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Home My WebLink About0068 WESTMINSTER ROAD - Health (2) CO g i�f 7 `rl s� Imo.,c i No.................. ? Fus ...... THE COMMONWEALTH OF MASSACHUSETTS EQARD OF HEALTH -- -- - -Town---.....OF....Barnstable ....................................................•---. Appliration for RsV' uua1 lVarkii Tonstrurtiun .eruti# Application_is.hereby made for a Permityt�o,�onstruct ( ) or Repair (X ) an Individual Sewage Disposal System at: 1_ _%"_ 5 8 Westminster Road ---•--•---------•................... ....................•------•------.........-----•--................_..----•------............----- Location-Address or Lot No. .......__•---•- �x F 7 ..._ erLtervlle.......................................................... r Owner f Address w ............. lv..t... ....f% ,� _,15 �........................ ...•--•-----------•-----...---._..._....... .------........__..-------------•--------..... a Installer Address UType of Buildipg,— Size Lot............................Sq. feet Dwelling L No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers G.� YP g ----•----------------•------ P ( ) — Cafeteria ( ) Q' 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GT., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------- -_..---------------------.--••------- •------•-------------.....-------•------------------------------------------ O Description of Soil....S9411 Gravel x U ---••-•-•••-••--------------•-••-•-••-•--....._.........-----•--•-••••••--............----••----•-..........••-•-•••••----•-•••••-•••-•-•-••----...-•-•-•-•--•-.............---- ---••- w U Nature of Repairs or Alterations—Answer when applicable---------1.-100Q___gallon_._pit...................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ee i ued b the Pgard 1 lth. Sign ,... .•-•--••-•- '' -------------------------- Date Application Approved By. ......... _ - 7 Date Application Disapproved for the following reasons---------------------------------------------------------------•-------------•------------------------...•-•-•--- .............................................-•-•--------------•-------.........--------------.....------------------------------------------------------------------------------------------••------- Date Permit No......................................................... Issued_.................................... - Date 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF -HEALTH Town....OF....Barns table ............. Tntifiratr of flu t �i nrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X) by.......... oseSh..P....Macomber..&..Son_-Inc .--_._. ----•..................................•----------•----....._...-----...._........--- t ller at......._.._98 Westminster Road, Centery `fe -Grant --•-•--- ---------•-- has been installed in accordance with the provisions of T !� 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. ..........AP/!2..... dated------ -. ....-------•--•- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................•••_____•_•.....-•-•--•--..._•_..........----......._.......-•-- Inspector............................................................................... No........................ Fss... .•00...... . THE COMMONWEALTH OF MASSACHUSETTS �. BOARD OF HEALTH ......................Town----....oF...Barnstable . ;Ap;,prliration for Disposal Works Tonstrurtinn Vrrmit Application is hereby made for a Permit t9r onstruct ( ) or Repair (X ) an Individual Sewage Disposal System at: 4 r 6 444-� ........5B-.Westminster Road Location-Address or Lot No. ................ ..G t....:----•- -•--... ------ SC.en_terxy111.e................. ..................... Owner Address a ........... ..•.--. ...... ' .�.................... .............................•..-•--••---- . --------....---.....-----....------....-•-----• �Q Installer Address UType of Buildi�g , Size Lot............................Sq. feet Dwelling No. of Bedrooms:....:....................................Expansion Attic ( ) Garbage Grinder ( ) � gOther—;,,Type of Buildin No, of persons............................ Showers -----••--•------------------ p ( ) — Cafeteria ( ) Otherfixtures .:---•••-••--------•----•-------•--•------•.......................................•-----• ........................................................... Design Flow—.........................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W .., 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 ( ) 0.4 Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �T4 Test Pit No. 2................minutes'per inch Depth of Test Pit.................... Depth to ground water........................ • Sand Grave 1 ----• ------------------- D Description of Soil :.,: .............................................••-------.....-------------•--•--•---- c, .............................................................................................................................................................. ••--••-•-•-•----------------•-----•-•-----------••----•-••-•--.....•--------------- '=----------------------------------------------------------------------...........--------------------...••••••. V Nature of Repairs or Alterations—Answer when applicable.____---_1-1000_._ga.11on...pit...................................... -••-----•------------•-•----•-------------•.••----•---------•-•-------------•--•---......----•-•--•--------.....---------------------------------•--------------------•--------------•••----•---•---••-- Agreement: The undersigned agrees to install the aforedescribeIndividual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—1The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the bard of 1 g lth. Sig - s"� /t' i Date Application Approved By\.. _ x- / Date Application Disapproved for the following reasons:..........................----•-•............................................................................... - -•----•---•--•-•----------------•------------...------------•--------••-•---------------------------------------------------------------••••- ^M Date PermitNo......................................•-•••-•-----...... Issued.........................................................Date t> ` f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH akJJ �owien�t.afoiFrtt#r�Barnstable .. �..... � .... ........................................................ THIS IS TO CERTIFY, ghat--the Individual•. Sewage Disposal System constructed ( ) or Repaired (X ) b) Jose ............................................a Son Inc. ---- -------------------------------._.....................................................................:..................... at.....•---- 8__Deaf.riirister_.Road..#.`�CentervM8 Grant .. .. . . ------ has been installed in accordance with the provisions of T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.,__ x� .:.: da.ted_.... `_>f._d1.'7 THE ISSUANCE OF THIS CERTIFICATE SHAL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................................... Inspector.....-J........................................................................... THE COMMONWEALTH OF MASSACHUSETTS p BOARD OF HEALTH �7 'xPKJR OF....BP.>I!nktable ......... .eo N FEE.... .......... Disposal Works Tontrurtiott rrmit Permission is hereby granted.... p n... 1 4 t .. .. Qi ...Inc........................... .:.. to Construct ( , ) .or Repair (X ) an Individual Sewage Disposal System at No.......58...Wa13.tZinAte. __Rcad,....Co;rllet".ville...............................................................Grant.............. Street as shown on the application for Disposal WorksConstruction Per ' N........... e ted/ _1444j7.................... Board of Health DATE.._`+ D :......:.......................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS