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HomeMy WebLinkAbout0085 BUMPS RIVER ROAD - Health 85 Bunips River- Road r Osterville A= 120 001 010 G TOWN OF BARNSTABLE LOCATION SEWAGE # !. VILLAGE %e (Jf 6.�. ASSESSOR'S MAP & LOT - l-&16 :I INSTALL �ER'S NAME Sz PHONE NO. -1> j SEPTIC TANK CAPACITY it LEACHING FACILITY:(type) . — i % (size) f _ NO. OF BEDROOMS _PRIV•ATE WELL OR PUBLIC WATER BUILDER OR OWNER i DATE PERMIT ISSUED: DATE' COMPLIANCE ISSUED: G L VARIANCE GRANTED: Yes No i Q • L ' TOWN OF BARNSTABLE to LOCATION_ PAS ,t RAy SEWAGE # VILLAGE �S 7� t/9 L-L� ASSESSOR'S MAP 6 LOT LaL at-(91b INSTALLER'S NAME & P14ONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 2 s ? i /�S (size) NO. OF BEDROOMS. PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ��J�� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No `� �e c t t6 4 x • r f Fim THE COMMONWEALTH OF MASSACHUSETTS l 9ti B d 3 � OARD OF HEALTH TOWN OF Y. H its Appliration for 14sposal Works (funstrur#inn jJprmit Application is hereby made for a Permit to Construct (1/) or Repair ( ) an Individual Sewage Disposal Systemas44 . ....... ..--• ....... �..._.. � w- .....- . •- .... ---.. . .. .....-• --------- - -- ----..---)_.......•.. Lti �pd�ress....� -...� v"..,...-.... ...�:�A................ ....----------•-... •.. dd ......-••--.....•........................... - r Lot ... Owner r A ress a ......,.. ...... — ..... / ........ -. 9...... :........................... .•...------•--•--...........••••.....................•..... ••.-Installer Address ' Y % Type of Building Size Lot._y�.__... (.. Sq. feet Dwelling No. of Bedrooms: --------..--•----_--_.--•Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin 4' -._U'� No. of a YP g -------....-•-- •-._. persons............................ Showers ( ) — Cafeteria. Other WGd fixtures --...---•-•-•-••-•---•--•-•••...-- ...................................... DesignFlow.................. . YDPer day. otaiY ow........ ........................... .... ..____gaonsPer P . gallons. Septic Tank—Liquid capacity............gallons Length............... Width................ Diameter................ Depth-.:........ R ; � Disposal Trench—No..............:...... Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) • Dosing tank ( ) aPercolation Test Results Performed by...........................................•.................••••...•.... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................:_. Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ' :� Description of Soil•...................... ------..----=-•..._._.. ------••-- ----------------------.._... ------ •... U ---•--------••.............................•-.---••--•-•-----------•-.---------------.-----------------•------•--- ` W U Nature of Repairs or Alterations-Answer when applicable............................................................................................... -•-•---------------------------------•-•---•-------•---...--------.....-•------........-----...........----•----....----•----- -----••---•--•-•----------------................. Agreement: , The undersigned agrees to install the aforedescribed Ildividual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Cod —The undersigned further agrees not to place the system in' operation until a Certificate of Compliance has n 's d b t board of health. Q Application Approved By........................z...... 2....\=................. .......... ..... Date Application Disapproved for the following reasons:...................................... ----•-.....•••-•-......•---•-••••-•••••••-•-•....................... ---•.................................••......... ----...-•----•--. .....--•---............._.......•••...-•---..... .-•-•--..........-••--•--•.......-•--........ -••-•-••--•-•--- /......r Date Permit No... .^:_/ ...... Issued_........................:t `. �.1.......... ' Date "I.V_...14 , -^'' No `? .._� � Fic �Gs THE COMMONWEALTH OF MASSACHUSETTS -�� BOARD OF HEALTH TOWN'OF Y.ARMOUTH 1 \" ;- Appliration for Disposal Works Tonotrurtion rrrmit pplication is hereby made for a Permit to Construct (1.4 or Repair ( ) an Individual Sewage Disposal System�at: � " �P�t_ P _ _ /_ _ • - Location•Address � �..•..••.... _......� /,� Lot No./ ...... ......._.. ........ _ _... �f y (J ...........)....... . Owner •• Address14 -..... Installer Address Type of Building Size Lot__y3:... / Sq. feet U Dwelling No. of Bedrooms...........................................Ex ansion Attic a g— p ( ) Garbage Grinder ( ) Other—Type of Building�� � - No. of persons............................ Showers — W yP g .............•--••----- P ( ) Cafeteria ( ) dOther fixtures --------------- ----------------------� -•...........---•---•••••-••....-•••-•-•---••-•---••.......--•---•-------_.........----............._.. W Design Flow................... U!............_...gallons per person per day. Total daily flow._.....y.y .........................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..................... Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1-4 Percolation Test Results Performed by-----•-•--•-•-••-•------•••..........................•----•---•••-.---_. Date_......-- Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......:................. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------------...............---------------------------------------------............------............ ._. ODescription of Soil.. 7.............T......----........---------------------------------------•----------•------------ -------------•---- U •---•-••----------•----------•.--..... --- e------------------------------ ------------•----- ------------------ ------------------- •... •--- •----------- --------------------- ------------•----.:. W UNature of Repairs or Alterations-Answer when applicable............................................................................................... ..............................................................................................................................-------•----.....------------.................-•--•-......--------•--•--- i Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIS 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 the board of health. Signed -- -�--�=�--•- ---a..... ---------------•--------•-- Application Approved B .-- E G - ��(......... .. .!4 .. �Dale Application .............................Date Application Disapproved for the following reasons:.....................................�/..._..._..._......_ ._......._.._ ••-•--•......................................G.............................--•-------•-•-----...••••-••--_..... . J Date Permit No... '.. �"/b�1 !� ------•----------------7..._.._ Issued...---''�-�---==--..�: ..��..�.r.--•--.... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r TOWN of YAR;MOUT'fI Trr#if utttr of Tomp' liattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (✓) or Repaired ( ) by.......!�ICif1'. ......(J �................:.. . --- --••----••----•-----------•---•--------•.......................................•-.................---._.._...... , Installer at...�...�'�''.�--w••••. .... ... --•-- - (/ r . has been installed in accordance with the provisions of TIXLE 5 of The State. Sanitary 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. DATE............. ....�.....�r?-•----.....•-•--..................... Inspector......---....�.... ..._._.-•------•---•-----....-----...............__............. ---__---------------------- lip THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ TOWN of-XA&MOUTH Disposal �Works Tonotrurtion Permit Permission' i 'hereby granted...... `-I1`T ...._C..!f.../f.............•----...-----...........----.........._....--•------......................... to Construct V) or Repair ( ) an Individual Sewage Disposals System at No. ---•............../1).... -/.. ....... ...... Streetn ` as shown on the application for Disposal Works Construction Permit ._•--•--�.•--_-- Dated-.-,f--=:�..-W..•�`�.. 7-. r- 1 ....................................... .. ...................................................... ,,�IIoard of�Health DATE ......--•------•%---•.......:......................... s- - -PA-ra tiI t or?I 5111GCZ F�LG P(.7. $E'Drt1=M4' : 6A=AC.t &MOOL sE•PrI c -rA9v- 4dax Iso Voz.(e60 6PD JET Iv t712?oSA L_ PIT_2 loco AL/Z lti � s 5F to A �� l88 .�J� 51DEWdLL �M'�S J O S SF = 4")0�� � vMoM Aa - 7 0 of ' I•o z 7 sA� Gov -bTAL UE551614 11A!o 6fV• -r'orAL- TorAL VAILY my/ =A40kb :, Of- pEt2G0[. 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