HomeMy WebLinkAbout0339 CEDAR STREET - Health 339 Cedar Street
West Barnstable
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ASSESSOR'S MAP NO. PARCEL 0 _1 �.117
L0CAT10N SEWAGE PERMIT NO.
VILLAGE
i
I N S T A LLER'S NAME A A16RESS
J. E. KENNEDY TRUCKING
WEST BARNSTABLk MASS. 02668
e U 1 L D E R 0 O W N E R 46 -3005
DATE PERMIT ISSUED
D E MP IANC ISSUED
AT CO l E
st
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No.... `. .... Fps......... ..... .........._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
--•............... ........---.....O F.........:......-......... ...........
Appliratiun for R-4p ti al 10orkgii Tuntrurtiun Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: /\
.......:WL.- ........................................................�. - ..... .. ........... ..
- ----
Locati�ddr or Lot No.
'•-- .. . ................................ .....------........................... . ......•...
W �Z , ram//tea ��I-, ss
,-� -------••-------•- .....
. ..`.....................•..... �� �o!f rG,�.� w���/'�..e.. 7, -
Installer Address /
Type of Building Size Lot............................Sq. feet
Dwelling No. of Bedrooms._....................................Expansion Attic ( ) Garbage Grinder ( )
a`4 Other—T
ype of Buildiu g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures .------•---•-------------------------------•-•--....--•--•••••-•-•---•-••-----•-•-•-•••---•••-•-•-•-•-••••.........................................--
w Design Flow..........�M... ................gallons per person per day. Total daily flow............................................gallons.
W Septic 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........................................
a
Test Pit No. I---- ---------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........................
1:4 -----------------------------------------------------------
-...
•----------
......
•----
----------
....--------------
..........
..--------• -.................
.--
0 Description of Soil...............................................................................................................................................................I.........
x
U ----•-•-••••-•••...••-•••---•----•--••.....---•....................•----------•-•---------.....-•--•-----••---------•-•----.-------------------•--------------..---.........
xw ______
-------------
U Nature of Re airs or Alterations—Answer when applicable._ ...
................ irk-y .. ..-...f
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITi 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 'ssued by the oa•d of health.
Signed .......... "
...... ...........................
Date
Application Approved By---•--------•-•• -- . ----•-..
..........-•--•--------... Date
Application Disapproved for the following reasons:. -•-•---•-•-••-•-------------•-----•---•-•••••-------------...-----------•-•-.....----•-•----•-•••-•--.......
........-•-----------•------------------••---------...------.......--------•--•-•---------•-•-------...------........---•-----------------------•----------------------------•-----------•--•--...------
cc�� Date
Permit No.. Ll. .:.. .4-�------------------------ Date
Permit
Date
1�
No....��-_;y__f..... FEB........ ................„
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........................................O F...........-........--.....--.-.......
Appliratiun for Disposal Works Tonstrudion Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: f
....... ...... ... .............................................. . ...........................................
Locat� •-
ddr or Lot No.
._..... .... - -•ir.................... �..r.
er
04e
Installer --•-•---- --------- ---•-•---• �r
� Address
Type of Building Size Lot____________________ _____Sq. feet
Dwelling-No. of Bedrooms__ _______________________________________Expansion Attic ( ) Garbage Grinder ( )
aa Other—T e of Building —
Other—Type g ____________________________ No. of persons._.__________.______-.______ Showers ( ) Cafeteria ( )
Other fixtures -------------------------------•-------•--------------
W Design Flow..........% _._".................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
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 ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
rs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
0 P4 .•--•------------------•••-•---------•-•-..._-•-•-------....----•-•------........_•-••-•-----•-•----.........................................................
Description of Soil.......................................................................................................................................................................
U •--••-------------------- --------•--------•---...-•-•-•--------------.....--•--------....----------•---•--------------•---------------------------•-------------------•--•--------••--------------
----•-------------------------------•-------------------------------------------------------------------•-- ---------------------- -- --- -------- ------ -- --•-------------
V Nature of airs or Alterations— sw r 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 Sanitary Code—The undersigned further agrees not to place the system in
P p y he oa doff health,
operation until a Certificate of Compliance has been ssued b t
Signed---- - �— .
Date
Application Approved By................ 4 � +� .........�'-2,6.�.
Date
Application Disapproved for the following reasons---------------••---------------•----•----------------------...................................................
..------•....-•------•-----------------------•-••-------••--•-------••••---------....------•-•------....------••-...._--------•-----•-.___... ------------------------------------------------
QQ Date
PermitNo........ ..................•••-•• Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTSy'.
e
wdBOARD OF E J T /� , ,r� �/f. / tAL
OF...... . ...- /.... 8
(Ipdifirtttr of Toutplianrr
THIS I TO CER Y That th In • idual Sewage Disposal System constructed ( ) or Repaired ( )
by ..... ... ....... =-------- ....................................
nstaller �
at ... - --- ----- - - ----••-•••-- -•-• -•-- /---- « �--------------------------------------------•-•-
has been installed in ordance with the provisions of T TIZ 5 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 CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...........................................................••-••-------•---•--_. Inspector............................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HE TH
.. . : . _ 1" .1 :............. . -
No... FEE.-
- •--......
toua orkukon++�wqv
- rrutit
_tV.
Permission is hereb grante �____
---•-------------------•-------•-•---
to Constru ( rt_.p -rA�) an In ' l Sewage/ ost
at No............ �
Street
as shown on the application for Disposal Works Construction Permit No. -- _ Dated..........................................
------------••-•--••-...-•------.... ...............................................
Boar of Health
DATE
FORM 1255 'HOBBS & WARREN, INC., PUBLISHERS
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