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Home My WebLink About0128 CAMMETT WAY - Health 99)..,00? Marstons Mills 'i (-� ✓ ST r �f�Dv- Li �Pd✓'bvw� � �r y t�•.� GZoO� C� ��' CAM Orr oy, M,M/Zjs �� - U 4)ev► TD l�eloui 00 q �-7 vo' OWN OF BARNSTABLEf LOCATION aNMt l iK '-4- 41n �uo 11 !SEWAGE #8 ((t�q�VILLAGE Mdu 5 i S �L; (I S ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY ! MrU QrL LEACHING FACILITY:(type) l (size) 1 Q"O"Z� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATERQ�b BUILDER OR OWNER i C� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No L _-_ �:� _ ,.. ,�S_ � � G ., � �� 3� ,. �� } I � � �- a� �__ r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH CD 1,4j .IX....................OF... .............................. Appliration for Uiipusal Works Tnnotrnrtinn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Sys at . 1 1(l!5.. .�.-- 1 of """"'" 1`��A -!.a� _...... ��.. ................ Locati n- dress or Lot No. W � ,/� �,fawn Address Installer Address Type of Building Size Lot..vc).�A,010_.___..Sq. f et U Dwelling—No. of Bedrooms__` ___________________________________Expansion Attic ®1 Garbage Grinder Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fix res ............................ W Design Flow..........15 ..........................gallons per person per d'py. Total daily flow__._5.�..........................gallons. WSeptic Tank—Liquid capacity..lUMgallons Length.V .�._. Width.A10. Diameter____. Depth......__. x Disposal Trench—No....... ....... Width ............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No,........I.....___._ Diameter- e......... Depth below inlet............... Total leaching area ....sq. ft. Z Other Distribution box Do ' tank Percolation Test Results Performed by" --- I ---! C �_--Date. `5----------- a a Test Pit No. 1.�..�_.._._minutes per inch Depth of test Pit__�s�_._...._... Depth to ground water'AA. .v' .f1�1.� 1, f= Test Pit No. 2.4Z----_-_minutes per inch Depth of Test Pit---1,3............ Depth to ground water--_-_-t. - .L O ................................ ....... .... .................................. .i..... ........___•• Description of Soil �_�_�... ►�.. ,.- 4a _ ......----- x " .r � .1?------------------------- -------------------------------------------------------------- U ..........................................................-------------•------------•-----------•--------•--•---------------------•--...---------------------------------------------•--...-•-..._..... 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 iITu*: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signe . ......= % ................................ ---------------••-•-•----------- DVat, t -Application Approved By--��~ .... -------- ---•-•------------ -- ��.�. Application Disapproved for the following reasons---------------------------------------------------------------•----------------------------•---------------..... ...............................•-•-------...-----......--•--•----------------------------...........---..._.....--•------•-•-------------------------------------------------------------------......--- Date Permit No.. -•-.._..._;....... Issued........................ ---------•--------------------- Date � _ LL �� LA No...._l1...S':� �y ARs.s�....o.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH W fa ........................... Appliration for Biip.ao al Works Tnni#ratrtion Prrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Sys at: ..... ► �ri .i. : ...... , 4 25y S.Au Ls ------------------ .`....�� ......................................................... Locatir-Adlress or. Lot No. r / h....... 1 Z _il.J.411................. ......................................... Qwn Address W - '6V�li Ji Installer Address UType of Building Size Lot..+ci. Q�......Sq. f t Dwelling—No. of Bedrooms___ •----------------------------------Expansion Attic ( Garbage Grinder ( p aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other�fi�res ------------------------------------•----------------.....------------------------------------......;...--------------------•-•-------...........•.. W Design Flow.......... .� ..............................gallons per person per day. Total daily flow----=-�.........................gallons. Septic Tank—Liquid capacit ...it(gallons Length._ .(V_._ Width._44�(?Diameter.:'"?�..... Depth... Disposal Trench—No.------)0�....... WidthA ............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........I........... Diameter...... ..........Dept below inlet......... ...... Total leaching area..a3. -----sq. ft. Z Other Distribution box .5;5 Do,' ar Percolation Test Results Performed by.. ..... ....I. ................ Date.. ? 1.4 Test Pit No. 1.4Z_._._.minutes per inch Depth of Test Pit--- ........... Depth to ground water ___— I (T, Test Pit No. 2.��'......._minutes per inch Depth of Test Pit...i3--_-____-- Depth to ground water--__ LJ-TGVZ- � .............................................. -•...... Description of S^•oiil------Q l C � �.+.`'I""�(?_._- �-= -""�'.� ?�, �� . . (� - .............. ........... ........5,�!..:. -a`---•-•---•-----•----------•----•----.......-•-------••---........-•----•-----•-•-•-•-•---•----- 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 TIT1, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Date Application Approved B ��Z1ar -�I� / .._.....--•----------•--- Date Application Disapproved for the following reasons:.............................................................................................................. .........................................••---•----...--•-------•-•-•-•---------.._...__.......-•--------•------•---------.....--••-----•••-----------•-•••---•--------•••--•--•---•---•----••-•-------. Date Permit No._.��.�..:..1��::-•F-•----------------------- Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Tntifirttte of TnntpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.. -s%1-fjmCD tiJ / g at....L 0 b / �:' .In to�� s/ ^/;/ /w E'f-"J),/ /0711 has been installed in accordance with the provisions of TITI�5 he State Sanitary Code as descri ed in the application for Disposal Works Construction Permit �'o.-� '..__.�o �. ._..._.__ dated_-.....1 _1- -3 �' •---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............OF.......`� .. 5........................._......................... 'WRojuv al ork,,sA 'Tnn#.rnr�ion rrmit Permission is hereby granted.........`_...---ft�r�'lj.......................................................................................................... , to Construct ( or Repair ( ) an Individual Sewage.Di osal System 2 .1-•/` /-, .................................................. �r Street j as shown on the application for Disposal Works Construction Permit Noc-..5 __11t4e1 Dated.......................................... ---..................... Board of Health DATE.. -•--•_... .. ..1 FORM 1255 HOHBS & WARREN. PNC., LISHERS i 0E51G-N DP�Tj-\ SING-LE FAM1t,� 140. oc)' lo3;7 No GAtZ13AG•E GtzlN DC1Z "_� \ rpz�C, OA11-Y FloW = 110 x 3 - 330 G.P. v. 1 1 --f-�9 SEPTIC TANK. = 330 ri iso7o ` .49S. G.P• D• ��s�1ii TFMC USE 10O0 GAL. TAK IV... 1914005,` /21 C ►+�-y y 1S oS v S E W t 000 GAL, ,� 1��. , � Q Si DCWAL - A 2EA 'SQ S. 3 7.5' Cr:P. 0. 13olToM ACLEA = o ;< 1 ter? .L 35' /03, / �� 103.3 $b S.F. x 1. 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