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Home My WebLink About0076 OLDE HOMESTEAD DRIVE - Health 76 O1de-Homestead Drive Marstons Mills A= 043-052-001 TOWN OF BARNSTABLE L� LOCATION L®/ ( c ®r/� bAtIP SEWAGE # 6 C) fAO 31- VILLAGE ASSESSOR'S MAP LOT . /j�L .INSTALLER'S NAME & PHONE NO.�VLDA SEPTIC TANK CAPACITY / 4 LEACHING FACILITY:(MO / (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER rR,.11,.,.-c 6--A:L� G DATE PERMIT ISSUED: G-W DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No I_ r - r S7-R r ASSESSSOR,S MAR NO: cif fil- =d- PARCEL NO.: 40e� Fmc...75_0.0........ , THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH LTH ---------. �jZt,X�1-.........OF...... ,i. Lt�d.[7'�- ............................................... firFa#iun for Dispati al Works Tonstrudion Prrutit Application is hereby made for a Permit to Construct or Repair ( } an Individual Sewage Disposal System at: L D ............. - na..... - -- Location-Add re or Lot No. Owner Address ............. .... •-• --- ............... . .................................. Installer Address Type of Building Size Lot__/$;,.q7()---------Sq. feet U Dwelling—No. of Bedrooms.... ....._.._... .Expansion Attic ( ) Garbage Grinder ( } U Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ------------------------------•. . W Design Flow............,.'5........................gallons per person per day. Total dail7 flow........330.........................gallons. Ra Septic Tank—Liquid capacity./OOD.gallons Length....V......... Width....IP........ Diameter________________ Depth................ xDisposal Trench—No. .................... Width_...!.......__._... Total Length......... Total leaching area....................sq. ft. Seepage Pit No.......1------------ Diameter....__....__.-__- Depth below inlet...4.............. Total leaching area..,a6Q....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---1,J_M.%...._iA)dA d.X_ �........................ Date......S,l fib__-•..._._--_-- aTest Pit No. 1......X.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--____-_----__:-----___- w ..... --------•-........................................................................................................................... Description of Soil----Oj-V ---------�..OAM....9...s�K (L..--••----------......................................---.................................... x - x ............................................................ka w4 -----------------------------------------------..----- U Nature of Repairs or Alterations—A er when applicable.............................................................. ................................. Agreement The undersigned agrees install. t a ored c ib n iv u wage isposal System in accordance with the provisions of i i:l:a. }of the State anitary Coe he ed further agrees not to place the s tem operation until a Certificate of Compliance has bee ed b o of health. •-/� Si --• . ............... ..... ............... ..... ......................... L. .�.......... - Dat Application Approved By.......................: ...... ........ --- ---------------------------------------- Date Application Disapproved for the following reasons--------------------------------•-----------------•-- ---•--------------------------------•-------------....... --•-•--•-•-------------------•------.......--•---------------.....---•--•--••-----------------------------•-•----------------•----•----•-------•••------•-•-----------------------••------------------ �'y Date (jJ� I ss u • ROW V 113-5� .d THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------Tv_-t`�.............OF..... .xL� iLt.G -----•----------......................... ApplirFa#iun for Mipos al Works Ton.strurtiun Prrutit Application is hereby made for a Permit to Construct SIe ) or Repair ( ) an Individual Sewage Disposal System at: , .hod..../.�1_...L 11�! ? 1sc la .afr ..................................................... Location-Address (( or Lot NT.. Owner Addre ss ----- � Ins•a.:er Address d Type of Building Size Lot_l�_1_7 __.._..._..Sq. feet U DwellingNo. of Bedrooms___. -_ �! _._..Ex Expansion Attic — _____________________ p ( ) Garbage Grinder ( ) A4 Other—Type of Building ............................ No. of persons......._.................... Showers ( ) — Cafeteria ( ) G I Other fixtures ----------•-•-- •-•------------ . W Design Flow............5.5..........................gallons per person per day. Total daily flow------- .3.0..........................gallons. 1:4 Septic Tank—Liquid ca.pacity&616�U..gallons Length.-IF........... Width...0..._....... Diameter________________ Depth................ Disposal Trench—NTo. .................... Width..._............... Total Length........ Total leaching area--------------------sq. ft. Seepage Pit No------I------------- Diameter......g_.._....... Depth below inlet.k..........._._. Total leaching area.d.eX......sq. ft: Z Other Distribution box ( ) Dosing tank ( )a Percolation Test Results Performed by._LJ.6n.:...... .......................... Date.....:fIA196................ a Test Pit No. 1_.._L-------minutes per inch Depth of Test Pit.................... Depth to ground water_-__-----.--_-_--- --. G_, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------------ ---------------------------------------------------•-----------------------•----•------•--------------••-•------------------•----- O Description of Soil Qr ��............/sr'ev..aa..--t..... -•--•-------------------------------------------------------------------------------------•-•---- x y lam. (� VW --------------------------------------------------------- --•------------...---------------------------------------------•------------------•---------------------•-----...-- Nature of Repairs or Alterations— er when applicable............................................................................................... ------ --------------------••----••-....----------------•------- ---- ................... .. ......... ; -- --- . -- ------ . ---- Agreement: The undersigned agree sta e aforedes i In i d a ewage isposal System in accordance with 'TILE the provisions of 1� 5 of the Stat Sanitary C The u ' r 1 ned further agrees not to pla/thee 1-11, operation until a Certificate of Compliance has bee ' ued by r of health.. ... •---• -•--• .............•------------- � �. Application Approved By---•---+-•- •--_ .... ............ ........ Date Application Disapproved for the following reasons--------------------------------------------------------•----------------------------...-------•---------•-•--•-. .............................................................................................-•-•� .._...._.. -------------------------••---•----------•------------------Date-------------- Permit No.- ... ----------------- ~_...<.. " Issued....................................................... Date 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............lGZv.i................OF....13a,1.).1D:f:aA,_ ,e............................................. Trrtif irFa#r of Tuutph atta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constr c.Yed ()G ) or Repaired ( } taller at. _t....-� .t! C.-1.7 f �.. Chl ---•---- .hest- ---_------i ��& 1;n.... t 1-- ? -------------------•---•------------ has been installed in accordance with the provisions of T I T E j of The State S Code/as d cr'I) d in the application for Disposal Works Construction Permit �To e� --------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... / THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAjL�TH rd Q ,.?U..........0 F.......64 .l.•fF- .h- Q ..... � Biapos al WorkiiChun ratr#iun pruti Permission is hereby granted-•-•K .t`{.t_ ....... i k4.----------------------------------------------- f • •-• . ..................... to Construct (,t ) or Re air ( ) an Individual Sewage Disposal System at \'o..- _.._�?l 1J� ' A.t��l�t ...... ................................ --- ---.......................... Street --Ir as shown on the application for Disposal Works Construction 2aesomit __ a d_.T�7__ .__- t........... I n Board of Health FORN 1255 HOBBS 11 WARREN, INC., PUBLISHERS AA 7 PEER oN J U L•( �(o, \9�,Co a SJL #tAN. x L c C STE , rp BAMA �Na 24090 1 ti 0 7s . Al w 7 �? 6 �20POg � v `� I � i ,� . �v✓�atl.r�J.AG� j �, f / C' '00A �4 r 9� UME:r.TeAD ' + ; . > N�k2STbKAS ��+ iI F, A?rL, \\ , 7aX i , '4�a= IO•X 10 TO THE �1 �I�,�.�c►..rC. 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