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Home My WebLink About0187 WHITMAR ROAD - Health u�l��}�1�-�vli 2octC�To D`ll - cc� `iSSESSORS MAP N0: .— /,� PARCEL NO.: Z14, rFEB THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ ..................0 �-....-..OF...-......�A-).....7.4 �—E................................ Applira#ion for Uiipnsal Works Tomitrnrtinn ramit Application is hereby made for a Permit to Construct (✓S or Repair ( ) an Individual Sewage Disposal System at: # ....GU ! ...... a..........CrT .. .............. ..... - ..........:.........._..._...... Location-Address or Lot No. Owner Address a .............................................. ,.. Installer Address Q Type of Building Size Lot....M 2 d,....Sq. feet U Dwelling—No. of Bedrooms_____________3...........................Expansion Attic �e5) Garbage Grinder (Ald) pa,,, Other—Type of Building ___ ...... No. of persons........&_................ Showers (,2 — Cafeteria (,&0) Q' Other fixtures -------------------_.................................................................................................................................. Design Flow........._ _ _________________________gallons per person per day. Total daily flow____.33.�............................gallons. WSeptic Tank—Liquid capacity Z 000.gallons Length-----%.0..... Width.._._.&...... Diameter....... ..... Depth................ x Disposal Trench—No._.l de.,E__.. Width.................... Total Length.................... Total leaching area...�_G.Y.._.sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box (✓) Dosing tank ( ) ~' Percolation Test Results Performed by........�g1_f A__d:_._l Yf f______________________ Date__.__�___�� o....�....-. Test Pit No. 1................minutes per inch Depth of Test Pit.....J.3__....... Depth to ground water...J S____._._. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-------•-------------------------------••---------------....._........--•----...-•----...._._..........._...---....---•--••-----------•••........•••-•-___-- 0 Description of Soil.......Q_ L-I'A:`_..........LCft./.9_..... ["--------- Al 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 TITLE 5 of the St anitary Code—.The undersigned further agrees not to place the system in o ation until Cer ti te,of Com e has been issued by the board of health. &�_� gned........... Ivy Q. �lf�lo2�f �.:.. '� .= �.:....... .... ,(p� ate/ A plication A proved By................ --•--�-� t:/ _ !!__ ....... Date Application Disapproved for the following reasons:............................................................................................................... _ ...................•--•--•-•-------------....._...-•-•-----------•--------•-----........---••-------...---------•-•-•••••-•-----....••---•---••----------••----••---•--••••---•--•••-•-••-----..._•-•-•- Date Permit No.... �'.�- ........ Issued....... -- Date No ..... � Ficz . t. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Ap iration for Disposal Works Tons#rur#ion rrrutit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: •-- /)wlag......AP..........� .......... ...... - .......-- =� r-- ..........- ........................... ocat�on-Address or Lot o. .....*I g X.$.� :...... It lr�/ _. t . = N -*-- '' ' r r 4 it ....•...................._......_.....--- Owner ddress wcJ ......... /_` 1�• .................................. ... CASs r t1��t„ ' .....-•-••• ............................. 1-4 Installer Address / ff ' /�- Type of Building Size Lot....:.................:.....Sq. feet ,., Dwelling— No. of Bedrooms............. ......:....................Expansion Attic {yc�5) Garbage Grinder eo) 44 Other—Type !of Building ...!�NPXA-f...... No. of persons........40................. Showers (.2 ) — Cafeteria (AO) 04 Other,,,fi?$tures -----------------------------------•-------...---•----._........---------......-•----------•........ Design Flow.........A. ..........................gallons per person per rr day. Total daily flow........:�.U....C___.............._.gallons. Septic Tank—Liquid capacity✓�?a .gallons Length................ Width:,....:..... Diameter................. Depth................ x Disposal Trench—No._.i!f0?v _... Width.................... Total Length___..._•_,....__..._. Total leaching area._.' `.!�..sq. ft. Seepage Pit No............:........ Diameter.................... Depth below inlet.....:°:........... Total leaching area..................sq. ft. Z Other Distribution box A Dosing tank Percolation Test Results Performed by...._...,E /3KJ _X.. ..A/y _ ��!6190 a ---.----• •..---_: Date ----._... 3,. $,;.r... a Test Pit No. l................minutes per inch Depth of Test Pit.....�.-. :;.:. Depth to ground water,_s��........._.... 44 Test Pit No. 2................minutes per inch Depth of Test Pit............ ?`:::. Depth to ground water ........... -----•--•--------------- ......••••..... ........_...... ............................................. O Description of Soil........ .' ........... :Ol'42 . .........................................., / . .......... ....................•-•-...........••......-•-•-•-•-- x .-......... _ ,'''/ --------------------------------------•-•---.......-•-............ w VNature of Repairs or Alterations—Answer when applicable........................................................................._...................... ...-..................................................................................................................................................................................................... Agreement: x The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIS 5 of the St nitary Code—.The undersigned further agrees not to place the system in o ation until Cer fi te`of Com a has been issued by the board of health _Signed-- ----I ----- ...... /. rj� y 9.. ----- A plication A proved By .�r-4.'. :�.p................ :... - • Date Application Disapproved for the following reasons:---•--•----•--••--------•-------•-•-----------------•-•-•-..............----.....------•---••......•••••..---- •-••••-••••--••-----......••-•••••-••••••••.......•---•....................••••-•-••-••..............••••--••-••••••-•••-•-••....•••----••••.._....._................................................. Date - PermitNo.... .................................... � 1 .. Issued......................................................._ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............T d. . OF............P-'VIVO/�}.8�.�............................ Trrtifirate of faoutplianrr THI -I TO CERTIFY That the Individual Sewage Disposal System constructed ( 1<0r Repairedby ( ) �.. lQ.6!� �.�...............•---..........---.....------•. t..........•...... � .....1 f.!..1 /�! ! .-1 ........---- Installer .......... —._. at .D? • �1 has been installed in accordance with the provisions ofTITIF. 5 of� e State Sanitary Code aside scribed in the application for Disposal Works Construction Permit No.............:........................... dated...........:`.,�_.,[__._.._J_. .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FU NSA ISFACTORY. DATE.................... -• ................ Inspector ----------...._......... ------ •--• ._.............:._...... TH`E COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............1.. ..........OF.......... ..! .5 ��.G ....................... cL No... .....f � Fim........................ Disposal Wors Tonnr#iott Fermi# M10/0�� .�915 �4 4-Permission is hereby granted._.. ............... ........---....-... ..........._.. to Construct ( or Repair ( ) an Individual Sewage Disposal System atNo..-_A.3_f-...LVI)U AA...... .P....................0............................................ Street as shown on the application for Disposal Works Construction Permit` . 6 .....f 8 tDated.. �!f ..--•-••.... -•--•---•------.----•---------------••-----•------------•------.----------•-•.-.--•.-----.----------•-•- Board of Health DATE............... ......................................... FORM 1255 A. M. SULKIN, INC.. BOSTON v� • ""� 0 FP�,�Ssr P. TER '� V �-�I'��r � DY Z SULLIVAN �E51�•L�l 1 fJo. 297330. f �AcTi� ,o 4 q t 0.Ads-i_x. t'hb11 L ass/%i�r 1. KAO "�a��X�i.r�•-! ; 3x Ito X = 33O C--t�''- D 3k 110 Y. 15C>96 L16a MOD G-�A>_wtit`T'��..tk � Foy COX 33o a:p 13 �QAG RY� 113 5F � �•o - 1 13 C-1.�7i 40L > Wt.T,.9 Y T.CtxJl1�N� }}A 30.0' ��.►= 3 Z�' 32.is" a 33;4 511LS.SOi Lr �ZD ter;_. - ° Z°t•;3 _. 29.? 29.9 3a 1 •'.1r QP .._ .._ 6' 11.1� 1 N� 1 NV 1 w/ TA►aK 11�1`( G =Zh•u� - W t1-d. 23 D •�u/.r Tmr c IFIEI7-FLO-r MW WILLIAfA �� 5G..4L� ►" _ SO:� P4 Y E A A'IJ No. 19334 # L�2'T'1"F TlIAT T >= 1'6Z��. U�ltil �ll }�t{� 6�'DZr 3.-1 N �y� -3�xz. v e ►. c. 4 6�"'13�cK I��Q�.I I�IrNtEtST�j a�'�'EZa'vttt•1� ��Is�e_�1�aaar� s�e�l>=(oe5 tr G�v►� t-kZ.Ees - Z�F •�A�-N STF�1�LL: ,�ri.aT7 \5 ISCSC' 1: tee„-c1�t) WIT +t�= U� ►b.1. z �v t`'�h s lug �rFt►s" �a Ls ttiac' 7au1�1J,tlasc - ,,._. UM�ti`r St1� ._`�..:_. . _ ��>�.C�1.+� St�oc�L'Ip N►C3t'"�� us�DTO OF �� P 7[:R v SUi.ill�r�i'� rn �;' 5tf CETop !ST[PE �O7-1 p , �P W \"y1Sid CJ Ad LN 4y, i I - t i_;. .' 301L)0 l 3N3NA8JA�'y' 3P— -W- V---------- No. Fee--- -------------- BOARD OF HEALTH TOWN OF BARNSTABLE 9pplicationforlVell Con.5tructionpermit Application is kereby made for a.permit to onst uct ( _ ), Alter ( ), or Repair K)an individual Well at: ---1-��------ m k' _ 6 ----- _ 1.L�ocatio�AddressAssessors Map and Parcel P -------------------------------- -----~-—-------—--------- - --—---—--------------- ------ � Owner Address ---Relm ----- ---------------------------------------------------------------------------------------------------- Installer — Driller Address Type of Building , Vo0-0"" Dwelling- - Other - Type of Building-------------------------------------- No. of Persons----------------------------------------------------------- YP z a // -- - Capacity- -3 S If----- ------------------------------------ --- Type of Well- - - --- — - -- - -- ----- Ca acit - Purpose of Wel1LLlF-__-SS �rn------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate of Co p ' nce has been issued by the Board of Health. t -43 Signed- - - - -------- -- 0 0 r------- -date Application Approved By -- --- -- ---- --- -d--- - -- --- _____ date Application Application Disapproved for the following reasons:----------------------------------------------------------------------------------------------------------------- --------------------------------- ------- --- ----------- date Permit No.-------------------------------------------------------------------------- Issued----------------------------------------------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTAB LE C ertif irate Of Compliance. THIS IS TO CERTIFY, That the Individual Well Constructed Q( ), Altered ( _), or Repaired ( ) _-W gL-S---------------------------- - S Q ' -W-----� -------------- Installer, Ifl / at----� - — y� �=►L l_-_-_-_�_`� ___�1.4�7L -— - has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ---------------------------Dated---------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT-BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------—------------------------------------------------------------------- Inspector—--------------------------------------------------------------------------------- R � J 3 _/_U----------- Fee--- - � � Fee BOARD OF HEALTH `` TOWN ' OF BARNSTABLE A.ppritation-for Vell Construction.permit Apc ationh�er,b y made fo permit to onst uct ( ), Alter ( ), or Repair K)an individual Well at: - -- -- - -- -- - -- --------------------------------------------------------------------------------------- IL do — Address Assessors Map and Parcel -�h�--- �� hun — -- - - - Owner Address �u k(1, � I 1�S �_ flA n _ Installer — Driller — — — Address Type of Building ;i _ . Dwelling— - 4 =1. 1 ,� — Other - Type of Building - No. of Persons------------------------------------------------ Type of Well--`� a Capacity 3 S m------------------------------------------ Purpose of Well r r j n x1_��-- f Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the'well in operation until a Certificate of Co nce has been issued by the Board of Health. Signed p--------- - PJ date Application Approved By--- ->� =--- -�'----%�------t�- U — — — — — date — — — Application Disapproved for the following reasons:----------------------------------------------------_______ ------- --------------------------- ---- date Permit No. -- _--____— - —-- --- --- ____ Issued----------------------- - -- -------— -- - date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (K ), Altered ( ), or Repaired ( ) Y— - - --- -----------=------------------ - _ v�-`� �------ - - -- Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No- ---------------------Dated----—------------------ � r THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE----------------------------------- ---------------------- Inspector-------------------------------------- — ---- - -- - BOARD OF HEALTH TOWN OF ': B-AR'NSTABLE Melt Con!5truct ion Permit No. -------------------- Fee-- -------------- Permission is hereby granted----- V C �:�it'—I" ------- f-' A Y_/ 1_V 1-------------------------------------------------- to Const�r-act ( ), lter ( ) o�r epair ( ) a }Individual dell t�: 1 ]0 Street as shown o the application f r a Well Construction Permit ' - Dated- -- --�`- -- -— — --- 17------------------ G - ---------- i I�f Board of wealth v t DATE _— 1 — -- mil- — - -- ASSESSOR'S MAP NO. ,�� PARCEL 4. 5" t C 7 l 0,Co4TAON-:2) t �.111n^�r �, � (� SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME A ADDRESS a S U I L D E R OR OWNER ` e DATE PERMIT ISSUED DATE COMPLIANCE - ISSUED �2f zI ' R arewA� Zg