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No....2�7- MAP Fss...a.P.-37 -
THE COMMONWEALTH OF MASSACHUSETTS PARC '
BOAR® OF HEALTH � �2
Town o F...........B......rnstable LOT
..................... .. a......................--------------------.......-----•----.........
Applirattilan fur Disposal Works Tonstrnrtinn ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: �02
-Lot 9-A Sheep-.Meadow Road, _"TRAILVIEW",--_West_Barnstable
_ ----- ..-------- - --- .._....
Location-plddress or Lot No.
_Mr.&_Mrs. Rica- rd F. L=.r.6 RLmnymede_Road, .Chatham N.J._07928
..--... ..... ... ...- ............... . ...........................................
Owner Address
a Bousfield Sanitary Ser vice,__17__Burbank Street, P.O.Box 255,__Sandwich, MA_02563-•,,,,_____-
Installer Address
Type cf Building Size Lot..... ..................Sq. feet
U Dwellin —No. of Bedrooms......Mda..............................Expansion Attic (X) Garbage Grinder ( )
'4 Other—T e 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../T.0 allons Length................ Width._=_-_---.-__- Diameter................ Depth................
x
Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No......... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box (n) Dosing tank ( )
'-' Percolation Test Results Performed by...Alan.W._ Jme.s &_Associates_______. Date... t.19 1978_________..
..
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................:"
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit---------.......... Depth to ground water........................
A+' •--•-•-------- ----•----• . •..................•--•--...-•-• --•....._ ...... .. .......... -----••----
0 Description of Soil.......See attached percolation test report_for soil description, and
V .---------------------- ....................ptic_sy_stegn_clesi gn acc°?> riyjW..................................................................................
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 TITIS 5 of the State Sanitary Code—The un ersigned further agrees not to place the system in
operation until a Certificate of Compliance h s been issued h o d of health.
Signed .-•--......�...-
Date
Application Approved By........ ..j4.....:---•--•--••--•.................... ................................... -•--•------�L=�,3 -"-r--
Date
Application Disapproved for the following reasons:...................................................
.........................
................................
Date
Permit No......74P
---•------------------ .�-----•----•-•---------.---------------------...........------------------------------------
*... -• ... ---.... -----•--------
-----•---••------•......-•----.....-• Issued:-.- �J �`3� ----•----- ------
Date r t•
BDUSFIELD SANITARY SERVICE
17 Burbank Street
Sandwich.,Massachusetts �
02563 24-
4 Name Sewer Permit No. 7�7Y
Location: f � AJ
f�1� 1�/GUI a2. ✓.�wrD
l
Builder's Name and Address_ 1
Date Permit Issued: S-
Date Compliance Issued: 1. `3-79 '
(�� � �
I
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►�`�' _ � .
No......_........_....... FBB................ ......._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town ...OF.........Barnstable
............... ....... ............. .............----•-............--...............................................
Applira#ion for Disposal Works Tontratrtion rrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Lot 9—A Sheep Meadow Road, "TRAILVIEW" , West Barnstable
................--.........•••........... ...•••.......-•••--•-•........-••................... •••-•--•--•-•--•---•---•---•--._.....-•-•--••-••-•-•••••••-----•-•-•-••-•-••-•--•..............---
Mr.&Mrs. Iisrd > ;atl Ainmers, 6 Runnytrede Read, Chatham, N.J. 6141d o'
--------------•------ ._... ........................... ..........--......................................................................................
Owner. Ad es�
W Bousfield Sanitary Service, 17 Burbank Street, P.O.Box 255, S ch, MA 02563
•-------• •-••••--
Installer Address
UType of Building Size Lot............................Sq. feet
DHdUag—No. of Bedrooms..._.!M................................Expansion Attic (X ) Garbage Grinder (PL4 )
Other—T e of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures ...-------------•--___----------_.
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity..!t..'..Lgallons Length................ Width------_---_--- Diameter._._._...._..... Depth................
x Disposal Trench—-No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No....................... Diameter.................... Depth below inlet..........:......... Total leaching area..................sq. ft.
Z Other Distribution box (I.) Dosin tank ( )
�lan W Jones .. Associates Oct.19,1978
Percolation Test Results Performed by.................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_____-_______-_---------
f% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water................._......
p See attac'ied percolation test report for soil description, and
Description of Soil
-- --------------------
-----------------------------------------------------------------------
---------------------------------------
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 Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance h s been issued by th�board of health.
Nov. 13, 1978
Signed...................... ....... ................G......................... ... a D .-....
Application Approved By....... ........................................
..._...... _
` Date -��
;..---/C-•--------------------•---••-------•-- !
3 _
3;,-----•-----------------------------•- ---------------------------------------
Date
Application Disapproved for the following reasons:-------•-----------------•---------•-----------------------------------------------------------•---••-•-•-•----
Date
PermitN,0................:� .............•---.....--•----.-.-.... Issued..-..----/I..........................................,n„ Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH �"
............... .
Trr#ifiratr of ToutpliFattrr-.
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
f >w z Installer
r•f C ...!✓:h........,:c_.:.............. ...... f .
has been installed in accordance with the provisions of TIT=E 5 of The State Sanitary Code as described in the
-application for Disposal Works Construction Permit No..___....�-r 2...................... dated------------ _......-___ ..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT-THE
t�SYSTEM WILL FUNCTION SATISFACTORY.
DATE.._..::: !•7.......1.. .................•••-•-----............._. Inspector...... .....-•-.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.
No.............:......... FEE'.......................
Disposal Works (11111no#rnrtion Vinmit
,.,"
Permission is hereby granted---------------=-- -... ...........= ' ` = __....._.._._..
to Construct ( u) or Repair ( ) an Individual Sewage Disposal System �:, t
at No
S14, treet as shown on the application for Disposal Works Construction rmit .. :___........... Dated......j'...............................
-----------------------------------
/��.• Board of th
DATE...- f-- !l/••"- ?_...••--•---•....-••.................................................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS -
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