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HomeMy WebLinkAbout0040 LOVELL ROAD - Health 40 Lovell Road, Osterville A = 140 - 019 u TOWN OF BARNSTABLE LOCATION- _ A1'4 SEWAGE# 017- a VILLAGE ASSESSOR'MAP&PARCEL &C5 000 INSTALLER'S NAME&PHONE NO:- :90)21'(f7rXs* tmjj! SEPTIC TANK CAPACITY;la{�j I.S"00 LEACHING FACILITY:(type) IL C`S (size) NO.OF BEDROOMS /0 �p ' OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance B'elden the:. Maximum Adjusted Groundwater Talle to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) 7/ ". Feet Edge of Wetland and Leaching Facility(If any wetlands exist within , 300 feet of leaching facility) i/�/ �t' 'F `' Feet FURNISHED BY 49 � � �' / TOWN/OF BARNSTABLE LOCATION Z✓O eC o v��le� SEWAGE # �� VILLAGE C3 ,5o -"C/ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. A �a C O �f ---Z V a SEPTIC TANK CAPACITY )5Z'3AMq /0Q0 l /o4T' r bJ70k LEACHING FACILITY: (type M�/// Y;r -t 5&CSizC&I /° NO.OF BEDROOMS BUILDER OR OWNER (J PERMITDATE: I :COMPLIANCE DA Separation Dis a Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by _ � a, � � � � � ,� '�/ x� ' ` � m u LOCATION ' SEN O,(:;E PERMIT UO. VILLAGE 11J5T NLLER•5 IJ NlE A0DRE55 BUIL ER 5 ME ADDRE55 D47E PERMIT 15 ED TZ - D b,TE COMPLI &KICE ISSUED : qi f�(. d / A6 \ i �`OG;4ti 1 . ��� '�' � oa� N.Y..`.S�-.. Fz�s...........30.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uitjipoittl Work, Ton.itrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (t.-r-an Individual Sewage Disposal System at: ..................................................� teeC----------------•------------------•---------- -----•.�. �_(U s. I -•-----------•-------•------"-'...........------•.... --•'--•- ocation-i\dqress _....--•-•-•----•-•-----��._or Lot No. !� �e0 Address �, S ----------------•--•-•---------------•--••--•• •-_... ............ Installer Address Type of Building Size Lot............................Sq. feet t, Dwelling—No. of Bedrooms........... ____________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons----_--__..___-_-----_.-__-- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ _ _ W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. 04 Septic Tank—Liquid capacity------------gallons Length________________ Width....__---------- Diameter---------------- Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. x 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........................ LX4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a ----•-•---------------------•--•---•-------•--•-------••-------••--•-••-•----------------'--............--'---....•--....------•••••....--------------------- 0 Description of Soil....................................................................................................................................................................... x U ---•••••--------••••-•--•••-••---•-----'•-••---...•-•-•------------------•-------•-•-•---------•--•-•-•----••---•---•--•------••----------------•-••----•-----•----••--•--..................----•••••--- w x •--•-•--------- ------------------------------------------------------------------------•••---•---••-----------------------------------------•------•---•-•---------------•-•------•----•--•......-'-••- U Nature of Repairs or Alterations—Answer when applicable------L1e_--1_CorLe-.-___----777�7—tl_e......=............ ----------------------•-•---••-•-----••--•---•-----•-------•-•---------------------•--•--•-•--•-••---••-•----•••-.•--------------------•---•---•-----•--•-•••--•--••••-•-•-•-•-••--•-•-••-------•-.-••-- 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 h s been issued by the board of health. Signed ...... P- ... ..... .......................... .... �e q Application.Approved By -------- -,O- . .....__.. .......-- ... . ....... ..- .. ......._.......... .--.... Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------------- .............------...--------------------------------------.__.........---------------...__..................._.............-------------------......---------------------------. ------._...-----�[e ------------- Permit No. ............. ----------- Issued .. .... J No. t7.. - •. f �` Fxs.....�2...G:bG..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Dhj-Vv!ia1 Wurk,6 Tongtrnr#iun Vamit Application is hereby made for a Permit to Construct ( ) or Repair (t✓fan Individual Sewage Disposal System at: ....C) Lou 1.�.....- ............................................. .r..s_:.l.1 P ...................................................... Location-Address a I or Lot No. Y� ! C- �1 J t ...................... 6........---- •-•---•-••---•-•••--•---•...--•- W Address Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.................----------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _----------- ----------:-- No. of persons--------.-_-_-- ---------- Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------ ---------•--------••••---••---......-'-••-•-•---••.......•--- W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacitv------------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 ( ) Percolation Test Results Performed by---------------------..................................................... Date........................................ 'a Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water.-..--.----..----------- L% Test Pit No. 2................minutes per inch Depth of Test Pit_----------------- Depth to ground water---------............... �+ ------------------------------------------------------------------------------------••••--•-----•---......................................................... 0 Description of Soil........................................................................................................................................................................ x W ---------------------------------------------------------------------------------------------------------------------------------------------------•--•---•--------•-----'---------••---•-•'•......... V Nature of Repairs or Alterations—Answer when applicable.-.__1-1 d:2---_.t.lA�-j.r.._---.-7 "..t.t.P....__.- ........... " -----------------------------------------------------------------------------------'-----------•--------------------- ------- --------------------------------------------------------........--•--•'- 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 Compliancp has been issued by the board of health. Signed ' Dace Application,Approved B w.,, . �, �� ------------------------PP PP Y �� � - -�� _ da -�' Application Disapproved for the following reasons: -------------------------------------------------------------------------------------------------- ---------.-...--------------- ---- ------------- -- -- - - - - ------ ------------- -------- ----------- -- ----- -------- --- -- ---- Dare Permit No. ------ ----`� -' _'.-_. --.. .. .. . Issued ....._.... ..: ..>. "` - Dace THE COMMONWEALTH OF MASSACHUSE-TS BOARD OF HEALTH TOWN OF BARNSTABLE C�e>r#tfira e of %Tiamplinurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by .......wa..t..e---------- - - ---I---5--------- ------------------ ------- ------------ -------- ------------- ------------------------------------------------------------------ at .. ...L- lJ�--l---`------ - -------- ------- 5.. E' --`------e ... --------------------------------------------- _ 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. ..._� _- 5... _.5-------- dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE' THE SYSTEM WILL FUNCTI9'N SATISFACTORY. DATE---.._----------------- .l./-. ,� Inspector .... �:: ,� �- ---- � � c s< t - - ------- ,-_ -/---.. -----,----- --- ----- •--- ----— -�- -- --- -. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.... �� - -?�:3� FEE--. .:�� �t���a��l urk� �nn��ruan �prmi� Permission is hereby granted. �J���A.1.• -r 'L� f S ----------------•--------------------------•'-•-•'- to Construct ( ) or Repair ( l�'an Individual Sewage Disposal System atNo �O•••••k-oUe•1-•1------- (Zcl n`�t �u.!.1.�- ......... ---------------•---------'-•----•---------------------------....................--- Street Z e— as shown on the application for Disposal Works Construction Permit No. ---:---a:------ Dated-...:_ _`............f5............. ...............•...---••-............... .............................................................. - .. Board of Health DATE..................... e------------•------------- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION '�� / v E�r SEWAGE# '1�r ASSESSOR'S MAP &LOT ..... VILLAGE Stp y� INSTALLER'S NAME&PHONE NO. —! �a cdoo SEPTIC TANK CAPACITY _ 5Zkksize' LEACHING FACILITY: (type ' � F r f�; ;• ,NO.OF BEDROOMS BUILDER OR-'OWNER PERMIT DATE: COMPLIANCE DA Separation Dis a Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility and Leaching Facility (If any wells exist < Water Sup ply Wel l 8 Feet to Y . .Private PP Pn : on site or within 200 feet of leaching facility) Edge of Wetland-and Leaching Facility(If any wetlands exist Feet':,:'. within 300 feet-of leaching facility) Furnished by . -- ,:_,_•.. E i NO- ©/ No.......... .1���17. FE ......... THE COMMONWEALTH OF MASSACHUSETTS .� BOAR OF H TH .............o .............. ......... .....:........._............................................... Appliration for -DioVosttl Workii Cfonstrnrtion Permit Application is hereby made for a Permit to Construct ( ) or Repair /,- an Individual Sewage Disposal System at: I-'y .... ...� .. ... ............... ....-...... ....................................... .. .... c on-Addres -- or Lot No. OW DR W .............. ...... ................................................... Installer Address 4 Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of ersons____________________________ Showers Aa YP g --------•-----------------•- P ( ) — Cafeteria ( ) a' 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 ( ) aPercolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Lti Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... - GG •---------------------------------------------------------------------------------------------------.......................................................... 0 Description of Soil........................................................................................................................................................................ .�4 U W ------------------- ........................................................................................... --_ VNature-of--F�-epairs or Alterations—Answer w n applicable._.__I'l//1y� ...:...................:.... ..... .. ........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued the boar Health. Application Approved ----• •-• •--•- •-•-._.•.....:.:......... lC -- ----- -7 � ------------ Date Application Disapproved a following reasons-----------------------•--------•----......---------.•-...-----------------------------------------............ _...--•----------••-•----•............. ....• ••-•--•••--•-•.............---•--.._....--••-•--•-•----------•----•---•--•--•---•....-----•--•-•--••--•••-••--•---••-•--•--•••-----••---•--•••---•-•----- Date PermitNo......................................................... Issued........................................................ Date No. . .`_... ....... FE ............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR OF H l .TH ---.....__. AVV irtttilan for MyviiFal Workii Toutitrnrtinn Vamit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: . ••. ..l ...... .............. "................. ...............' .... a on-A res or Lot No. �d..d.r.. ' Ow � ess .• -- __. � Installer Address - UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms...............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ._.__._....__ _.._.._.__ No. of ersons____________________________ Showers — a ng ---• P � ( ) Cafeteria ( ) dOther fixtures ...................................................................................................................................................... Design Flow.........................................___gallons per person per day. Total daily flow............................................gallons. W Septic 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 ( ) 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 pe- inch Depth of Test Pit.............. Depth to ground water........................ 1:4 •-•-•-•---•---------•-------•-•------••----•--•••••-•-••......-•-•-•-•••••---•-....--•---------••---•-•._._..._-••..........................•--•-•..._....•- 0 Description of Soil........................................................................................................................................................................ x -------------------- --------------------------------------------------------------------------------------------------------•------------------...-----...................................-........... w x - U Nature•of Repairs or Alterations An3wer w n applicable ....-� 'X� t.,_--- -^ --------------------- .........................,rc.� ........ Q` ........................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned f-irther agrees not to place the system in operation until a Certificate of,,Compliance has been issued y,the board health. Application Approved - • ----•- ••._...---•--•.....•-••-•.................•-----•-._..._..__ __ f___: ... ::- f Date .................... ,---....-•--------.__..---•------•-------------•-------....----------......_•--••----•-•----•-•__..._:_ Application Disapproved f following reasons-------------•-------......••--•-••-•--•--••-. •--•••-••-=-••••--------._:._--••----........_ Date PermitNo.................................._..................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALT ;!'••�v . .........OF......... ..................:........::. ......... ......................... C�rr#ifirtt#r of f�untplittnr�e THIS 0 RTIFY, T t tl:e Individual Sewage Disposal System constructed ( . 'or (�"7 by.... ... _ . _ ---•- • ,- C. .. ����� Installer ••------ at__...�' - --- -------- - has been installed in accordance with the provisions of T T.�F' )o The State Sanitary d as • bed in the application for Disposal Works Construction Permit No. -�_ '1� a_ ................ dated- ----- -f�------------------------------- THE ISSUANC OF THIS CERTIFICATE SHALL NOT BE/CONST D ASA GUARANTEE THAT THE SYSTEM WILh/FJID TION SATISFACTORY. DATE.....-�� .............................•-----••-----__--•• Inspecto -......------------............:__:....------..._...---•-•-_-••--• THE COMMONWEALTH OF MASSACHUSETTS BOARD JOF HEAL TH.............OF.. :.- .: :.:_..._. ..__ _.:_. No. ............ FEE... ...f./............ iaxtt1 n a #rUan rrmit Permission is hereby grand + --------------------------•-------__----•-----__----------_____•- to Construct,_ ' ar epa' ( Individual Sewage Disposal System at ;f�'' ..............................................................------ Street as shown on the ap ratio or Disposal Works Construction Permit N __ _____________ Dated__*�f16-h ----• .............. ................................................. Board of Health DATE fr - --•------- ------------- FORM 1255 A. M. SULKIN, INC., BOSTON - v. �I /i