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HomeMy WebLinkAbout0132 ESTEY AVENUE - Health /3� e34et gcrm 's TOWN OF BARNSTABLEr� � LOCATION �� - �� ���SEWAGE # 5 J�� VILLAGE ASSESSOR'S MAP & LOTJOT 0 INSTALLER'S NAME & PHONE NO. _ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) lU/,� ��� (size) 3 �� � f NO. OF BEDROOMS PRIVATE WELL O UBLIC BUILDER OR OWNER �6 �� toe r=n n ri r= m DATE PERMIT ISSUED: A C DATE COMPLIANCE ISSUED: � 3 VARIANCE GRANTED: Yes No X __ � � I '�� � � i � �r �. � �_` a �� _, � � c � � I � ��,�+ � � , �� , � �. � C, � V� . A� .. .. 10 .. ' � °� � � . � � � � � � � $ .. �,. VRCELW.: 7 No. - Fps ............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 7 7 _0_:W_V, ....OF...,.- . `. ....................................... Applirutiaatt for Mipogal Worko Touptrurtion lirrutit Application is hereby made for a Permit to Construct ( ) or Repair Individual Sewage Disposal System at: ......... !- - ......... ..Y._.....IA e ...... ............ s =�-s .. ....- . Location-Address or Lot No. . .4�� ,r.,... ........s..ra_ s. .... ._..... ..................................... W Address � r S..... c`?-3 6"7�.............. 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 ( ) Otherfixture"s ------•------•--•------------•-----•---------•-•----•--••--•---------•-•---•-•---•---•--•--•--•-•---------------------•--•---•------...._...._..---- W Design Flow........ �-......................gallons per person per day. Total daily flow------ .�.z a_--•---...___.._._._..gallons. W Septic Tank—Liquid capacityL gallons Length....a�...__. Width...... . Diameter________________ Depth................ r; x Disposal Trench—No..../............... Width_..._.8._....... Total Length__.. - 5�._ Total leaching area_._.-_---_-.--------sq. ft. 4 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area...................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by------------------------------------------------------•---•-••-•---•----- Date......................................... . �7 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. l P P P Q ------•-------- --- -------------------------------------------- -------------------------------- •-•---•-------••----------------- •------------------------------------------ O Description of Soil------.� �t �^-....... °J-------5" ?'c.Y---------------------------------------------------- x U ...................................................------••--•-•---- ----------------- Z •---••-----------------------------••--• ---- • • .....���Ss�eO x ........ pV�t �o'RG '----____I�G__._rc�� U Nature of Repairs or Alterations—Answer when applicable.....�-'j-'-G_.. 0' ----e r4.....0 cSS_rG z-. .......jpZ.7........ --7=r1'-k ..tea -----------�- f �stv�z� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of THIT-1:p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has the bo d of he .. ... ... ..--......__ c�• _ .: ate �PPlication Approved BY -..: -------------------------------------------------- vJ! �P .............. Date N eApplication is for the following reasons---------------------•---------------•------------------------•.................................................. ''► 1._ Date Permit,No ... . ... Issued...................................................... f Date �'► 72 a-`t 0 ' No. ...I I Co`7 � F��B-�-a_-- --..--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --....OF c, \ --------------------•-.---.---------- Appliration for Disposal Works Toustrnrtiun Prntit Application is hereby made for a Permit to Construct ( ) or Repair Individual Sewage Disposal System at: -` y Y:.v`e ! `fir tzq-!�=`'c'`-5 --• ........................................................ � Location-Address .p or Lot No.1�'..l`G .......... ...............................................^........ Address .....- Installer Address QType of Building Size Lot............................Sq. feet v Dwelling—No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........_------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ........................................... -•-------------•-----------------------------•-----•-••-- • ------------------------ ------- W Design Flow....... _5.......................gallons per person per day. Total daily flow____? _........ gal 1:4 Septic Tank—Liquid capacity�.r >__gallons Length... Width........... Diameter................ Depth................ Disposal Trench—\To..-/................ Width....!-c-.......... Total Length... .._ Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter-___-___-__--___.-__ Depth below inlet.................... Total leaching arm.............:...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by.......................................................................... Date........................................ `4� 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........................ a ------------------------------- -..............................------------------------------------------------•---•---•----------------------------.----- Descriptionof Soll--------------------�F �-- l�'.....----------•--..�.-----••------------------------------•-----....-----------------------------------------•-------•----- W ---•------------------------....................................... U�.....!��-- --•------•--••••.................... . ------- VSsCo �(20VNA �j O RG�} �111C�G�F A.s-------�--1-T ----•-----• --------------------• ---------.... !-.?ice..------... to -------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T iT:2 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha the bo d oAh . Signe .......31.------ Application Approved BY ' '= p- r .................................................. ------•. vl 'ZO---•••- Date Application Disapproved for the following reasons:.............................................................................................................. ................--..•-----------------------•--....---------------------......_......-----••-------••--------•-•••••••-••••-•--••••--------•---••-••-•---••--••••--•••-•-•......-------•---•......-•--- ��� Date Permit No. - '"' 1�.� -- Issued..... ..-•---.... ---•-------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ^T.U...W...Y`. ...........OF -u. :Q................................... (Iptifirttte of f fampli anrr THIS IS TO CE That the Individual Sewage Disposal System constructed ( ) or Repaired i(� by----------------- ��... �: ------------------------------------------•.----------.-.-----.--------------------•--•--------------------------------- --------- Installer � . / has been installed in accordance with the provisions of T i TIE: 7 of The State Sanitary Code as desc .1bed in the _. -- application for Disposal Works Construction Permit No �p..._.t�..5``.1� _ dated_--.____,_. _�. ( .. � ..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTI N SATISFACTORY. DATE..........................��... � ........................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , r n`--T1� .1.t!✓ ........O F.. �.�`-" .............................. C�- 1� ....'1. f FEE........................ �in��an 1 n ��aatn�rnr#uan �ernti# _ Permission is hereby granted----------`- .------------•-�--••-`°=-�---- .. ----•-------•-'---------------------------------------------------------•-•----- to Construct �.) or Repair (L_j an Individual Sewage Disposal System atNo............ ........ ---------_ -------------------- ............................................ . _ J as shown on the application for Disposal Works ConstructionPerrnt N io._� -��--_ __lated.._..•.� L..1...!-. l n Board of Health DATE............ _ ..�. - ........................... FOR�fy 1255 HOBBS & WARREN. II�1 PUBLISHERS I