HomeMy WebLinkAbout0112 WIANNO CIRCLE - Health 112 W anft, Circle
Osterville
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SEWAGE INSPECTIONS �2. 1 C73
DATE
ASSESSOR'S MAP do LOT
-INSPHC`POB �p� �� �
SEPTIC TANK CAPACITY
(size)
LEACHING FAMITY: (hype)
NO.OF BEDROOMS
BUILDER OR OWNER
OWNER MAILING ADDRESS
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i . ;LOCATION SEWAGE Et391T pO. `
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VILLAGE w '
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I N ST A- LLE1l'S NAME & ADDRESS
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TOO ("VeWle U,121J rW d 40
d U I L D E R 00 OWNER _
DATE PERMIT ISSUEDEtz_6
DATE COMPLIANCE ISSUED '
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No. tl ( l Fee /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ftpliration for -Misposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair X Upgrade( ) Abandon( ) []Complete System [.Individual Components
Location Address or Lot No. AJ&)o C(b Owner's Name,Address,and Te No.
[1 C-Ql C -(- S'43 nr"A
Assessor's Map/Parcel , L 0 �� �J' F "('t91�tJit J iEPc>i&jGr C
Installer's Name,Address,and Tel.No. SOS—q 7 7—2 8 77 Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) W 60 W54DL
li),Ig SZte , 'tomx11sv
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of H
Sig d Date �'
Application Approved by UD Jy '(A,-, -.,I Ar Date
Application Disapproved by Date
for the following reasons
Permit No. Z.0 f-7 Date Issued (a —a 7 /-7
-. " ., .�:>rw!ngr��' �-:. T- y ._ate, � �..>n++r.-�++t--.-�••+ , .. _ - jr-
No. , Fee
THE COMMOIVWEALTH``OF MASSACHUSETTS Entered in computer: 1,
'Yes 3.
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for -Disposal *pstem Construction 3prrmit
Application for a Permit to Construct( ) Repair X) Upgrade( ) Abandon( ) [:]Complete System Vndividual Components
Location Address or Lot No. ( l a w 1*4 (� Owner's Name Address,and Te No.
M l cEu
Assessor's Map/Parcel ' I-T,Q
Installer's Name,Address,and Tel.No. S0'9-1{7 7-2%'77 Designer's Name,Address,and Tel.No.
(d.40CG r D L ��/.z'S-r Sit�4-S�P�' - N
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
r �
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) WT - gpd Design flow provided I" gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
(
` 4
` Nature of Repairs or Alterations(Answer when applicable) met) -- 5G W CTN A,(54�k
Date last inspected:
f Agreement:,, ,
f
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliancerhas been issued by this Board of H
Siguad
Date ',Z�•../�
Application Approved by ( Date / - 7 7
Application Disapproved by Date
for the following reasons
Permit No. �'� U (7 - t�) Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( )
Abandoned( )by (�2/4 PC" I p is' C VT 6AAk($CS
;. at I kj1OwAJ 0 t A-V_cj�: O S 7- _has been constructed in accorr ance
with the provisions of Title 5 and the for Disposal System Construction Permit No. _? °/7- L/ +dated
Installer CAA W f i E C JV? �LCSE4 Designer &J aA
#bedrooms Approved design flow �- gpd
The issuance of this permit)shall
all not/,be construed as a guarantee that the system will-funct�on as designed.
Date 1 f ,/ �, Inspector
No. -2-o 1-7 I/ Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal *pstem Construction Prrmit
Permission is hereby granted to Constructs( ) Repair(x) Upgrade( ) Abandon( )
System located at (2
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date ^a 7 _ f Approved by �,t•J
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No................•�6.....-- -�c a-ti�fiy Fes$..... ::s:d�—
` THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.......77TOww....
........oF.......309f�'ysTTC
ApplirFa#ion for Disposal Works TonstrurtionzPantit
Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal
System at:
40- 4jJV0 (�,2c4.t D E' v/ C A_c,7-� /3
........�L ..1�✓.. ........ ...T....'_.....-".. . ....------L.�•-'-----------...........---- ..`f....-----------•-------•--------•---..............------
Location-Address or Lot No.
.....................E—�c' �9r/- H 4! ..... _3��F%� P9�-t/7�PE� M9.
��9.eNJOUTh� Address
Installer Address
U Type of Building Size Lot......
feet
Dwelling—No. of Bedrooms............:-3...........................Expansion Attic ( ) Garbage Grinder We,)
'PA A Other.—Type of Building ............................ No. of persons............................ Showers — Cafeteria
Ga Other fixtures ------------------•------•-•--•. -
W Design Flow..-_.-......................6— ...............gallons per person per day. Total daily flow.__......._33.. 0 ........
WSeptic Tank—Liquid capacity..ZPPU-gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No.----_-- .---•-•-- Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------- Diameter.........!�...... Depth below inlet.......ik.-....... Total leaching area... ....sq. ft.
Z Other Distribution box ( ✓} Dosing nk )
aPercolation Test Results Performed b .... ,_._. u c/!'f�!5 Date!9�C�..Z S /9 7 8
Test Pit No. LL;k,;o/J_minutes per inch Depth of Test Pit....... _... Depth to ground waterlS.o... .,?P..W4Tr
Test Pit No. 2 ...P....minutes per inch Depth of Test Pit...... ..... Depth to ground water-___--_u ?!! ����
------------------------------------------------
....--"------------------- ---•---
O Description of Soil.........0.! .."-- ""-<-o�Al" .................................................� i � .. '�
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 iIIL a 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has ben issu�byhrd f heal
� ate
Y
Application Approved BY----.. ....•. •.... ..... ........................ 7
a
Date
Application Disapproved for the following reasons:................-............................................................._......._.........................
-•"--"--•"--------"-""---"•------•--------------"---"----.........--""-"-"---------...-------"--"----"--.---•.__......•-••••--•-....------•-----•--------•-••-•--•...•------•-------•••-••••----------•-
Q Date
Permit No......................................................... Issued.%-.�_'�/.... !
Date
...... FimB..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
VU ..OF.....
. ............... .. ./A). ................ ........................................... ....................
Allpfiration for Dispoiial Works Tunstrartion runfit
Application is hereby made for a Permit to Construct ()e or Repair an Individual Sewage Disposal
System at:
W11PVA10 eWC
&.1 1.q- — /,.*7"'
....................... .................................................................................................
6*14LP51V111 iws 1_14pex-, *11r.
.................... .................................... ..................................................................................................
Address
............... ....................... .......................................... ...........................Ig.....................................................................
......ins r Address
Type of Building Size Lot.... ... .................Sq. feet
U
Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder W40
A4 Other—Type of Building ............................ No. of persons.........._........._....... Showers. Cafeteria Other fixtures .............................................................
------------------------------- ----------*--------------
Design Flow..............4�......;tVVV....gallons per person per day. Total daily flow------------ -------------- ------------------gallons.
Septic Tank—Liquid capacity............gallons Length................ Width..........f Diameter..._____........ Depth-..........I.......
Disposal Trench—Flo. .................... Width o................ Total Length.......... Total leaching area.._ sq ft.
1p f 71 &7-"7--- ZW&W---- *
Seepage Pit No..._._.__.. i Diameter.................... Depth below inlet.................... Total le;3:chingarea..................sq. f t.
Z Othepistribution box :( Dosin
0.4 1 !!�04. Zf-, /778
Perd6fation Test Re Performed by........................................................................... Date ...... ........t#
.................
�4 qh.....minutes per inch Depth of Test Pit......1Z...... Depth to ground waterA10__'C;k'*b..W1#T'
Test Pit . "d"i
..........
4:?-v
PLI Test Pit No. minutes per inch Depth of Test Pit...... ...... Depth to ground water........................
VAJAI rO
0Ddscnprion of Soil, ...7 47 ..
................. ...............................................................................................................
................................. ........7...............................................................................................................................
W
------------
............................. .................. -----------
.... ...................................................................................................................................
U Nature of Repairs or Altera tidAs—Answer when applicable...........................................................................................,
................................................................................................... ................................................ ............................................
Agreement:
,,The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
th
e provisions of I"IT! `0
f the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has Aen issue b h ar of hea
e ....I..........7......................4 . ..
4Rplication Approved By_ ........
.............
......Y O/. V................. ........................................
Date
Application Disapproved.f or the folloAng reasons:..........................................................................................................
............i'�........... --------------------------------------------------------------............................................................................................................
Date
;Permit NoA------------------------------------------------------- Issued...... ... ...................................
Date
V THE COMMONWEALTH OF MASSACHUSETTS
1. \BOARD) QF HEALTIJ�.
...........................TH
................................................
rdifiratr of Tompliaurr
S TO C� Th e Individual Sewage Disposal,System constructed or Repaired
_44........... ....------ 9................. .... ..................
?n
,0 ............
�* ,--- --------- -------------------------*.........................*...............
has been installed in accordance with the provisions of f The State Sanitary G d in the
.,.ode tkdepPe
' plic�64 for Disposal Work IT .............. dated................................................
application �'Cen�$truction Permit ..........................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT,BE CONSTRUE® AS A GU RANTEE THAT THE
SYSTEM MILL FUNCTION SATISFACTORY.
Inspector....... -------
DATE........� Z7..................................... -------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD QJ3 HEALTH
. ............OF..... ........................ ............................................
Noff............... FEE..... ....
osa r T ion "WrMit
....• ........... .
Permis'sion,is,hereby vranted;'..,.�.On?.............................................................
........... ..... ..........
to Constj;uct )*�o �pair an .firid ial, eiVe Disposal t t
N .... .......... .............................................. ....................................... .............
Streg
as shown on the application for Disposal Works.Construction"P No. Daied
------------------------------------------
4
........................................... .............................
e
Board of Aealt11
...................................................:
DATE'...V
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
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SEPTIC wTA1V-K D/ o o�.A D
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INLET SEPTIC Ti4/VK ��FT I _
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rI/JTLET SEPTIC TANK SG' FT. _
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+JV,LET DISTRIBUTION BOX �'`• IS FT- ' GROUND N��ITE TABLE
SECT/O/V OF
;041rZ&TDISTR/BIITION 60X-FT' r
' INLET LEACHING o/T: FT- SEN/AGE O/S/oOSA L SYSTEM �TABl1LATlON _
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- D/Af S
NUMBER' OF BEDROOMS._ -` " ` - D/ _HENS/ON G FT
G,taR9AGED/SPOSAL 41N.1r = C SOIL
. , .. F�'i x, •- .� . SOIL TEST�.; _: r� Y; ' • r
TOTAL esT/MSTEG: FLOW 3 u G.4L DAY SO/L .TEST #/ SOIL TEST
/YUM ER OF LEACNlNG f'ELE✓. 9 DA`TE Off' SO/I- rssr c,,
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S/DELEACHlNG PER PIT-_ �� SQ, FT ,. / 3 r',G/�2� -� R�S(JLTS+/�t//TNESSED` BY k I7 l" J
60TT0/N 4C74CN//VCr PER P/T //
- )a'�•J .[,�p �`.sc.h t. ; PERCOLATION RATE ! • e e
TOTi4L LEACH/NG AREA LC SQ' FT a ��'`- - �°1�hCot�+T/oNR�T_EfkQ Mlnl�INCN
r RSSEeg6iELEAG'�5l IVG�4/?Ef► SQ. FT
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