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HomeMy WebLinkAbout0136 TIMBER LANE - Health Irnr+ �ns sr� , L L I i r TOWN OF BARNSTABLE V LOCATION cy\ _SEWAGE #—� 3L, VILLAGE2'WSio 1 S Mi I(S ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ��-S� 36 -Z- 6237 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ` IMO (Tall-Pc+- (size), _ NO. OF BEDROOMS ^PRIVATE WELL OR PUBLIC WATER NP-11c, BUILDER O OWNER - DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_ VARIANCE GRANTED: Yes No f 11 Ln m �' C° A r- ASSESSORS MrPT' NO: Au�,CEL "a. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........._0F......... .......... ..... ........... ....... ............................................................................... Appliration for Dispogal Works Tontitrurtion "amit V Application is hereby made for a Permit to Construct or Repair (P11"an Individual Sewage Disposal System at: I X+" -MA . lu_m 3 G 6-o-o— 6j , ................................................................................................. .................................................................................................. ........... res ..^ ............................. .... ........... ss... ................... we4o, - 0 ..47 W Z<feees . g,,i.,,wn .......... .......... ................... Installer Address U Type of B 'Iding Size Lot-------_------------------Sq. feet Dwell No. of Bedrooms........ .............................Expansion Attic a Garbage Grinder Other \Type of Building ............................ No. of persons............................ Showers Cafeteria 'Other fixtures ...................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width-__-__--_-_-___- Diameter._...._..._..... Depth................ �4 W Disposal Trench—No. .................... Width____________________ Total Length___................. Total leaching area--------------------sq. ft. Seepage Pit No____________________• Diameter________-__--__-_-_- Depth below inlet....._.............. Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation T st Results Performed by.......................................................................... Date........................................ Test Pit TN�o. I................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 7 Descripti Soil... A 0 of U ............................................................................................................................................................................................... ...........I............................................ ................................................................................................................... U I s gure of Re r Rea or Alt ration —Answer when applicable— ------ r...... .......................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T'121 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been 1 Alud by the board of health. Signed. ....... . ...............c _77:.............. Date Application Approved BY------------------ ... .............................. ---------7.. Date Application Disapproved for the following reasons:.............................................................................................................. ........................................................................................................................................................................................................ ------ Date Permit No- ......................................... Issued....................................................... Date n I,. Fm:a....2-5.(............_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a ........ ............--OF....... OZ�Vf�'�,�� ApplirFation for Disposal Works Tonotrurtinn itruti# Application is hereby made for a Permit to Construct ( ) or Repair. (Io<an Individual, Sewage Disposal System at: . ..... - ----•-----•---•----------------•-----------------------•-•-•.......... _....--•------•--•-...••••--••---------•......•------•--•-•...••---•-•----•-•--••-._..._.......--- L/ocation-Address U�il/, I/i' ..--- --•---- t�...r/AJ�.V.' `M / .......... ...................... -•- __ Owner 11 A!d res -- Installer Address d Type of Building Size Lot----------------------------Sq. feet V Dwelling—No. of Bedrooms........ _____________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) Cafeteria ( ) Q' Other fixtures -----••----•-••--••-----------•. . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. C4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter_=______________ Depth................ 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......................................0-1 .. Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------------------•-....__...-----...----•-----------.........._....-----••---•••••--•.......................................................... ODescription of Soil....................................................................................................................................................................... x rJ ---------------•---------------------.....----------•--.•.--.-..---•--•---•-•----••------------------•----------------......----...-•------------------•-------------------------------••-•-•---••--••. Uw •-••-•-•----•----------.•--.-------•--•••-•-••••-••••-•••-••--------••-••-•••--••••-•••.--•••••--•.----••--••-•••---•-•.•••••-•••-••-•-•••••••-•-----•-••-•--- •--- ------- _Nature of Repairs or Alterations—Answer when applicable._._'" 1°~!_S____ !_ _ ^ '_..._._ ................. � ....................... . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTTL 5 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. Signed_ - ., -----c .e ' .4� ' ....................... 7 r •--------•............... \n-•-- ! � Date Application Approved B --•-•-----•••----2�-e'^-------.�1 • ---------------------------- ...-- '�•�' y Date Application Disapproved for the following reasons________________________________________________________________________________________________________________ ...............•----...-•-•-•---------------•------•--------•--------------------------------------•-•---•---------------•--•-••--•---••---•-•-•-----•••-•-••-•--••-••••-•----•-•-••••••••--•-•...._..-- Date PermitNo. .. ..........---- ..................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEALTH ...................................OF........e-rYFe- ...f. l.'..._.............. dw Qrrtif iratr of TuutpliFaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ---------------------------••_-----••-------•---------•-•----_._.._...._ sta'ller has been installed in accordance with the provisions of TT T'r" 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... ...... ........ dated________________________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL,NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................----� _.�—.2, .:-..5�.. C Inspector ----------------•--••---_______-__________... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................OF....... 1'de s(rs'/_.!' .................................... ......................... FEE... ._. .... Disposal Works Clustrurtion Prrutit Permission is hereby granted___- _________________________________________________________ to Construct ( ) or Repair ( an Individual Sewa a Dis o al System at No._______/'__�t.�_... Ct�_ ��:_. _•_._.__.,t.!fe; !� .......W.4-.,. Street as shown on the application for Disposal Works Construction Permit No.111-3. ;,,Dated.................................. ....__ ........................................... ------------•-•----••••••••------••----•----•--. DATE................................................................................ oard of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS I V - or LO CATION SEWAGE PE RMIJ NO. VILLAGE INSTA LLER'S NAME i ADDRESS BUILDER OR OWNER -le c— v r f40 L L f4 w peaks ti�n- DATE PERMIT ISSUED _ G � r DATE COMPLIANCE ISSUED 3 .o�� ,. �� r G oT 3� �� w � ���� '� �� � � � +�� M c-�6 � - � ®� . o 1 �,� ��� � �' � .� � '� � � 4 No FEB....L =:L.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .........................................OF......:................................-----•---.............__........................... Appliration for Bispao l Works nstrttrtuan Prrutit Application is hereby made for a Permit to Construct (, ' or Repair ( ) an Individual Sewage Disposal System at: 0 o Loc .io Addr ss or Lot No. ....... � ...yl. .................. ' ......••----•---------.....--.............. ..........................•................... Owner Address a '... G. Z Instailer Address Type of Building Size Lot.i 3=Sq. feet UDwelling—No. of Bedrooms............ ..........................Expansion Attic ( ) Garbage Grinder ( ) 4 Other—Type T e of Building .. No. of persons............................ Showers w yP g -------------•-•--...----- P ( ) — Cafeteria ( ) a Other fixtures -------••--•--••••-•---- .t� oed -----------------•------•--....-........ ....._......_.__...... W Design Flow.....//t>...........................gallons per geme�per lay. Total daily flow__......... .............gallons. W Septic Tank—Liquid*capacity/ p q --gallons Length....R-_--... Width._. l_.__..... Diameter................ Depth....,_.....__. x Disposal Trench No. .................... Width.................... Total Length......__.............Total leaching area....................sq. ft. Seepage Pit No_____ ___________ Diameter..Z A15 .;Depth below inlet... Total leaching area_.4?c�?P...sq. ft.6,eo Other Distribution box Dosing tank Percolation Test Results Performed by.G .�,� l C�- :--� .--•---------... Date_./.Z—�__ 3 .. tom...... Test Pit No. 1�'Z_.minutes per inch Depth of Test Pit.f- _y. Depth to ground wa -,?__4 _S� fZ4 Test Pit No. 2.a.:;:;2,.._minutes per inch Depth of Test Pittl.� .�°.. Depth to ground water.__......_........... 9 •-------------------------------- ............................ r O Description of Soil . �-........_........_ _...�` - lJ. S {e- �`' ------ /s2 t _ w UNature o epairs or �ilt�aons—Answer'when app�ficabTe'----------------------------------------------------------------- -----•------------•------- ..-----••--------------•- •••-------•-•----•----.....---•-----•-••---•-----......------••.......----•••------••---••-------•----•••---•------•--•••----------•-•--•-•••••-•--•-•-----•-•---•.._...•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT Z- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of ComplianceV by the boar f al Sig ..._ . Date Application Approved By---_. �� . .... ` &-/--•------- --------•-----•---••--•-•-•-••------ Date Application Disapproved for the following reasons:................................................................................................................ ....---••--••-•---------•--....--•--•---•------...-•------------------•------•---•-----•-•- .-------- ----••----•--...Date•---•-••••--- Permit No......... ... n ._ Issued --.. el.....------:1.. — — — -Date — J �� 1 N ----------------- - = F ...........�........ THE COMMONWEALTH OF MASSACHUSETTSy '`J f..-- ,BOARD OF HEALTH ..................................... :::._............................................... Appliration for Diapaii al Works aynotrnrtion ramit . Application is hereby made for a Permit to Construct ( or Repair an Individual Sewage Disposal, System--at: / / k, "" 1 111 Loc i -Address •or Lot No 9. ....... .......t ......... _......____..--.-----........... ....... Owner Add ess Installer %�&ress ` Type of Building Size.Lot '?._ 1 --_Sq. feet Nwelling—No. of Bedrooms............�'�___________................Expansion Attic bage Grinder, ( ) p,, Other=Type of Building ____________________________ No. of persons.............___-____.,__... Showers ;w ) — Cafeteria ( ) �. G4 Other fixtures ---------•---•-•-----•••---•••... => d , c7 !�' c...........................; ---- -----• ---- _----- W Design Flow.....Gfs`�...........................gallons per persen-per ay. Total daily,flow _.L......Z-.,..____________�_gallons. x {' Septic Tank—Liquid*capacity, dG?.S�allons Length___ -..�'....__. Width._. 'r........Diameter_______________ epth�_...._..... Disposal Trench—No..................... Width_________.___.____._ Total,.Length____•_.__....___.___.Total leaching area _____; ::.....sq. ft. Seepage Pit No ............. '��_...____._. Diameter.. .�. Depth below'inlet___r�-.=. ?.. Total leaching area;. -'_sq. ft. o•— Other Distribution box -' Dosing tank '-' ,Percolation Test Results Performed b C ..q,�.•.,...,_'-€�..:�__ _.{=:_�..__________________ Date._.: a Y .. .. a Test Pit No. 1=- '!.',,._minutes per inch Depth of Test Pit.. Depth Depth to ground water_._ (Z4 Test Pit No. 2.45::. _:_._minutes per inch Depth of Test Depth to ground water,.::___'..__`'_.............................. Ri :ty _• --•- -----••------•-•- --------- Description of Soil - = �' ' s.��.ry '►�i % Cos?% ......... tJ J - ...12-2•_��/ ` - ''aCr-�� �!9 s►�. (> -- ••--- ---- W U�''� t/✓..............S'S"�i�. ,/� �lC .�sr r Z3 '' 1Z1` G= .5 '���► i/�_ U o, .�s `" / .......ems . mar �5 ,y,a-r.r. ...__ j. Nature of�)tepairs or Alteraifions—Answer when appficabN.............. ______ _________________________________ __________________________________ Y. ----------------------------•----------------------......-----..........-----•--------------•-----------------•-•-----•---- Agreement The unddsigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions 4ITLE 5 of the State Sanitary Co The undersi ned further agrees not to place the system in'" operation until a Certificate of Compliance ha been ss e y the bo �jh� Sie _-- . .....! -----''-:----_-=-- ------•._...._..••. .......................... ApplicationApproved By_...................................... .............................••......._......------. ........................................ I Date Application Disapproved for the following reasons-...............-................................................................................................ -•.............................•••••----......_...••••---------••••••--••-•-------------••----•--•----------••---....--•--•---••-...-----•-------•----------••------------•-•--•------. �1 ................ Date PermitNo......................................................... Issued................................� . - Date THE COMMONWEALTH OF MASSACHUSETTS BOARDLQF HEALTH ......�t x�-.................OF...'................................................................._.._...---......... wn if iratr of Tnntplittnre ' TY14hk'�P CEL1TjFy,,.That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) -•-•••-----•• ----•----••-----------------------•--------------•-•---•---------•-----....-•----••--•----•--....--••-••---•...........--•-••...... at....................................................................................---..--•--------- has been installed in accordance with the provisions o !y The State Sanitary Code as described in the application for Disposal Works Construction Permit No_________________________________________ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL FU,NC ION SATISFACTORY. t DATE..... _•-•-•••-•••-(...:... ..•--•--• ................... Inspector--- .......... .. ----------- ............................................. THE COMMONWEALTH OF MASSACHUSETTS ' BOARay OF HEALTH Kam hr Al ...........................................OF..................................................................................... No._..,18,14)---4,.. FEE......................... + teal ,a Ykv �p . Uan rrntt ; Permisi i is hereby granted.............................................................................................................................................. to Constr cat - _Tkpair ( ,�d itjjual S, v rage Disposal Sys � /e e r atNo............................................................................................................................................................................................. . . Street as shown on the application for Disposal Works Construction r mit o.•______ at ------------------------------------------ Board of Health DATE............. ...............----...--••---•---......_......--•-----k FORM 1255 HOBBS-& WARREN, INC., PUBLISHERS k ' �o �n✓v� l /emu ,S'T-4�. � 4 Tio-� 7' T L C: / ,7 , pti S7 B3 �J.e 74 °Q I' o . G Z �'.. : �cJi9.S.5/6'� . ST�.vim ,�,•q.../,!� :�J�.0 i.7 0 � � Ss SG . - ... o o pro�oSe o/ grovno� Prof� /e `+---"- 7 7•n U r" ,f" P e { O f _ w -- ->- . yy 'N T .-v---sr- �3„ F + ao • O/ST x 6' Sump C v� /000 'GAL 5 EPT/C TA- ti/.gL 3�'f ,/r • • c&ashad sto.-ems • r • ,• � .. 3�' ; SCF1� E-. % = i -D,; GE/4GH F�/ T ti P a � °� LO S G �./ S T H ® L. L-_ O G - - I � ^ f Ll Try BEc>�e o0M HOUSE- Oti T� /z 80 h3 ,7 2,AJ G. W_ E4- LE-P- TPA. �Gp �7o v/i5P05er G E AeG. /171 A.11/Al C H !N i T A/E 6 5 q T Z2o GAL OAY S. 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