HomeMy WebLinkAbout0049 PUTNAM AVENUE - Health 49 PUTNAM AVE41 v �'-
_ COTUIT
` A = 036 044 001
r
TOWN OF BARNSTABLE
LOCATrJN 7� �/c��li�Ct/i► I(Y10e SEWAGE #
VILLAGE r) u
ASSESSOR'S MAP &.LOT
INSTALLER'S NAME&PHONE NO.iTd AJ .r �p/V�c �'a `Ap-�
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) hed f? )C a k a- (size) 'YJljt-g?P T
NO.OF BEDROOMS
BUILDER OR OWNER + AeC t t �5Yfr—
PERMITDATE: S5/� 41/ COMPLIANCE DATE: 6//-1-hl
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on-site or within 200 feet of leaching facility) ;--ZVAd Feet
Edge of Wetland and Leaching Facility(11
y wetlands exist �ee
within 300 feet of)qaching fac Feet
Furnished by aLL
a
A T. �s a
c
t ��
No. Fee%&o V
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYtcation for Migool *pgtem Construction Vermtt
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components
Location Address or Lot No. 9 t!p ,��r Owner's r e,Address and Tel.No.
Assessor's Map/Parcel ®��j Q /'1 �d/
Installer's Name,Address 7d Tel.No. 9 x (� Designer's Name,Address and Tel.No.
_�S, P /�/
eq
OT
Type of Building:
Dwelling No.of Bedrooms Lot Size6'�sq.ft.--' Garbage Grinder( )
Other Type of Building L No.of Persons Showers(j ) Cafeteria(c?)
Other Fixtures
Design Flow A,7 YIX !? gallons per day. Calculated daily flow -5 0 gallons.
Plan Date JON o2 4 0661 Number of sheets 9 Revision Date
Title
Size of Septic Tank hL oo C'�i% Type of S.A.S. solve 3 a- c
Description of Soil m/�- �e� �i9 Y1 o� /,Y, i,_Qd /�'' � 7� �e e
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issue y this B d alth.
Signed n ate u, +
Application Approved by a , ate i C 10, 1
Application Disapproved fo the following reasons
s
Permit No. Date Issued
_ l r
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V/
' Yes
PUBLICHEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS
2pplicati0•n for Mioo!gal *p$tem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon("~) ❑Complete System ❑Individual Components
Location Address or Lot No. 1 u, Ala#,, AL 4 .ju,T Owner's Name,Address andTe1.`No S 1IV'
e, Assessor's Map/Parcel / ~
'Igstaller's Name,Address;and Tel.No �' Designer's Name,Address and Tel.No. _ 0 5 ,*1l P vy
Type of Building:
Dwelling No.of Bedrooms e Lot Size -?D,�o sq.ft. Garbage Grinder( )
Other Type of Building .57)Y-4,wt as L No. of Persons Showers(% ) Cafeteria(d)
Other Fixtures
Design Flow - ��� gallons per day. Calculated daily flow 2 a gallons.
Plan Date Juiv e�d � Number of sheets `' Revision Date
Title
Size of Septic Tank lb 00 GG Type of S.A.S..- l•P1v
A
. /
Description of Soil / o it A a, 7up S 0[
7, 04✓'S-e- �eu/ S dN�✓�
Nature of Repairs or Alterations(Answer when applicable) f
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Ceitifi-
cate of Compliance has been issued by this B'�d of �alth. '�
Signed (` ate '
Application Approved by /�` i !.' ' % ate
Application Disapproved for the following reasons
Permit No. Date.Issued
- - - -_ - - —_-- -------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the n-site ewage Disposal System Constructed( )Repaired( )Upgraded( )
Abandoned ) y TG f✓��
at v i dL- ha bee structed in jaccordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. ted Z dt'
Installer Designer
The issuance of this p rmit all not be construed as a guarantee that the sys ill futioa a'desi ne
Date G Z G� Inspector
".. �,,.....• ———————————————————————
No. Fee l 'mil��,, THE COMMONWEALTH OF MASSACHUSETTS
r PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS
Mizpooal *proem Construction Permit
Permission is hereby gran d-to Co ) e ( XV
(
System located at (�
Tr
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction m bQe�c /m }e d within,three years of the date of thi permi .
Date: V tt-/ Approved by
a+ ss't�"'�.y'S. :. s,,•vyrF 'r y '.� �x y,"-YYs'tit: _s,.,.M.F ^7''
TOWN OF BARNSTABLE �
4i idte2: �.
LOCATION 7 SIWAGE #
VILLAGE s tv l fi ASSESSOR'S MAP & LOT 3
INSTALLERS..NAME&PHONE NO
SEPTIC TANK CA PAC JS'oo r
LEACHING FACILITY (type) �J�oI a )G' �2"6— k�- (size) �i�C-Zf.�
NO.OF BEDROOMS
BUILDER'OR OWNER .v �j�i a se(l'
PERMITDATE :�1 COMPLIANCE ATE. 6 X� /D./
Separation Distance Between the;
Maximum Adjusted Groundwater-Table and Bottom of Leaching Facility 4` Feet
Private Water Supply'Welland Leaching Facility- any wells exist
on site or-within 200 feet of leaching facility) /r%� -. Feet,
Edge of Wetland and Leaching Facility( y wetlands exist
within 300 feet of aching fac Feet
/'�
1 Furnished by:
ti
c/
MEMORANDUM
DATE: January 26, 2001
�S
TO: John Whit "OFley y
195 pond Street s
Osterville,:VIA. 02655 A'
FROM: Stetson R. liall,R.S.
28 Rambler Road o�i Fy��uPt°�
Osterville,MA. 02655
SU18JECT: Septic Repair at 49 Pu am ve.,Cotuit,MA.
As you regvested,I have prepared the attached sketch along with design
calculations for a septic system to be constructed at 49 Putnam Avenue,
Cotuit for Sandra J.Dannhaus,owner of property. The septic system will serve
the former i-.e house as shown on Lot A (Barnstable Registry of Deeds Book
12504,Pagt 78)which, is to be renovated into a one bedroom dwelling.
The septic system design shall iAchrde a 1500 gallon septic tank,distribution box
and leach trench containing two 500 gallon leach chambers with a 2'foot effective
depth and with 4 feet of stone on all sides. The design calculations are as follows:
Number of bedrooms one
('design for 3 as required by 310 CMK 15.002)
Total estimat-W flow 330 gal(110 gal x 3 bedrooms)
Bottom leach area 320.75 sq.ft.(25'x 12.83)
Side leaching area I51.32 sq.ft.(12.93'+ 12.83'+25'+25'x 2)
Total leach area 471.32 sq.ft.
Leach area 348.8 sq. Wgallon/day(.74 x 471.32)
assumed :ate o <min/'( perc f inch)
Design flow 348.8 gal/day
JAN-26-2001 10:23 BARNSTABLE CTY LAB 15083756612 P.04
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SA 'fAO toOUNTY
AE�STRY OF DEEDS
A TRUE COPY.ATTEST
JOW F.MEAD RDQ1Si EA
TOTAL P+04
JAN-26-2001 10:23 BAR NSTABLE CTY LAB 15083756612 P.03
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TOWN OF BARNSTABLE
LOCAk N YJ 11%daoW 4110 (,oVul� SEWAGE # 096'Jo?l
VILLAGE �Q�� ASSESSOR'S MAP & LOT ✓O-044-0
INSTALLER'S NAME.&PHONE NO.
SEPTIC TANK,CAPACITY JcOd �A/ f
LEACHING FACILITY: (type) (size) f ��
NO. OF BEDROOMS &—
BUILDER OR OWNER S 6'l4vuAl�'
PERMITDATE: COMPLIANCE DATE: 690
Separation.Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist � �(
on site or within 200 feet of leaching facility) YD;Ae V/+'/ Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 f t leachin i - Feet
Furnished by
.i.
L z
9 / /
P
fw4
TOWN OF BARNSTABLE qq
LOCATION �� �il/4s3? 1/e l D�u� SEWAGE # 096 -.2a�
VILLAGE�,�1/c, i \(— ASSESSOR'S MAP & LOT L�
INSTALLER'S NAME&PHONE NO. %/$� -
SEPTIC TANK CAPACITY 06
LEACHING FACILITY: (type) Al e it (size) 14`f 7"
NO.OF BEDROOMS
I
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table.to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist ��((
Feet
on site or within 200 feet of leaching facility)
Edge of Wetland and Leachin Facility(If any wetlands exist �'
within 300 f t leachin i ' ) Feet
Furnished by
pa
A.
YqV 'p
y
r
i �Iholl
No. Fee /O
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Application for Migoml *pttem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System 0 Individual Components
Location Address or Lot No. O 4 �5 C / Owner's Name,Address and Teel.No. �a N AQ L/S'P(/
Assessor's Map/Parcel AAm AV;�,,V
`7 /I/ I-ti�*�
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
f <<
y
Type of Building:
Dwelling No.of Bedrooms Lot Size-sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank h6-00 Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when ap licable) cp,. e 3f ear.4 V/!^rN c` d�
Add 7 f)d Cl-
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been=isy thisB ar Health.
Signedl t9 ate
Application Approved by ate
Application Disapproved for the following reasons
Permit No. Date Issued
No. Fee o
S
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS
2pprication for Migpozaf *pttem Construction 3permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. — O y 41 60 / Owner's Name,Address and Tel.No. G,�, ,US
L� P v
Assessor's Map/Parcel / "' �N 6� '"l V'P
Installer's Name,Address, Tel.No. Designer's Name,Address and Tel.No.
J a�►N �(��i� � r yak sy y3" ,
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow ^,F gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic4Tank /S�aa Type of S.A.S.
fr,
Description of Soil
r•
Nature of Repairs or Alterations(A swer when applicable) `�+ Cu Pur,4
�d 7d q 1p)D/6T e -0-t/
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of e E vironmental Code and not to place the system in operation until a Certifi-
cafe of Compliance has been is e MB ar Health.
p Signed
Application Approved by ? �- ate
Application-'Disapproved for the following reasons
Permit No. ( Date Issued
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTT-F, �at he On-site Se .age Di spos�l Systemstructed Repaired Upgraded( :
Abando _d � � i 'l i
at 1�vf IVA
I I I N 7 L (DrI V I I ha be constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No dated i
Installer Designer 19 a
The issuance of this pe t all t�e construed as_a guarantee that the syste "�wil.fu ctior/n as designed.
�! / Ins ector %�lY � !I
Date � # � � p _
V
---- --------------------------
No. Fee .....--
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS
migpooal 6pgtem Conotr coon permit
Permission is hereby gr t . to o s c epair �Upgrade Ab doff( )
System located at o
12
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Cons t' n us p
pleted within three years of the date of this
Date: Approved by
k TOWN OF BA'RNST LE
LOCATION `� � 1 V f ""� SEWAGE # -2 L
VILLAGE AS ESSOR'S LOTc1 "� y 4fl
INSTALLER'S NAME&PHONE NO. r/&
01
SEPTIC TANK CAPACITY / ® 1� /
LEACHING FACILITY:.(type) Z4naek (size) /X X x
NO.OF BEDROOMS
BUILDER OR OWNER "I"
PERMIT DATE: OMPLIANCE DATE: 111Z 2 /
Separation.Distance Between the:
Maximum.Adjusted Groundwater Table and Bottom of Leaching Facility 7 Feet
Private Water Supply Well and Leaching Facility (If any wells exist .
on site or within 200 feet of leaching facility) ot� Feet
Edge of Wetland and Leaching Facility(If any wetlands exist;.
7 :1—
within 300 feet leaching f i ' ,..) (Feet
t
Furnished by
L
� J
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: `'�
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Application for Mtgpool *pgtem Com6truction Vermtt
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components
Location Address or Lot No. 1/9 fNu 4K'e C4o a l Owner's Name,Address and Tel.Np,.
,Turnes �Sakdgr ,�Ja.v,r..tlau6�d
Assessor's Map/Parcel �(o _ c�C�: p 0
J!G Installer's Name,Name,Address,and Tel;,o. � 5 Qa�¢rV/!�Q Designer's Name,Address and Tel.No.
Otis
Type of Building:
Dwelling No.of Bedrooms Lot Size 1, $Y sq.ft. Garbage Grinder( )
Other Type of Building Waget No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow .S-j-0 gallons per day. Calculated daily flow 6 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank /-"O CA Type of S.A.S. r c
Description of Soil St,-d e (a 55
Nature of Repairs or Alterations(Answer when applicable) &c4i r k"r eC-k
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issuW by this ar f alth.
Signed Date AOF 5 9p
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued "
No. — J0 6 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V�-
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
_ y
01ppYicat o-n-for 045'pogar 6p5tem 'Cow6truction Verffrft
Application for a Permit VC struct( )Repair.(`�)Upgrade( )Abandon( ) O Complete System El Individual Components
LocatiotAddress or Lot No. �/4 P fi+%di°• /hi u� �'� a Owner's Name,Address and Tel.N
,�JuN�/!'ou5er
Assessor's Map/Parcel O J?(p
Installer's Name,Address,and Tel.No. p M y �f ,,,.v� �� Designer's Name,Address and Tel.No.
ya
Type of Building:,,'
Dwelling No.of Bedrooms Lot Size /. 8 y sq.ft. Garbage Grinder( )
Other Type of Building Wood No.of Persons Showers( ) Cafeteria( )°
Other Fixtures
Design Flow ,S—SO gallons per day. Calculated daily flow 6 Yo gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank. /3 O0 /G� P. Type of S.A.S.
Description of Soil 5��� C lrFsS
i
F
Nature of Repairs or Alterations(Answer when applicable) Qcepu f'r P�-�2 tg c
E
Date last inspected: '4W
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to placefthe system in operation until a Certifi-
cate of Compliance has been issued by this TarcYof Ifealth. `X
Signed _L-- Date V/s i9MCI-
9
Application Approved by Cn Date
Application Disapproved for the following reasons
Permit No. Date Issued "---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the On-s'te Sewage Disposal System Constructed( )Repaired ( )Upgraded(
Abandoned )b �e 6
at / 26yo 62627i has been constructed in accordance
with the provis ons of Title 5, d the for Disposal System Construction Permit No. b dated 140-2-0-' �Lr'
Installer h/ sjoo l /.,o.�Q // Designer
The issuance of this permit shall not be construed as a guarantee that the sys will function as designed.
Date ° ldo 9 0 Inspector
A .
---------------------------------------
�—
No._ Feed
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS
Construction Permit
Permission is hereby granted tQ,Cpnstruct( )Rep ( —)Upgrade( )Abandon( )
System located at t—i 9 (✓u1v► Ave ,o wt ,
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
�t.
Provided:Construction must be completed within three years of the date of this pet
Date: l 2� Approved b.
ti .
1/6/99
t
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only. -
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)
I, IL /Cf W h ��e hereby certify that the application for disposal works
construction permit signed by me dated /��3 /y concerning the
property located at 417 Rgo/C-.'-tof �c.<P 1�9�,�`C� meets all of the
following criteria:
v/. The failed system is connected to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
✓• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
✓• There are no wetlands within 100 feet of the proposed septic system
V• There are no private wells within 150 feet of the proposed septic system 79-w"
"�• There is no increase in flow and/or change in use proposed
There,are no variances requested or needed.
V• The bottom of the proposed leaching facility will not be located less than five feet above the
ma.,dmum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor
/ method when applicable]
N • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed
leaching facility will not be located less than fourteen(14)feet above the m ximum adjusted
groundwater table elevation,
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information)
B) G.W. Elevation 10 +the MAX. High G.W. Adjustment?17
DIFFERENCE BETWEEN A and B
SIGNED 01 DATE:
(Sketch proposed plan of system on back].
q:health folder.cert
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TOWN OF B/ARNSTABLE
LOCATION `� , �e C '� SEWAGE # 99~7n 1
VILLAGE ASSESSOR'S &LOTJ�
R'S NAME&PHONE NO.
INSTALLER'S ,SEPTIC TANK TANK CAPACITY
LEACHING FACILITY: (type) /dW'V c / (size) /Cd x x "Z
NO.OF BEDROOMS
BUILDER OR OWNER 1 t S G�fi /J u 5 (/
PERMIT DATE: �e A,C/ COMPLIANCE DATE:
Separation Distance Between the:
Maximum.Adjusted Groundwater Table and Bottom of Leaching Facility 2 7 Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within.200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet pf leaching f i J + Feet
r;
Furnished by
fi
of �,
LOC'AT ION � SEWAGE PERMIT NO.
VILLAGE
Lol
INSTA LLE 'S NAME i ADDRESS
BUILDER OR kWNEIt
PA T E PERMIT ISSUED
DATE COMPLIANCE ISSUED
a
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No..82- y 3... F.Rs...... ...5.00....
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.Town.........OF..........Barn$tab�e......... ........
Appliration for UiipusFal Works Tnnstrurtinn ranfit
Application is hereby made for a Permit to Construct ( 15..,or ,Repair (x ) an Individual Sewage Disposal
System at:
4.9 Putnum Ave. Cotuit MA 026 �'
-•--._....--•----..............•-_... ---- ."....................... ................................................ •-------•-------•------------•-----------
` Location-Address or Lot No.
Edw.. J. Rope$------------- •-----••-•----•-••---•----. .!��.-P�itnum__Aye.._,..C atlai tt.. 4-----0-2b3�....----•---.....
......................dw. Owner ^' Address
W A & B Cesspool Service ... ...Q2601.
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms..................... .....................Expansion Attic ( ) Garbage.Grinder ( )
Other—T e of Building No. of persons........2................. Showers — Cafeteria
Q, Other fixtures ....---••-•-----•-•-•...--••--. .
d -----------------•----------------------------------
W Design Flow............................................gallons per person per day. Total daily flow................._..........................gallons.
P4 Septic Tank—Liquid capacity............gallons Length---------------- Width................ Diameter................. Depth................
'Disposal Trench—No. .................... Width.................. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Deptlit below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing.tank ( )
Percolation Test Results Performed by---•t•...•••---••---•-----•--•--••------•-•--•-----•-••••-•••-•---.---... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water•-_-_-_______-__-_---_--
rT Test Pit'No. 2................minutes per inch Depth-of Test Pit.................... Depth to ground water........................
W
0 Description of Soil---•--...-------•••---•••••.....•--- and..........................•-••----------------------------------------------------------------------------...........-•---
U •..---- ......••-•••-••-•----•••-••-••••...-•••---------•..............•-•-•---••--------•••••-••--••--••-•---••-••---•-•-•---••••-•---••............................................................
W
UNature of'Repairs or Alterations—Answer when appl•cable______.....lallation of a 1,000 gallon, precast,
stone packed leach pit with extra stone �ar erfl ow) .
-------•-------------- ---------------------------•--------------------•--•••---•--------._....--•••-•••-•....•••••--------•--•-•-•----•--•----•-••.._....--------•---•--••-••--••--•--............----
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 ben issued by tie boar of 1
Signed.._........ 8/11/82----------..
Application Approved BY- .A-- --8/11/..Race
Date
Application Disapproved for the following reasons:-----•--------------------------------------------------------------------------------------------------------
.,-----•-----------•-••---•-•--------•---••---------------------------------------------•---•••
Date
PermitMR...................................................... Issued......................8/11/$2.................
Date
No..2- Y33 5.00
FEB .....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
"rown Barnstable
......................................... .........................................................................................
AppliratWulor Ui_qpasal Morkii Toutitrurtion "amit
Application is hereby made for a Permit to Construct or Repair (X an Individual Sewage Disposal
System at:
"A 02-635 ......... ................................. ...........
49 Putnura .Ave
..............U6ation ,Address
� or Lot No.
26 Edw. J. 'RoTies 49 Putnum Ave:.,..Cotuit._i .....o 3.5................
..................................... ..................................... .0............... .... ........
Ow' ner
Address
anni s.
A ,,'L, B Cesspool Sje�rviae., .�' 12S Bishops Terrace. I 'A 02601
........................Cesspool ....................................... .... ............... ..................................... .......................................
4 Installer Address
Type of Building Size Lot............................Sq. feet
U
Dwelling—No ofi Bedrooms........................2
....................Expansion Attic Garbage Grinder
a
pe Other—T 4.'hulldiiig ...............0............ No. of persons........?................. Showers. Cafeteria
y Other fixtures ................................................:.............................. ................................................................
Design Flow...... ... ..........gallons per person per day. Total daily flow............................................gallons..................** I......
1:4 Septic-Tank—Liquid.tapacityi..............gallons Length................ Width................ Diameter---------------- Depth................
Disposal Trench N ...... Width.................... Total Length.__................_ Total leaching area....................sq. ft.
Seepage Pit No......... -------------------- Depth below inlet_............_..._.. Total leaching area..................sq. ft.
Z Other Distribution box,( Dosing tank
Percolation Test Results .:;?erformed by.......................................................................... Date........................................
Test Pit No. 1... -_.: :._--_minutes per inch Depth of Test Pit.................... Depth to ground water..................._._..
Gi, Test Pit No. 2--- ...7-.minutes per inch Depth of Test Pit.................... Depth to ground water..__._......._......_._.
.................I---------5d6d:
0 Description of Soil______I.....................................................00.................................................................................................................
................ ........................................................................................................0...................................
--------------"*---------------------- .. . ........................
777--------------------- ---- ------------------- ...precast,
U Nature of Rei)airyr Alterat�)ns.7-Answer when licable... ---------------------------------------------------------------------------------
( C
Ked i,
ST.one pael eaC pi�, W-.,,h extra 8,,ApTb erfl
....................................................................................................................................................
Agreement--- ------_:----------------- ----------
-The undersigned agrees =to-install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIT11 56f-the-State Sanitary Code— The undersigned further agrees not to place the system in
operation until,a'Certificate of Compliance has be issued-by the board of h
)f 11
d.. K.Signe, .................a
.. ........ .............................. ....................yApplication Approved"B ..... ..... ....... . .... ............................... ........................................Date
Application Disapp roved jor,;the following reasons:.................................................................................................................
4
........................................................................................................................................................................................................
Date
Permit 142:n.................................................... Issued......................81111F)2
....................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T own Parnstable
.........................................OF.....................................................................................
TyWrtffiratr of Tantpliatta
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired X)
. . . .. 128 Bish..o.ps....T..errac...e.. ....0260..1............................by. .. . . I..............4... Put... ....... ...... .m. . ..... . .l.ler
at.........9........ umeCotuit,..j,A....0263 . .g.W..
J*. .R
. .........................................................................
has been installed in accordance with'the provisions of TITLE 5 of The State Sanitary Code, as described in the
82- Lj 33 ryl�/82
application for Disposal Works Constrbction Permit No....................................... dated-.............. .............................
THE ISSUANCE OF THIS CERTIFICATE RTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION,.
SATISFACTORY.
DATEV11 2
Inspector__._.... ........................................ ..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
82_ .........................T...o..w...n.........OF...:..........D.am.p..t...a...b..l...e.........................................
$ 5No._.........93.7 FEE............-..0..0..
......
Permission is hereby.granted. ......A & B CessDool Service
.............................................................................................................................
to Conqr)icllitn' erA4pairC(o 41;tI 1phivitet,�
5m:ag,jq,&.spT s
at No............................................................................I..................t•................................................. ...................
...7t--------------
Street F2- 1 /11 62
as shown on the application for'Disposal Works Construction Permit No................1.... Dated........._..__..__......................
. ...........................................
DATE........8111/8-2 -7" 1............................................ >AMFiiealth
...........
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS