HomeMy WebLinkAbout0014 BUTTERNUT CIRCLE - Health qlBuv-,a�,
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LOCATION ' SEWAGE PERMIT NO.
Lot 33
VILLAGE ,
Co�uf
I N S T A LLER'S NAME `` A ADDRESS
� �er® �hec� har� fS
S • ��rMo�f� •
s—R UILDE R OR OWNER
7-A eo Ct.V
Yma�
FDA T E PERMIT ISSU E D 611l
DATE COMPLIANCE ISSUED. fZ
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No 13.=Ahl ..........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH '
----..Town.....................OF.............Barnstable
..................I....................................................
, ppliration for Bispoii l Vorkv Towitrnrtion anti#
Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal
System at:
Lot 3--Uternut Circle Cotuit, Ma.
............ ._ ....... ......... .... ......................... ...---•-•---••----•----------•--••-••-----•--------...........•--••-.__..........
Theo Construction Coss, Inc. 24 Great POndL bf°• , So. Yarmouth, Ma.
•-•---••-----••---------. ........ ..._.... .......................................... ••.....-••--._.....•--•-•-----•-------•----------res.s-----------••.......--......_............•.
Owner Address
W
Installer Address
Type of Building Size Lot...24-,.b.5.Q........Sq. feet
Dwelling—No. of Bedrooms................3
............................ Attic ( ) Garbage Grinder ( )
a'k Other—Type of Building No. of persons............................ Showers
yP g -------------•----------.... ------•--------------------------..-..---------------...(----)..— Cafeteria.(...__).
d Other fixtures --------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow................3.3.0....................gallons.
WSeptic Tank—Liquid capacity...l.Q QGallons 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:.. ?gber t:-E-,___Raymond P.E. Date_Nov..............................
9 , 1982 Test Pit No. 1........2......minutes per inch Depth of Test Pit.................... Depth to ground water----none.........
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......----..............
•-----•-------•--•---••-----•---•- •---•- ••-- --•-- -•---•-- --....... ---•--••----------•---.-----
0 Description of Soil........Q"..-... 6_ _..subsoil. .._3.6.". --_.144"-_finetomed. sand
" ,
V .......................••-•------..........•---•---•-----------•----------•--•----•---•--......---•-....-•--------------•-......•-------
W
VNature 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 been iss d byU'Lobo.ad of health.
Signed-- ' � -�--: ;rs���,., ---•---•--------- --------- -D----•-•-•-•-----•-
Application Approved By__..
Date
Application Disapproved for the following reasons:................................................................................................................
..------...-•-•-•----••----------------•----------...----••------•---•---•-••--------•---...-•-------•--.------•------•-•-•----••........-•••--•...-••••----•--•••-•••----------•-----------•-----------
Date
PermitNo......................................................... Issued_.......................................................
Date
ti
'THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH '
..-----...Town...................OF..............Barnstable
-- --------------.................................................
App iraiion for Disposal Works Tonstrnrtiun 1hrmit
Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal
System at:
Lot 33Btternut Circle Cotuit, Ala.
................_.. ............._..._... ....._.. ......................... --•---.....--•------•---•---•--.....----••--••----•--.........-•---•---._......._...............--
Tnstrue ton dress
Theo Co o. , Inc.- 24 Great PorfBzob$t°: , So. Yarmouth, Aga.
.... _...... ..................•----.....-------•----•------•----.........----• -•••--••-•--•-•--•-•---••---••---....-•------••----..........----.....----•-....--•'-----...------
Owner Address
W
a ........................ ..........
� Installer Address
Type of Building 3 Size Lot....2:�_A 50-------Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aa Other—T e of Building No. of persons............................ Showers
YP g --------------------•------- P ( ) — Cafeteria ( )
Otherfp4ures -------••---------------•............................................................................................................................
W Design Flow............................................gallons per person per day. Total daily flow.................
30---- ._.. ...........gallons.
WSeptic Tank—Liquid capacity.._IQ 0.9allons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft.
3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) NOV. 9 , 1982
'-' Percolation Test Results Performed by Robert E. Raymond P.E. Date........................................
Test Pit No. 1........2.....minutes per inch Depth of Test Pit........1....... Depth to ground water.....none.....__.
04 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O ---•-------•------------------------------------------------------------'•-••--••-•-r-------•----•----------.
Description of Soil...._,_.0" - 3611 subsoil,................................................3 6" - 14 4" f ine to med:..•... ria-•-------•-•----••------•----
x ----------•-•-------...........
U ---------•----------------•-------------•-•---------•---------•-------.......•-------.........---•.......----------•-••---•-----------.....
---------------------------------------•---------------•-------------------------------•-•------•-------••--------------------------------...------....------------------........------.........._------
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:ITL,- 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 of health.
Signed...................................................................................... ................................
Application Approved BY s....3 .- :� °.! i�j j - ....
Date
Application Disapproved for the following reasons__________________________
.................................................................. ............_
-•-••--•--------------••-•-------•--•-------•---------------....-•-•--••--------•----•-----•-••--•------------------------------•--•-----------------•------------------.._..----•-----•--••---........_
Date
PermitNo............................... Issued.....................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................. own............O F............Barns table.........................................
Tvor#ifiratr of f ompli tur
THIS IS -0 CERTIIFF ', That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by-----•......-_.... x. / t---------------------------------------- ---------------------------------•-----------------------........-:.....--------...-----..............--
�,�,, �,..�Instail
has been installed in accordance with the provisions of TIT IF 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No... .. r _.......... dated................................................
THE ISSU NCE F THIS CERTIFICATE SHALT. NOT BE CONSTRUE® A GUARANTEE THAT THE
SYSTEM WIL F CTION SATISFACTORY.
J
DATE....Y... ..................................................
........-•.......................•...---•-...... Inspector .-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Barnstable
..........................................OF.....................................................................................
No.., ...W FEE......
Disposal Works TD,an#rudion
Permission is hereby granted........ Theo Construction Co...,......Errmit
C.
----------•...........-- ........ --.... . ......
to Construct ( or Repair ( ) an Individual Sewa e,Disposal System
at No......Lot__---3 BKu ternut Circle, Cot�iit, l a.
. . • ...-•••--......••-••---•--.-------•------------•------•---------------••---------•----•------------------••-------•.......
Street
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
-- ------•--- ------ ----------•-----•-------......••......_
DATE....................................... ........ Board of Health
-
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