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HomeMy WebLinkAbout0024 ASPEN WAY - Health 24 ASPEN WAY Osterville A= 120—054 , C TOWN/O,F BARNSTABLE LOCATION eA //�.� '�` SEWAGE # VILLAGE Q ASSESSOR'S MAP & LOT 3 2® ®5 6 INSTALLER'S NAME& PHONE NO. i (r/ SEPTIC TANK CAPACITY 1,006 LEACHING FACILITY:(type) l000 (size) ' NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE DER41T ISSUED: DATE COyiPLIANCE ISSUED: / �d VARIANCE GRANTED: Yes . I`10 �`/ r 33 Xg S, • 0--651....... L Fps...... No... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ` o.vJf1.................OF......... LF .M4 2S.Tv4.C3 ... Appliratiuu for Dispuual Works (�uuitrurtiuu irmi# Application is hereby made for a Permit to Construct ( ) or Repair ( V<an Individual Sewage Disposal System at: ....... ---------------------------------------•-•-• ••-•--•-•--------..__...........----•----- Locat' Address or Lot No. A.:..... �(z��r✓i£rz �`-1... Asg.a �n 1_�.. Add Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.........._3.._..... ....__..__Expansion Attic ( ) Garbage Grinder ( ) Other—Te of Building 1 Other—Type g 0 ............ No. of persons............................ Showers ( ) — Cafeteria ( ) h L� dOther fixtures ------------------------•------------------•-----------••----------•---- W Design Flow............................................gallons per person per day. Total daily flow............................................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... jo 9-4A'Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_-_-____-_------_-_____ W Descriptionof Soil---�A.' ----- �----- ? ------------•-----•------•------...---------------------•-....................................................... x c.� -------------------------------------------•---------------•---------------•- -------------------- •-----------------------------------------------------------------•------------------------------- W U Nature of Repairs or Alterations—Answer when applicable-----------------------------------1.+_0_t'?O.......y&).......O.V iw -----------------------------------------------------------------------------------------------------------••-------------------------------------------------......................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of -T p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een issued by th board of health. Signed..... .f�"" ......... . C �_!4-... ....= Date Application Approved By...... ... ..._ Date Application Disapproved for the following reasons:..... ...•------------------•--------....-................................................................... --•-----•...................•----•--------•-••---•-----•-•-------••---•---•--••--------••--•-••-----••-•-tee►2r./ -•---•••...._....----------•-. ------•--•---------------------------------•-------•-...------ DatPermit No..... .............. . ------------ Issued........................................................ Date No. - ----701 im FR ......---JC`- `---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH o T LC ...........................OF........ _�,.A lis ......................................................................... Appliration for Dispaiial Works Toustrurtion rumit Application is hereby made for a Permit to Construct or Repair ( V<an Individual Sewage Disposal System at* . 5.............. .................................................................................................. .... ..... ...... ........... ALocat1e5,Mss,, ,,, ,, ,._, or Lot No. ............................I....................I.................................... ....... .......W.A.�............0-ST-4............... -F_ C 0�qXncf � 'd ,S!;A...... S 9 01 kA .................................................................................................. ......................................... .......O.S? ............... Installer Address Type of Building Size Lot________________________----Sq. feet U Dwelling—No. of Bedrooms__________________________ ______..__Expansion Attic Garbage Grinder 'RA V)0r, a Other—Type of Building .......................... No. of persons_._____._____.______.___._._ Showers Cafeteria Otherfixtures .................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily fiow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length________________ Width.__.__._______._ Diameter.____..__.______ Depth_______.__.____. W Disposal Trench—No. ........ Width____________________ Total Length______.___.._____.__ Total leaching area....................sq. f t. �141 (...*....... Seepage Pit No.__1_j0_'_0....0__c:Q__ Diameter____________________ Depth below inlet__._.______..._..._. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Per-formed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit___.._______________ Depth to ground water------------------------ Test Pit No. 2................minutes per inch Depth of Test Pit__.___.__._________. Depth to ground water------------_--------- 0 Description of Soil..,5_....A..v)c I........I-------G--i?----A---V----Ej-------------------------------------------------------------------------------------------------------------------- W ...............C........................ .................................................................................................................... U ........................................................................................................................................................................................................ W ....................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable---------------------------------i.1­0.0_0......t.A_).......0.\a.Z_[10W ........................................................................................................................................................................................................ Agreement: .The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TILE 5 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 tlx(e board of health. Signed. ......... ......J/ ................. ---V-1---------- -------------------------------- Date ApplicationApproved By..-- ..... ....... . ....... ...... .................. ........................................ Date Application Disapproved for the following reasons:.... ........................................................................................................ ........................................................................................................................................................................................................ Permit No---- ?, -.R.. 170/------------- Issued--------------------------------------------Date .------- D z_ tc THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��e\ ye v,\ ,4 A.b)..� .........................................OF.... .............1­.................. .................................. Trrfifiratr of Toutpliaurr TO,�ERTIFY That tke Individual Sewage sposal System crnstructed or Repaired b ...V\ .......... ........R ............. .................................. ............................................... ....... �j tristaller at...... ........... ........... ... .. ..... .. ... ........... .................................................................................................................................. has been installed in accordance with the provisions of TIZE 5 of The State Sanitary Code V desc 'b9d' in the app lication for Disposal Works Construction Permit No._ __"_____-e,?- .4�91... dated... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILLFUNCTION SATISFACTORY. C DATE........................... (.................... Inspector._._.__..._......... -• . )•........................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................................................................... No-Z .. . f*... 01 FEE..60........ laispagal Workv Permission.,is hereby granted. ........ ....... Min rmit............................................... ...... .. ............. ..... ............ or i an Individual Sewage Disposal- System to Construct ( ") Repai at No...-�_'( 45-d-le P1 ............... .................. .................................................. ----------------- -- -- --- ------ - -------- - Street -Dis osal Works Constructijlf`v�rmit No as shown on the application for �_ Dated._. ........ . ......... ............ .... . . .......... Board o H �th DATE............................................................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS