The URL can be used to link to this page

Home My WebLink About0182 ICE VALLEY ROAD - Health 04ear �(ui I 1 S M E A D KEEPING YOU ORGANIZED No. 12134 2-153LGN SUSTAINABLE FORESTRY MIN.RECYC!ED INITIATIVE CONTENT 10°k CerWad Fiber Sourcing POST-CONSUMER www.Sfiprocremorp SR012G0 MADE IN USA GET ORGANIZED AT SMEAD.COM TOWN OF BARNSTABLE LOCATION Zo � _cf_ y�_'_4 I'd _ SEWAGE # VILLAGE Ds��1 ASSESSOR'S MAP & LOT 0 INSTALLER'S NAME & PHONE NO. J04 n � SEPTIC TANK CAPACITY ?rldp LEACHING FACILITY:(type) 2 4ao LPs (size) -yX/4/ NO. OF BEDROOMS PRIVATE WELL. OR PUBLIC WATER BUILDER OR OWNER. DATE PERMIT ISSUED: /®- 2f- 99 DATE COLPLIANCE ISSUED: v / � VARIANCE GRANTED. Yes No ��' i i i ' �� I �� ^\ /� � \ � �� j i \ \ \ 1 �i i 1 � i � � �� 1 � � , - � � !`` , �'` i � � � •�_ �� i ` �;y � .. � �; `O � � , No... .. Fx$....... . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..........T'cka?.h.1.................OF... I R�. ► .!'a.t. Allp irFation for Uhgpvii ai Works Tomitrurtion "amit Application is hereby made for a Permit to Construct (X') or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. n Own ,tv, Address ........................ °'�'' =��-.i_l.. - ------------------------------------- ....---•-------- G�� 16?.(_r6._.....----------------------------------------------- Installer Address Q Type of Building Size Lot........9-7___F__l�___Sq. feet U Dwelling—No. of Bedrooms......... ?_X..........................Expansion Attic (A&) Garbage Grinder (415) Other—Type T e of Building ____________________________ No. of ersons.__._____.__._.____.________ Showers —p-,-, yp g p ( ) Cafeteria ( ) A4Other fixtures ................ ..... .. `- W Design Flow..................................._S.S-_gallons per person per day. Total daily flow----------------------- ......gallons. WSeptic Tank—Liquid capacity_ gallons Length_1.1�f./_" Width._6..��'_ Diameter________________ Depth. :±:g y_`t x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area_...._._.___________sq. ft. Seepage Pit No.....7 wr).._._ Diameter__._..... Depth below inlet__ _4?`._. Total leaching area__4r—:30...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by--- Date.../!-Z.....- ............... Test Pit No. 1....Z--------minutes per inch Depth of Test Pit___ Depth to ground wat _-_. 444 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground " OF �s Q+' •-------------------------------------------------------••-•-•-------•--..._•----------•.._............................... . ................-4 O Description of Soil......o=1.4 i...Wk).Lk-=SaeA --- �a STEPHEN W2� = .. ----vei.y.-.Pe .�r, ......Firut.__�a i--'�`-----`�1 lr r=� .1C1lc c��rr�__.,S r t3- ---- y U Nature of Repairs or Alterations—Answer when applicable______________________________________________________________ 90 G�g�c, -------------------------------------------------------------------------------------------•----------•----------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System • accordance with the provisions of'TTL p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been •s ed y thebooard ofealth. ...........................T . .............e r --._...--------------•-- �igned. Date Application Approved ) ' — '�� - Me Date Application Disapproved for the following reasons-------------------------------------•---------•---------------•------------------------------------------_••••-- ....._..-•-------------------------------•-•------•--------•------------•....•--------•--•••---------••----------•----.._..----••----- --------------------------------------•---------------------•-- Date PermitNo.-- --- -----•----•- Issued-....................................................... Dste -• � y y FEE. .. ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 71ii c i.W-0-------------- OF..:...1 � ��.` r !.i:;.t l ......................................... Appliratiun for Disposal Works Tonstrurtion Vrrutit Application is hereby made for a Permit to Construct `or Repair ( ) an Individual Sewage Disposal System at: G c�-. l..�...-----•----•--•--•-•------•-------•------•----•-----•- .....-•-•--.........................................................•--.....__......._---•--..... .....................-- . --. Location-Address _ or Lot No. Gam... -r-""�--- - Owen r L-ess a --••......-••••--••-•-.........-•-'�•-- -._... ----------•----•--------- ---------------- Installer Address QType of Building Size Lot-------1t2.216.__Sq. feet U Dwelling—No. of Bedrooms.......... !. ..........................Expansion Attic (Al) Garbage Grinder (410) Other—Type T e of Building No. of persons............................ Showers Pa YP g -•--•----------------------• P ( ) — Cafeteria ( ) a' Other fixtures --------------•-•---•--••-•-•-•• . W Design Flow....................................5�:_gallons per person per day. 'Total daily flow..........................6,6,0......gallons. WSeptic Tank—Liquid'capacity. 4.k.)Ogallons Length.././.._/i}`. Width__!=sue_::_ Diameter_____________- Depth_: :-' .. x Disposal Trench—No..................... Width...._..Z......... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..... ----- Diameter...__Z, ...... Depth below inlet....3,:612.2'.. Total leaching area...6�3CQ...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.... Date.../!'__w'_--.Z•4-............... ,aa Test Pit No. I.....0........minutes,per inch Depth of Test Pit__ Depth to ground wat (T4 Test Pit No. 2................minutes per inch Depth of Test Pit..........._-------- Depth to ground OF _ r •--------- -------------------------------•--...... ------•-----•---• - ------------------------• Description of Soil- '- -CC®�� SRtE tYN ti•-� -Q•-q- �'g 11.e aV--�n-V...._tit... ttj _� � O - s'� ••-•---------------------------------------•--•••------•-----••••--•....-••._....•-•••-•-•••----••-----•----------•-•------••••----••-•••••••-----------•-•-••••.. .... . nn.3A2JE 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'T'LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be su-d by t/heboard of heal h. a te rAPPhcation Approved By. = � -- -- -._f .......... � Date Application Disapproved for the following reasons:-----•----------•--•------------------------------------------------------------•---•-•----•••••......•••---..-- ---------------------------------•-------....-----.........-•---•----------------•---......-------------- .............................................................. .............................. Date Permit No........................................................./ Issued. Date THE COMMONWEALTH OF MASSACHUSETTS __-- BOARD,-..OF HEALTH Cav ti `\ ��a �..................... ............................O F............................ (Irrtif iru#le of Toutplianrr THIS JS TO �CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by------------ - ..... t ._....__... ---•- / _ Install �... has been installed in accordance with the provisions of TITL 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----� FS:_..�� ......... dated-------f_.z}� ___------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � \—� DATE -_.- -�•-----...-••-----•----•-•-•• Inspector.................... { ,0............................................... THE COMMONWEALTH OF MASSACHUSETTS . BOARD OF HEALTH / ................................ 0K�?..6.'.r r �,�(.. ...................................... �`v' .. �� FEE. ..�_......... Disposal Works. Tono#rnr#ion rrutit Permission is hereby granted...--•-• --- tt:......................... ------------•----..._....------------.......-•------...------•--....---...... to Construct ( ) or Repair ( ) an Individual Se ge Disposal Sy tern at No. 1.-,--,)f V Il<i ------< Street as shown on the application for Disposal Works Construction Permit Nc��, __ Dated............. .l� .... ....... . ................................._.........i--- -----------------------------------------------------r Boar of Health II, DATE........!- .......................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ry` L A I � I ,[30� ��c✓ -PERC TEST Vp'1'r 1 ' ��- '•599j 7,E3 pcktC; Nov. 2 , 1964 Icst 13y: P, Sullivan AC,7 Sand Z/4444.7 1 43,7 Kne a n4 au"A l INo W;tkr) 144"- �. r►llclll'�lll /oo' •� 9�c 4L %" IK 5'u-'ioE ENS�r77�ti1T�---- 1 I1 1 z 1/ / 1 c j - 4 .,cl S F'(`OC LI�C Tcr Vic.',lcC l ti bG� !'Y J!^ 4 f AEI n 'r. 30'' L.� 4c, c3 F: (n t IJ✓ sCG GcllOr, hIST. NV !n/vC qZ7� 1MT 9I V -BOX IN84 �gz.oc> 2000 Ga//cn Wa IK� b 5t<'n� U ti nS Id 41,37 Q i 'E- 14 � V bottom o )cst DESIGN CilTF1 Sin51c F :��Il.t 6 bcalroom No gq.^Iaocrc `ri„dc: r- �- �l ram,."'!" --pB1L.Y LOw Io* I I n - o G P P / �r., r .�,FPT�G Tri►.1N. G(oo X 15ovp = 9-10 Go iio.� L �• •? �% •� �. E I//�f LLF- I U;c 2000 GcMon ScFtic -Ta11}v _ L-5)►7-A:- 06-W 4.3 r L L LEAGHIN1G E'-{E7EWt • 2- G0U Gcllon Prf=_ v./mot !tcnc I 514c"., +II /C6 / -f Gfd'l = 4 0 z GPD x /•D 6�d%�� - /�� GPD DATE. �scr/7' /96'R ..�4 �::.c • /�� i 4 � 'SS7 GPD X2 xG I I E I 1 CEe1T%/—Y %riffT THL' f�G _ F/6WN ('"1 / t' x;, h/�i�ELF! COr»i�L Y5 GJ/Ti5/ THE S/Oc�:Ji✓E /-c'�G/.S T i4t=c� L/!/J L7 vU�'(Jt Yf�'S /a.cJO �'ET�3r9C K �E (J/.�2E�!JEiJT G A Tr�c� M P�1N L ��t/C-�i/✓�ERA' %Ou�i l qF .CAI UTiYG?LE N/JU .c5 /JG 7- �al�i Rl HARD��`� L L Lvcfirct� IiYirsli+t/ Tf+E �LoOt��•'�f}/N c NO.24D46 4\ Nki lbti�,S ��._,.. ._ - .3.v. .W,_�>.,,...�.».,W.,�.......<....�.•...M,.»....,.....�..w......,...,c.W-.,.v,..�.•.,r.__.....,..,.•,,..,.......�...b..�,..rc...�.�,,...,.�,..,��....,«•.r,...«.Y.n-.....,,,:.,..,.,,.,...,,,��..,•....�.x.,�....,,...�...,.,.a...e....,,•..,.M.,. .�..„,....•...- -.W.�....-,,. .�..,......_.....,.».__.r..........,.,�.._..-..-»....,.,....,...»�,.....,._...,...........ff,..�_-..�w_.Y..._..._...._._.,.w..,