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Home My WebLink About0075 FOXGLOVE ROAD - Health "t S F(jxgt oVe o �'d TOWN OF BARNSTABLE LOCATION /�CJ� � SEWAGE # VILLAGE ASSESSOR'S MAP & LOT ��I INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY /jL/)�q LEACHING FACILITY:(type) /00 (size) NO. OF BEDROOMS PRIVAT ELL OR PUBLIC WATER l® BUILDER OR OWNER /� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No a—� ��° �� — b , . lg C l 1 Co rnMOrva iy �IQea f N }11e� P MORO No. --l,N Fmc.............................. THE COMMONWEALTH OF MASSACHUSETTS ON BOAR® OF HEALTH .....---....OF. y ApplirFaiion for Disposal Marks Tanstrnrtion ramit Application is hereby made for a Permit to Construct (' or Repair ( ) an Individual Sewage Disposal Sys — / .. .......... — -- -........ t-----....... .••••----• .. ... ................. . ••• Location-Address or Lo,04 ---------------•-....__. ............................................................... ................. .................................... Owner Adiress�/ a ---•----.--•.............- lT:......--•-----•---•---_•___-----•----•-- -•-••--•----- .�Le:i!� _• -=4_f-rG..r .................. Installer Address d Type of Building/ Size Lot '-'__ _Sq. feet U Dwelling No. of Bedrooms_ --------------------------------Expansion Attic ( ) Garbage Grinder ( ) PL4Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures --------------- --------------------------•------ - W Design Flow........lleP-----.__.._.-------------gallons per person per day. Total daily flow__ 1.1----•.-_---------------gallons. WSeptic Tank lztiquid capacity/4P*4_0.gallons Length................ Width................ Diameter-----........... Depth................ x Disposal Trench—No..................... Width.................... Total Length_................. Total leaching area.._�•;_-�4:.;..sq. ft. Seepage Pit No------/------------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (,—I' Dosing tank ( ) '" Percolation Test Results Performed by�'t�� !/... �. .0 y ' Date....__27 ._.___. a P Test Pit No. 1______ ________minutes per inch Depth of Test Pit---/,?......... Depth to ground water,A/1..__._�.__. Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+' --••.................•-•---••--------•-------•---••-•-_...- - ---•------•----•-............_._.......--• ---•----•----_._ ....._...•---__---- O Description of Soil....... -`._._ ....... �, -�-_ �9aoR. -----------••-----------------------------------------------------------------------------------------------------------------------------------------------------------•--------------------------_.... 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 TIT= 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complian has b n s ed by e o rd of health. Signed .G—� --------------•--•••-•••••-•-_... ate Application Approved By. ....... --•-•--••---••------- ------ -- - - - --------"ate- -------•-- Applica.tion Disapprov 'for f or ` e following re ons: • ----- . • ••--------•---•--•-•--------•----••---••---• -•---- -•--•---•-••---•----•------------•••- Date PermitNo......................................................... Issued........................................................ Date No...X......... Fps........................... • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A"p iration for Disposal larks Tonstrur#uan "Trani# Application is hereby made for a Permit to Construct p or Repair ( ) an Individual Sewage Disposal System at: a. Location_Address or Lot No.ri•. .... ----•--•-•-•••-•••-•---— W Owner V Address a ••-•----•................. ..........._...........__.................. Installer _ Address ? /- n S U Type of Building!l, Size Lot_��:�f__. _Y:_.___ q. feet Dwelling dNo. of Bedrooms_ _________________________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) 0.1 Other fixtures ---------- --------------------------------------•••- d -- ... W Design Flow_______;!'_________________________gallons per person per day. Total daily flow-,.:� 2......................_:._gallons. WSeptic Tank 'I_igmd capacity <^ ; !._gallons Length................ Width...... _._._::_ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length..___.__._________._ Total.leaching area__Z ...sq. ft. Seepage Pit No-----/------------- Diameter.................... Depth below inlet.................... Total leaching'area..................sq. ft. z Other Distribution box �, -3- Dosing tank ( ) '-' Percolation Test Results Performed by,!'� a / ` i1 Date fry` ..... ,.a Test Pit No. 1.... _.___minutes per inch Depth of Test Pit.. 2_'_.___._ Dept to ground water•r i;--_ �••--. f= Test Pit No. 2................minutes pernch Depth of Test Pit.-/.. ............ Depth to ground water........................ a ------------------------------ -----------------_-----•-------•---••......••...... -----------_------•- ..... O Description of Soil r ' = ---••- .r.--- =' ......... ,71 ........- U _______..-Y -- ' C� _--(•�! __________________________________________________________________ W VNature 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 issued by the board of health. +� Signed....................................==------------------...---------------•-•--••----- .....-.................... ------ a Date Application Approved By'a�_v.:_................. . -: ----------- jai Application Disappr . ed f the following r ons.. 1 ---- ------------------------ - , ---.................................... ...-........................................................................--•--•�'- -.-....- - r�+°�+�_...-------•--•-------••--- ..--- .............................................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... vErrtifiratr of TomVIianr TIS' TO CERTIFY, That the Individual Sewage Disposal System constructe�a..--)-or Repaired ( ) by-•-,:Pef"OZ�fl?.&�1171:f! ..............•--•---•••••••=••••--•••-•-•••-•...----.......-•----•-••----•-•-•••••••••.......•---••••...._..--•----••-..............•-•....._......•-••••........•••- �' --.•..............' Installer at.. r a� tCrzza -•-------------------------------------------........................................................ has been installed in accordance ith the provisions r f TITLE 5 of The State Sanitary Code as described in the i '16 application for Disposal Work onstruction Permi ._._. , .................... 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 / ...........................................OF............................................................._....................... No • .............. _ _ Es........................ (1 Eiapps"a1rk� �nairUan Trani Permis ion is hereby granted - f1 Ac;l--------------- to Cons ruct ( ) or Repairs( )� an 14 In 'viduafiwSewage Disposal System Y...� � / at No. .................. G r treet as shown on the application for Disposal Vor s Construction-ermit No..................... Dated........................................... : .......................................................•._....................................__ Board of Health DATE............................ FORM 1255 A. M. SULKIN, INC., BOSTON A y .S/.✓GG 6 F��y/ter -,�.��o,evo��J �-_ f __ `s� ' q✓G. �.V/L Y r-max/=.3.�r�io =..3.�o G P.� � �- � ,� O/S•�O.S.�C.- ,o�7' •IJSE" /aUo G, ,k/- O T7-O � � 7�9 S�-. X U•�� = G S. G.vo. 0 7OT.4L-IJ a771:W ,Niv. oe I . • _ � sus v � l� CF WILLFAM o DAVID FC. 7 C THULIN v N Y E Pi u No. 29976 ti No. 19334 0 �� •p 41V/L- �O 2-6 N 1F �' F�lst�� r .O,ep� ,�✓c� 0 Cgq,U 3T V�rO� fsSION \ I . SUS• T. I I I 7 I. s . F G• .�9 /`- / Z. / 0.4w /x/vl Q��' S? 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