The URL can be used to link to this page

Home My WebLink About0079 WATERFORD DRIVE - Health rons I ' 9 TOWN OF BARNSTABLE LOCATION wcj . \ ,6j, \Cnrt SEWAGE # VILLAGE V4?e•s i�v7 - , �, �a SESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. �• ��,5 w�� 7 ( '(d`I SEPTIC TANK CAPACITY ( �dw 4 O� ,5 LEACHING FACILITY:(type) Lef Gti\ T (size) 06 q ckAldii,S NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: 17, r `� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No + 9 9 Z i No... FizB 7_5---------— THE COMMONWEALTH OF MASSACHUSETTS BOARD,,�OF HEALTH L.......................... Appliration for Disposal Works Tonotrurtion Permit Application,is hereby made for a Permit to Construct (Kor Repair an Individual Sewage Disposal System at: ('eo) .......................................... ............:!��................ .... .. ...........*.. . ......... ---- Locat -n-Ad ss,,. or Lot No. ....................... ...........I----------------- ------------------------------------------- .................................................. n Address ............................ ...... ... ..... ---------------------- .......... .................... Installer Address Type of Building Size Lot..... t...4....01 yp 1(_ _3.Sq. feet Dwelling—No. of Bedrooms......... Expansion Attic Garbage Grinder ----------------------- Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other xtu !s ................................... ...............1%.r... .......................... .. ....... ........ ... ....Wd Design Flow lions per --er-day._-Totai-`da.i-iy-fIow.......... _.........._gallons. -r-41 �p 7--� ............. I Septic Tank—Liquid*capacit" Ions Length................ Width:--- I.......... Diameter................ Depth......---....... Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...-----:4r sq. ft. Seepage Pit No.. I, Blow inlet... _.�>...... Total leaching area.. sq. ft. Diameter.....J..;�...... Depth Z Other Distribution box Dosing tank 0-4 Percolation Test Result Performed by....._._.... ...............it............ Date............... 1.4 f T P. Test Pit No. 1.4.�L..minutes per inch Depth f Test; 4/Depth to ground ter.. f T Test Pit No. 2................minutes per inch Depth of Test .................... Depth to ground water........................ ................................................................................ - ---------------- --------- ---------- 0 Description of .............................................................................................. U ......................... ........................................................................................................................ WW .......... ---- -- ----3 - 7- .. .................................. ............. ........................................................................................................................................................................................... Z 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 TLITLU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been-isu. S led by the board of health. Signed--.._ ... ..... . Date Application Approved By----- Y.".d..... I.. ...... ............. .......... Date Application Disapproved for the following reasons:............................................................................................................ ....................................................................................................................................................................................................... Date PermitNo..... ..................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS --i t BOARD O OARDO F HEALTH Appliration for Uhipoiial Works Tonotrurtion Permit Application is hereby made for a Permit to Construct (>kor Repair ( ) an Individual Sewage Disposal System........... at. . - D --------------- ../`��.: �rt�f'_ - 1 ?� v �� -... .... _ . .. --••---- ......... Locauou•Add�es�s � I or Lot No. ................ �!��"f•��/N''t.�t/�........_�.......»... ..._______^...�. .........._.._... ............ ^- .............»....».»..... w O,wne Address -----------------------------------------------------------------------------•••...._......_..... Installer Address Type of Building Size Lot.... ? Sq. feet Dwelling-No. of Bedrooms......... :.:.............................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building~___.___. `...__.___ p . -• ( ) Cafeteria ( ) ___ No. of ersons________________ __________ Showers — dOther ffixtu es ................................. `.. = .t.......:..... ...... W Design Flow............ �_-__-.-__:--r. :gallons per pro p r`day. Total daily flow.......... "_ _��._...___...`._gallons. WSeptic Tank—Liquid,capacity/._,j_ gallons�,f Length'�.___._._ Width________________ Diameter................ Depth................ x Disposal Trench—No_ ___________ __ Width:_..__..__. ..... Total Length.................... Total leaching area--------- .........sq. ft. t--~. + 3 Seepage Pit No..____ `J. Diameter..____ -� Depth below. inlet_:-. ..._... Total leaching area...��Isq. ft. Z Other Distribution,box ( Dosing tanker( )e � J l C `" Percolation Test Results Performed by t`_t -0,,_..:.n...............Y:........... Date.... ,,r�� Test Pit No. 1._.:._. ...minutes per inch Depth Fof Test Pit...:' 7,Depth to ground water_.,4 .. 44 Test Pit No. 2................minutes per inch Depth of Test .........._.!-7... Depth to ground water........................ 9 ..............•=-.................................._........................................................................................................ O Description of Soil..r' ? _..-------•--._...-•--•-••....•----•---•--------- x U 'Nature of Repairs or Alterations—Answer when applicable.................................... ......................................................... Agreement': 1 ' 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•__ /'�i;ZRYl l,est!�'t• l, -l'str� ... /•41. d/..k'.�. � Date r.. Application Approved By...........v.__-..... t.__2�a U.... ..:C.............:` ......._._..-•------•-•--•-•-- -.......... Date^........... Application Disapproved for the following reasons:............................................................................................................ 1 ................................................••--•---•••--.._..•-•-•-•--...._.._...------....----.....--...------------•--__.•---__.__-•---•---------......_-•--••--•-•-.._...---••............._..» ! Date Permit No..... 1._.. 70 /-------------•---•-•• � 'Issued_................................. ...:.........».....» Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r.�CL//ivRy..-......OF...........,1.. 'ovfvu.?.Z�4;JCk............................... ' Tntifiratr of Tomplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (kr) or Repaired ( ) by....................•.. •__.._. 0.-r-ir.�.6 ........... :........................ - . t .........:.. ..Installer 1 = 4:, T" S .. t _. .rat....-••-----•__�__._;''.�._.__�...-•-•--ILJrc- <...._.. �.__;......A 54----------•--------------------•--,. ................................ has been installed in accordance with the provisions of TITLE j 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 CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r ........................ ................ ••--DATE............ ................•---......... Ins ec o ,n- 2- �. 1 - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH QG -�7 f 2 �. ...... .OF.......-.. �a......;c� ..................................... � No......._. /�/. FEE._......`:............ Disposal Works Tonotrurtion rrrmit Permission is hereby granted............ T 1 to Construct ().,,) or Repair ( ) an Individual Sewage Disposal System at No........... :_.n 7... .!!�E l.tJ �. = M = ......---•-•-••---•-•-••-•-••-•-•---•-•................................•-•• ..............................................-- 4- Street �/ rye as shown on the application for Disposal Works Construction Permit,No.....?__'.._-,•.J_v.__ Dated.......................................... lei ...........................................•_and ---;I-- --- ......._.........._ i-4 �,�y, _ Board of Health DATE `..............•--•--•--•:..... ................................. C2I t�t"� 3r� ,- O 51 O Z.MutitUPAL WaTEFZ evslt�►st,E \ � Q� � I 3. PiQE QI7G�. 1�4'�Ff UNLESS OTt.iEP�1rSE. tiOr6D. a.LL-?cecAsr u�ttT� Ito — - ' -44-. �'� ;,� - � � 5, P t�Joi f.,1TS St•4b U., �E MDOE ►,.1a."CE¢Tl(s-N? �►•;sTQUG?tot4 06TatLG"ro P.£ t�E T� 2�M :�.E t�►rtU �� '� r � r�nss ErlvtRo�! IENTe�, GoC'E 'CI'r Stu��LOSC9 vZ sT�wr(bk<7'::�, LP�107 � � � � � ►.ioT To Sc-e.�.,E (10010 —Z"oc r�a.sro•� -Tti'c�c Four k Pib- icy 1 64)1e Q� s .i` ` . �� DQ�hk OC' �'xd 4 FT �25r •-� �"Pt� �I�f � � � Gr— / � ouT ET tt-�. ZD �"u��i dL Q7�i►t� LAi Y ��iY E L '� ' -- I� i _.�, •P�ED�*gS � `G' Epp/�� = _'= ` GP'D no CA A4-�rill,• `J,DES ZcC 3.5 13,! - ------ 1�t}c•�E� I ) C..� 1- ►`'�EG�-�"� Cc:-ltc:..++ �' _ �T , � ,`.!'� -------- .F tMTar— Of 1 1 ?, r-+`--G ^•tir a. ? '. �� c - - �� `^<r 11j'...{` l� �i.�,- �.e^i ARK$! n. ARNE / WALA w Na 30 ,d�► UDc✓n Ga�Dr Cn�InGCr�n� � inG �'` g�-E ' , - � Da,"TE � �o� Z7 ,. i of 'R-tE �a �eeMo�1T>a, r�osls a�rJ� os4.�A , -.t_,s.