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HomeMy WebLinkAbout0129 ACRE HILL ROAD - Health E Barnstable ' ti cd e r .O yoev� r;� P t _�a -:.� � .-� aC.=� it e_ ?: ... �, ,* �a k _, r c ir 7 LO CAT IOa SEtvAGE PERMIT UO. Lol` 3/ fC&c-- H%LL VILLAGE ,6,19mi INST_A LLER'S NAt 'E b ADDRESS ASS TA,C- _ 6:: / t BUILDER OR OWNER AS G US o A,' DATE PERMIT IS-SUED 6 0V— DATE C04APLIAItCE ISSUED ��� � II r i®�� ���' � ��p ���R� of %��tJ$Lt �'1 �_ �.iJ . k9y No.Q.c :. Fxs... :r.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH App iration for Uhipati al Works Tnnitrurtinn Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: .... ..._ �` Location-Address ,�I r t No. l/ta� �¢oSCv°a�e /f-... A/ ra .... ............................ •.. ... ................ Owner Address 114 T L ! l ..... `----------------------------------- ------------ � ................................... Installer AddressPQ J__;_fa Type of Building Size Lot............ feet Dwelling—No. of Bedrooms............................._...............Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -------------------------------- W Design Flow.............. __________________________gallons per person per day. Total d aily�flow._...........�-q................. R; Septic Tank—Liquid capacity.�12�g?.gallons Length..VX"... Width A. _..._. Diameter________________ Depth.�`�.".... W Disposal Trench—No..................... Width.................... Total Length............__...... Total leaching area....................sq. ft. x Seepage Pit No........I.......... Diameter.._.. .... Depth below inlet................. Total leaching area..4X17.......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.....�W.A. . .�r Date....... Test Pit No. 1.4.4.....minutes per inch Depth of Test Pit..... ._ epth to groundwater-__-__°' fi, Test Pit No. 2.!!5�.'l.....minutes per inch Depth of Test Pit.... .... Depth to ground water........................ �+ -•--•- ---•---•-------•---••-•---•-----•-------•--•-----•-•-------------------------------•-••----......................................................... O Description of Soil----- ir�,�ey-ir--..._l�l _ '?"1. - v v-$"f' `e' ---------••---•--•------------- --------------------------- -ow er W ••-•---•------------------------•----------•---••--------•----------------------------••-•---•••••------•------•-------------------••---•-------.............-•-•...............----...--•-----••....... r 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 A.iT ,;». 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 f health. 100, Signed---- ... --•---------------•-----•-------•• :.... ... -•-- t� ate Application Approved By.. .iQ---- ..................... .................. .` �L.............. Date Application Disapproved for the following reasbns:------•-••----------------•-----•-------------•-•-•---••••---------•-----•-----------------••--•-----........_ .............................................. ....... ------------------......_..•...------------....--------------•----•-•----•-•-•-----•-•---.....-•---•---••---•-----------•-•--•-•-•-•------------- Date PermitNo......................................................... Issued........................................................ Date No..p.........�...!.` � ,i Yq FI$Ii..... Tu............. THE COMMONWEALTH OF MASSACHUSETTS a BOARD OF HEALTH l.v.In/ ...........OF...... / /�/S]- 1-3e-4-..................... Applira#ion for Disposal Works Tnnstrnriiun rumit Application is hereby made for a Permit to Construct (,,-)"or Repair ( ) an Individual Sewage Disposal System at //-3/ �- Location-Address --- r Lot No. G"L4 s �b t� f "4C�,e'r7 fia�?/l,/ A -ST j��C ._.................... ..._..........--•--............... ...•••......_. Owner Address I ...... ................................. W 11L T� � In/v / I2dS 7 �STi "1.3es L-'� � nstaller Address ..�3/3s Q Type of Building �• Size Lot........:..................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria P I Other fixtures -----•------------------------------------------•• --.•- W Design Flow...................................gallons per person per day. Total daily flow..............................................ga.11ons. 9 Septic Tank—Liquid capacity.lq�G_gallons Length__R.K� Width..'4_.'__. Diameter................ Depth.!:`_....... W Disposal Trench—No ____________________ Width_____...__.___.__._. Total Length.................... Total leaching area............__......sq. ft. x . Seepage Pit No........./......... Diameter._._.�9-`_._. Depth below inlet......!_......... Total leaching area__447_.._.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by..... ........ Date..........................._............ a Test Pit No. 1_ ."' _____minutes per inch Depth of Test Pit..... Depth to ground water........................ Test Pit No. 2. _.d_._._minutes per inch Depth of Test Pit..... y.__. Depth to ground water...____._'_._...___. W ---••---••--------•-••-•••••-•--•-•••••-•-•-•..............•---•--••..........-••-••••...._..._.............................................................. D Description of Soil......_l,__.�_- 4✓ ....... .... ......... � Sc�/ G- ......•----•--______________--- ----------- .._.. ----------- __----------------------- --•------------- 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 :ITF:I:. 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 f health. Signed__ . r'�—.. _ .. ..------•-•.....-•--_-••-• r' Application Approved By.� " �_; �...-•-•_• ............�� ate Date Application Disapproved for the following reasons---------------------------------------------------------------------......................................... -•-•-••---------••-••----••-•--•-•-._.._...•-•-•-•-•-•--•-••-.._..•••••••••---•-••...............•---•---._......_....••----•----••------•--••--••--•----••-----••--••••••--••--••------•-•--•-•••....... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS 16/ti BOARD OF HEALTH ,�- Trrtifiratr of Toutpliattrr THIS/J DOCEERTIF,Y, That the Individual Sewage Disposal System constructed ( L.�-or Repaired ( } / Installer at. , _._ ._ +tw' .. /Z/............ been installed in accordance with the provisions of TITL 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No,-��Y___ � dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FU CTI N SATISFA TORY. , . DATE.............�-_-�=4�-_`-'-J.�----------:. _.. Inspector.............................................. ----------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............-............................OF..............----....._......._........_...._....._......._.................._.... N .---.._..•-•............. FEE. -r.'"'_":... Disposal rks �nnoir ion 'Permit Permission is hereby ranted_..____ Y g .., d vm.� ----------------------------------------------------------------------------------- to Constru (�o� Repair ) an Individuals Sewage Disposal System at No. �"' '3 .. ---------------------------•-----•--------•----........ -- ----- ----------- Street as shown on the application for Disposal Works Construction Permit No..................... Dated..................................... � . d try?..V/4 / Health DATE.................................. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS- AsBuilt Pagel of 1 L0CAT10N1 SEWAGE PERMIT NO. LorXt3 - ,« / _ spa-sT,9cE � _ 1 I N S T A LLER'S NA WE i ADDRESS 8 U I L D E R OR OWNER Cw� c�S � GvS ow DATE PERMIT IS-SUED `��_ DAT E COMPLIANCE ISSUED L 2: L f. . f f l http://issgl2/intranet/propdata/prebuilt.aspx?mappar=297080&seq=1 4/10/2015 -Z3r- lk&-- % EZ. L® � Wiz. e7 y ! 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I.EAGN WAsNEO IPNERT +�000 � INVERT 9//4 JI � � Pi'�' �" SToN� 4Z.os S, E OT tt9,w/3/R� �N D+A C f4i�� ' ALAI GALL c CpPpGi PTk G (WATcR?1WHK t 11�v No GARSA S GQW10SK �z.83, -- 201miM. _ _ J SI~PT1G SYSTEM CoNS�"Ruc-r�ON ,�k�;�- -- � 1 5 ALL CONFORAN TO THE MASS. vi ` t ;� NUnn� ° of � 4uooM5: — 3 -- — I ' v1 RONMENTAL CODE -nl .S$ ;�' REV I Sev 7- 1-77 ?y -rHF- TOvVht Y �'> D�GjIGa IJ F1.01/�/ : 33o C,P,2� 0otARo OF "eAL:n4 RErat.11�notJ5 L SA G1-i 1 N G RATS- : 44s 7 5EP7tGTANK, �lSTRI BcJ� tioN p>o�l � •� -:.� 33o AND LEACR tN!, �T TO 13S OF R EQ ►O. LF.AGI-�. G�4�A G IT — — —, — RElIJFoArlev Got-449 'f'E PROPoS�D LEAS-F�CAP/�c1TY MltJ���F..�E �ST�NG�2 PSI — N 10 L oADI t4Ga � DRI-JE.vJA)1 Nor To 8E WcAr v CRAM ovs16t WS*rEM 0E4v16aN WAMWCa C..t5E0 ,. TI'm .,. gySo' S apt g/A SO&S REFER 0AI ate. C DEEDS - - - - 1 nA .:� ENGINEERING C.R. DESIGNING BUILDING NC. N EA .--rk A<a APP90VA1- DENNIS, MASS 3 00 5 °2 8"'31