HomeMy WebLinkAbout0115 BUTTON WOOD LANE - Health �h. T
WEST BARNSIFABLE, MA.
LO CATION SEWAGE PERMIT NO.
Cyy
VILLAGE
INSTALLER'S NAME i ADDRESS '
B U I L D E R OR OWN ER
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
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ppliratiun for Uiupuiittl 3Vurkg Tonotrurtiun trrmit
Application ismade for a Permit to Construct (�or Repair ( ) an Individual Sewage Disposal
System at: —•�+ i hebyl5
,- L catio: Address o Lot No.
...... --
caner Ad
a W�...._.�4A. .... ..................................
..................................S)ee �� ..` ...........
Installer Address
Type of Building Size. Lot..�' } ..Sq. feet
�~ No. of persons
Attic ( ) Garbage Grinder ( )
Dwelling No. of Bedrooms--- �--��___.__.__._Ex a
a g Other—Type g ---•••-••-•.....-- •---•--- --•-- P p •---•--•---....... ( ) (. )
Other—T e of Building ..._..._.. Showers — Cafeteria
p' Other fixtures ................ ...........
d _ ..._...••••••....••-•....._..-••-••-••...-••-••...... ............
W Design Flow______..._._J`—.. ..................:...gallons per person per day. Total daily flow_..........�'.�Z.?.............. lons.
R: Septic Tank—Liquid capacity.IPPTbgallons Length 5 t�... Width. ":_-`-t... Diameter................ Depth.- -
Disposal Trench Total Length.'P Total leaching area3:14nAb..sq. ft.
3 Seepage Pit No--_-----------------
Diameter.................... Depth below inlet....................Total leaching area..................sq. ft.
Z Other Distribution box (xJ Dosing tank ( )
'~ Percolation Test Results Performed by...___...M.. ....t_.'''t.._4- G��`)'......_._,._ Date__.__' "86'-......
a Test Pit No. l....<4....minutes per inch Depth of Test Pit..... :•. Depth to ground water?'
fj. Test Pit No. 2................minutes per inch De th of, Test Pit..... �`: -- Depth to ground water �H.Pa -t d
d0 ` `?u4sr � j - M{ L-�rt'�.�4r-c •to�ft�,
c>r -- . . .......... ....
O Description of Soil.. `4,t�ttG.S....... a._�4�.`..:�'!�G�,.:..�at-t�__�±�`f'1
� .4.�a y/ ... l o��r—!�.�.....��.d.:-�±z-C�..- �Zx._a?.-_z`-i=---..�'�_. �.>��i�-• -•---. . �F.�PJ---•�t�eclt,.rt+.•+
+ e-•w ."f't^4Sa .101 "'�Z-�.. G►�-+ ..4t�.`� ' �'�G =.IA �satj.
U Nature of Repairs or Aerations—Answer when applicable---- --------------►rt�..`�_±�±_e_.._S_ss.r►�...W�`�!"tGS
Agreement:
The. undersigned agrees to install the'aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TI':LL 5 of the State Sanitary de— The ersigned further agrees not to place the system in
operation until a Certificate of Compliance has be. e oard of health.
.�®- �
Signc°. m ....`.....`.'. .. ................................
• Date
Application Approved By............................ •. ...............•-•-_•--••- --
--,-•- Date
Application Disapproved for the followin easons:............................................. ............
..-•-•---•--.........•...............•----•-•---•---•----........:_...:-•--•----••-------•----•--•---•---..........-•----------.....-•---•------.....................................................
•Date
Permit No..... q Issued---------------------
Date
No.. . 6-0 Fmc...........................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
% ..............OF............ i ..t ;n
..............................................................
Appliratioti for Mipaual Works Tom1rurtion Vamit
Application is-he eb made for a'.� Permit to Construct or Repair an Individual Sewage Disposal
System at:
..... ............................ ..................................................................................................
'pati;f Address or Lot No_OZO, 7Z�
................................ '!4.9 Al
-/��ner Add.ress
-------------- ..........
A/
..................... ...................................�' ............. ..........
Installer Address -7
Type of Building Size Lot..�� ..8q. feet
Dwelling—No. of Bedrooms...... kpqnsion Attic Garbage Grinder
A4 Other—Type of Building ............................ 1&---of persons.............................. Showers Cafeteria
a4Other fixtures ........................................................................................................................................................
Design Flow............ ...................gallons per'person per day. Total daily—
flow.......... .................gallons.
Septic Tank—Liquid capacity.!!�:�'5-,.gallons : Length Width!!�:...:::..... Diameter............... Depth ::`
Disposal Trench ......... Total Length. .4EE- Total leaching area3:!-n...-,,'zl-.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...:��A....minutes per inch Depth of Test Pit.....!.L:9' ; Depth to ground waterDG-7
Test Pit No. 2................minutes per inch Depth of Test Pit....!. ... Depth to ground water:Y:-�....:.......
41=- ........................7 ...........................ffy
..
0 Description of Soil...::L r ....... .....
. .
... .. ............................
............................
..................................
U
............ I...... ................ .......... .................;.............................. ..................;............ ..........
U Nature of Repairs or Alterations—Answer when applicable...................!:--mvtc(......
.............................................................................................................................................................7..........................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TAI'LL--' 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been is5,qed,by,4,he,board of health.
Sign ................... ................................................ ...............................
Date
ApplicationApproved By............................. . .... ... . ........................ .................
Date
Application Disapproved for the following eas.o!!s*----------------------------------------------------------------------------------------------------------------
......................................................................................7...............................................................................................................
-"-) Date
.............. 1SSU6&-.L...................................................
Permit NO..........
Date
................ ........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................0 F........ .......... .......................................I........................
Trrftfiratr of'-Tompliattrr
THIS IS TO CERTIFY,, That the Individual Sewage Disposal System constructedX, or Repaired
by------------------ - --- PA ...SP.c ........................................................................................................
at........... ................'6-U-7 Installer
....V.1M.O.Jb....... ................ .....G.Ai..W............................
has been installed in accordance with, the provisions of TITLE 5 of The State Sanitary Code as described*in,the
application for Disposal Works Construction Permit No......................................... dated......:........_......._.._.....................
THE, ISSUANCE OF THIS CE RTI F1 CATE,S HALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE........................ ..1 O ... ............w................... Inspector....................................................................................
...........................-------- ......V......... ..........
V'I C 0 CC
-)
E*061r4 THE1,14COMMONWEALTH OF MASSACHUSETTS•:,-
WRI-Vico 0r-2-T1f'FC-'1 -T)0ej BOARD OF HEALTH C'b#V0'
Are
OF...................................................................................
Fi ..............
'Bisposit: Works Tonstrurtion Famit
Permission is hereby"granted. . ------------------7................................................. ...........
to Construct PC ) "fir Repair--( an Individual Sewage Disposal System
at No........... ......................
........�ZaT•-•T"T�leio.. J& .........Axj f........V6......?,*.P
Street
as shown on the application for'.'Disposal Works Construction Permit NOSS.7.4-0Dated_._.__........ .........................
....................... ....... . ..... ---- .. ... .............
(I eCa
DATE. .............. .....................................
362.4541
926 main street
yarmouth
mass. 02675 down cope engineermg
civil engineers&land surveyors
structural design
Arne H.Ojala P.E.,R.L.S.
land court Richard R.Fairbank P.E.
surveys
site planning
February 7, 1986
sewage system
designs
Barnstable Board Of HeaZth
Barnstable Town HaZZ
inspections
South Street
permits Hyannis, Ma. 02601
RE: Lot L15 Buttonwood Lane
Gentlemen:
On January 9, 1986 Down Cape:-Engineering inspected
the installation of the -sewage system on Lot L15
Buttonwood LaneAand it meets the requirements of
our design dated 6119185.
Very truZ,y, �yours.,
Arne H. 0ala
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