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Home My WebLink About0029 MOUNTAIN ASH ROAD - Health a9 m in Ash ,gym mA-rs�ims mires /a3- aao LO CAT IONA /SSE AGE PERMIT NO. HILL EQ A AB I N S T A LLER'S NAME i ADDRESS S U I L D E R ON OWNER 3'1A DATE PERMIT ISSUED /V-t/ DAT E COMPLIANCE ISSUED ,�,� , ��- G'�5 �i �aA� f�' r �t�v�� ti -�, �� :R �.�,P`_ LOCATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME i ADDRESS BUILDER 0- T A DATE PERMIT ISSUED ii ��liLi DAT E COMPLIANCE ISSUED - -4 5� HOc15 r _ f � b Norl.53�.. Fmc.... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH/ �•- I`'l��v,��- f 77��............OF......eA:°"S--A1-Y.7...''1.=-)-- _-•-------_----- Appliratton for Diopootti Works Tonotrnrtton Vrrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at• f. - 1.. --•.. f ---------••-------------------•-- Location-Address or Lot No. ... ....................•••..... -•---•----- ......... Owner Address W Installer Address d Type of Building Size Lot..- .. .... q. feet V Dwelling—No. of Bedrooms........ _---------------------_-.-Expansion Attic ( ) Garbage G nder 04 Other—Type of Building ............................ No. of persons........................--.. Showers ( ) — Ca pa Other fixtures ..---....--••-•-•••--•.......... .. . W Design Flow....... -`r. ...........................gallons per person per day. Total daily flow.............T.7.9....................gallons. WSeptic Tank—Liquid capacity/ .gallons Length................ Width................ Diameter..--............ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........./..,--...... Diameter......r.......... Depth below inlet................ Total leaching area.2.' . ....sq. ft. Z Other Distribution box ) Dosing tank ( ) aPercolation Test Results Performed by./, ��.�..t.`?�.:��`'<....4.1: *7.v.....cl-OoPrL... Date..../--lilkly ........... a Test Pit No. 1.-- -----minutes per inch Depth of Test Pit.-J2_!......... Depth to ground water.....I/.............. Test Pit No. 2................minutes per inch Depth of Test Pit............--...... Depth to ground water........................ ----------------------------------------------•------------•--------.............----•-•...........•.......................................................... 0 Description of Soil............................................. .............../`r•---•-•-•------•-•--------------------------------•------------------------•-•-••-•-•--•------------- U �i��.. ............11Z. v -------------•----•-•-------------•---------------•------•----•-•------------•--•- rA ----------------------------•••-•-•••--••-•-•••-•-•••-•••.......------------------------------------ ..----------......--------------...------------••----------------------------......-•-•---•----•... 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complianc has bee 's d b the board of alth. Sign ----- . ........ .................. ................... ............ ApplicationApproved By... •--•-•• .......... •-•--••....... ..... ....• .................................. •••. Date Application Disapprove f or a following reas • •.. -•-....-----•-•-------•----••••--•-.........--••••---•••-••-•••-•.................................. Date PermitNo........................................................ Issued-...................................................... Date I _ y N .. Fxs....�� ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................................OF,......................................................I................................. Appliratiun for Klhipuuttl Workii Tomilrttrtton thrtuff Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -------------------------.............. -------------•-----•----•-•-------------•---•-------•--•--------- ---•---•------- Location.Address or Lot No. Owner Address 'UT' Installer Address d Type of Building Size Lot.....................6nder q. feet U jo) Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage G aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Ca aI Other fixtures ............................... . . W Design Flow............................................gallons per person per day. Total daily flow......................._....................gallons. W �cptic Tank—Liquid capacity............gallons Length.............•.. Width................ Diameter................ Depth................ o x Disposal Trench—N .................... 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit......._............ Depth to ground water........................ f24 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ _.....---•--.......--•---------•............................................................................................. 0 Description of Soil...............................................................................................-...... .............................................................. x V ---•--•---------••------•••-•••--------------•-••--••--•-•-----•-•-•••---•--•••-••--------•-•-•--•------...------•-•---------•-•-----------•••-•------•-•--...•--•-•-•-•••------......•----••-•--....... W VNature 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 Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate /Complianc has been issued by the board of Health. ne .:_..._.. ---------•--Application Approved By -------------------------------•--..........................--•------ ............ Application Disapprove or reasons:.............................................-----•-----•-------------•--------•--•------ •------•-------- ..................•----------••------•-•--•--•-•-----••--•---•---••-•-•----••---•-----.........----------...-•-----------------------•-•-------•-------•-----------------••-•-•••.........-••---••..-•--- Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... 6 Trr#ifiratr of Tontplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( oiRepaired ( ) by ...--•-.••-- =- --- .----• -•-- r � I aver at. ® ��.... `�-- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Co sc ibed 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 SATA FA J RY. DATE..................................... 6 -...... .............. Inspector........... ................................................................... COW w„ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. ...........................................OF..................................................................................... u No.. .. ---....---•:..... FEE—*, Disposal Works Tonntrudion "Prrntit Permission is reby granted......_... �nsik� s f °i° ��k'r.. __ --•---•-----------------------•--........._............... to Construe or R a posal System atNo.--- 1 .. : ---- ............................................-•----------- -- ....... ............... Street 7'?.J-,y lI t� y� as shown on the application for Disposal Works Construction Permit No.............. :.:_ ated----I_.___.yam .•.• i.............. ............................ .... ....... ......................................................... �l • r`. s'/� oard of Health DATE........................ .....Z................................................ ,• ,. .� ...:. FORM 1255 A. M. SULKIN, INC., BOSTON ' S I w G LC_ FAMILY - ` ►.J� GARBAGE �jRaNDE2. II Dh►�.�( F►.oW z I10 X 3 = 33oG.Pc? II S1E�PT1G TA►JK = 33Ox15C>% 495G.P. Q vs� 100o GA>r. � t o1-5Po5A1- Prr u6E l000 GAL. 1 t5o 5.F i f oy �4 goTTO/4A AREA= jr� S,F,_ 03•/ I o = 5o G.Po 1 PV L II I 5o s.� x I• /oz•� /,�o I '7oTA 1- DESIGN = .¢25 G.P D. 1 ' -TOTAL pA l"%? F>--DW LOT t PE2GOLAT104 RATE : lIto zMIN oP-t_E55 � ,Z coo 0 !I /oL.a !mac s 5�0 OIL t t A"ry ALAN �I Q � /_..N...../�%D ' 1 EifCHA4D ! O. A. W. i+.t 11 BAXTER Z: NES y' Na 2a048O . 2510 . �QtSTB�� 4T SURyF'y I� NOLF rR Z!O// �G ^ /O'3•� •y/`Y To P FND= ta,Ao ,I ,444,( loov INS• ✓�vBSo�L_ 016T. INS. GAL. gUx SEPTIC- L ' 1000 INS. /00-� TANK yy/� bb LEAGl1 PIT IN41, INV. s ' WITu 99. 7 99.9 1 1'/31 •I%L li �G�Ait/ WASNGD �niay/ 6TohiE I GE2TIFIGD PLoT PL-A-W /-3 • �3 PRUFILI~ A-T 10 I J No• SCA<_E SCALE i p p.N REFT= GE I 1 CE RT��Y THAT T%Ar--- SEA �SNovYN � NE•QEON GOMPI-�(S Y�ITN'CME. SIo�L11J� �-OT /S AwD 5GiTeAC,K 21-Q019- t4Tt�l oF 'Yµ� 7c->W N o F� Lr= A ND 1 s "Orr I L.00p.TE�7D,��W�►,TNI*1 T E f00 ALbiw D AT it L� ��t� N`{E INC. K.EG I S'T EQ6'D t-A►.t D S u Q.Y EYoe`� a N osTE2v �Lr=- a I.l 1 orT � c n o n. I -Tl.t►5 P� s N a 5 . IuSTRuMENT Su2VEY Fr"T11E l�hF5ET5 6Uou1,D No-t D& U S E D•Tc5 D E'T E �Zl�I►� t-.oT 1-I N E�j �4 P P L 1 G A►J'r s�,�,c:4n/7.� CO.//�✓C �I No. - - ----- Fee- BOARD OF HEALTH TOWN OF BARNSTABLE ApplicationArVell Con5truct ion Permit � Pr,144V ..0 Application is her made for a permi to Construct ( ), Alter ( ), or Repair( an individual Well at: .� - - --- - off-—- ------ Location Address s rs Map and Parcel R ---- - - -- - -- - --- - ------- Owner Address c✓CC�r-d�� yid Installer Driller Add;?Ss Type of Building Dwelling----—-------------------------------------------------- Other - Type of Building ------ No. of Persons------------------------------------- Type of Well--- ^....... GT -- ----- ------ Capacity---- 41 -----—-----— 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 Vell Protection Regulation - The undersigned further agrees not to place the well in operation until.a Cer,11ficat .o iance has been issued by the Board of Health. Signed -- —-------- - _�-7`- e ----- Application Approved By F"' --- - ---- �� ------- date Application Disapproved for the following reasons:-- ------------------------------------------------- ----------- -- --- _ r 3� — —_ — -- ---—date -------- Permit No. � �g Issued--� f/ ��-- - date BOARD OF HEALTH TOWN OF BARNSTABLE (certificate Of (compliance THIS IS TO CERTIFY,ied 06 �i IFY, at theIn ividual Well Constructed ( ), Altered ( ), or Repaired ( ) bY-- ----- - �G�/--- ----- - --- - - -- - ------ ---- - `/ Install at- - d Afi:2K2A 4r;-/_ has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --------------------Dated----- ------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--__-- ----- - Inspector--------- --------— -...,..�s: v....,,,;P. :,,,.,,....•��♦ .-..�� . ...-�,.,.,,.__,..,«v.+.iwkw.�.w�Y�?.�a^o,.....r.'Si""'r!+r;L*�tr+M+.»�w-+E.+w--^W,y.rr: .+«>::. _,,,,�.�„-.z;�r ., ..._. , y ...,,:+,:.,";,,,F,.,.�:,. .- No. 's-��-d� y.�U� Fee--- ----------------- BOARD OF HEALTH TOWN OF BARNSTABLE 4 Zipp[nat ion ArWell ConotruttionPermit woo �v Application is hereb made for a permit to Construct ( ), Alter ( ), or�( �'an individual Well at: �0_ ® ---��-- --- ----- its --- �----- -- - ----- 1��-----_- _��__ _ Location =`tAddress —— — * rS'Map'and Parcel GA//I�r 4)-e /v'A/onr ------------------------ - - ---=—-- --- Owner Address Pa ax yid _.rU-- Aw-2o 4,------�--�'¢S57 Installer — Driller AddrEss— TYpe of Building Dwelling ----------------------- --------------------------- Other Type of Building-- � ------------ No. of YP C-.�S d —- Capacity-- T e of Well---=- - -- ---- — ---- Purpose of Well Agreement: --- -------- ; 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 i .Ce tificate�b lance has been issued by the Board of Health. Signed -------- ate � Application Approved By �" _____ _ _�___— --��/f—�--date --- Application Disapproved for the following reasons: ---------------------- -- —-- - -- -- — — --- ---------------—— ------__------ date Permit No. �— .. -- Issued--o =f - --- - —— ----------- date c �r+�.awe+•�.aieo.c•rsl�p+roaPeTa$aaevo'Y«�e9r;+e-9ded�'l:�.ceaVee�2a.asaes�amesu+soe.ceaec.avmwaraaxe.eiMa�s-�..e.:vmvaew�v..wvev;.scesee.•�.bRe.va.saegs:l6viv4zbe::.:evlwivefivc3.a•e::de:.e'VCaeow«a BOARD OF HEALTH TOWN OF BARNSTABLE Certifitate ®f Compliance THIS IS TO CERTIFY, That the Jndividual ell Constructed ( ), Altered ( ), or Repaired ( ) by---- - LfF �ec� — -- -- -- Installe ------------------------------------ has been been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as.described in the application for Well Construction Permit No. -----------____Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-—--- -- --- -- Inspector-- - — -- --- —----—- .siti4ilavrli�ivfl8.!fl:/fwvavelceNlr�fvcliife3Kv:ssblfRieGlbvl�0ivfvreieee6:f vUvil6ef efeflrefBflilrvfesvfsaPYs4wiv'f W/ri}i+KP.Yv.iM:KTi°el:i!ti.K94aS?itsl;v4vMCN9fvi937f�a`� BOARD OF HEALTH TOWN .. OF BARNSTABLE Mel[ Conztruct ion Permit No. W---9 _ Fee-- ------ Permission is hereby granted to Construct ( Alter ( ), or R air_( ) an Indi idual ell at: CA �� /�' No. —---- — 11UsV ---/ ` _—------ ---------------------------- — - - Street as shownthapplication for a Well Construction Permit No.-- — Dated-- -- ----- ---------------------------- DATE Board of Health =—�- -- I I I I• I 1 fj I , + e itG t (69 i ' f � i � E 1 � 1 � • I � � 1 4 F 1 I � r � , � � � � � II � i i � � � I � ; I � I , - - - _ _. - -1�_ � _- -� _ ===� J=r � � � � i � ! �I