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Home My WebLink About0284 SCHOOL STREET - Health .284 SCHOOL;.;STREET 'COTU IT - . �. .�� ■1 I i w �- c2 -- � No.....5.I.::.P Fps...;... THE COMMONWEALTH OF MASSACHUSETTS BOARD OFq !�-��E� ALTH ..._...Towf�.........OF........... N-K 9. ..:............ Appliration for Disposal Works Tilustrurtion 1hrutit Application is hereby made for a Permit to Construct ( ) .or Repair ( an Individual Sewage Disposal System at: c. S 2 - Locatio -Addr or Lot No. •--•••------....-•----. L.L1 ....... ..� .Sn'....... ............ ....... .........._....._..... w Oner Address ................................ �1�C? 1..w--....0.l.6t.. .�).......... Installer Address Type of Building Size Lot..__'_ ...___. ____. -€eet U DwellingNo. of Bedrooms..._.__.__.��___.._._..__ .....Ex ar sion Attic a — ............. p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtuus •------------------••--••---•--••--------•-•...---•----•------•••--•••---••--••----••--.•--------•----•........-•---•••-•-.--.... w Design Flow................5.%�i.._...._.___._:_-.•.gallons per person per day. Total daily flow.......................3. ......gallons. WSeptic Tank—Liquid capacitylb allons Length................ Width................ Diameter-__.____--_._.__ Depth................ x Disposal Trench—No- -------------------- Width.................... Total Length................_... Total leaching area....Z..,.-...sq. ft. Seepage Pit No.:.........'......... meter........l.Q..... Depth below inlet.......(a........ Total leaching area...... ....sq. ft. Z Other Distribution box ( Dosing tank ( ) '-, Percolation Test Results Performed by.......................................................................... Date........................................ 4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ r1r4 Test Pit No. 2................minutes per inch Depth of Test Pit................... Depth to ground water........................ a •---••-•----•------••------------••..........••-•----•---•------••-••--•..........-•••-•••••--.-•-•-.......................................................... 0 Description of Soil.................................................. I—— ----------------- -------•................................................................................... U .....................CL iaAj. .....---.' D....-- �w� -~.. eats. ... w U Nature of Repairs or Alterations—Answer when applicable.____. .................. ......... C 6 5il 4s-- '..1.1�1.1`��h4 _.._N.4. ..............YST? 'W..... ....5A -IT ..----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI.E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hx9leen issued by the board of health. I I I �/ WByy Signed :_........ -----•---•-- owl— �t Date Application Appro •--.. U . � ..._........ ............. ----------- —CvF r Date Application Disapproved for the following reasons:------•-----------------••-•----•---------------------••------•--•--------------... .......................... ... ...--•••-------••----••-••-•--••••-------•-----•--•---•....................••-•--•-•----•-•-•----......•-•-------------•---...----...Date PermitNo........ 1 ......................... Issued........................................................ Datet No....... Fizz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T jUn-6.................. .............t-.0 2A.5 . -L---W..I. ......OF........ Appliration for Disposal Works Tonstrurtion Prrmit Application is hereby made for a Permit to Construct or Repair ( Lj�an' Individual Sewage Disposal System at: .............:D—V4..........5coo.c).L....�>T ...... ......................... ......... kANP 'Lo PcL Location-Address or Lot No. ....................................... .............................. ....... ..... .......... ......................... . Owner Address. . ............................. �q.......0. C............. .................................................................................................. ....C) . Installer Address PQ --7& A:- ,t Type of BuildingLot_._._' ... . ... .- -j.., 6 Size Lot.. .......... --------- Dwelling—No. of Bedrooms..............�3..........................Expansion Attic Garbage Grinder P4 Other—Type of Building ............................ No. of persons...._................__.___. Showers Cafeteria 04 Other fixture s ...................................................................................................................................................... Design Flow.................5'-N......... -.-gallons per person per day. Total daily flow........................ .....gallons. WSeptic Tank—Liquid*capacitylb______-._gallons Length................ Width._.............. Diameter..._--_--___--__ Depth.._.._.......... Disposal Trench—No. .................... Width............._._._.. Total Length_................... Total leaching area....... .........sq. f t. Seepage Pit No------------V------- Piameter..........1.0... Depth below inlet.........L....... Total leaching area..... -e.&Zsq. ft. Z Other Distribution box ( .11* Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I----------------minutesperinch Depth of Test Pit.__._._............. Depth to ground water...._._.___._........__. 44 Test Pit No. 2................minutes per inch Depth of Test Pit............._.._... Depth to ground water....-_..._.....:',...__. 94 ...................................................................................................................w...................................... 0 Description of Soil........................................... I.................................................................................................................. �4 ---------L5 !�.� .......!)6. ...................................................C ................. ..... ... ................................ U .......................... W x ................................................................................................................ .................................................................................. U Nature of Repairs or Alterations—Answer when applicable....... ---L-4— I W---A-.:�YISTJ.Q(� .. -- -------------------- ...I....... ..................... ........................C.e5.7.ssl) ..... ...R.LZj,4j............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T ITA iZ- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha en issued by the board of health. Signed-- - - ............ ........... ............... ................................ Date Application Approved By................ ..... ........ ............... Date Application Disapproved for the following reasons:............................................................................................................... ......................................................................................................................................................................................................... Date PermitNo.---....._ ....................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............[Q.m.l.........OF..........�`..-? 4,-L 11 5-r/V5.L--t Z��)............................ ........................... (Intifiratr of Toutpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ily/ by----------------M........... :I.................................................................................................................................I I taller at.............. .........5..,ijAen.0....... ... ........ r . ...... -------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........ ------aa.......... 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 BOARD �F HEALTH .....Or.............. 7T-/ No...... FEE..... - Disposal Marks T11mitrudion ramit Permission is hereby granted...............10.......... ............................................................................. to Construct or Repair ( Lran Individual Sewage Disposal System atNo. ........... .......... .....57........... -- -------------------------------------------- Street as shown on the application for Disposal Works Construction Permit No. ft-J/23 Dated.......................................... ............................... ---------------)--------------------------- ........................................................................... Board of Health J FORM 1255 HOBBS & WARREN, INC., PUBLISHERS M A-P Z.o Al _ ��tJ�r .� - v1n� mot, �► - — ----- PrLOp' pfLoPos�`� F'LL ceSs ooc,S _ Ioo0 GM— FaA --- bWew-1NC� j — i F� ° '0 L 61 - M 010 ULSPOSAIL, PUP. plzoposs7D D-8oY. I"'LL l as Per All, 2, STOWS -LU6�— AAT 11J rl - l DoD GAG._ S�PTtG i . i I I PIT �l �„ — ---- - —�-F— f TOWN OF,'BARNSTABLF. LOCATION i- -S SEWAGE # 2)—I 13 VIII:AGB Tel x ASSESSOR'SnMA�^P 6i LOT IN3T.9 IAIR'S"IiI�AME & PHONE NO.1 ��2n .t ._. ,_- ok SEP C.TANK..CAPACITY LFACHNG FACILITY:(type) i�tL�C�S�' (�,! (size) f1 NO. OF BEDROOMS ®� PRIVATE WELL OR PUBLIC WATER?,,6�Vt BUILDER OR OWNER DATE PERMIT ISSUED: . DATE COMPLIANCE ISSUED: t4- VARIANCE GRANTED: Yes No L Sri tic S i/S�-�,r,.� ��r,p�� r��►� �'i wry ,w Y a �-AL QsN