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Home My WebLink About0664 POPONESSETT ROAD - Health �-blo-v�b Caha.c�4- - - / \� LOC TION EWo,(:StE PERMIT MO. jb INSTQL ER 5 U&ME � ADDRESS BUILDER 5 Q L V AF- �-- ADDRF-SS - - - -- DATE PER" T_15SUED 2�— DATE COMPLI &MCE I ,1 t THE COMMONWEALTH OF MASSACHUSETTS V;��OARD O H EALT�F�..........OF........... . ..................- .............. ApplirFatiura -for 'iipuiial Works Tonfitraurtivat Vrruait Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal 5�� sr---q...<) .......................... ................................................................................................. oc 'on-Address or Lot No. -Rd- - ----- --------------_- ------------------------------------- Own Address - .1__... a C ) - Installer Address QType of Buildin Size Lot............................Sq. feet U Dwelling <o. of Bedrooms_.__ ExpansiAttic ( ) Garbage Grinder_.....- ---•- agwell�_� _. No. of persons..—Type of Building p ` '_______. Showers (� — Cafeteria (X ) Otherx ires -----------------------------------------------------------------------------------------------------•------- ----- W Design Flow__ _________ �__________-----------gallons per person per day. Total daily'flow....._._____.3 P...................gallons. WSeptic Tank I Liquid capacity`s-Agallons Length---------------- Width-................ Diameter----____..... Depth---_______-__-- x Disposal Trench—No.____________________ Width._.___._....______ . Total Le t _-_ ____--- Total leaching area....................sq. ft. Seepage Pit No.__ _____ Diameter._ ht p �C leaching area 1 �.--•_- �---DO•_A��ab� �-------- ------ Total leachm area--------------__..sc it. z Other Distribution box ( ) Dosing tank ( ) ��''�� - 7- 7S— aPercolation Test Results Performed bY--------- ----------------------------------------------------------•---•- Date--------------------------------------- ,_l Test Pit No. 1----------------minutes per inch Depth of "lest Pit.....:.............. Depth to ground water.................... (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ I ------- --- n f _ �r _ ('oDescrtptton of Soil � Q _ 4__ __ ', -y- U ---- ---• ._ ... --•-- ! f ------------------- - --- - f21 VNature 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in .operation until a Certificate of Compliance has bten issue b the boar f health. Signe Date Application Approved BY f ...... 4 -. I Date Application Disapproved for the following reasons-------------------••---_____--------------------------------------------------------------- ------------------- -----------••-•-------•-•••••----•--------•-----------------•-••---.....-•-••-------•--•--------------•-•------------•------------------•-•---••-•--- ................................................. Date PermitNo.-- / Issued........................................................ /i�1� /� - /�t y./. ysv -.1. ' , Date l�. No......................... FicE ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD 02 HEALT 1, ,r,00_�-i - - -OF�.......... .. ....6.L744"t.-.4...Z:.�... ................. Application -for Biiipagal Workii Towstrurtion Vantit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal _,5ystern-jat: ....... ......�-I-----I--- ................... 0 nZ- ...... ................................................................................................ Address or Lot No .... ....... —.44 R_*..... . ................................................................................................. 0 Address ).43&t................................... ...............................................................I----------------------------------- Installer Address Type of Buildin Size Lot............................Sq. feet U Dwelling No. of Bedrooms----1.5, Expan io Attic Garbage Grinder Other—Type of Building .. No. of persons______ ow PA -------- /----------------------------p-e-r s ..s.q-------------------- Showers ers Cafeteria Otherres ------------------_-------- ....................... -------------------------------------------------------------------------------------- Design Flow ?�, ----------------gallons per person per day. Total daily flow------------3.4.9-------------------gallons. ---------- S I Liquid capacitvt,.Q--O-gallons Length................ Width..___........... Diameter...._...._...._ Depth-._.-.-------_. ept c Tank T Disposal Trench No. .................... Width-_____- - Total Le ht I-- �p A------------- Total leaching area.............. -----sq. ft. ------- ....... ... let Total leaching area------------------s(l. it. Seepage Pit No--- --- --- Diametenkq .0 ) 71'� C — Z Other Distribution box ( ) Dosing tank ( ) —d,401, //- 7— 7-s— Percolation Test Results Performed by------- ------------------------------•---•-•••••....-•••-•......•-••-••. Date---------------------------------- Test Pit No. 1----------------minutes per inch Depth of Test Pit..._......_......... Depth to ground water_..----------.---.-..__. �14 Test Pit No. 2................minutes per inch Depth of Test Pit-.-___.-_-_________- Depth to ground water-_---.-.-_-..---.---._._ 9 6) n---------- 0 ----------- ----------------------- Description of Soil ------------------------ ___/. ........... .......4. ..........G�--------------------------- ---------------- -------------------- ---------------------------------------------------------------------------------------------------------------------------------- ------------------------------ 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en issu the boar of health. , _b S j e ign ------_-------- -------------------------------------------- ................................ �/. . ................ Application Approved By----- ... .... .. .. ........ ---I--------------- ----------------- --------- Date Application Disapproved for the following reasons:.... .......................7 U ----------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------.......................................................................................... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF VALTH ...7. OF................ ...... ....... .................. ...... nfifirate of T'lompliaurr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed or Repaired by......... y----.... e cn ,- 2-t.. .-.-.-.-.-a. Installed---------- ..., , .. ------- ................................................................................4 has b @n installed in accordance with the provisions of 7 e XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit Uv.....el Y----------------- 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 (S77;�V,/_ BOARD OF� EALTH ........OF............ .. .................................... No......................... FEE.._4� ............. onli r ,Lion rrmit X� I Permission is heAeby granted--- ------ .... ......... a-1 ------ ------------ to Con uc.t......... Re..air ..( I i idu I w ge Disposal Ujq$,1-------- ___� ---------------------------- ..... . ... at N ..... . .. ....... .............Str-eet .......................... as shown on the application for Disposal Works ConstructiorPefqt -,Dated_R____Ak_6........Z�........ -- ----------------------- Board of Health DATE.............................. ................................................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 8 �\Y ipopomE5 1 i t i f i ! s f j +( I • i O F� FblJh/DA.T.tON. .0NLY i s � ; s LOT 1 t cos 3 i CUU E '� , N i J6PO GAL.77x Lot- 2 38• , AREA 2/,750 } W j /3 d.00 i WIDE...PUBLIC) Plot Flan Scale 111 30 t Being lot # 2 as shown on a I, hereby certify that plan entitled "Cotuit the existing foundation Highground" by Bates location is correct as Chellman Engineers dated shown and does conform July 1926 and recorded in N0F ,M with the building setback Barnstable Registry of deeds.; r requirements of the Town o� of Barnstable. Feb. 20, 1976 " Joseph D. Ford ' ►3o. y 134. Eileen Road Yarmouthport, Mass. Signed