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Home My WebLink About0394 OLD OYSTER ROAD - Health ci q cub m/ �' ;. / 3� OWN OF BARNSTABLE -� LOCATION f O`2'� d .�r leC /!5�� SEWAGE # VILLAGE ® � s ASSESSORS MAP & LOT Oq INSTALLER'S NAME & PHONE NO.AlAr k.4Wu SEPTIC TANK CAPACITY LEACHING FACILITY:(type)?�f' CAS 1 A/,;e (size) of f X , NO. OF BEDROOMS .3 PRIVATE WELL OR PUBLIC WATER, BUILDER OR �WNER�G�,91f SO(J,74 DATE PERMIT ISSUED: DATE .COZIPLIANCE ISSUED: VARIANCE GRANTED: Yes No r` 49 :SM - i No.. _.....__.•••• Fss............. ....._..... THE COMMONWEALTH OF MASSACHUSETTS �--••��RR BOARD OF �H\EALTH 1_..V.W.:Q.--•---....OF......CJt. .1 /5 . _�. ............... AppUra#ion for Disposal Works Tonti rnr#inn famit Application is hereby made for a Permit to Construct ( 6 or Repair ( ) an Individual Sewage Disposal System at -'� ��' 0 ............../. -- �__ -----•---.._.....•••••-----..._.........---•--------...............----_... • �------...--•--- ----.......�� ----- V cation--Address / ,ror Lot No----------------------•---•-•---__....._.. -_.._....---•---•............... ........ l.._ ..... Address W 1� `�: f `--1•�-..f.-•l-•............. Installer Address Type of Building Size Lot__s.5-5:510._Sq. feet V Dwelling—No. of Bedrooms........... ____________________________Expansion Attic ( ) Garbage Grinder Other—Type of Building No. of persons____________________________ Showers — Cafeteria aOther fixtures --------------•----------------•---•----- -----•------------------------------------------------------__-__------__--_------------------•-•------- d W Design Flow............__-��-_.!`___...................gallons per person per a Total daily i�ow..._._.. _ _.. ._ dons. IxSeptic Tank—Liquid capacity/5a�gallons Length4'`~ ___ Width`'::&V___ Diameter________________ Depth_______ x Disposal Trench—No_ ____________________ Width.................... Total Length.. Total leaching area_.______ ___._...sq. ft. Seepage Pit No-_____-.R------- Diameter._/�_�_._._ Depth below inlet. P_ �__. Total leaching area a..sq. ft. Z Other Distribution boat ( ) Dosing taank ) � , aPercolation Test Results Performed by. .!�fX ��,--t-- - ........".'.._._------- Date.�"�__.._ Test Pit No. I......2 .___minutes per inch Depth of Test Pit.....�,�___...... Depth to grown water_ (i Test Pit No. 2................minutes per inch Depth of Test Pit....1_3_!...... Depth to ground water___L _ S Is O Descri -tion of Soil_.se-.AJ.,D___ _ ..�. ...1-.-"_t,-'...... __ - -__ 1004__.A&* __. x _..." ..''�r+ GJ� y jam` Z�'/"� 13122.. `':'�} � 7�,,�i` ---------------------- WiA -~..57_��--..��/.4 .i L' d_._G�.�l �� f• -_----- •-_! VNature of Repairs or Alterations—Answer when applicable............................................................................................... ---------------------------------------------------------------•-------------------•-••••-••....--------.......------•----------------_.._._.._..---------------------------------------------••-•_..._. Agreement: The undersigned agrees to install the aforedescri d Ind•vidual Sewage Dis System in accordance with the provisions of TITLL 5 of the State Sanitary Co T ndersigned f a ees not to place the system in operation until a Certificate of Compliance has bee is ed o Signed----- -•• ..... f................. ..................................... ................................ Dal q Application Approved By............... ...... . ........-- ........... ....... ...................... _ D to Application Disapproved for the following reasons:----•-•----------•--------------------------•-•-----------------•----------------------------------------..._._ ....................•--••--------•-----------._......--------•-------------••----...-----......._.....------•-•---------....--------------------...----------------------•---------------------------•-- Date PermitNo.... .-....................4............... Issued....................................................... Date No.Sr? - /4 7Z- 2-2 ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7M..W.�............. ................... Appliration for Disposal Works Tonstrurtion Prrmit Application is hereby made for a Permit to Construct ( 6 or Repair an Individual Sewage Disposal System at: ........................................................ .................................... .....MJ�;tiL...5.. cation-Address -.-or Lot.No. ............ ............... -------- ---------------------------------- ------ XW Address Address Installer ..........Type of Building Size Lot......5�510.Sq. feet U .......*............................Expansion Attic ( ) Dwelling—No. of Bedrooms---...... Garbage Grinder '_j 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P4 Other fixtures ---------------------------------- ----------- ..... ... Design Flow............�.5�5...................gallons per"person"p$p'_d`a---------*----i------------------*---------------------------------------------- .,v Total daily WV--------401W...................gallons. sI �Y4 Septic Tank—Liquid capacity/�.W,&f&allons Length/ Width.5..417.. Diameter................ Depth.5� Disposal Trench—No.................._ Width................._.. Total Length....._.... Total leaching area....... sq. ft. W------ Seepage Pit No..... ....... Diameter.ZZ......... Depth below inlet. ........ Total leaching area.;.V.,9 ..sq. ft. Other Distribution box Do-sin&,a.....tank 'V Y.a ........ Date Performed b Percolation Test Results ... .. ...*---- -- i------------- Test Pit No. I......2.....minutesperinch Depth of Test Pit.....0......... Depth to groupwat Test Pit No. 2................minutes per inch Depth of Test Pit----11!...... Depth to ground water---�VI :;e L)a f _5--.57 A/) 0 Descrip ion o S 41 A -,.P _V)Ajb ............................ .....9Z . ............ .......... .......... ..... ..................4.................... ............'_ '> . .... ..... . ............... ......e.1.1 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 T I TiZ 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----- .................................................................... .......................... D!tat . .......... . ......................................Application Approved By............... . ...... D e e Application Disapproved for the following reasons:.............................................................................................................. ....................................................................................................................................................................................................... PermitNo. :��.. Issued..........................................Date............. ............ ............ ...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ......................OF.................... . ........................................ Tntifiratr of Toutplinurr THIS IS TO RTIFY, That th6end*v'd4al Swage Disposal System constructed or Repaired ii "I W by ........... X_ ............................ ...... .................................................................................................... Installer ......C at.......4_ZDFJ........ ----------- ......J( -1----------- ............................................................. has been installed in accordance with the pr.,Ji -.—.s--o, T- E- 5 of The State Sanitary Codp_ay scr bed in the application for Disposal Works Construction Permit No.....�;..! ..... ....2 :: ......... ... dated....... ......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................Z'.. ................ Inspector.... -- -------------------------- THE COMMONWEALTH OF MASSACHUSETTS ..................... BOARD HEALTH ............. ...........OF.......... ...................................... No......................... FEE........ ... ....... Disposal Works %oustrudion frrutit Permission is hereby granted.... .......................................................................... or Repair n Individual Sewa'—?l to Construct age DisiD sad System/—, at .................... ........................................................................... —.............. -0s' No........4npt........'m........ dc� t IF Co Street _Qated......... as shown on the application for Disposal Wo2s, ... .... ....... ------------------ --------------- ................................ Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 1 i ,J N �y•a z" TWO h.P. tZ 12' VIA x c� - ?, 15 0 o GAL DEPY N t5E A 1J y I x/r�h7a✓ 990 0 39 0 t�„ C �•iarEE I v � L/ a, �?� /3_0 .o �-3 _'7'b T-4 L ��/��/ = $►�� ./?� O•K . ,c/a w.�7�,� t�/cc�v.clr�,e�t� 4-- �� /S -Alln 7— QAXI 77R ZA- ey