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Home My WebLink About0053 CHIPPINGSTONE ROAD - Health 53 Chippingstone Road v - Marstons Mills _' � A 027 036� �I ASSF-SUR'S MAP N0. ; PARCEL Q 1!�, Li41tRT10N S [ A L PERMET MO. iT L A G E. I T LLER'S NAME ADDRESS 0 U t L 0 E R 0R OWN ER DATE C0MPLIANC. E ISSUEQW /2 t. i �. r , - �. 1,� �.. 1 ,; L��/ ', i f3� �� 1. � i � y�� 1�' � �� w ASSESSORS MAP ND;_ n U60 PARCEL N0: Fx$... .... �.: �. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town. OF..........Barnstable ............ . . . . ................................••---•---•-------- App irFation for Uispvii al Works Tomitrnrtion amit Application is hereby made for a Permit to Construct ( ) or Repair (X)o an Individual Sewage Disposal System at: ---- 53 Chippingstone Road M&M ..... _............................•---•------•-----------•-----••-----•------------- •-•••-.........----•-----•---••----•--•----•-------...------------•-------•----•--------------•••. Location-Address or Lot No. ..... Qh11...D—eigil D-eigilaM.......................................................... .........................................................................................._..... Owner Address l...P._ria�omber----------------------------------------------------------- -------------------------------------••--•------------ Installer Address Type of Building Size Lot............................Sq. feet V DwellinW-X-No. of Bedrooms.•.•---..-.-•.3----------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Pa Other fixtures -----•--•-------------------------••-••...... w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid'capacity............gallons Length................ Width................ Diameter.--------.------ Depth---------------- 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-..---------.--__......- (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------------------------•------------------------------------.....................------------......-------------------------••-•-••------...--•---...---- 0 Description of Soil-------------5alld...&c-_G am2I--.............-•----....-------------------------------------------•------------------------------------------------- x U ..••---------•--•-•-......----•-------------- ........ w U Nature of Repairs or Alterations—Answer when applicable---------------------------------------------------------------------•--------------------•---- 1-1000 Pit -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage. Disposal System in accordance with the provisions of TITT L ;of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued e bo rd of heal Signe ...... �:.. . ----------------•--• ----- 8 Application Approved BY Dat e �c. .......,...a--z.,-------------------------- Da Date ' Application Disapproved for the following reasons--------------------------------------------------------------------------------------•-••-••--•-......----....._ ----------------------------•------------------------------.............---------......---------------------•---•..............-•---•--•-------•--•-•••-••-----••-------••-----•--•----•-•--••-•----.--- Date Permit No..... .7.- f -_.._. Issued....................................................... Date a: ,No.. 7_.: �L1 -- Fss..f....2 ..00.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...__Town ..................._OF.........Barn .................................................................. ApplirFatinn for Diiipos al Works Tonstrn.rtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair Q(X) an Individual Sewage Disposal System at: 53 Chippingstone Roach M$M ............................................•--•--••--........._....---•••-•...................... .......---••-----...•--....._.......-•----•-•---..............----•-........_.........-•••--...... Location-Address or Lot No. --------•----••------•--•-•-•--------------------•--------- ...............-•-•-•---•---•--------......----------•---- Owner Address J..-Ra1�1aicamber........................................................... ..•---......_................... installer Address Type of Building Size Lot............................Sq. feet V DwellingX-No. of Bedrooms.............3---•----_---_---•---.______-•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. 1:4 Septic Tank—Liquid capacity............gallons Length................,Width................ Diameter---------------- Depth................ 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........................................ 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........................ a -------------------------------------------- •------------------------------- -... ------------- ---------------------------------------------------------------- D Description of Soil.........._Sand...&. GI av'e3 x V .-----------------•-•----•--•----•-••--•-••-•--•----------•------•-•••-----••....•••--•-•--...------..........__......---._.....•----•••••----•--•-•---•-•-•--...-•------------------••-----••-•---••-•-- W -----•-----------------------------•-•-•--•---•---•----•-----------•--------------------••-•-----•------•--•-•--••--------------••••------•------------------•--------------------•-----•--•-----•-•---- VNature of Repairs or Alterations—Answer when applicable-------------------------------------------------------------------------------------- 1-1000 Pit -•-----------------------------------------•----------------------------------------..............------.....-------------------------------------------------------------------------------•--•-----••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI..;; 7 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has;Zb.en uedy Zell, rd of hea Sign = ' = ` � .�.��"✓ �!f// 1!---------------------- - ------ Application Approved'BY / � Date Date---••-•-•------••---------• --•--•------•---•-------------••----•--- Application Disapproved for the following reasons---------------••----....--------------------------------------------------------••---------•--•------......-•-- -•--•-...-•--••••---...--•-••------•-•--...--•--•-••-•--•-•---------------•------.....--•-•-•-------...-•---•-•-•........--•----•-••-----•••----•--------------•--•------••---••-•-----•------••----••-. Date PermitNo..... ........................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........Tovn...................0F......Barnstable ..........................................•-•--- (InfifiraU of Tout phattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (' ,) or Repaired gX) by---3-a P- Ma omber---•---•------------------------•--------------•--•-•---------•-------------------•-•--•-----•------------------------------------•------------•--------------- Installer at.....53 Chipping Stoup Road M&M . •-••-•••-•-••._.._._...-••---•••-•--•------••-•.........-•••-•••---•••----...--•-•-••-----•--••---••-•-----•......--•-•-----•••... has been installed in accordance with the provisions of T1 TI. j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----- ........... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................f ` --- .. ................... Inspector...................... --•-••------------•----------........---•----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable $ 20.00 No......................... FEE........................ Disposal Works Tnnstrnrtinn amit Permission is hereby granted.. J.PMacomber - ................................................................................................................................... to Construct ( ) pr Repair M an Individual Sewage Disposal System at No53 Chipping -5yone• Road M&M • ------------------•--...---------.-•--•-•---------------••••-------•--•--•-•----••--------••----------------••••---•..._......... Street as shown on the application for Disposal Works Construction Permit No Dated.......................................... t -------•-----•------- DATE............... -•'.... - _-'------------------------ Board of Health �--`-�' �--�-"•�-7 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS l0 CAT ION SEW GE PERMIT NO. VtL AGE IN 4,T L 'S NAlAE & AD-DRESS BUILDER OR OWNER Akl aea DATE PERMIT ISS-UED DATE C0MIPLIANCE ISSUED ��,�" � �. F_�.,,..�,�. Aa . _ � _.. 77� i ., ��,,� �, ' �. � �� - � S . �� i