HomeMy WebLinkAbout0015 EEL RIVER ROAD - Health 13 EEL RIVER Rb*OSTERVILLE
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TOWN OF BARNSTABLE
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LOCATION ?/C4Zf /2O SEWAGE #
VILLAGE C ASSESSOR'S MAP- LOTII!Z�/�
INSTALLER'S NAME & PHONE NO. 66777 �ST.� MY,
SEPTIC TANK CAPACITY
I LEACHING FACILITY:(type) �- 5 (size) �1>4:,*/
NO. OF BEDROOMS- PRIYATE WELL �UBL�ICWA�TER
• � BUILDER OR OWN •
DATE PERMIT ISSUED: �4
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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ASSESSORS MAP NO: �� e
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PARCEL NO: /dam
No.. ...... Fes................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
v -TOWN OF BARNSTABLE
Applira ton for 11isputia1 Works Tonstrurtiun Errant
Application is hereby made for a Permit to Construct ( ) or Repair (X an Individual Sewage Disposal
System at:
14�.-_........... -4 .___�___�__.....cc :----.. ------------------------------------------
on re �.. fc or Lot No
.se ..• ......... ....... ._..... w_......... -
w s�� f/� a 7 U,l Fly ��e�/tom . _..
____---- -- -••--- n------ ;�-------- _.. - .._.... :: f
� Installer Address yL
Type of Building Size Lot3 ."Sq. feet
U Dwelling—No. of Bedrooms.__..___.._. .____.__._Exp ns tic ( ) Garbage Grinder ( )
----
Other—Type T e of Building _ N of ersons_._._____.
a YP g ------•-•-----------•-•---- P •----•--------_-_- Showers ( ) — Cafeteria ( )
a' Other fixtures __________________________________
w Design Flow.................... ...................gallons per person per day. Total daily flow.............. ,..................gallons.
WSeptic Tank—Liquid capacit3 Vr .gallons Length_,/4.-5__ 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 ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
G%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
----•-------------------------•------•-----------------------._.._..-------------------------------•.........................................................
0 Description of Soil.......................... ----_____----___-__----______--=------------------------------------_____---_____------------••••---•------•---______---
x
U
•--------------------------------------------------------------------------- --------------------••- ••• -------- ------••-------•-•-----•--•----••--•-•--•----- ....
U Nature of Repairs or Alterations—Answer w en ap licable. 0
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 Compliant Weenisjb boar of health.
---....- ..--
Signed....---- --... ....../-.-.�.......Application Approved By ........-- . ...--... ---------------------------------------- ------- ---��. 0......
Application Disapproved for the following reasons- ------------------------------------------------------------------- ---- ---------...--------------......--....
------------------------------------------------ ..............
- ..
Dace
Dar
Permit No. ..... .j. ....�- Issued ......... ------.--
--
-
116 Z
No........ ..,.. F>c$............._...............
THE COMMONWEALTH OF MASSACHUSETTS
IBOARD OF HEALTH
to `
c7 P v 9 TOWN OF BARNSTABLE
Appliration for DiApuiial Works Tnnitrnr#inn ramit
Y '
Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal
System at: -
................................................................................
o tion-Address or Lot No.
loS Gt��'� y .....................................
s /l G�
c�................ ........................... .................................. .... ----
Installer Address
d Type of Building
USize Lot_3�.��.._a.....Sq. feet
I—. Dwelling—No. of Bedrooms_______________._j
_.________Elsi tic ( ) Garbage Grinder ( )
Other—T e of Buildingof e-rsons............................ Showers — Cafeteria
Q' Other fixtures _...----='
d - ------.•••••••••--•-•--••-•-•-•-----•-----•-•-•-------•-••••-••••---••---....•-•--••--•-- -------
Design Flow............................................gallons per person per day. Total daily flow___.._....__:)..................gallons.
WSeptic Tank—Liquid*capacity,./"...gallons___gallons Length_./4_5_ Width______ _______ Diameter---------------- Depth................
x Disposal Trench—No. ____.__.._O-__.___. Width_.....k_ ____._ 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........................
P1 ---------------------------------------------------------
•••---------------
-••----------------------
------
-----------------------------------
------•---------
O Description of Soil_________________________ u-�-�0
(� -----------------------------------------------
___-----------------
-______----------------------------------------------------------------------------------------------------------
--------------------------------------------------•--------------------•--._.......----.....•--------.._._.. --------•----------•..•----•••-----•••-•-••--••••--••----••••-••-••--•--•......-••_.....
U Nature of Repairs or Alterations—Answer when applicable._Z�---E-AQ✓ ___ CG4�._..� !>✓._.. �
__._.f;_________ j ...... ____._ S .......................................
_________________________________________
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 Compliance as een is ue bye e boar of health.
Signed ......--'`--- --� -'=- - -- ---...-- -- � "L
- ,.. ' ...--� to
Application Approved By --- --' .---------- - -- - -�--. ..------ --... �..------------------.------ --------. ��...�c_�"'
J Date y
Application Disapproved for the following reasons- ------------------------------------------------------------ ------------------------------------ -------------------------
------------------- ------------------------------- -------------------------------------- -- - ------------
-------------- ---- Date----- /
Da[e
..........-
Permit No. P� r .... Issued ...... (��-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
&r#iftratL, d C omplianre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x )
by - 'c/ o� . .. ...........c-'cw s�------------------------------------------....-----------------------------------..............
Installer
at ............................. ........... ..--------g�5G 2/UC... ..
has been installed in accordance with the provisions of TITLE�f,. h Sta e nvironmental Code as described in
the application for Disposal Works Construction Permit No. .....:f . ................t�a'-- dated ................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS'A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----------------------------------- -- '...: :'.`.../. r = Inspector - ' --------------------------- ------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE --
No. —..........; FEE..,.....................
Rapnottl Wurkp Tonotrnrtion ramit
Permission is hereby ranter ..................................77 ---------•---- ------------------•• ........
........
....
to Construct ( ) or Repair ( ) an Individual Seti age Disposal S
at No.......................................... :}....••.... ------../ -- , Q 7ZRClAw
IfEl
Street ��
as shown on the application for Disposal Works Construction P mit No � `/_NDat d..___' /_.%4-110h Board of"Health_
DATE-----•-•••---••• •--- ----__ --------------------------
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FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS
TOWN OF BARNSTABLE
LOCATION �gLfc, ;2,6 SEWAGE #
VILLAGE S%<��.BlfP.� ASSESSOR'S MAP & LOT�e,(a
INSTALLER'S NAME & PHONE NO. ,� 60'777
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS-PRIVATE WELL UBL1C WATER
BUILDER OR OWNE
DATE PERMIT ISSUED: ZZZ�//dl '
DATE COMPLIANCE ISSUED: c/
VARIANCE GRANTED: Yes No
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EPTiC SYSTEM PAOSTBE,
i TALLE IN dOMP
sessbr's office Osf Floor) �` I ` WH
sesser's map and lot number i ?l t ENV,RONM
nservation � ���� rnnte
and of Health(3rd oor)' � n rua
wage Permit number C1
gineenng Department(3rd floor): + Ito dar b
)use number
jfmitive Plan Approved by Planning Board 19
)PLICATIONS PROCESSED 8:30-9:30 A M and 1:00-2,00 P.M.only
TOWN , OF BAR.NSTABLE
BUILDING I C TV
APPLICATION FOR PERMIT TO �7 t li l"�� 6.7/-2V
TYPE OF CONSTRUCTION �/ O'®A �'
19 9�
'O THE INSPECTOR OF.BUILDINGS: :
'he undersigned hereby applies for a permit according to the following information:
.ovation
'roposed Use
'_oning District
, Fire District
Address
flame of Owner
NsI2 i L Ti U L c. �
Uame of Builder 70� 6` Address `
Vame of Architect
�1'% N P/� 4 y Address o2 a0
Number of Rooms 7Y 0-0 Foundation
cl k �� Roofing
Exterior g
Floors / � � Interior
Heating
J�07 jql/t Plumbing
T1/
Approximate Cost
Fireplace
f G
Area
y Fee
Diagram of Lot and Building with Dimensions
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