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Home My WebLink About0031 BONE HILL ROAD - Health 31 Bone Hi11 Load Barnstable A= 336 - 082 1 n i. u a 1 ° y Q LOCATION SEWAGE PERMIT NO. 3/ A>-% //IV ?'3- - / -6� V I L L A G E ASSESSORS MAP N0 .9 Q i elt PARCEL NO: Z I N S T A LLER'S NAME ADDRESS ® U I L D E R OR OWNER DATE PER Ill IT ISSUED DATE COMPLIANCE ISSUED i� �Q � Gr �� v) ��. � � � � ��,o� � $ -. 4 7 �. No....S-s_.. Fss......... .® .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ................. .......................OF........................................................................................... t 4±. Application is hereby made for a Permit to Constru t ( ) or Repair ( an Individual Sewage Disposal System at: - _.............. ..... ...... ------•----- ----------- ------------------•--•----•._......-----------•-------------•--•------------------.-----........._ Lo tion-Address or Lot No. .............. ........ f.'• /................................................. —Owner // Address a 2.........................�.� �e � ---------------------------- .......... C :�.-r r v, 1� ... -•- ---- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms___...:_..........................Expansion Attic ( ) Garbage Grinder ( )U Other—Type 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_lmm45.!gallons Length.................Width................ Diameter---------------- Depth................ x Disposal Trench—NOA__�7_%�S� idth.................... 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 ( ) `-� Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_______________________. f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....._.................. R+' ....................................................... -------- -•---------- ------- ----------•--•---•---------•-_---------------------- Descriptionof Soil........................................................................................................................................................................ c.� ------•----------------------------------------•---••----------...---•-•-------------........-----------...-----•-------------------------------------------------------------------...-••-------------- ....................---....................................................................................................................................... •----•-- V Nature of Repairs or Alterations—Answer when ap licable._�� . _�<!S! _fz:_.._.____-3..F.�oc ' i•fFe ,�- �0-- ..-?---•5fi c�_�s+-ocr 6-�ci,_:_�c:� ..'-o Gv�7C� �'�� -------------------------------------------•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI LE 5 of the State Sanitary Code— The undersigned further agre of to place the system in operation until a`Certificate of Compliance has been issu by the b of 1 Sign . --•----•-- -- f --................----•• (Da ate a iApplication Approved BY------=------------ ---- -- -• ---------•----------•----•--------------•---•----•--------- --------- Application Disapproved for the foll ing reasons-----------------------------•-••------------------------------------------------• -•-----•--------- ...............................................-------------- -- ------------------••-•----------••---'---------------------•-----•••-----------------------•-••---•-----•-------- --------•-•--- Date PermitNo....................................................... Issued....................................................... Date ---- -- --- - - - - --- -pia- - - -� No... 4:Z IL . ........ FEz THE COMMONWEALTH OF MASSACHUSETTS .,,BOARD OF HEALTH ............................. .............OF............................ Application is hereby,--made for a Permit to Construct or Repair (44-)"an" Individual Sewage Disposal System at: 3 /36,s.,.e ........................../ ........................ .................................................................................................. L ation-Address or Lot No. ............................................ ........T ............................................... --Owner, Address ............................-• A..... ..ee..(.............................. ......... ....................................................... Installer Address U Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms..... ............................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons........_............._.____ Showers Cafeteria 04 Other fixtures ............................. Design Flow,...........:................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity/j?.!q!C'.gallons Length................ Width..............._ Diameter__.____......... Depth....._...._..... Disposal Trench—NQ3 AVidth.................... Total Length...._._...._.-._._.. Total.leaching area....................sq. f t. Seepage Pit No..................... Diameter.._........._._..._. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box Dosing tank Per6olation Test Results Performed by.......................................................................... Date........................................ Test Pit,No. 1................minutesperinch Depth of Test Pit_................... Depth to ground water.._......_.._.__......_. �'. Test Pit No. 2................minutes per inch Depth of Test Pit___.........__..._.. Depth to ground water........................ .............w............................................................................................................................................ 0 '00� Description of Soil......................... 0 ............................................................................................................................................... ---------------- ------------------- ...........*---------------***-------------------------------------------------------------*----------------------------------------------------- U - ---------------------------------------------------------- -!#.N----- -------------------------------------------------------------------------*...................................... ------------------- ature of Repairs or Alterations— 7,9..1-.4............1X.F1jP4W..d;4... U1,1_1 �nswer when applicable./.0,A_.4:.,.. /0 Ire 0'r 41�7 4 - r- - I I .......................................—.............. ........ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T IT IE 5 of the State Sanitary Code—The undersigned further agrepsnot to place the system in operation until a,Certificate of Compliance has been issued by thud of ea 2 th Sig .......... .... .. ..... ....... ...................... ... ... Dae )D Application Approved By................ ..... .................................................................... _ --- -----In7--- D e- f:/tn Application Disapproved for the fo of ing reason ................................................................................... ............................................................... ............................................................:1. ........................................................................... Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Tntifirate of Toutpliatta THIS,I 4S TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by...........'K.�,OPK�...A�. ..................................................................................................................................................................... Installer at..3.../. 130.,VW.- 0'r I - ... ............................... ...................... Z.......................................................................... has been installed in accordance with the provisions of TITILE 5 of The State Sanitary Code as described din the application for Disposal Works Construction PermifA,No-------_--_-----_----- ............. dated------.-__.----_----__ _-X .......... THE ISSUANCE OF THIS CERTIFICATE SH,ALL NOT BE CONST UED ED AS A GUARANTEE THAT�THE SYSTEM WILL FUPCTIPN SATISFACTORY. DATE................... ............................. Inspector................. .. . ......... ......... .... 1q AS A THE COMMONWEAI�TH OF MASSACHUSE S BOARD T HEALTH ..............................OF...................................................................................... No t FEE... ....... Dispol Works %Tonstrurtion Op"amit Permissionis hereby granted_.. .... ............................................................................................................... to Construct orkRepair n d' idual Sewage Disposal System at No w Street as shown on the application for Disposal Works Construction Permit N0(3.jttS.1j6_. Dated.5--,7-0. 00 ........... ................... --- ------------------------------------------------- DATE........ _1U....................................... .............. Hoar of Health FORM 1255 A. M. SULKIN, INC., BOSTON