HomeMy WebLinkAbout1415 OLD POST ROAD (CT & MM) - Health y s asp A
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Town ---_OF ._Barnstable
................................ . ........... ---- . . . .
Applirtt#iott -for Dis uiial Marko Tottfitrttrtiott Vrrmit
Application is hereby made for a Permit to Construct (**) or Repair ( ) an Individual Sewage Disposal
stem at
���__..Old.._PQst___. Mills Lot 21 —Avis 24
Location-Address or Lot No.
01d Post a ng 32-Wianno...Aye.•.•.•--•0ste_rvi_11e---------------
Owner Address
...Paul.... :__Le e 1------......................................................... -- Mystic Drive 2 Ma r s t o-n-s----M-i11-s
------------
Installer Address
Type of Building Size Lot...22,_ 00-------
Sq. feet
-- -
U g— -----------------------Expansion Attic ( ) Garbage Grinder ( )
Dwelling No. of Bedrooms....-...3.._..-.._.
Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
a' Other fixtures ------------------------------ -
Desi n Flow-----------_------------------ gallons per person per day. Total daily flow....._....__300
w g g� P P P Y Y -------------------------gallons.
WSeptic Tank—Liquid capacityl.1000gallons Length---------------- Width................ Diameter..._....-..._- Depth..--------_._.
x Disposal Trench—No.kRtW99_-- Width.................... Total Length------------------.- Total leaching area..-_----...-------sq. ft.
Seepage Pit 1No.,LP_l_000-- Diameter.....1.0.._._.... Depth below inlet-----6_!-......... Total leaching area.240........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.--.-..-----------------
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-..--_----------------
---------------------------------------------- --------------------------------------------------------------------------------•---------------------------------------------------
Description of Soil---Clean-.white____�_garsesand__.�ncl---gravel____y�__________________________ _____________y____-.-._____._
x sfit_ ��9.G .6SL'k- ... .---. .` ---------�" vG C �fvfc/e/s
U ------- - --------- ----------
w C- 3� 7
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 Article XI 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 oar �oflth. /
Signed....� . ----------- --------•------------------------------•-- ..... .31.75----------
D to --
Application Approved BY------------T_.-A........................................................................... --------------- �- ------
Date
Application Disapproved for 0 following reasons------------------------------------------------------- ----------------------------------------•--------•----•--
---------------------------------------------------------------------------------•---....---•--------.....---------------•-------------------------------------------- ..................................
Date
Permit No. �--------------------------------------- Issued. �.`3 -7S
Date
___ ___----_-------------------- ----------------�I
No....... yL---=--.. Fss.,A.�G....._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........Town ......... ... .OF....B.i.i.rnstable
.............. ... .............
Appliration -for 43iipasttl Vorka Tomitrurtion Vrrluit
Application is hereby made for a Permit to Construct i�*) or Repair ( ) an Individual Sewage Disposal
System at:
---O.Ld.._P.os.t...Raad,---Mars.t.Qna---Mi11.a.......... ......L°t---#21.......'Avis---- 7 2
Location-Address or Lot No.
---O-ld...p-o-st...Laxidirlg................................................ ....32...Ntanno-_Ave_.•.x---dsteryi11e...................
Owner Address
a P.ay>ti--- -,--.Leber________________ M stic Drive Marstons Mills
-----•y' •---•----------------------------------•---
Installer Address
Type of Building Size Lot_.22.,..7QP--------Sq. feet
Dwelling—No. of Bedrooms.-----_3----------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons--.__._-._-_._--_._--__--_- Showers ( ) — Cafeteria ( )
Otherfixtures -----------------------------------------------------------------------------------------------------------------------------------------------------
w Design Flow..............................5Q--------gallons per person per day. Total daily flow............300__--------_-__------.-..gallons.
W Septic Tank—Liquid capacitvl_0-0-0_gallons Length---------------- Width---------------- Diameter................ Depth----------------
x Disposal Trench—NoXR14—QR__- Width-------------------- Total Length.................... Total leaching area...-----_-.---------sq. ft.
Seepage Pit No.LPI_QQQ.. Diameter....A-0-1-------- Depth below inlet__-_6............. Total leaching area2-4Q-------..sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date--------------------------------------
a Test Pit No. I................minutes per inch Depth of Test Pit--._-__-.___--____-- Depth to ground water--------..--..-.---.---.
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__-__.---------.-_---...
-----------------------------------------------------------•------------------------••-.......•--•-•.........................................................
0 Description of
x Soil--.0lQ_2 ]__-�bite_..caarse...s.a.n.d __and-.-glr, ave1 --
---------i--s--�--�-----t�--- --------------- --------------- ----� L, 6 C I
U -------------------------------- --.......-•---------•-------•-------•--•----•------------------•-•---•----••---•--•--�--------------
w 1. .. - %�
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 Article XI 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 bo rd hea
Signed.----.I'? •---•- ----•-----------•--•-•--------------• ----613/75.'-------
Application Approved By----- �� j 5 >
Date
Date
Application Disapproved for thre following reasons: .....................
-------------------------•---- •---------•-......----------•------•-•-----•----••-----------•---•••-•-•-----------------------•--•---------------•-----------• =-------- -•••----
Permit No------- -•-•-•-•---------•-•---•-•........•--.. Issued-•-- ,---- .®.
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...............T..Own...............OF...Barnstable
. . ............................................................
�rrtifirate of 'T"uutliarcrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed *) or Repaired ( )
by Paul T* Lebel.a...Myst o...Drives...Marstons__Mil.1s..................................................................
Instal e
Lot #21 Old Post Road, Marstons ills Avis 57/21+
at ----------- ....... -------- -
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the --
application for Disposal Works Construction Permit No--------%Z�(...:...................... dated.._......a:.:....% ` I
-----------------------•......
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS GUARANTEE THAT THE
SYSTEM WI L UNCT�N,SATISFACTORY. 00,
�
DATE----------- ----- ...----- ................... Inspector------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town..................OF...Barnstable ia. i� O
No. -��r�- FEE---•••'................
�i��g�ttl vrk� �rr��ir�trti�at ��r�tit -
Permission is hereby granted......�a u 1 T. Lebe 1
to Construct � ) or Repair ( ) an Individual Sewage Disposal System
Lot #21 Old. Post Road Avis 57/24
at No......................................................................................................................................................
Street �.�U -
as shown on the application for Disposal Works Construction Permit No..................... Dated.........................................
----------------•-------------------------------------:)7 //r 1��—n./
Board
L..... ....................................... of{Health
DATE------------�.......- � ....�_ 1J/
i
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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