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HomeMy WebLinkAbout0109 CEDAR TREE NECK ROAD UNIT #B - Health 109 Cedar Tree Neck Road PF A = 075-012 Marstons Mills r 7 TOWN OF BARNSTABLE 7 -j j � LOCATION A© /V"Cfr 4cl/SEWAGE #'7 4 ;VILLAGE ?a,vsdi '/iT ASSESSOR'S MAP & LOT r _ INSTALLER'S NAME & PHONE N0,0092.Gl'l L-o-�3i SEPTIC TANK CAPACITY '~ LEACHING FACILITY:(type) ��E G.9Si�j T (size) /y Z)o .� NO. OF BEDROOMS OR PUBLIC WATER BUILDER OR OWNER i /h r"Q A,) DATE PERMIT ISSUED: DATE COMPLIAN:CE ISSUED: VARIANCE GRANTED: Yes No �� ' r 3� :& AZO] No. Fxs..` .. .1..�........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Apli iration for Uiipuiial Works Tomitrnrtio rrmi# Application is hereby made for a Permit to Construct or Repair !� a' n Individual pp y ( ) p ( ) Sewage Disposal System at: 2ki................... .... .•. ... .--••--------•--•-•--------- ............ ............ Iycn-Address F or Lot No. .......................... ./ 22 y.................. ..........------G...`-y-----•----•---•-••------•----•------•.......................•----•--- Owner /" Address -----A�L ti..... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.........:v::�................ .....Expansion Attic ( ) Garbage Grinder ( ) P4 Other—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 capacitye/®®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........................................ �-.7 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (T Test Pit No. 2................minutes per inch Depth of Test Pit..._................ Depth to ground water........................ P4 -••---•---••--------•-----••••-•-•••----•--•----•-••---••----•-•.....................................•-•------------•--•-----•-----•---._......----•-•.....•. 0 Description of Soil...............................................................................-----------------------------•---------------•----------------•-•-------........_.•-•--- x v --••-•-••••--••--•-------------------•---•---•--•---•--•----•-------•------------•--------•-...-•-•-------------------•••--•----•-------••-•••-•----•------------------•---•------------••-•-----....... W -----------------------------------------•-••••-••••-••-•-•--------••--•--•----•••••••-------------------------•----•--------••------ --- ...................................... U Nature of Repairs or Alterations—rr Answer/when applicable.____?.��_..--_�___�`�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 Compliance has been issued b the bo d ealt . L Sig -... .. ��%`............................:..................'- - --.....--- . ---------�---....---.. 4161 Application Approved By ..41 ............ ,�.. -ra. - Date Application Disapproved for the following reasons: .. --_---- .............................................................. ................. ............... -- .--..g...........................................--------------.............-----------.. .-- --...........---.......................... ........... --------------- -- - --........... Permit No. ------- ..... � Issued `' � s`��,� Dale ............................. _......................_----- ---- - - Da[e .�--�.--...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH D TOWN OF BARNSTABLE Appliration for Dispnv�,' l Works Tonstrnrtinn- rrnti#- Application is hereby made for a Permit to Construct ( ) or Repair (; A�andividual Sewage Disposal System at: .....----•--.6�1 .. __... --•-•-.. ----------------------••--•----------------•--•...------- - .... at}�n-Address or Lot No. ........ .............. .. .. ...... ......................... .................—•-------..................- .---------•-•--------------............... Owner ddress Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms.__..._._ __________________________EX Expansion Attic� g— p ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------•-----.------•-------------------------- ............................................................. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity-Zm-'.?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........................................ Test Pit No. 1.................minutes per inch Depth of-Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...:�.__.._.._________... P4 ------------------------------•-----------------•--•---•--------•---•------------------..........---......................................................... 0 Description of Soil........................................................................................................................................................................ x W -------------------------------------•-----------•--•-----•--•---------•-.._.__...--•-------------•--•---•---------------------------•-------------.....*----------------------•------------------------ -----------------------------------------------------------............................................................... _ U Nat re of Repairs or Alterations—Answer when applicable._____ _.�r`_._ ---------------------------------------- ------ --------------------------------------------- --------•----•-----------------------------------•-•--------------....----..................__.....__.. 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 been issued by-the board of-Fealt Signs - - -----.---C�/` Application Approved By ......... . ....................... ~----- ------------------ -------- Da e Application Disapproved for the following reasons. /---------------------- ---------------------------------------------------------------------- -------- ----------- --------------------------------------------------- ............................................................ ................... ..........----------------------... Date PermitNo• ------------------------------------------------------------------- Issued --y-------.............-...------------.......--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Celrtt£t.cate of C ontyXtttnE THIS IS TOO CERTIFY, Thhaat- the Individual Sewage Disposal System constructed ( ) or Repaired ( �- Y------------------------- ....----- .- ......... .... ..... Int Ile `�� at ......... .G.... ............C -4..` ......................./Z L.-................................. j /1 has been installed in accordance with the provisions of TITL�pf T,h�$tat Environmental C ge a�escribeL4n/ the application for Disposal Works Construction Permit No ../.. ...�.-.--p.-..d.................. dated ...�...' .........�.. --..--- 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 - 4� TOWN OF BARNSTABLE No. -••-••��,•-•.......... FEE........................ Disposal Marks Tonstrnrjtion rrnti# Permission is hereby granted.............. _' c �'` �' ,q ......................------•-----------------------..__...------------------•--.......••---.........•-•--.......---- to Construct ( ) or Repair ( an ndividuaL Sewage Disposal System at No-----------------•-- �•-r'---• ---- C ��'l��i //LC r /t/E e- - _ ---_--- f 1 Street ��^ �' 9--' �.'/ as shown on the application for Disposal Works Construction Permit •D. � `✓ Dat _. i�Z�f ...... DATE_ ! / Board of Health / --------------•---------------•----------....--•-----._....... FORM 36508 HOBBS&WARREN,INC..PUBLISHERS