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Home My WebLink About0830 OAK STREET (CENT./W.BARN) - Health d 830 Oak Street A= 216 -001 W. Barnstable 1✓ I TOWN OF.BARNSTABLE r LOCATION + ,; SEWAGE # —5 t VILLAGE.LV, RC4 W ) ASSESSOR'S MAP & LOT Z 16 ®01 INSTALLER'S NAME & PHONE NO. Vtj 44 alit!I' 2..-Yo SEPTIC TANK CAPACITY 0 On, LEACHING FACILITY:(type) '�� / (size) NO. OF BEDROOMS PRIVATE`WELL OR PUBLIC WATER f BUILDER OR OWNER ! j ^#x�$ C & 5. 04 V L, i I DATE PERMIT ISSUED: 19 J C, r I DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No a� d t �wrYyal�C d,4 }�,, No..$ -S.-'Y 7 F.E$.... .: THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH --------- u`u-----.....OF............. ... -- -----------------.-..------------ Applir�atiun for DhipmFai Works Tonstrurtiun Vamit Application is hereby made for a Permit to Construct ( ) or Repair (V,/) an Individual Sewage Disposal System at: • ®. ,. ...�.L....�5✓i✓ qca!✓------•------ -------------------------------------------------------------------------------------------------- Location-Addrsss or Lot No. ................... ------................... -...-----..........-----......................-- �---- Own n Address e .........................................L r�`✓�a/..4------------------ -----------••------•-----•-...._................--••---•--•-•••-••---------••-------•--•••....•... Installer Address t p �+ UType of Building Size Lot___TJf0�,---Sq. feet Dwelling—No. of Bedrooms.___.._____ ___________________________Expansio Attic ( ✓j Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Gd Septic 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.___-______-_---___-___. a ----••••---•-----•......-•••------------------•---------...........•--•-------------------•--•---............................................................ ODescription of Soil........................................................................................................................................................................ U ---------- ------ --- ------------------------------- ----------- - -------------------- -- --�-... -- U Nature of Repairs or Alterations—Answer when applicable______... 1 S�_ _1______T.P-4Z------ ----------------------------•----------------------------------•-----------------------.......................----------------------•••---•-•-•-••---•-•••---•••••••-••••-•-•-----•••......-••---••-•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TT T L:% p 5 of the State Sanitary Cod0— e ned furtl er agrees not to place the system in operation until a Certificate of Compliance has been isand of health. Signed......... •------•.......................•---'--------....--•----••-------•---•-- _�� Da Application Approved By................. --�--.---..Q..e •--- -- ................ ...........9... `e. ? Date Application Disapproved for the following reasons:---•--•-•-•----•-------•-------•--------•-•----••--••----•----•----------------•----•-......•--•••......------ -----•--•--------•-----•-----••----•••---•••-------••---•--••-----•-•-----------••••---•---•--••--••--------------•---•------••-••----•-••--•---•••-•-•--•----------•..-----•-----------•--•-----._...._ Date PermitNo...... .`f-�............. Issued-.--------------------------------..................... - No.(,�.1.�.: 7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --------------------- -------------------OF.........................-----..................... . lipfir atinn for Dispoii al Worka Tomitrnrtiun unfit Application is hereby made for a Permit to Construct ( ) or Repair ' ) an Individual Sewage Disposal System at: r`^ice-.- ---LocatioM..'nd esys, � , or Lot No. ......... ................................. \ —V' I (� ow r Address L. 'I A Installer Address Type of Building Size Lot.! ©�__.-Sq. feet �-, Dwelling—No. of Bedrooms.._..._..... ..........................Expansi� Attic (✓) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons...._.--.................... Showers ( ) — Cafeteria ( ) Q' Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length_-••--.._----- Width................ Diameter---------------- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. 3 Seepage Pit No--_---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. It. Z Other Distribution box ( ) 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-___-_____--_-_--_--___. 94 •--•---------•--------------•-••--•-•••---•-••-•------•..........------•--..............---•--------......................................................... 0 Description of Soil.................... ••----••--•------•-----..........-•---..........----•-•---•---------•------------------------------•-------•--------••••......•--••---------------- V •••--•••--•--------•--------••---------------•--•-••-------------••---•----•--••----------•----•••------------•---••-•-.....--•-----••-------•-•------•••--•--•------••-•-----------------•---•--•----- x �..... U Nature of Repairs or Alterations—Answer when applicable_......_� l.__ _____-_f � _-_----- / -----------------------------------------------------------•-------------------------------•-•-•-•.•--•-•-•----------------------••------------••-•--•------------•-•-••----•---••••---••------•------•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'IT of the State Sanitary Code— he d .gned further agrees not to place the system in operation until a Certificate of Compliance has been iss and of health. Signed...... -- •... -- Date Application Approved BY � .. = .` ,,� �-------------------- Date L j Date Application Disapproved for the following reasons:----•---------••---------•-•-----------•---------------•------------------------•---.------------------------- -•--•-•--•-------•••-----•---•-•-•-••----•--•---....•---•----••-------•----------•--------••-••-••-----..._ ............................................................ Date Permit No-----..��..-�--- ...._•-�-�--•---•---.._. Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .......OF........... J *?'- !' .............. .......................... Trrfif irtttr of Tnntph anrr THIS fS TO C RT FY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } by.. =` -----------------------------------------------------------------------------------------------------------------------------•-- e. ( Installer at--•-----------6..�.J -� t�.-----fir--T-----...._t&,---�f�*�='`'`=.. . ..... ---------------------------------------------------------------------- has been installed in accordance with the provisions of iT j o' The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. � ___.. ./.T. dated------------_____________..___-___--_-_-____--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE®.AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... '7 =!.7............................ Inspector........ c. -. '.'. 3---•---------•----....-_. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �j ........................................... ...�... FEE. Disposal luork.0 Tonstrnrtion prrmit Permission is hereby granted .... .. { ' ! �4 r to Constru ( ) or Repair ),an In ividualSewage DisBP System at --...............................•- ••-••----- .-- Street as shown on the application for Disposal `'Forks Construction Permit N .....a..�7.._ Dated.......................................... ............................... t`-- - a ...................... qi Board of Health DATE ----- •••-- •-- --... . FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS