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HomeMy WebLinkAbout315 Main Street, Ost019 c0No.......... _.... Fimic-,....o.......... THE COMMONWEALTH OF MASSACHUSETTSr/53 4 BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Dbip mj Morkr, Cfonotrnrtion runfit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: M Location-Address 1-------------------------------•-- /6__ry se-¢.5----fa---I !Ai.l!.fS, ncr// ................................ Gr /6 v_jC... d teas Q .<i%/s Add ess Type of Building Installer Size rLot- Sq. %, C- t Dwelling—No. of Bedrooms----------- .............................Expansion Attic 440 garbage Grinder aOther—Type of Building ---------------------------- No. of persons--------------------------.. Showers ( ) — Cafeteria ( ) d Other fixtures ---- Design Flow------------ 0....................gallons per-gersen jw* da.4. Total dail flow---------9 O----------------------ganons. WSeptic Tank—Liquid capacity allons Length..t',?"'--- Width-e.-Z.... Diameter..._—'----- Depth.7-_-._..._- x Disposal Trench—No. -----2...._....... Width...ID.......... Total Length----k7-------- Total leaching area.153%...sq. ft. Seepage Pit No------------- -------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box (*5 Dosing k (b Percolation Test Results Performed by....-.. AsK j -e -4 1 E;.. : c.._. Date... Test Pit No. I------ -------minutes per inch Depth of Test Pit._. -_....._. Depth to ground water.--.34t............... 4q Test Pit No. 2................minutes per inch Depth of Test Pit........-.__-_._-__. Depth to ground water........................ 04 t r: Descriptign of Soil---q 0, .A...'. ....UA_a!!'lt r,?. 6'? 0...l x 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—The undersigned further agrees not to place the system in operation until a Certi ' e f Co Iance h een ' e y th r l of health. igned Application.Approved Application,Disapproved for the following rearons- -------------_----------------------------------------------------- q Dace Permit No. .... .- f...i.................... Issued .................. D IVAN 04 r L. 3 Fx$_ ..,.'............ t THE.COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE AvOrattnn fur Diti-pnia1 Wnrkii Tomitrnrttnn Urrmit Application is hereby made for a Permit to Construct ( ) or Rcpair an Individual Sewage Disposal System at: Location-Address b . ` t Q w) $( y c ow Address Address p Installer Type of Building Size Lot___.___ •-:---------Sq.feeC' ' Dwelling—No. of Bedrooms........... -------------------------------Expansion Attic Garbage Grinder aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) d Other fixtures ----------------------------------------------------- W Design Flow.............gallons per.persem-pef.day. Total daily flow---------9.9_0.__....................gal Ions. WSeptic Tank—Liquid capa6ty?6 al Ions Length---V °-G- Width.G"_G____ Diameter_ ---- Depth__--....... x Disposal Trench—No. -----.2---------- Width....1,.Q____---_:. Total Length.__ ....... Total leaching area._3_',2?4r...sq. ft. Seepage Pit No_____________________ Diameter.__..._-.-_.._-__.__ Depth below inlet__.____...._.._.._'. Total leaching area..................sq. ft. Z Other Distribution box (Yd5 Dosing t,ak (0) Percolation Test Results Performed by.______Js Date-_-7b7 1_ '_ 9_ ... Test Pit No. 1___.. •......minutes per inch Depth of Test Pit_.,>G_' r._.. Depth to ground "Water----34............. 4 Test Pit No. 2................minutes per inch Depth of Test Pit_____.-_______---_ Depth to ground water........................ C4 O Description of Soil...._.C> A-0------A--. Sall .... 4&ko---- 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—The'undersigned further agrees not to place<•the system in operation until a Certificate of Co pliance h been issu`e'dby the'`boj'rd of health.P w igned' ------- - Application.Approved By-- 1 IQ/' 7 Application Disapproved for the following reasons- ------- --------------------------------------------------------- l ......._..............— Da..................... 1 Permit No. J.."- L.Cv..l..` ------------------- Issued ---------------' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifiratr of Complianu THIS TO CERTIFY Th?a the Individual Sewape Disposal System constructed or Repaired V eby -------------M.1-7_ Installer at --------31S.......KtAN 4- 0.7-------------0.517S L—U-1.................. -----------------------------------------------------------Q1 _ has been installed in accordance with the provisions of TITI.E 5 of The State Environmental Code as d scribed in the application for Disposal Works Construction Permit No. C'..5------------1.& 1.1..... dated .-V7,/__,y _1---S...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARA TEE HAT THE SYSTEM WILL FUNCTION SATISFACTORY T-\ DATE................. 73 -------- Inspector t....... -------------------------- ------------------------ 5 tor ------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 'HEALTH TOWN OF BARNSTABLE No..95.....ZC019 FEE... _ LW_)( 0 Displatial Workii Tomitrudion "vanfit Permission is hereby granted----------9eq to Construct or. Repair ( )() an Indivi d,p4.,Sewage Disposal System k.7atNo. 3.15_3....KAcA_A,)...2!!t-J ........ 7 m..................................................................A.L Street ( 5 as shown on the application for Disposal Works Construction Permit No----------(6 4 Date "--- I............................................. Board of Health bATE.............. ................................................................. 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