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Home My WebLink About0065 WATERFORD DRIVE - Health xc I- L �`� OWN OF BARNSTABLE LGCATICN 40T SI UIal-A tor'l 0&, SEWAGE # g 7� VILLAGE �d�� A-ASSESSOR'S MAP & LOT S9-S?7 INSTALLER'S NAME 6a PHONE NO,_ (�Qi I! S_d/�• SEPTIC TANK CAPACITY l�� a1w Q 0 LEACHING FACILITY:(type) aZ lew� PI'rS (size) 60 c� ENO. OF BEDROOMS _PRIVATE WELL OR BUILDER OR OWNER fI/Iwo DATE PERMIT ISSUED: /` y DATE COUPLIANCE ISSUED: % VARIANCE GRANTED: Yes No I w10 v op Al n FEs. ._ THE COMMONWEALTH OF MASSACHUSETTS "'HARD OF HEALTH, T Appliration for Disposal Ularks Tonstrnrtinn Ifrrtnit Application is hereby made for a Permit to ConstruZ or Repair ( ) an Individual Sewage Disposal System at: /^_( � r,�, �� ................»..»»» .....Lo � Ce ! "��Jam... .. » Ca---------•-----•---•----•----._�o ..........................._..... » ....__ w i Address W c d ! ...............•-•• ----••............ .................... .•. -•-••••-•----_................................•..... ....-^-^•••--......... Installer Address Type of Building Size Lot.vG.S.�I �...Sq. feet .. Dwelling—No. of Bedrooms............ ..............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g ...............•----•------- P ( ) — Cafeteria ( ) Q Other fixtures .......... �--..----------------•-----------•------•-••......... ......- Design Flow................. ... �f�gallons per n�e� day. Total y ft6w........... ._..... ..•--•-..--......gall�ns WSeptic Tank—Liqui pacityi7!/�.gallons Length_.....�.._. Width:... ... . Diameter:............... Depth...�.....(a.. x Disposal Trench—No. .................... Width__..:_......_...... Total Length.... .._.. .. Total leaching area...ITT_ sq. ft. 3- Seepage Pit No.._.... __... Diameter.....`A.. ..... Depth below inlet..... Total leaching area. .sq. ft. 0t1\ier Distribution boxDosing tankResul� erformed by.__..... ... ..... ._._ Date....:(. __Test Pit No. 1................minutes per inch Depth of Test Pit_... to ground ater...... ........... Test Pit No. 2................minutes per inch Dept of Test Pit................_... Depth to ground water........................ pa♦ -----------------------------••--...............---------.......•••-•---....--------•-•..._...........••--••.........,..---•••-•••........•-----............. 0 Descriptio Soil.................... W __ .............................0..._..--.••••.-•-•-......---.--------.-...----•------........._........... ........................ ........�- .. - .................................................................................................................................................... U Nature of Repairs or It rations—Answer when applicable............................................................................................... ..............................•---------------------....--••----------......------.........---.......................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordant ith the provisions of:ITL:; 5 of the State Sanitary Code The undersigned further ees not a�ie in. operation until a Certificate of Compliance has been issued by the board of health. Signed.... ...... ..P ...... •••........... ...•. ......1, 4ri ��roved BY....APPIication APP .•...Q..........kv....:..._........:......... `D _ e Application Disapproved for the following reasons:... ....................................... ................................................................ ».. ..... ................••-•-•...--- ..........-�---•-••------••------•--•--•--•••-••----•--•....._.......-•-...............-•-•---•-------••....-----•..._........----._......................» Permit No...._-�. .................................».. Issued..... Date THE 'COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH ......._.�..V..W(v .........OF......... G�l.�N..... ...........---------------•--.............. Appliration for Dhip iiaf Works Tonstrurtion Vern fit Application is,hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: � ..............._...._/� cation `Address, j+ .. ... ...............__.._......... .....r Lot.No .................... N � c r �/.• ... ..�( �p1 ,C r f(: •r� (-:...r `. .� l ................................... .. W Address. J Installer Address �( �� Type of Building Size Lot..................7..7.._..Sq. feet Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -----------••-•-•-... -•-- �:.�... -�. d �;.�< ....... .... Design Flow..............�...� _ vr?gallons per person per day. Total daily flow.......... . ... gal - - •--••---..._.. . Ions. Septic Tank—Li uid ca acrt j � allons Length. �.. _. W P 9 P Y, g gt �... t'. . Width:.!!..--- Diameter................ Depth _5.....r_. x Disposal Trench—No. .................... Width.................... Total Length...................... Total leaching area_._.... _..........sq. ft. 3 Seepage Pit No,.......�-�---_---. Diameter.....;!. ::-:__..... Depth below inlet....Z�-':._ .... Total leaching area-.-.... � sq. ft. ..-. z Other Distribution box X) Dosing tank ( Percolation Test Results Z Performed b0-4 ....... �_'.:....k./ ?.�% ��....:.. ..�.�............. Date...47I._ 4 Test Pit No. 1..�........minutes per inch Depth4of Test Pit......... :.. Depth to ground water....r(of ! .. G14 Test Pit No. 2................minutes per inch Depth of Test Pit....{.........__.... Depth to ground water........................ •---•------------------------------------•------..........------........................:....- ... ........ --.-.--•------..---------................. .... 0 Descriptiot Gf Soil........................................................................................................................................................................ V ......-- �� .....__........ •-----....... --------------- .._.__... ----------------- •----------- -........ .------------------ •-------------------- •---------- U ...........-•-•-- Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------ --- -------------------•--..............-•-------------•--------..........................-----•-----•-------------•-......----•-..........---•-............................................... Agreement: ti The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordant j' ith the provisions of TITLZ 5 of the State Sanitary Code— The undersigned further agrees not to'��Ihe in operation until a Certificate of Compliance has been issued by the board of health. Signed---:... ��. ..... 1............. �f D to Application Approved BY.............. �... ... ..'L...f / i Da e Application Disapproved for the following reasons-........................................... •t------------------.._..-----------....---..._.. .................:.. Date r'^r ,�r 1 Permit No. -�••-••��-��.-------•--. Issued.... ..1 .: .. ................. _--____........ ...,..z__....m..,,_...._.._.._.........n�....,«..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7C)-27 ,f�r�� ..........................................OF. .,/..."J....................................................................... t Ter#if ira a of f ompliattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (,)) or Repaired ( ) by....... �`�..��+�� h!C/_..... Installer..... .................... at..... ........................................................ I` ....!.. 1�- .....................`--•- .................................................................... has been installed in accordance with the provisions of TITI. 5 of The State SanitaryCode as,described in the application for Disposal Works Constructin Permit No..-.�I..' i'� '7..7._... dated ..,,�� .��............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARA TEE THAT THE SYSTEM WILLrr FU C jJON SATISFACTORY. DATE.........fC... .t. -•-------•--........ Inspect r .. �1�' � .�`.::...:..: ffi 4C.4+'^"�«^•�••«s_.Fwwrtl s'o isrevs.arreorr m+rre�emwrBM tf t�re��b CC03}.!.[`^«••••••+•.•••r••!'r.t.art-�r�egr��-rsrrsor�aoarwe�e:bosra>>rY�e�••«•wwr..R..,...,.p.: THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................ OF................................_.................................................... .'sP No................... Fm..... .......:.... Disposal, Works Tnn#rndiun Errant Permission is hereby granted...:��:. �� .............................. to Construct (X) or Repair ( ) an Individual Sewage Disposal System at No.... ..............` - !► ! f'J i i% lid l� Z` 4 -•----------............................ ........._.._..--------•--•--------.........--••----•---•-- ----. ........... Street as shown on the application for Disposal Works Construction Permit N( q�:f.�Dated...a,/._...-�.�1�.�6�...:.. z. 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