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0030 BRIARWOOD AVENUE - Health
- _ . . ....�- 1 i tl / ( 7 L O CAT 10 S G E PERMIJ NO. VILLAGE 14 INST'A LLER'S DAME A ADDRESS j� 0 UILDE R OR OWNER DATE PERMIT ISSUED ^g- DATE COMPLIANCE ISSUED � �� Z-S'3 r - 1 -4 !ao IJI r T ry , No....-3-:.1..Z I_. dw Fes$.... .:. ................... THE COMMONWEALTH OF`MASSACHUSETTS BOAR® OF HEALTH Town. OF..............Barnstabl Aliptiratiou for Mipaiial Work.5 Tomitrurtiun rrmi# Application is hereby made for a Pe it to Construc (X ) or Repair ( ) an Individual Sewage Disposal .System at /Brj ar ood Road Lot 28 S--• . ..... ........................... .•• ••-••••-•...........•• -••-................. • g� _4atwl ---..........--- Location-Address or No. ` Owner Address ---------------t� ..----------------------............. ••........----- ........................................... Installer Address d Type of Building ,Size Lot..l 2 z 3 9 0.........Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) A4 Other—T e of Building No. of persons:........................... Showers — Cafeteria Q' Other fixtures ---------------------------•--•• . -- W Design Flow............ . ...........................gallons per person per day. Total daily flow...........330.........•-....,...••.-.gallons. WSeptic Tank—Liquid capacity l0 0 0gallons Length8'.6..._..... Width4.'1_Q"... Diameter................ Depth5.'.4......... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.---____--I......... Diameter...U............ Depth below inlet.....5.............. Total leaching area..2.6.7....... ft. Z Other Distribution box (X ) Dosing tank ( ) aPercolation Test Results Performed by.CaRq...Cod...Survey---Corlsultarlt Date.........2-a/83.............. ,� Test Pit No. 1.................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2......2........minutes per inch Depth of Test Pit...l 2.. Depth to ground water.none..,__.._-__ ------------------------------------------------------------------------------------••......•••...••......................................................... O Description of Soil....Tp# : & TP#2 0 .0' -2 .0 ' wood loam and subsoil, 2 .0'-7 .0 ' �4 medium coarse sand,.. 7 _0' __12 . 0_' fine white sand v ••.-- -------- -•-•---- •--..... --•-•--- ----•---- W -•-------•----------------------------------------------------------•--------------------•-------------------------------------------------------------•----.....-••----•.......--------------•------- U Nature of Repairs or Alterations—Answer when applicable............................................................................I.................. --------------------•-----------......_......_...••-------------------------•--------------------------•-----------•-------------------•-------------------•-----•-------...------------...........•-•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TiTI 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has i y the oard f n - ------------------------------ --•------ Application Approved By...... --.. ............................ .--- ........ ..................... C Date Application Disapproved f th f o110 ing reasons--------------•------- --•---•-- ---•--....--------......................................................... . ---------------------------------------------------------------------------------------------•--•-- Date PermitNo.................................................•....... Issued....................................................... Date t ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........To.wn...................OF...............Ac4rA table ApplirFa#ion for Uispoii of Works Tomitratrtion rrani# Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage Disposal System at: Brtanwood Road Lot 28 .......q..1.......A.... ............a'. .................................................... .................................................................................................. Location-Address or Lot No. •...&Z �� 1 Owner Address W . .......................... ..... ^--•- Installer Address �1`� ___ U Type of Building Size Lot__ _..U3...............S feet Dwelling—No. of Bedrooms............................................Expansion Attic ( } Garbage Grinder (i©) a e of Building a Other—' Type g ............................ No. of persons............................ Showers ( ) Cafeteria ( ) Otherfixtures --------•---------------------------------------------.•-••-------•-•-- W Design Flow............ ...........................gallons per person per day. Total dail flow._.........3 3 o........................gallons. e n W Septic Tank—Liquid capacity l9,®flgallons LengthS...6. Width4........' ._ Diameter................ Depth5.F411..... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area___............__...sq. ft. Seepage Pit No.........I-------. Diameter.....0............ Depth below inlet....6............. Total leaching area...?6:.......sq. ft. Z Other Distribution box (x ) Dosing tank `-' Percolation Test Results Performed b ! cAR!8 �O Su�'Vej Consultant 2f 3/8 aY ---••...............••--_. date... Test Pit No. 1................minutes per inch Depth of Test Pit___-_-..__.......... Depth to ground water........................ f� Test Pit No. 2_..__Z.._.._..minutes per inch Depth of Test Pit---1 •4......... Depth to ground water.??S?Y2e........... 04 ----------------• . ----•-•-•••••------•--....---------..._------•-•---.....------•------•--•--•-•- ••.-• .. O Description of SoiL...TP#......................... & TP#2 0.0°-2.0' wood loam and subsoil......2.0-'-7. .... ----------•- .................. medium---coarse_wind_,...7.0 '-�12.._0'_._ ne_.wh to sand. U -•-•-•--------- . • •------••..................•. W x ----------------------------------------- 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 TI L_ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Com fiance has the P P ,; Y oard f D Application Approved BY -•-= .. 'fix ......• � � � a b;; ..._ ....... .ri..... --- __ Date Application DisaP in reasons:...........fi �. - - Proved fr -------••-•-----------------•••••------•......---•---•-•--•------•-••- -----••-----....-----------VZ-... •••---•---••--•-•-----•----•---•------•--------------•--------•---•-• •- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................................................. Trrfifiratr of Toutpliaatrr T - SvJSS T CERTIFY, T at the Individual Sewage Disposal System constructed ( or Repaired ( ) by ---- I staller. at. � - -------- - -------- ------ " has been i stalled in accordance with the provisions of TI71-rT. j of he State Sanitary o---_------------------ ...........ribed in the application for Disposal Works Construction Permit No._ '." _.._......... dated _.THE ISSU ANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE E SYSTEM WILL NC ON SATISFACTORY. DATEJ ...... ✓...--••••- Inspector.... .... :........••---------•••---•---•--------......---•-••-•----•••••••..----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..----..........................---............_..................................... No... -'':. `d .... FEE.0.............. apos-ai Warkv Tuoaao#rurtion rrumi# Permission is eby granted = ". �" '--------•---•-••-•---•--•................... . to Construct Re air ( an elndry Se ge isposal System at No.. --- --_ ............. --•---.... -------------•-••---•-----•---•------••..--- ........ Street as shown on the application for Disposal Works Construction Permit No....................... .atc ._._....._ ._.. ............. .............................................•--..--.....•--••••-----•----•......-•-•-•......•-_..... --, Z / - DATE...................... oar of Health �----•----/--�=�•-----•--...-•--------.....--- ' FORM 1255 HOBBS & *ARREN. INC., PUBLISHERS