HomeMy WebLinkAbout0114 LOMBARD AVENUE - Health 7 �
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11% / TOWN OF BARNSTABLE
LOCATION DM ��I 6'(/e. SEWAGE # 7`7al�L
VILLAGE0, C)/10��Cl C�'I� ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. � C4C {� h tO
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) �f (size)
NO. OF BEDROOMS < PRIVATE WEAL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE .COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No t/
r
m b cr )9v&-
t
ASSESSORS MAP NO: A
PARCEL N0: O / 3
No..�.1._al.o. Fizz... 2L1.�.QQ....
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
O~Ow"n " ..................oF..........B.arnatable---------------------.......-----------.........
Appliratiou for Diipu,ia1 Workii Tonstrnrtiun Prrmi#
Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal
System at:
..........1.14...LQMhand..Avenue...Aeat....aarxaaltabJ.a..............................................................................................
Location.Address or Lot No.
..... -Johns4s--------------------•................--------•-..: .---••-•--
� J,P, Owner Address
_Macomber ---------••----•--------- --•--•------ ----------•-------------------•--------•---
Installer Address
Type of Building Size Lot..----.--••----•--.-•-------Sq. feet
U DwellingX—No. of Bedrooms.--....... ,.. .--..Expansion Attic ( ) Garbage Grinder ( )
PA
Other—Type of Building ............................ No. of persons.....................--.---- Showers ( ) Cafeteria ( )
Otherfixtures ..----•----•------------•---•-•----•--•--•---•--•-----•••••••••-••----------•-----•---.......•---•---•••••••--••--•-•--•--•---•---•-•----------------
W Design Flow............................................gallons per person per day. Total daily flow............................................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 ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..--.---................
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit--..............--.. Depth to ground water...---..........--..---.
-•-- - ------ --•---------------••--•----••------••---•-•-------------..-------•---------•-----•----
O Description of Soil-....Clad f°or° ten feet. Sand for the remainder to lei t.
x ---•-•----------------•--------------..•..-------------------------------------------------------------------------------------•-•••-
U •-•••-•--•----------------------•••--••--•-•----•-•-••-••--••••---•---•-----••••-•-•••---....•-•-•----••------•••••--------••-•-•-•-•-•---•••----•-•-•••-----•-••----•-••-•---•-------•-•••----------••-
w
U Nature of Repairs or Alterations—Answer when applicable----1�b00 gallon pit with three
feet of stone,.
------------------•---------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T T;,;"• ; of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue b he b rd of healt
54 Sign Y.. ee. .................... .4,m9e8 --------------
Date
Application Approved By................ ----.-�..et.s�v�:,�x�.---•--•...............
............••.... ...-••••-•---
Date
Application Disapproved for the following reasons:--••-----------••-•--------------•-•---------------•--•---•-------•----•-----------............................
Date
w Permit No.._..?:t-t---�L-0•------------------------ Issued........................................................
Date -
FEs.
.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
•.. OF........ :... .::..:....1,.::� ------------•---.-----------------.-----.-.-•--
Applir�ation for Dispas al ,irks C om4rnrtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
;. _ r ,
Location-Acdress or Lot No.
... _ :.................. ............•'-•--•..........._._...._.._...... ..........._...............__.___.__....._. ..._........___................_.._._.........
Owner Address
W D r
Installer Address
Type of Building Size Lot----------------------------Sq. feet
Dwelling'=No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P I Other fixtures -•--•-••---------------••.-•-•• -
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
G; Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter-__-___..___--_ Depth................
Disposal Trench—NTo..................... 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........................................
,tea Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-___-_-_____•_--.-----.
Test Pit No. 2................mir_utes per inch Depth of Test Pit.................... Depth to ground water---_-______--:--..-._.--
a •--•--••-----'----------------•-----•-•-•--•-•-•-••--•---•-•----........•--•.............---•-..............................................................
D Description of Soil----- t y_ i r t.. :,: =-j r = j ........-x ------------------------------------ ----•-------....
U --'-•-•-----------••-------•---•••-•-•---•---••-'-------'--•---.....•••--•-•'••'•...................••---------•-----------••-------•-•-------•---•-•-••---••--•-•---......--•-•-•---•'......--
W ---------------------------------------------------------------------------------------------------------------------------------------------------------------------•----------------•-----•----------
UNature of Repairs or Alterations—Answer when applicable___ ..____`_1-. 1_L _ i. ::. L.:.. .
i
Agreement:
The undersigned agrees tc install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of'T'p 5 of tie 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------- `_
r .......... J. - ---------------
DAte
Application Approved B
J Date
Application Disapproved for the following reasons---------------------•----------------------------------•---------------------------------------••---•-•-----•---
------'•-------•--•-•-----•-•'••-•-•'--•-------------------•......-•---••...._._............••----------•-----'•------------•-•-'-•-----•--•--•-------------•-••-------•--------•--•-•-•-•--•------•----
44 Date
Permit No.....5rl:t----;9,1_0-------------------------- Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
x
BOARD OF HEALTH
TrrtifirFatle of ToutpliFanre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired,-( }
. y r
by. e._ . c_�
,, r, _ E
Installer
has been installed in accordance with the provisions of T i T iE 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 YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..............- .-... . ..-_.` . ................................. Inspector.....�- ._1 J•rc•t�'->-`- ----------------------•-•-•-----
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No.Y_7-n 1.'Q.... �.. FEE. ., ......
Permission is hereby granted..... :'.a._ »_' ... '..................... ----------------------------------------------------.....................
to Construct ( ) or Repair -( ) an Individual Sewage Disposal System
at No... 14i }3�{.t�e...�.d 1 i�r C-i f � ....._ �w�_:....�. .��,'
Street -7
as shown on the application for Disposal Works Construction Permit No. `
PP P ,!_.r�.�l,�--- Dated.................................
.--- ....-_ . .. -------- ------------
DATE � •-• Board of Health
---------- - ...... . ....................•-------.
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
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RESE R'.Jc 2\ O W L'LL
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(VAciN-r) ?A R E L. / 7 Is-1
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l.Oi AC p E 1..�.1
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i VV EEID Y i
LAN E
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�l�=2 Y G D . Y
C RTIFY THAT THE
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SHOWN ON THIS PLAN IS
LOCATED ON THE GROUND
pauL A.
AS INDICATED*i LEVY y!
No. 10617
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DATE RE S ERED L ND SURVEY R
'"°
t3ARNS'rACiLE
LEVY Ek ELDREDGE ASSOCIATES,INC. CLIENT � CERTIFIED PLOT PUN
ENGINEERS — LANDSCAPE ARCFHTECTS JOB No.
1zo7
PLANNERS— LAND SURVEYORS �C RC_FL 17 SRr NSrx 6L IF
a
DR. BY: �� IN FRLr"f0.u-rH 2D
889 WEF MAIN STREET CHKD. BY,
CEhITERVI ELE, AAA. 02632 SHEET OF =Ito '
_.. .L.. SCALE DATE_
LEVY, ELDREDGE & WAGNER ASSOCIATES, INC.
ENGINEERS-LANDSCAPE ARCHITECTS-PLANNERS
LAND SURVEYORS
889 WEST MAIN STREET
CENTERVILLE,MASSACHUSETTS 02632
(617)775-2244
July 7, 1987
Town of Barnstable
Board of Health
367 Main Street
Hyannis, MA. 02601
Subj : Septic System
Dear Sir: Lot 17 Barnstable/Falmouth Rd.
Please be advised that the Septic System at
subject location was essentially built according to
the Proposed Plot Plan dated February 25, 1987 .
A field decision was made to change the location
of the primary pit. In light of this we have redrawn
the Plot Plan. See attached field location.
Very truly yours,
LEVY, ELDREDGE & WAGNER ASSOCIATES
... -
TPul Levy, P.E.
PAL/mlw
enc:
1207
88 WAVERLY STREET FRAMINGHAM,MASSACHUSETTS 01701
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