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0039 PERCHERON WAY - Health
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" , "' �_ �',`,�,�,��-"' ,';`:; ''�, , ., ,, , " ,, � -, "e� t�, " - � �: "',,� ; I I I ,"���:,'���'�,,��,',����i,,',�,,,,"� �� _', "", �, , "''"r,�!� ,, � ,, , , , I"- .", , '' , " :_ � S, , , ,�� � , to.a 1;AS Aff .. , 4,�__ �,`,-_?,,,�_:,,;,��,,_�,� ��!�",_,-_, .I", ,�' 1.1-.1-,__1-1�I�,�,�.'-'I.,-�._';'.��,,"� ,,,� , " , ,,��i7,,, "�� 11 �, ,I, ,_,� to Z - , . .'_ , '' " , �t, - " ,,:�':� �� Y�' 4 OWN OF BARNSTABLE LOCATION Lo4 l q,J Ve W COV' ")j SEWAGE # �1 Q 3 J s5-9 VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.�•3l Or' `777j- 16LIO SEPTIC TANK CAPACITY 1 ,000 1�q 6f4s LEACHING FACILITY:(type) � D`f (size) ODO c�a l.(o►NS NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No , 9g Q,h =9 E , i L. o4 1 �1- 05 '�- _ ...�. No.... =S,5_. FEs...&O............... 6 THE COMMONWEALTH OF MASSACHUSETTS P BOAR® OF HEALTH TOWN OF BARNSTABLE Allpftration for Diripaiial Work,6 Tonfitrur#tun ramit Application is l--reby r ade for a- 'ee�niitto c oils (Aot�or Repair ( ) an Individual Sewage Disposal Syst at• Ac ..... ..... .'......Y.......�---•..._......•-••-- .------ .... ------•..... ..............................•.............. at' n- \ddrcssn nA ^ ,t No. ' -------•------✓--ems ... ^................... -.-•........................ ..•--------•----•-- - �n.r Address a ----------------•-• ---•------------------------------------------ --------. --�---•---------,.................................................... Installer Address Q Type of Building Size Lot..`.�y<. .$Y..Sq. feet Dwelling—No. of Bedrooms._______ _ ................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures Q --- ---------------------------------------..------------•--- W Design Flow.......................ilo...........gallons per n per day. Total daily flow.....__..33--._��-'�--_........................gallons. CY' Septic Tank—Liquid capacity/��galIons 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. Other Distribution box ( ) t';, Dosing tank ( ) a s Percolation Test Results nPnu ormed by-------------------------------------- ----- --------------------- Date-----••--•--.....------ Test Pit No. 1_. ..____-__. tes per inch Depth of Test P ........_._.__.. Depth to ground water._�dA1j....... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil.............._ ..._ x .......---•---------------------------••_ --••• - . - -.•••-• •------- .---- --••-. ..... -...... •......._.. V ..-••------•••-••••-•--•••-•••••--•-••-•••-•••-•••••-------------------•-----•.......... W --••••••••••---------------••--•-••.................--•------•....---..............•--•-----.....------•--•------------•••••--•----•••••••---•••--•-•-•-•-•--••-••-••••••......--••••......•••---....-- UNature 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued/bey the board of health. Signed -- o{ � ...................... .................................:...... Dace Application Approved By ........._�' V....... .. /3/// �.d..Date �. ..%................................................................... Dare Application Disapproved for the following reasons: ........................................................................................................................................ .............. ............... ... ... ..................... ................................. --............. . .................................. ........................................ at PermitNo. .........�. ....... ..°'...��................. Issued .................................................................... Dare �..•V-t�+i-.,.�-.....�0�-i--e-.a`w-.r.^.•.,,r•.....--.•,s>a.......-�.f.r...-- �..r-d...'..+ay.1WR.-,.�.:e..'w:'.+"�.+-•�.:•^+.+'r•+"•.,'+.-.�•r-�::.W^+'^^W":"...tiv�a.w-s^-..-^'...•...,:,ra,_.•as�s�+••...*+-_.._...-•.r"r.,w�a.-..-.e. ( � � aDU 1 0S ';t . F�s....(.:.�...... .......... 6 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirtt#ion for Diripntiul 1Uur1w Tutui#rur#torn Permit Application is hereby made for a Permit to Construct (V�or Repair ( ) an Individual Sewage Disposal System at: '`` t'I wow ........................................ i �u/ I• --------- -., - ----- L�"estion-:address or Lot No. arc / d-� i ......................----------...._. ... --- .... ---- (/�J G\) q Oaener v -__ Address ✓^✓ Installer Address / UType of Building 3 Size Lot..a.Y, 0.5..e-LSq. feet ►� Dwelling— No. of Bedrooms-----------------------------------------.__Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Buildiu 4V .AI.W.. No. of persons............................ Showers — Cafeteria QI Other fixtures -----------------------------------------^- d iZ---------------------------------------- .............................................................. W Design Flow.......................w...........gallons per p sr�n per day. Total daily flow--------�.___------_--__---__-----_......gallons. � Septic Tank—Liquid capacity/aMgallons Length-_.------__-_-- Width................ Diameter_.............. Depth................ Disposal Trench--.\Io. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter----------------- _. Depth below inlet.................... Total leaching area..................sq. ft. t Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....... ..........••--••--•------•••--••--•-••-----•--------------•----... Date........................................ ,a� Test Pit No. -----minutes per inch Depth of Test Pit-----1_ (...... Depth to ground water.. ."--d ... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ...............................=-••-•-------•----•-----•-----.....--------•----•--•-----............................................................... 0 Description of Soil........... 4A.....Z�...a_�144.4-•........................•---------- V ...............•----•••------••------------...........----------------------•----.....----•-------.......----------------------•----------•--••----------•----•--•---............_..................-•--- I W UNature 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 TITLE 5 of the State Environmental 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 ... ................. ................. e..,........:...... Application Approved BY ..... .. � ......... .................................................... ........J.. G Dace vDate .�..i..3 �l Application Disapproved for the following reasons: ...... ................................. . . ............. . . .................................... . .................. ............. ......................--------- ------------------------------... . ...................................................... ........................................ Dare PermitNo. -------- Issued .................................................................... Dare --------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (fQrtifirate of (fentylitince THIS IS-TO CERTIFY, That the Individual Sewage Disposal System constructed ( L/) or Repaired ( ) Ely .......�s,Q........ -.l5 CrJ L C- lL/ !1/dL.'.....Inscall r ....(/v • 1t,f//i.� !I/.-4,�............ at ......... -------�----.-/...... . . has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ._. ...-.S..,S". ...... dated .....___............................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED-AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------- `' ../..- .. Y/ ........................ - lnspecto ...... .... ---------------- ------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ---- TOWN OF BARNSTABLE No.....7.....'31..-S FEE../ -`l......... �i��Ia�tt1 �r�,� �nai,�#r�.l•#uan �rrmi# Permission isyliereby granted... J_._._.__ �2./ 5C( . ..................................................................................... to Construct ( V) or Repair ( ) an Individual Sewage Disposal System at No.......tA�........... ...... - ------1-...7.---------.Street------ - •--._.....-- -y---••-•---... as shown on the application for Disposal Works Construction P rm't No.,..,-,.........Q.7_Dated__------_.._---------------n.....:..... Board of/Health ` DATE...................-,._..... ; FORM 36508 HOBBS&WARREN.INC..PUBLISHERS ♦ y �J'ES 16 N 7�ATA 51t46LE FAMILY 3 13EWWAA4' � 6Arzs,4csE L-RI�J�E� `` 'PAILS( (=UVt 3XW-330 &PP e0N � SE'PTl C TANk = -4?0 v ISo yut 4qS LFb :ICE IODD 6A - D117FMAL. PIT 1-iooO"(,fzsTzWF- 51DEW4LL AWeA ` 188 5F" I 1 i 71i ,:�f X 1♦,g s TOTAL D6516W = S 415 6W a ' 6 4 S. TofAL VAI LY , , ' p e 0 y� ;L\�\\ O\ ♦PE¢G�L.AT1oN ¢A'� �I�iu��a�ir� `� � '�"��I^`' ° �`or ` � `.\ � � ` Q i�a► �° PETER SULLIVANco I'll gc �30 No. 29733 E'� P IsrAV sa� ss�OWAL�N6 O TEST R��29 FG=l3� T.F. tµc. Ioe �o•5-g� � � L-Outj lov. 133 )AV- Gorr ►uv 3 �u� MKT -,4 i 2G SETIC P �32'b 1flnc� aJ �,7.BAK �u� 3 T NL Mm ,FA ..: ��As+•►.Lt1.S tBQeu�,v�.fls si r s�c°-301;ua /Z MPU a r EL0 Zoww& ICI® PLaT' Fu 4 �VElvpr� '�I�-- Lac�rTloN : 4(f. STa �l Ild EGA Lam, ` �� VaTc ; I Ito W ATEL 1 CFx[1� '(�dT THE PLAN QED=ERFJJCE� %OW w NON CON(1FL S %ut-rA iVE %ELlNE LOT 144 ¢. tV 41� IDA o5. BWZ. ira3 010�tFEQ- 4IL,, - Sty. 7ar AO 15 47T 1-O4ATm -W I E VLOoD M-MU, aPt►� Seca SI Iy�SiorJ NYE ML PrvFE%106J4L- LOD 5of-VeyceS -TEIK Fuq 15 Not- BASED aJ AN 1qS7xMEIJT' Z:W i L �4 Ei,14I W GELS S:)P/V f MD TI•{E OFt=SETS 44omx> our Be 51Erz-v I LL.=— MA,S , usca To ESTA'BUS0 'Ftzcp&1zTy U ue5 1PPLIC.AWT; 3��sID�, Bvrc�i►�c �;