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HomeMy WebLinkAbout0051 EAGLESTONE WAY - Health 51 Eaglestone Way Cotuit A= 054-009-005 B 1 TOWN OF BARNSTABLE .LOCATION 1vt 3 LA SEWAGE'# VILLAGE ASSESSOR'S MAP St LOT' , INSTALLER'S NAME & PHONE NO. JoA^ A, #'Ov SEPTIC TANK CAPACITY X614 LEACHING FACILITY:(type) 9 X/V p% tf (size) G 3(%0 NO. OF BEDROOMS ' PRIVATE WELL OR UBLIC WA BUILDER OR OWNER DATE PERMIT ISSUED: y DATE COMPLIANCE ISSUED: 4 -1-!�e �S VARIANCE GRANTED: Yes No ✓ A �, f0o vy o Of- 1 v 5 a51ohvl !p 30 L/ THE COMMONWEALTH OF MASSACHUSETTS I/Fimic 1;0D........... 3 BOAR® OF HEALTH ............ ...............oF. � i�. t -- -- ----- ApplirFation for Bi-spaa al Works C omtrurtion Prrutit Application is hereby made for a Permit to Construct ( L. Repair ( ) an Individual Sewage Disposal System at: ` 97 ,,DLocation-Address or Lot No. -- — �"�"""'.. ........................................................ ---...----......................----...........••. Owner A des a �.. . .. ---------------------------------------------------- ------e5. ................ s ........................................ Installer Address of U TypeDwelling Building Size of Bedrooms............... ........................Expansion Attic ( ) Size Lot-Garbage�Grinderq(f�� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures -------------------------------- - W Design Flow.....................5.5_...............gallons per person per day. Total daily flow____.............._......._�Q._....gallons. WSeptic Tank—Liquid capacity_1 .gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-_______--.____ sq. ft. Seepage Pit No_______ _________ Diameter.......1.0------- Depth below inlet_..._0......... Total leaching area.....5A4..sq. ft. Z Other Distribution box Dosing tank ( ) 4 Percolation Test Results Performed by.._`BA)701_ .._..O.....�Y_SX___ Nam.......__... Date....._�_�2�....�.�'....___.. 1.4 Test Pit No. I......_Z.....minutes per inch Depth of Test Pit......... 0_`__.. Depth to ground water_._. ................. ( Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------.................. 9 --------••-----------------------•-------------------------•-•-.....------------•---•-............-•........................................................ O Description of Soil...................... LVYV.....5A"A ...------------------------------------------ V ..............................................---•-••------•---•-------•--.........-----------------•-----------------------------------•-------------•-•----------•-•................................. 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ben issued by th�bord of health. 6 Signed . ............ ---------------- Date Application Approved By --------------r�--W - 1ZY` Application Disapproved for the following reasonf- -------------------------------------------------------------------------------------------------- ------------------------- ............. .. .. ......... ..........................--------........................----- q .................. Date Permit No. ........1 5----------5_7 ------------------ Issued -------------- ""�3..--%it --------- Date r• No-7 Fimic A20............ THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH .1-otp_ ...............OF. ............................................... Appliration for Dispaiial Workii Tomitrarthin Prruat Application is hereby made for a Permit to Construct (Wl"Or Repair ( ) an Individual Sewage Disposal System at --- -......................c esTa E wA� Co .!t" �- - - Lcats n ................................ .......------......•................--" ' Location-Address or Lot No. ............. . !-^' ••--••--------------------•------------------- -•---------------------..........------ Owner Address W Installer Address //��,,�� d Type of Building Size Lot...."! .___ 7.Sq. feet U Dwelling—No. of Bedrooms................4--__--______---_-__--___-Expansion Attic ( ) Garbage Grinder ( 1/� PLOOther—T e of Building No. of ersons____________________________ Showers — Cafeteria Q' Other fixtures ..... ------------------------ - W Design Flow..................... �...............gallons per person per day. Total daily flow.................._._......�9...._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.......I.f?__.___. Depth below inlet.....I(F............ Total leaching area-___15� ..sq. ft. Z Other Distribution box ( ✓� Dosing tank ( ) • 9.. Percolation Test Results Performed by.___B_,Uj-6_7Z ....f____.4 �...RC ............ Date....._..___�__________________________. aTest Pit No. 1......It.....minutes per inch Depth of Test Pit._.......�O._... Depth to ground water...'°".:........ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+' •-••----•--•-•--------------•--••-••---•••--------•-------..........-----•------•---•-'-.._........•......................................................... O Description of Soil---------------------- ......�y A 1.17...-•---•-•----.....: 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 TITLE 5 of the State Environmental 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 ----------------------------------------------------- ------ ---- . --------.-- .............. ........................................ Dace Application Approved By ------------- J -------............------------------------------ ------------------- Eel�e4.�{..b Application Disapproved for the following reasons: ................................................ ...... .. . ...... ......................... ... .. ......... .. ........ ....................................................................................... ..... ... ......... ..................... .. .... ......................................... ................. qq ... .... .. .... Dace Permit No. ------...1..-- ---- --- 1----7-h------------------ Issued ------------ ..- ...-. �:. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... ------------- OF ..... ............................................. Q-1-er#tftra#e d C�oxnyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( >-) or Repaired ( ) byp ----------------------................................................----------------------------------------------------------------------------------------- .................. Installer ................-'------------------------------................. at ....... .r7..(....Z)...........`G`°�f�..:-_ems' ---------------1�,7�(?z..... -1 C, 4..................................................------------------ has been installed in accordance wth the provisions of TITI 5 of The State Environmental Code as described in C the application for Disposal Works Construction Permit No. ------- ,l�- 6 76...... dated ----.�-----. .�......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........................�p.. ....�--y�. '.. 3 Inspector ........ �__;n........................... i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A(j.L .r .........OF............................. � ....................... No. :._.... //pp�� ,.. FEEJJO.�2............ Dispoti tl Workii OD11nitrndion amit Permission is hereby granted.............................................................................................................................................. to Construct (y) or Repair ( ) an Individual Sewage Disposal System atNo...------. ----------------------•---''•--. Street �- as shown on the application for Disposal Works Construction PermiPNo..41).�--,= 7n. Dated--___ -------------------------------------------------------------------------••--------.....--••---•-......_ Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS f-� /i I 1 I r I T {�l ; FAJUL .: 4 r. i I ; OF 2 � � GRIrJT�ETZ I , GA ACHE I � . 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