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HomeMy WebLinkAbout0081 CAMMETT ROAD - Health 81 Cammett Road A = 079-026 Marstons Mills y TOWN OF BARNSTABLE tA it �t,� LOCATION I CCt VM M -e. SEWAGE # r VILLAGE `NS , ASSESSOR'S MAP Cz LOTQ'�Q a� INSTALLER'S NAME PHONE NO SEPTIC TANK CAPACITY 1000 -t;;=A`, LEACHING FACILITY:(type) I (size) , NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER WEROROWNER `S DATE PERMIT ISSUED: & 0. l. — DATE COMPLIANCE ISSUED: 3av,3 - t C -,+ 1 Q VARIANCE GRANTED: Yes No �j�ra�F � Z a c _ s��� ��� a�' M � `� ' a 39' 5� v7q No... Qa�iC •- 06 FL � -O`t� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Diipuial Work,i Tunitrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair Individual Sewage Disposal jSeomn at �D -------•-------••---•----•-.-•-......------ -P oc 'on- ess /' or Lot�. "`!`O-S-- ---------- L Ylllllkl.�' r US..0 . + .: - PAC, - Address Iustallar 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 ( ) dOther 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ------------------- •. ---•-•-----------••--------•----••---••----•----•••--••-----------•-•-••----•---•-•-••-------------••--•----.............----•----- 0 Description of Soil........ __ U ---------------------------------------------------••----------- {-------------------------------------------------------------•------------------------------ ----------- •-------... W ------•----•-----------------•------------ .....................................................-------------------------- -------- U Nature of Repairs or terations—Answer wen plica �a.►'-s..�.__.I.______ . .�. _..._ ,5 .`. ------------ -------------- ---�-...Ce_%5 -4a6S-------------- 5. ......-- � : �____:_� I-.00Q..-s. ...:�_._�� 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 Comp ' n has been issued by the board of health. Signed ........ ..C .. ,• .��� -5^ Date Application Approved BY - - ... ' 11_- 4•- ---- ---- ------------------ L.^.L7 ------------------...---'------------' Dare ,� A lication Disa.....roved...orthe...ollowin....rearonr...... J.`_-!.`.7-- =Ui PP PP f g _Dare Permit No. ... ...-... .�_......... e............ ........ Issued .................�.- L.^7.---- Dac i F-y4 Q L� 6 ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di- phial Wor1w Cnnnilrnr#iun f anti# Application is hereby made for a Permit to Construct ( ) or Repair (400*)40'an Individual Sewage Disposal System at A rLo Slim-Address or Lot ! + r l V .......... .... ?; . r _ .........•....._ .lamvl�l.o_-f .....20. ..r.... wner - ess Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling— No. of Bedrooms.........------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) al 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.-..-.--_..___-____. Depth to ground water........................ a .--••- ••------------------------------••..........•---•-•----•-•-•-•-•-•--.....-----------.....•••....-•••-••---••-•------•••-••--........................ D Description of Soil........_.. ._..... l--. .--------•-----------•-----...--•--...------••-•----•---. W ---•--------- ------------------------------------- ........ 0 Nature of Repairs or terations—Answer when atpplicabJej�:___. .. _..._ 1�ci..�.... _..___ ..F.�.,_._....__..�' 4 , s_h. .. 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 Complians has been issued by the board of health. Q Signed ! _ Ml- Al- ----------- ' Dace Application Approved By ................. � . .- ................................................... Dare Application Disapproved for the ollowing reasons- ----------------------------------------------------------------------------------------------------------------------------------- -------------- -----------------------------------...........----- --...------------ -- ...------------- - --------------------------................................._..-..............._........... ------ Date Permit No. _....7_5---- yl Issued .............._F/..,e' �. ... "----------- Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifi ate of Compliance I4S IS TO C RTIFY, That the Individua Sewage Disposal System constructed ( ) or Repaired ((,�` brn.. ............. �- ... ........ ---- -------------------------.......... y.... F ... at --- ------- .. 1--------------- - k--� -.1,n .. `--- (s---------------------------- .............. has been instal ed 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-: ..... (---------------- dated -------------__------------------_------.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE - ----------- - Inspector- - ... .............. .............. .L -� � ------ ------------------------------ ----_---------------------�------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / TOWN OF BARNSTABLE ,s © No..�,f.n...�i FEE.. .��� Dinpnnitj Works� Tons udibin f rrntfl / ll ��------. ............... Permission is hereby granted_..( C 14-_`...1` -..___......_,._._,__ to Construct ) or Repait�( an Individual Sewage Di . osal System f r at No...__..... � 1 . �!'''z fan `s- ---------------� . .---------- ------- .=--l ..........................S..-.. Street A„t as shown on the application for Disposal Works Construction Permit No.&K.'1- -� Dated -- .------t---------/------------- --- V Board of Health ------ - ------ DATE......�---"""=--�--�---�-�--c�--�- r FORM 36508 HOBBS&WARREN.INC..PUBLISHERS