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Home My WebLink About0046 CAMMETT WAY - Health � �S�o t� S 1/Ll + � �' -S egg - aab C f TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE � �-rS c�� ' 11 �"s ASSES`SOR'S MAP & LOT_ INSTALLER'S NAME & PHONE NO. is kkli�-�� ' C, SEPTIC TANK CAPACITY A ' _ • . F -- L�� s LEACHING FACILI.TYAYPO v� /��> (size) _ NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER .BUILDER OR OWNER (Os''' DATE PERMIT ISSUED, DATE COZIPLIANC b ISSUED . '�- VARIANCE GRANTED:-YeS��',' No V �� '. . . � ' ,. ,. . � � 'i ,.�- �� . � � � � ,, �i / � i *, �" i .� ` ,.� ,- � � � ,_ .� -e, �. 9 �- �` AAA ?,',.�. � ��: , - Y^x � � y� \.. i �.�� No..V=30:6••- FRs......11.0).......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........................ ................O F.........................................------..._..............._......---......------•. Applira#ion for Disposal Works Tonvtrurtiura 11nmit Application is hereby made for a Permit to Construct ( ) or Repair K--�an Individual Sewage Disposal System at: - ...----C�.,..... .... T �-�..s.................... ........ ........................................... -------------- --- .............--- ) ��cation•Ad ess / or Lot No. S . /.�,� •...................•.......... ..... // ��7diid,S.......!�/.. .............. ......................— - 7 t. weer Address a4d........� .!!3r'4"7........................•--•--........---•- ------------------------------•-•--•------------------•---------------------•--•--•-------•--•-•-- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling.—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............. No. of persons_......._...__........_.__.. Showers — Cafeteria Q' Other fixtures .-----•-•----------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity j'®...-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. 1..........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........................ ---•---------------------------------------------------------- -•---•--------------------------••--•......................................................... ODescription of Soil..................................................._.................................................................................................................... x U •-••-••-••---••••••------••-------•-•-•-•---•--•---•••-•--••-•-••-••••••-•--•--•-•-•-•---•-•-••-----.....•------•------•••••-------••---•-•------•-----•••------••••-••-•-•-•--•-••--••......-----•..... W -•--••-------------------- -------------••--•------•-------------------------------------••-••---•-•---•-------r------------ ----- -- ..........-••-•,-33-_..... U Nature of Repairs or Alterations—Answer when applicable__e^''.:. A._ ........................................ ._ _ _ l_....� d ---------------------•------.........._..--•---......----.-•-••--•---------•----._........-----•--•---•-•--•---------------------------------------------------------------------------...•---.._..-•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL,I, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ` ued by the board of h. sig •---- Date Application Approved By............... ...... ...----•---�'--D t`i Application Disapproved for the following reasons---------------••----------------------------------•--------------------------------------------------........-- ...................................................... ..•---•---•-•-----••••---•••-•-----•-----•----••----••-•-•-•--•••-•••--•----•-------------------------------------•------•---•••----•---...._..-- Date PermitNo......................................................... Issued....................................................... Date 2.c).......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............................:............OF......................................---------•------•--................................ Appliraiiou for Disposal Works Toustrurtiou Prrutit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal S st at Jr / 51ca n-A ress /"- j�iif t No. J ................• -�--••--•----•-•••-•. ......=S-...--........----------------.. ......... ..•............----------............_....-•----•------- .............................. Owner Address a ............L G.�........ _®ti•.ST... . ....................................................... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ...................................................... W Design Flow.......................................•...gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacit/.��'p•gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench— 4 .................... 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. 1................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 ••••-•------••••-••--------------•---•._....•••••-•••••---••--•...------•-•-----•---------------.............•-••-----••••••••••--•-•-•...................... ODescription of Soil.................................................---••-----•---••-•-------------------------------------------•---------------------------------------............._.. x U •--••-••-----•------•--••-•--•---•--•-•------------•-•-•-------•--•---•--•----•---•••-----------------------•--••-----.........--•-•--•--•••----•.................................................... W ------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable.. ^'. _T. ..l........................9 .....� ''....°�....................................� o ---------------------------------------------------------------------------------------••--•-•----•-----...-•------•-•----------•-•-•••--•-•••-•••-•---•--•----•-••......,--•-------•-.............•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beeg_issued by the board ofkedth. ......... tc Application Approved By.............. - '" ` a ! $ �� --•--•....................•-------. Date Application Disapproved for the following reasons-----------------------•-------------------------------------------------------------------•-••-•--•------------- ••-•---------------------------------••-........._..-•-•--•--...••••-----••-••._.............•------••---I---•-•-•----•---•--•-•-------------•-•••••---•----------•--•....•----••----------••----•------. Date PermitNo.......................................................... Issued_............................................---------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD,! OF HEALTH �..,C .. '............OF...-�' !' w�.. `.``.!............................................ I.T11rdifiratr of ToutpliFattre THIS is . RRTIF, That the Individual Sewage Disposal System constructed ( ) or Repaired has been installed in accordance with the provisions of T1*T7 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-------?49"_......p..5_......... dated------------------------_----_--_-_-__--_____-- THE ISSUANCE OVTHIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT TIME SYSTEM WILL FUNCTION''SA FACTORY. DATE........ .� "�._=� :_. r ..5. 1.7..... Inspector............... ---•----------------------------------•-•--•--•---- THE COMMONWEALTH OF MASSACHUSETTS BOAR :�DF HEALTH ..................... ............... : FEE. ................. DisposalArks �uttu#rudivat Vprrmit �-��.... , ermission is hereby granted. .................................... to Construct_ or $.epair ) an Individual dew ge isposal Syst ` r�' ' v/ at No. �.. r'1 7? y _i ---- •-••----------------------•----...........-•--------._....--------.....-----._.....-Street•--------............��--------•---•---------.._................-----•--.... . : �f x as shown on the application for Disposal Works Construction Permit NoV*3 Dated.......................................... C� Q� ..........................--•-.... --- ----•••-•-.................................................... V / a ..................................... Board of Health DATE--------•---------•---�---.....':....... � �- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ''v