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Home My WebLink About0426 OAKLAND ROAD - Health "1 �s (D and 9 n v � M � . � D k o� 3 . p 4 r Qr p.. i y' 1 Y.I , I (, rC b G ., `-. _ . z .r i �TOWN OFBARNSTABLE LOCATION ZCP �,�•,C,C1rJI� SEWAGE VILLAGE lb ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. bx0,Cb) SEPTIC TANK CAPACITY IbC LEACHING FACILITYAtype) (size) 's NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BetEg**OR OWNER DATE PERMIT ISSUED: l 3Gf �O DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No N r No.-��_.:aa FR$...30. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ApplirFatiun for UiipuoFal. Warks Tanotrurtiun frrmft Application is hereby made for a Permit to Construct ( ) or Repair (�'dn Individual Sewage Disposal System at: ........... . - ..:.( .fa....._..QPtS� ....IX........ ............. ---------....................------------. ----------- �� - Loc io�Address or Lot No. to-'....._..._._.... ..��-�i-----------------------'- ................ ...... ---.... Owner Add s ..........................`........._.. W --------�� .................. ............ ................. � .----vim .v f .-- a Installer� Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms__--:—_;.................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures ------------------------------•. . WDesign Flow...... 75..........................gallons per person per day. Total daily flow..__..�.Z0........................gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.......I------------ Diameter....J.D..1..... Depth below inlet.....&.(....... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1_____-___-____minutes per inch Depth of Test Pit.................... Depth to ground water------------_-__---_---. 444 Test Pit No. 2................minutes per inch Depth of Test Pit__-_-___----____._._ Depth to ground water........................ a --------------------------------------------- ••---------------------------------------------------- -...----------••--•----------•-------.--------- 0 Description of Soil....................----------•----...------------------------------•-----------------------------------------•----•-------------------•---••-••-•......--------------- x w UNature of Repairs or,Alterations—Answer when appli . ble_...._*it91(>....07tk!�_....ra"-.vb....p%. (c ........... 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 o m liance has been.issued by the board of health. gned ✓ .—.r Da[e ApplicationApproved By ---------------=--'�t ----......----....---------....................................................... Date Application Disapproved for the following reaso r- ---------------------------------- ---------------------------------------------------------------------------- ---- -- --- -- -------------------------- ------------------------------------------------------------------- ----------------------------------------------- - -------------.................................. --- ----...............-------- Permit No. 41�.-_ Q1................................. Issued ----------��—_.3� �t? Dare --... Dace...............'--'--------........ FEB THE COMMONWEALTH OF MASSACHUSETTS BOARD OF- HEALTH TOWN OF BARNSTABLE Appliratiun for Uiupuual Works Tonutrnrtiun 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair ( �_)san Individual Sewage Disposal System at: ................4 n NPv ..W Vc� Location-Address or Lot No. .��-.a- ..,., . ........................ ................ S r .............................................................. Owner Address L_ U o� L(It (c; Kk 01 )b Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms._.... ................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building .............. No. of persons............................ Showers — Cafeteria P4 Other fixtures -•-•-----------------------•--------------------- W ` Design Flow...._. .:�•......................gallons per person per day. Total daily flow.._...Z7n..................._.._gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. t c Seepage Pit No........J----------- Diameter.__.. ._?)_..... Depth below inlet........._._..... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 14 . Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water....................._.- 4, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--__-______--•-----•__-. 04 ----••--••••-----------•---------•-••--........•••--•--.....•-•-••••--------•---....-••--•---•--•••.......................................................... 0 Description of Soil...............................................................................--------••-•----•--•••--------••--••-••••---•----------•-••-•----•-•-••-......-••••--- U -••---•----------- .................................................................................................................................................................................... W ----...----•-------•...............•------•••-•••••-----------------•-•-•-•-•---•-•-----••••--••--------•--•-----•---•-----------------------•-•---•....•---••-•--•---•-•-----•--•--•--•••-•--••-•-_.... UNature of Repairs or Alterations—Answer when applicable_...... .---- 1-�'...... �:�__..!..!._?..�__..�c�........._.. .....................-�--•-...��._f�T�'-�......•-�--��...:/..brS�-:.. 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 mpliance has been issued by the board of health. Signed -.. .. -\ / // 1 -_zi ......... L G�"•�•--- `,. Dare a Application Approved BY ................ Q,C? 7"..l�..--------------------------------,-J.--•--------.... ---------- --------:............. ..... V ( Date Application Disapproved for the following reasons; + ..— ................................................�-/-------------.--.-------...d.........................................................................--.................................................... ............------------------'--------- Permit No. `7 " 02.7.......... Issued ..---------��._. - D Dare <.......................... ' Date THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE CEelr#tftrate of (�ontyliantre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( Installer at ....................... `,. .......--.-.-h. .... 1 :- - .- . J .. 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. ................................................ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. i`2i / DATE..... ---------------------------------------------------------------------------------- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.............. F>sE... ........... Disposal Works Tnnutrudiun rrrmit 5--0 r•N.C.................................................................. Permission is hereby granted..............1.!��►-:.. .�:�......_.._.. to Construct ( ) or Repair ( an_Individual Sewage Disposal System at No.............•--•--..•--Q „ n A � k " —0r�:_ ._ : _......... .. 3 Stree as shown on the application for Disposal Works Construction Permit tNo471)._nl Dated....... /.— ..................•-•------.............•-/- / -er. !n g- ,. ........ - ;�,�. m ,^ � 2O �� Board of FIealth DATE.....................•-----•---.--...----...........................••-•••...... FORM 36508 HOBBS at WARREN.INC..PUBLISHERS