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Home My WebLink About0764 OLD POST ROAD (CT & MM) - Health (2) 764 OLD POST ROAD Cotuit A= 054 - 031 77. No.... V FEE..... THE COMMONWEALTH OF MASSACHUSETTS ...OF..... / ......................... Appliratinn for Disposal Works Cfunuitrurtiun lirrutit Application is hereby made for a Permit to Construct ( Y) or Repair ( ) an Individual Sewage Disposal System at: S .....P��.. �� s--•------•.............. _d-•- .: �� ... .... .. ��f .._. �= L�c�ifio� d ress� � � -��' -----• -•• l t1�1...---..� ------------------------ .... ....0gib . °... 1/1 M S-- 'Owner Address W Installer' Address Type of Building Size Lot...... t__�__ G'_Sq. feet U Dwelling No. of Bedrooms_ ________________________________________Ex Expansion Attic g— p ( ) Garbage Grinder ( ) a Other—Type of Building __-Bedrooms,_,, ______________ No. of persons______................. Showers (/ ) — Cafeteria ( ) Otherfixtures ------------------------•------•---•------------..__....----------------------------------------•- W Design Flow........quo.........................gallons per person per day. Total daily flow-___._ �--------------------------gallons. 9 Septic Tank—Liquid capacity_/:S _gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No_ ____________________ Width... Total Length_-____.____.-I___-__ Total leaching area............. sq. ft. Seepage Pit No...... ---------- Diameter.....0----------- Depth below inlet___.._......._. Total leaching ar _ ...sq. ft. Z Other Distribution box ( ) Dosing tank ) y G Z -- Date - =i a Percolation Test Results Performed b .______ _.._. _________________ _•_.___..__._____ __.___ _______-__•--- a Test Pit No. I...1 Q_._.____minutes per inch Depth of Test Pit....1.3.......... Depth to ground water-. (-_.--._ i Test Pit No. 2../Q_______-minutes per inch Depth of Test Pit----J_.3_`__-____- Depth to ground water.. O Description of Soil............ ______ 1 ................. ajp......... _..p-___...._...::.........__ U� V Nature of Repairs or Alterations—Answer when applicable.-------------------------------_--____-_--______-__--__-_-_----f.._.._.__.-_._________._____. J ..........................................................r_________-__._-____.__-_._......_.________________._...____-_________..-____-_-________-_.___._--___-_._.__._._............................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the rovisions Of TT T I p S 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.......... ------ Q... -•------------------- -�1_e .... Application Approved B PP PP Y ' --•••••-- Application Disapproved for the following reasons_________________________ �.. .................•--••--------------------•--•--•--•---•-----...----------------•-•-----.._....-------:--•-------=--1-----••----.._-------------------------•-•--- _ � C� V "•'`•� �, Date PermitNo.. ._... Issued---------•------------------------••-•--••-•-•-•--•••-• Date o Fxz ls. THE COMMONWEALTH OF MASSACHUSETTS 4! AR ............. . .. ... �l........OF... /-t'. v --- ------.._.......-------- E 'U Allp ration for Disposal Works Tonstrnrtion Frrufit Application is hereby made for a Permit to Construct (�or Repair ( ) an Individual Sewage Disposal System at: .......�s_---...U•.=d.... T l p �lr�(�(r�l ...........................EJ--..1.._F 3...--------.. c io - d e o vo. Owner •Address -------?/ t W Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( ) dOther 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—so..................... Width... ----------.---. Total Length_.................. Total leaching area____-..-----._--.-_sq. ft. Seepage Pit No......t .....__.. Diameter__.............. Depth below inlet..... Total leaching area J?. ...sq. ft. Z Other Distribution box ( ) Dosing t�nk (/��) a Percolation Test Results Performed by.._._..!�l..L.�F-c ..._. !7`c�................... Date..... -�1�._ a p sE� & ---------------. a Test Pit No. 1...._....sEm mutes per inch Depth of Test Pit....�.?t.I....... Depth to ground water... _U. ...._.. minutes per inch Depth of Test Pit....J.3_...__.._.. Depth to ground water__ ________ ____ rs., Test Pit No. 2._ D._..... ------ O Description of Soil.. Q $G •---...._: 1. ..- � �C4-•........��l_�. x .......................... •------••••••••-•-•-------•••-••-••••--•-•••••••-••-------••....._.•-•-•--••--•-•-----•------•--••------•---•--•-••-•••-•----••-•••-••.............•-•••............-'----••- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------••--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 1�14^ the provisions of!:'II t lL 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 �. c..•-----••-•••--------•--....-- ••--•---••-D••• ............. Application Approved By.....- -----`='--...... ._. . `��/i`..... ------.. _......---.. Cl .... ..... t --•- / - ate Application Disapproved for the following reasons:................................................................................................................ _...-••---......-•..................................••••••-•---•-•--•••-••••--••------......•--•---•---'......------•--------•----•-•••-----•-••-.....-•---•-•-•-•-••-•........---•--r Date-••••-•••-•--• PermitNo... ....................... Issued................................................•....... Date THE COMMONWEALTH OF MASSACHUSETTS f) OARD H 1_ �1�� ..........�1/ .....�....... OF.........r �....1 t��.............................................. (9rdif iratr of Tompltanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by......_t�.. ...............�........••••---•.........----•-•--•••••••••-••-••----••-•-•-•••--•--•-----•---.........---••-•�-�......•--•---------- - o-r............................ n 0.0 �� /� p ^ stal at••••-J- �--------0. la1..---..�.. ..-7-:.....P_.'J-----------t f1 t r-�.-_.f-Tf-•-#M---------5•---------------•--•----•.............................. has been installed in accordance with the provisions of TI 7 '?•-. of e Sanitary Co d -b ' the application 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....................••---...................................---•-•........-•-... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS QARD O E / ................1�ff•�,1 .........OF.... ......_................./ ......... c Nd,J.. ..`y ...7 Disposal Works TWantrnrtion frrutit Permission is hereby granted........................................................................................................ to Consty,ct ( or Repa ( an In�dividu ewage Disp al System •--••....... pp P ' Street `J _ _ as shown on the application for Disposal Works Construction Permit N Dated ................. ......................................................................................................- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 76/ TOWN OF BARNSTABLE � LOCATION bl �O SA- KcA Las F t t 1- 3 SEWAGE # . VILLAG ' ASSESSOR'S MAP 6 LOT INSTALLER'S NAME & PHONE NO. rl ( L_ F E R R SEPTIC TANK CAPACITY Q . LEACHING FACILITY:(type) L (size) rOtS® ; NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No . -- 93,0 ►Q� 4 i d TOWN OF I3ARNSTA23LE LrC'AT2ON 1=� 3 SEWAGE 01- YI.L.LAG�? GpTLt►:E _ ASSESSOR'S MAP CT LOV �SLI- o 3% INSTALLER'S NAME fiz PHONE NO._Mislt.,rona-l _au l _,,> SEPTIC TANK CAPACITY �) � O O C��L LEACHING FACILITY-.(type) (size) 1 Unto NO. OF BFDROOMS_�j_PRIYATE WELL OR PUBLIC WATER Mai�AJ BUILDER OR OWNER S0'l N '5 01 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_ VARIA14CE GRANTED: Yes No �' -n' N pv�°= H .:�. 1 I �9 4�/ �6., S� F ^ / T.e-r i "^/e.? C1 j.roo 4,94 u'j � .. � z�. K .i ',�?,6 '1tr^rn-;bY'a "'n°r i t•v��m :^l "' :1"VKQi.# S yc.7c L 95.S TOP OF FOUNDATION CONCRETE COVER ' 11 X7� \ \ G,eec� ' • CONCRETE COVERS A� •'; 4' t:AS IRON 12'MAX '*rrr. f!s► OR SCHEDULE 48 4' SCHEDULE 40 PVC (ONLY) R PV.C. PIPE PIPE - MIN. LEACH PITCH 1/4"PER.FT PITCH 1/4"PER.FT _ PIT PRECAST � LEACHING I �' m. _ •, NVEF7 T� c� a`.; PIT OR ` SEPTIC TnN K I t'•vERT 1 n� •1 El u, .c.l!+ T T Q • • ti _ - EOUiV. ti �I F, E- d�: 3 . _ z GAL. I �g INIi/Litf �' +; .. 3/4"TO r- "` ELY°�S3 • ' WASHED ; i1 EL'Q�•a!� • i i STONE ��/ � I � ' �-�•-- /Q' DIA--- i✓rtac•/7'N,r� PFZOFI LE OF ^GROUND WATER TABLE F«✓ -7 ' SEWAGE DISPOSAL SYSTEM i {r` ✓' NO SCALE 4, / 4\ SOIL LOG WITNESSED BY u � V T (' DATE''yU( TIME. .//.'.3�/Jr•'� T,, :'7� /C,•-f'N �•7,S'ti�f �f1c�t:! BOARD OF HEALTH j TEST HOLE i TEST HOLE 2 �e;S:;�; /• '. ��/�L� ![' " . ENGINEER r ELEV. 97,c'��` ELEV. If DESIGN DATA + NUMBER OF BEDROOMS �I , rc� (. ` � - �� ,r_ .o> �S. � � -1. /'�Zc T•rs - '�` lGr7�'.T'°" .✓..y ' TOTAL ESTIMATED FLOW GALLONS/DAY L ` BOTTOM LEACHING AREA 7g-1' So.FT. /PIT )s T Rl�' �� 4`�"'� �c ��r, , SIDE LEACHING AREA /�8,.� SO.FT./ PIT � � GARBAGE DISPOSAL . ^/d _('SO% AREA INCREASE) TOTAL LEACHING AREA 2407 So.FT x Z �-.4140" Ses /� GL.�SyQ PERCOLATION RATE MIN/INCH LEACHING AREA PER PERCOLATION RATE 1OV9,-'SO.FT�/�'a �O WATER ENCOUNTERED 7- x 2 /C c,Q• ��. . . . . - NUMBER OF LEACHING PITS / ! l /�l j �~ / l �✓ l ( BOARD OF HEALTH 2 - 6'/7, f.•-� x G t-f/' C' '.�T Lc.�r/! �'� `r ►^'�~•`i ( APPROVED SL / J p 2 �r�'7't�'A'• �a.✓ .�yl�.4ji�``'s. Y DATE �r F C;I 1 AGENT OR INSPECTOR JC H!\l �J L _ 1 '�1 �``N o` 4!y f c ED WARD G ! r -. "A?F✓ n/�? E. r �t 147,Jr r/ ,! .� C i 40 w KELLEY S�► No. 213100 pECISTOk . . s��a�L uao`' j PETITIONER <,jr�{c! ""��r,/