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Home My WebLink About0387 OAKLAND ROAD - Health F3�8' 7O Oakland"Radafyannis _ r% P Q I, 4� I-, TOWN OF BA"STABLE LOCATION 171 SEWAGE # </ VILLAGE,yYL,,� ASSESSOR'S MAP & LOT INSTALLER'S NAME 6i PHONE NO. /"/�r�f'� SEPTIC TANK CAPACITY LEACHING FACILITY:(type)s��.�� (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER��'c AjjjiiWt-OR OWNER —=DATE PERMIT ISSUED: DATE CAPLIANCE ISSUED: 2% 71, 51 VARIANCE GRANTED: Yes No 12 C , Q� Q � � y � � a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstrur#ion 11truti# Application is hereby made for a Permit to Construct ( ) or Repair (gyp an Individual Sewage Disposal System at _ .......... .....� ...... . cation.Ad ress �� t No .. _. ...... - ......... ...... .... ------.. ..... .. _...,��--_------------. .. - -- -- - s O /� Address W ,t� i/tom �'^'�.. Ins Address Type of Building 3 Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria 04 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........1........ Diameter... �i _. Depth below inlet.....lt.......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) &, a Percolation Test Results Performed by.......................................................................... Date........._._.._.................. -...... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ LZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.--..................... Pa' -..-...--•----------........ ---------------- •-•........ -.............. ---------------- .......... ODescription of Soil...--0, ... --.-..---•--------•--•------••--------------•-------.-----•-------------•----••-•---••------•--••- W t, ---.--------------- ............... --------------- •---------------------------------------- ------------- •---------•---•--•------•---------..-.-------- •-------------- ................ -----••----- W --•-------------------------••---•---------------•---------------------------•---------•--._.....--•----•------•-- ------------..... t....._..... ................ U Natur Repairs r Alterations�nswer when appli bl -... .. . ....._.. 1� �.� ... i .... -------------------.......... 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 lace the system in operation until a Certificate of Compliance been issue��the b rd of health. Signed ..... ................. ........... ............................... .. .... .. 6 ApplicationApproved By ..............a ..... ..... . ...... .............................................. Application Disapproved for the following reasons: ........................................................................................................................................ ................................................................................................................................................................................................................ ........................................ qv tore PermitNo. .........1. 10 -.... .J .................... Issued .................................................................... Dare �No.. 7-Z7-. THE COMMONWEALTH OF MASSACHUSETTS 4 BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Eliipuiitt1 Workii Tonstrurtion Prrutit Application is hereby made for a Permit to Construct I( ) or Repair ( an Individual Sewage Disposal System at: Leo"ation-Address 1 or I of No e Owner Address =•rY Instr--�' Address i Q Type of Building r Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms.............`3_.__............_...___?---Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of'persons............................ Showers — Cafeteria Otherfixtures .........................-••••-•-•----•---••--.•••-•I-•-•--••-----------••-•-------•---•---•--•••---•-•••••••-•-•-•-••......-•--••-•-•••......-•-•-- 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 aPercolation Test Results Performed by...................................... ••------•-••--•-•--•--•-•--••-•---• Date--- -------------------------------•--- Test Pit No. 1................minutes per inch Depth of Test Pit....................'Depth to ground water........................ fX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... RS ---•--------------------•---•-•------------------•--......................................................... D Description of Soil..... __l +r!L__. + -e' er----------------------------------------------------------------------------------•.....--••----- x U ...---•--•••--•-•-••••--•----•••••---•-•---...._...••-•-•-••------•••-•-•--••-•-•••-•-----•-•-••••-•--:•.......-••----••-•-•-••••-••--••--•-•---•-•-----•-•-----•-•-----•-•-------••-•--••-•---•-•------- UW ------------------------ Nature of Repairs or Alterations—Answer when applicable zx ='" '____._ �/f _, _ -__. 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 issued by the board of health. I Signed ....... -- - ----------- fG't� Dace Application Approved By ��, b�• ..- Date .�._ '/✓ Application Disapproved'for the following reasons: -- '---" '--""........................"--'-"-''_-"--- ------"'""----------------------. ..---- --'......._.. -------------------------------- ------- -- . -- -------.........---------"'--..........-------------------------------------------------------------------- ---------- -------------- q. ITare Permit No. -' ...-.... ' /".............. --- ---- Issued ----------------------------------------------------------------- Dace ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cer#ifira e of (iffontpliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.............:......... -' ------------- ---- -----------------------:---------_------------------------------------------------------------------------------------------------------------------------ Installer at - --- ---------- � - ..- 111�f v� has been ilafed in accordance with the provisions of TITL(V 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. -------- dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE `".....0L ---------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C� TOWN OF BARNSTABLE No. .l �`G FEE.-- .... �i��la�tt1 nrk� �nn��rttr�tinn rruti� Permission is hereby granted................ �-:,� .......:.hi 'y, ------------------------------------------------•-••--------.------.------------ to Construct ( ) or Repair ( � an Individual Sewagsp`os System atNo...._... Z� ..7 �� .-�'�s.:.��_.... �;!-_......... �' 2 ------------------•---------................... Street v as shown on the application for Disposal Forks Construction Permit N7 Dated.......................................... ............................ of Health--- ----------------------•---------------•------•--------- (� DATE................ 1_. .' %1.....---............•----...---- Board FORM 36508 HOBBS Q WARREN,INC..PUBLISHERS