HomeMy WebLinkAbout0040 CRANBERRY RIDGE ROAD - Health ��rs�s uj��1S p�� - pS� _
'LOCATION , SEWAGE PERMIT NO.
LAGS
INSTA LLER'S NAME i ADDRESS
V f
ASSI
BUILDER OR OWNER
0k,Uk: PERMIT ISSUE-6
►
DATE COMPLIANCE ISSUED
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THE COMMONWEALTH OF ASSACHUSETTS
BOARD CHEALTH
....----..... ..............OF........... ....
Appliratiou for Dispn'Fal Workfi Tonstrnr#inn Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
..- --.. EAW... ......................... 1`.�.d�.....- ••---- ......----
, j tali ss or Lot No. ��
---- `-- -- """ .. .......................... --•- -•-- ... ...........••..................... -----
._ -•-- - ..... .........
Owner dd as
a •------------------•-- ........14..*. ....L.., .�._.......... ........................ .-.•-_.----•-......_.._.--•---•--•--••-•.._...
Installer Address
Type of Building Size Lot....:.QQ ......Sq. f t
U� Dwelling—No. of Bedrooms................ ._.._..................._Expansion Attic'
( ) Garbage Grinder �
Other—Type of Building ............ No. of persons.........5.............. Showers (2) — Cafeteria ( )
dOther fixtures -----••-----------------•-----......---------.......................................................
_ _ -
W Design Flow._.........5.....�. ....... ...... a Ions per person per .day. Total daily flow....-.-.-.-...........................gallons.
y W Septic Tanl Liquid capacity-.-.-. allons Length................ Width............ Diameter.----.--_....... Depth................
Disposal Trench—No. .................... Wid .._._.....--.-._--•• Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.....)------------- Diameter....t............ Depth below inlet.....4 -----.---:.Total leaching area.... .4. gq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Result Performed b ............................a2./t.
-..Y............ Date.,..:. '..... �d -7�p
Test Pit No. 1.. ...-..minutes per inch Depth of Test .............. Depth to ground water........................
fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
.
_ ...
x Description of Soil..._._._.._..__ l� .It .....jv.-. --------------------
U ...........................................................................................................................
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 TLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been iss d y the board of�he �
AAigne .........•---..�••... ............� ------•••••. ? '? --
` Date
Application Approved By..._---- .. Ll�d ._.. a 3` r
Date
Application Disapproved for the follo ing.reasons- ---------------------`------•---------.-.----••----------•-••---------------.-------------------------:------
.............................•------------•---•-•--•......-- !/ ------------•.
Date
Permit.No............................ Issued._ .:�5�'?9_ IC
.• ,--------- . Date •..............•• ......•..
i -
No...........,'''r ��"... Fps.. ...............
THE COMMONWEALTH OF MASSACHUSETTS r
BOARD HEALTH
OF..........: ...: ................._......................................
lrl ti ri for Bispoa al Works Tnnstxnrtiun ramit
Application is hereby made,,.for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
- �
or
cati sr
Lot No
..... -• .......................... ...........................................
Owner �1d ss
......... ------- -..... .......
� Installer Address P
Type of Building E Size Lot___ `: .:...Sq. f t
Dwelling—No. of Bedrooms___. Expansion ( ) Garbage Grinder 01
aOther—Type ,of Building � ............. No. of persons.........s57---------------• Showers''(aZ ) — Cafeteria ( )
Q' Other fixtures ................................
W W person per day. Total daily flow................. tx
....._.___gallons.Design Flow _...... ,,,Paons per
anl Liquid ca aci Depth__Septic T tY . allons Length _..__ Width________________ Diameter...__ �'
I.
_..
Disposal Trench No. .................... WM .................... Total Length......... Total leaching area___....................sq.ft.-
Seepage Pit No____ ______________ Diameter ..__._.__ Depth below inlet_... _ Total leaching area___ ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Result Performed by___`:-....................
� ............. Date_
Test Pit No. '1. �'"__minutes per inch Depth of Test rt ._._.____ Depth to ground water.....................
f3, Test Pit No 2,:._,............minutes per inch Depth of Test Pit.......... Depth to ground water..,.'*....................
Y a'
Description of Soil.......... ..._- .: �.......
................ _.__...._______._______._.____........._.._ --_._.__________ -___._____._.._____..._.._._____......_..._..___
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 Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of.Compliance has been iss d y the board of h th- .
.� .
'61
Dat
Application Approved By..." -•- ---
Date
Application Disapproved for the following reasons____________________________________________________________________________________________ ___________________
................ ......•.....-•-- --- .._..----••------...------•-------•......•-•---......------•. . ---•-..__...._
Date
PermitNo.................. .................................... Issued_--•------•-----------------•----•-----------••-
'"C.�.. '-•-----
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........... ...�1�'"' .OF......... ., ...................................
%lurrtifiratr of Tomplianrr
THI 0 CE .TIF ; That th ndividuaI SA�g. posal System constructed ( or Repaired ( )
V
by-......... ►-.-r. - -----
f
at • r.. +!= ----- ---------
has been installed in accordance th the provisions of T 5 of e State Sanitary Cede as described ,,in the
application for Disposal Works Construction Permit No _ .:,:_'"'_.- - __.___. dated_ ..•__. t���- -
$...
THE "ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON RUED AS A GUARANTEE THAT THE
SYSTEA+ -W 1. FUNCTION SATISFACTORY.
C _z�
DATE.......... k Sl....... ...................................... Inspector.................... ..------------•-------....---------
THE COMMONWEALTH OF MASSACHUSETTS
i
BOARD OF:: HEALTH
0`.: .... O F......._.. .._.
r/
11.
S�* ., , ._.... ,...
No._....... ... �`.,S FEE.............................
ks Upinnn#r ion rr it a
Permission is hereby anted;_.-- • _..-•-• .-•--- ---------•-_-- -----• O( -- ...
to Cans r t ( r i ) an' Indroldual' S v age Di osal Syst �+ r 4
------St -et• `.
as shown on the application for Dispos or onstructon Perm- / __.._ ated....7`' "��.'.. f..........
.............. - nof- eall
pK BoarDATE._.. _._ ! r
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
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__- TtiUly A" l-41.��:.
TOWN OF BARNS ABLE
LOCATION SEWAGE # 7
VILLAGEA1111 ASSESSOR' MAP & LOTd347-10--f��
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY < U®
LEACHING FACILITY:(type) ` L-4-1v (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER I
DATE PERMIT ISSUED: / fZ6
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
CRAW
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4077-�
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/THECOMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Dio oottl Work,i Tomitrurtiort Vrrutit
Application is hereby made for a Permit to Construct ( ) or Repair YJ' an Individual Sewage Disposal
System at:
�_
cation•Addres sV or Lot N .
owner Addre
...pRd ............................ .. . ....................................................
Installer Address
d7Iype of Building Size Lot....................
U ............................Sq. feet
,., Dwelling—No. of Bedrooms.___.___________________________________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 capa6tyJAQ0..gallons Length---------------- Width..._..__----_-.- Diameter................ Depth................
Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.... ------ Diameter-------------------- Depth below inlet...C.............
Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water......................
fs Test Pit No. 2................minutes per inch Depth of',Test Pit.................... Depth to ground water........................
a ---------------------•------......------.---•---------------•----•--------•----------._...--•-----
Descriptionof Soil "•..-------------------------•----------------------------------------------------•-•----------•---
V
W ••-•••-----•-------------- -------- -------------�----------------------------------------------- = -- .
UNature of Repairs or Alteration —Answer when applicable.-..__ �1-� _____� .1 _e----------------f9 l .�.........
P.: .._-•.---4M eA---Z s-AA14-------------------------------------------------------------------------------------------------------------------a...........•---
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 theboard of health.
Signed .. - L.'. t'c l A?��
_ Da
Application Approved BY '' � '.
Dace
Application Disapproved for the following reasons: .................................................... ............. .................................... . . .
...................................................... ..........-----------------------------------
-------- ......------
*.....
........-I). e
Permit No. .............. ~.. ` ...... Issued ---- '"... ..�. T
Date
f
No.r�...'.�..`.''� ' r ' Fx$....................
/THECOMMONWEALTH OF MASSACHUSETTS
i
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratiou for Diripoiittl Works Tonitrnrtion Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair (110 an Individual Sewage Disposal
System at: f / -
�() CAA4)��R!� � J�./�G -I �4d /�i:5.,'C t r,,. f�%7I./ c
..............•-•-............._.........--•------•............................................ ..................................................................................................
Location \ddressf or Lot No.
1...!�1...----••...............•--•---•-........................--... ......................................................./*'r :�:.../ ..............................................
nn Owner Address
Installer Address
VType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms______ ___________________________________Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
dOther 'fixtures --------------------------------------------------------------------------------------- ---------------------------------------------------•---------
W Design Flow...............\...........................gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid"capacity_tg�?O_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 Qther Di-,trr"ibution box ( ) Dosing tank ( )
`" Percolation Test Results Performed b �1 - % 1 -� Date........................................
a y--------------------- f -;
Test Pit No. I..n............minutes per inch Depth of Test Pit.................... Depth to ground water-----------_____--___---
4, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..............._........
a r
Description of Soil!. --
-------------- ----------------------------••-•-----• --------•--------.._..----•-------••--------------•-••--••-•••-•••--•----•••-•-••-......------------.
x
U ----•-
W ---------------- .-.._.. ...------••.... ---------------------------------------......------....
U Nature of RepairsorC�Alterations—Answer when applicable._____ A�,��--_.----C A:T-. .............�_��...�_-•..........
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 health.
Signed �m = I ?......... / c'....... ��...
�- � - - �-
Application Approved By ------------ - ------ -- - z � 1 1
Date
Application Disapproved for the following reasons: ............................. ........................................
.... .......................................................................... (/ ....................................................... --------------------------------------
Z ~.. G,7 / r� F Date
Permit No. --------- .. ...................... Issued .... a,e ..�✓-..
� Dare
------- ------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(IT rtifi ate of (ITampliance
THIS-IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (,A- )
by ..........1 � r --------= ----�C , ._....--------- n tall
cl
- er ..-----------
/� �
at ..............���e1........ !'f' .C.. �/'4 {-- r a r� cC - � .............
has been installed in accordance with the provisions of'TITI.E of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ._..._.. ....."'. .... dated _.. ^" ---
the f
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE ....5 . - - l_. ,�= Inspect c.-.... �--�.----------- .. �'✓.��'� ..
------------------- -------------------------------------------- -----
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
fNo_..,............... FEE........................
�tl� ork� �unotritrti,an �rrntit
Permission is hereby granted...._'_ .......�r..__ .
-----------------------------------------•-----------...............
to Construct ( ) or Repair. (�V) an Individual Sewage Disposal System
C3 street__1) -
as shown on the application for Disposal Works Construction Per it%d:"'.. __� Dated---./..............
�J/v
DATE.. r
a `T--'r .� ..
r - Board of Health
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS