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HomeMy WebLinkAbout0081 HIGHPOINT ROAD - Health 81 Highpoint Road Marstons Mills A=028 -047 I I i I � .......... ......... Fick ... ..:................. HUSET ;-le THE B- OARDAO OFHEAc TH TS 2/-Z 10e j'%...........O F......... . .. ...... ------- ........................... Applirtttinn -fur 4%iVviial Works Tonfitrnrtinn j3Prniit Application is hereby made for a Permit to Construct or R air an Individual Sewage Disposal ;. PP Y ( ) P ( ) b P r System at: Location- r s or Lot No. 1 W /T �' fY/Y® Address Installer Jij1� Address Q Type of Buildin ��J / ize Lot------------------------ _Sq. feet V Dwelling=No. of Bedrooms-----------2.............................Expansion Attic ( Garbage Grinder WO) Other—Type of Building ----------------••-__--_-__ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------ Design Flow....:.._.._. ®_------------___________gallons per person per day. Total daily flow.......... .......___.____._.__._._gallons. W WSeptic Tank-k Liquid capacity/QQU_gallons Length................ Width_......------. Diameter.....--_----_ Depth................ x Disposal Trench No. .................... Width------------ Total Length.................... Total leaching area-.------_---.-.._-.-sq. ft. Seepage Pit No._,-./_____________ Diameter.Z 4©. _ Depth belo; inlet_... ___....._..... Total leaching area-----.------------sq. ft. z Other Distribution box ( ) Dosing tank ( ) 1) °7 aPercolation Test Results Performed by--------------------------------------------------------------------------- Date................................... a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.........----.----..-.-. �zq Test Pit No. 2----------__----minutes per inch Depth of Test Pit-------------------- Depth to ground water.........._------------. ------------------------- O Description of Soil � " r< (" -� 1 `� ``�'�9' W ._ W ------------------------------------- A//�� ____________________________________ t&� .{^T. ... - - - --- -----------------------------------------------------.---.---..--.._----_-.---_-.-. 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has.b sued b the and f he lth. r Signe -'---- -- ------•---------------------- Dat Application Approved BY.-- . ------. . ••. lG1 a 7_- _�� Date Application Disapproved for the following reasons----------------------------•-•._ _._....--.___.___.............._...___._________._.._........_..........._..__ -------------------------------------------•-•-------------------------------------------------------------_---------------------------------------------------------------.---------------------------- Date PermitNo......................................................... Issued..../ --- ---------- -----_--------_----- Date No........ ............. F,x..:.....{/...... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Apptiration -for Ui.ipooat Works Tomitrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: /✓/.'Irr •'.�'�T /-:� ' l ----••---------------------------------------•-•----•------•--------------------------------.----- --••-•------•-•--•---...------------•------•--•--------------•-•-------•-------•----------------. Location-Address. or Lot No. ....../ ... O .. i- ,r1 T .. j ------�....................iX .J'.....=/)i/,r'.y.1.��41..... . .. ...���........ Owner / Address fr Installer / �.} �/—�y � Address d Type of Building..,- ��`Vvvvv�c l 7/ Size Lot............................Sq. feet Dwelling ZNo. of Bedrooms._.__._-_.-7_____•---.•-_-__-__--__--__-Expansion Attic (✓) Garbage Grinder (4,16 Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Pa Other fixtures ------------------------------ W Design Flow............ ________________________gallons per person per day. Total daily flow.......... r'�'__..........._.-_--_-.gallons, P4 Septic Tank / Liquid capacity_2�!!��:_'-gallons Length---------------- Width-----..-__--_ Diameter...---.--------. Depth---._--__--. xDisposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No.....X------------ Diameter.................... Depth below inlet.................... Total leaching area-------.----------sq. ft. z Other Distribution box ( ) Dosing tank ( ) r I - - Percolation Test Results Performed by-------------------------------------------------------------------------- Date-------_--- ---------•-- ------------ a Test Pit No. 1----------------minutes per inch Depth of "hest Pit-------------------- Depth to ground water.........-.--.----.----- fiq Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ P4 ...............................................•••... .........................................................................-•......................�... ODescription of Soil......:r=------------------------------------------------------------------- -------------------------------`--------=------------- x --- U = = = W + � 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 Article XI of the 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_.- 071 Signed............=-------------------�-----------------------•.........---------------• Date' Application Approved By---- ..........-------- ------------=..-----•-••••-....... =............---•----•-•---•---. ------ ----------'. .... Date Application Disapproved for the following reasons:----------_........................_ _ ------------------------------------- -------------------------------------------------------------------------------------•-•••-•-•....----••. Date PermitNo--------------------------------------------------------- Issued------........-------- ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f- • ................. +•................... .. Qrrtifiratr of fgoutpliaurr fir THISIIS TO CERTIFY, That the Individua ge Disposal System constructed ( ) or Repaired ( ) i . / nstaller fA at------------------------------------------------------------ ------A------- ---------- ,------------------- --------------------------------------------------------------- has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.`_-_-_--__� �?�______________ dated_./A_-2..-.-'. _________._ THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r �. DATE-----, `-= rr`" 2. Inspector--- - �. ...'. r t� THE COMMONWEALTH OF MASSACHUSETTS � BOARD OF HEALTH' L/ / , -� -� /_ NO.-••..................... FEE---. ................... Bi-rijimiat Vorkq Cnouistxttrt�oat ; _Permission is hereby granted.---. "-- '`".� -- --.P......- •---- -- ------ .......... .. to Con tr ct ( � or Re air ( ) an In jiv{dualL�ewage—isposal S.ys ' y/ f �. �l DEC 1n�-�yiin ..� /V / /A_ at No. c.�t �- p� �f = - -------- -------------- - -------- ..................................... / e I'll Street as shown on the application for Disposal Works Construction Permit No.*�7_f�.___....__"' Dated.__.l<_11_-"_ -----------__-___- /i r_st11._ - / DATE-------------------------------------------------------------------------------- Board of Healthr/ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS t t cco Fa c.. -germc� rnWI 1 � F,xc) d i 'd ✓ a �= PzobsaD (\j ` r A.4 SURV 4Q ' O �atiT3��q'a'' t ^�-1k:T�5.:.�/ ;r..t jA T' .r l-� �� 1'rDUt.l�.�• S[-1r..0�•1 �-sl ,C�.:.; �:'�' � -; t_ { L: ,l `,`., ;�-, 1t.,,r:t, N� a.. . _.,��,.�.a.�-ram, �>r• •���i t:� !.A� �ouc�c �f.•A.iJ 3454•!a s�4 '1"1-1t".:: S�i�A,.►�1 ',', 1•��'T' tc�;.:ti��t.'i� Ul.! �:i.,! C.`S�-F.�C'�/�L.l,�. •c, /'YI�h';•'i t:.Qr u. u t m L-1 IAA L-T--,r TZ. TOWN OF BARNSTABLE LOCATION SEWAGE # $P1-3"6.3 VILLAGE 021= .-IIU5 ASSESSOR'S MAP & LOTff,4�-cy7 INSTALLER'S NAME & PHONE NO. y OP 60AX77 y� = SEPTIC TANK CAPACITY /G LEACHING FACILITY:(type) (size) 6ael� ---------------- NO. OF BEDROOMS RIVATE WELL R PUBLIC WATER BUILDER OR OWNER DATE PERMIT`ISSUED: Z4 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes 6fNQ C r A I \1 00-F- 6 V7 No... �` ........... THE COMMONWEALTH OF MASSACH ab P P , L0 CST a� BOAR® OF l--IEA TLA �� 1` °f�tZO TOWN OF BARNSTABL n � Sl$red �4 Appliration for �i-4pooul Works Tonstr ton a a Application is hereby made for a Permit to Construct ( ) or Repair (_'�6 an Individual Sewage Disposal System at: ................. 1......t..t-fl�-�f� ............................ �___f...........G4S..---------------------...------------------......--•--•••---- -- Location—Address or No. -- ...✓.-1�................ Owner ddress a . G0�7 ,�s'T ��S 1�t.1 91 � ......... ......................................r�/GCS {� Installer Address U Type of Building Size Lot ;F�-QQ- .Sq. feet Dwelling—No. of Bedrooms.....................................Expansion 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. WSeptic Tank—Liquid capacity/W6__gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------- Diameter...._. Depth below inlet.........__r_.. Total leaching area..................sq. ft. 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_--_-----_--__-_-- -_. (T, Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water......................... P4 -------------------------------------------------•-----•----------------............._......._-----•........................................................ 0 Description of Soil........................................................................................................................................................................ U ----------------------------------------------------•------------------------------------•---•-------•----------------------------------------...-----------------------------------•---••-------•-----. W ---------------------------------••---- -----------------------------------------------------------------------•----------------•------- -----------••--------•--------••••----•-----------•----•--- U Nature of Repairs or lterat ions—Answer when applicable.----.AhJ------.--/ee.0 ..... 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 Complianc3ha bee issued b the board of health. Signed . .. . .. - - - --------------- Dace Application Approved BY � �' .. ­75-------------------------------------------------------------------------- ... Application Disapproved for the following reasons: ................................................. . ---.. ...--........................--------- . .-- -- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------- GG Dace PermitNo. -----//.--- 63-- ------ ----------------- Issued .......................................------- ---'----------- Dace ' ------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE- Appliratiun for Disposal Works Tonstrurtion jkrmifo Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: ....._..-- �- // /ice{.OJT- -�2 - -- -- - - �J, ✓yl/G LS -------------- Location-Address or Lot No. --------- 577----- lo�4_ ,4-,4 .W11(S Iner G l D7J7 C-'IJo�S7 ddress Installer Address Type of Building Size Lot--21)006):2-'Sq. feet Dwelling—No. of Bedrooms..........................------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) Cafeteria, ( ) Otherfixtures ------------------ .------------------------------------------------------------------------------------------------------•-------------------------- Design Flow.................. � -------------gallons per person per day. Total daily flow_-----------.__ � G--------------- W Septic Tank—Liquid-capacity- gallons Length---------------- Width-__-.__-----___ Diameter----------------Depth---------------- W Disposal Trench—No--------------------- Width....................Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No----------- Diameter.......eD_..... Depth below inlet---------_4o------- 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--__-.--________-____.._ P4 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-_.-_-_-_______-----_-_ a ------------------------------------------------------------------------------------------------------------------------------------------------------------- 0 Description of Soil......................... x M ---- -----•-----------------------------------------------------•--••---------------------------------------------------------------------------------------------------------------------------------- x ----------------------------- U Nature of Repairs orAlterations—Answer when applicable_..._. ��_�__---___----A4e _ RCJ_1'Z - .j�T_l-_____. -=---------------------- �/ S OoIJ� x T71 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'Elie system in operation until a Certificate of Compliance has.beep issued by the board of health. Signed-------------- ---------- ...... -- -------- `' /� Dam Application Approved By ------------------ ------------ ` --------------------------------------- /o ------- -- ------ - Date Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------- Date PermitNo. --------/ �-- ------_------------------- Issued ------------------------------------------------------- ------------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE TPrtiftrak of (f ampliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (.\ ) b - s ' l7l�C W1-------C'D ` UC' 71� J-------------------------------------------------------------------------- y------------------------------------------------ J / Installer at -------------------------------------------------------------- -------17�C�` / /iITT"22.E s 7.J17/GCS has been installed in accordance with the provisions of TITLE 5 o The State Environmental Code as described in the application for Disposal Works Construction Permit No. ._--__ � �� ------------------ dated ------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ........... - Inspector C-4! �( l THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE __. Diupuuttl Marks Tunu#rnr#iun f rrmft Permission is hereby granted.................11��a-t7_151 ------ ..t � to Construct ( ) or Repair an Individual,Sewage Disposal System at No....................................22..------... ... La' -- ----�J i- 4?/ -.< ------------------•------------------- Street q/ rJ 3 as shown on the application for Disposal Works Construction Permit No. __-_.--_:-_---_ Dated------------------------------------------ n ---------------- DATE -- - � 1 J (/ Board of Health FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS