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HomeMy WebLinkAbout0064 COLONIAL WAY - Health 64 COLONIAL WAY BARNSTABLE A = 237 052 a i �2 3 No....� .... .. g THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou -fur Disposal Works Tons#rnrtinn Vermit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: LPN51 Ablr -- �' ...f..•-'�...W....� ----•-.......---•-• � .� ................................io A Te or Lot No. ....Lo... .. .. .... ............................. ...........•-----•••••----.._..............---.........•---••••--•-......-••-...................-- er ............ _OS_!ICW •.A:.i:.55 �!1��_ Installer .. ... Address Q T e of Building Size Lot...:.......................Sq. feet U Dwelling No. of Bedrooms.............................. .__..Ex Expansion Attic a g— --------- p ( ) Garbage Grinder ( ) aOther—Type 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............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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fT4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water.-------------- _........ P4 ......... ------------ �� ..em�ss ----••--•--- O Description of Soil____________________ r...SY _ --- -- _ txj ------•----------------------------•------------••------------------------------•--------------------------------------------------------•-----...................................................... 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 TITLE 5 of the State Environmental Code=The undersigned further agrees not to place the system in operation until a Certificate of Compl' e has been issued y the board of health. Signed - ------- -- --- ---- ---- Date Application Approved By ..--------- Ion..-10--�.9.,./. Date Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------------- -------------------------------- -- ----------- -- -p............--- ---- ----.......----...----- ------------. ---- ----...---........----.--- --- ----------------------- -------- -----------------------------------=-- Permit No. ...........pl ------.--- Issued Date Date qQ No...........S a FICs. .....'...... THE COMMONWEALTH OF MASSACHUSETTS Fh BOARD OF HEALTH Wj TOWN OF BARNSTABLE t - App irntiun for Uigpuunl Works Tuntxnrtiun rnmit Application is hereby made for a Permit to Construct ( ) or Repair.,( ) an Individual Sewage Disposal System-at'` L� _'� ..-- .....--•---- , ' Looelio r-A 're� ................................ • -- .... Y_�bl.!�%��?!�{St............Y�....f......{..:............................ ................ ............•---....----or ........----•-....................•.......... Ad J ' ' v— ...... ............ Installer Address — TV� eorl uilding Size Lot............................Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons--..------..............--.. Showers ( ) — Cafeteria ( ) 04 Other fixtures ..---•------------------•----------•-------------------••-----------------•-•--------------------•----•--•-•---•--•--......----•-•-•••-••-•-•---•-•-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—L-iquid 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. I................minutes per inch Depth of Test Pit-----..-__.._------. Depth to ground water......------.........--. 4� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......----.............. Description of Soil P� ..�� �� =' �'." - x !/ �: V ---•-•------•-•--•••---•-•---------•-----•---••-•--...-•-•------•------•--•-----••--•---••------------................................................,................................................ 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 TITLE 5 of the State Environ ental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli e has ben issytedUye board of health. Signed . ...........................................1 ............---------- -- .....................-------------- �. Date Application Approved By ------------ ;....-..-. i ------ --ln--`-Sid ........... ...................."-------.....-......................................---'---'--'----.._.............. Date Application Disapproved for the following reasons- ------............................................... ..-----------. .........--------- -- ........------ --------...... ............................ . ............ -- --- ....----------------.....--....-... ... ................. ------ ---- ---- ---................------. ---- --. ..............-_..................... ^ y r� Date Permit No. //7 - ----------- Issued ----- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE QuIer#tftra e of (Qlorayfianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) y ..............', ---- _....__ ......................................... ...........................------...................=------.....----...----------------...........`...—.....------ Installer at --... ... - --....- ....................................... .........................�lJ ' ........i' , ............... t - - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No- ------------------------------------------------ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.! DATE - .... ;1 AI. ..' �......... Inspector 1 ............ t r ....... --.......................................`... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No............ss(... FEE..:�� .:�:..... Disposal Works Tontrnrtiun randt Permission is hereby granted........ -....... ? --------------••---------------- ---•........... ---------------.... ..... to Construct 4( ) or Repair, <) an Individual Sewage Disposal System atNo.............................................. 3` ---. ' --------------------------------------------•---------...--•••••........st t as shown on the application for Disposal Works Construction Permit NoJ..�n_.. Dated.............................•............ .. 1. , J - Q�DATE.............. � Board of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS 1.9CATION SEWAGE PERMIT NO• Lot 7 Colonial Way 74-62 V I L L A G E ASSESSORS MAP NO: Barnstable PARCEL NO: S v __ LNSTA L.LER'S NAME i AD.DRESS . Henry Lampi BUILDER OR OWNER Richard L. Cahoon DATE PERMIT ISSUED 2-15-74 DATE COMPLIANCE ISSUED 4/16/74 2r s�4 L Zp I a�— S YA . LR4L � �y 7 IW A- o L v YZAL .. I A Fx No..... ._Z.... �....l. ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. .. .. ... .............. ............ . ... ......... 171:------- Appliration far i, powaX Iforks Tonotrudivia Fumit Application is hereby made for a Permit to Construct (,- ) or Repair ( ) an Individual Sewage Disposal System At: --...`'..�:`..:...... ....-•---- ��}` ._..f .__ .. ....... _ ..F.. catio ddres � i/ o� t - - --------------- - - .. .... ... . . . Owner .------•-------•-------------Address ... ----•------------------------ I taller Address - Type of iBuiding 3 Size Lot_..-� .� .__Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p,, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other"�fixtures ..:....................................................................................................... W Design Flow___..._..1�.. ............. gallons per person per day. Total daily flow_...__.... .._____.__gallons. WSeptic Tank=Liquid capacity/�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 (k ) Dosing tank rY 1-17A4 I Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit............. Depth to ground water........................ 1:4 -•------------- -- r O Descri Description of Soil _____________ ' l/� �................................ .. VNature 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 Article XI of the State Sanitar Code— The and -si ed further agrees not to place the system in operation until a Certificate of Compliance has ee is ed by d h lth. Signed. . ..• ...... ................ ............................. D to Application Approved By__`.----• --•- ...•........ . _ ..... � L Application Disapproved for the following reasons_....................................___..__..___.................................................ate.............. .......................•--......•--•--------•-•----••----------•-•---•--•-••....-----•------•----•----•-..•-•--••••---...............------------------- ----------------------------------------------- / Date Permit No......................................................... Issued...�r ( ........... Date �. �_.. ---- --------------------- —_--__--� No...!.:Z:........... Fim$......./Z... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . � 4_ 1.1......... 5��. ...........OF.........ix'e:24�. . Application is hereb .made for a Permit to Construct 0 or Repair, an Individual Sewage Disposal System - 7. ...... ... .............. ....."-,-'.� ------ catio Address a ow t N ' j Owner Address W ... ............................ ..................�-........... --..64ar -•-----•------- taller Address U Type of Bul ding „ . Size Lof1..�4j_ �...Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic. :( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures = ......---- ---------------- -------- - ------------ W Design Flow_ __ ....._.. `f�___________ __ allons per person per day. Total daily flow.'...._:: hT�-gallons. WSeptic Tank Liquid capacity allons Length................ Width_., Diameter................. Depth---__.__........ x Disposal Trench—No:.................... Width..___.___.._. .. _ Total Len �' Total leaching area ... Sq. ft. Seepage Pit No - Diameter / �-- e t I '� A . T a 1 hin ar s. ft. P . . -- q• Z Other Distribution box (�j Dosing tank ( ) 04, , a Percolation Test Results Performed by.......................................................................... Date----.....----------...........------.... Test Pit No. I................minutes per inch Depth of Test Pit.....................rDepth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-______-___......... Depth to ground water........................ Description of Soil ............ ......................................` � r - � l��` ` - ----- ------- x r ' / P _ _. -------------••. ----------- ------------------------ 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 Article XI of the State Sanitar� Code ' The un si Aed fu ther agrees not to place.the system in operation until a Certificate of Compliance has bee is ed by d a h th. _. ... geed . /Da to Application Approved By---- - =�- ce ' ---/ Application Disapproved for the following reasons------------------------------------------ ------------=-------------------------------------------------- .....................•--••-------•----------------------------............------......_..._..----------...•-••--•---•-----------------------------•-••------------••---------------•...-•-----•----..... Date PermitNo......................................................... Issued...------......•• ---•---•--•----•---•---..... Date' THE COMMONWEALTH OF MASSACHUSETTS _Y BOARD O HEALTH .......� ........,OF........ .. .. .........::.: .............................. THIS IS T CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by-•--•.............. . . ................. ----------• --------- -----------------------------...............---------------.•-- o Installer at----------. - "" . . .................................................. has been installed in accordance with the provisions Article XI of The State Sanitary Code s descried in the application for Disposal Works Construction Permit No.................... dated___., __�; ---- .� •..... THE ISSUANCE OF THIS, CERTIFICATE SHALL NOT BE CONSTRUE® AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. --=-------------------------- = Inspector... -" ............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD Of HEALTH ,. / i l... `OF...... .................................;' ;�. No.. l. FEE.. ............. 01 Permission is h eby granted... ......------•.. :.. -----..._..-•--•---------------------•----....----•-•...••••.........---- to Construct ( ; or a a' ( ) an I vid 1 age s sal atNo.. .. ... i .. . ....... .. ... . . ..... .................................... Street as shown on the application for Disposal Works C nstruction Pe No. --- --__ Dated.......... .......:. _ ...... d Board of Health DATE �11Z ...... " FORM 1255 HOBBS & WARREN. INC., PbBLISHERS t