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Home My WebLink About0014 OXNER ROAD - Health (2) bxner i v No..........(-D........ Fis....�' .1. ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD QF H Aj H , pphration -fur IN-4puiittl Works Tonstrurtion Vrrmit Application is hereby'made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal ystem at �o It O .3 3 C�JCh, / • �w� -------------------------------------------------------------------------------------- ....................................................--o......................................... ,, �,� = Loea`ti� 9fdd or Lot No. "'"' r�T` r Address 7st. --••....................c�1��:_.. ......................_.... ......••.....5 t�!!t4&[C!L ---------•-•-•-------•--.............................. er Address Q Type of Building Size Lot...��=_DQ----Sq. feet U Dwelling—No. of Bedrooms.--_------- ___________________________Expansion Attic ( ) Garbage Grinder )G�� aOther—Type of Building ---------------------------- No. of persons_--,____--_____._._-_--_-- Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------- -- Design Flow________....` 0________ ______________gallons per person per day. Total daily flow------- 04__...._____.________......_gallons. WSeptic Tank—Liquid capac -__gallons Length_._....6'_______ Width-._ .......... Diameter................ Depth.-_.-___- x Disposal Trench—No. ................... Width-------------------- Total Length.................... Total leaching area--------------------sq. ft. 3 Seepage Pit No.14r V Diameter____________________ Depth below inlet__..__n..... 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 "lest Pit____________________ Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-.-.-_--_-_-.-.----. - �+ ---------- - -------------- ---- - •--•--..--.._. o a Ar - Description of Soil-------"- t� r - `/�---- �+�! x W -------------------------------------------------------------------------------------------------------------------------------------------------- ------ ---- --------------------------------- VNature 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 Article XI 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 boar o ealth. Si ed.-- ---- ��g `l � ') Date Application Approved BY ---- -- �j" ---- --- �.� -_�.." 7 Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- •-------------------------------------------------------------------------------•---•-•---------------------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued......................................................... Date No......... J Fas............................ •• .. THE COMMONWEALTH OF MASSACHUSETTS rBOARD F H H ..........:. .../ �...---------OF...... ........................ .............................. Appliratinn -far Disposal Eorkii 0=51rurtion Prrutit Application is hereby'made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: �L _ t/i%o� f� 0 X 1�e-tom � G� < t-0/., ......................................... .................... ................................. ............................................... LotNo.................................................. rFrr. 12, ..� aw � Address Installer Address Type of Building Size Lot__.�`!f_�` .---Sq. feet Dwelling—No. of Bedrooms----------- ----------------------------Expansion Attic ( ) Garbage Grinder ) l�v Other—a Type of Building ___________________________ No. of persons-_-_---_______________-_.__ Showers ( ) — Cafeteria ( ) dOther fixtures ---- ----------------------------•---------------•-----•----•----------------------------••---••-------•---------- -----•- W Design Flow-------------5o..__.___�r_ gallons per per-son per day. Total daily flow........°5''.....................................gallons. WSeptic "Tank—Liquid capacif..- ®._gallons Length__._"._______ Width___ ._.-.._._ Diameter--.............. Depth...._____._.... x Disposal Trench—No-_______ ___________ Width-------------------- Total Length____________..--___ Total leaching area__.-_.__..--.---__--sq. ft. Seepage Pit No.1A�0 `-Diameter.................... Depth below inlet_p_._ �._._..nTotal 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-.-_._-..____-_.__.-_--- f=, Test Pit No. 2----------------minutes per inch Depth of Test Pit..._-_____________-- Depth to ground water--...._____________-_--. ------------•-�------.-.--f''----;--A'-------•--........�---•------•-------'-'-'-•-------�----•-- f -- •- -- ---- D of Soil © '7 ------- Descriptiont` -I L `r � `�r`"` ' x .... - - -- - - '-- ---:_.-. - 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issueil by the boar fQLhealth. --------------------------- ---------- fr �,g� Date Application Approved By------- y --�-�x-ki-1 r'1f x__--•--------------_---- ----- -----�--_---'----------- Date Application Disapproved for the following reasons:--•-•----•-------•-••--•-•-• --------------------------------------------------------------Da.--.............. ................. •. ------•----•---••--••--•--------•-•...•----------••.....------•---•---•---••-•-•---••------------•--..._----•-•-•---•. ---- Date PermitNo--------------------------------------------------...... Issued........................................................ Date i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... . ............OF...... ,�. .....................P./ 011rrtifirate of 0.11w atirr THIS IS TQICTER FY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ......................................... ------ ................................... st er at LOY ------------ --- -------- - ---- •------------------ has been installed in a ordance with the provisions of _ ��i.�� XI of The State Sanitary Coded desccild in the application for Disposal Works Construction Permit No- c'_:___--I-�..................... dated----------._...-------------..-.---------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE-CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... -----...2./7--- ��---------------•---- Inspector....r.... =------•------------------- THE COMMONWEALTH OF MASSACHUSETTS �-� BOARD O,•F HEAL H, 6 l No...........1.f!....... FEE arMil �0 strurtijan "amit Permission is hereby granted a `= '°� ----------------------------•••-•_----. to Construct ( x Repair '6f an Indivifltfal v. Sea,ageQr9u sal $ -at No •-------- • t A- Street as shown on the application for Disposal Works Construction P it No. Dated____..........................r` Board of Health // DATE---------------------------------------------------- - r FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS OFF �_ N Z07 2S 4 ti L OT 33 W 15, 030 5,f t �' �` o b pc : 65.00 L. 0 T 3.2 00 ti0 O 00 / hereby certify thot the Foundation PLOT PL A N is located as shown on this Plan and LOT .33 A conforms to the Zoning By Lows of , Me Town of Barnstable. " CROSBY H/LL____EAST i N r. CENTER VILLE- BARNS TABLE, MASS .Scale l "= 40 Dec.20, 1976 GRETE N. 8OHANNON R.L.S, A��A (Nest Bridgewater , Moss. 02379