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HomeMy WebLinkAbout0065 BAYBERRY LANE - Health Gr gQyy�,� � � — _ ,���� �+,s�/eye_ f — No. 4210 1/3 P arm&V-Malz ESSELi E 1 0% ►—�i TOWN OF BARNSTABLE 0 LOCATION , � _SEWAGE # L VILLAGE ASSESSOR'S MA.P �,OT , d INSTALLER'S NAME PHONE NO. .Psv� 00 SEPTIC TANK CAPACITY LEACHING FACILITY:(tyPe) NO. OF BEDROOMS, PRIVATE WELL OR PUBLIC WATER BUILDER OR OW NEI. DATE PERMIT ISSUED: /°QApAg I T C011.PLt.ANCE ISSUFD w.. VARIANCE GRANTED: Yes No Y Q �? 61 � sz, 0 r 2 { ��� ✓® �� � � � �� � L 1 � � ��� �� ��� � � � �� ��� ���� ��� �1���� . W v No.� l .....�..f�. Fps.... .............. THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH -------------- Appliration for Disposal Works TouBtrnr#ion Prruat Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System,. /� a • .. - - 1A)..-•-•IC1��1.'��,t. ._A.-- •--..... .. ----------------------------------------•---•----•-- Lo tion-Address or Lot No. A�i Owner Adekess W ................. .20'0. 10'ok--------------­----------- Igstaller t , Address Type of Building W Size Lot............................Sq. feet �--� Dwelling—No. of Bedrooms.......;-11 -------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g --------------------------•- P ( ) — Cafeteria ( ) Otherfixtures.................."....................................................................................-----•-•----•-------------•-----•-•---------•--- W Design Flow...........................t...............gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons 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 ( ) Dosing tank ( ) aPercolation Test Results Performed bY-------------'............................................................ Date........................................ a Test Pit No. 1----------------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......................... ---•-------------------------------•----•-•-------------•--•------------••-•--•----•.................................................................... 0 Description of Soil-------------------------------•-•-•-•---------------------.....-•-•--------................................. .................................................. x W -- -------------------------------------------------------------•---------------------------------------- V Nature of Repairs or Alterations—Answer whe appl'ca le.._eE'lC�ll __ � r1 ...� o. . .............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State SanitZbessued —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has the board of 1}e lth. Signed. ----------- .................................--------------- Zat Application Approved BY y ----------•---•----......--•-------------•- ..... Application Disapproved for the following reasons-------------- ---------------------------------------------------------------------------------------•--------- ..............................................................................................................---------•-- ---------------------------------------------------------------------•- Date Permit No.---. ---_ 4 ------------••--•- Issued-----` ........... -•...... ................ . Dat i ppppp- No ..... 'r> FEs... ..f�............ THE COMMONWEALTH OF MASSACHUSETTS BOARD...,OF HEALTH Applira#ion for Dispoaal Works Tonitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ) an Individual Sewage Disposal System at r � �(/. .:.....S.3k �' c`.lf. ..'.... ................../._'=....eh="-3 ...... -.... -.............. Lo'ation-Address or Lot No. •---•------- .+.,..°).ok_......_..... .................... ale?. : Address ......................................................... Owner w '� .®C).SplL.41 ........................... ............. `, '!'. �??ia i(r fl........................................... Installer Address Type of Building Size Lot............................Sq. feet -I Dwelling—No. of Bedrooms..... ..................................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building _...._..... No. of persons............................ Showers YP g -------•-----•-•- --------._. ... Cafeteria ( ) A4 Other fixtures ............ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons 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 ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 94 .....................--...................................................................................................................................... 0 Description of Soil......................................................................................... ----------------•---------•---•-------•------------•••-•-------_..........---- x V -----------------------------------•------...__...---------------•.._..----------•-----_----------•-----_•----------_•-•-••-------------------...------•--••--------------•-_--_-•-••••••••.........-•-- W ---------------- .......................................................................... / ..._.. V Nature of Repairs or Alterations—Answer whe ap licable. c�r� �tj. . ._ X/,��tK -- �? S ©✓-----_•--_---_-. ._ r[%mod. ..._. 2 ° '----......' ��'----------------------••-•-----...---- 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 has beenissued by the board of Ith. Signed/-' 0�.!yt.. . . ZOv. li�A_�.e Application Approved B ' ?fig - -r� '......•_•.......-•---•----- ...... • 'Dare Application Disapproved for the following reasons:------•--------•-------- .................................................................. D ---------------- -••---.....---•----_•--•.......-•--••-•--••-_•-•-__-_•-•-•----_-•-•...•---__-_-•......-•--- -------------------•-------_------•---•••-----------------•-••--------------•_------•......-••_-•--••-•_.-_- �a Date Permit No. � -••......--•---•... Issued '�" D ....................... -- ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............0F... ............................... y. %rrfifiratr of Tomplianrr THIS IS TO ERTIFI'1 That tie Individual Sewage Disposal System constructed ( ) or Repaired (�%) by------•------------------ 4)✓....115 0 •t_I+ 1�......... 1 j Inst311r at...........6,!S ..... ........Z.At...---•------ ��>C1 has been installed in accordance with the provisions of '—1 al 5 The State Sanitary Cod as described in the application for Disposal Works Construction Permit No_________________________________________ dated_. _Z. _-'qooI___.__.-_--._._--_.--.- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A IS A ANTEE THAT THE SYSTEM WILL FU CTION ATI FACTORY. DATE.......:......`.°. ...:�°_��.... ..!-----•--------•-------•-------.. Inspector..._!: ..`.! '-•`---------- .._----•_... 4_....... f THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH ...................... FEE...{d _........... �t��r000l� rk� �ono�rnr�ion rrmi� Permission is hereby granted.......... ....... -•------------------------•---•----------.......... to Con or uct /)f R it ) an Individual Sewage DisRosll,Sy tem atNo....ry 6� � .E�c,►• t�� A �t..r ---------------------------------------------------------------------------- Street as shown on the application for Disposal Works Construction errs it No.................... Dated./4!__ �4�C�._.•._-••_._.•.. ..................... Board of Health DATE--------'� = 'r�' /r- .................................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS LOCATION : T Zaal SEWo.f�E PERMIT VJO. IMSTNLLER 5 1. &NA tt' RESS BUILDER 5 tJ ADDRESS DNTE PERNA T ISSUED -- 2:-2 — —� 0 ATE COMPLI &KICE ISSUED : ��� l A i^, I✓ y��` III V 71 � A �4� J * I A N0•--10......... F3ic....a...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE4/TH LGn. . ........ --- OF...... Q.. . L .................. Apphratinn -fur �43hipmat Workii Towitrurtion Vrrui t Application is hereby made for a Permit to Construct ( ) or Repair ( t j an Individual Sewage Disposal Sy em at: ..... ` ....1_.�?�1�!ss ✓...... ................................................................................................. Location-Address or Lot No. --•-_----_--- (v . �. .... dress...----••-•---------••----••--........••--- i Ow -------------- !llfff Installer Addres UType of Building Size Lot----------------------------Sq. feet �-, Dwelling 2 No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. W Septic Tank—Liquid capacity------------gallons 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 ( ) Dosing tank ( ) aPercolation Test Results Performed by---------- ............................................................... Date.......-----------------------------.... Test Pit No. 1----------------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_-.-_----_---.---__----- r-•• -- -------- ---- -----.................................................... Descriptionof Soil- ------ _----------------•----_- _-------------------.-...-•--•----------------------------------- -•------•-•-- U --- ----------•----------------------- ...•----••--------•-------------•---.........-----------•-------•----••-•-----.............---------•----•---...... ------------------------ W ---------- ---- -------------- --- -------- ------------------------...................................... � �� V aure of, epairs o Alterations— nswer when applica e..._. _ I at�i-e-1 ... ....OV...... `- Gs wtin�t -------- greement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee7issued by the boar of health. ' Date Application Approved By---------- ems: ----- 7 Dat: Application Disapproved for 'the following reasons: ........-•-•--•...............•--•-•-•-------------...------......--------•-------- -----.-...--•------------------------••--•-----------------------• ----•---------------•-•-•-•----------•-----------------•----------------•-------------.----------------•--••--•-••---•---••----•-•--- Date PermitNo.......................................................... Issued........................................................ Date �G No....... {//.1..••--• Fa$...49..................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH �L! +.. . .... ... ....OF............. Y�ttY�1 �.�G � .......... ....... Allpfiratiun -fur Di,ipuiial Workii Tonfitrurtion Vrrnfit Application is hereby made for a Permit to Construct ( ) or Repair ( Uf an Individual Sewage Disposal System at: ---•----------------� 'sAz.. &/'AK........L� ..... ...--------•---............................ --•---..................-- Location.Address or Lot No. ------------------------ ! Address wn f {/ i' vL1 �` r Installer A ress f � UType of Building; Size Lot----------------------------Sq. feet Dwelling�[No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons-------------............... Showers ( ) — Cafeteria ( ) dOther fixtures ......................................................--------•--••---------------------------•--•----••--••••••-------------••--•-...--------------- W Design Flow............................................gallons per person per day. Total daily flow-------------------------------.........----gallons. WSeptic Tank—Liquid capacity--_--.-----gallons 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. it. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by----------------------------------------------------- --••--•-----....... Date-----...........------------------...... Test Pit No. I................minutes per inch Depth of "Pest Pit.................... Depth to ground water--------................ (4 Test Pit No. 2................minutes per inch Depth of Test Pit._--_----_---__-_-- Depth to ground water-------------.---------- ------------ G Description of Soil--------- x U -••--•-------••--------------------- ------------- -----------••------------.......................................................... -------------- -.-_-..------- -. ..--.---.--_--.----__--____-_-•-----_-__--_--_--__-_-----_-•--__ __._____ F •._ U fa ure of repairs or Alter ions— , nswer when apphcajale r./1"9 f �y - C _ --_- ----- ` � s. i .....-•-------------- ----:----.------ Agreement: The, undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI 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 th_',oar�l of health. fined .. ' tf'.... ----I.............................. ' is .... Date Application Approved By-------------- ----__.._ ____.._ �� � D to Y .. Application Disapproved for the following reasons:-----------•----------------f..---........................................................................... --------•------------------------------------•---•-----------••--------...----------•-••----------------.------------•-••----;----------------- .............. ••------------•--•------•--•------------- Date PermitNo.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS -7 BOARD OF HEALTH �� (/v�+� ..........` ..............OF..... ................................. %U.rrtifiratr of OVAImphattrr THIS IS TO C R FY,That the Individual Sewagq=Disposal System constructed ( ) or Repairedby --- ,. . --- -- ------------------- � nst ler at...t..��/.'-`-�-----R�✓,!C!I„���,/ -• .f!�---------Al���-=�--�'=-'-'-�-r _ ---------•-•-•--L-/.A_(st.i a.,�-_T.a•K'`/�--�------•--------•---•----------- has been,iiXtalled in accordance with the provisions of Attic � I of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------ �� ._--� __/_--._---___ dated (�_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE© AS A GUARANTEE THAT THE SYSTEM WILL_FUNCTION SATISFACTORY. DAT1✓........ --------------------1 — S ��a : I -•--P0? /.•----------------•-----••---•------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF LTH, .� 7G' ......... ........I.OF.... No.. FEE.--•-------•--• ....... Bi> uiittf 1U r �giitrurRou g., it Permission is hereby granted �et .......... ---•--- f,I�L/Z✓' to Constr t ( ) or Repair ( fn Indivt ual Sewa Dtsposal Syste at No._.a!::�.�'. --- �'5"-- �� � s�� Street as shown on the application for Disposal Works Construction P it NO.. ;._._. __ Dated------------------------------------- ----- DATE........... - d• Bar f eal� FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS