HomeMy WebLinkAbout0030 BARNHILL ROAD - Health r_ r
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TOWN OF BARNSTABLE
r,,0CA.T10N �_� I '7 �c�a - SEWAGE
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VILLAGE /:TJ Z l+-,gl��/i� ASSESSOR'S MAP S: LUI`19S e - C)
INSTAi_LER'S NAI,IE & PIIONLI NO._ e"-4 ,t�-E-�7) __.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(tppe}
NO. OF BEDROOMS PRIVATE WELL OR FUBLIC WA':tER
BUILDER OR OWNER ��
DATE PERMIT ISSUED: ly
DATE COMPLIANCE' ISSUED: ��
VAIUANCE GRANTED: Yes No::
46
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X � Y
LOCATION SEWAGE PERMIT NO.
VIIIAGE --- _-
JtORS MAP N0:
INSTA LLE 'S AME i ADDRESS
BUILDER OR OWNER
Bpi C1
DATE PERMIT ISSUE D ,�-2�- -- 17
DATE COMPLIANCE ISSUED
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OIL-
WELL -m �a
.... 75
THE COMMONWEALTH OF MASSACHUSETTS
�- BOARD OF HEALTH
1 ....... ............OF.......R)9k.N..S.7-.J3..LL._....
Applirattilan for Bispaa al Vorkg Tomitrurtiun ramit
Application is hereby made for a Permit to Construct l� ) or Repair ( ) an Individual Sewage Disposal
System at:
B/.9jR[a1. « .-••— •�°: -W..!... 1ad l�.!1� T 1.4r3 __... L a�.Z .�.. ._.......
ocation Address or_Jot No.
Owner Add ss
------....-•..................... --- -----.............
Installer Address
Type of Building Size Lot.:3,5.5 6.Q.....Sq. feet
U`4 Dwelling—No. of Bedrooms--_-.----- ............................ Expansion Attic ( ) Garbage Grinder (ivd)
Other—Type of Building No. of persons............................ Showers
Q, YP g ---------------•-----------• P ( ) — Cafeteria ( )
a Other fixtures ..... -
d -_.------- --•-------------------------•---••---------.....-------------•-------
w Design Flow.........// ............::........gallons per person per day. Total daily flow........3.X.0......_........_.•....gallons.
WSeptic Tank—Liquid ca.pacity............gallons Length _. _...._ Width.��.lo__.. Diameter________________ Depth_.._._...®....._.
x Disposal Trench—No.................... Width.................... Total Length.................. Total leaching area...................sq. ft.
Seepage Pit No ....... Diameter..<9............ Depth below inlet' .�....6 ___._.__. Total leaching area.ZZ ...sq. ft.
z Other Distribution box ( Dosia tank (
Percolation Test Results Performed by. 014Af—b..... ....... Date...)44-Y......
a
a Test Pit No. L.A4!:�-...minutes per inch Depth of Test Pit....LS_`..__.• Depth to ground`water.._
(X4 Test Pit No. 2....L.L-._minutes per inch Depth of Test Pit.... Depth to ground water.. ......
P4 •-•••-••••-•......-----•••-••-•..................•••••• -----••••••-•-----•---•--••••-••-•---•----....--•--••-•-•-.._...-••----•-........_...-•-.....•.....
ODescription of Soil..........C�....... .f..._... _c/, ..Y..........................................................
U
....
-• .R
U Nature of Repairs o t rations—Answer when applicabl ................ ._
- ✓Q - -
.•-••••••••••............•-•.............••-
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITLZ 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.
Sigd•-•.•-•-• ...............:.:..........:.•-•-••------.........---••----....--••-
Dat
- ................. l ......�-� ----.-----
Application Approved BY .••--• •-• -- . •
Date
Application Disapproved for the following reasons:----•-------------------•---•----•----------•----------------...----------------•-••••...--•-•-•-•••--........
---•---•-------------------•-•----.....--•-----------------.....----------------•••-----..................---.........-•-•-------•------------------------------------------------ ......................
Dt
PermitNo......................................................... Issued--••---...-----`-----��0.----------•-•------------ '
Date
No. �� ...........
' r THE`COMMOqffArLTH OF MASSACHUSETTS
"fBOARP OF HEALTH
Cy. .3. ... ...0F....... A 1�1.`�x"1`�.?��1x.................................
Applirn#iliWfur Dispiml Works Tonlitrnriiun rrmi#
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
System at:
_
1329 f. 1. t ........ -R----------hat..3 41Z L s I ------------- -._ Z. d. ................................................ � I
Location-Address or Lot No.
Owner Address
W r
.: .. ...... ................ •�----•�•`-------•----------_---
� Installer t� Address
Type of BuildingSize Lot3__....5._a_---------S feet
Dwelling—No.,of Bedrooms........... ___________________________Expansion Attic ( ) Garbage. Grinder (NCB)
Other-T e of Building No. of ersons____________________________ Showers
YP g ---------------------------- P (---.)..— Cafeteria (----->
dOther fixtures .----------•-----•-------------•---•----------•------..•--.._..••-••-•--•-••-••---•-•------•---•••-••••-••--
W Design Flow________ Ze. ......................gallons per person per day. Total daily flow.___.__ .I7. ?_.____________.._....__gallons.
WSeptic Tank—Liquid capacityJq!�e>_.gallons Length6_'6-."._ Width _/6.�}_ Diameter________________ Depth_P"__'g'.'
x Disposal Trench—No.________ __:..Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No-_____----- ______- Diameter a ..:._.__.._. Depth below inlet.... ._.____. Total leaching area ...sq. ft.
Z Other Distribution box ( _ 'Dosing tank ( ) ,
aPercolation Test Results Performed by. .. t . .`....... Date___—4y �9
Test Pit No. 1. _.minutes per inch I3epth-1,of Test Pit .......... Depth.to ground water A i�'' _..
f=, Test Pit No. 2.... _L___:minutes per inch DG-th of Test Pit. C_ "",._� Depth'to ground water_. { _ru.e____..
R4 --•• --•-----••--..........•-•.......... ................
Description of Soil '� e! 'JY S(/ K ray .ice t' �, .......... ............. -
............
.--..--.•-------•--------
U Nature of Repairs rations—Answer when applicabl _........................................................ ,...........
. 4h
M
Agreement: ry
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.
Si ed_- _ ._ .'.
, pp
e Dat
Application Aroved=B ....-. : -'- .....
-
i Date
Application Disapproved for the following reasons:==-•---•--•-••••••-•--••-•-••--•-•-•=••-•••-•••••--•-•--••--•-----=---•••----••----•-----•---••-•':............
--••----------•............................
Date
PermitNo................................... Issued-.:h......................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...............0F........ .......................
�rrtif irat a of Tompl anrr
THIS IS TO CERTIFY, That the Individual Sewage Disposalf'System constructed ( or:.Repaired ( )
b
Installer.,, 4
has been installed in accordance with the provisions of rnirr' } of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No --------_--- dated....64_!9_Y'.-_-_-7 '�______________
THE ISSUANCE OF,THI-S CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. w
q� ;
DATE..... '. ..._. -_. !....................................... inspec tor........V. C_. .. ..............................................
THE COMMONW LTH:OF MASSACHUSETTS <
79 BOAR? OF '.:HEALTH
_..
0C ..A...............0F......... FEE.. r !t!_S_.r .1 .. �} !'a+...........
No...... ... _I?.e.--/
Disposal 1vorko Tnnotrnr#inn Vrrmft
Permissionis hereby granted................................................................................................................................................
to Construct ( } or Repair ) an Individual Sewage Disposal System
at No. _•27-.... _..� �d e l fl�f �:_.__._.t b:bir..--.-..-.-6Ll_ r.... ..............................
-Street '
as shown on the application for Disposal Works Construction Pe it No,.. __ .:__.__ _ Dated..4''!2_........ e7_•_........
el....... -------• -----•--__-`-____
Board of Health
a DATE_ "
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FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ,. �.....4..�. -
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l�.3' LOB; 64. { MAY 9 , 19 '79
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