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Home My WebLink About0043 CRAWFORD ROAD - Health Cam - - 30 �r i TOWN OF BARNSTABLE LOCATION SEWAGE /# 92- VILLAGE ASSESSOR'S MAP & LOT Do b3� INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITY 5-6-22 � LEACHING FACILITY:(type) -�'y / , (size) lG NO. OF BEDROOMS :5 PRIVATE WELL OR PUBLIC WATER— BbINDM OR OWNER tt/4-rat, DATE PERMIT ISSUED: 7 11 J 3 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 L 6opt 0 14 0) OF 35 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A m / �C(�J LI DATA .............. THE COMMONWEALTH OF MASSACHUSETTS �630 BOAR® OF HEALTH Sb� ._._...�.-��Al...............oF........i;&. . ...�....�.. .---------......_......-----.--•--....... R ,11 ApplirFation for Uhipati al 10orkii Tututrurtion Prruat Application is hereby made for a Permit to Construct ()0!4 or Repair ( } an Individual Sewage Disposal System at:- .............CQ P�a �` +'� ....... T" Q � _ .. ................................................ Location ddress or Lot No. - C��uc --..�s2� i. l�A1.. s --- --------ld� �x l -=....4F1< . ...:................. Owner Address ........................................ ....e .� �....... Installer Address g .Sq. feet U Type of Building Size Lot___��_'�__o_____ Dwelling—No. of Bedrooms____.___..._____________________________Expansion Attic (/gyp) Garbage Grinder (/j(c� pa., Other—Type of Building kK1.bE4e_1w_.... No. of persons............................ Showers (Z) — Cafeteria ( ) P4 Other fixtures ---------------------•-- - -----------------------------•---------.. -- .-----------------•------------------ •---------------------- W Design Flow...............1f_0......................gallons per person per day. Total daily flow............3 ....................gallons. Septic Tank—Liquid capacity.t0. .gallons Length................ Width................ Diameter----------------- Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___lPP�!PG Diameter....__ ______ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (--A Dosing tank ( ) Percolation 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......................... a ---•--------•-•••---•••---...•-•---.......••---•....-•----------'--•.........--•--•-•----.._._...•--......................................................... 0 Description of Soil........................................................................................................................................................................ x 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 prxocisions of iITLE 5 of the State Sanitary Code— The undersigned furtl grees not to place the system in operation until a Certificate of Compliance has been i the and VI -."-le/y, �,igan/ed r �L. jQ '. ppat ApplicationApproved By •• .• '...............•-•---'---•-----------'---'--'----'•---••••. --.. Date Application Disapproved f t `following reasons:--••--•-••----•-•••---•--•-----'•----•------•----••--•--•---•-••••-••••-••---•-----•-•---•---•--- ....................•-----.....................-•----------...----------••------•----------•-------------------•--------•--------------------------------------••-•----••-•-••-- PermitNo......................................................... - A No. =-•------ m FEs... ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............OF..........` A"=S. .............................................................. Appliration for Disposal Works Tonotrurtion ramit Application is hereby made for a Permit to Construct (X or Repair ( ) an Individual Sewage Disposal System at: - ----_.. ................................... --- .................. ._...... - ress 1 �. oL" No 7..�! ---• _.: ..J : y b � �� --•-----•-----•- Owner �A -..... ---•••-- Q�2 J *kb.-..._�k� .---------. ...... ---------- Installer Address QType of Building Size Lot_.__46,.a�....Sq. feet U Dwelling No. of Bedrooms...............�'a..........................g— Expansion Attic (1.I6) Garbage Grinder (G1fe� 14 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures __________________________________ w Design Flow..........UD...........................gallons per person per day. Total daily flow......... _____._..___:________gallons. WSeptic Tank—Liquid capacity__ C*caallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___1_----o �Diameter........C......... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (><) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ �_l . ,.� Test Pit No. I................mmutes per inch Depth of Test Pit.................... Depth to ground water__________________._,__. rZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 --••----••----•-----------------------------------•------......._..-----.._.................._--•---......................................................... 0 Description of Soil.......................................................................................................................------------------............................ W c, 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 TIT1Z- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu the b a d f lth. Signed_:. ''............. _!.. ...-•-_•---- -=--•••••--••--•-----•----• Itlefoll4owing Application Approved BY- ------•--. •..............•--------------•-------------------------------•. -- DateApplication Disapproved r reasons---------------------------------------------------------------•------------------------------ a.t e----•-•------- ------••----------••-----...-•••-...-----•--------------•••-•-------•----..__.._..•-•--------•--••-••--•--••---------•---••---------•----•---•-•-•----•-••••••-----------------•- ...................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH {.�.?.0 !�F...............OF......J&9,PJ.�1A..,9 ....................................... Trdiffiratr of Toutph tnrr THIS IS TO CERTIFY That the I,ndividual Sewage Disposal System constructed or Repaired ( ) bY............AI it I_ ....... 4.�tiE; u ,__ Installer has been installed in accordance with the provisions of T of-The State Sanitary/�2cribed in the application for Disposal Works Construction Permit No.___..__._.............................. dated---- ____:- __...__...__._.____._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED S A GUARANTEE THAT THE SYSTEM WI F CTION SATISFACTORY. DATE..... .:.121b....................-................................ Inspector--•-- =-----------------------------------------.....-----------......_. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 913 ........... .70�4.........OF.......... . ................................ � No......................... FEE........................ Disposall orku Tonotr ion rrmit Permission is hereby granted..........&. A..-••..ek.ti ----------------------------------------------------------------------•--........_.. to ConstruUA'jm)J or�2epair ( ) an Individual Sewa e Disposal System at No. _. 2 RC � 411........................C. T 7 - ... - .................. Street ^ ' as shown;on the a pli on for Disposal Works Construction Permit No.�--,_ - r''Dateth' __a��___n_z_.__.__ _ .......... ----------------------------•---- .- ------------....------------ = - - DATE___ _% .._d" . . Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS '- s i .y a / 1 v � h 1 r !•h t, Z 1 ' Co0 J. (49 Vo MA I No ltao•ro 1 Z L• 15 ` Z ! ,PRoR tom. ' f} ,i-i 7hNY. Vvy 37 t TOT, FNis P-�44� _TES G:lv� Q f . VN 1000 ST- $oX tNv LEAt.•2t IVA. S p Z - . .a 1'oF 3/rai 1AI115H eta �•--ce'� i'�- = 1A o -�r_)r s-P i ° uo '+� D�SPosr�t PST - A)Sa - 1o4x>.*� ►5c7 s.f -lc z TOT M_ VF_sk4a.K= 4LS G. _ its of t4 'T°c�`t' �.\.. 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