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Home My WebLink About0009 GUNSTOCK ROAD - Health � its/o zz L ?17T OWN OF BARNSTABLE ' LOCATION/,0-r -71 SP&�V S 7-0c. SEWAGE # VILLAGE j,Z'. Ag ASSESSOR'S MAP 6z LOT 14 J 02-2 :INSTALLER'S NAME & PHONE NO. A SEPTIC TANK CAPACITY /4J00 LEACHING FACILITY:(type) (size) lea 1 'NO. OF BEDROOMS , PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER Sr! I'/a4Am) ° DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No s g$ ?`J ........ Fimic :1./.).......... THE COMMONWEALTH OF MASSACHUSETTS BOARD,,Gf =� HEA .......OF....U.�L_ . �...................... Appliration for- Dhipolitd Vorkfi Tomitrurtion Prrutit Application is hereby made for a Permit to Construct or Repair. an Individual Sewage Disposal System at: �/ /7 0------------------------------------------------- ... --- --------------------------------------------- cation ddress Lot . ....................... . .... ...................................... nr Address ........ . ...... ............................. .......... .. ...................... .................................................................................................. Installer Address j -Type-of Building Size Lot-------1_ J.&L.Sq. feet U Dwelling_—No. of Bedrooms............. ....................._...Ex pansion Attic Garbage Grinder ( ) Other—Type of Building ............................ No. of persons.......... ------- Showers Cafeteria ( ) Otherfixtures....................................................................... ....... ............... .................... Design Flow..............J___J----------_--_---gallons per person per d y. Total d *1 flog_-__ 1!?**'2 01 ---.a al[y o-vy-- -.7... ............ gallon%; 9 Septic Tank—Liquid capacity-.----------gallons Length;K,�f._____ Width....41716 Diameter________________ Depthj-•- Disposal Trench—No. .................... Width...... Total Length........ Total leaching area_._......._.__..._Aq- ft. Seepage Pit No_____________________ Diameter....46........ Depth below inlet....... Total leaching area._ ft. Z Other Distribution box Dosing to ........... Percolation Test Results Performed by---------ft��... ... ..... 2,6,, Date... .., �4 Test Pit No. I..4__--::__minutes per inch Depth of Test Pit---- ........ Depth to ground water........................ Test Pit No. 2...!_-Z__._minutes per inch Depth of Test Pit.................... Depth to ground water........._.......__._._. ----- ... ....!.................. ---------------------------------------------- Description ot Soil --- --------- ...... ........ - ------- .... .................. ------------------------ ........ ...........:..........................................................................I...................................... U ......................................................................................................................................................................................................... U Nature 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'TTLE 5 of the State Sanitary Code— The undersigned further gre to place the system in d urtler gereto p has e e operation until a Certificate of Complianced:by the boar _health... .............. Si -....... .............. ... ................ ..... ApplicationApproved By........ .. --- ----- -------- .............. ....... ..... ............... ..... 7 Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued ....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BO A RDb7 HEALTH .........OF.................... . . 0..................... ..................... THIS IS TO C IFY,Zhat the Individual Sewage Disposal System constructed or Repaired - ------------ ---------- by-- ------------- - .... .. ...... -.-.-.-.-.-I--n-s-t-a.. e..r..............at .............V ....................................... has been installed in accordance with the provisions of T 5 f The State Sanitary Code as described in the application for Disposal Works Construction Permit No 2.............. --—---- /--------- -- - ------ --- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... 5 t No.9-r- • Fps..... 4,e). _ THE COMMONWEALTH OF MASSACHUSETTS . : BOAR® .O°F- HEAL ,.H�' r - - ...... �.......OF. Applir ativat for Diipuual Workti Toustrurtivat Vrrmit Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal System at: / cation-Address r•" Lot 1�Io. /. ..F..!f.}` �Q = rM � •- " .sue'.r�! ................. . .......... !��.. e'"' i. .......... t/� n r Address .........fp-.�q......•........................ ns- --............' e ..................• � Installer � ~ Address i ;T"""' Type of Building r� Size Lot____._ .: 5 ....Sq. feet 1 ., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No, of persons----------�;�...... Showers Cafeteria ( ) a' Other fixtures ................................. . WDesign Flow............... r.._..�................_.._gallons per perso per day. Total Bail. -flo'$....._.....,� ,+d_____._...._,......g�Ions. WSeptic Tank—Liquid capacity............gallons Length-.....114_------ Width..._..:_._ f� Diameter................ Depth. 4. .. x Disposal Trench—No. .................... Width.....j ------- Total Length................ Total leaching area.._..........., _.....s . ft. 16 . Seepage Pit No..................... Diameter..... Depth below inlet....... ....__... Total leaching area...= '.sq. ft. Z Other Distribution box ( ) Dosing ta, ' ( ) — _ '-' Percolation Test Results Performed b ------•--= _ .{ .. T - .. �`•-j--- W • Y --..�..... .�C�- Date----- --�--- -• - ,� Test Pit No. 1..__t-�_^___�_.minutes per inch Depth of Test Pit..../ _....... Depth to ground water----------------------- (i Test Pit IN 2....e-..5 .__._minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1x �----- ----- :. .. •---�------•--------•---•----------------•-- O Description off Soil . ... . �'=''±t'' r r' `' _ ?� -. U . �-tl ...---- .� .......... ----•-•------------------------------------------------------•-----------•---•••--------------•---...... 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 f^IT/"1�•-• 1TTL_ 5 of the State Sanitary Code—The undersigned further pre n t to place the system in operation until a Certificate of Compliance has been is ued by the board.ef)health. , �. .. ,� to Application Approved B �. ---- ---- ... --- . -•-- . = r l PP PP Y �� / Date Application Disapproved for the following reasons:.... ------------------------------°--------------------...................... ---------------------•--------------------------------------....-•-----•---------.........•..--------•---...-------------------------------------•---------------------------------------------------•--- Date PermitNo.................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS Z,. BOARD,,.-OF HEALTH- L '� ................OF...... � r '?�_' ......................... Tardif iratr of ToutpliFatta THIS IS, TO CERTIFY, >hat the Inu viduM Sewage Disposal System constructed ( ) or Repaired ( ) Installer�y has been installed in accordance with the provisions of T 5 f The State Sanitary Code as describ . the application for Disposal Works Construction Permit No. dated -�y`."..0..."---- - ....... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................•--............-----------...........--•-------••... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD, OF HEALTH- ., o `..OF....l� .l"g ' s� ' rr a'7 .) '0__V No. ---•............ '-_. FEE. . g ur�u r�iun �eruti# Permission is hereby granted--• u?.c to Construct f '�) sp Repair ( )TM; n Ind�iv dual Sewage Disposal System Street .• ••.- as shown on the application for Disposal Works Construction P No...... 5ated..T77&._A/.-_..._.... Board of Health DATE . .^ '/-•----••-•-••--•---•-•-•-•-------••-•----•....... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS "' ~ IWO Nf 1 41 1e L7m- AR Ike _ 5 i✓- 1 i j h it-. Jf LEGEND p=N--P CERTIFIED PLOT•- T OxQ PLAN. . EXISTING SPO ELEVATION ��`� � q� - EXISTING CONTOUR 0 - - o`er ROPERT y /� FtNiSHED SPOT ELEVATION, �0 _0 ;` F FINISHED CONTOUR ---- 0 -- BUNWIS Lo - r ' No.22162 n AN APPROVED BOARD OF HEALTH. `{ DATE AGENT SCALE a r DATE ELOREDGE ENGINEERING CO INCH .____._ CLIENT _.____ I CERTIFY THAT > .THE' PRQPOSEO EGISTERE (REGISTERED f=s/�i BUILDING SHOWN ON .THtS ;PLAN , +' J 0 B N 0. ,,l a .._1 .1___� CIVIL LAND CONFORMS TO THE ZONING 'CAW.S ## DR. BY ENGINEERS ,SURVEYORS OF BARNS B�pE , f 71? Nif\IN ST CH. 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