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Home My WebLink About0025 WATERFORD DRIVE - Health S a-t-e -x-03 To t1 S In TOWN OF BARNSTABLE LOCATION ] r C�� . p(� 1SEWAGE # VILLAGE 'M )ASSESSOR'S MAP & LOT &„Q AISTALLER'S NAME & PHONE NO.� c)` iSEPTIC TANK CAPACITY I ,� a .LEACHING FACILITY:(type) (size) ENO. OF BEDROOMS L-1_PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER r(` (-0 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: "'7 - ). 7 VARIANCE GRANTED: Yes No ' 3S� qb — lot No.-- v THE COMMONWEALTH OF MASSACHUSETTS . B ARD F HEALTH OF .�s ........................... Appl ration for 11hipasal Warks Toustrudivit 1rrmit Application is here b made for a Per ty�•W1, �nnsstruct ) or Repair Yd/( ) an Individual Sewage Disposal System at: ._.... ..... ... �7' _......-- - .......... .. .. ....... .... ..... .�oc t�ot��Jess or Lot No. ........... .._• Owne ....................................... Address..................................... ... !........... ... .•---•-----........................ .....•..... ......................... .. .......... jlY1._1 ................ .. Installer Address Type of Building Size Lot ......Sq. feet 1-4 Dwelling—No. of Bedrooms----------- -------------------------------Expansion Attic ( ) Garbage'Grinder ( ) a`4 Other—T e of Building No. of ersons............................ Showers YP g -•------------•--...---.... p ( ) — Cafeteria ( ) QOther fixtures .------•---....-•---- .........--•-•-••-•-•--------------------- rrGG //n��•---....-•--•----.......... Design Flow........... gallons per pweer2 per day. Total daily flow...............`. x.l..._............gallons. W �- WSeptic Tank—Liquid capacity gallons Length................ Width:....,.......... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length....__......... Total leaching area . sq. ft. �.... . 1 .. Depth below inlet... .c.J..... Total leaching area__.. ... _�sq. ft. 3 Seepage Pit No..__._. .._ Diameter...... Z Other Distribution box ) Dosing tank L�.. Xees�t Percolation Test Result Performed by.............. ..._...___... Date......�.. ..�.(..... ..... a Test Pit No. 1__....... inutes per inch Depth ofPit . Deptto ground wa r_Test Pit No. 2................minutes per inch Depth of Pit.................... Depth to ground water........................ •......................:......................................••..........._.._............. ODescription of Soil........... ....�....... ............-...........•-----------------•------••-----...--•-•---•--....----•-........--••---•--................ • . -- UW •------------------------- ----------------------------------------------•..--.------.....--.------......-----------..._..........--....._.----------.------..................................._........ 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 TITLE 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....... .... . .. . ............. . ....... .................... ` ✓7 a��s. . ...... .... .. .. Date Application Approved B ...: .......................................... �. Date Application Disapproved for the following reasons:............................................................................................................ ---•-•-•-•--•••...-----...•-------•-•-....�- •-•----•---••-••........................................---•-•----•-------..................................--•--..... '••........ Date _ PermitNo.......�1 --..1...9.................•..... �2 - Issued....................................................... •--•--•----•------......-•---....... �/Y `� Date No.._ .:._� �, Fxs. r . THE COMMONWEALTH OF MASSACHUSETTS t-BOARD OF HEALTH ........OF......6�. 5... .... Appliration for Uhipuuttl Works Tonotrur n rrmit Application is hereby made for a Permip )Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �0 / __... ......... ..... - 'Location Address ��..^^•I or Lot No. �t/ ............ ........_.._._................ .........---.-------•---•.........._............._... W jV " wnetT Address -------•-•----------- Installer Address '! /� Type of Building Size Lot.............................Sq. feet U Dwelling—No. of Bedrooms... ------------•-------•--_------.Expansion Attic ( ) GarbagerGrinder ( ) Other—T e of Building ....._..._.. No. of persons............................ Showers a YP g ---------------- P ( ) — Cafeteria ( ) Otherfixtures ..._.._.. ../). -------------------------------------•-••-- y��',.. = �.._................._....... W Design Flow........... ..... ............_.....gallons per person per day. Total daily flow.......... ..' ..f ...............gallons. WSeptic Tank—Liquid capacityS4S al_ lons Length................ Width:..... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length................. Total leaching area....................sq. ft. 3 Seepage Pit/No------i;1- Diameter.......��r'��------- Depth below inlet... _:..1..... Total leaching area... (Qsq. ft. Z Other Distribution box ( Dosing tank (� ) Percolation 'Test Results Performed by..................< ...VF �I�Z&L-4...... Date...... A Test Pit No. I...----_=l-minutes per inch Depth of `Test Pit... ,.n..•. Depth to ground water.,m ....4 f3. Test Pit No. 2................minutes per inch Depth of 1Test Pit.. `.................... Depth to ground water........................ --------------- ...............................•..................................................................... Descriptionof Soil..... .._ _ `-..r.4---�-•-.................................................................................................:.............--- V ---------•................. 1.. - ---------------------- -----..-.-------------- ---------------- --•...... --.------------ ...._..-------------- •............... •--•-•-•-----... ..................................................-........:..................................................................=.......... .............................................................. Y U Nature of Repairs or Alterations—Answer when applicable............................................................................................... It Agreement: ....l...----------------------------------------....... ------------------------------------------------------•-----------------------............................ . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITUr- 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 ...... ..... .. ..................... ........ Date°............. -� 3" _ Application Approved BY -----•----•-- �---��------.-----•----------------------- � nat1.^..� Application Disapproved for the following reasons:............................................................................................................ ---•-----•--....-•-•--•.....................................•---------•-•--•----.............-•---.....-•-•---•------•--•---•--••---•-•------•--•--•-••--.....--•-•--------•-•...--•-•..........._.... Date PermitNo....... .-_ / .................•..... Issued....................................................... - _C7 ,.), — V 7 - / y-3 V Date ds.... ....... es�S^�.S"H^C'!'l S4k�S Pl4sli.........../.......MM.st.. .. ...... a .C.�.eT+.•_.•.e.a THE COMMONWEALTH OF MASSACHUSETTS 3 l BOARD �yOF HEA�L/TH, 9 ..............�. 1 :. ........OF............ e. r'��a- l.............:.......................... (Irrtif iratt of Toutphatt r THIS IS TO CERTIFY,, That the Individual Sewage Disposal System constructed (>�) or Repaired ( ) by............. ...... �.... ..•• ............ .---------- -------•-•-- ---..----...----------•----------- -...... .----------------- ........... .---.-- Installer at............../�I," ). �'� --'��--••. ,-...........H'l_:_ ---••-•--.•--- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No:_:::_ c ....... dated........................__--__................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION—SATISFACTORY. DATE ..........7 ` ` _ ................................. Inspector......................v--- .......................................... �r.�,.s•wr.�T._.r�.wey w.^v.n.a rtwa�s•..w�.+llnw.9t iS.lP� ........... qt� c1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . OF.......... . .. iQo. .. FEE..--..:•.c-�.............. Disposal Works Tonotrurtion f rrmit Permission is hereby granted............ a ............��...............•-•---•-----------------.............---••----.......---•-•-•-••-. ...................:............................... .system to Construct ( �� repair ( ) an ndividual Sewage Disposal`--�-.-•-••-.--•---.•-•-•-•------•-•-•--•--•--•••-------------•-•-•---•----- at No............. �.,- II .. r/.a�� 1 .r- iv as shown on the application for Disposal Works Construction Permit Street ��1_.//�Dated +...................................... "sf ..�.s . '' tY..-. ! C-G��...................._ o DATE..................... .._...'.. ..----'...• Y Boar of Health 5(116Lz FAMILY 4 $E'L WW' `j:ao;e;i o r 'L N� 6AZ5Ar-E GRINVEV, R-DW 4ztto=d�4 5E?ri C TAtJV-- d�OX °Io'(oleo GP►� Uh 19 ,J DISFMA PtT b HE a 5 i�E WAiL. AAA r -2�20 LdT- Bo TToM � = I st- sF 2 '�-f >< I-o z is('4,m, v/v(-r:k-Foi7-i) 1�2A v.I3 TOTAL t>6516W = --7oe, 6W, TOTAL VAILy "-0ri/ = 44o erPA :, off. Czra) rr PR240 LATI oN �P DdW�) CAp- Lw6-►Nm-,7Ljj4& OF 0 �l!G 9 Ax A. �� PETER �yo 3 � SULLIVAN l Ilks61STf�R AL EN O Sz TF= sco 'L 'Z. PKT tr+>J. GAL 600 rwv E;tK '-1 Go.l GalINA ✓ .� r N r 5 ,Ps u tln WAQE�t Oom: Au_._5mgvQEs sr---r sTDtJE MW5 THAN 4 VEEP . , Imo- C�i-1�►® nor- SCAN • ► rN : 470 IT I CFJzf1 I>�st� PLAN vROJC.I FY 7�AT THE `pw e-t.c_.t t l ._,slow tJ NE2Wt4 r-omlpcyyS� LOTwrrA i-AE j(pEUWE 2 15 Vao. Ev 'CIE- 7DWN OF, Ul?-W;' A2L 40 15 90' l-o-CATfD W t4I L( VE r- 140r> �a`T�'. 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