HomeMy WebLinkAbout0086 CARDINAL LANE - Health g� CA-✓cz Lzi 0 e
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TOWN OF BARNSTABLE
LOCATION SEWAGE # : —:3 C lO
( �0
VILLAGE S �I�l l�\�; ASSESSOR'S -MAP & LOT ✓a
INSTALLER'S NAME PHONE NO. V 'L.- �✓
SEPTIC TANK CAPACITY_ -eK 15
LEACHING FACILITY:(type) 1" y�'� � (size)
NO. OF BEDROOMS G PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER '"
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes r No
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No.............;'1�1�0�ED O Fins.....................�r-
ftf fVaUOh0epartMOI HE COMMONWEALTH OF MASSACHUSETTS
OAR® OF HEALTH
5�1 Date TOWN OF BARNSTABLE
Ap-phration for Diripw3al Works Cnvastrurtion Famit
Application is hereby made for a Permit to Construct ( ) or Repair (Vn Individual Sewage Disposal
System at:
Location- �ddress or L.ot No.
C .............................................................
(a Owner '- Ad
`
... �•----•........................... ...... _._.. ...... ... ('
.........
Ins Iler Address d Type of Building Size Lot............................Sq. feet
V Dwelling No. of Bedrooms.__3-------_•___________________________Expansion Attic Garbage Grinder
aOther—Type 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 capacity------------gallons Length---------------- Width---------------- Diameter................ Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No—..../........... Diameter./6----------- Depth below inlet__4! .. ........... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by........................................... ----•-------------------••--•- Date........................................
aTest 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........................
�+' •---••-----•----•-.....-•--•----•--••-•----------•-----------•-•------•------------------------••---.........................................................
ODescription of Soil........................................................................................................................................................................
W
V .....••--......•--••---•-----•••.......................•••--------•-•--••--•-•---••••----•....------•--•--•--••-••---•-••--•----•-----•-•----••-•-••-••...-••-•-•••••--------•------•-------------.......
W ............................................................--------------------------------------------------------------------- .-------•-----•------
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U Nature of Repairs or Alterations—Answer when applicable----------L _ __..� _ ,f_ ._j - � �,�'"�.�..........
!" -------------------------•------------------•-•--•--------
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 Compliance has be tv the b and ealth. y
Signed . .................................. '" .(.`1. ...
Daze
Application Approved ........ 9 C...... �.... .. ................. ..........................
Dare
Application Disapproved for the following reasons: .......................... .............................................. .. ..............................................
............................................................................. ................... .. ......... .-- ........--� . . . ........................................
U� Dace
Permit No. I. '..RJR.... ........... Issued .... �.77-. C,�. .1�............._-
Dare
./r- ,�..1 �_�...� �.r--...�-_-.�-....i...r.._L��� .� . •. .,.-.-.d... ..�_....+..�-x.:.--...r..,_..a,... .....__./c,�:;+l,..b%,r/t,i]>.../�.,t,.....-.,...�.....-r-•-'r��•j1��"-, '^,. .+ -"..-.-wn+rry
No....�. .... O Fxs... J D....f�' ,
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THE COMMONWEALTH OF MASSACHUSETTS
Ak_�'L_-L� a')-S9(y BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Ui ip vial Work,q ( omitrnrtion famit
Application is hereby made for a Permit to Construct ( ) or Repair (Zan Individual Sewage Disposal
System at:
Location-Address or Lot No.
4� -- /yi;/��
Owner Address
...
Itrstaller Address r .
US Type of Building Size Lot........................... q. feet
.� Dwelling— No. of Bedrooms----_5---------------------------------___Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
al Other fixtures ._.-.--.._______-___________._ _
d ---------------------------------------------------- ----------------- •-------
•--.-•----
W Design Flow..........._''.`e .................gallons per person per day. Total daily flow.. z?�' .____..._._._..._..._..._..gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width----------...... Diameter---------------- Depth................
x Disposal Trench—No. .................... Width...... ............. .rotal Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No.......1............ 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........................
f%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 ------------------------------------------------------......................................................................................................
0 Description of Soil........................................................................................................................................................................
W
U -••-----••-------------••-•-----------......._............------------------------•-----....•-----------•••-•--------------------------------•-•----------------••-••-----••---.....-••---------------••
W
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U Nature of Repairs or Alterations—Answer when applicable----------10---- _------------r �::
.....................-_-_.- k� < -//„ e ``t d'f ( �./ ..............................................................
Agreement: - I
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 Compliance has beewissued-b_y the board of health.
Signed
..............
� ` ..............
- - ............... . e7`-�7...`....
...
.... .. ... 1APPhcation Approved G ....... J --------------------------------------------------
Dale Application Disapproved for the following reasonr: ...................................................................
................. ............................................................ . ................................................... .. . . . ...--.................................... ............. .--...-.--............
Dare
Permit No. -. ,�...'.....�.............................. Issued ..... _.. 7
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certift.ctt#e of Gntyliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by ...... ......................._...._.(:: r1 1.4C J�IGc_Q. z- ,.d ......._.... ......... .....................................................
r' � � Ins%lller
.......,._�...-
at .............................. . ... .......��tv` ...l!` :� c th-� ------------------.._----------- ------------................ . ............
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. -.- dated '�. ..:-....��'1�
PP Pf.. ..._. .- ..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE"CONSTRUE A AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............6... 7 . -.-----
...-..... Inspec or- ..._ .._._..... �!�/t�=
f
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE --�
No.�l�......_..-�. FEE.✓ ..
RaVviittl Workii Tunitrurtuan prmit
Permission is hereby granted............. (! ?'... .�I i .,�� _ ' --......•.-,:.--•--------------------------------------------------
to Construct ( ) or Repair ) an Individual Sewage Disposal Systeml
/n /"
at No........ ------......•--•-- . t �. , __l., . -,1 --- ?:: ..................................
Street
as shown on the application for Disposal Works Construction Permit 1 C._ 1`.. Dated...._ ..........................
DATE----`•-----=-^-- -7f7---- ....................... Board of Health
FORM 36508 HOBBS a WARREN.INC..PUBLISHERS
FizB
THE COMMONWEALTH OF MASSACHUSETTS
0(� BOARD F HEALTH
Y�.......OF.... g.. ---- ..-------------------------------
Appliratiou for Bigpniial Worko Towi rnrtion rrnti/Diposal
Application is hereby made for a Permit to Construct (�or Repair ( ) an Individual Se
System at* ,
........�44 G a
l ((C
I y� I I �
bf
...................
\ Loc - ddr ss or t No.
: �....�� _�.. ... ... �cl(R?- --------------------------------------------
Ow. r Address
W
� Installer � Address
d Type of Building Size Lot............................Sq. feet
V Dwelling—No. of Bedrooms.............. . Expansion Attic (tom Garbage Grinder (�
----------------------- —
`� Other—Type of BuildingNo. of persons...... Showers Cafeteria
Ga Other fixtures -------------------------------- -
W Design Flow............................................gallons per person per day. Total daily flow.............. ...........gallons.
WSeptic Tank—Liquid capacity.i.OQ.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 (vj Dosing tank ( ) I I
~' Percolation Test Results Performed by.._b,,, _.....0 &. ------------------- Date... ...............
aTest Pit No. 1...... ......minutes per inch Depth of Test Pit------15CO----- Depth to ground water........................
(i Test Pit No. 2.......�....minut per inc D th of Test Pit......1�? `.�... Depth to ground water........................
(e �r� t .�._. ---•?�- � �......................................................................
® Description of Soil.....
,.3 ._11......v... ..5". _ ----------
------------------------------------
W ••••-•----••-----------------------•---------------...-•----------------------..-•---•----------••••---•-----------------------•--------------------•-------•••--------••-......------------------....
UNature 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 iITI YU� 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issu,� the oard of health.
Sigd- ---••- -------•--•---•-------------- .... ........a................
Application Approved By....• -jam - 7'`_7 :'....
Ar=� Date
Application Disapproved for the following reasons:................................................................................................................
..................•---••...•--•-•----•---•--•---------••----------•••-•-•----••---•--------------------••---...---------•-•------•----••---•---•......-•••---•--•-
Date
= Permit No......................................................... Issued... .::./ _. 7 74f •.
Date
No,(-,)1w
THE COMMONWEALTH orMASsAoxussTrs
U����� ��K� ��
��==""" "�° " " "��4
---'�r�~'---'".......- -v '--�--`-'�-`---r...............................
� �� ~�
^~~n-n----~------ �*°
---- -- --'v------ Works -- -- -'---'' '' p, ' ' '-'- �
Application is hereby made for a Permit to Construct L~� or Repair an Individual Sewage Disposal
System at�4
A ..>&.t........... ................�)061 J . .................. .......................
Address
IEstaller Address
Dwelling—No. of Bedrooms--- ---------------Expansion Attic
Z Other Distribution box osm
~~ Percolation Test �eao�o ��r8�oz�db� �����\�?�-.�������.���� ' ' .- Uute-������-�-l..------
O
ke
_-'_----.-'-_-'----__'-_-------__---- _.- �
'--'_----_---.-_------_.-_--_._____--'-_.----_'_-
U Nature of Repairs or Alterations--Answer when -_'--.__.-----_.-'-'______r.__._____..
.......................................................................................................................................................................................................
'`,'__'--'.
' The undersigned agrees to install the uforcdcucri6ol Individual Sewage Disposal System in accordance with
, the provisions ofTIIL LE 5 of the State Sanitary Codc-- The undersigned further agrees not to place the system in
operation uzdd u Certificate of health.
---------' ----------'--'---
z�ool�xt�o� Dy' ~^'�� f ~ -'�[����'����.���-�--
^^ '-'�'-'-- -'�-r'----'--�'--��- .--'-- � Date
Application Disapproved for the following reasons:................................................ --..........................................................
--
...................................................................................................................................................-', '----_-__''.---__-
� ~ Date
~ Perzoit Nn..........�............................................. Ia000d'...........................Date
............................
�*s �ommo��s��r* op w�ee�oxussTTs -�
' ,
B.~' �'D OE HEALT
Tntifiratr UL
TH IS TO C R Vat the Odivid walx- ispfal System constructed (4501'0�r Repaired
has been installed m ^
application for Disposa'l Works Construction Permit N.......
THE ISSUANCE OFTHIS CERTIFICATE SHALLnwOo mE «°ONSxRwE �
SYSTEM nn�u�o� n FUNCTION SATISFACTORY.
^
�
DAtE.......... .......7.,,j'e........................... Inspector....../ ......... ... �
THE COMMONWEALTH orMAsSwo*uSsrTs * �
�
��� �
BOARD
---'JL' ---��F-�- ----'---.-��___
FEE
No ..
-
M �
'
to Construct' .
~at No. ' - - ' s�,� '
�
°" shown `n the application for" Disposal Works Construc4on ~ '
'
- - J
Board of u=u*»� '
ronm /zss xoaeswWARREN, INC., puousxEny
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TEsr f 000 C,
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RESULTS
PE,e T"OY./�/
7 7
3 ,
TO LJ/V l /F� T E R c 7- V/ / L p 8 L_ E
6E7 L319CK 1EEQ U/ 12 EI`7E/,/7-S
F /2 0ti7- S/D i 2E� 2 f
D2 / vEL /-is" ti/ 07- TO /3 E ac -?TED
O (/C /Iz:� SE 2,/EA-2 /-:�C' E Sy,5TE U/`/ FL
I-/-20 DES / C-Al L0 /9D /A-/G
SEP ;C S >-'STEM Co�vsr,euCT/ O �ti pE/�COL �-7i/ O�! TEST
/e/"I 7-O /"I,� S S. E/V '✓/'� O A//'-I E/J 77/9
CODE Q D /97-E.D T(JLY / /977 6A-1D 7OIVAIOF 2ESULTS < A-l1 , / / ,U( y
7"' A-4,E L7-/ 2EGULF� 7 / O/VS'. S/4--.L cLEV. To 8C- � ~- F7 F�(301iF 2D_
% P / C' Q jL PR. OF / ,L E Z
frY Fo UNDHT/oN •�J�'�� /V O
MANHoL.E eovEg To ExTEND To To p9EVENT FINES
IA/lTH/N l' OF F//t//SHED GRHDE
24"WOVE eS 20 D/ST ` / + �y / l�i�IS//ED 5.70NE
/ I COV��
q CAST f $OX `/ "W/��f�L C /'�),eO UND
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i; /`7/N — � MiN �e�
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t✓�T7j,9 , TIG NT� IA/VERT- n �I,� III !07✓
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OA/ PL.. /4?A/ 2 E C O2 D E D /Al THE 8/q/en/- �4 n� '01S ,
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STi913LE" C 0 u T'y DEEDS /A/
�102 f SEPTIC 7r9 /`/K Tv 8E .
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I 9eo�c� e Coco c' o. T/ oN � ,�� � c,� 0N TITS .
L E,—'2 0 H /N G 7-S TO 73 E /9 I-II A/-
,S
Z CE/eT / y T"NAT T/-/ E f . ; '' � • CEQ E : L / NES /9ND SEPT/ C -7'F� lUIC
S N o W n/ Off/ TH /S P L.F� N / S LOW, A � O' F /2 O /`-I F O U/\,J D /9 T-/O/v.
ON T HE G 2 O L/AJ D E S S,HO 1✓N f/EAE CEO�/
— — — — — —
D A T E 7- °T E
cr 7 O THE T.3 U / �,- DING . SE7T`8,--)0'
M E ti/TS O F TH L 7 O IV N / - i✓,5 `i" s+ ,
D HT E 2E G. �JT�P/eOVED T
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