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Home My WebLink About0395 SEA STREET - Health 3 q S &a SArr4.G* , -- _30 _ / av_-a--- -- --- - 0 Lnive, 3ulo www.myunlversalop.com phone:1-866-56.4676 UNV1291® MADE IN USA ODIL Ail W� W ) W o �, U� o `6 o 00 vy N a vJ g d O y+ J 4 Q J > C 0 Sens 5 0 i.opO�e,q 1 1 U W AV t � `#. No... Yzi3 .$...5...oo....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..................T. wn---.----.....OF........Barnstable . --------------------------------•-----...........---.. Appliration for Dispas al Works Tonstrnrtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: . 9. .Sea�st .,...Hy,.�xd... 4.....42641. ................. Location.Address or Lot No. Kenneth .... .........••---------•---•-------------- �5.Sep St._.�.. Y�rite ., ......02.kol...................... Owner Address a A & B Cesspool Service28-•Bishops.Terrace,__�Ixais-,.•MA_•-••02601••-• ................. ----. Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' 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.�I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---____--_-_-_.-..._-_. - Q+' ----•-••-•-•----------------------•----------- •------•--------------................._.....•..-----------------------....-----•-••••------•--•-•-•--...... O Description of Soil......Sa?4...._ - . W ••-•-•-------------•-----------•-------------•--------•-•••--------••-•-•---------•-••••-•••-•-•••-•----•--•---•-------------•--•-----•--•-•-----------•-••-------•-••-•-------•--•-----._....•--.••-•-- VNature of Repairs or Alterations—Answer when applicable._....installation._of__.. 1=000..gallon._pre-__._... cast,1stone packed leach pit with extra stone I overflow) . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of-the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by th&bDo d of th. Si nedd: (! � 7/2�:/$1------- Application Approved BY E --------------7..Gµt/81 Date Application Disapproved for the following reasons:-----•-•------------------------------------------------------•-------------•--•-------------•-•-••---••-••..... ...................••-••......-•----..................---•-••--•...••-•••......-------••.....-•-••-----...-•••-••.....•-•.....-•--•-•------•......••-•••------•---------•••---•-•-•-•----------•...--•--- Date --... Issued..----...••-•7/24�/81 Permit No81- ............... . Date 5,aQ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................7Wn............OF.........Bamst&ble Appliration for Bhipaaal Works Taustrurtiou Vrrmit Application is hereby made for a Permit to Construct or Repair (X ) an Individual Sewage Disposal System at: .....02601...:11�aa&Apts........................................................................................... Location-Address or Lot No. ... ... .............................................................. .395.. v ...0.2kol.................... Owner Address .... A.....&..........B Q@�oqp.Qpl..alirdco............................................Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder '_l P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P4 Other fixtures .......................................................................... 9� '*----------------------------------------------- ------*------------ W Design Flow............................................gallons per person per day. Total daily flow....................................��;-----gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width._.............. Diameter--__-__-____--_- Depth................ 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 ( ) 1.4�_4 Percolation Test Results Performed by.......................................................................... Date........................................ ,.-I Test Pit No. I................minutes per inch Depth of Test Pit..___.._...__....._. Depth to ground water.._......_......._....." 0-4 Test Pit No. 2................minutes per inch Depth of Test Pit............__.._... Depth to ground water....._.............._.._ ........................................................................'................................................................................... 0 Description of Soil....... ....................................................................................................................................................... W U ......................................................................................................................................................................................................... ........ ......... i ns U Nature of Repairs or Alterations—Answer when applicable --- ta... - ----- -_-----of 4 ..1A9Qq gA9;1..P ...... .11ati o n .... ... .. cast,lstoi.e packed leach pit with extra stone ow ........................................................................................................... ................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T 1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board ofhe4lth. S ................ K ... ........ _k� i gne..... .. ...... ..7---------"-------- -- ------71? A� ......... Application Approved By............ 100 A181 1............................ ................?........................ X/ Date Application Disapproved for the following reasons:................................................................................................................ ....................................................... ..........................................................................................................................................I .... 81- 7/24/81 Date PermitNo. ...................................................... IssuedL...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................T.own..........OF.........3a...r.n..stable................................................................ T.5rdifiratr of Toutphatirr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by...____. lfya 1A 0.. .. 261..................................................... Installer - at.............3.9 02601 Kenneth Ethier "3 ................................I.................................................................-------------------------- has been installed in accordance with the provisions of T 'LE '- of The State Sanitary Code.as escribed in the 81 application for Disposal Works Construction Permit No._ .................. dated--- --- A.... ..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................... .................................... Inspector------ y .............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barn stable� 81 3vl .............................. ............................................................................ $ 5-00 No........................ FEE........................ RoVasal Works Tonstrurtion "amit Permission is hereby granted..........A..&...BCesspo.ol...Service............................................................................... ...................... ........----- to Construct or Repair ( X) an Individual Sewage Disposal System at No...395..Pe;k..PtAA--HY.a i93...1!,14 02601.... Kenneth ....................................1��Xi...................... ........ .. ................. ............ .. Street 81- 7 as shown on the application for Disposal Works Construction Permit No..................... D5ted..................:....................... ------------------------------------------- DATE........................7h / /81 .)KXd of Health ....................................................... FORM 1255 MOSES & WARREN. INC.. PUBLISHERS