The URL can be used to link to this page

Home My WebLink About0219 OLDE HOMESTEAD DRIVE - Health a- lG o Me- c�.C3 p61(U� i �i s S M E A D No.2-153LY UPC 12934 smead.com - Made In USA SLBMRIME FPORESM WMARVE Certlfied FiherSourctng DreD=LwY Ad TOWN OF BARNSTABLE � 4 " 'S��, LOCATION �4+ �� O� �+MeS �cgc� �C,i,g SEWAGE # -7 V VILLAGE Mnt 0`15 ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. `j , � �J6�SGd�I ��l /(AlI SEPTIC TANK CAPACITY 040 ys+�otis `LEACHING FACILITY:(type) a�� Q� (size) �y00 e tjews \3NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATE BUILDER OR OWNER GC P7 +4 Ins (_o DATE PERMIT ISSUED: Oc+d�ec id, DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No o_ A s; i ASSESSORS MAP NO: • No. ... PARCEL NO.: 00 7-1.uO:0- THE COMMONWEALTH OF MASSACHUS TTS BOAR® OF HEALTH .. 101 flitX✓-.-.--......OF......6dlJto'1.Q2i Applirutiun for Disposal Works Tonotrnrtiun Prrmit Application is hereby made for a Permit to Construct (0) or Repair ( ) an Individual Sewage Disposal System at: Z ..jut...&.2...0.1jab....11.dYr!V'eA.Aaj...&U jz..... .... ............................................ Location-Address .o t No. I�.fY1! W---.---•-----•------"-----------------------•-•--•---- .�"a n o_...._�... .............................................. Owner Address aK„@ i ,►rl..... I -•""""""". ........ .... Installer Address Type of Building Size Lot..f-lo,.` ,M.........Sq. feet Dwelling—No. of Bedrooms.........3..A5%P .................Expansion Attic ( ) Garbage Grinder ( ) 4 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ............................ W Design Flow............6i5........................gallons per person per day. Total daill flow-------5.330-.........................gallons. 9 Septic Tank—Liquid capacity.I.MD.gallons Length.....8_e_...... Width.....(a........ Diameter---------------- Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------j------------ Diameter........e.-I--..... Depth below inlet.......6!....... Total leaching area..cV.0......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) // / aPercolation Test Results Performed by-----.ls.�-M ...... .............. Date._vi Ab......•.......... a Test Pit No. 1......J.......minutes per inch Depth of Test Pit.................... Depth to ground water............--.......... f3, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.---_---.-.---..------. ............... --••-_....-"- .�"----"--"----•-"-- -_------- - ........................................................... O Description of Soil.�____Q__�B�)_,�___�_t� tt, �.r �__sd... 1 --------------------------------------------------------- VW ....------=•-•......................•---•---•-•. -----------""----""-"----"-"•"-""----------------------""----""--"--""--------"-"-----"-"---•---------"""""--"""--"""-"". Nature of Repairs or Alterations—Answer when applicable..---.•----------------------------------------------------------------------------•---••------ -•---•--•--•-•••--.......---•---•--•....................................•-.•-•-----.............•••--•-••---._.....-•---•------•----•--•--••---...................................................... Agreement: The undersigned agrees to install the aforedescribed ividual S age Disposal System in accordan--e with the pro ' ions Of 5 of the State Sanitary Co e e u er ' d " rther agrees not to place t syste in o ati until a C cat Compliance has been ss e y r o iealth. Signed..... ............... •--• . ............. .... ..................... - Date Application Approved By....._.....-• ..-- -- •------ ....... • ..... . ..... .................. -----' 31 Da e Application Disapproved for the follow re ons:--- ---••..................................................•----•--•---------••••---............_......•--•••--- :"" -- -•....•-----....---•-----•-•-----•-------•----•-----•---•••-•----....---•--•----•--------------••--------•--•---- Date Permit No....!1.0..... ........ Issued....................••---•-----•----- Date r tom., i 1�� •' -' N ..... .... ..... e— THE COMMONWEALTH OF MASSACHUSETTS �D BOARD OF HEALTH ------..7—ef-u iY:t�..------..OF..... r'�d./�t i - �C A App iratiou for M-4p sal Works Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct (O or Repair ( ) an Individual Sewage Disposal System at: -------------------------------------------- ) Local. an-Address rOLot No. -�h�'s.(C' l ..............•------•----------..... `1 r l'-�•---._��t Its ........ owner Address } -------------------------•-------------- , r .� 1: Q......------------. .... ------------------------------ installer Address Type of Building Size Lot f k°t_121...__._....Sq. feet Dwelling—No. of Bedrooms........3....31J....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures ............................................ WDesign Flow.........._55..........................gallons per person per day. Total daily flow......,..3_0......_..................._gallons. 9 Septic Tank—Liquid capacityr't U...gallons Length.... ._...... Width....?........_ Diameter................ Depth................ Disposal Trench—No..................... Width....._._.....__..... Total Length............•....... Total leaching area_-_-----______------sq. ft. Seepage Pit No...___/______________ Diameter.._....S...___.._. Depth below inlet..... .t........ Total leaching area_:2.-6..._...sq. ft. z Other Distribution box ( ) Dosing tank ( ) / '-' Percolation Test Results Performed by....L_J_l>)_ ........ZL!A.e?lA�4.C1E�...._._.....•-.• Date.: h.1 1-�s ^................... Test Pit No. I....j=_.__...minutes per inch Depth of Test Pit.................... Depth to ground water-----------_............ �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_--.-.___.._•---_______ M ;---•---•--------------------•---•••----...------• ---•-----•-----••.....--•-.--•- • ......................................................... ODescription of Soil?'--3---..r_.-(cp. `1 - �t .f t ...................................- --- --------- --------------------------------- x A�_IC,--/_t,i " -----------------•.W ---------------------------------- - ------------------------------------------------------------------------•---••.•----- U Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ ............................................ Agreement: The undersigned agrees to install the aforedescribej4dividuai Wa e Disposal System in accordance with ppsions of 1, of the State Sanitary Coe e uide i ned 'urther agrees not to place e syst in until a ticate- Compliance has been is by, k d health. Signed-•---- ---------••------- ••-•-•----- ..--•--•••--•••---•-•----•- . ... ...... ---•--......... Daton Approved By f -----� --- D to T�ry Application Disapproved for the f ollo ' g r asons-.............................................----------------•-------------------------------------------•---- •-•----•-----------•------------••-•----...•-•--•••-•---•----...-•--•--•--•------------•---••---•----•••--•-----•-----------•--•- -------------------------------------------------------------- Date PermitNo..............................---•-................. Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .T-rkA:1 .................OA .............................................. Trdifiratr of f omplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed �Q) or Repaired ( } Installer at_ l.? __.:: .�... o 1.� ._t �;ZArl. bAi i-�...•••------•..1"1 2%� f 1� .......................................... has been instaited in accordance with the provisions of 11a"2. j OTT State Sanitary Code as described in the application for Disposal Works Construction Permit No.._._ �"�� .._... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AGUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. r ' DATE........................,.J.k.:.9-j-------•-------•••-••---...... Inspector.................................-•---•--- ........................... j THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........77az•texas............OF........133t2A4-.0-A.h.6..................................... %S NQ......................... FEE nrk� ��an��rnnr#Uan rrmif Permission is hereby granted- •---••--••--•-•----••-•-------••--------•---•---------------•---•-••-------..... .... to Construct C )`or Re air ( ) an IndividualI ear, ge!Disposal System at '_T o. .....3.1..... _. ......c.Z---IT."L:�.!)�1� ...�✓�.r4-•1 f P• 1 lf��T t�`��T!./�?...... .-•. Street .0.6_7.��/� ted. as shown on the application for Disposal Works Construction Permit Q-"" (l v -•��..................................... DATE.(] 11 ec ( ... �BOard of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS I ti 10 ff - , {r' rRl '�IFN fi � hM �-• `S �bo _ �I '$IAF=. r oco �E�L`�T'p�tJ�1C; ''33O iX 1 StO/a = -Q95 Cat'iJ T h-PK PETER ,. t U �15�05 � "` ,U6F_ )OOC� GAU•_O►_X �:( � .,M%,AF_ Al No 29733 H l✓'i��clA:l.:l-- f-�X->rA 150 -5'F % pp((s. GA t�AC. 50 5 r G� 1.0 C./5 t- 50 h��o A.t 1,`C �.�'E�1 be��r<:�G1�l.�T 1��..Jt�ia'T1�. .'c'' f•�; �•_l 1%�2 I U f_t�. �_�, �1 �I<�T ROL 'SAC YLI�A(., j 1 cl 6s Nd1�7. w �7.Zil,o' vt-:� i7 7t b I000 -17� F� rr? -- - I --- cam -Tr,4 v i►av: ` 711 p�tjl I LL /fir � • Nopo fat. _ �, vj i al'l 1 VJ4Sti•l.6 t7 �1 �� M 6�hL �s No�,b :t7JU�; 5'cOtAl 03110 � _ I zoPoSEz� �� V✓M,Wa�wtc.K KXL N:x-Ee (t\e $ACC VEQ L1125M IA75 Z:�FTR E -rc>wij Cr I�3h V1.E FQp 1S 1JCSt' ' ) 41_1"f_=' X,__> I i ;�•� tnf�'�- -�-',, �'�VE S t 'FL00'7 uo r -- 1cie.- j.�_: VZS"i -13 t,. 4 i �rotlunxv' I �— KEf1EEE�k E?2E!• C( ' { 1 I -3 T f`139L ' GLTe Al - `" `/04, LU 0010 cz 0 How NVAII ins la SQ' rsb�, JQ �1tid 7 Y''� _ � 7Z1t�► I � rx