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HomeMy WebLinkAbout0169 SANDALWOOD DRIVE - Health C�1 d--c�33 � �= TOWN OF BARNSTABLE LOCATION `+ GucVD 040 SEWAGE # VILLAGE ��?J>% ASSESSOR'S MAP & LOT6Y0—6a3 INSTALLER'S NAME & PHONE NO. F04F6LCyW7 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) krqRP 40 //004-ev(siZe) �,k6 ZD OG4- NO. OF BEDROOMS 3 PRIV,ATE WELL R PUBLIC WATER] BUILDER OR OWNER_ �� DATE PERMIT ISSUED— DATE, COMPLIANCE ISSUED VARIANCE GRANTED: Yes No < ' I c vsl?-GtAw.� CFI Pt r Leikc.H PI"r lo ,� LOr ItiJs � � ^, ~~~--7,5--- THE COMMONWEALTH or ^vASsAc*uesrrs =�~^--- ��K~��� ���� �� BOARD �� " " ------ .--OF-. ..................................... ��� �� ^� ���u��lir«xtiou� ��/� ��is viiwxl lVarkg Tongtrurtion Vrrmit � Application is hereby made for u Permit to Construct ( ) or Repair 0 an Individual Sewage Disposal S - ____________ __ ___________________________________ L"cati" 'Add="° or Lot Installer Address Type of Building Size feet Dwelling--No. of Bcdroonno-------'z=2F....................Expansion Attic ( ) Garbage Grinder / ) Other—Type of Building ............................ No. ofperanuo-----_------' Showers ( ) -- Cafeteria ( ) °c Other Designfixtures -'--------------------'---'---'------------------------- Septic Tank—Liquid capacity,01694�.gallons Length...... _WidthZ��--- Diameter---SpqM-.. Depth.*-'--------- �� ()t6ecDio�i6odoobos ( ) D ' tank ( ) ^� Percolation Test Results ' I`erfuroue6 by.......................................................................... Dutc'------------'----.. Test Pit No. l................minutcvyerincb Depth of Test Pit.................... Depth to ground water---.--_-_- rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth ro ground water........................ � . ............................. ............................................................................................................................... u ------------------------................................................................................................................................ ..................................... U Nature of R.Wairs or Alterations--Answer when applicable......a+���--.---I........6 --��!5�����-����_- - ------__'_.-__'------_-_-'-'--_.--_-'_---.--_'_--_____ The undersigned agrees to install deaforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTIE 5 of He State Sanitary Code—The undersigned further agrees not to place the system in operation until aCe/tificate of Compliance - ~ w" --'--' ---.-'----. Date ApplicationApproved 8y'-----------.---------------' ...................................... ........................................ Date Application Disapproved for the following reasons:................................................................................................................ ........................................................................................................................................................................................................ PermitNo ....................................................... _ ^- . r' �e THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Diopuoal Worko Toatotrnrtion rumit Application is hereby made for a Permit to Construct ( ) or Repair (,N an Individual Sewage Disposal System at: ------------------------------ ... Location- Address or�Lot �yti .... .. ............................................................................._ ....� ......_!d 1E1 _. __ ... .. _ caner _ A dress Installer Address Type of Building Size Lot. _ ......Sq. feet Dwelling—No. of Bedrooms............... .....................Expansion Attic ( ) Garbage Grinder ( ) pa-, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ........................................................ W Design Flow.........`'. gallons per person per day. Total daily flow........... ...................gallons. WSeptic Tank—Liquid capacity/©oG..gallons Length..... :a_`�'_ Widthr_ _ __..__. Diameter__- .__- Depth. ..._..._-- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------- Diameter.......:.-------- Depth below inlet......j.)......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water________________..-____. Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ -----•--•--•------------------••--•••....•••--•...•----•--•---•••-•••-•---•---•----•----•-------••--......................................................... O Description of Soil.........r2..Z...._.../5;? ------- ............. - ..........�'�'� ---"� .ci..? rSc x < W UNature of R pairs or Alterations—Answer when applicable______ : ,______________ _--------s<?a'k.........1�1�'��:W-___P/f ............._ .............. .................__._..................................._..___.._.____..._....___..........._._____.______.__.._.._..___.._._................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTT E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been--issue by the - / h. / Signed---•� � ,, . ���`. �� (� Date ApplicationApproved By•-----•-••-•-•-•--•-•-----•--•.......................................................... ...................................... ........................................ Date Application Disapproved for the following reasons:-------•------------------------------------------------------------------------------------------------------- ..------....•••••------••-------------••----•-•-••--•-•--........--•--••--••----•-•--•-------------•-------....._.........--•---•---------•-•---•-•-•-•----••--•--••---- ............................... Date Permit No....... Issued........................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............................O F..............................................................I...................... Qw"rrtifiratr of TompliFanrr THIS IS,T0 CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................... =w >>7.�:_?..� _- -----------------------------------------------.......................................................................................... Installer at...................................................................................................................................................................................................... has been installed in accordance with the provisions of TIT-Y--. 5 ot—The State Sanitary Code as described in the application for Disposal Works Construction Permit No----._.-_ ._��..-_.S. ........ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... .........-............... Inspector---............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.__.. ."... - FEE._.....:?.............. Disposal orkoALono#rudion rranit Permission is hereby granted I:..:.. =.,: .:`_s.. .1_1--r-------•-------------------------........................................................ to Construct ( ) or Repair ( an Individual Sewage Disposal ys stem at No............ •-oa f----•-•- ..r:_. .�(.�C:._Y .??'Ts----•-• ?....---•-----..._.,,_-C.=_` C P Street as shown on the application for Disposal Works Construction Permit Nolk_V(�L D1 ated.._.•..................................... \._.... r -------•--------------- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS LO-'CATION SEWAGE PERMIT NO. VII..LAGE C G ro l�. INSTA LL7E "S NAM/E & ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 7, . i�lei V�� Cr r No..••-•••••-••••--. ..../...I........�.9........ THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH . .W et..................OF.....�4- .f`-vt.-S�f&k : ........-.-....-.....:...-.-.......... Appliratiun -fur 430poutt1 Works Ton.itrurtiun Vrruiff Application is hereby'made for a Permit to Construct ( fi%f or Repair ( ) an Individual Sewage Disposal System at: .Z49 5------•t 1d Cow --U..!� -:�............. l� r ---------aT.......G_ « 1 � ......... _ Location-A ess ��� r Lot No. Mel) h.-__ �san r ss �_ ►��-------------- .... -I.......O f---------------------------------- Owner �j Address Installer Address Q Type o ilding Size Lot__ P_d ......Sq. feet U Dwellin No. of Bedrooms------ _________________________________E Expansion A is (jd�) Garbage Grinder (e7O) aer—Type of Building _________________•___.___.__ No. of persons............. ----------- Showers ( ) — Cafeteria ( ) QOther fixtures ----------------------------------------------------------------------------------------•••--••-••-•--•-•-••--------- W Design Flow..................S'a______________,__gallons per person per day. Total daily flow__________-3!0_Q..................----gallons. WSeptic Tank—Liquid capacity/600--gallons Length................ Width-__-____--__-- Diameter----- ---------- Depth__-____-_-_. x Disposal Trench—No_____________________ Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..........I-------- Diameter....6 _____ Depth -below role T tal leaching area------------------sq. ft. z Other Distribution box ( l�f Dosing tank ( ) ?� — �G `Z? '-, Percolation Test Results Performed by------ .............................................................. Date_---_-------------------------------- a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water..............---------- fi Test Pit No. 2................minutes per inch Depth of Test Pit_-_______________.__ Depth to ground water--------------------_-- ------------------ ------------------ .—Description foil-------------- -4-4---` /tom-_- 6``t ''Z` �► - ----------------------- c., --------------- 'a � i /2- s' , W ------------------------------------------------------_---------------------------------------------------------------------------------------------------------------------------------------------- V 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 been issued by the board of health. lop 000 Application Approved BY1�' .d .L+til-- - ------------------------ - '77 Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------- ------------------ Date PermitNo......................................................... Issued........................................................ Date No.... •-•••-----•-- ....... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD, OF HEALTH b y ...__OF..... relf.a Appliration -for Bigpoiia1 Workii Towitrurtion Vrrmit Application is hereby'made for a Permit to Construct-,V-1-T or Repair ( } an Individual Sewage Disposal System at: /�r+�� 1` �/B p j /p l 0/d (Q'S'F f.t i( �+° a @ �{ I b l�y[�_I tJ2S l�l Location-Ad ess r Lot No MAR s, drr w f Owner dress ......••. •....................................... Installer Address UType o ilding Size Lot_.-P6i oQ Q-_-.Sq. feet Dwellin No. of Bedrooms-.-.__ .._.......................__...Expansion A tic (,#d) .Garbage Grinder 04) PA ier—Type of Building ._......................... No. of persons...---------V----------- Showers ( ) — Cafeteria ( ) al Other fixtures _______________________________ _ _ W Design Flow___-_-__-__-_----��................gallons per person per day. Total daily flow----------- A0_______---_-_------gallons. WSeptic Tmik—Liquid capacity/600_.galions Length---------------- Width................ Diameter---------------- Depth...-_.---_-.-... x Disposal Trench—No. .................:l— •-__---_-____--.-_. Total Length,-------------------- Total leaching area------------.-------sq. ft. Seepage Pit No----------I........ Dia erg._. ?K2----- Depth below inlet-_________.. .•, Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tank ( ) U 'I� !`�' ti - 77 aPercolation Test Results Performed by---------------------- ------ Date---------------------------------------- F a Test Pit No. 1________ ______minutes per inch Depth of Test Pit-.---___._---____-. Depth to ground water_---------------------- 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water__.-.-_-------_--_-_---- R'+ 0-- / ! -- ' = / - Lt-w ------------- %. --------O Description of Soll. 4 (� --------------- -ec---,-- _..._.�2...__•_.-. '---�- --'_..__-/•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 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 been issued by the board of health. T ate Application Approved By-----•-----1- Date Application Disapproved for the following reasons--------------------------- ---------------------------------------------------------------- ------------------- ------------------ Date PermitNo......................................................... Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD-OF HEALTH {. .................OF....� t!s Stc ........................................ Trrtifiratr of Tampliaurr THIS T CER IFY, That the Individual Sewage Disposal System constructed „4_ or Repaired ( ) Installer has been installed in accordance with the provisions of XI f the State Sanitary,Code as described in the application for Disposal Works Construction Permit No. r fti ------____kk:-........_ dated--'- __-_/.S ._-. --�___........•.-- `Ti HE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEKIWILL FUNCT�N SATISFACTORY. `' . f /Gtj DATE--- • ---`--��----- --------------........................ Inspector------- -------------- \ -------•------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARtb rOF HEALTH � �. ................o F...... . ..54 .11e....---------------............... No............... - FEE---1 ............... Oa4ktj ork,o Permission is hereby granted--------- ... '�" - r;+r to Construct ( ,) or Repair ( ) an Individual Sewage Disposal System atNo..................................................................................----------------------- Street as shown on the application for Disposal Works Construction Permit NO., _;_______ _ Dated---- .`�.5..`-7 ............. ------------- / ------------------------------ Board of Health DATE---•-------------•_.._..----------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �(,= grM,•y.M.. •^?,gw'V••R±.-�•s•.+- Mwf.• .. •v ... � .-.+Am. ..w .. A-� f•• -T �'^'4.{� �..�s77 „'�r� � . . •^r.— .. .. .rz .. ,� 3 s4 �xi',j,�.#rk-i' f. y Y /"�".. - � 4 ,�+ �./•/ f r Y i qt 11��.d ;„'t{:+ ��r '.�yR a'w 4 � :� � .y!.� s/4"��ii 1 (/'\)�•f�''�` SA 4ir✓L�k�'" "fn<:sY� �` �t ,.,• *; #F'L;i✓Cr LX�'i�tej }-.•tr- °'y i°Y'X" _ y �� ?"V �g ".,. .�y.."y�r/ t -�'r �ti1•�yJf.¢ F{ti vl.- ,q!'2 :'#:_'y`at'T s a.w` # ' tt• V' Jw � � © \ •Cr / ..! ,fir '.. 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