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Home My WebLink About0075 OLDE HOMESTEAD DRIVE - Health S owe VIA . bU�3� 1102 TOWN OF BARNSTABLE {� LOCATION LOA IV '�0 . 6tAt 4o► fv 9(,,(SEWAGE # q(o` VILLAGE WtkS5•12w5 `-��3 ASSESSOR'S MAP LOT 3 S Z JNSTALLER'S NAME & PHONE NO. ASEPTIC TANK CAPACITY IZJD e-Vt '0 LEACHING FACILITY:(type) ie,i P j% (size) N NO. OF BEDROOMS PRIVATE WELL O UBLIC W�AjTE a BUILDER OR OWNER_ ] _ y` i•� G®ro ,DATE PERMIT ISSUED: G %0, MR DATE .COZIPLIANCE ISSUED: c, '7 VARIANCE GRANTED: Yes No �� ;., . .�� -� ° r ASSESSORS MAP N0: PARCEL NO.: ...... l> Fps... ...... THE COMMONWEALTH OF MASSACHUSETTS BOAR®- OF HEALTH - -.0 nuft-,�----------------OF..&./.tfW1 f"G.6 .....--------------........................._..._ Allp irFatiun for UiupuuFal Works Tomitrnrtiun Frrmit Application is hereby made for a Permit to Construct ()0) or Repair ( ) an Individual Sewage Disposal System at: ..1�.��... ..Q ?..... .Bll b lt4..r...... .Ozjorlg4�.......J ......................................... Location-Address ,o t No. rtm�.a.1-------------------------------------------- I'la! f�tn.n ......................................._..... W Owner Address I tah4r Address QType of Building Size Lot---- .��.$_Q_Y-_...Sq. feet V Dwelling—No. of Bedrooms___...._..8..,..................Expansion Attic ( ) Garbage Grinder ( ) a4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures .----•-----•-•. •--•-•-•--•-... - Design Flow..............35.....................gallons per person per day. Total daily flow.__.-330......__•_...._......•.....gallons. W ,W Septic Tank—Liquid capacity.&W..gallons Length..... Width......LO.�--... Diameter________________ Depth................ x —:�?o. .................... Width...._Disposal Trench _-....._...... Total Length............i Total leaching area....................sq. ft. Seepage Pit No-------I............ Diameter.......... Depth below inlet------&.......... Total leaching area..�12....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) j aPercolation Test Results Performed by.....W-M—I------. , I,U{(,JC.-1.................... Date....._ /9/?1--__---_----_-- a Test Pit No. 1...... -------minutes per inch Depth of Test Pit-------------------- Depth to ground water_______.________--_____. PLI Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Fri .. .. .................i--•-•--._...._.........•.................•......................................................... ODescription of Soil----0 .3-j-----------TAO,-J,-56 ---•-•------------------------------------------------------------------------------------------ Ux -------------- --- -•------------••--••-•--•-•-•-----•-----••------------••-•-•......•-----•-- UW ----------------------------------------------------------------< ' 14�w -------------------------------------------------------------------------------------------------•--•--•------- Nature of Repairs or Alterations—Answer when applicable_________________________________________________________•-___-___-__--_---___--_--__-_-._-___. ---•------------------------------------•-•--- •l --------................----•---•---------------------------------------------------------------------------------.......... Agreement: The undersigned agrees to install. the aforedescribed divid al age Disposal System in accordance wit the provisions of'TIT E 5 f the State Sanitary Co e e u ed further agrees not to place the yste in operatio u i Gertificat o" mpliance has f health. OVigned..... .............. •••----••---•-•••----------------- ....................... Date— Application Approved By........................ .... ....... ... ......................... ... •-11-11 ...... ate Application Disapproved for the following reasons:----••-••-----•-••--•-••••-•••••--•----•-••----•-•--•-•-••••-••-••-------------•----•-•-•--------•......:.•-•--- ------•--•-••••........•--•---••--•--••--•---•••---•----•----•--------•••....-•----•----•-••--••••----------•--------•••---•--•--•----•-----•-------------•-•••--•-------------••---••-•--••--•-•-•----- Date Permit No....... :.... - .�....`.. Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ----------....... ................................................ Appliration for Elhipaiial Warkii Tatuitrurtion Prrutit Application is hereby made for a Permit to Construct (�O or Repair an Individual Sewage Disposal System at: ------- .... ..2re.&_n' ......................................................... Location-Address I No. .................... ............. LCA2 . . ................................................ .......................... Owner Address .......... sta r Address Type of Building Size Lot_d./ 21,".All.....Sq. feet U r Dwelling—No. of Bed,00ms----- 1311L..................Expansion Attic Garbage Grinder P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow.............5.5.......................gallons per person per day. Total daily flow.-_33.0............................gallons. 1:4 Septic Tank—Liquid capacity;&Ck..gallons Length....9........ Width.....&........ Diameter................ Depth........_...._.. Disposal Trench—No. .................... Width...-_............... Total Length.__...............__ Total leaching area....................sq. f t. Seepage Pit No------I............. Diameter......_.1i......... Depth below inlet.....(--............ Total leaching area.4 GC� .....sq. it. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---WYK1%......JjaA_j.LX'-1 L . ........................ Date....-I/ TL.................. Test Pit No. I....zL.......minutesperinch Depth of Test Pit.................... Depth to ground water..__........_......____. f14 Test Pit No. 2................minutes per inch Depth of Test Pit.___._.............. Depth to ground water--_______---___--_..--_. 9 ....I.....................................................................................................................................*------------------ 0 Description of Soil-- ............1�9.I_51�al...4"1.4------------------------------------------------------------------------------------------------ �4 1 U ................................. .............. ....�uj t:v.......................................................................................*------------ ............................................................. ------------------------------------------------------------------------------------------------------------... VNature of Repairs or Alterations—Answer when applicable................................................................................................ ............................................. ................................................................................................................................................ Agreement: CIO 11 The undersign agrees to install the aforedescribe dividual 6wage Disposal System in System wi h 1 the provisions of T ITLE 5 of the State Sanitary C .de he u, ed turther agrees not to place th syste in I'operation until a Certificate of Compliance as bee- 1 b of health. My �7 Signed... ............. . CT I .................................. ......................... .... ........ ................ D4 Application Approved By...................... ............ .... .......................... ....... ate--- ------- Application Disapproved for the following reasons:_............................................................................................................. Dat e Permit No___"�.............7_�. IssuedL........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .........OF.... ........................................... Tatifiratr of Tompliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired - ---------------------------------------------------------------------------------------------by---.....ice Installer --------- ......Web -------b.dul-0............. ..A.f .. .......... ZJAA ------ .............................. 'has been installed in accordance with the provisions of of The State Sanitary Code as desorih-ed in the 7�To. Me —" _4_0. dated-------"177 ---f........application for Disposal Works Construction Permit N ...............................7 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A I ijANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............L.-I..:nllc? ................................ Inspector--- ------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... ...... .................OF.....13et1.)A,0.tA.A ........................................ FEEf ................... Disposal Workii T.1111notrudivit ranfit Permission is hereby grante��.... ..=Pt.77...#_77'_.I.r.,_tJ 9�....... ....................................................... to Construct �d ) or Rep it an Individual Sewage/ System at -I- r) ,.,U* te-0.....................................................................................No.".t..30......0. ...RM."lp-/ tf ...a. -1. Sueet Lo. Dated.._.... 3!as shown on the application for Disposal Works Construction Permit N;�.Z:r��_rtr7j .............. .. .................... ........... :r,------ Board of Health ..............IT)ATE.C.&��_ I C).I---m" -� FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS j LA. C-/�..� Ti�l''tJl�/� '3"� DY.UO►�'l S o e- mil.hx_i �I Fr'...�, I`� �tc..�{��oVJ}�s 3��1D - � 330 Gov 5 t-tr•~�':.+ 'r`_.:�F• � ,. �J E7t1 '33o X l SCo:/o - 495 C�S'iJ USC O I Ilk 1 - P_TF_R SULLIVAN �15?OSAc1-- fT "�. .lJSL ; 1 OC7C� �A►.l•_Ut�l Igo. 29733 t! �✓' I-PEWAL.t-. / EA 115cO -s F ,opOF��Ia°,�� 37S %IAFD CA t�AC,I`C`t So 5 r t✓ 1.0 G./5 r=- 5 O �-r t71� � ,��.,B `T'OTt�f 17 �j!Grl.�ll ; ! �ZS�•r'17 r ¢(`/['�` �`� . � , �f �CF R/•tl� � �> ?A L rrr m, ► ►_l F Not--- , , �� T I-ilJl. S-�-6(? 1 1 F'� spa i-• : AL - _ .. �•� �.S�(m 1t� Z i �� i F ILL w � L.�t-}>'i�1 l�J�!-•ac. SANt:, li l.. I . < r M c,kkaPi(J 6u►+F t'I SUB 1000 GAL CIO.E, .,, '' : . . .. 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