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HomeMy WebLinkAbout0150 CHUCKLES WAY - Health 150 CHUCKLES WAY Marstons Mills A 101 057 op l W OF BARNSTABLE LOCATION167 llx 5, SEWAGE VILLAGE ,�,, p Tf ASSESSOR'S MAP & LOT�i INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY /69 67 LEACHING FACILITY:(type) � ✓f (size) Z " D NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 0 0 � S r 3 La� �Y e I�t11� �� �,w` No... fx.:: ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for 14spntial Marks Tutuartulion 1hrmit Application is hereby made for a Permit to Construct (&) or Repair ( ) an Individual Sewage Disposal System( at: \AJ& 1"114+ZSj�rie S..!:!<u.5 2 ro - ....... _ __............................ ..••• ----...---••----------•-•............---------•--------••--....•--------•--------.............•--- c 'o Address ^s� � ..-or Lot N Q�,, Ow er Address a ....... .................................................. .....4 . ._......_._.._............---- ____ _ Installer� Address S 2 Type of Building Size Lot...1 ......Sq. feet Dwelling—No. of Bedrooms.........3.............•......__.........Expansion Attic ok) Garbage Grinder (k o PL4Other—T e of Building No. of persons............................ Showers Cafeteria Q' Other fixtures ............................ . W Design Flow............... .......................gallons per person pier 4�y. Total daily flow__-___-•---3-30......_ _...--......gallons. it WSeptic Tank—Liquid capacity_10 C2_gallons Length_a_— ___ Width. -_`_ ___' Diameter____'__----_---- Depth...S=8-_ x Disposal Trench—No..................... Vidth.................... Total Length......._._---._..._ Total leaching area...................sq. ft. Seepage Pit No--------1----------- Diameter.._...5......... Depth below inlet......P?.......... Total leaching area._?-G�.....sq. ft. Z Other Distribution box (Y4 Dosing tank gel `" Percolation Test Results Performed by..___`P2 kz .............................................. Date._ ��.3}._19g 1...... a 1-4 Test Pit No. 1. 2__-____minutes per inch Depth of Test Pit----)_Z......... Depth to ground water.16T E &Li&(LED �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.................. a -•-••----•---•------•-----•••-••••-••----•••-•--.......-•-••-•------•..........-•------•............................................... O Description of Soil......Q."..2`•.•... .....Z_,nA. . �:k-_k M E .�."0 ----------------••--•- x 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in ope n until a rt' tc to of Co e has been issued b he board of health. ................. .................. Dace ApplicationApproved By ------------ -- ------ --------------- ----------........................................ ---------------------------------------- l- /---..... Date Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------- ----------- ---------------------- •. / ,�/ Date Permit No. ----—ZI` ---------------------------------------------- Issued --------- !'� 1 - �.... JJ No....? � LOT �� - � � FEs........Q . ........oa THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Dtnpunal 19orks Ton,strur#tun ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: 1 2 � ►�.Z.S1Z............ cc c.5 ....-•-•--••••-------•-•.......-•-•--•.................•-----••-•--- ddressor Lot N .......... W Owner Address � Installer Address........................................... ••-• .• • UType of Building 3 Size Lot--- 51 2a-----Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (1,c) Garbage Grinder (k aa4 Other—T e of Building --___---- No. of persons............................ Showers YP g -----------------= P -(---)--- Cafeteria ( ) d Other fixtures W Design Flow..............5 ......................gallons per person per day. Total daily flow--_-----_33:330.................... G t� tt t W Septic Tank—Liquid capacity..LXY�gallons Length__ . Width.A....JO_. Diameter-_---- '____ Depth_•_- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------- ---------- Diameter.......5......... Depth below inlet......?.......... Total leaching area.. ....sq. ft. Z Other Distribution box NOS Dosing tank (qo aPercolation Test Results Performed by......ch?kJre*... . .............. Date..J�N-_3�._�91...... ' Test Pit No. 1_.Cz......minutes per inch Depth of Test Pit----i2t......... Depth to ground waterJ_pm6►cnuFAmfLED 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P4 ---------------------------•-•------•------------•-•••--------•-------•-•---------•-•....----•-••--....................................................... O Description of Soil-•------ � A''1- `�u ��4�_4.....2-_ .1...... -1_ _ .....`���..................... W U ----•---•------------------••••-------•••------•---••-------•-----------------------•-----------••------......•---------•-•-•-•---------•----•---------•----------------....------............•-•-•-•••. UW -••--•---•-•-----------------------•-------•--•-------------------------•-•-••--------------------•-------------•------------------------------•-••-------•-----------------------••--------•---------•- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in L operation until a rtificate of Co ph cn e has been issued b the board of health.�/ —� — C/7Z% Dale Application Approved By ... �� ��--------------- - ---- - ----- ------ -------...---------- ---------------------- ------------- -----./-=----y^9/------- Date ` Application Disapproved for the following reasons- ------------------------------------------------------------------ --------------- ------------- ----------.................. ` ..........................................------------------------------------- ----- ------------ -----------------------Issued ---------,�.---- -- t Date PermitNo. --- ------------------------------------ Da -1 .... te THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Gerttft ate of Tom ltttnre y I IS 0 CER IF That the Individual Sewage Disposal System constructed ( �C ) or Repaired ( ) by -aQ------------- ----------------- v r -2 Installer at =---------------------------------------- ._- 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. -...V_-^.�`............................ dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �� DATE...._..---- ,�� '.. �`. - 1------------------------------------------- Inspect r_=- . ------------ tip......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No...GJ� TOWN OF BARNSTABLE .__. ._... . FEE... tspa urkg Tunn#rurttun antit Permission is hereby granted_. --- ------ -- -----�,�:f!_`:`-� -----------------------------------------•--------------.--..------------•---•-----------.--- to Constr ct `� or Re a'r an Individu 1 Sewage Disposal S s atNo.... `��.... -------2.1---- - ----- • -- ---•-...••-------•••••-••-----------•-------------•----•-----......... Street // as shown on the application for Disposal Works Construction�it No.._%1-'-Y..... Dated ���................ � 1� r 4 - ------- -_-- .. Board of Health DATE .71 -----------.........7 36508 HOBBS h WARREN.INC..PUBLISHERS ` I or--S tc" it>AxA. �✓IL.IGl1E G. +v\lt_�( .- . 0M . p. 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