HomeMy WebLinkAbout0498 NOTTINGHAM DRIVE - Health (2) J
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No........ 2 Fas..
n THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�y—S OWN OF BARNSTABLE
Qato
Apptiratiou for Diripo3u1 Work.5 Tomitrurt"ton ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( L)_-an Individual Sewage Disposal
System at: `
.... ......... ------.........-----.....--------------.
ncat'n a-Address or Lot No.
l .�... .--�.....-•------•----•-- .................... ................
cne Ad
a •c s a .. _;�c��.................................... ._ ...I _rrn�i ._... 2�. .....
Installer Address
UType of Building Size Lot................ Sq. feet
�.. Dwelling— No. of Bedrooms......... ................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
04 Other fixtures ................ .............. . .
d
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 ( )
aPercolation Test Results Performed by-------------------------------------------------------------------------- Date........................................
Test Pit No. 1................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........................
P4 --------------------------------------------------------------------------------------------•-•••..........---.........--------.......------•----........----
0 Description of Soil........................................................................................................................................................................
x
x ------------------------------------------------------------------------------------------------------------------------ ---- - ------------------�,._
U Pleement:
re of Re i s or Alterations—Answer when applicable_ ------16 �.---_& ......f ... .... ._._.
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 undersigqfd further agrees not to place the
system in operation until a Certificate of Compliance has been ' sue
y
ApplicationApproved By .................... ........... --.�.... ..... ....................................... . .... .. . .................... ..... .. .....6��En....9..../.
Application Disapproved for the following reatons. .................................................................................................................... .............
................... ...................................: .................................. .... ....... . .......................................... .......... ........................................
uu Dare
Permit No. ... ..... ... Issued ! .._�.y............1......... ..........
Date
�`'-1;".v.r�P^.tr..�'-- �•-..-.--•-ti....r�.r�-4...-_.,:31.,,,,.,�,r+y.- ..-:.:-•-.....Y.�� i:..•_.....w.i^E'9'4. -.—..--.�..�,,✓.. ...�"a.' J�,r •i
J.
1 `Lr .. r....r9..::.r 1..a-.... �'�. �...�+•,•^w;,.--°`.'.`.. � .-4':..-.-3rl�fa:�-._.,....-w
No... ...f ----Z 2 Fas.. ...........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratinn fvr Diripitiul Wi nrkB Tongtrnrt"ion jhrmit
Application is hereby made for a Permit to Construct ( ) or Repair (. (,),.man Individual Sewage Disposal
System
at' ` f
4 N / l / 1 /
_. I
Location-Address .••••._.....
� / or Lot No.
1r )—to/Id t� � i CY_�� - ............................. -••-•-•-----------•••-•••--•-••---•-...........-•••-•---•-•--•••-.................-----•..........
pane, Address
w � P17��, �� 7/�� /irt,r,� �f'X._ ylr:.. 7 ,�ht,�// /1 •- Z.U ,�
......
Installer Address
U Type of Building /7 Size Lot............................Sq. feet
.., Dwelling— No. of Bedrooms--------- ................................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..._.�a......................................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........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
GZq Test Pit No. 2..............:.minutes per inch Depth of Test Pit.................... Depth to ground water........................
Q+' •--••-••••-•-----------•--•-••-•••••••••-••••-•-••••-•.......••••••••••••-••••-......•-••-••••...............................................................
ODescription of Soil........................................................................................................................................................................
x
rJ
W ......•....•-------------- ------•-•----•--•----•-------------.....--------------------••••-••--•--•----•------•------.....-----•......--- ......-••••-•••••• ' .....•-
U Nature of Repairs or Alterations—Answer when applicable._.__._._ �0 C ��
lI l 7 /L .
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 been '�ssued-by-th-e-boa�ig.-of-hea�l'th'.
Sig e '_ , ��� ......_....�..... 1 ` �7...
...,.y.......r.Y..............-... �.......w;;.. .. ........ ...................f-................
Alication Approved B ,/ /-�/. C ---- ---------------------------------------------------------------- .. ....9.._
Nate
Application Disapproved for the following reasons: ............. ...................... . . . .......... . . ..........
i
`7 l 2 2. . Date
Permit No. ........ ............................. ......................... Issued ............�......�...� ........Y.....................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
10ileztiftrtt#e of CZompliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
l ......................._ 1...� �lat ......................... .. . . . � � Lv � /� ) If) ) - �� E/-;Ib",(�/.�-4...........................................
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as des'ribed in
the application for Disposal Works Construction Permit Nog. ..z .Z:..._..................... dated .......
./�. .. .. .......
HALL NOT BE CONSTRUED AS A GUAR TEE MAT THE
THE ISSUANCE OF THIS CERTIFICATE S A,N � o
SYSTEM WILL FUNCTION SATISFACTORY. t _} /` 0
DATE.......................................... ..� .(.,... _...... ........ Inspector ...... --..,.... ........_............... -
� I _ .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
2 Z TOWN OF BARNSTABLE
No.....J.............. FEE-.fv�..:-. ...
Dispaiia nrki Tnnitrnrtilon ramit
Permission is hereby granted........... :.... /1�1.f ....._ -�t � -F�t( 11c� -
r --- --•....--••----••-•-------•---•-•••••••••--••--••-•-••••••............
to Construct ( ) or Repair ( �an In
Sewage Disposal System "
at No. {'�[ (//1-I/� )Ct !7 p I y C E�x t✓/Uf _.. -------
Street
as shown on the application for Disposal Works Construction Permit No��-^_¢Z__.��ated___--.�..._�y y..............
r/
1 ! ' _/ Board of Health
L
DATE - ....--•-••-•t•-••.---•-
FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS
No.. .-.: ,Z Fxa..J� ..... .....
THE COMMONWEALTH OF MASSACHUSETTS APPROVED
BOARD OF HEALTH Pornstable Conservation Department
TOWN OF BARNSTABLF '\ ' ct�'c3
Signed, Date
Appliration for Uiopoottl Work.5 Toustrnrtion rnmit
Application is hereby made for a Permit to Construct ( ) or Repair (p4 an Individual Sewage Disposal
System at:
..--•..........................................................•---•---•-........
-•-•--....--.... •-------•-----•--•-•--•-••----•-•••---••---••-----•----•----••----------•-------•--•----....---••-
anon-Address
B Cr-. cal c-S'C.u00 _ 0i4 f
-•-----•------------------------------ ---- -•------------•••---•-- .........................................
lwne� dress
,v�a2,VC,7.VAj _7Cv�
Installer Address
Type of Building �� Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.__......._7//...........................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type
of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
dOther fixture -------------- -------------------------------------------------------------------- --- --------------------
�Vye
g -gallons per person per day. Total daily flow....................... .-
W Design Flow----------------------------------------- ------------
•.-gallons.
--
-
WSeptic Tank—Liquid capacity Q___gallons Length-------------•-- Width---------------- Diameter----------...... Depth................
x Disposal Trench—No. ........./...... Width___-__7._-___._ 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. 1----------------minutes per inch Depth of Test Pit_----------------- Depth to ground water........................
0% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ----------------------------------------------------------------------------------------------------•--•....................................................
ODescription of Soil........................................................................................................................................................................
W
V ....._...•--•---•..................•--•--•-•--•-...-•-•••......-•••---••----•----• ...................................................................................................................
W
U Nature offRepairs Alterations—Answer when applicable._... �C.ES%?1�- om___ OO •C-- �
...... .............................................c j----------=�------ J L. +r' �` - '�....; , ??�.1 ...........----
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 Complian has e�F'
by e board of health.
_--
Signed ......�-- ----. o:./.-.�DaceApplication Approved By ............
.,..,�,.�� .�.-... '-. ��....
Application Disapproved for the following reasons: .......... ... ............_.................................. .. ............... .--. ...................
.................................... ................................................... ... ................................................................. . ... ........................................
Date
PermitNo. ........................................................... Issued ............................ . ................... . ..
Daze
9 �
•. •:ice 7 i t � 1 i'+��'� � C'� �-'� Cl`�
...........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF H EALTF
TOWN OF BARNSTABLE
Appliration for Diti-poml ]Uorkg Tonitrnr#inn remit
Application is hereby made for a' Permit to Construct ( ) or Repair (ry.C) an Individual Sewage Disposal
System at:
..-••••-•-- ..y.- ........
Location-Address
2uB_�1 U�D19oj`~' 'r?4 � e +r.............................................. ... ... t ` '•...;....-
........
Owner fess
I U4 1ZtV, �
............................................ -------•-•-••----•-•••••-••---•--•--•-----...... � tt`S
Installer Address
Type of Building Size Lot............................Sq. feet
�. Dwelling—No. of Bedrooms------------�---•--------------------Expansion Attic ( ) Garbage Grinder ( )
a Other—Type of Building No. of ersons---------------------------- Showers
a g ---------------------------- P ( ) — Cafeteria ( )
d Other fixtures ---------------------- --------- =
W
Design Flow................ ..._._........__._gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacityA.�OA__galIons Length---------------- Width-----.--------. ............. Depth Depth___.._..........
x Disposal Trench—No_ _________ ______ Width........_._.__.
..... Total leaching area--------------------sq. ft.
Seepage Pit No---------_---------- Diameter.................... Depth below inlet.................... Total leaching area---f--------------sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
0-4 Percolation Test Results Performed by------------------ ....................................................... Date........................................
W
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........................
P+ ---•••--•--------------•----••--•--•-•-•-•-•••-•---•-•-•••------••••--•-----••......•--.....-•-•••-•......................................... ...............
0 Description of Soil........................................................................................................................................................................
x
V ...............................••••••......-•••-•-•----.......-----•----•--•--•---.............•--•--•---.........------••-•••-•••-•-••--._......--------••-••-•---•--••---------•-•••. ......-••••••...
UNature of Repairs or Alterations—Answer when applicable.._1- �?-4-�._....4__.-.1��..Q'
�..............................................
t. --•-•-.... :.................•--•---/�Ji- i:. (/7� 5 --•--- `�1- /` ......... .................
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 Peen 'sued by the board of health.
Signed ........ /. ::. ,...... � C-...... ........ ..I Dat�0.. ....
Dale
Application Approved BY ------------------------------------------------
.......
Application Disapproved for the following reasons------------------- ------------------------------------------------ --------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ........................................
Date
PermitNo. ................................................................. Issued .................................. -- . .. . ...........
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
01-lertifirate of 01-11amplianrie
THIS IS TO CERTIF_Y,-That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by----------------------------------------------- ,n:GIG :.:vi/� ..... ��1.� > c2,��7e)tj
> t
Inar,Jlrr
at ............................................._.........._...�.�.... .�5 -U1�0 t, .-,��l.,y.---- �------ -1�-------------_C-: �-�1 -',-C✓j.t-----��--------
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. ..._� ..-...r.�-1 ............ dated _._.........................._.............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION
/SATISFACTORY.
DATE...............................r ��'. - - ------.------------------- Inspector --------
1 -
_....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE ,
..� FEE........................
�io�nottl nrk� �nn.�#r�r#inn �rrntit
Permission is hereby granted........................:.. -�-- !--_rG'----------------_-_____---C-:%b----------�
to Construct ( ) or Repair (; ) an Individual Sewage Disposal System
atNo.................................................... �z 1........ -fit �J Sa ! ' _'.I----..... � t......................................................J C ,E,- 2 )t ...
Street �
as shown on the application for Disposal Works Construction Permit No.2347j� Dated......�.�-... --?........
----•••••--••-----•............... ..[----- `----------------------
/ ....................................... Board of Health
FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS