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HomeMy WebLinkAbout0197 OLD MILL ROAD - Health O(p �4c,6� ��� TOWN OF BARNSTABLE f ? M— Oil LOCATION CA fil,i I R LSEWAGE # 6C VILLAGE //�'S�Q.0 S /�/i��S ASSESSOR'S MAP & LOT;ij, '--Zk� INSTALLER'S NAME & PHONE NO.CAXI lq"101 SEPTIC TANK CAPACITY GZ41 � T LEACHING FACILITYAtype) `/ (size) /0 Q NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER C F Ali 6', 0(A DATE PERMIT ISSUED: l—] DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 / o err. J� ,s 33 d b � I� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `'",6 C 7� n ....................OF....... M_��O�J ..................................... Appliratiun for Disposal Works Tonstrur#iun Frrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: �J 1 ..'fY1i 1. .- >�r_ O�Y'(1_il lS.�'(`�-�------------------ ---------•-------•••-----....----•---•---- Location-Address or Lot o. ........�. .�. ��C................................................. ..Zen.ZeQ M _��../..� ... / ` Owner► Address a . ............................................ I aller Address Type of Building Size Lot...g;a.� ..Sq. feet U Dwelling—No. of Bedrooms.___.._.___3__________________________Expansion Attic ( ) Garbage Grinder (­-1 Other—Type of Building No. of ersons____________________________ Showers a YP g ---------------------------- P ( ) — Cafeteria ( ) Otherfixtures ------------•---------------------------------------------------------•------•----••-•. -----•-----------� . ._.. W Design Flow..............___________//��_�� gallons per person pfr jVy. Total dVily,flow.......3_t_?l.l..._____......_-...gallons. WSeptic Tank—Liquid capacity lJ.gallons Length__(O..... Widih.5___ Diameter................. Depth__,--)....!Pt x Disposal Trench—. o..................... Width.... --------- Total Length..........j......... Total leaching area ..... ____. qp Q s ft. _3 Seepage Pit No_______ ____________ iameter....../Q________ Depth below inlet---�A___...__._._ Total leaching areat�Y� Z Other Distribution box ( Dosi tank ff I J '-' Percolation Test Res It Performed by.- f .......................p Date..... Test Pit No. l� 11 minutes per inch Depth of Test Pit._l_7-_____....___ Depth to ground waterncR. . t� tL4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •- --------'----- ------------------------------------------------------------------------------------------------------------------------------------ O Description of Soil_.-: �.�1O1n W V ------••---------------•-------••• ------ ___-_------____-_--------___----------_____---------•---------------•--•-----__-------------___--------------------------... ------------- _------ 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 iITi i 5 of the State Sanitary Code—The undersigned further agrees not to place the system in oper 'o u 1 erti to of Compliance has b*issu.e.Q.by the board of health. Slgne -- -- ................ e � • ApplicationApproved By............................... - - ...... .....-------•- ---•--.• •�•. ----� .. ate Application Disapproved for the following a sons------------------•----------------------...----------------•-------------------•--------------------------_•-•-- ...............................................•------------•._...--------- --.....__..._._..---•----..._.....__...•-•-•-----•-------•------•-•----•-----------------...--------_._ --------...--- Date PermitNo......................................................... Issued•........................................................ Date THE COMMONWEALTH OF MASSA No._4?6 - 6 5,S ............J....... _ Ens ue ....... a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town—n—...................OF.......... . �r 41.E ,� r�rlirtttila i-fur iu u tt� Works. Tonstrnr#'tun Permit • /� Application is hereby made for a Permit to Construct // or Re air an Individual Sewage Disposal ( ) P ( ) g P System at •-- .... . ..- & ....... - NI / •- A Location-Address t or Lot.••o. ................................................. ....-/ v...--.....__. Owner t Address a . -•--••••••...................... ...........••-•••--.....•.. ...••••.................. (/oJ In, er Address Type of Building Size Lot_.__J�.®"�.Sq. feet U Dwelling—No. of Bedrooms..............--.3...................._.......Expansion Attic ( ) Garbage.Grinder ,a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures --------•------------------------------------------- -..................................................-• .........--•-•••-•-..........•.••-• _ WW Design Flow...............55--------------------gal lons per person per day. Total daily�flow......._ ......._._....--......gallons. W Septic Tank—Liquid capacitvky%.gallons Length.-_5.!(0.._.. Width tA Diameter_______________ Depth... >�._.�. ' x Disposal Trench—No. .................... Width..................... Total Length ... Total leaching area.....................sq. ft. Seepage Pit No------- .............. Diameter....../(�._....... Depth below inlet..:t ......._... Total leaching area,5Y?,.��1Q Z Other Distribution box ( �� Dosing tank ( ) a Percolation Test Results Performed by-,���f�1��� .1,1�\�f?_ `��__..._:._. Date_._._�.�_S�..C.� l?.L4....._.... Test Pit No. 1A���.!).,�.)minutes per inch Depth of Test Pit_.A/y------- Depth to ground waterrC-D2.(M-1f)" 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...._................... Qi _ is Description of So ......................O U --•-----------------------•... ------.-------...------------------ ------------------- ----------------- i.....................................................•-•---•..............-••--•............_ 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 TITLI 5 of the State Sanitary Code— The undersigned further agrees not to place`,the system in opera�ao�n u13t11 • Certi sate of Compliance has bee issued by the board of health. l ,tf'1 Signe ,p Q Application Approved By................... ..... . `r--�`' . ---------- at Q Q--- ._ate •�- --- Application Disapproved for the following a ons:................................................................................................................ --•-•-••------•-----------•----•-•-------...-•-•---•••--••••---•-------•_..._ ----------------------------- Date PermitNo......................................................... Issued.--------•---------•-----------....................... Date �f Y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................r..n,AfAf...OF........ ' -t ;.........................................:. `. w. ................ 1 Trr#ifirate of Tuamplittnrr THIS IS TO CERTIFY, That th Indivi4ual Se a e Disposal System-constructed --or Repaired L.X - ( ) ( ) by........................ ......................... . --.:.....-- ` Installer R_ --•-- . tip t l -J v�1 Val W--. =' has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the .application for Disposal Works Construction Permit No.•�-��. ._ `'�__�.r::-__4__...._. dated_..�_:.--.�?.___.\'�..................... _ _ THE ISSUANCE OF THIS,,CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION;SATISFACTORY. DATE..................................... ` ......................................... Inspector--•••-•-'. •-•---•--••--•-•-------•---....-•------••--•--..........--•-....... 2Z 4— -2 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF..............:........ t� `] No..... :E?.."..�is ' FEE.-.../.................. 'Diupulial o o Tunutriun permit Permission is hereby granted.............. .... ..:........L4j(AA--,T------------•---•---.--.------------•----..--.-------------•-- .--- .... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No... ....:-.--1-D ? )• Q.E.��_..►�!l.t.I�.. t ..-•-•-•----•-f=�-=� •---•-•----_.... - ..... Street as shown on the application for Disposal Works Construction Permit No. `b S( __. gated. _. . ..... ��.............. . . .... -_-� ---------------------•-------•-------•-- ' /ll n d o health BATE. -----------------------------------•------------......---------••---- I i ate. ! • _ i -------- I — - _ - - --- -- -- --- — __ -- ----- ! I /v o 7rC round ro 1/e ,� E)CTE/l/,U FALL 19 PPLlCA BLE 9 9 P f yp,e/z. SGALE • �j C T / O N VE ,e T. SCRLE . / _ /o` MAA.JA4OL E CO(/E,eS To IJ/TA4 AJ -0-0--0-o- /aroP05CCY around Pt-ofi/e 12" F er o tAJ� -- --T 4 min. %4 `parf'-t � FLOW SCHED. 40 )CIV C. O,e rn/n/mum / /ver foo t EQui9L TO SEPT/G 771 i D/ST BOX FlIC l I NIAt<k E L. ln.c- __ - --- ----- .--yi. �-'�___IZ. z / !1$ a i �: !,;?' ti' :Jr�1. �„y l _ `.' - -,- ' -- __ `" ^� .. 1`� i-70 L S - �lu"had/•7 rR' ` - /O©O GAG.. SEPT/G TANK T/�:? LEACH PI _.. - � _✓-�--+ •-,J[ �_�'.Zf� '• -"��lk...- -t. - _ s-..._ -_ - _. s C.r/ 7 L E / 1I / O ii iVFNAY `\ - - - TEST EiY• E- 2C- A2 AT& - /-7 Aj. / ,,t = Low ,2 ATE r r ii u5E-: - GAL. TAti./K `� / �� ;;••�,n -r r,�-. L E f1G"H I IVG F1�2EA � _ _ � . / �u '1i �;� .'`-� t;� C.. �, � , �>�t-=s:� r .SIDCG.Jf�LL, iFv>� � x •--�, 4�i .3 G. P.D. .�.i� �� 607TCM -V 4 Ra'Y EL � i i 1 I C E -FI F�- THAT THE BUILD//VG P�20P0$E D ON 7A4 E 45120L.1AJ DL- ` SHOWN OA-r THIS PL AAll DOC-S �^C�~' ! I COAJFO2M TO T"-4C= BUId-DIIL/G SET- So TE 5E�1q17 PL1e::� l�J -7 L .v! M<+ ..�_T = 4` BACK )2E OL)1�2C/")EtiI776 'OF THE 7'0W AJ OF ;,a . �r FO�e : �o� 37 ::'i.G ;�;', .L �.% " V?5; ��? _ 5 ?sir. ;r j+ ,✓t _ , `. P/ZE PAX2E D FO)2: ' t 1 SG,gLE. AS IIIOTED DATE:_____,...•. _. ._ .- - _ ..__-.. PLA /V (5Cr9LE _ -- V 1 E vV DA TE `.' o 0 0 e x /sf/ n y eleva.f-ion BL DG. SETBAGkL QEau/QE �'�'1F- AJTS proposed c/e va.tl o r '�k?O V E D ' _______ �r-or� t v :Y �'/ Bo�12D of /-IEALT� L(�ln� L��LL�I inc . 7/4 MAIN ST2EET - — — proposed con-four-5 5 de _ __ , MF-� S YA�2,^?OUTH POQT _ ----___- pi2oFE�SlUN1/�( Eti/6/NEER25 fr L/9AJD 5U12;/ES-'0425 `