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HomeMy WebLinkAbout0011 TIMBER LANE - Health I Tfrn �a No... Fins30.00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiun for Biipuiia1 Workii Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair.(X� an Individual Sewage Disposal System at: 11 Timber Lane Marstons bills ----------------_---------...................................................................... .....-•-•--••--•------•--...--•----•--------•---------------------•---------------------.......--- Brigham Location Address or Lot No. - __..............•-•---_----- W J.P.Macomber Jr.Owner Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling x-No. of Bedrooms..........3_ _Expansion Attic ( ) Garbage Grinder ( ) �-, Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures __________________________________ W Design Flow............................................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. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area______...._`:_____sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date......................................... Test Pit No. 1................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........................ -----------------------------------------------------------------------------•-•--•---•-•--••-------......................................................... 0 Description of Soil...............................................................................------------------------------------•---•-------•-------------•---------........__-•---- W Sand & Gravel V -----------•------•--------------------------------••-------------------------------------•---------••------------------------------------------.....---..._..-----............_------•----...-••-__---- W UNature of Repairs or Alterations—Answer when a plicable___________________________________________________________._._.._._.__._.__.__.________.____._. 1-1000 gallon leaching pit. --------------------------------------------------•---------------------------------._.............._....__.....-----------------------•-----------------------------------------------•--------•------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia a has been u d y the boa of h th. Signed + 8�21 9 ....... ApplicationApproved By ----- ----- ---------------------------------- -------------------------------- ---------------------------------- -- ..-?1..c��------- Dat Application Disapproved for the following reasons• --------------------------------- ------------------------------------------------------------------------- ----- --------- ................................................................---------------------------------------------------------------------------- ------------------------- --------------------------- ---------- -------------------------- Permit No. ! 0.--...---. Issue S�2 �/5 Dare No._ ._.: y FRs_.1 3 O0.00 t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Biupunttl Works Tunitrurttun Vernfit Application is hereby made for a Permit to Construct ( ) or Repair ( X�Y, an Individual Sewage Disposal System at: 11 Timber Lane Marstons Mills ................_.._.._._.................. .......................... ......_..... .......................................... Location-Address or Lot No. Flri wham Owner Address j .._hla e?:c • -- oMj X' r1X'_.................................................. ---------------•---••--•-•-••--•---•------....----....--•-•---•-•---•••-•...........--•------..... Installer Address Type of Building Size Lot----------------------------Sq. feet Dwelling X No. of Bedrooms...........a.............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ------------ -------------•-•••-•--------••-•-•.._... W Design Flow........................................ 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. Seepage Pit No..................... Diameter.--...--..--.--..... Depth below inlet.................... Total leaching area..................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........................ rT4 Test Pit No. 2-------------•.-minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil-•--------------------------------------------------------------•--------.......---------------------------------------•-•---------------------------------------.----- (xj --••----•----••---••-------------•••--•. _nr .. -•-�rta,`ra ..... --•--------------_--------•--...-----------------------------•-•---•------ W ............................................................----------------------••-•----•-•---•--•---•-•-•-•-------•-••••--•----•--•--•••------•-•............--•-------•----•--•-••-•--••----•-•-... exj Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------- •.x� -t................................................... Agreement: I The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been/issued bb. the board of health. Signed Ef�'t1ti'! A-`"r � .. -4 ....... !1...------ [[ � � Dare Application Approved BY :.....__ �ca/%l2-1/-5� -�`--------------------------------------------------- / Dare' Application Disapproved for the following reasons- ---..............................................................................................--------....------------------....---- ---..................................... Dae Permit No. `.r g / `� Issued ---------------- ...............---�--------...-------------------- Date r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of QuIomylinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) by.._-J.-P,Macomber Jr. -----------------------------------------------------------------------------------------------------------------•-....................------------------------....----.....................-- Installer at ----1 1....'1:'.i an e r..T p n a...Mars t o— e...M j-Il r_'...............................................................................•....-------------•----......------------.....----- has been installed in accordance with the provisions of TITLE 5--of The State-Environmental Code as described in the application for Disposal Works Construction Permit No. .... .!0.38d�l'dated ...5 bt- .`'�................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED-AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------------Q.r '7 � ............ Inspector .................fir— I �C- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �/ TOWN OF BARNSTABLE No.....!.�.....:�.�y FEE..........-��.o Disposal Works Tnnuir iun ''trmt# Permission is hereby granted.......=7g P.Ma w r+mh c?r...:T .....--•-•••••-•--•......................................................................... to Construct ( ) or Repair (XN) an Individual Sewage Disposal System atNO..__1 1..Ti mhP r-•Ta n P-_Mar t nt s M i 1 1 a.................---•••--•-••..........................................................••---_........ Street Z I Pa as shown on the application for Disposal Works Construction Permit No..................... Dated....-•--••................................ /Z J Board of Health DATE. Y...---•-•-> . ...... ---------------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE � LOCATION O i rtmkP Ln, SEWAGE # VILLAGE- rc<Sl�S MIN ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) G NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: 8 • l /� DATE COMPLIANCE ISSUED: "✓� VARIANCE GRANTED: Yes No O LO.eAT ION SEWA G E PERMIT NO. Z � t �� VILLAGE I N S T A l L ER'S NA. E & ADDRESS BUILDER OR OW. ER jf A D A T E P E M I T 1SSU E lb 6-- DATE COMPLIANCE ISSUED ^�� 4��,_ � S� � ��� -• . ,..� — .._ . _ . ���-.chi-�— •-, (79 No.•---.•---....-7S-• Fizs........13..`..-....... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH -----OF....... ...? r. ...................................... Applilrattun -fur 43wpouttl Works Cnunutrnrttun Vrrui t Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: r � 1 .--- T..---- .....--- oca' n-Address /f or Lot _ � ---•--------•- ..... 1 ��i $r 5� 2�r................. W Owne r��j� .. Address Installer Address d Type of Building Size Lot._a�L ------- feet U Dwelling—No. of Bedrooms_..__.s�................... .. .Expansion Attic ( ) Garbage Grinder ( ) d Other—OtlType ier fixBurestng_______________________________No•••of persons ---•-•�•--•--:-------_--Showers-•(---:)-------Cafeteria ( ) I W Design Flow............................................gallons per person p.er day. Total daily flow------- 26 q..__................._._..gallons. WSeptic Tank-/Liquid capacity.&VOg _ __allons Length Width._ _'G_.. Diameter.............._ Depth..?I111. ..-. x Disposal Trench—No. .................... Width..........._....._._ Total Length--_.-__._-___--_-.- Total leaching area--------------.-----sq. ft. Seepage Pit No.......1........... Diameter------ Depth below inlet_............... Total leaching area__) r?___.._.sq. it._ z Other Distribution box Dosing t nk ( ) ~' Percolation Test Results Performed by.... igt/t__..kgg-91.............................. Date.....9/ ---__--.----. a Test Pit No. 1----------------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__.__--.:--.---.---_---- - --------,---- ----- -st _. .. -- - -- - ------------ ----- - -- -- - - ---------------------------GDescription of Soil--a`�? --- S11-• - ------ - - - - ----- ----- ---- ------------------------------- U --------------------------- -4--i2 ------ o 2s NJ s 29✓€ --------------------------------------- W 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 \I of the State Sanitary Code un igned further agrees not to place the system in operation until a Certificate of Compliance has been ' ue e rd of health. S -i Application Approved By-----r4a_ f�j -- ------ ---------------------------- ------fP v`-7-------- Date Application Disapproved for the following reasons:----------•---------------------------------------------......................................................... --•----•-•------•----•-•---•-•--•---•-----•--------------•--•-•-•-•--------••-•-•••--•---...--•••-••••....-••--•••-•----------•-•---••--•---•-------•-----•••••--•-----------••---------•-----•--•-••---- Date PermitNo......................................................... Issued.--.. ......................................... Date ? 7P FED... ..�✓.�.. THE COMMONWEALTH OF MASSACHUSETTS c BOARD OF HEALTH _..... .....OF..................................... ....... ................. . .; . Applirtttiun -fur Biapoottt Workii Tomitrnrtiun Vrrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..................................:........................•-------------------•--•----•--•----•-- --•----------------------------------------------•--------------------------------••--•------- Location-Address or Lot No. . — Owner � Address ...... a ..............• -• . ... .....................�-----------------------------------------------------------------------------------------------•. Installer Address Q Type of Building Size Lot-------------_--.-<.--____Sq. feet U Al Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) W Other fixtures ---------------------------------------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow-------------------------------------....L.gallons. WSeptic Tuck—Liquid capacity------------gallons Length-------------_- Width_.............. Diameter_--.-.._...--.-_ Depth---------------- x Disposal Trench—No- -------------------- Width-------------------- Total Length.................... Total leaching area--------------------sq. ft. Seepage;Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank( ) Percolation Test Results Performed bY--------- = ------------------------------------ --- Date----------------. -- ----------.... Test Pit No. 1----------------minutes per inch Depth of "Pest Pit._.--__-____--__--.- Depth to ground water._.__..___:--.---..._..- G14 Test Pit No. 2____---.t_.....minutes per inch Depth of Test Pit.................... Depth to ground water--.------_---_.--_-_.__. ----....----•-------------------•-•---------------------------------•-•-••......•-------••--•--•-•--......................................................... ODescription of Soil------------------------------------------------------------------•------------------------------------------------------ --------------------------------------------- xr W 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 board of health. S- ................................ '.-------------- �-'----------- ---•----------- ............D.a................... Application Approved BY �" L`-T �1�----------- Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------- l _ Date Permit No--------------' -: Issued.------.......------------------=-....................... '• Date k THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ALTH g - /' '1 .. . ..O F..... .. .... .. . QTntif irttte of 106.1amptittnrr THA ISIFY, That the In u 1 Sewage Di osa ys em constructed ( ) or Repaired ( ) r. by......*.�. 't"' 9 �� , -------------t -..,(}��------ ----- at-- = t ... = --- -- " .... ... -•---- I s Ilex V has been installed in accordance with the provisions of ie State Sanitary C,/oge as described in e application for Disposal Works Construction Permit No.-: -----_•._:_--� --- dated._..U-" _7"`�� __________________ THt'ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A.GUARA?tTEE`THAT THE v.,u. SYSTEM„WILL FUNC ION SATISFACTORY. DATE--------- -•-- 7 Inspector . --------------------------------------------•-- ell THE COMMONWEALTH OF. MASSACHUSETTS f BOARD 'HEALTH w iy _OF.... � .................. ................... : l � •! FEE....!•- io uotti or n tr dioll err it . Permission is hereby granted- -- ----- --- to Constror Repai (•_ ) .ateJAdividual, age/ ispos System {' , %. . Street as shown on the a PP P lication for Dis..osal,VVorls Construction P t No.. _ __ _A! Dated_.Z_. ' ..•............. -' DATE......-••------ -------- ------------------------------- --------•-•---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - i a 7W N L ©T 2 fZ .7144 E3 . ono ' a` Pdc,HAFROD zr a. 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