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HomeMy WebLinkAbout0023 BRITTANY DRIVE - Health �3GnAbx,jA Or%v2. e 0a6 -030 TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP 6z LOT ©�ti INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY "ELtz LEACHING FACILITY:(type) e/Ts size) l�/G NO. OF BEDROOMS PRIVATE WELL ORC WATER R OkilawRL.tli'�� �f1�s DATE PERMIT ISSUED: l0� 9 DATE COMPLIANCE ISSUED: G�% 9/ VARIANCE GRANTED: Yes No o�D Silt Poi Zb r T Ili 10 1- L 0 CATION S-EW A G E PERMIT` NO. on VILLAGE : F I !,�kAAL R'S NA E & `'ADD , ESS S U I L QE R OR OWN ER � t 4 DATE PE . IT . ISSUED DATE COMPLIANCE ISS:UE.D N t . , N Q Q O a J 't r. No.... /: c .?.X 1�....-...... HE COMMONWEALTH OF MASSACHUSETTS 0 02 3 BOAR® OF HEALTH. TOWN OF BARNSTABLE Appliration for Uhipasal Viarkii Tono#rurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: .....--- ----..... i i >v.` _...,Q%i tJ .............. ........��l"U�l' -•----•-----...................------------------------------ Lo tion-Address r Lot No. /?«5----------------- ----•-- j21T U,�......%-/�itJc�.............�%zJ ...------ ------- - -------- - Owner Address Pa Installer Address U Type of Building Size .....:Sq. feet �-t Dwelling—No. of Bedrooms.................._.._...._..._...___Expansion Attic ( ) Garbage Grinder ( ) a1.4 Other—T e of Building No. of persons............................ Showers Other—Type g -------------------------•-• P ( )--- Cafeteria.(.....>. dOther fixtures ------------------------•-----------------------•------•----------•------•••---------------••---------•-----------. W Design Flow..................,fit.-...............gallons per person per day. Total daily flow_............(3 ................gallons. WSeptic Tank—Liquid capacityAo-W.-gallons Length................ Width................ Diameter--.--__..___.__- Depth................ x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... Diameter....,e/ __--__- 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........................ f� Test Pit No. 2................minutes per inch Depth of.Test Pit...:................ Depth to ground water........................ ---•----•-------------------------••---••--•----••-------------.....--------.............-•----••---......................................................... 0 Description of Soil............ --•-- Sf 4Z o � ���......Q_i--------------------•------------- x W UNature of Repairs or Alterations—Answer when applicable..._____....__ -._. _` 0' -•------------------------------••-•--------------•---------------------•--•--------•--••---....-----------------------------------------------•-------------------------------------•---......._...---- 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 Complian as een issued by e board of health. Signed .. .... ............... ..... ... ... .. ... ................ ... ..... Application Approved By ------------- --. .............. ......................................................................... ................ ................. Date Application Disapproved for the followning reasons: .................. ...------- --- .------ ......----------------------------------------....--------.... ------ --------------------------- --------------------------------------------- - -- ------------------------------------ -------------- --------------- ........ .............................-------- te PermitNo. .../ ... -. .171---_-------------- Issued .......................-----...--------------------..Da ----- Dace No....7Z.1 sy Fps. ..... ..._ THE COMMONWEALTH OF MASSACHUSETTS a (o 3 J BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uis#nial Workii Touts rnrtion Vamit G Application is hereby made for a Permit to Construct ( ) or Repair (5� an Individual Sewage Disposal System at: 3 t3 ...(i¢ru` --•—:�/�/cJ -------------- --------C OTU/T'".-------------------••---•--••-•-•--•-------•---•---••------- ........._.. ._... -- c Lo tion-Address r or Lot No. ....... �JGecls .._..._ /�7v� 7LJ� el—:110;7J/7- Owner Address Installer Address ' � d Type of Building' Size Lot��/__dQ0......Sq. feet aDwelling—No. of<Bedrooms.._.... ..... .......................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ...........................: No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ...---•-•------•------•-•------------------•----------•-•-•--•-•-••--•------••--------------....•-•------•••-•----•••••....-•--•-••- WDesign Flow......................1. .............. per person per day. Total daily flow............•. ................gallons. WSeptic Tank—Liquid capacity-AM.gallons Length................ Width................ Diameter-___-__--___.-_ Depth................ x Disposal Trench—No. .................... Width................_... Total Length.................... Total leaching area....................Sq. ft. Seepage Pit No.........c:z�y-... Diameter-----mod------- 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....................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 -------•--•--•-----•------------•-••-------•--•---•-•----•-•-•--••-•-•-.....---••--••-•-•••--.------......................................................... 0 Description of Soil............11..— ' - I. SD - �� cD x W U Nature of Repairs or Alterations—Answer when applicable._..____444—....._ l� Vh �.__.''� ..__... _ 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'lias een issued by the board of health. Signed----- - -------�------- ..................... ----- Da e Application Approved By ................... . .. '� �^r+J-'--'-'-'---- -- Date Application Disapproved for the ollowing\reasons- ......................................................- ------- -- ----------------------------- ----------------------------- ------------------------------ ---- ---------------------------------------------------------------------------- ----------------------------------------------------------------------------- -- ---------------------------------------- . Date - Permit No. -----.....c..:...- -- �-�.. Issued ------------------ -------,..•--7..........................-......... Date t THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEALTH t TOWN OF BARNSTABLE r (0:1er#ifi a e of C�ontylian.ce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...............................................................:..Ci. 7 2�G1S?/1 �D�T' -------------------------------------------------------------------------------------------- ------------------------------------------------------------------------- Installer i 7T�+v at v?-------------------- ----- -- -- ------- -y..--,` .................---.......--. C..O_ U/7"..------- ------------.--- has been installed in accordance with the provisions of TITLE 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....................... •!................... ; ------. Inspector -------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.... 1-. � FEE.. ............ Bisposd Works T11notrurtion ramit ` Permission is hereby granted................... L 0�7 C OAS 7--- -------- ....... ------•.......... ....... . to Construct ( ) or Repair (p�J. an Individual. Sewa a Disposal System am ' �� C6?Uat No..•-•••-......-•••••......--•-•....._. ......... T - -----...--.. /T".................................... Street as shown on the application for Disposal Works Construction Permit No.� �f ..__ Dated.......................................... ................................ ------------------•-•---------------•-------..----- o rd of Health DATE................................................................................ v FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS MW No.. _. _. Fes$.... .. �. THE%COMMONWEALTH OF MASSACHUSETTS BOARDADF HEALTH .OF....." .. . . —-----------------_------ ApplirFatwi n for ]iippp al Morks Tonstrnrtuan Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an In vidu Sewage isposal Sys t �{� �O_d v *- 1 . qV9.!;t . . ......... Ation- ress or Lot ­07 Owner Address w Q4 Installer Address Type of Building Size Lot-- � �_/3.%.Sq. feet U Dwelling�O. of Bedrooms---_----�-__________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-___-_______.-_--__-__-_____ Showers ( ) — Cafeteria ( ) Q' 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..---I.............. Diameterb)e�.P Depth below inlet....... Total leaching area..c�...o��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.-.-__.-:_________-_-_-. fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__..--_-___-_--.___.-__- 9 - ------- .._.... - ---------- --- --- -------- -- O Description of Soil_____-. __ -------------- .'.....__ ____.� ,_ x ° w --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- UNature 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 Article XI of the State Sanitary Code—The undersignePnot to place the system in operation until a Certificate of Compliance has be4issuethe boar hSig d =---...... . •••. ' /D ,Application Approved By___:_ _.. ate Application Disapproved for the following reasons:----------------------- ------ ....... Date c Permit ssued Date n r i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I: --- ....OF.... .- Appliration for Diopoottf Worko Tomitrortgott Pumit Application is hereby made for a Permit to Construct ( ) or Repair ( } an III ividual Sewage. Disposal System at: E I i � s -------- -- • -------------- ........................... oration-Address or Lot No / Ownes�''F '' Address W Installer Address U Type of Building Size Lot-.. _.yf ..Sq. feet Dwellingj<No. of Bedrooms._...._._z - -------------------Expansion Attic ( ) Garbetge Grinder ( ) aOther—Type of Building ____________________________ No. of persons__--._----_-__________-_____ Showers ( ) — Cafeteria ( ) a' Other fixtures __________________________________ W Design Flow........................�� "'y;e------_gallons per person per day. Total daily flow............ .__g -------gallons. WSeptic Tank—Liquid capacityj.6�' :Jgallons Length-----------­--- Width---------------- Diameter---------------- Depth................ x Disposal Trench—No.___--_-_ _ g .---_--- Total leaching area--------------------sq. ft. Seepage Pit No.___/__ ____-- Diameter ldtllJ- ..5 • -De t obelown inlet .... Total leaching area-__ ' d,_ ft. r? ------ �`�- P --------- g ...�-- mil• z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date---------------------------------------- Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.-._-_--___-___-_____--- tq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__---__-__--___---_-... O Description of Soil------- A-n uu3 f {f�'.. __ - y ----- ice"--''i7•_YP.�'. 9_..:F_._..... b ?�.,�.......L .<..._.ar Y•id��1 ai"f ____•__ '_ ` ' _ ...__—. y r�•• .go-s. ------------------L_------___--•--------•--------------.--------_________-_______________----<_--___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 Article XI of the State Sanitary Code—The undersigned rther a rees not to place the system in operation until a Certificate of Compliance has been issue'the board h 0 f Signed �� 1 t• Da Application Approved By-,-, ` f � ---- `/. � /`Date Application Disapproved for the following reasons:-------•--•---•-------�`-•-................................................................................... Date PermitNo......................................................... Issued—..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH ' t ? .... ...........OF. ,s d., r. ... .. . c, ... ,x ,• ,.... r�,,4�,,- Tertif irate of T'ootphatta THIS IPtO CERTIFY, That the Individual Sewage Disposal System constructed. ( ) or lRepaired ( ) by........ •.........•-- ......• -•-- .-•--- - --- --- ------------------------------ I`-Al .1 f �.. f J�`Ntall rs s r e -— "� at � r& s b% ;�. -rr:.-r — ; r,y"�':�j �'a s i ' �. has been installed in accordance with the prow' lons of Article XI of The State Sanitary Code as Jdescribed in the application for Disposal Works Construction' ermit No------------------------------------------ dated'.. ............................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT RE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ,7,1 DATE---------------------------- -------•----•----------- .......................... Inspector---- ( -``- jLg ='----------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH o.. , °?.d� �i.:...........OF......... ..................... No...? �. ... FEE .................. Dgspogal Works rurttoit erotic Permission"is hereby,. granted-.-*.t,*.-Q.......l @ --•------------------------------------------------ ------ - ------................. to Construct,( 4<10r Re pir an Individual)rgwage Disposal Stem �t at No.;' " - -= _�rt i ~. .. .g e 2 (7 `' a.�`� s' r j1 t (id'fr✓�f ��' . �. StreetaSit. k as shown on the application for Dis osal�4vorks Construction Permit No __.__ `"" PP P Dated...,` t / --'"...---- N9.6 .J•iR�./x% ••-_•------------------•--•-- --.._.... _.. .--- i �oard of altl� DATE.9- .d�1 FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS