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Home My WebLink About0200 OCEAN VIEW AVENUE - Health ZOO UC�aUt �l ler.<� a.V�u CbTU �i terra e°� LOCATION ,,5EWAGE PERMIT q0. y i'fit/ 9 se i TILLAGE I N S T A LLER'S NAME 8 A00RESS JOHN A. AALTO i 1 i West Barnstable, Mass. 02668 S U I L DE R OR OWN ER Rkrr )q ��► f�%M GATE PERMIT ISSUED DATE C0M-►LIANCE_ ISSUED 1�� v� ® /411 ri No........ 1.-.?_.L s~ -. YE ......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..................... ....................O F.................................................... Appliration for DispagFal Workii Ta marur#iun truth Application is hereby made for a Permit to Construct (//)�or Repair ( ) an Individual Sewage Disposal System at: G7'�.'t CQ U� - ..... ...... ...... ....... 4ocation-Address or Lot No. h----------------------------------------------------- -------------------------------------------------------------------------------------------------- W 0—wrier Address a ............................................... •----•----•--•----------••------•-•-•----••----------- Installer I.Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms------4..................................Ex Expansion Attic a g— p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons--...................------. Showers ( ) — Cafeteria ( ) Otherfixtures -------------•--••--------•-•--------•-•••......•...---••-----•-•----••••-•••••-----=--•------•------•-----------.....------....--•---....._....... 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--------------------- Diameter.................... 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.......----............. (z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......---............... a -------•------------•------•••-••---••--•------•------•---••--------------------------------•---•-----•---.------------------------------- •------------------ 0 Description of Soil........................................................................................................................................................................ x U .--------------- --------------------------------------------------------------------------------------------------W U Nature of Repairs or Alterations—Answer when applicable. --• ........Z6. J --. -------- 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 ' sued byAhe board�ofhealth. Signed ••-- --- ...-- --•--•----•---...--- / .. ................. � Q ate Application Approved BY -- ' -. "8--.--- Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------•-•-----•-•----•-•-•-- ------.....-•-••-•--•---------------------------•-------•-----•--••--••------•--------••----•------•--------•----••------•--------•-•--••-----------•••----------•-•-----•-•-••-•-----•-•••---•••-----•- Date PermitNo.......................................................- Issued-....................................................... Date I No........ �' �q r '� 1 Fxs.....0�.. ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH w„ ................................OF..........................................-.....................I................... ..._.. fiat ion for Disposal Works Tonstrurtion rumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .................. ....•-•......... .. -••---..........................._.... .......---...._----•-----.........---....-- •--•----•..........--•----•---........... �-^ L cation;Address or Lot No. ..,....��Ylf'�r�5i� ° .................................................... _.._ Oner Address Installer Address Type of Building rj Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...................•...._...._.. .....Expansion Attic ( ) Garbage Grinder ( )U p, Other—Type of Building ............................ No. of persons..........:........•.......... Showers ( ) — Cafeteria ( ) p•l 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--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-, Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to"ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to,ground water........................ a ................••-----••----•----•-•-•---•--•••••---•-•------------.......---..._........_...••••••......................................................... ODescription of Soil...................................................................................................................................................................... x U ....................................._.................................................................................---•••-•-----•-•••----••----•••-•••-------------...-•-------........------------. W --------•--------------------•-•-•-•-•-------••-----•--•-•--------------•-------------•---•----•-•-----------•----------•---------•--•-•---•----••....••-•-•----•.......-••-••......---•-•-••••---•••-- U Nature-of Repairs or Alterations—Answer when applicable.• Q� � ,e . t ----- '* Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITl:1LL. 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 i ued by fhe board of heal . Signed = r --- --- ----------------- Date Application Approved By-------- = /�% 1 '-'21-0 i.....-•--- Date Application Disapproved for the following reasons---------------••-----------•--••----•--------------------------•----------------••--..........-••-----........_ ---•-••••-••••.•••-••----•.....-•----•-----•-----------•---•••...•---••----...••---•-------------••-•---••---•---•---•-•-•-----•-•----...••-••---------••--............................................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA�L✓TH ..........f.D' •+.....I........OF....... � s:: .......................................... Trrtif irFatr of ToutpfiFaurr THIS IS�RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ) b -------•--------- ------------------------•-----•......--....---r.....--•--•-•--.......----•----•----•--.................----------- y--------------------- -- --------------- Installer has been installed in accordance with the provisions of TITLE Zrr,of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..,SO.../.. .............. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................�L�6 1 ...................................... Inspector............ A . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ''...................OF..... ° ............................................No. FEE.... 'a......' ......... .._ ................... Disposal Works Twon#rnation rrnti# Permission is hereby granted17..... .._...(_ a S�_----.- to Construct ( `or Re air ( ) an Individual Sewage Disposal System at No.................. ...- ------_. ..--•-----------•--••------•••-----•-••--•--------•-------•--•-•--••.................. Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... -- ✓f Board of Health DATEL................••-........ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS "' o6 I�2 OCLI,TION 5EW8,GE NIT U0. . Its! T LL 5 1L�Nl fi ADDRESS - - - - - - - - - BUILDERS - Q &V A �- - ADDR-E SS DATE D ATE -COMPLI-&MCE_ ISSUED ; ,. � �D S ' „� �� _ �. '� � �� f�� r '