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HomeMy WebLinkAbout0096 HINCKLEY CIRCLE - Health ��a z � � � F __..-. _ 11 a 1 G TOWN OF BARNSTABLE LOCATION 9� Ltk�ld— SEWAGE # c� �� VILLAGE © /�(�c, j" ASSESSOR'S MAP & ATIJ"7`� INSTALLER'S NAME. & PHONE NO. t�J�- 4!�)t S SEPTIC TANK CAPACITY /0<D C' LEACHING FACILITY:(type) 4 a 0 ` (size) NO. OF BEDROOMS PRIVATE LL OR PUBLIC WATER BUILDER OR OWNER -?�Oc1L' r DATE PERMIT ISSUED: i O DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No k �C) c Y AMMED THE COMMONWEALTH OF MASSACHUSETTS 7PWnmnt/ BOARD OF HEALTH Application is hereby made for a Permit to Construct or Repair 4�an Individual Sewage Disposal Sy&tem at Q.......... If................... .......... ......F....................................... Owner Installer Address �2; Other Distribution box ( ) Dosing tank ( ) ~~ Percolation Test Results Performed 6y-------'.---.---'.-----..---.-- Date........................................ Test Pb No. L----.minutes per inch Depth of Test Pit-------------------- Depth to ground watec------_' 44 Test Pit No per inch Depth of Test Pit-------------------- Depth to ground water--''_--'.- ' -'---'--------'-'----------'---'-------------'--'------''----- 0 Description o{ Soil........................................................................................................................................................................ -_'''-'-----'--.---------_'----'-''-._-'.--.--_.-.----_-_-_--_''-'-'--'----__..------ U Nature of Repairs or A teratieftro Answer when applicable------ �8cceq�.uc �� � v '~ SignedThe undersigned agrees to install the aforedescribed Individi ewage Disposal System in accordance with the provisi6ns of TITLE 5 of the State Environmental Code— he und igned further agrees not to place the system in operation until a Certificate of Compliance be b board of h4h. 1.09 p ^�=' - --------� --^Application Approved -�'- B, ................... _'--'-_-_ __-_ [/ "� / � Application Disapproved for the following mw/wmc --------------------------------------------- _____________________________________________________ _________ � ' D. Permit No. ---. - ------ [oouc6 -----..----------------' Due ' ------------------------ ---------- No.... U-. �' Fims.S...........©.. THE COMMONWEALTH OF MASSACHUSETTS r ' BOARD OF HEALTH R �` `TOWN OF BARNSTABLE hration for Dim u3tt,��� � 1 lVar1w Cnu$ttitrur#tun rrrutt# Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: ................ ...... ....................... ...................q� L... T....................................... e�li9on tlpddress n .Lot.No.-----••-•................................ Owner - Address f - = �.... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) p' Other fixtures _____________________ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W x Septic Tank—Liquid capacity------------gallons Length................ Width--------.------- Diameter................ Depth................ 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........................ c4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... P+ ------•••-•-----------------•...-•••---•-•••----•...----••....•••------••••••••-•--•-•-•-•••-•-•..........•••-•--••••••--•-•-•••-..........-•••-...---•--... 0 Description of Soil..............................................................................................................................................................=........ x U W ............. --------------------------------------------------------------------------------------------------- U Nature 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 Environmental Code he undersigned further agrees not to place the system in operation until a Certificate of Compliance h-as been;s`sued by 6 board of he th. Signed i r "✓ fG/ r Date ApplicationApproved By .................... . / ... .9..1/....�......... ..... .............;................-............-........................... Application Disapproved for the following reasons- ------------------------------------------------------------- -------------------------------------------------------------------- .._----------------- ---------------------------------- ........................................ e� Date Permit No. / Ll- `�'.. ......_.......... Issued ................... ..... ...... ...................... Date F __—___:___.—___.—_.—_.— _.—__.__-___.—_.—_.——®____.—_ _.__—_ —_._——_.—__.—— _.—_.---______._.__—._.._.—_.—_.—_ —_____ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE TErtifi ate of U-IIlK plianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( .......' y ,� �= 6v/ b ....... � s� '`....: - ------------ `� �� / � m, ue at ....� ...... ��_'..( /r f �/- ll'e3 r �J has been installed in accordance wrrh the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....... ..`/..-.. .. .....Y------ dated ....._...---------------.................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ,ram DATE ..... ........ ...... T.------------------ ---- Inspector....,....------------ ------ ---- ---- ------------- ---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH p� TOWN OF BARNSTABLE C 0 0 No... � � FEE.................... �iu�u�tt1 urk�_-��ratu/rtiun �rrmi� Permission is hereby granted..../.� _ �� � ........................................................... to Construct ( ) or Repair (1 an Individual Sewage Dispo al System at No. '�' .•••-•.• /6 ( _`, �---�/ ,_.._..- J }f r T_4e...... ......... CX as shown on the applicataon for Da posal��/Orks Construction Per No.._.y"rJ� Dated_._�4 <-. 1 :., .f....... . �� C r ard of Health DATE.............. ...� .. � r-•.................... Bo�. FORM 36508 HOBBS A WARREN.INC..PUBLISHERS APPROVED THE COMMONWEALTH OF MASSACHUSETTS rns to conserve 'o Depa BOARD OF HEALTH -� << �yTOWN OF BARNSTABLE ignea � ti ppliratton for Db5p j ial Wurk,6 Tomitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair Xg) an Individual Sewage Disposal System at: 48 Parker Road Osterville -----------------------------••----•--..............--------•-------.......---................... ------•-----------------------•--------.....--•-.......----..........--------•-------...---------- Location-Addn•ss or Lot No. _John C: ConleY......................................................... ------------------------------------------------------------------•.....-------------------------- Owner Address WJ. ......................................................................................... •-•--------------------------•....---•••.......-----•--------------•......--------•-------••--•--- Installer Address UType of Building Size Lot............................Sq. feet ,.., DwellingX— No. of Bedrooms...............a--------------------..----Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ...X9od------------- No. of persons..........2................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ------------------------- -----------------------------•---------- W Design Flow............................................gallons per person per day. Total daily flow............................................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 ( ) a Percolation t N I minutes pe Results Performed n Test pi o. ch Depth of Test Pit................... Depth to ground water................. fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground-water........................ P4 -----------------------------------------------------•--------•-•-•-------------•-•-••--•••--------.......------------------•----....---......--------...--- 0 Description of Soil...................................................................................................................................................................... W_ ..Sand.._& Gr.avel--••--•----•--•••---•-•-•--•--------•----•-•••--------------•--------.....................-- U W -------------------------------------------------------------------------------------------•-------•-•-------------------------............---- U Nature of Repairs or Alterations—Answer when applicable....Omit cesspool . Install 1-10..0 -- -- - -- 0 :pallor.. tank 1-di-stributi-on--_box__,1_-1000___ rallon---leach-•.pz_t .•_____________________•__-__„__,,,,__,__-_• 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 of and f healt . system in operation until a Certificate Signed Compliance has bee iss d by he board - '----..... 5�4/94 . girl. .........:...... ...................... Dare Application Approved By ............... .........' - --- '..-..//..-...�'. / G-e�l�u Dare Application Disapproved for the following reasons: ..... .......... ................. .................... ' .................................... q Dare Permit No. ! L .....� ------------- Issued --------------.............. Dare j $ 30 00 THE COMMONWEALTH OF MASSACHUSETTS � BOARD OF HEALTH 5`/TOWN OF BARNSTABLE Appliratinn for Uiripnittl Works Cnnntitrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair fig) an Individual Sewage Disposal System at: 48 Parker Road Osterville .........---•--•-----•-----...................................................................... .•----•----------•------•••-•--------------•••--------...--••-----............------.....------•-- Location-Address or Lot No. _John C... C�nieX---•-•-•-•-.A Addr. -- ........ ----------------•-----......_....... Opener Address W J.P.Macomber Jr. . Installer Address d Type of Building Size Lot............................Sq. feet aDwellings No. of Bedrooms---------------?--------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _._Wooa............. No. of persons----------2---------------- Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------------------------------------------------------------------------•-----•-•------•-•------............••_.. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Gd Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------------------------------------------------------------------•-----------...........••.........-----...--------•--.....----------------...---.......... j0 Description of Soil..........................................---•-------...-•---------------•-----------------------------.......-•----•---•---------------------------------..........._.. xSand .. Gr dyV --•--- .. ... ----•-•-'--•-------•--••----•------------•-••---•----•--•--••----•. W UNature of Repairs or Alterations—Answer when applicable....Omit e e..s poG l . Install 1-1000 qa l l on.-tank___1_-d i,s tr i but i,on_..box...l--1000.._ga l-1 on---l gacr�-_.p i t..•.--•--------••----•_--•-_-.------.•.-.•--- 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 been issu d by the board of heap Signed ..... G�6 �/� 5/4/94 - ��� ----------- ---_ .. -.e-.--........ .................Dace................. f Application Approved By ................\\.,.-_.......-......- ..-��wa� ................................ ............................. Dare i Application Disapproved for the following reasons: ............................................................... ..... ..... . ..................................................... ....................... ..... '- ..--.... ' ....................................... ... . . ............................................................. ....................-' ......--.... ' qq Dare Permit No. ...........1..U...........I�� CP Issued --------.............. .......................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (11eztifirate of C11ompltanre 7�HIS S TO CEgRTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) J.j�. acomber Jr. by ...................... ....... ..................------.....-------..-.---------... ...... . ....._.. ........... . ...................... ..--. --.............. 48 Parker Road Osterville at ............................... ...-...................------------------------------------------------ has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. dared ..........-_........... ........_..-...._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... ?-..-...'"".--. ... ' ' -....... Inspect .r� .-y.:: .. ...- -- .........��....................................... '---._,--_-.-_,._-'------.___-__---.__-.-__,---_.,_.-_---_,_ -- -----��-----------__.-. t• THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c� TOWN OF BARNSTABLE FEE... $...�4.:.0.0. Dispnott1 Work.5 Tnnitrutinn "ern it Permission is hereby granted.......J.P.Macomber---Jr.•--- ----•------------•-------------------------------------------------••--•............. to Construct ( ) or Repair (XX) an Individual Sewage Disposal System atNo.48 Parker---Road---Osterville-----•------•-••-•-•••'------------------------------------------••---------------'-_... ............................ Street p r_ as shown on the application for Disposal Works Construction Permit No. .� ��_��. Dated-_--->-5._--_.`�.-���........ I ------------------------------- DATE- ; •• Board of Health ----------- .-.I•L - -------------------------------= FORM 36508 HOBBS&WARREN.INC..PUBLISHERS