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HomeMy WebLinkAbout0193 SANDALWOOD DRIVE - Health 193 Sandlewood Drive Cotuit A= 010 - 035 �I TOWN OF BARNSTABLE I c LOCATION SEWAGE # 3 �fC� VILLAGE. U t� ASSESSOR'S MAP & LOT (J/D-G 3S INSTALLER'S NAME & PHONE NO. 0a/Ct7 eL0-) SEPTIC TANK CAPACITY /aa� LEACHING FACILITY:(type) Imo' �c J (size) NO. OF BEDROOMS PRIVATE WELL OR BLIC WATEJ� BUILDER OR DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED:. J J VARIANCE GRANTED: Yes No / BOX 0 3 y L �7 Fxa..... 40.............. THE COMMONWEALTH OF MASSACHUSETTS APPRM0 BOAR® OF HEALTH TOWN OF BARNSTABLE �tr i fnr Difipnial Nurbi C uatitrurtiun ramit Application is hereby made for a Permit to Cortstruct ( ) or Repair ( an Individual Sewage Disposal System at: .....z1c....... G�YrmO �l�t1J� --'---.....!-T----------------------------•------------ Lot ... �G 6�Fft7L6............ � �J �. -.'✓�.���J ��.�.............. ... o�cncr d ress -----------•-•--••••--------•--•- ......._��_.. ................ ............ ..... ..........�:. -----------------------!)�1_...!. ...... Installer Address d Type of Building Size Lot............................Sq. feet UDwelling— No. of Bedrooms.-__-__----_•.:_�?------------------__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixture ---------------------------- ....................----------------- .............- ---------------------- --------------•-------------------- W Design Flow.................�._S---------_--------gallons per person per day. Total daily flow................ 0................gallons. 9 Septic Tank—Liquid capacity/M...gallons Length................ Width---------------- Diameter---------,...... Depth................ Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter----_---_--.-._---. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ 4 04 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----•---------------------------•------•-•-----•---------------•---•--•-•---•-•-•--.._....................••••-----•--•-•-•-----•---..._......--•-----..•-_. 0 Description of Soil..................................................................................... ----------....._..--------------------------------•--............................ x V W --•----------------------------------------•------------------------------------......-•-•--------------......------------.....--------------•---------••-•---•---- UNature of Repairs or Alterations—Answer when applicable...... __._._1000-. .......��� . . .. ..........................................................................................r 3 ........................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance�beeued y the and of health.Signed ....... .-...:.............. ........................... ......... ........7. . Dace Application Approved By ............. -.'.-.-- ......? e^... ,�.. Application Disapproved for the following reasons: ................................................................... . ....... .......................................... ................................................................................................. ............. .............. . ............................................. . ..... ........................... qq Date Permit No. ------/ .3--------3..l0.................... Issued .................... Date THE COMMONWEALTH OF MASSACHUSETTS ;7 TOWN OF BARNSTABLE Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: Owner Address Iiistaller Address Z Other Distribution box ( ) Dosing tank ( ) U Nature of Repairs or Alterations—Answer when applicable .........�.4.......�e,'P_0 ...... The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued y the board of health. Date Application Disapproved for Afomiowlng reaf ons: ....................................................................................................................................... Date THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE THIS IS TO CERTIFY, That tlie-Individual Sewage Disposal System constructed or Repaired ( _,e_1 � Installer has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. __/....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ... ...... 7 �L ...V -�_- 11......... - -------- -- --- ------------------ --- -------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH o Construct or Repair an Individual Sewage,Disposal System - � . No..................................................... - ��4���l-./���.�±!�-----��.!c.�.��.��-_____. Street as shown on the application for Disposal Works Construction Permit N ----'----- ---'-----''--'—'--'-'--'''- ( � u=� ae=u [�A7�I-_---,�'����.�'�-��'-^'--'------'--- ~~ . ~�� � . ponM 3w5n0000my&WARREN.wc'PUBLISHERS � | oilkng�' - -g a G ` 2%'-�n� ,O,_%„ rs.q..k,R•�ws1MaA6bn�N�r.A1N1wo V..rDN�Awr f��.. � �m d P.9..>:'E a . ` {�a.r.iabaAele►fbM o�rrulTYr/TAf*717,rr�Yy. -.aC � � �'�° G�.3 n'�0�"2��9 4VOi.4DvAWkW.wbUO4WNy.TL a p—i.ien.of 700GTPL f.00V - ' .NAI wPPIY ro a,i.Mry bJildind.whiaN hw�s bssnlogwlly oa4upiad wrd/ar d.od I��l�/ � ( o '+ " ' s_o fwwpariod elwrlow.tri�o vowr+.Any rsdildi nq for which tharo w r.rwndinq ne Mao er violw Mon cr oMiar odor of 4.bulldinq�ciwl.hdl net a, j4Ai6,1,1 o T 9O G1'IP 4 V.00 dnla. —h propo+ed work i-IdJ.the I }r uwliF rrdVaorder+ofor 7oO G>�9f OulO+h.11 aFon,to o q yw.aai. q purpo.a. . 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