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HomeMy WebLinkAbout0320 MAIN STREET (COTUIT) - Health oZZ ®0 9 i L O CATION S E.W A G E PERMIT 930. -Ila.ns � `� VILLAGE IN SIT A LLER'S NAME i ADDRESS JOHN A. AALTO BACKHOE SERVIrF 50 Walnut Street West Barnstable, Mats n2titig M U I L D E R OR Owf ER DA T E PERMIT ISSIJEO DATE C- OMPLIAWCE ISSUED _� �-� , �{ �, _.� . \ _ , �. � i �. � � � , ! , � � 5� � ,' ` � `,,x:. THE COMMONWEALTH OF MASSA Fits TTS BOAR® OF HEALTH TIC L. l•. 4 Apptiratilan for Dhipuga1 orki Towitrnrtinn amit r Application is hereby made for a Permit to Construct or Repair) ( ) an Individual Sewage Dispo System at Location•Address or Lol No. �... ................................................ Owner Address W �..................................................... .. .. ,�. Installer , Address ��• .7 J �i?G'1 �. Type of Building Size Lot.40� ........ feet U 3 a .. Dwelling—No. of Bedrooms_____________________________ ___________Expansion Attic ( ) Garbage Grinder ( ) p� Other—T e yp of Building -____________________________ No. of persons....... Showers ( "L) — Cafeteria ( ) p, Other fixtures ............................. .t.... ____..�___._____._ allons er erson er da Total dail flow___.__. 3 fit_._ ' !�____._._._ W Design Flow______. ____ - � g P P P Y Y = gallons. WSeptic Tank—Liquid capacity./_gallons Length-------------_ Width................ Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width__3______.__._._._ Total Length..................... Total leaching area....................sq. ft. k, Seepage Pit No--------------------- Diameter..... Depth below inlet____✓__.......... Total leaching area_r,,w/.....sq. ft. Z Other Distribution box (v) Dosing tank ) Percolation Test Results Performed by._._ �iXl _ ._l �Yl ..._._____..______________________ Date_, 1 / ................. a Test Pit No. 1._ __________minutes per inch Depth of Test Pit.....,u __....... Depth to ground water........................ (z, Test Pit No. 2................minutes per inch Depth of�Test Pit.................... Depth to ground water........................ Description of — : '= x x U 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('1T Rl'1, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation untilµ a Certificate of Compliance has been issued by the board of health. g Date Application Approved B ._ _____ -------- Date Application Disapproved for the following reasons__________________ ____________________________________________________________________________________________ ..•--------•----•---•-------=------------•---•--•-----------•-------•-•-------••----•-------------•------...-----•----•--•--•-----•-•--------------------------•---------------------•------------------- Date ��/ Permit No. Issued ................................................ Date l L THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH l; w { Appliration fir Uhipuii al Works Towitrnrtinn Vamit 4T Application is hereby wade for a Permit to Construct or Repair ( ) 4an Individual Sewag Dis o System at: �led✓� d 1 Location-Address or mej A. Owner Address W ..%: If.... :..::: ".4 Installer Address d Type of Building Size Lot :a00_________Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion.Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ____________________________ No. of persons......... Showers ( z+) — Cafeteria ( ) Pa OtV_Q r fixtures ------------------------------------------•---------- ---•------------------••--------- ............................................................. . d W Design Flow..... ��' �_ _______gallons per person per day. Total daily flow.......3 .�?-.- ..........gallons. WSeptic Tank—Liquid capacity/�_�_Q---gallons Length................ Width................ Diameter................ Depth_................ x Disposal Trench—No_____________________ Width_____............... Total Length.......... Total leaching area________._____......sq. ft. Seepage Pit No---------------------- Diameter._._ _______ Depth below inlet.....0____________ Total leaching area_J ....sq. ft. Z Other Distribution box (V� Dosing tank ) .� aPercolation Test Results Performed b/JVy.._. /`4."l(_ ....___. _ Date...../e//_— Test Pit No. 1_. ::_________minutes per inch Depth of Test Pit...../P_......... Depth to ground water........................ (z, Test Pit No. 2...................minutes per inch Depth of,Test Pit.................... Depth to ground-Water......................... 3` "` - O VVV y (. .. '� --------� Description of Soil._!49 IJC'_ 1 5-/'� ....� ----- --------------------- -•---- -------------------•---•----. 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:i p 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: Sig .. Date Application Approved B ___________________________ Date Application Disapproved for the followingreasons:........_____ _ ;.} Date PermitNo.............. ••---------------------• Issued-....................................................... Date THE COMMON%% ALTH OF MASSACHUSETTS s BOARD OF' EA�,L,,T' Trrtifiratr of Tvutptk anrr TH IS TO',CER Y, a,.he Individual Sewage Disposal.System constructed ( or Repaired ( ) b �. '_._.... L'o Y ) ------------------------------- `' / Install r has bn installed in accordance with the provisions of T 11. of he State Sanitary Code as described in the 7 �*,, gppkicaton 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._._�1.7-.. � ............................................ Inspector � ; THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT l �- . 7 t ' © .... ......OF.......... '.... �x�. ; FEE ............. &tA t�o�n rrntt# Perini ssion s hereby granted...w-- ---------------•-••------------•---...------- ----- -t , to Const ct �or_ aiQr 4 ) �}nd�ivi ual .w a Di`ssposal Sys at No.- tl ►- d Street � � . as shown on the application for Disposal Works Construction Per 't No. � �..... � ted____.. l � .. P Board of Health k t� "; ¢- DATE_. �. w. FORM 1255 HOBBS & WARREN. INC,. PUBLISHERS - - � - C��•r lC t..1 �:Q\TA "0 C A.rzs F-7 - Dd J LS! t Low Z. l t b 4 3 = 33o 45..P-v --- - --- _—_ -E -tc 7-44-lt< = 330v (Sc 6-PD. 2�0 USA t000 CQA,_. PIT ISPC AL PST - Usr= loop Gv�.l . �ir7 Of D.OonAlNt EXR TOTAL 'C�ES16Q = -4/LS 6-QD• PROP• T2>ToL CDA-1L.-( Fcow 4 VE2GDL,6 lOLj CZATE : CiU 2-MIiJ OR LL-9;. N N i f 7 ` C'TU CT - 45".kkI"f't? 1 1D1' j et✓►� mat�r' 'T>-ST /p�78 Tor Pwo ioo.es q81 l 4/pp& DKT. IW. GA.L. S sn,L -Box 9 G.4 Sepnc �WV TAWK 3 loop G5.8 ,�� 1w. 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