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Home My WebLink About0046 AVALON CIRCLE - Health Circle Oste'rville iA= 145 -054• + `r i TOWN OF BARNSTABLE 0001, LCX'ATION _ .moo P��/►o �v� �� SEWAGE # I — 7T _ VRLAGE-- ASSESSOR'S MAP& LOT IV o_,V IN jTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY � O snc—) Gtn� LEACHING FACILITY: (type) (size) 14ZFJ NO.OF BEDROOMS J BUILDER OR OWNER PERmITDATE: COMPLIANCE DATE: 3 79 Separation Distance Between the: Maximum Adjusted Groundwater Table'to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by `�Z,�.�S�►� o��./"'� e e` 36 ` 01 ��c 3t i __ � LOCATION �1 jf SEWAGE PERRJIT NOo. 6- It- ��' zff VILLAGE o6� n 1 I N S T A LLER'S NAMIE & ADDRESS BUILDER OR OWNItk , DATE PERMIT ISSUED DATE COMPLIANCE ISSUED REAR of � J E % p IN . E 3 ° NO..... ....... FEB.... :................... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF H�� j _emsL,� Tv -- ------------------OF... . . ...... ..................... ---------..................... / � l Allp irFa#iun for Biipusal 10orkii Cfuntrurtiun ramit Application is hereby made for a Permit to Construct (40 1 or Repair ( ) an Individual Sewage Disposal System at: (o Av 0 -- . .... -cir ( ............................... --- --- ------------------ -•••-•• :. Lo tion dress V or Lot—No. k............... ...................... ............... ... .... .. ............. ........ .. . ... .................... Owe .ivl. ..� . .Add - -- ----- taller Address e of BuildX0. Size Lot............................Sq. fee U Dwelling of Bedrooms.- Expansion Attic (° ) Garbage Grinder �- ------------ — '� Other.—Type of BuildingNo. of persons............................ Showers Cafeteria dOther fixtures --------•--•--•...........................................----•----------------------------------.................. ...... Design Flow............... gallons per person per day. Total daily flow.._..... .....'..........gallons. W g � - .-- ---- g P P P Y Y ,. . WSeptic Tank—Liquid capacit� gallons Length................ Width.........._..... Diameter.___............ Depth............ x Disposal Trench—N --------------------- Width ...... Total Length........... ....... Total leaching area............../.....sq. ft. Seepage Pit No._.... ________. Diameter..... ........ Depth below inlet.....La_.......... Total leaching area. .`.[-._..sq. ft. Z Other Distribution box ( ) Dosing Percolation Test Results Performed b _..._ ..... . !?ZCr:.. Date_.._:....._. �.`.. .�... Test Pit No. 1....�....minutes per inch Dept of Test Pit.................... Depth to ground water_-_________-_-__-_-____. ( Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Descrition of Soil------_ (� 'lv ----........... .................................................................................... x U ---------------------------------------•••-----.......---------------------------------------------.....-----------------------------------------------......------••--••......---••------------------- W ------------------------------------------------------------------------------------------------------------------------------------------------------------••-•--------------------------...._......... UNature 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 TL ii'TIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issu t oard of h h. Si ------- ............. ...... r /. ..� Date Application Approved BY------ -- - - - - -- - 1 =------. Date Application Disapproved for the following reasons------------------------•-•-••---------------------------------••-------------------------------------......... -•-------•-----------•....................................................••-----............------......--------------•--------------------------------------------------------...---------------...... ' Date 7_7� Permit No. Issued.... ....................................... Date 9 No FE ............... THE COMMONWEALTH OF MASSACHUSETTS .-,? BOAR OF H To-----et......................OF.:. .............................. Appliration for Disposal Works Tonstrurtion Prrmit Application is hereby made for a Permit to Construct ( or Repair an Individual Sewage:.Disposal Sys at: .. . . .. ... .... . .... ...... .......................................... ..................... ............................ 77 ---- ---- - ation dress or ...... ......... .. ... .. .... .............. ..................................... ------------- .... ....... 0 ........... ...... ... .................................... ...... ...... . . ........................t� 5-rol taller 4 0 vv- Address e of Buildin Size Lot----------------------------Sq. fee Dwelling No. of Bedrooms...... ---------------------------------Expansion Attic Garbage Grinder o- a Other—Type of Building ............................ No. of p�ps'As............................ Showers Cafeteria Other fixtures. .........................I..........................olio . .......................................................... --------***"*-------------- Vd�ly flow.._.._ .............gallons'. ... ... gallons per person per day. Total Design VJow............Z7 Liquid Length________________ Wi 14 p�' 4 4 ank Liqui, a acit?, allons Lengt d1K..............�tt. Diameter................ Depth............. p .9 Total area_.._ I ,osal Width ....... Total Length.!...p I L"F7......... q ft. t S -------- meter.....I .......... Depth below inlet ........... Tqtaileaching area._!�A.. q. f t. See it 1 0- Dia ......... Z Other ldistribu'tion.b.ok,( Dosin 11 --�d t7 e -R Performed b -A......... Date. 7f Percolation Test esults) erfo y --------------------- 'l Test Pit No. I---4/1----minutes per inch Dept1 of Test Pit-----.............. Depth to ground water........__.._.._._..___. Test Pit No. 2................minutes per inch,;, Depth:of Test Pit..._.........__::._. Depth to ground water._......_............___ R'i ............. I.......zi;.. ., "- ------------------- 444,, — .I . ..................................... ........................ 0 .... .. ... .. Description of Soil..............P................ .... ...... ............... U ............................................... ...................I............................................................. ......................................................................... ...........................................................................I............................................................................................................................. U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ..............................................*------------------------------ ......................*............................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Dispqsal,System in accordance with the provisions of T!T L1 , 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has begn issuV, tbe+oard,of lie4h. Si -"I, 1. . ................. . .............. ....................... Date Application A Application Approved By...... .................................... ....L-Smt.7 40 Date Disapproved for the following reasons:--- I Application Disapp *V, ea.s .................................................................................................... ......................................................................................................................................................................................................... Date PermitNo......................................................... ......................- Date THE COMMQNWEAILTH, 9,F-fMASSACHUSETTS BOAF(6 OF HEALT 00, 1-115�.�..............OF.......4 .............................................. Tntifiratr of Toutpliaurr THIS,'l TO ERT 4 at Individual Sewage Disposal System constructed (4::;-oY—Repaired I TO IS W� P .. ............. ........... .............. ............. ....................................................................................................... by................ An alier 03 .... ..... at.......... .. ............. ...... .. .......... .................. ............................................................................... has been installed in accordance, w,ith the provisions of T -1 of The State Sanitary Co�e as described in the P, application for Disposal Works Construction Permit No ................ dated-- .._ ;.r/ -77-------7-------- THE ISSUANCE OF THIS iCONSTRUED AS A GUARANTEE THAT THE CERTIFICATE SHALL SYSTEM WILL FUNCTION SATISFACTORY ................ DATE............ ............................... Inspector.... ...... .................................... ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR HEAVH ......OF...... ...51-4 ...................... A;? No....... ..........i FEE.. .................. .... ................. Disposa t"'tw rk tt . ............n :F amit Permission is here F-fran to ConstrujA..ror ep aV dividu0jewag. posal System atNo.......)K.. .. ......... ......... .............. .................................................................................... I S eet /* as shown on the application for Disposal Works Construction it N6........I........... Dated.../----------------------------------- k............... ............... Board alth .............. V*1 DATE.- .............. 70 i�pv FORM 1255 HOBBS & WARREN, INC.. 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