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Home My WebLink About0151 ROSELAND TERRACE - Health l� t ��-t�-�v� ��- Y - - �� ,�615'1 ®t /� �,F ` >2� LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME i ADDRESS JOHN A. AALTO BACKHOE SERVICE 359 Walnit Street West Barnstable, Mass. 0266`3 B U I'L DE R OR OWNER 74,ow ?— -ew )Fr/Y'9 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED i i d No. g ................... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH a....---.....O F.. .....fl g;;�.?(z. ........................ Appliration for UWpoaFal Works Tnnitrur$iun JIrrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ?.....` ... .,� !!!, .. .l..�,:- ' S rdrrl, '... .G. ..................................... atio -/A'd{Tre s ,,�/y)� /^1orr t/�JNo�. _ .................. .....+4/. :..iL. i...:.5.. '.......................... ��'�''f� ,cam /� y—� �,,�f....._ /� ! `_ a .......1.1.!... ... /T. e7L.V.................................. lr.=•.� !.�. L.5�� ................... Installer Address Q Type of Building, Size Lot .�,�d _.-Sq. feet DwellingANo. of Bedrooms...a..................................Expansion Attic �(/� Garbage Grinder �C o `4 04 Other—Type of BuildingNo. of persons-- Showers — Cafeteria Other fixtures ------------------------------ -- . W Design Flow.......-/A..........................gallons per person per day. Total daily flow------ ®........................gallons. WSeptic Tank—Liquid*capacity .gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width. _�......_._.__. Total Length.................... Total leaching area..__.._....... ....sq. ft. Depth below inlet....:..._...._.. Total leaching area ..-._ ._.....s ft. Seepage Pit No.___.�_____________ Diameter....... :__; p g � q. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by............................................... .. .. Date........................................ aTest Pit No. 1----AA......minutes per inch Depth of Test Pit---Ica---------- Depth to ground water....0................ Test Pit No. 2................minutes per inch Depth of Test Pit__.___----_.____-_-- Depth to ground water........................ W' --•- •--•-•-•-••------•----•-••••••---------•--------•----------------------------------------------------------------------•-................--- O Description of Soil.. Q�N1 V-aS'fY ...- , 5 �L/f �r--.`�r.... cx., ,�.? -`---------------------------- ---•-•-•----......-----•--•---•-----------•-•-------------•----------•-----•-•------•--�-----••. x ---------------------------------------------------------------------------------------------------------------------------------------------------------------••-•--------•--------------------------- 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 iI'l11Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issued by he bo o health. a s, )S Sig ---- . ............•r...-• `-�°..-------------- d..... ' Date , Application Approved By.........�••• -----•-- .... .. ........................ ....... Date Application Disapproved for the following reasons-.............................................................................................................. ---------------------------------------------------------------------------•-----•------•-----------...--•-----•-••-•--•--•••---•--•-...----••----•------•----------•---------•--...------•••••--------- Date PermitNo......................................................... Issued....................................................... Date A16 ............ Fps... ............... THE COMMONWEALTH OF MASSACHUSETTS B0ARQ,,0F HEALTH .71---- ........... ........................... Aliptiration for Uhipasal Norkg TouBtrurtion Vamit Applicat.ionls hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: r..40...RAW AANQ......7"EAR i I.0 V ...ZVLI�.................................6 p L....& 7W ....... ........... ................... ..... ....t e ........................................... ................... Installer Address feet Type of B ild*n Size Loto Sq. v/ U DwelZin No. of Bedrooms._:.43...................................Expansi n Attic Garbage Grinder Other—Type of Buildin No. of persons__ ..................... Showers Cafeteria 4. 1'.Building_:-------------------------- Othufixture's..f....................................................................................................J�. .................................... < 1 4 Design Flow:______. _.1l4............ -gallons per person per day'. Total daily flow................ .........................gallons. W Septic Tank-Liquid capacity F --gallons Length________________ Width.._.__.____.____ Diameter__._____________ Depth__-________.___. Disposal Trench—No_ ____________________ Width ....... Total Length.................... Total leaching area__.__._._ . Sq ft Depth below inlet___..__________. Total leaching area��q.*ft.'Seepage Pit No....)--------------- Diameter._._._..._.__. Z Other Distribution box Dosing tank Percolation Test.Results Performed by.......................................... ...... ....... .Date__________.___ 4 1 ...*----------Test Pit' No. I......at.....minutes per inch Depth of Test Pit---142 Depth to ground water....4............... Test Pit No. 2......... minutes per inch Depth of Test Pit._____.__._________. Depth to ground water._.__-_________:_.______ ....................... ......... 0 Descripytiqq o Soil? --------------- --------- -------- -1-- ----------0..... .......I.;... y. ....... T .� .. ............ ..... ........ ......YA........................................................................................................................................ U ..........:........................................................................................................................ ..................................................................... U Nature of Repairs or Alterations—Answer when applicable--------------------*.......................................................................... ..................................................................................7................................... ........................................................... ................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions`of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation,until a Certificate of Compliance has e'�'bqihe bo.;��, o health. issue Sig ... ............................................................. . ............ ............ Application Approved By........ .......... . ....... ......... ...................... ....... ..........................4 ... 7 .. Date Application Disapproved for the following reasons:_................................................................................I............................ .................................................................................................................................................................................................. Date PermitNo......................................................... Issued................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y. ...72........... ..............OF. ......._0*10.0........................ (9rdifiratr of Tautpliatta T4 RT YhaLthe Individual Sewage Disposal System constructed or Repaired Ab ...... .......;"................... =.........*........... ------- 25 7YN.3 44 144 at................................................................................................... ..........t...................... ............. ----------------------------- has been instilled in accordance with the provisions of T1 0 die State Sanitary Cody as descriDSid in the j_ application for Disposal Works Construction Permit No----- .......tis.................. dated-..... 4F--- d------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT,BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................... .......................................... Insp'ector.................... ................. .......I............................. THE COMMONWEALTH OF MASSACHUSETTS BOA ®F HEALTH ....."'........................ . ...........................................OF ..... No. ............ FEE....JAV........ r Permission is hereby grante ............................... .��.................. -------------------- ---------to Construct jA"or Re an I di al Sewake-DISDOSal System P r at No..,( Z -A ivi u Or.. A r.......................... ...... Street �6 mo,2 � as shown on the application for Disposal Works Construction Permit Dated.... ................................ .......... ........................ D.a, of -7 _kali� PATE_------------ . . ..................................................... FORM 1255' HOBBS & WARREN, INC., PUBLISHERS r StLIGt_b r lt_�4 - 3tZao� I _ G i•Sr t>&I L%-( IM Low 1 to .4 3 = sso G.F.V. 1 SEF'TIG TL�.+•11C = 330.r IrjG % s d�}�'j 6.Pv. t USA t c>oo s,a1. 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