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HomeMy WebLinkAbout0730 OLD STRAWBERRY HILL ROAD - Health ��4 - d35 1��o•M.r�,s a 6 fi k F r 4 !, dt5' ;3 'u a . 5 P A b O TOWN OF BARNSTABLE LOCATION �,30 ocD 2a/ Fi? V/kJ&SEWAGE # VILLAGE ASSESSOR'S MAF' tic LOT INSTALLER'S NAME Sz PHONE NO. SEPTIC TANK CAPACITY loos) -VgWe ! 800 LEACHING FACILITY:(t7pe) (size) NO. OF BEDROOMS _PRIVATE WELL O UBLIC WATER) 0 BUILDER OR OWNER' CR I4,0 0 DATE PERMIT ISSUED: 7y.5' DATE . COMPLL4NCE ISSUED: z�l 96, VARIANCE GRANTED: Yes No '� V '�, n s-� . C � � cr �. c� � i o �-�� r t �� - ; . THE COMMONWEALTH OF MASSACHUSETTS j 00P BOAR® OF HEALTH ...... .... ....... . .............OF......................... Appliration for Mipoiittl Works Cho trnr#ion amit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: 4P -jo E ` .......-•-.T(A �..0 _ ��..I�-� -------------------------------------•-----.. Lojcation�Address or Lot No. .................. ...._.�•-. at — ------................... ............................................ ...... ._............... "� /�` � I I owner `� � ) Address _y ------•---------------- Installer Address Q Type of Building Size Lot....ay �-3.51.Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ('\j'rP p`4 Other—Type of Building ............................ No. of persons.....................--..... Showers ( ) — Cafeteria ( ) Q, Other fixtures .........•-•-••-•••--••-•-•... - d .......------ •------------ 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 ( ) =it--., a Percolation Test Results Performed by-••••---•---•----•••-•--••-•--•--••----•---------------•--•-•-•-•....... Date------------• ••------ Test Pit No. 1................minutes per inch Depth of Test Pit.--................. Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-------................. a •••••-••-••--•---------•----••••----••••---•••-•--•--•---------•-•••--•--•-•-•--•-••......-•-•............................................................... 0 Description of Soil............... .....-•-•----•-•-•----- x U ----•••-••••••••--•••-•....••••••-••-••---------------•-...........................--••......--••-•-••------•••-•-----••---••-••.....----•---••••---••••-•---•-----......----------.......---•----•----- 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 TITLE 5 of the State Sanitary Code The undersigned further agrees not to-.place the system in operation until a Certificate of Compliance has bee 'ssued by the board health. Signed ---------------- -- Date - ------ Application Approved By.............. 1! .. :.. . .... .. -.2d•:9 - .......................•-•--•----•— _. _.. Date - Application Disapproved for the following reasons:------••----•--•---------------•------------•-----......------•-----------------•-•••--•---••-------- --......-•----•------------------•-----......--••----•-•-------•---------•-----------------•-•-------------•...-•-•.......-•••••----•••••-•-••-•-----•---•••••--•••-••••••----•••••-•--•••------•--••••. Date Permit No....... —S=-- Y25---------- Issued....................................................... Date NoJ3:S..!Z.,y:57 QtC .rzx' vtFim is-------------- THE COMMONWEALTH OF MASSACHUSE77S BOARD OF HEALTH ...........................................OF........................... Appliration for Disposal Marks Tanstrartion errant Application is hereby made for a Permit to Construct ( 4,� or Repair an Individual Sewage Disposal System at: . ................................... .....................................................7--------------------------------------- L t' -Address ...*----- f-'V � "" . or Lot No. ............. . .... d--- ----------- ........ ­­......*------------------*,-*"'**..........*---------- ............ Owner : Address U- .......... ----------- -------- ------------­------"------- ------ Installer Address Type of Building Size Lot_.-. 3&.!7�17.Sq. feet U Dwelling—No. of Bedrooms.............0':-?%k........................Expansion Attic Garbage Grinder PL4 4 Other—`Type, of Building ............................ No. of persons-_.._..._._......_......_... Showers Cafeteria P4 ,. .< Other fixtures .............................................................................................. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—liquid capacity............gallons Length................ Width....._.......... Diameter................ Depth_.._............ Disposal Trench—No..................... Width........._..._...... Total Length......._.._..._..... Total leaching area....................sq. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) b.j 0--4 Percolition Test Results Performed by.......................................................................... Date........................................ 14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water...... ------- Test Pit No. 2................minutes per inch Depth of Test Pit..........._._...... Depth to ground water...._........_._...._... fYi ...............................:.............................................................................................................................. 0 Description of Soil.::............:. ......S.V.K�................................................................................................................ ------------------------*..................................................w....................................................................................................................... ...................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable.............................................. ................................................. ............................. .................................................................. ................................................................................. Agreement: The undersign'ed.,' grees 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 bee i sued by the board 9)health. Signed.- .............. 5 ................. ................................ Date Application Approved By--.. .............................. ......... . .............. Date Application Disapproved for the following reasons:........................................................................................................... .....................................................................................-------------- -------- ------------------I------ -------*--,*--------"I------- ------ Date Permit No....... IssuedL.................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF................................................(Intif irate of Tautplitt"r That I THI IS TO CERTIFY; constructed or Repaired ndiv dual` Disposal System by.. - .... ......►.......... a . --- ....-.....-..-.... ...............................................................................................................insi.11er, at.. 7 ..n ........... . , .Lo.. ...... ........ ....... . ........... has . been installed in accordance with the provisions of TITLE 5 of The State Sanitary C-ode as described in the application for Disposal;Works Construction Permit No........ dated__......... .r-................................ THE ISSUANCE.:-bFTHIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FYNFTION SATISFACTORY. DATE.. 11. ............................................. Inspector_ . ............................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r7qj!E7. ...........................................OF..................................................................................... ............. arks Tons�Urtion Prrmit Permission is hereby granted............. ......................................................---- ---i----------- to Con struct f'l—j"or Repair an Individual Sewage Disposal System at ...... Street as shown on the application for Disposal Works Construction Permit S Dated.......................................... ................... .. .......... ................................................. DATE........e'�l------- .... Board of Health -- -----r. .............................................. FORM 1255 A. M. SULKIN, INC.. BOSTON i LP 0,• ry _ LaT `7 34, 739 S•F t �c a 4, o' OF x o�3►�p pis G� O WAFTER k 00 f G�K , C.2 SMITH,JR. CIVIL ` 10'-k 14 #15128 t<-, itgoorA M.. ou:5s �FSS10�1E�1 �: ix �h 1 ��1p / ROA D 2 h0' 52 ' BARNSTABLE-, MA. D t. s Po sA,L- Pima tJ AR.TH.UR CA1A,00 LITTETON MA H0S ENcT-Assoc.lwc.RNYNHAr-1 SCALE--'l"=60, JULY.,2O,1985 r1 g7.v g3 z 93 o PST..BcK '94.0 14- ,�• L o©o GQI. Cont. 3 4 A o 4 a . G Fi- ScP+rc. T4n l� 8 3, s A & AA CO�1G. LeA,C)q;I-' r P,r, A 4A G AAA . AOA ��J% 6 z� • T � .Pr -1�L kln,hcd 5�one SO I L ST R.F1 Tfj S ��A GROVnIp D E S t-!Cl N D A,-TA ; �3^ LoAM 4Sv73SOIL C �cZCoLA--T-1 0N R -24 A.'i'� . 2 M/VIl1JC1-� TEST PC-P->+'oRM Ev Dec. 6, 1980 C,aAvct_ C'3GDRooMS K I lO C-tPD ; 9$0 C P NO-79 72 C`zArZ�qC_'E DISPOSAL U /OOO „ of CAPAGlTy PR O\/ 1D >✓ p .; CoA�esE 73oT-rc).M s)2x1..0 = teas G pD SAND SIDES 2_1T"S x 6 x 2..s = T OTA,I.- . 471. 2 C P D^ 73. — CAPf�c�!-ry f' 0v1D 51-97 11Pp -J44'" l�.o VIA TE2 ►�l oTE — D ISPpSAL. Ste(S-r-c1.01 D�s1c�NED o N s o.F /4eTHUR CA►ADO LOT7 OLD S� _?WBE2py PILL. ROAD i