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Home My WebLink About1387 OLD POST ROAD (CT & MM) - Health �3,gq OTC\ PDs-r �eoc-c) C TOWN OF B STABLE L � Iviv SEWAGE # VII,LAGE �bTwy� ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPAC= 0 LEACHING FACILITY: (type) `�� (size) C j NO.OF BEDROOMS a , BUILDER OR OWNER PHRIOWDATE: LA Vu t\0 , COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table 7✓ Feet Private Water Supply Well and Leaching Facility (If any wells exist 11 on site or within.200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist f� (� Feet within 300 feet of leaching facility) Furnished by ��140 � � I�i i �"` �, 13�� rr�c�i 1 Z `� � 3S► t3�- sr �� `Q_�� ° a�-fib 0 _- � TOWN OF BARNSTABLE LOCATION / . C � SEWAGE # VILLAGE (2� ASSESSOR'S MAP & LOT Q 3a-SOY INSTALLERS NAME & PHONE NO._� SEPTIC TANK CAPACITY LEACHING FACILITY:(t9Pe) 11J-T A r,3,�r(sizee)) .. NO. OF BEDROOMS J PRIVATE WELL OR PUBLIC WATER✓� BUILDER OR OWNER r DATE PERMIT ISSUED: DATE COZIPLIANCE ISSUED: lgq / VARIANCE GRANTED: Yes No t/ '� r. 1 '� t ' � , � � � �� l ' f,�� _.. .l ';i __� - _ _ � No.4.7' � Fss............ THE COMMONWEALTH OF MASSACHUSETTS ------- BOARD QF HEALTH ............O F........... . ....... . ......._.._.. Appliration for Disposal iYorks Tonstrur# lan Vrrutit Application is hereby made for a Permit'to Construct X�_or Repair ( ) an Individual Sewage Disposal System at . ..�:.,. ..... ...........................1. ^.....1 . ... .................... .. --- -Address or Lot No. >�.�.::...�...--------------------- •--•-------•- ------------------------------------------- ........................................--..... Owner Address . M Installer Address Q7i Type of Building Size Lot............................Sq. feet U Dwelling,—No. of Bedrooms........J�..................................Expansion Attic ( ) Garbage Grinder ( ) `.. Other—T e of Buildin ayp g ............................ No. of persons.............................Showers ( ) — Cafeteria ( ) dOther fixtures .-----------•---•--------=---------•--.....................---•------------•--•-------------•----..........-----------------....._......------........ Design .Flow..........................::................gallons per person per day. Total daily flow.............................................gallons. Septic Tank—Liquid capacity qP .gallons Length._e.4?"... Width.A-,6........ Diameter..............:. Depth_ ti 4-Q_..._ W Disposal Trench—No...................:. Width.................... Total Length.....................Total leaching area....................sq. ft. x Seepage Pit No. .._...._..t.._...... Diameter......AV........ Depth below inlet...4............ Total leaching area4��:_L..a�ftCi�O Z Other Distribution box (x) Dosing tank ( ) a Percolation Test Results Performed by.._.S'T.F-�F.......11 A�- 7!J.`................. Date._ 'z - �J.......... ,..1 . Test Pit No. 1_.�.'�r...'minutes per inch .Depth of Test Pit....)_` ......... Depth to ground water.._.l11?!.%.q.......... 44 °Test Pit No. 2..G.Z.minutes per inch Depth of Test Pit....i` .._..._.. Depth to ground water_._.rtore.......... x ----------------------------------......-----..........................................................................--............................ O Description of Soil......... ......P ----- ............ ------------------ --------- -............... ......- - ---•-------•-- -.......•. - •---------------- •-------- -•-----_-----------------------..-.-----.---.. W ---------------------------------- ------------- -................ •......... ._......... U Nature of Repairs or Alterations—Answer when applicable......................':..._..__._...._........::.......__._...__............................. ------------------•-••-----............----...._..............---------------.....----._..........- ................................................ Agreement 1 The undersigned agrees•to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi iZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b ued b the board of health. " Signed ,' ------------------------------------------ I:, _'.. ........... D at Application Approved BY - ��" 1 --- G'`.`. f..... '' F / ......................Date Application Disapproved for the following reasons:..................................................................... .............. ..............•--•--••---........------...........-•----------•-----------------.........----------•-------------------------------•-----------------•---------------------•--•------•-•---••-------•--- ��yy Date Permit No...........OIL _..��' .. -1 .-----••-----_• Issued-...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS ;. ;,.. BOARD OF HEALTH ... r Appliratinn for Disposal Works Tonstr ion frrufit . . Application is hereby made for a Permit to Construct X)�or Repair ( } an Individual Sewage Disposal System at: _•cat __f�__5 _►. .!. .{_ r�l ..... ...........................t-1�!.:..-.d............................................... �' Lo ation--Address or Lot No. ............... �� I� Owner Address a G1.t� ZG tte�'n �r�nc �cl• 1-�Cu� �c.h ..... --.... �r' .........---------- Installer Address Type of Building Size Lot;...........................Sq. feet Dwelling—No. of Bedrooms.._...`�--�...............................Expansion Attic ( ) Garbage Grinder ( ) `4 e of Building a Other—Type g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures .----•-----•-----------••-----------------------•-----.•-------•-•-------•--•• f Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic � q p .. y100p g ----•------g.. Total Len th-----•----•1._.•,. Total lea ,...--------•'_..Depth-4��..--- '� x Di osal Trench_i uvoca.................... acrt ------_�a�ll�hnst Len th_�.�_...inlet g idth.4_�.._.._ DiameterChing area ................sq. ft. Seepage Pit No...........1......... Diameter...... Depth below inlet...:............ Total leaching area4` ;�d..-sq--ft-r-r_P'0 Z Other Distribution box ()t,) Dosing tank'( ) a Percolation Test Results Performed by..__ 1=. ....... .................... Date_.: . - ram._____--.. _ Test Pit No. 1..C.'P...minutes per inch Depth of Test Pit----14`........_ Depth to ground water.....n.Oro.......... f� Test Pit No. 2..G..�.minutes per inch Depth of Test Pit---- `I` ........ Depth to ground water_._.ea� .......... 0 R+' .•------•••--......-- ---•-----•---------•----------------------------------•--•-------•-------------•------------.._....----.......-•--........._....•. Description of Soil.......-v P•----..-LA0,tnt--------------------------------------------------•------ W ---------•-------------•------------•---•-------•----......-----••--------•------•-.......-•-•---------------------•----------...------....---......--------•-------•-•............--•---•..-------•-. 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 the provisions of A. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sad by the board of health. Signed,.--;-- �--�.�t- ................................................. ........... Date Application Approved BY....._..... { /�/_ ��........ -----•..,.. Date Application Disapproved for the following reasons: ` ------•--....------•----------------------------------- -------------------------------------------•---•-------•------------•-....---------------.....------......__....-----------------------------------------------------•-------------•-•-•--•••-•-•---•.... Date PermitNo........... ................................... Issued_................• Issued-....................................................... i Date -----------------------------_.--- = r�.—- ---_------ —————— ----- 9 THE COMMONWEALTH OF MASSACHUSETTS , BOARD OF HEALTH �f ........... iL/f ....OF................:.� +!��A: !�:!�........................... 46 Trrtifirtttr of Tnntpliattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by............. ----------------------------------------------------------------------------------- ------ •------------- . .-------- .._. Installer at... .. ._ram..._ .......r �� has been installed in accordance wits the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.......... '_ !'f. ........ dated_..._..__ ._ / ................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO'd SATISFACTORY. c d DATE. Inspector /....tip., ilk , THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH s� .......,.,r'( /�Yt> OF........... 1. No... �!..'.......... FEE.......: ... Disposal Vorks Tnntrnrtinn ".erntit Permission is hereby granted....-----•.....�" ---`^' _ .5�.- :: to Construct ( >ey of Repair ( ) an Individ PSewage DisposirSys-.teem atNo........................ ^ � �9_..._�) f ,(fi t- = ..... ..IA4- .............................................................. Street as shown on the application for Disposal Works Construction Permit No._.--,'?4r'-/_ D'ated_---__------- ................................ r.-�d....................................................... Board of Health DATE--------------- :`.:. t t rt ^ ------------- I Oro.f5 TOP ter FouN vAnoN ✓' Ioz. 9G..O o _ —.• '3 S. INV 96,50-a' B 95. 77 k X/07-& ' _.� _ E)CTE1VaU ALL F3PPLlCRBLE i2 MANhfOLE cOV _Rs To WITH/A! -' ---�—o---o- Onrar�osed �r un� �r f'i,le /2" OF !C=/�J/Sf-QED �2A17E rl lim !l r er l /aye' }� r 16-peasf�e E4/�G To Q SEPT/c I, \_ P/PE To 6E . //S f 61_Gv. 111.40 moo- ZN — Sct-1.4o P�/C_ &3' stone•. TAAlKl LEr CL4. 7 I OLD BOG 7 S T �--! SIEVE W I _SON � ETa�2ooM HovsE 0ATE: 8 Z3 TEST BY' ,Q�iTE- G Z , M/ti/.//A/CH WI TNESS: �. Gt1N 11JKl . BAZNSTA6� _ 8 of 1-I�AhI•H 10 q - �5 ,��T/C TA NA' : *33Q x /.5= �495 GP,D, Woob �1aoo 4 L/5•&: GRL' Tf�"Q�: Lo 4M 6 L61AI� _— /p 6 FZo ttil N Is Rah1 N � S.r�N.gY 5.�1.IDY Ias I -,-r _ / F.Qa, SOIL. n c \ \ �" /O�- Jr �� 19�i. . 1So.B h2.'S - 377O /oZ.2 24 LT Soil- /0 I! �99 Bd ToM: 113. t X /.O ., 1 los "_. TOTf1L ■ 490 G.P.D. 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