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Home My WebLink About0010 AGAWAM ROAD - Health MCA P,!�7fo LL t Q TOWN OF BARN STABLE LOCATION 4c54 JApPj 56�SEWAGE # VILLAGE ASSESSOR'S MAP & LOT V 3- 0 6G INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 4 000 LEACHING FACILITY:(type) (size) l oao NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �r9�w-PS ��+-►-7`"� , DATE PERMIT ISSUED: "' r► DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 97 3c . �3 FizB THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -----_.....mil tV------.......OF......... . ✓.�iR!�!_�C� :!`!C Applira#ion for Kliipnaaal Works (fumitrurtiuit rumit Application is hereby made for a Permit to Construct (V/) or Repair { ) an Individual Sewage Disposal System at ......z.....s......... .... ......M.A, sTo-Q s----M*i.u--s---------------------- ocatio d ss r of R. ---.....MC-LE pup ..�N......_ ---•--.R.Di. 9...q ...::.. 1,__NI�.�. -- a r 'I11-1- ---------- Add ' �� •--• ...... i .... ...........................------- O M _ Installer Address �� Type of Building Size Lot_____ ......Sq. feet V Dwelling—No. of Bedrooms_ ..............................Expansion Attic ( ) Garbage Grinder �() Other—T e of Building '� s•__.__._._. No. of ersons____________________________ Showers Cafeteria f� YP g •----- P ( ) ( ) Pa Other fixtures .---------•-------•---•--•--•--•-----•-••-•--•-•••••--••-------•-------•-•-------•----•----------••---•-- -- - Design Flow................. ....................gallons per person er day. Total it flow_.____._____.__ _ W e,,II i j' gallons. tx Septic Tank—Liquid capacityl _gallons Length__ _.`t_._._ 'Width... ._(Q_.__ Diameter________________ Depth___ ._}____.... Disposal Trench—No_____________________ Width_____ .__._........ Total Length.................... Total leaching area._._.__ ---------sq. ft. Seepage Pit No.........I----------- Diameter......1Q....... Depth below inlet__. e 5______. Total leaching area__�_91......sq. ft. Z Other Distribution box (V) Dosing tank ( ) ff Percolation Test Results Performed by.......................... AC . i.__ Date_____7 .......... aTest Pit No. I__-41______minutes per inch Depth of Test Pit......1_�......:__ Depth to ground water... Test Pit No. 2................minutes per inch Depth of Test Pit__..__._____________ Depth to ground water........................ -- j O Description of Soil '.L- ... L ............................................... V ttLL.. 1�, W ---------- ------ - -- -------------------------- V Nature of Repairs or Alterations—Answer when applicable.______-��._ _ ___________________ ____sue—Tp_��' -------------------•--------•---------•--- Agreement: i The undersigned agrees to i�tall the aforedescribed Individual Sewage Disposal System in accordance with �•1T I.1x�. the provisions of iITIE State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certifica ompliance has bee issued by th;board of health.Signed-- - ••---•-••................... ........-•-•-----•.....--------=---•-- � o ,� / - D to Application Approved By..--•---- l,�x" �______ --•--- .-------- �---------•----•- -----1,E-A Date Application Disapproved for the following reasons--------------------------------------------------------------•------------------------......................... ...............................•-•-•----..._..----•------._...._---•-•••--...-•--------- q� � Date Permit No....... r'.�----._ -----------_ Issued_....... 1---- ..-- Noel-...: !!� Fps.... �7.�.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � � . .... .......... \� A) '�TA F=,��...................... . ................. ApplirFation for Uisvvii al Workii Tonitrur#ion rrrinit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: -- - ..._.._ ............. .•--------------------------........ ------ .............................................. Location•-Address or.Lot 10. .............-------_-... ... - ... --- ................................ f Owner , Address ............ .:.. -•-••- ------••• ........ ........................... Installer Address k- Type of Building Size Lot.... .......Sq. feet Dwelling—No. of Bedrooms.........................................Expansion Attic ( ) Garbage Grinder Oc) `4 Other—T e of Building "^ 5 No. of persons............................ Showers — Cafeteria Other..fixtures ................................. . WDesign Flow..............- ......................gallons per person per day. Total daily flow.............. e. ..................gallons. WSeptic Tank—Liquid capacityL CM.gallons Length_��_. ..... Width...-t..b.... Diameter................ Depth.....--_.._..-- x Disposal Trench—No..................... Width_....f..................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.................... Diameter......1. ...... Depth below inlet... .: ........ Total leaching area.19.._...sq. ft. Z Other Distribution box (✓ ) Dosing tank ( ) ll Percolation Test Results Performed by------------------ +.......................... Date_._.-.-1-12`- %'_.- - 1........... a Test Pit No. 1... _'h:......minutes per inch Depth of Test Pit------L�........... Depth to ground water___t � �..___. Gx Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water._-_____________._.-____ 04 .....................................................••---------....----------------..........-•--••......................................................... J _ , ft T O Description of Soil�- -�)� -U�� -� - !�' ( ( '_ ��..........�... .�.... ` v . ' •----------- ( �% W _ UNature of Repairs or Alterations—Answer when applicable------- ___1.* 1..._....._ _ �_'=...._'._�:!'.:+...__ Agreement: ' The undersigned agrees to itutall the aforedescribed Individual Sewage Disposal System in accordance with TITLE ^ the provisions of I i.'.E t th State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certifica of ompliance has been issued by the board of health. Signed---... �.v._ L _.......�_ !........................ ti Date,' Application Approved By... = ..... �� .......-•----•. � P � Application Disapproved for the following reasons-------------------- _-•-•----.----•--...-----------------------.•------•--.._..-----.....------ ••................•.........-----------•-------------•---•-••---------•--......_...-•---.._._...-•••--...._...............-•--•••-•-•-----•••--•-••..................................................... Permit No....... .r,�=" -•--•-------- Issued--------='�S,---Jt--19' - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........1............... ... ...................... Trdif iratr of TontpliFanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( } by.............•-•••••---'-l'1(` s� �._'�...••i '_.................it - r- Installer ---------------------------------••---•-----•-----•-•----•-•------••---- has been installed in accordance with the provisions of T I T IE 5 of The State Sanitary Code as cjescri ed in the application for Disposal Works Construction Permit No...... .1...... dated_---- _ _ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO,N SATISFACTORY. DATE...... '-•''�� 0t -------------•------ Inspector-- -- ---. ..... THE COMMONWEALTH OF MASSACHUSETTS �< T,� .�t (, _;^r,�'c� _ BOARD OF HEALTH _4ams-( - 1- r .('.�Q`:�!. ...............OF......... r'..�_ .. .1.t t � ...................... ..' No. 1.:: �x�--... FEE.... ..�.e 1.3 Rapos al, ork.0 %Taanotrw tioat Vrrmft Permission is hereby granted # .!-_ ?. ) #= 1 - I�_ ).......�� J, �ea..... to Construct (v ) or Repair ( ) an Individual Sewage Disposal,System at No.•------.LUA.--•....L... ....•. ..�- ..-----L--A-� --.---- . _.. ._�j a5....................................................( - Street �// rt�y s as shown on the application for Disposal Works Construction Permit N o& .:�� Dated_.!/__. ........... •.................•-•--...-•--- •••--.. ................................................. Board of Health DATE..................... -...7....iK... ......... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS EL.1�3X•. TOP OF FOUNDATION ' • t ' %Heff TE COVER • • :CONCRETE COVERS 4 CAS IRON T I �snmr.•;r " 2 MAX. riN c )C0 . OR SCHEDULE 40 1241 MAX: i .•• P.V.C. PIPE. ' 4 SCHEDULE 40 PV.C.(ONLY) • PITCH 1/4'PER.FT PIPE - MIN:' LEACH.. ; PITCH 1/4"PER:FT. PIT, PRECAS .e INVERT LEACWt, ELp.Xo �INyERT INVERT �? a�: PIT OR o SEPTIC TANK DIST. s INVERT EL.S9X.dY. BOX EL$.9.X.Z�. ' : (: y= �:' EQUIV 'a EL.S9X,S..: •��.f: GAL: NV RT H� ��• � ELx.Yf! INVERT m :wCL w TO I I EL g�X4. WASNE[ /p w STONE v DIA. 'Y '.PROFI LE OF }— ,(/(J GROUND WATER TABLE E[._ 8/.s- SEWAGE. DISPOSAL SYSTEM NO SCALE . S I L . . LOG WITNESSED BY DATE .7/z8 . .... TIME.. .. T . �/, 1JP<7.:./l./L eO ot/. . .. BOARD OF HEALTH . TEST.HOLE i TEST HOLE. 2 S- T!'1YOr3 i ELE.V..93Xo - ELEV. .. ENGINEER .. . . . DESIGN DATA o: r .c s NUMBER OF 13EDROOMS r TOTAL ESTIMATED FLOWLLONS/DAY r DOTTOM LEACt11PIG AREA p, � . ,.'SO.FT. /PIT. . SIDE LEACHING AREA . . . l�.f� ,:SO.F'L/PIT_ GARBAGE DISPOSAL . . !�Q. .�(50'/o AREA INCREASE) y�'� 60 S •✓O TOTAL LEACHING AREA .� b.,7, SO.FT � PERCOLATION RATE .4' 75 S 2, , MIN/INCH WAT ER ENCOUNTERED I LEACHING'AREA PER PERCOLATION •, SO.FT. ' .. - • RATE _ I NUMBER OF LEA C ING PITS APPROVED . . . . BOARD OF HEALTH R �• 3.�yi DATE o J . d,TZ�P�/ l..z �.(.v- ! . _ t AGENT OR INSPECTOR r' D T A ( . .. 3CZ Gf9/j 1 14AL s o a /0 fT ESN T . . . . . . ESQ/i9 ACO �6 ti✓ �✓o Tb ¢N 4 A. . . / o s. 6� Ec • Q . .CU.•�To rr. //��oYf/. �C• ��EAL�� PETITIONER . �f 40 9(2 S3. y� �J1 N �3 9z � a N N ' /s 14 I I � s3:o S�pNAL v , � AGi9.W///J 4,0 J(9 so '/?ow a J Q �F ALI wnr A T .LOT ZS (�/ /�JQ�� /G, 925-Sf SCALE : / „ yo , UPf E�CA�,E ,E"N61NEEh1Nq ,roa xvo. z� DAT,E•' / SyE,ET of