The URL can be used to link to this page

Home My WebLink About0390 MAIN ST./RTE 6A(W.BARN.) - Health 3qo Ync�n Diu No..... a-` -----� J �-/O Fes$.... ......................_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH /GGcJiV OF.......... c G Appliratiun for Uiupuuaf Workfi Tonutrurtiun Famit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: �G' _OJ/! f;G.. 3F/.lY�r ..! : ...................................• Z C Location-Address ,,� _ �} / /6► Lot No. AV Owner r Address i a ----------- V�------------3- Us1.�� Z�----------------------- •-•-••-•••-•-••-•••----••--•-•--•••--•••••••••---•--•--•-••-•--•.............--•--._.. . � Installer Address Type of Building Size Lot.... _IJ........ t Dwelling�. of Bedrooms___�._..12214'X.......•.___..__Expansion Attic Garbage Grinder '4 Other—Type of Building No. of persons............................ Showers — Cafeteria Otherfixtures ---------------------------------------------------------------------------- W Design Flow.............................�-- .._-_.gallons per personyer day. Total daily 4ow.._..._...._.J.r�_-.n........... lons� WSeptic Tank—Liquid'capacity.l�.gallons Length__ .�:�..... Width..!51.-,9 __ Diameter................ Depth.-_. ._... x Disposal Trench—No....' ........... Width_._.._.------------ Total Length............r__--- leaching area................ ..sq. ft. Seepage Pit No........../------- Diameter......A0....... Depth below inlet.....6P.............. Total leaching area6......sq. ft. Z Other Distribution box (liY Dosing t (�. -e Percolation Test Results Performed by..... -- _.&r.�� .. Date- �� _--------- Test Pit No. 1.�_.�tk&inutes per inch Depth of Test Pi -__1.�__....... Depth to ground water.O.Vc-!�'.ZZ_. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.A_2 ........... Depth to ground watenlay_.',_Y'_J.*'.L' Ix ... ------ �� ----------- -- ----------------------p ,f---------•--------------- -- O Description of Soil...d..'_ .12..................... c, x -------------------•-...-- ••---------------•-•••••-------------•---••--•--•........•--•-••••-••--••---•-------••--•-•------•-------......-••••••--•-•------••-•--•-••-•••-••-•--•••......--•--•----•••- U Nature of Repairs or Alterations—Answer when applicable_.....S.C:�_ _-_---_--_14 ._.___._L.g `R....__.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1,,^. 5 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 Signed - ................................. •••. ••-•••......•- - Date Application Approved By--••-- '...... ......... Date Application Disapproved for the following reasons----------------•------------------------------------------------------•----------------••-----••......•---•-.._ --------------------------------------------------------------------------------•----------•---------...._.....••---•-----•...._..-----•--•--•-••••---•--•••••••-••-•••••-•--•-•----•••-......•----••--- Date rPermit No......................................................... Issued-....................................................... Date Aj IoTo.. rO> Fizz.......................... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ..OF.... d�JA�1C�. k" iration for Disposal Works Tonstrurtion Vanfit Application is hereby me for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal System at: t_1L r.... 7% C L, -•.. �1 fJ.l "// fn .. ................. ................................................... Location Address .................. O ne L Address y WU / 'r �------ •-------• -•----•---......_ Installer Address "" ' U Type of Building, Size Lot.._. '. _. _______-Szl:�et Dwelling—No. of'Bedrooms---Z....)n. ................Expansion Attic ( Garbage Grinder 010) er—T e of Building .._. No. of a Oth� YP g ------•-•------•---•--•• Persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures -------r-•-•--•--•--...----•----••---•------••••••----•-•........-•••-•----•--•-•--•--••••...........- - ......... W Design Flo .................... _.gallons per person pe day. Totald4il ow............. .gallons........_0........ ..... WSeptic Tank.-.,,Liquid capa&ty.:-•. ..gallons Length. ''_-g..... Width. --=K.... Diameter................ Depth {- ..... x Disposal Trench—No...4........... Width........_.._...... Total Length............0...... Total leaching area..:... __... sq. ft. Seepage Pit No........../______-- Diameter...... J.__..... Depth below inlet....(-�'............. Total leaching area� ��....sq. ft. Z Other Distribution box (L-- ` Dosing t ( ) '' `-' Percolation Test Results Performed b �y•rf / `P�' '�' o� ti Y•-•-•-......••....:••-•_..•-•......... ---- - Date _e - 4 Test Pit No. 1_ ':: !A�'minutes per inch Depth of Test Pit---- ......... Depth to ground water. 44 test Pit No. 2................minutes per inch Depth of Test Pit.A.� ......._... Depth to ground water.a`_�'�.�.4. a ----- f O Description of Soil...-"y- �-1 r .: tl ,. �' �-- � �ra j f�' �- x . .................•-•....---------••-----...-----••. ~ x ••••---•••••----------------------•---•-•-----••-•--•--••--•--••••••-------••--•-----•--•-•-••---•----•••---•-•-•••-••--------......=••------•--•-----••••••-------•-•-•......---•-••• ----- U Nature of Repairs or Alterations—Answer when applicable......-��,�'Z'..........� ,��._.. ..._ "27e..�___•_• 4 ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TiTITE 5 of the State Sanitary Code— The undersigned further agrees not o place the system in operation until a Certificate of Compliance has be `issued by the board of!4 alth. Signed • ----- ----------- ------ ApplicationApproved By..................................................-;;y- ----•---•------------ ---•---•------ -- -----•---------------------••-•--- �,�•• _ Date Application Disapproved for the.following reasons:---------------•--------------------•------------------------•---- ........................................... ..-------•---------'•-----•--...---•-------------•-----•---------•--------------••---•-----•---Date h r PermitNo......................................................... Issued---------------••-•-- Date . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. .........OF..........�L�: I :N)O)O"A B1�................................... (9rdifirat e of Tontplittnrr THIS IS TO CERTJFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ............... .a i, ......-------•----•----------•-----.......-----------................----•-------------•-- staller at.............................................r b�3 R�-• t`"...............................................i ' �"I " has been installed in accordance with the provisions of TI17 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..__: -"X)�............... dated._..______.-..._ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................................... 2.1 .. .1. ..._..... Inspector....--------........'. / � �.!-.............---........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH w .........OF............�............ - FEE.... ............. Disposal Works TOnstrudivit ranfit Permission is hereby granted........... A, e..__.._r�.......� � .h ------------------------------------•••••--••••-•----....._.. to Construct ( ) Repair ( ) an Individual Sewage Disposal System at No............. Street as shown on the application for Disposal Works Construction Permit No...................j. Dated.......................................... � and of Health DATE................... �.:�.........._.r. .. FORM 1255 HOBBS & WARREN: INC., PUBLISHERS CLOUGH & CAHOON WELL DRILLERS INC. WEST BARNSTABLE. MASS. 02668 ew Q 11�� ` . !s a r V TELEPHONE: 362-4860 362.6106 LEEMAN WELL DRILLING SERVICE OWNED & OPERATED BY CLOUGH & CAHOON WELL DRILLERS INC. WEST BARNSTABLE, MASS. 02666 1-3 vx\ L AA-A' �k 6-a 7X61 5tC4 ol -;kvl c-" lei d _ L0CATIr � '� SEWAGE PERMIT NO. 94YE/ 0 8 3 -f07 411LLAGE I,N-STAILER'S NAME i ADDRESS �xx�s�te�� I �f7►l�f a}iCf-f ,94FKMK- lt' OR OWNER DATE PERMIT ISSUED DATE CO`M/PLIANCE ISSUED J f kL S 1 hE } UO GAMBAC-ra Cw;Z1 6,-MVJZ r;,dl LK I`L.D%A/ a 110 < 3 • 330 G.P.D. USE`• k000 6A1`. j bI5PO501. P11A'�• uSe. 1 Ooo G �t> WAL1. W+EA - TUT•RL 'L'7ESIt'a�.! •�G.RD. : . • ; ! t ! .TbToL FL.ow l`_I ?y; Gf�2Gpt.�TtoU ¢eTt✓ : !"ty Sm, oV L>rS',. , ` . . .: 1Ko> ark.. , o AIA g . _ .... . . . ,. .: .. .. . . . ToPFwti y�:• •��- . ..9as•. .. ..�. . 4: -max qt:4 Sc�nc t o i 1000 B9. twv tw. ; 't• rT - C>✓tZTtt=tEL� pLc7T' . . .. i j tbGATio" WEST ' QPt2P45T"ABLI ua Nv waTelz. . : . : : : �i,zq•Pz GGLZTtfr`! TAA r T"a rQ%) ►JVATIt�IJ SNo�,c►1.1 4 J 3 $�PZ. •�dF:Q�a1J 4oAAPLgS W ITI t T1a:� �jiOt�:.t_IN� . :�� Q.1JD SETL%AC4 VG4UICeAAE TS Dl= THE to XXTErP -Toww olr DoRN sTA$L.Z AUK U LoeATEb• WITti•II T 1✓ � PLAtu. t 6/�XTCtiZ G4 ueE 1&.IG. ��/ �0 !? RE6tI -RED "Wo SUCV�YoR: T%415 IwoLAtom! I'S L'oT ZASct> vN a•J OSTEmV%L.LG o /MASS. jj4.; QtJMC1JT -,�Ut~ IM*? -k TiAL- - UFC;LT4i Si4r"JLn STEPH EN WAt_LAC.0 . �r i #er.rn *r, n�*tr•CM1%Il_ �..D`f' '.l_INa•5 - - );-rS Uk O F fS CEo ,� R� -PLA N Sc�.�.� t►a• = 4of7 ^�GO FO F. ST E PH EN WAU.ACE 4.�v tip 3•P�,8 �- N . 83•q ' 8► . 8 L 84 • S 4- !1f . lu/ LL� h 0 o `�,# 8 3 0 jar. L yj rr.ti P.Ld a z M y .5 10 �' 78 . Z Q 9 e (ay-8 tf �A PIT rN w 100._ E4 Ip 9 � 60►'r IQAX e► � - , .lcx�0 GAS.• � T+�� 93 1� 85�z L 7B . Z. 9 .�* O'E •'01JN D/��I4N _ i 60.7 89•s Is . 1 �� `Np / f • �� ea .5 �oQ ,d 9► (9711 PRO?. �Nk2� 83 A e 78. Z I 03.