HomeMy WebLinkAbout0016 WINDING COVE ROAD - Health 16 Winding Cove Road
A = 077—046
Marstons Mills
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TOWN OF BARNSTABLE
LOCATION �" SY llxvinre 604� A, SEWAGE # ojg -
VILLAGE /)I . ✓`')ILLS ASSESSOR'S MAP & LOT 077
INSTALLER'S NAME & PHONE NO. B6YL' l b*') Cl xw e -, q Z F 9R2-E'
SEPTIC TANK CAPACITY f S-0 0 od ,
LEACHING FACILITY:(type) p 1�r" ) ) (size) /D
NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATER
UILDE-R OR OWNER
DATE PERMIT ISSUED: 2/77IgS-
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes nNo
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THE COMMONWEALTH OF MASSACHUSETTS
P $ 11 BOAR® OF HEALTH
Gcv O...........0 F.... --------------------------•-•-------------•-
Appliratiou for Dhipaaal Works (foustrurtinn Famit
Application is here /made for a Permit to Construct (� or Repair ( ) an Individual Sewage Disposal
System at: � /
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..............
. . .................................... ...................................................
cation Address r�, or Lot No.
� ,�`` O ne�r��� FP A yss
W U �f/..... �lwr. / � �..a� yVl i
F Installer Address
d Type of Building Size Lot... feet
Dwelling +�No. of Bedrooms... Attic ( Garbage Grinder -
aOther—Type of Building ............................ No. of persons_....................----- Showers ( ) — Cafeteria ( )
a' Other fixtures ____________________________ _
W Design Flow.................................gallons per person per, day. Total da'ly flow____-__---__-�.2..S.................golons.
W Septic Tank—Liquid capacity.�6�u O.Ugallons Length._/ ...... Width.5........... Diameter________________ DepthV�,------
x Disposal Trench—No. .................... Width-................... Total Length__..._ ._...•...... Total leaching area........_..q_.�._._.sq. ft.
Seepage Pit No.......... ........ Diameter:._..` ....... Depth below inlet___.._............ Total leaching area.'V.�____sq. ft.
Z Other Distribution box�� -Dosin tank )
`"' Percolation Test Resul Performed by--- -�4 ._ .._F�-'!� _ l.J�\................... Date....!_2.`z�:..g ._.._-
,aa Test Pit No. 1__-4-.3—_minutes per inch Depth of Test Pit..... -.._.__ Depth to ground water---ems............ Z
fi Test Pit No. 2................minutes per inch Depth of Test Pit.......(_._.-------- Depth to ground water........................
O Description of Soil-.Q �Z-� �� f, �
VW ----•••••--••---------------••--•---------------•-----•----•....•---•-••--•-•----------------••-•••-----••---------•-•---•-•-------••-••......-•-- ...................................................
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 Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Complianc"hbbee issued b e rd of health.
Signed ----------- ---- -----------......--......-.... ----------------
Dace
Application Approved By .......... .[[�.......�...-.`�....... - .-- . . -- ---
Application Disapproved for the following reasons: .................... Date........Y ..
.................... ..................................................................................... ........................... ...... .... .............. -------------------- ........................................
ce
PermitNo. .......... .. -... -------------------- Issued ----....................Date Dare
No......................... Fizz.............................
THE COMMONWEALTH OF MASSACHUSETTS
_ BOAR® OF HEALTH j
--------IF-1- � J...........0F....l'IV0 57/41 1L..............................................
App iration for Ngpoii of Works Tonfrurtion ranfit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at: / r
/r rr'Zttil)/�G l-e,u P ll� .............................................'
............ __................. . --• -----------....... -
.....
Location-Address or Lot No.
W Owner ss
lJ/Z�� 7J LLII_�� `�N'� -?G', l�3�-1C ``� t V ✓V�e t w4l 1 l t S
Installer Address
Type of Building ('' � /�
YP g Size Lot............................Sq. feet
Dwelling Z''No. of Bedrooms............ Attic (,C•b Garbage Grinder (off)j
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures ------•--------------------------------•--------....-----•---------•---•------...--------•---•---•----•----•-• --------••----------...
g .._.......�?.�:?�_._gallons per person per day. Total daily flow._.__.______ /_ ..................gallons.
W Desi n Flow_________________ _
j W Septic Tank—Liquid*capacityh:l gallons Length_1?2......_. Width_�........... Diameter________________ De th?Z :___r..
P .
x Disposal Trench—No..................... Width.................... Total Length._____:__._________ Total leaching area ______i__--sq. ft.
c
Seepage Pit No.____.__..1-------- Diameter...../_y�_....... Depth below inlet__ Total leaching area_l��,X.._..sq. ft.
z Other Distribution box (--'')- Dosing tank ( )
Percolation Test Results Performed by.-_f'�A_:9J_>-_.f....�JV.1'. :__..._ # 2 -;- Kt"
-- -----... Date----------------•----------- .......
Test Pit No. 1..e...?----.minutes per inch Depth of Test Pit.....;.. _._.... Depth to ground water_. .....................Z
fsl Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a %__ _
Description of Soil '...�1 to-l..G S u 1 i.. -.. f -�� (.......................................1 �i�-,_
U ........................................r '��........._..._=t 1-' `''.....- ? ` ! � - - - - t
..
W
________________________________________________________________________________________________________________________________________________________________________________________________________
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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance ha`ben issued b Zbrd of health.
/
Signed /�.. ............ -----
Date
Application Approved B f'
Daze
Application Disapproved for the following reasons- ------------------- ---- ------------------------------------ ------------------------ ----------------------------------
..... . ... . ............... ............ .... ........................ .. ............. ................ . ....................................................... .......................................
Permit No. / ..-,.fit,- ------------------- Issued ............................... Date
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
i
C e r#tfira e of Conrclaitaare
THIS IS TO CERTIFY-That-the Individual Sewa e Disposal System constructed
g p y ( ) or Repaired ( )
by-------------------------------------------------------------- --+'C f 0.7- 7---- - --c--c ,vS' c V-`x-ra, ------------------ ---------------------------------------------
_ 'Installer
at ..... �t? U-)-l. a ! 1 �1. � l l i!.,1 -12 � ��. �fi„► . 11 t
....- - ,:..- -------------------------- - �...- �.. . l: - .......................................
.-... :.
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. ................................................ dated ......................-----.----------.---------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE ------------------ - -- -------------------------------------------------------------------- Inspector -----------------.......................--•--- . ......................--
THE COMMONWEALTH OF MASSACHUSETTS 6 7 — 0 L �o
f— BOARD OF HEALTH
...........................L: OF.....+' :: . ': .'... ....................•-............
No._../...% � FEE........................
Disposal kii 0.1111notr ion rautit
Permission is hereby granted............... U 777 C c^j-S 7�Jc%a
-•--•---------------------------------•----------•--•----�--•l-......---•-•....---•-....................
to Construct (X) or Repair ( ) an Individual Sewage Disposal System
at No.... a_ �� ►. 1i7!i., /. '`r.tl Y! 1 f}{► ':!•r'1� ... 'it 1/
-- .......... y _: - P...•.. y...............................
Street
as shown on the application for Disposal Works Construction Permit NoN./13. Dated------- 7'.� --
----------------•-------•---- ---------------------------
DATE-------•---------.- q ............................ bard of Health
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FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
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