The URL can be used to link to this page

Home My WebLink About0055 RAMBLER ROAD - Health ��Zc�.�rn lo�� f�� C No y. Fps...Z-�_ .... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH L � �...............OF.........�..�`�Z .L(4= Alip iratiun for Elhipat at iVurks Tantitrnrtiun TIrruat Application is hereby made for a Permit to Construct ( ) or Repair (K) an Individual Sewage Disposal System at Location-Address or Lot No.� /lam" �W-;_, '� owner Address W ca2 u, *7 ° ' /°-=v............................ 7 La1 i�£6 ^r�X.�� . ^ �w'? j 3 ,-a r � Installer Address UType of Building Size Lot-___-1A .¢_.Sq. feet Dwelling—No. of Bedrooms............e-��--_-_---_---___----Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building p•� yp g .....____ ____........... No. of persons........6................ Showers ( ) — Cafeteria ( ) a Other fixtures --------------------------------------------- W Design Flow................ ..gallons per person per day. Total daily flow............ _®.................gallons. (li Septic Tank—Liquid capacity/tOd..gallons Length......... Width-_!.%z........ Diameter________________ Depth................ Disposal Trench—No..................... Width.................... Total Length...._............... Total leaching area....................sq. ft. Seepage Pit No.___...../'...... Diameter.......... ..... Depth below inlet...sA ... 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........................ rz Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.-_-_-.------_____-__-- ►x -•-•-------•----•----•-••••••--•--••••----••••••-•••---•------•-••---•••......•--•........................................................................... O Description of Soil.--------0 ----•• ....... ----•----- v ,-----------------------------------•-•---------------------•--------------------------------------................ W UNature of Repairs or Alterations—Answer when applicable_.-4041WO!✓U___.__� �.._._� �� G......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'y t IE 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 by the board of health,. igned....l__... / .................................. // .. Date Application Approved By-- = �� Date Application Disapproved for the following reasons-................................ `-----------------------------------------------...__.._...--•------.._....._ --------------•-----........-----------------------•---------------------•-•--------------•-•--------•-----•-••-•----•--•-•-----------•----••--••-••----•-----•--••-••-•••-•-•--•---•-••-••••---•-.•--•- Date Permit No._----•-��-• � Issued...........1 A . ti o�tz - TOWN OF BARNSTABLE `6 0CATION ' - (gCrr�2 ,rZ _--- SEWAGE # 1 �� VII .AGE ?Uv ASSESSOR'S MAP & LOT INSTALLER'S- NAME & PHONE NO.Za"-1�0'2d SEPTIC TANK CAPACITY 0 4 LEACHING FACILIT Y:(Type) _(size) NO. OF BEDROOMS -PRIVATE WELL OR_PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: f�/ % DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No a j TOWN OF BARNSTABLE LOCATION i �� /� -�� SEWAGE # V1I.L AGE �1'Sr-W'J "` / ` ASSESSOR'S MAP & I.UZ l3el �a3� INSTALLER'S 11AME PHONE NO.��_ SEPTIC TANK. CAPACITY _ LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER j0/v/3sk BUILDER OR OWNER /( a �Uy� Jti—h�'�•+' -- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_ VARIANCE GRANTED: Yes No _ -. � ^� / �� - - - � `�-' '� � ----, � e � �-� I i X � � � T � � I � � ,�Z � �. i ., .. i� \� 4 No' .�........-/ .......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (ftJU ... OF....... ...-.....- .............................................. ApplirFation for Disposal Works Tnaastrnrtion Prranit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: A. -.- rcOC'F1 y / Location-Address or Lot No. /V_ //,} E.!� / .._.... U . ...................:............. CC _.. r... ....! --......._..ram;ul_..w''' -- .. .....---- -•_-......... ---•-- ----- _ Owner Address `7G----------------r��l..�c__-•••• . ......................7-/c�1------------....-----_...... 7c,l � ... ..... l s�►.us ,......cS------ °.Installer Address U Type of Building Size Lot___/� _¢__Sq. feet Dwelling—No. of Bedrooms-----....... -_-- _---__•-__--Expansion Attic ( ) Garbage Grinder ( ) PL4Other—T e of Building 9,F ............ No. of persons........6 Showers — Cafeteria QI 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...,3:�_.__... 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_-_-__--___--___-:___--. (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••-••••-•-•------------•--------•--------•-••-•-••----•-------•-•-•-•-•........_••_••-••---------•--•--•-----------•-••••----•--•--••--•---......................................................... O Description of Soil------... •r-- I YI = U' ......... �r ��{'' !�� -.. i ` =_-� v ' .. W --------------------•....................................................................................................................................................................... --------- U Nature of Repairs or Alterations—Answer when applicable__-e4/?!✓W-'>0M r'S�S�a4L-s �� G', -------------------- -�D®Q F 1C. 7r Vi� /ST.._....__Q.+� �k-G>..:✓ir----`'u ---...' .5......t/...----------------------V. - - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTT .w. y g g p y 5 of the State Sanitary Code— The undersigned further reel not to lace the system in operation until a Certificate of Compliance has been iss ed b th boa-rd of health. Ic. ----"Signed ------------------ f ..\ Date Application Approved BY-=•-_-�,'--� _�.�!.-=' = :......--• •--- --------4/4 '-fat�v -- Applieation Disapproved for the following reasons:...............................::....... ................•...............................Date---........._ ------•-------•--•--------------------•--•--..__....--------•-------------•---•-•-....-----------.....---•----•-•-----•---••--•-•--••---•••••-----•---•-••-•-•--••---........-•-------•-••-•--•......__. Date Permit No........ ........................................ Issued............ ( 2 1 e '7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f .........,...�i-'l' ...... ............O F......... .......'............................................... Tntifirate of Tomplianrr THIS IS TO-CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( !) by.......................•.�G...?P�c!G.................................................1 (.(.�Dr1..-_....__•--•-•---•-•••-•---_-_•-------........................--------_--••--•---•-_--. Installer I s� a -� t has been installed in accordance with the provisions of T I T E 5 of The State Sanitary Cod as described in the application for Disposal Works Construction Permit No.......51�... ��......_...•... dated-...-_/_ ._r described .................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................� �..��.:. c�........................... Inspector-•-•-----•----.%--'o---•--•-•---------_-_---------.--____--_-..------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` ..........OF......�rr� ......-------•............................. No�� I U.. FEE........ ...... disposal Works Tonotrnr##ion anti# Permission is hereby granted--------- �owC7L CJ ?f7....elw, ?�U 37 QR1-----------•----•........................................................ to Construct ) or Repair (No an Individual Sewage Disposal System Street as shown on the application for Disposal Works Construction Permit No ...... Q Dated.......I ............. 7 J Board oard of Health DATE. ===;� f -I•..........................•----••--•-.... FORM 1255 OBBS & WARREN, INC.. PUBLISHERS