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HomeMy WebLinkAbout0096 WOODSIDE ROAD - Health qto ��g�d� oadl ,m�S�ns m;�1 S �_ �- 6►3 --� ; TOWN OF BARNSTABLE LOCATION �� Gf)� ��Cll�. SEWAGE # - VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. .�C���`lOC CO�� ��F- / SEPTIC TANK CAPACITY � 0 ,0 c a cu/a �' `'� LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL PUBLIC ATER BUILDER OR OWNER DATE PERMIT ISSUED: - ` DATE COMPLIANCE ISSUED: -al _ ��-- VARIANCE GRANTED: Yes No _ �� ICI � �i �� ➢`�'� �,� �� `a ` ' � � y ASSESSORS MAP NO: Z,2>2 - q PARCEL NO: NO.- -ate /73 Fx$..................... .._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH � ter A TOWN OF BARNSTABLE �@�CZ�3nment Appliration for Did niia1 Works Tome - d %z �ur to Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: •oc tt Address or Lot N Gsl� // ...-----•. .... G_'zJGi �.Si D /iJ -- - _.._.. . .._ r... .....- ..�.._ Owner Address �• 14 Installer Address Type of Building Size Lot _ ....Sq. feet �. Dwelling—No. of Bedrooms...................3......................Expansion Attic ( ) Garbage Grinder ( ) Other 0.ai —Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -----------•--• ------------••-•••..................•-----•---••--•-----••••-••-•-••-•-•••-•--••••-••--••-•---•----••••........-•--••......•••...... W Design Flow.................. I ...............gallons per person per day. Total daily flow..........-_�3c?____._............gallons. WSeptic Tank—Liquid capacity ..gallons Length................ Width................ Diameter.........---.... Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter...............,.... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit--............-----. Depth to ground water..--.................... 44 Test Pit No. 2................minutes per inch Depth of.Test Pit....--.............. Depth to ground water-..----................ 9 -••••••••••-•••--•---•-•••••••-••----•••-•-•••--...---••-•-•-••....-•-••.....................••..--•......................................................... 0 Description of Soil........................................................................................................................................................................ x V ...............••-----•-•-•••-•••••••-•-----•---••••••-------------•-•-•--•--•••-••••••----•••••••••••....-••-•-••••-•-•----•••-•--•••••-••-•-•••.....•-••-•-•.............-•----............•-•---•..... W x ....................................... -•-••••••---•-••------•-----•------•••...-•---•......•-----•---••-•-•-•. ------ -------------------••••• ......... 0 Nature of Repairs or Alterations—Answer when applicable.------... Zoe 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/e�jh,' be n issue y t oar of health. Signed -------- - -- ------ -....- ----- --.. ..- -- --------------------- -- . ........... �---sue-- Dare Application Approved B Date Application Disapproved for the ollowing reasonr: ......................................... .........--- -- -------------- -- .......-----. ....----------.....---------- .............................. .. ...................................... .. ... ........................................ .................................. ........................ ..................................... Dale PermitNo. ----- ...... .......................... Issued ................................................. Dace A_ � No..9cr z.LZ-3 FEs....`" ...- .... THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH TOWN OF BARNSTABLE /� ,� Itrtt tan for t u g1 lark Cann trnr tun rrm r `Application is hereby made for a Permit to Construct ( ) or Repair ( -,�'an Individual Sewage Disposal System at: ...... _.. /�_.... _ S ........................... :. 1. ........ ..................................... Loc tion-Address or Lot No ... �G � _ ...� 5 91.E L.q,1l�J�.Si6� .....- /Uf / _.. �� itl:S:`-i !f .._..... ................. ...-•-- ...-__._-- Owner Address ?7O% ..._fa.: '.l./5....---...__._��'..... ( f�./��J....._._....!�J!.11.�e s.... .._. Installer Address U Type of Building Size Lot_<-.:�h.ekklt .Sq. feet a Dwelling—No. of Bedrooms............................................v� Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ___\_______________________ No. of persons.................._......... Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------- ---------•--=---------•---------------------------------------•---•---------------........-------•--•-------•-........•-_.. W Design Flow..................>-�................ per person per day. Total daily flow.............: (.�.................gallons. WSeptic Tank—Liquid capacityd__gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_------------------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ------------------------------------------------------- ------------- _--------- ---------------------- ------- -------------------------- -------- _.----......_... 0 Description of Soil........................................................................................................................................................................ x U -------------------------------------- •------------- -__-_------------------------------------------------- •---------------------------------------- ------------- _----------- ------------ •------•---•---- W U Nature of Repairs or Alterations—Answer when applicable._____._�M_--_-_____..�1�.4�___5�l�f_._.Z, s�}f�__L��� 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 ben issued/by the- boar of health. Signed ........../ .mac�f..--1./�---- - �--_:_... =------------ --- Date Application Approved By ------------- �,t<u �. .. .....--...------------------_..... .............................- .... -_- .0. Dace Application Disapproved for the following reasons- -- --------------- - ------- ---------------------------------------------- --------------------------- .................. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---- ----------------------------- --- ................................. Date PermitNo. ---- -..' �- -- ---- ----------- Issued .---------------------.....--------------- ...-----------...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE - C�ex#t�t>Lrxte of C�um�li�xrtce THIS IS TO CERTIFY, That-the Individual Sewage Disposal System constructed ( ) or Repaired (�) _sC Gr'CZ1 C�/ C'lJNsr------- ------------ -------------------------- ---- -- ...------......--------------....... by..............................................---------. --. -Installer at ------------ -----.......��cJGG/,�5���--- -------- � r.v - 1!1�.... �4, 1 .. 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. ----.?_ .-.../-.7.3.......... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION gSATISFACTORY. DATE..................... 7 Inspector .............. n1 - ... ------- --------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No._•• _......... a. TOWN OF BARNSTABLE FEE-�_-TQ__ ..... Dispos t Works 01nni#rnrtion ramit Permission is hereby granted...................... . .2r 4� - _--.....O/vST. to Construct ( ) or Repair (A an Individual Sewage Disposal System atNo...........................................................�� -------- ^Y:, :.5/ ..---_ i(1_ Street ec��,, // as shown on the application for Disposal Works Construction Permit No/.�_!_Z3_ Dated__________________________________________ - --------- -----------------................... _� Board of Health DATE.............. ` -D. - ' •-------- FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS // TOWN OF BARNSTABLE _ A- l� � # o��-' LO © 13 C TION ' �� � SEWAGE � VILLAGE /&S "JS llC JS ASSESSOR'S MAP dz LOT lam-- � INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 10cc) —(size)- NO. OF BEDROOMS P""" 4F15 Wfo ' OR PUBLIC WATER BUILDER OR OWNER C� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No -��� N � � �� � :o a �����- ro j .A$SES�YrR'S MAP N0. PARCEL I o9 u I LOCATION t SEWAGE PERMIT NO. YILLACE � INSTA LLEER'S NAM-E-�� A ADDRESS ✓" 02- I r d U'I L D E R OR OWN ER DATE PERMIT ISSUED � � DAT E COMPLIANCE ISSUED __ :� ��\ � ��� ( ��,� l ` - -� � .1 �1 �b � `$a r a- o ; No. FEs.....1. L1_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............O F. Ami iratiun for Disposal Works Tonstrurtiun rrrmit Application is hereby made for a Permit to Construct (),(-) or Repair ( ) an Individual Sewage Disposal System at: ......... ....._1. T �... ---.....�00 ... ..---••.��--................����-rods_���5�........ ................ ................ att-i�on Address ....or Lot No. �"" T ...._ .... .. Owner Address ...... .............. «.«.«.«..... W Installer Address Type of Building Size Lot.5J5" 12?q':.QS feet �--� Dwelling—No. of Bedrooms.....7................................ Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Buildili yp g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures ................... w Design Flow................~?_r'.2.................gallons per person pier day. Total daily flow...........Z2A......... gallons. �a W Septic Tank—Liquid capacity A�'..gallons Length..8.-:e'... Width:47 n.(O." Diameter................Septli....4.`ne" x Disposal Trench—No. _.f................. Width.... q ........ Total Length...3Q---.--_ Total leaching area.'"? :P---sq. ft. 3 Seepage Pit No--------------------- Diameter.............._..... Depth below inlet.................... Total leaching area.................sq. ft. Z Other Distribution box (I�) Dosing tank ( 0-4 Percolation Test Results Performed by..•-•-- _B PS(. �, , Date. ?�:3 nf54- .a r._..._...- f••.. ._..... ,.a Test Pit No. 1..4-2.eminutes per inch Depth of Test Pit.... ...... Depth to ground water... ......... 44 Test Pit No. 2._,/.Z minutes per inch Depth of Test Pit....1?-E?...... Depth to ground water.. -----. �i................... ..............._...... O Description of Soil. --•..3....-•--0--310 CO►c `--�.�----- -6- !l�rt'�! It-tF `�'rtilD -...... ......•-••••----------------- U -------------------------- ---------------------------------------- -................x..t..... ' °.:. .._. -+ y,.�rF c ......... w UNature of Repair Alterations—Answer when applicable..11fi � d- •.. ._...•. r ........................... •-•-•-------••-•-•---••--•-•----•-•------------------------•-----•-•-------•---------------•-------•----.........----.................... Agreement: The undersigned agr restonstall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL% 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.......... ..........W-................... ly. Application Approved By •-• . .• --••• ... .......-• -- ---- •-• / �i ....... Date Application Disapproved for the following reasons:...................................................................................................... ...........-•-•----•--........--•................................................ -------------- ate Issued......................................................« Date No. .._. FEs...... - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r-1.............OF................................................� 'al._ -- Appliration for Disposal Works Tonstrnrtion remit Application is hereby made for a Permit to Construct (/-) or Repair ( ) an Individual Sewage Disposal System at: / ---- ... ---.... -Address ' ` "or Lot No. Owner Address w Installer Address Type of Building Size feet TV Dwelling—No. of Bedrooms......Z................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Otherfixtures -------•................•-•-•--•----•--...............-••-•--••-•---•--------•-•-•-•-•--.....•---•-•...--•...------..........__...................... D sign,Flow................�.�"a_..................gallons per person per day. Total daily flow...........?7r�.........-__.......gallons. �( Septicl Tank—Liquid capacity!C00.-gallons Length.%3-�Q_.. Width_:-19.. Diameter................ Depth....4.'P. Disposal Trench—No. .J................ Width.... /........ Total Length....3.6._....... Total leaching area.:�:f!..sq. ft. 43 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (4) Dosing tank '~ Percolation Test Results Performed by........�'y-.---.-_Y .. ._-. :....... ........ ..... Test Pit No. 1...4;--? minutes per inch Depth of Test Pit.... Depth to ground water... ........... Li. Test Pit No.,2.._,1.7.minutes per inch Depth of Test Pit....A? ��.-_. Depth to ground water..1-�.,��k-.._... O Description of Soil. T ._±..S.........v.......................,c�hM Su ....• 3r , ''_.._ •--I-ti-.d..........................................................•...... ........................Y-.. A`T —...E co_........c ....... .r> W .....---•-•-------•••-••••-•••--•••----•----•-•-•----•••---...--••••••-----••••------•----•--------•---•----•-......•... ---•=------•.... •. -----•-••-••=........ U Nature of Repairs or,Alterations—Answer when applicable..��..., _ / .. ... �:_ ......_... _... .._...--•••-•----•-•-•••-•-••--•--•---•-•....................•-•.........•---•-•----•-••••-•-•----•-----•-----••-••••-•-••--•---•--•---•--•-•••••......•..0....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL: 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. ,_..._. �.._,, igned---.-:-:----d.- -- PJ9�/A_ .. . ^ •---••. s-APPlication APProved B ..... Dn..jta�t oe .�_»�. ._..........1 Application Disapproved for the following reasons:...................................................................................................................................................... ......................................................... .Y ...---•--..-••----•-----------------•---------•............................._. .......---.. Date PermitNo..... !._"- ......��......-•---•............•• Issued_-------•---••-----•. ................................... Date a.....♦..• ....f.O ........... ............... --------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF I c'�tC .�c.......................... (Irrtif iratr of Tompliattrr THY$ IS TO CERTIF,1, That the Individual, Sewage Disposal System constructed `( or Repaired ( ) ..--•-••..... n at_ k�. Inser `'S has been installed in accordance with the provisions of TIT1� 5 of Thh State Sanitary Codas/(di..,Scribed in the application for Disposal Works Construction Eermit No.____. �-.�_.' .../�............. dated__...��llQ ........_._.._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.........��.._'.'.6- 7700 ... Inspector_;5`' ._0 A/ ------------------------------- --........_ _ , _.. ...._.._-_- -,.,..-_- -----Mw.. ---..-.-..-..-_-_- ___--...._. THE COMMONWEALTH OF MASSACHUSETTS BOARD 1OF HEALTH qa.l ................./..,t /11 1.OF........ �`) _ �±dA.�................. FEE.0 Disposal Works Tunstrudion Pgrutit Permission is hereby granted1_f ... 5l- tJ- 1 ....................:................ to Construct ( ), or Repair ( ) an Individual Sewra a Disposal Syst at No.•. /') t°/�.,�ir`) �; .--_..� l n ....�s.. .............. j - . PP P Street ��l -•'.. /�n /n . as shown on the application for Disposal Works Construction Permit No......:.............. Dated_._.�1 //`� �.. � Board of Health DATE........... :............... ............... -•------•-•.....- ; P;. s o 6 U 53v✓ Aw _ � i '. .. -- ��a{�,4.t `i��.�m�.l. 1. f%rx.Tu M �S�j -?Z E c�i t~'w,.a; �,i.i I a'S� Qti�.,..� ^r df�• .- .. � � ,,\� y � ��+��• �T. �. ..�'�-+Y - � Z.Muc�..►t;��dt_ W„el�-t�. :� evD.l;�fst,,� i?v Vi-c-►i• Irq, 1.:�+�E4f� CT �iJt LjOTEP `d' - 114 -_1if. - ,d.4, i_.tao-d t, v .iU!�� LL�d+C>ihiir i1.�.'v'7{�'�"GAST ,;►.11TS f+b '! -i. + - I Iwo ... �. � � �'\ �. '�.,;,�� £ ✓c ;'#� ::��.=3 Cn �AtiST�Uv'cr.� �E?"dt+ 6 � r3E ,�..15pt•�a2C�:t.:C-c WITr + "E iiS�tlui rp�y10- "V wU21G,oNL_, gr ip Svrtolrl LG f'aFEZ7q ►.L S'CbJ4t-4(r —04 0 oil \ I !"WIN ` �• r •+� 1 - _ _ _, �b}Pcx F'uus*a.C�l►'Ttdl '� , u •,� r..,r ��, �� q l aC� ...__..__ `A t_. _ �i '".., ,�' �{°� �-� :..,.. ,. 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