HomeMy WebLinkAbout0030 GINGER LANE - Health 30 GINGER LANE
OSTERVILLE
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3O.W14 OF BARNSTABLE
LOCATION � iy4 L��U� SEWAGE
VILLAGE QL579201eZE � __ � �'4�ZB
ASSESSOR'S MAP & LOT ®A—� r�
INSTALLER'S NAME & PHONE NO.se5'25�G0)77 C&Ak ,-
SEPTIC TANK CAPACITY ��SZZ"JcQ
LEACHING FACILITY:(type) size) /a2
NO. OF BEDROUM51'RIVATE WELL OR BLIC WA
BUILDER OR OWNER 'A"o LI B
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes Nq
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
Appliratiun for Disposal Works Tonstritrtiun Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair {i\) an Individual Sewage Disposal
System at:
- Locatio Address or Lot No.
Owner Address
------- --------------
Installer Address
UType of Building Size Lot___, a4Q__....Sq. feet
Dwelling—No. of Bedrooms_____________��____________________.___Expansion.Attic ( ) Garbage Grinder ( )
'k Other—T e of Building ,1?�S.............. No. of persons____________________________ Showers - Cafeteria
Q' Other fixtures --••------•------------------•--
W Design Flow �_ --------------------gallons per person per day. Total daily flow........... --------- •-----gallons.
WSeptic Tank—Liquid capacity, _gallons Length___Ae 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 ( )
PercolationTest Results Performed by.......................................................................... Date........................................
aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water---------_-----_-----
rT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ..................................................................................................._....•-----•-...---•-•- --_-••--
O Description of Soil---------Q�-;- l---- �__.$�� 1 �C /�..c �/ �� .......
V ............ -•----------------------------•---.._......_..........---------------._._.......------••---....----•---•----------------------------------...._...•----•••-----------•---•.
M. -----------------------------•-------•------•---------•••---------------------------••-------------------••--•---•----•--•----------------•-----------•------•----------------•----•-----------..__..._.
U Nature of Repairs r Alterations—Answer when appli ble.•._��_ f`!°. `- �___C�.-�R?.��JG
,ter/
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 s*enissueA,by t board of health.
or
Signed ------ -- - ---------- ---.-------- -- ------------. .Application Approved By --... . ...... ............. .�.. g � !V
Application Disapproved for the following reason • -------- --------------------- -------- ---------------------------------- ----------------------
---------------------------------------- --------------------------------------------------------------- ...-..--------..-....------------- ...... .. ----------------------------------------
Permit No. �/.... /.I. ---........................ Issued . ( .. ---9��....------...�e------
i
No FEB �aO
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appl ratilan for Dispniial� Works Tonstrnr#ion anti#
Application is hereby made for a Permit to Construct ( ) or Repair (, ah Individual Sewage Disposal
System at:
Loca iro Ac�dy � A^, r Lot No. '
•• --•• CJ/v ------- ----------------------------------Y-T-^✓--•--- - -------------------------------------
------
W Owner Address
r>%77 �'on.Z�— -••1.c. t ,G�y----- ........ -••••---•-----
Installer Address
d Type of Building Size Lot____ ...Sq. feet
U Dwelling No. of Bedrooms..............` _Ex Expansion Attic�-+ g— ---------------------- p ( ) Garbage Grinder ( )
aOther—Type of Building .......iZ.5�s----------- No. of persons........:................... Showers ( ) — Cafeteria ( )
dOther fixtures -----------------------------------------------------------•-•-----------------------•------•--------------•-
W Design Flow................ ---------------gallons'per person per day. Total daily flow-------------- ................gallons.
WSeptic Tank—Liquid*capacity, gallons Length____,e-0 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. 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........................
04 ----------------------------------------------------------------------•-------------___---•-•-------------...---•------- -------•--•-----•----...------•-•--
O Description of Soil...........-). :7... 1 Sr1/� c /off ' FQ r i
w
•--••-•--•-.5�� ---------•--•-----------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs r Alterations—Answer when appli ble_C/[ s `_ GL___�c55�7Q'S� /�1s�}t-G
----------- ---- -
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 has b n jssue th,,board of health.
Y P P Y
Signed ----. .... .. ---- ' ------- ------�..---- -�- ...
U ly_ q
Application Approved By. . .... x... /f�% f��
/ Dare
Application Disapproved for the following reasons.--- ------------------------------------------------ ---------..-..-------------------------------------
------------------------------------------------- .......................................................... .......... - /...........f.
/� 9 O Dare
Permit No. ../------------------ -------- Issued ---------- !
-..---T-----------------------------------
� � Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(frr#tfirate of Contyliance
THIS IS TO CE FY.That the Individual Sewagge Disposal System constructed ( ) or Repaired (X )
by......................................... O�G% C O�7"7-- -------------------------------------- /'U- -------------------------------------------. ..------------------
Installer _
at --------- ------------------------D.--------... :/'6- �-�'�� / �,`S��<2 /GG
has been installed in accordance with the provisions of TITLE 5 o.f The StYE
nvi on mental Co A d s ed in
the application for Disposal Works Construction Permit No. ..--..y.Ur �--. dated ----.--- �-, O
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR �►S A G ARANTEE'T 1 T THE
U
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.......... -"-'... --------------------------------- Inspector .. . ----......----....
Ca THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No ��.�-- - FEE_.-i�O Disposal Works TWInsfrndilan ramit
Permission is hereby granted________________ __ .._..
to Construct ( ) or Repair X) an Indivjdual Sewage Disposal System f
at No.................... r'�D.......... 'l.�t/-�_'��.....C-'Q:iIJ 4(J/GG
Street
as shown on the application r Disposal Works Construction P t No.....� . Dated..........�` . ...�a.-.--
----------_ _-__ _ _ �, - - r. o................-
Boar � Igealth
DATE---....� 1---�----- ( ------------------------------
FORM 36508 HOBBS&WARREN,INC..PUBLISHERS