HomeMy WebLinkAbout0626 PUTNAM AVENUE - Health h26 .Putnam Ave.lj�l
A =039-107
Cotuit
I
I
6a� TOWN OF BARNSTABLE
LOCATIONSEWAGE #
VILLAGE 40-77,-,`7'" ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR BLIC WATEit�•
BUILDER OR OWNER
DATE PERMIT ISSUED:
'DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes no
���
(o u �a`
.�
i
.��
o {
J
i A
�—a
No. .-- ... Fps.. ...........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
-OF.... ....................... -_
4pliratiou for Disposal Works Tonstriirtion rumit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
�z......�..a--Tv..........-••--•---------- ---------------------•----•-•-----•----....'...---------•-------•------------._...---------------
Location-. ddress or �o.
,� Owner Address
Installer Address �® o�
Type of Building Size Lot.._._...¢......... .....Sq. feet
,., Dwelling—No. of Bedrooms.................7.......................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures ...................................
----•---
-----
•---------------•--------------------- ------------- ----------------------------------------------
W Design Flow.................................�.�gallons per person per day. Total daily flow... 7,z ............... _........._gallons.
WSeptic Tank—Liquid capacitye$' -gallons Length./,d.4.-.. Width....`�� "_ Diameter_______ ______ Depth- _4 '.
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No-----------/_...... Diameter......_9._.......... Depth below inlet...4............ Total leaching area.7�......sq. ft.
Z Other Distribution box (V� Dosing tank ( ) _
Percolation Test Results Performed L---,#-erz—....�%�� `'✓��....... Date_�:. .' ..............
aTest Pit No. 1..... ......minutes per inch Depth of Test Pit----—_S Depth to ground water_______________________
Test Pit No. 2.......Z....minutes per inch Depth of Test Pit---- Depth to ground water...........
------------------------------------------------••----....-•---•---•-----------------------..__..............................................................
Description of Soil ZZ_' wse✓�' .. r. /�
x
W ---------------------------------•-•----•--•---•-•------------------•---•-•--...-•---•.............................................--------------------------------•-----•----•-•••......--••-•.......
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
f'i T�-14^ '
the provisions of 'l LE 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. ........... L4----------------- -- - ....................... ................................
Date
Application Approved By.. ... . ..... ..�.. .-� ........................................
Date
Application Disapproved for the following reaso :.---•---------------------------••••-•••--•---------------•---•---•-------------•----•-----•----------•--•---...
................................................................e........................................................................................................................................
2 Date
PermitNo... ..:.................. /v.. Issued-----------•---------------------------•--------------
Dl:to
7b
No.Q.. .. FEB..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
7f./..7;.`jc_-N...............OF... t?6✓ .l A?- 1 =-- ,
Appliration for Dhip iial nxkii Ton�tr�et'inn ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
s
Location-Address or Lot No.
......................—.......................................................................... ..........------------..........................-----------•-•--•-......................._.....
^„�, Owner Address
a o,..,v 4 A L.?'o �3 µ � .�/
..----- ----------------------------------------------------------------------••---------. 1h1: _ ._._:...-----------------...-------------------------------------•------
Installer AddressPQ
_
Type of Building _ Size .....Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
'4 Other—T e of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures -------------------------------- .
W Design Flow.................................Z��rgallons per person per day. Total daily flow...3.3..0.............................gallons.
Ri Septic Tank—Liquid capacity/S !._gallons Length_1J.' ::_. Width__Sir '_ Diameter________________ Depth..5_'
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.........../-______ Diameter.......--9---------- Depth below inlet... ............ Total leaching area..77�/......sq. ft.
Z Other Distribution box ( 4 Dosing tank ( ) _ _
Percolation Test Results Performed by..� :4.. �'! ...! '�:%:'.�.�✓�........ Date._:. -.d ................
W ---.......�
a Test Pit No. 1...... ___-_-minutes per inch Depth of Test Pit..__/Z__5..__ Depth to ground water_______________________.
44 Test Pit No. 2.......?....minutes per inch Depth of Test Pit---- :.> Depth to ground water------------ .-____-.
a .......................... -------•--------•------•---•-------•--•-•---------••---------------------........................................................
D Description of Soil....'T"! ......zz e�F
U -----------------------------------------------------------------------•------•------------•----------------------•-----.--•--
W
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 I?`:11 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.
f
Signed.......
Date
Application Approved By...•---- t1-•------ ---
Date
Application Disapproved for the following reaso ----------------•--------------------•-------------- .........................................................
...................................................
Q -- Date
PermitNo.__l1 ........................_.__. Issued--------------------------------------------------------
THE COMMONWEALTH OFF MASSACHUSETTS
OARD F HEAL
/...v."�..l..V.....OF..... .... . l...V..-.. /Y�../ .
(9rdif iratr of Tomplianrr
THIS IS T XCEfTIF hat Individual Sewage Disposal System constructed ) or Repairedby---•---••-�Q -------- - -I • --...-----• ..._.....
{ I stall /
at . -- Q /
.�
has been installed in accordance with the provisions of II'I 5 of Th.,g tate Sanitary C d as d scr he
application for Disposal Works Construction Permit No------ .$40.. 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
PARD6 HEA
.................... .. 4 . .. ..
.................... ..NO..00 - � 441_1�7 FEE.....�.�_' .....
Disposal lugr s T � �� ion :rrntit
Permission i hereby granted..� ....... A-R-470-------_......................................................................
to Construct ( ) Rep* ( an)I v'd l gage D•s L
System ll
----- ... •----• --.. ... •°- •---•-
Sweet - `
as shown on the application for Disposal Works Construction Permit No �l �ated.____�..!- ....... . .......
----•..................•-•---•---•---------------------------------------•------------•----•-•-•---.•--•-
Board of Health
DATE................................................................................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
.Cod 6
S&N
S0.0 JGo.00 49,z
4G.4
.Pat S
. , 20,053 —
c> P, I v_E _ — Pu tncua
44.7 474 Au eyu+e
34' m 601wide
M N
/OOo p N u/ C
IA 1500 w fy WATEIZ �7
i -
0
/ 0,
-6 �� 6 'Pit T P f
a tone 4A ra z
v20/ 4 ' , 30 4
427
45.1 47.E i�o.00 45.3
Scat e l"-40
�G,te 9-8-88 f
fitt Cape £nc- �� f i
4 ��-� n5
I
5 49 %latboa road
Pto?ite- No Seate !lycuui4., Ma. 0260!
Qj I C SAM` --
Nor-
tp \/l
pit
No. bedhooad. 3 �;;`; J// dtof2e
C4,turted ?tow 330
Ol
1?e0.ew e " 201
Capaci�t�� :?7 a,p d
I Sketch /tan o f Y-a,zd in Co to t, l'a. {
�O t fVICZ& o (Iaorno 3
icbi tot aj. jJ. n on ZC. 136608
i
Ltwat was acre on arz a usaecl da twu.. j
i
i
JC,-L `rr•P�lit: hGi� �e 1'10C✓F[d O .�C'L✓(it r7
i
j 1
t_ !
i
` 9edt P-i t P-6096
Made 8-20-86 ,
J. McKean
jNo wate,, e,,"uy&te ted
j%e%c. 2 rru2 pet
p 43.7
4o.L top
L-
ct can c l,.ea z
XIIN
3?aa6
_
i
o aL
- - 30.1
dot 6
1 .Sr
50.0
lot 5
201053 S 9P\ i v c
. 44.7 7 47��
34' 60 'wide
M N
N 100 j ' I S00 v, rY W+4 TE/z W/Cj
0
1-6 'x. 6 spit TPI � rn
.tone 4zoG Tcz 4
z201 ag a
gpd
4 1 7..45 i�o.00 49.3
a .o
tot_ 4
i
fitt Cape £na nemltnj. j
41. L 9 l,cvcbot road
If cu2vr is Vi a, 026 01
)&o?ite No ScG 1-e y
a S 9 o `n o N 11�.; 1-6 l�C 6 �p�,t
j
Nirs� 3 ��1 ��'-e o. bedLoo j
`
Cdt�iatdte ?.how 330
201 t
f?eae/,w��e rr 20/ a. — --
Cap"..`„""7 4..] �l f
�io�i (�iaai.o (''Iacno
l.7ein tot S a, dwwn on X.C..%-`36608
{ iom. '
I
I I
�c„Te:- -eh.�--- �� �e r oc,/uT. o7 �rec.7i
I
_ 1
i
i
Made 8-20-86 '
(;)it.' 9. McKean
No wa-te,L encouxl,,.e,,,-cd j
Pe&a. 2 min pee I ''
& o 45,7
4o.G
41•7
c.CecwL c)-ean
pe�--&"4
�J
at a
co
LAB 7