate of Compliance has been issue rby the boa of h alW , /. , - ' 41, gned.. % (------- ---------------- ----r -•-----'-- Date Application Approved By---- . 06'�i�' ate Application Disapproved for the following reasons:...............................•._... ....__._._.....-_...---_-_._.----_...._...---,_,---..__-____...._.______. ----•--._.--..-•--•---------------•-•-----•-••---.......--------.._.......-------------•-•----.:.--------=---.------------•---------.-----•----------•----------------------•---------------•-•--•----- / Date PermitNo......................................................... Issued-•. V ...................... ate a THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEAL N f �- Trrtifiri ate of f110MVIiatirr THIS ISMj61C�ERTIFY Th the Individual Sew Repaired ( )-„ by _<-:' ----••.. 1--�--- �------------------------------------------ ------------------- at-----`--•e _�` -------`---I/------- 1 / /.f_ �L/�/ I stalle ,s 1-------- �L../ ................................... has been installed in accordance with the provisions of Article X of The State Sanitary Code s descr•bed in the application for Disposal Works Construction Permit No............ ---------- dated'_ j =---- -- - - --�-- -��'---�"F--�I--;;w��--------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL UNCTION SATISFACTORY. DATE- 1��7� �. ...._ _ _,t.. Inspector---_ a - t - THE COMMONWEALTH C� MASSACHUSETTS BOARD F HEALT /J ...t..- ...........O F.......iL� /�kr- ?fit �'...... . . .: ✓......e................. No. •--- - - FEE-_v .. lisp tti IU r ,i oniitrurt f ,rrmit Permission is hereby , ranted_._........ : -� i� C :Y g . -------------------------------------- to Construct (-;_)tbr Repair ( ) an Individual Sewage Disposal System .r at Nod ! == � /✓✓ f -- n >-- Street as shown on the application for Di posal Works Constructio?PP `''' No------- ' __. e ... ,"� .. ...- and of Health DATE............................... 1255 HOBBS & WARREN. INC.. PUBLISHERS • ' 7 Assessor's map and lot number ./l Sewage Permit number Y"ETN 0 F 131 A R N STABD LE a % BAHd4TADLI, 'O 039. 9. �� IOU I LO H NG I MSPEOTH O APPLICATION FOR PERMIT TO : � .'"`ut? { }.... .................................. ......... .......................................... TYPE OF CONSTRUCTION ....ZV'...��,. ...._. . ....... .. .. . .. .. ........... . . ,_......................................... ...... .. . . ........................................14 t0 T!-'.t IN iPECT,JA �ji BUILDINGS The undersigned hereby applies for a permit aa:ord n, 4 tc, the foilowioxl information: 1 f Locatior :...... ......... ..�........:..1 .... '.. �. :C. r .. ...................... Proposed Use ;......./.. Zoning District ..... ..Sir...... ............................... .........Fire District .......1„�f�r1f ... ...:2�2:��r�rC....... Name of Owner .`'. � !/�d j... f 1. `,. .. . Add!es's r L � . Z'LLt ........ .��ly�p Name of Builder A 1.31e15s Nomeof Architect .......'.........................._.. ..... .....,..............Address .. .... . .......................................................................... ....................... Number of Rooms ............ ............................................ . ......Foundation ... 1./.,`.,..... �. L(, C � 'r . `:...... A $ Ex t e r i o r .:6'�.�-'��t'l�x. :�...�:". `�.!i'�..�....................... . k o o f,n g . .�°'. . .'.. ..��C��.�! .........:... .......................... I / 7 Floors �1 .!! k '..........��` LL!`�....................... inten� r �1 .. ...,.. �.... ............................ i r Fireplace /........................................... ..... . ... ..... .Approa,rnate Cost .... 1.(r.. ................................... Definitive Plan Approve I by Plh_nni-ng Board 14 49 Area ........... ...... . ildin, with Dimensions i __. _ ...__ Fee ............................................ SUBJECT TO APPROV OF BOARD OF HEALTH � rot,; r { r r ��t t 1 IJ I 1 I hereby'agree to conform to a;l the Rules and k=gu,;; ar•: r,f *4,r, T ,,-n of Barnstable regarding the above construction. ...................................................................... d All` 1 i, r /p/9 jf/''��/ /J •p G T��- .��/lam - - -- -------_ -- - - - - - - - - - ---�--- -/-_ _�- - ./- - -- - �/-- - -----/ -M--��- ��-.-_�%/9��1 _mil, �ir�f�lQ�GZS _�3`�_v/Cus�ileT/�d _�`�-'c!�r _ rs e�_ _� _ o - - - --i - � -- ---- .__ --- _ G�� s r