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0097 KETTLEHOLE ROAD - Health
LOT 44 KETTLEH®LE ROAD, � ARNSTABLE s. Fl- ASSESSOR'S MAP NO. _PARCEL LGCAT ION * 9'7 SEWAGE PERMIT NO. j l-tyT elzl �TrLc-#Ls VILLAGE ,INSTA LLER'S NAME i ADDRESS III M //�-' A/lc-/fc�.Y0AJ Y. /3/fek)s�� ✓V4 . 026, 3 � IUILDER OR OWNER 716 eo olr® ✓ GJ000e &sT Jq&qL7-� c oRp, DATE PERMIT ISSUED / 'L '1( DATE COMPLIANCE ISSUED � 1 SG N ;S a D ` D `' No. :: Fps ............ THE COMMONWEALTH OF MASSACHUSE77S BOAR® OF HEALTH T_ ... OF...................................... ApplirFa#iou for Uispao al nrk C�nnitrnrtiun .eranit Application is hereby made for a Permit to Construct (- ) or Repair ( ) an Individual Sewage Disposal System at: ....�..._ :....L�_ .... : ---- ....... ...•................•-----•••-•---`�...� ..------•--........._..................--. .• •---- L,ocation-Address or Lot No. ((N��\e) !( �//�r Own Address a ..........t..L."r.{rl.:%�/ -QA------------------------------------------------ ................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet a Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (NO aOther.—Type of Building ___________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------------•-•••----------•-•-• ................•.--------•-•-•••---------------•---•----•--..••-- W Design Flow......`�5. __ -.--.........gallons per person per day. Total daily flow.......... �CD............gallons. WSeptic Tank—Liquid capacitv_J.DI� gallons Length.............•.. Width................ Diameter................ Depth................ x Disposal Trench—No. _.____•------------- Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No...(P__Y,Y-____ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (L,�— ' 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........................ R+ ---------- - - Description of Soil..... ... . ..__ ----�-........... W - ----•------------------------------------------------ ---- U --•-•---•-•---•---•-----•--•-•-----•---•---•--•••--••••••••••-••---•--•-•••-•-••-••-----------•----•--•••-••••-••••••----------------------•-•-••--•••-----•----••---•--••---•-------•--••-•....._•--••- W x ..........................-....................... ••-•--•-------••-••••--•••-----•-------•-•-•••••-----••-•-----•-••------•••••...--••••••--•......................................................... 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 i1_'11E ;of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance haWis.s; b. .x b rd of health. rd Signed ............ •.-• ..................................... Date Application Approved BY ---------- ..-- ------•------- ---------- Date Application Disapproved for the following reasons----------------•----......------.....-----------------------------------------------.....--••••......-•-•-.... ..............•----...........-----•-----.....------------------•-----------------....--.......-----...--••----•-••--•••----•-••••-••--•--•---•-...-------•-•---•-•••-••-•--------•••-•---••------------ Date Permit No....... 1 .... issued_....................................................... Date No.V.-� .:`........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - x,: ,._.>k)_Vj............_OF........................................� Appltration f or'Bispooa1 Works Tomouartton Prrutit k.. Application is hereby made for a Permit to Construct..,,(-„ ) or Repair ( ) an Individual Sewage Disposal System at: ................1.....4................................................. s. Locat,, `�res 01 or Lot No. W Own Address --------------------------•-------•--•--. ..... --•----- .---- per ------------------•-•-----•-••----------------------------.... v 5k all.r Address UType of Building Size Lot............................Sq. feet I—I Dwelling—No. of Bedrooms................,,,�........................Expansion Attic ( ) Garbage Grinder ((v6 p-I Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ..... ........................................................................................................................... Design Flow........ gallons per person per day. Total daily flow..........- .............gallons. 1:4 Septic Tank—Liqui 'capacity-_--__� allons Length................ Width................ Diameter................ Depth................ Disposal Trench—NTo. ..............�_�._ idth........_...._...... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....r..n...YY.__c.�.... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution"b0 (t ) _,�- Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 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........................ a ------------------------------- ---------------------------------------------••--•----...--•--.......--•••----•--•----•---------------•••......•-•---..----- 0 Description of Soil..... ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•---. 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'T111E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been Issue bytW board of health. Signed =` !---•----•------------------------ ------------Da.t.e.............. Date ApplicationApproved By.................................................................................................. ....................................... Date Application Disapproved for the following reasons:................................................................................................................ -•-------------------•----------------------------- -•-•----------••-------•---------•-•---------•--........................•..Date Permit No...... .--�.. �"'-- Issued............................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �... ........OF........................�-.... .. �.��................................ Trrtiftratr of f�ootplittnrr THIS 0 ERTIFY, That the, Individual Sewage Disposal System constructed ( � Repaired ( } by.........................��1 C <s L Installer at...................2..---O--.......... ............. { .. has been installed in accordance with the provisions of Ti T iE 5 of The State Sanitary Code as escribed in the application for Disposal Works Construction Permit No------- ! ____ .r- dated_...-_-___. .�f_ ALP................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCT19N SATISFACTORY. �- 2 DATE..... .... .. 2- t --- Inspector---....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �._. � �f!�...OF................. ��`` 1 r �� ............../......(,,�..... IV o.....Q '.. �.. �............................. FEE...... � -- Dispolitt1 rk �ono#rttr#ion rrntt i Permission is hereby ...............TT...<:!� _.. ............................................................... to Construct h�or Repair ( ) an,I' divid al Sewage Disposal System ? -� c. Street as shown on the application for Disposal Works Construction Pelt d........... .� . i Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS BOARD OF HEALTH TOWN OF BARNSTABLE am&ppqppit ' n- orVeIt ConfStruct ion Permit Application is hereby made fo to. Construct ( ), Alter ( ), or Repair ( )an individual Well at: -------------------------------------------------------------------------- ------------------------------------------------------------------------------------------- Location — Address Assessors Map and Parcel y ---—-------------------------------------- ---------------------------------------------- Owner Address S ----------------------------------------------------------------------------------------------- Ins aller_— qn1ler J Address Type of Building 0+ d' n2n///h y Dwelling------------------------------------- - - - Other - Type of Building A -4 No. of Persons------------------------------------------------ % P y� Type of Well ---------------pl_ --- Capacity-------------------------------------- Purpose of Well --- -—----------------—------------— - Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until Certificate of Com lia ce has been issued by the Board of Health. Signe - - - — --------------- - --------- date / Application Approved By date Application Disapproved for the following reasons:--------------__ ____—___ __________________________________--_—_---------_----------- --- ------------------------------------------------------------------------------------------------------------------------------------ date Permit No. -- F, 1"'-1? - - --- - Issued - l M--- -�- —Z-------- date -- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS O(C RTIFY hat the�idiviAu Well Constructed ( ), Altered ( ), or Repaired ( ) by - ---�. _ � - --------------------- -- --------------------------- --- - - -- —-- - — 1 n �(1 Installer j at---�-` -��--- F �J� ------- - ------------------- ---------- --- --- 1-/ems-� ----------------------- has been installed in accordance with the provisions of the Town Barnstable Bo9ard,of Health Private Well P o ction Regulation as described in the application for Well Construction Permit No. X1__j15/,�jated- ©---- -- (--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE - ---- -- —------------------- ----------------- Inspector------------------------------------------------------------------------------- l No.---------�-------- . Fee---==-------------- BOARD OF HEALTH TOWN OF BARNSTABLE r n ^)� erica ion,f'orVerr Con5tructionAhruut Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: ---—------------------- -_ _ ---- - -------------- ------------------------------------------------------------------------------------ Location — Address Assessors Map and Parcel _ -------------- - --- ---------------------------- r J Owner Address 3)V(?/V,; , -�S -------------------------------------------------------------------------------- ---- yp g Ins alleller 11n� Address . T e of Buildin � �V�(_ \✓T,'tnnl Dwelling--------------------------------,-----=�----------,--p� /; ,� Other - Type of Building 1�®"``�_ "w No. of Persons------------------------------------------------------ Type of Well L�d —-- — -- —;- - C.-- Capacity---------------------------- / Purpose of Well----------------------_—____—_---____-- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Com lia ce has been issued by the Board of Health. date Application Approved B -- - - ---- -/ ate ---------- ---- -------------- t _ date 'Application Disapproved for the following reasons:- ------------------------------------------- ---------------------------------------------------------- /,� date Permit No.__.P!/ z- --- -1'�_.. -------------- Issued-- -- /�'T _ � _L_ ------------------- date BOARD OF HEALTH ' TOWN OF BARNSTABLE Certificate ®f Compliance ` l r THIS TOrC,YRTIFY hat the dividu 1 Well Constructed ( );%` tered ( ), or Repaired ( ) b - `-`"'N" —d` ---- - ------------------------ --- - ———----------K - - Installer _' --------nl has been installed in accordance with the provisions of the Town Barnstable Board of Health Private Well Protection ti Regulation as described in the application for Well Construction Permit No. A,!_�� 'q1 ' -�( ated1------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE —=-------------------------------------------- ------------------- Inspector----------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE lVell Congtruction3permit No. --------------- Fee-`----------- Permission is hereby gripe -- — ---------------------------------------------------------------------------- to Construct ( ), Alter f✓), ortepair ( ) an Individual Well at: ------_------------------_- _ NO. - ---_------------------------------�----------------Street---------------------�r------------------ --- --�--ftf-----=p'- ------ ----- �/ f as shovyn on the application for a Well Construction Permit No.-- � �-- --------- --- Dated - r -— Board of Health DATE---�-�------" ---�---=---�--------- -- l� t i izl_ -7 7-77,7 -7 -.7 '�7 7�.',7` -,,7,r-- , �7 ".77 7777'277 77 7,7- 7i-: 'J v hu, 4., 7 2 fTt., MN. 0 41 FOr OF FOUND. MIN., 'j E 0, FT, 6 C T`E CLEAN 'COV RS 4'. SC14 PVt d PIPE"`MIN.� PITCH tp CONCRETE 1/8" 0ER FT. COVER:, L YE OF too 2" 41 CAST IRON I/Z -,WA 9 12�,!.,MAX. PIPE MIN.t PITCH. J 1/4" PER '-FT ]STONE Z, z DW, IL N -pT- _�W EL. /0 MIN cli EL.= /04, 3 EL. 0.'� ig, EL.= /0 0 DIST ul CF BOX 12 WASHED STONE� ir uir 'PRECAST LEACHIN 00�'GAL. BASIN OR � EQUIV. 'PR EL GROUW ATER TABLi OFILE, 0 m ST -:>I 'SEWAG 0 EM SAL ,�-,SYST -SCALE NOT:: T 0 -ULATIONS 0 CALC DE 'SIGN TE NUMBER,;OF BE6ROOMS .. . L -DISPOSAL� -UNIT.,. ... . . . . . . . ALL 0 �S61C TEST _-o TO WITNESSED GARBAGE" BY /0 TAL .' ,ESTimATED,', FLOW PERCOLAT ION - RAT E R 0 BR. GALJDAY' 1vD 40 AY x M'IN INC 14 7 GAL/8R./D L E�. EQUIRED 'SEPTIC , TAW , CAPACITY_.. L'. WSERVAT EL -IC TANK..* ATIdN ACTUAL SIZE OF, SEPT 'GAL' EVATION�'- LEV LEACHING ,AREA REQUIREMENTS DEWALL,- AREA -GAL./S.F. si BOTTOM AREA-_ ', N ( BOTTOM 4 'Ott LEACH,14,6. :CA.PACITY 0AL. Y;?�s x] 1-4 x .tow)KT GAL. RESERVE LEACHING CAPACITY,.................... Flol"Iyl r M ep v?j. f__4evo M, Aj D �__LAY CrA AS). NOTES NO VVA7,El� 00/vo A A17- SHIP 'MAN AN 1. ALL, WORK D MATERIALS SHALL CONFORM 71) D.E.0.E, TITLE, 5 ' AND THE TOWN OF !I:: tS _ ' AEGULATIONS FOR SUBSURFACE DISPOSAL RUL OF. SANIT40Y 'SEVAGE REGULATIONS SHALL BE .�, 2.COMPLIANCE- VAT H- ZONING IONS PER BUILDING-- D&EkMNE'D Y . 'BUILDING INSPECTOR OR BUILDING BUILDING SETBACK INSPECTOR OR BUILDING��'' COMMISSIONER E K MIN. '#P:'NT,: _FINA GRADI�S SHALL REMAIN ESSENTIALLY .3 EXISTING AND L MIN. REAR SETBACK S E T eAcK: 7 SIDE MIN., VED BOARD -Of� �:HEALTR T APPRO oj�-' otj rT Wl�� 14kN 14 DATE, �AGENT,: PROJECT LOCATION: APPLICANT, p rZ5f C. DATE DR; Wi 7 SCALE ttGEND.' 4. .Not A '7 -:0 JOB . REV., 'TING 7X ISTIN( LEVA is '00 ON 0 �'EMS t ... .. ........ ........ DRAW11h A FINAL�,:c-,-.-SPOT.�-�'ELEVATMNS, 7- RN, ES`i�, '-6CATI 'N I P 1/8 iRON 4" CAST PIPE MIN PIT ...........