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HomeMy WebLinkAbout0048 WOODCREST ROAD - Health (2) COCA coe�si- ecoA No....,,7..^__.:: f! -��' - Fim.............. lt'? rq THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' TOWN OF BARNSTABLE I ppliration for Disposal Works Cnnn6ur#inn "truth Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: AA / Location-Address or Lot No. --- ..._ Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............3.............................Expansion Attic ( ) Garbage Grinder ( ) '_4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ---------------------------•-•-• . W Design Flow............:...............................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.La?d..gallons Length................ Width................ Diameter........:....... Depth................ Disposal Trench—No..................... Width.................... Total Length-------------------- Total leaching area...................sq. ft. x o 00 f Pi No.___�............... Diameter_._...__.__....._... Depth below inlet___.._.____......_.. Total leaching area_..._...._._._.._.s t, t � Seepage P g q Z Other Distribution box ( ) Dosing tank ( ) � Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R4 ----------------•-... ----•-•--•••-••--•---•-••-•-•-...••-•--•••••-••-------•-----------•----•------••--••--•••---•------...........-•-....._..--•--...... O Description of Soil------------------ °��' - x c, W --•••------•----------------•--•••••••••------•-•--••-•-••-•--------•---•-------------••-•---•••--•----•--------••---------------•-•--•-••......•--•-••••••-•-••-•••--•-••-•-•-••-••......---•----•_.... UNature of Repairs or Alterations—Answer when applicable....._. ......;.r.... Aoxs............... -•-------------------------•-------------------------........----........_......---•...•-•-----••••-•-•-•-••---••-•••---•------•--•-•--•-••--•-----................................................... 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 has been issued by the board of health. ---------- Date ApplicationApproved By -------------------- a!-' ------- ............................... ............................ / Dare Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------------------------- ......................................... ------------------------------ ------...-------------------------------------------------- Date Permit No. ... .-'....^ --. Issued .....140,........ ''Z----"- ?.......... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tertiftraxte of Tantlslianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( �/) b - -------�----/ � ...............................................------------------------------------- - Installer .. �r/oo�Gl�e ff at yg -------------------------------- -------------------------------------------- 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. ...... '.'may..:.... /. dated .... ---1f THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C6NSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... --------------- --------------------- Inspector ' " ------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE � Disposal Works Tunstrur#ion rrntit Permission is hereby granted.............` " ���� to Construct ( ) or Repair ( -j an Individual Sewage Disposal System atNo............................................................................................................................................................................................... Street as shown on the application for Disposal Works Construction Permit NO S9wti�.,Pated.._.b � '��� ..��•� o DATE.....L/�-` �-`-.&1 1•----------------....-------• r...� Board�of Health r FORM 36508 HOBBS&WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION � '�_�����.�j 7` �� SEWAGE # VILLAGE /���y ,s /����s ASSESSOR'S MAP & LOT 0'30- o'7 7 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 7 -(sue) -iP/0 NO. OF BEDROOMS '3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: /o,/t DATE COMPLIANCE ISSUED: f � v eq- VARIANCE GRANTED: Yes No ' S\ 5 A� 1 {,y4 Q r L 0,' CA T 10N E W A G E PERMIT NO. VILLAGE INS L ER'S NAME & ADDRESS 711 B U Il D�E R OR OWNER - DA.T E PERMIT ISSUED HATE COMPLIANCE ISSUED - y Jr 1 a i IN 7 7 No.......... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD. Q/E HEALTH ........... .... '�'..............OF. __........................................................... Appliration for Uhip ,sal Works Tow4rnrtinn ramit l`,;�g Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ` F System at ... Y... .. . L&6........................................... .............................,f1Y........_.. - ..................................... cation-Address { i or Lot IType .... ........•---.......-••-------------•- -•---.._...w rAd. ..-- .... .. ..................................•----•-_.. Installer Address f Building Size Lot.....a3j.-4Q_6.....Sq. feet Dwelling—No. of Bedrooms..............3...........................Expansion Attic ( ) Garbage Grinder ( a`4 Other—T e of Building No. of persons .._ YP g ---------------------------• P �--------------- Showers � ) — Cafeteria................................... QOther fixtures ----------•-•-- -------------------•--...----------------------------...-------•-------- W Design Flow.........lCf..........................gallons per person per day. Total daily flow....... . ..............gallons. WSeptic Tank-/-•Liquid capacity_190 allons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench-�No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......I............. Diameter...1.0p6-------- Depth below mleej�. _._._._. Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( /�� ''" Percolation Test Res is Performed by................ .. �� Date ................................- 7 Test Pit No. 10.....minutes per inch Depth of Test Pit_ ________________ Depth to ground water_____..______.__.._____. (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ uu �... ---------•-----_---- --•--••---------- Description of Soil......... - t P ............ �W-----'----2 - 1'Z ---------------•--•----------------------------- --___------•------------ W UNature 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 TIT1Z 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 the boardlof ghhhhh, _ Signed. tu. ------------•---- --- -•�------ Application Approved By.......... .....� Ou- ---- •......... :-•---------------------•--- -3 7 Date Application Disapproved for the following reasons:................................................................................................................ . ........•------------•.............................••----•---•---.....---...-----•--------•----•--........---...---------------•-----•------------------------------------•----------•--------...._---•-- Date PermitNo....................._.................................. Issued....................................................... Date. Ni .......... Fic$ �... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH g ---------..0F..:.:.-- .A;.ekU- ------ ------ ..................................... Appliration for Diopon�l Works Tonotrurtion "anti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal a ystem a ............ _ . f.......................................... .............................. - .......................................... Sation-.Address fr or Lot.,, wrAddr•-- -•--- -- ... •-- -- ---- ................................................ .....---- ----- -•----- -_-.:----- ----- -•-----_-___---------------- Installer Address :72Type of Dwelling of Bedrooms Size Lot_____ �t.'9l> .....Sq. feet U g J.........................Expansion ttic ( ) Garbage Grinder 4AW A4 Other—Type of Building '_____ No. of persons_ .._._ Showers — Cafeteria a' Othe ,S tures ..............----................................................................................. W Design Flow.....• _____________ gallons per person per day. Total daily flow .. .............................gallons. WSeptic Tank L Liquid capacity 7600.......gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench -No--------------------- Wid h ................ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No. _____________ Diameter ..-.... Depth beloy''nl70% Total leaching area..................sq. ft., - Z Other Distribution box ( ) Dosing tank _.) "" +"` - . -• C Percolation Test Res is Performed by................ Date___ Test Pit No. 1 ________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......•................. ,. ............................ . . � ..� .. w - �. . J�,. ------------ escrion oS .oD f il . W --------------- -•--------------------------------------------------------------------------------------------------..-------------------......------.................................................. U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------- e_ .............................. Agreement; The undersigned ,agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T U 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 A the b rd of 441th. Signe • •-- ....... l Application Approved By....... .... --- .......... Date Application Disapproved"for the f ollouiing reasons: --- -------•-----=------•----•-----•--••-••-•--••---------- ......................... ................................................•:••----•--•---•---------------•--------...------------........:._.._...------....-------•--------.................................................... Date PermitNo---------------------------------------------------------- Issued_....................................................... Date 5iW(AGE' S%JS*T-�ZM �T'1�E�COMMONWEALTH OF MASSACHUSETTS UM 1N G L/1� BOARD F HEALTH '��FtCDR �PLt1NIC3it�C INs�Ec7a '-Vy c�TE P�-UMi3 } :M�s�- �oNt�c�- �� r„ iffiratr of Tontplianrr TH TO T 4t the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by .__.... 1 ........44�� has been installed in accordance with the provisions of T �`pf_ he State Sanitary de de�rsbyd in the t application for Disposal Works Construction Permit No.__: __ T- da.ted..... .... .. ....... ..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM-WILL FUNCTION`SATISFACTORY. DATE.-- .. ••-•1_7................................. Inspector -----•--••••-••---------. THE COMMONWEALTH OF MASSACHUSETTS 1701, BOARD F HEA ,T V;; t .... ................. .OF...... ......... ................ .. ................ ............ .w.�' No........• °. FEE ioronl k otrnr�ion rrntit Perm> sion s,.hereby gr me ---- --•--•-- ----- ------ -- ---- to Const ( or Re r an In Ivldual rage DIsp s yst --...... 0,4 st et M""..� - "y as shown on',the application for Disposal Works Construction P` No t __;•__. Dated �+._�__________________________ Board of Aea DATE ✓✓--- •-•---......1 ........................... x FORM 1255 HOB_BS & WARREN. INC.. P,UBL�'_SHS ,•,l Az rg 13S- oo ' - ;-//vG D„itY FL0P/-i/a x r JIV4" USE /G00 rjAG WALL I �3•r ISO .5 L-,K -2. G 9.^.. to f.'arrr'G�r•-1 A,4 TO 7;9.L DESK G n/ - ¢.?� G-•G' [ , N 0 77 ,r ; .. 'Nct pG 1� G l FG•91 6 yH TpP, -q7 7 / t. ( Bc r-t 67 -s CaVM711aD PLOT F>L.Aa,►J G o L e/a c Ai A7/T- -• u,�, . s ra�.c, LbCATIou NEwr©�., ry CrtZTiF- ,-� T"AT- T14G DWEL-L-i N c� -5"0vJ1.J PZAt`1 R F"�cL�1.1G Gc>0V\,PLkIS W I TN T"G 6 D'i= Li�-►E L U`C 1 1 �{- Ea,�z� 'f~gtJtc?C&AE OP TW k. a z r PCB• 1,97 jC5'!./►J C� I3A T /�P�L ' l_ONCo F'Cl1y 'l�, ,t"iS'. REGIS"(•Cr'7E�D LA,610 5UZ'Va. 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