HomeMy WebLinkAbout0151 SKATING RINK ROAD - Health 151 SKATING RINK ROAD
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PROJECT 1!�adroom/Office Addi+ion Far. m�er:
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X Plans 1 552 +'o or.
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LOCATION•
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LO ArwN SEWAGE. P RMIT NO.
ILLAGE ^.
IMSTE! LLER' NAME & ADDRESS
R w-a'-wE-R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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.THE COMMONWEALTH OF MASSACHUSEI
BOAR® OF HEALTH
Town Barnstable
OF.........................................................................................
Appliration for Bispoiial Workii Tautitrurtinn Prrutit
Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal
System at:
Sk tin Rink Road ..............................Lot 56
Location- d e s
.y..-__ o s ............ Ga�_...... ..._.n k...-U-7.------. A ----------------------------
Owner dress
W '� 'A#t..........................................................
Installer Address 10 080
Type of Building R 14,At C14 Size Lot............................Sq. net
Dwelling—No. of Bedrooms................ ......................... Attic ( ) Garbage Grinder
aOther—Type of Building ...............•-_--..:__._ No. of persons............................ Showers.( ) — Cafeteria ( )
a 55 010 , 336
Other fixtures ..____.__._.•------•------__
W _g P P P Y Y s
Septic Tank—Liquid capacityl..........gallons Length............... Width-___............ Diameter................ Depth_...__..4.. .
--
Design Flow................ _gallons er erso e a ota i ow......_.._.________._........_
W Disposal Trench—No................. --------Length ... area
Depth below inlet.................... Total leaching area.._----._-_.......sq. ft.
Z Other Distribution box (K ) Dosing tank ( )
Percolation Test Results Performed byCape...God...SL nv.ey....Gaaaultari$EDate........... /24/79---------
a Test Pit No. 1......_2......minutes per inch Depth of Test Pit........L2.!..... Depth to ground water...nnne......
__.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ...............................•-••••-••-----••••-••••••••••••••••-•••••-••••-•••-•-----------------•...-•-••...--••••.._......_....••.........--•---.......
O Description of ...med.__.hr-oven-_.sand_,__._ _.4.-12-Q__.
vmad„•••to---aaarz e---sand-..&.-graue-l- ------------------------------- � .".Of.
W ----••----••-----•-------------------------•---......•-•----------•--••-•••----•-----•----•--•--------•--••••--------------•------•........---•---- ........ ba-• ........... s�q
UNature of Repairs or Alterations—Answer when applicable------------------___ _______ ___ __ _ ___ ............ ------R�NVVaG.-_. 0
................................................................................................................. _ .._.._. ...= _... .......___... Q.-----------Ej._....._...
Agreement CHAPMAN H
0 27654.
The undersigned agrees to install the 'aforedescribed Individual Sewage Disposal System i ance
the provisions-of iITLE y g g p 5 of the State Sanitary Code— The undersigned further agrees not to la
operation until a Certificate of Compliance has been is ued by he board of health. NAL E
Sie .--•- . - ............................................................ -- . ... - ..............
15ate
Application Approved By.......,� =.. . ----------------------------
= �'.-----
Date
Application Disapproved for the following reasons---------------------------------------------------------------•--------------------------------•----------------
........................................................ -----------------•------•---........----•----•---••---•-------••-••••-••-•-------------••---------•---......----•• --------------------------
pDate
Permit No..... Issued--- {� --�-.1----------
_ _ � Date
. J-
-THE COMMONWEALTH OF MASSACRUSET
BOARD OF HEALTH
ow>I7►.- ----------------OF..........ftrastable.---------------•----------••-•................
Appliration for 11hipoli al Works Toutitrurtion Famit
Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal
System at:
.............Skating... --% --------------------------•---•-_--- --------------------- ...._.. o M-- ......------------•-------------•--....
ocation ress or Lot No
— Owner " t g f.N cv"t j l Address 3 `t A
a -� B J 9
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................................._..._.;......._ ..._........._............................... f_.............................................................
Installer t ``r Address
U Type of Building J', A.AI C 14 Size Lot---10.,Q Q_.......Sq. feet
Dwelling—No. of Bedrooms.................3--........................Expansion Attic ( ) Garbage Grinder (W)
Other—Type of Building ----_= ............... No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures .......:..............................................................................................................................................
W Design Flow.............5..........................gallons per person per day. Total daily flow..........._.........;3.�Q..............gallons.
WSeptic Tank—Liquid capacitylOOQ.gallons Length.8.!.6".... Width.rj�.]Q?t- Diameter................ Depth, .!_+�?t_...
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.........1--------.. Diameter....10-1------- Depth below inlet......4........... Total leaching area.ZQ ........ ft.
Z Other Distribution box k ) Dosing tank ( )
aPercolation Test Results Performed bye-,--,.._ ..��+u�� y•._ v ,,j_.,, ,Date........._i j.24_/.7. 'T.........
a Test Pit No. 1.......�......mmutes per inch Depth of "lest Pit.....
-.i2.t..... Depth to ground water.._none_.........
Test Pit No. 2................minutes per inch Depth of Test Pit-___--__--______--. Depth to ground water........................
0 Description of .ft•Soil __. _
�} �2....4...I-o-am--A---sub-sni1------ ---brcwn--sand------7-;4-r1-2Z_ ---
w ................................. :�eri-:----o---coarse---s.�.n�t---8-grave1;--•---------------------------------------....------..... ���`����" s
x •-•--•----•------- •---------•--••--._...•••......•----------------•-•--•-••-------•--....._•-•. ----- ------------------------.----------------••••..--..._.._ _ .... .
U Nature of Repairs or Alterations—Answer when applicable...................... __________�___r_ ... .. .._..... �_.._RENvN1t;K tiN
•• __ �+
Agreement: �y 7 � v CHAPMAN N
The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sys em in a o 4�o �e
the provisions of TITiE 5 of the State Sanitary Code—The undersigned further agrees not to place
operation until a Certificate of Compliance has been issued by the board of health. \ sS/ONA1-EN
r'+
/ 7iY/ ..t " �Datef /
Application Approved By--...... � ;..•• jf�f. _ -= �G '_. ...... �?t�.'.7c1.•.•.-
Date
Application Disapproved for the following reasons:...................................................................................................................
•---••--•--••....----••--•••-...•--••--•-•----••---•-••-•••••--•-•••-••••-•.................••-•••-•----.---•••-•--••----•-•----•---•---••-•-•-•-•••--•••......-•--•••-•••-.........-••••---••-•-••--••.
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 0,7 HEALTH
. ... .................................................
�prtifiratr of ToutpliFanrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed O or Repaired ( )
by---------------------- - --._.`'�.-`.. t: s Installer
at.... .fry � �.'t? .:+
has beentfnstalled in accordance with the provisions of lr�.................................
c r
-� of The State Sanitary Code as� described m the
application for Disposal Works Construction Permit No-__-�.-___-_�_ `.................. dated------V__.-._....._.._y.__._..._._.__.___.
THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector.................................................._.................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF .HEALTH
No .................. FEE........................
Diaparsal Workstonotrurtion amit
Permission is hereby granted •••.•--
to Construct O or Repair ( ) an,Individual Sewage Disposal System
Street
as shown on the application for Disposal Works Construction_Permfit No�____;:_1....... Dated,.........................................
Board Healt)�of
DATE................................................................................
FORIN 1255 HOBBS & WARREN. INC., PUBLISHERS
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