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Home My WebLink About0111 EAST OSTERVILLE ROAD - Health I I I 'East Osterville RQaj A= 122= 102 Osterville Y ' v No........ .... FEB............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD H EA T —.....OF......... ............ .. Apphratinn for Disposal Works Tom1rnrtinn rantit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal Syst "_ l ... S ` .. ....................................... ..... ................................... -------..............--.--............-- ocation- ress or Lot No. ._..... ...... ..... ............ - .......-• .................... .. a ............. . .......................A-V. 4z ... _..... ... ......• ........ .................-•-------...-•--•----------A---.........•-................................... Installer Address UT of Building Size Lot...Z�� `=r_..Sq. feet Dwelling—No. of Bedrooms......3................................Expansion Attic ( ) Garbage Grinder ( ) 'PL44 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ________ _____ . w Design Flow..•.........:...�a........__._....__._ aallons per person per da . Total dail flow.......•..... _®. ..................gallons. WSeptic Tank—Liquid capacity/ ons Length................ Width-_- Diameter________-__--- Depth................ x Disposal Trench—No.................:... idth_.._._._ Total Length._ ........ ..... Total leaching area.................... ft. Seepage Pit No:_.F_E - ......... .... ... ��.�.sq. ft. _._._. Total leachin ar ____ Z Other Distribution box ( Dosing t (. ® _- �� /—�Z - aPercolation Test Results Performed by . ......__ l_.� _ -- __ Date....?l._= .�1_-_Y��...._.. a Test Pit No. L.� _.____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........................ O --•--••-- --------- .. f --------- ................ Description of oil -' g�� d''G G�i� ...... .. .................... x � " �t '. -. ------------------------------------------------------------------------------ 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 TITLE 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 b and of health. J� igne -•-------- --- .'".. ... . ..... Date Application Approved By-------- • � ......�f�/- .......... -2/Date Application Disapproved for,the following reasons________________________________ ---------•-------•-•------••.............................. ...•-------- -•.................................•-----•-•----....----------.............------•---------••------....-----------------------------•-•-•------•----------•---------•---------••--------------•--------- Date PermitNo......................................................... Issued....................................................... Date '�1I •? Rom' .!... THE COMMONWEALTH OF MASSACHUSETTS BOARD A H EA T -----OF.... ....::.....::_ Appliratinn for Di ipog al Workti Tomitrnrtinn rvormit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal sy� t . 14 .. . ....._... .. .... .. ................................ .--•-•-- -------- --...--- --- -......... .................... Lot ocation- rr+W+^C+" s o�r �No .... 0 �'.iaf" +!..... - - -° -•-'--•-•------------------ -------------------•-------��--p•0' -•-•--- !' ..-- --___.-.--_•------- M � r�0n fees a ............ ..... d"3r •.. ................................ Y dT e of Building Installer SizerLot---!r+~ .�......Sq. feet U Dwelling—No. of Bed rooms-----i ....................... .....Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Buildin __.... No. of persons.......................:.:. Showers — Cafeteria Q' Other fixtures r ' ......... W Design Flow.............. -_______ � gallons per person per day. Total daily flow........ ..•...............gallons. WSeptic Tank—Liquid capacit/ ----._- Length................ Width................ Diameter .-___ ._- Depth................ x Disposal Trench No >dth ..... Total Length ... Total leaching area....................sq. ft. Seepage Pit No.______ r __._::_.___..__ 1 e �_ Total leachi a 1�. ..sq. ft. Z Other Distribution box ( Dosing GQ ��'"'r ►,► ' a ,Percolation Test Results moo,Performed by. ._. �._ " _. �!"��.. Date.._��'"`� � ._�.......... •--••- P P -- P ;n .. - er (s, Test Pit No. 2................minutes per inch Depth of Test Pit-___._.._._....._... Depth to round water Test Pit No. 1.... minutes per inch Depth of est Pit................. De Depth to ound'wat P P P g er---------------------••- O Description of oil- di ` - �1 "' -t. y - x �.� W ,..' UNature.of Repairs or Alterations—Answer when applicable................................................................................................ a_ ...... Agreement The undersigned agrees to`install the aforedescribed Individual Sewage Disposal System in accordance with 1.the provisionsof T1T 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 f health. Date Application Approved B �.' .._ Date Application Disapproved for the following reasons:........................ ..................... ..................... .................................. --•------------------------------•-•----------------------......------•-------------------•---------•-------------------•---•-•-----•-•------------••-•-•-----•----••-------••=----------------......_.. Date PermitNo.....................-- . Issued.......................................................--••-------••-•-----------• Date THE COMMONWEALTH OF MASSACHUSETTS BOAR%..1 HEA TH ..... . a�' °y'tb`...... OF... ............:... ....: ......................... . . (9rrtffi0tr of Tourptimnrr THIS IS TO CERTIFY hat Individual_,Sewage Disposal System constructed ) or Repaired ( ) by >• ...... : Insti " ..................... ------ at = - ------------- has been installed in accordance with the provisions of T r o�T e State Sanitary Code as described in the application for Disposal Works Construction Permit N : ,�._. dated----A _� _".t . ................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F /CTIO SATISFACTORY. DATE----_a-- --,�•-L.... ------.. ' Inspector..... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH .......... OF..:� .. .. ................. - No......................... FEE:----••................. �i��a�.��1 - Permission is e y granted..... :------ --- -••- -•---------•-- :.... to Construc or Repair ( an I dividual Sewage Di sal Syst'JR at No...... ... .: . ....- �., treef / as sh non the application for Disposal Works Construction P No. .�1A�oard Dated.._, "'" '7 Healt � -........................... DATE----- f 7•••......................................... : . FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - F`' - o �::a ,i-�AiZBAG,�' C��'I 1•.tC�"�-�G; U Ste- t OOCJ 14"AL. 75y ,c ,bL ,S' UZWALL AeFA L50 S.F. �xP. ox r Mis r�-oAvt ae T 0 sr. l'�01 CS.PD: t r��rCj 4 ) 0. TOTS L -C>ES6KI = .425 FL!>\-A-/ = 33D6.PD. CT- rlcvLaTlo�r t< l�t"E : t� !u 'Lhttu o2 Fwp I dl•� t -ram T Tor Fuo -�oo.o J Poe I noo tuv. luv.- 4'PPS �tsir i W. yay t -Sox wv. 9c,•SS 5�-tc I o �:: L.EAcN ;a &A, P�T C L W SA t!F? WASTED LiSToe iE . I Ct�C'_T t F t CD P L.b-r L a CA T I o t,J L,12 i Elzy`ru.-�. I- I Cl IZTtP-Y Ta--!,47 T14L rQvODA-r+otJ 5"cp,.A,/►J } 1ZI~r lZei.;Ga S-t% Q t_i]IJ Gcalrlr�L�FS Wit""( Tt-1=- . �j(L]G.LI'► lE LC%(" ti►aa `�E'rl?y/tCl� I�.'CCJi(.'t.Mc:�T'y. �� 't� t�A'i(� I1 "?`} 1. f I'i=TE�2SDti.J 1Ttw4t=tits QLk- ( .19-M GZEGIS t-C (Zt=D FJ(D Suzy -(L) �( i Il 17t_/at-t 1', LIOT IIA.-AGO of-4 4" l.. .0 l;I C., ,LC) Fu l�i _1'i t_Ml��L l._CU'C Assessor's: map and lotOnuniber �IU 5 ��S� LIANCE7` 7 _4 s 1> 3 � "• LED IN COMP 77,. E INSTAL. I I STATE Sewer-age Permit number ............. a� .... WITH Ai'TICLE AND TO VVh9'a RY CODE ��: N SANITA _ m r, N , Qy�ftHEir,�� 7 TOWN` OF BA1JIi LE G; {t. Z, EAUSTOD1a8. , `SP Ci nt 9� BUIL�D"ING IN . . ECTOR A41 PPLICATION FOi`n:PERMIT TO ........... ...Q...— .... ...... .................................................:. TfPE OF CONSTRUCTION �7 �,/ �� r v�� ......19 TO THEW INSPECTOR--OF- BUILDINGS: --• I„ The undersigned he eby applies for a permit/according to the fol/lowiwinginformaatiom Location .... .(/. ................... i... ...................................................... ProposedUse ....... j '/......................................................:.... k...................... 7— P :Z_ Zoning District ........ ...............................................................C , Fire District .. .. .. .............. ............ ............. Name of Owner ..... . ... e. ......./C '� /--........Address .............. ......... . .......................................... Nameof Builder .. .............//..........................................Address .......................... ....................................................... Nameof Architect ..................................................................Address .................................................................................... r, Number of.Rooms. ................45............................... ................Foundation ........�0'.........C��-�..................................... Exterior .....................................................................................Roofing h*OT Floors .............�f/i..`f�t..Cr.................................................Interior Heating ! Plumbing .............................. ...... Fireplace ................ ....................................................Approximate Cost ....A5.o--� Definitive Plan Approved by Planning Board _____________________-_______19_______, Area ..�760 . ..................................... Diagram of Lot and Building with Dimensions Fee ... .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i t:it? F I hereby agree; to conform to all the Rules and Regulations of the Town of Barnstable regarding the above ' construction. Name