HomeMy WebLinkAbout0059 INDIAN HILL ROAD - Health �� � iar� ��, I 1 �r-d'
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THE COMMONWEALTH OF MASSACHUSETTS'
BOARD OF HEALTH
T.M 7... ....................O F..........R&F.NSTARLE.-.-----.--......-------------._..-..............
Appliratiun for Dhipuiitti Workii Cnunitrurtiun Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at; _
........................ � � da _•j?ill Ro..........................d Barnstable, Mass. 02630
........•---•--._.......... - .........._..
Location-Address t N
...... ry-••Crean ... 9-:Indian Hill �clt: , Barnstable, Ma.
Owner Addres
W Cashts Trucking Inc. Off Union St. , Box �, YarmouthPort, Ma.
Installer Address
QType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms___..._.__.._______________________________Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
114 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 ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
ODescription of Soil........................................................................................................................................................................
x
U •-----•---------••---------------•-•--------------...--•••-••••----.....---•---•-•-...........•••-••----•--•-•••-•--•-------•-•----•• ----------•---•-•••-•--•--••-••-..........----•---•-•-•--•------•-
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 TITIE 5 of the State Sanitary Code= The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has beenA�ssby the board he
Signed_._... ... -----�0/20�.8......
Date
ApplicationApproved By.................................................................................................... ........................................
Date
Application Disapproved for the following reasons___________________________.....................................................................................
..••••-•-•------•---_.._...•------••----•••-•-••••-••----••••.....••••-••......_.._••_-•••-_--------•--................•--•--•--•----------------------------•---•-------=-•-----•-•-•••-•-•-•------•----
Date
Permit No...... _'_ % _________________________ IssuecL_____•__0�..r f /��3
.- = ..............
Date
1
THE FOLLOWING
� IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I M A� L
DATA
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
" TOWN...._..................OF..........F:4 S`!'AFi=-C..................
Appliration for Diopo.s al Workii Tonotrnrtion rumit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
59..>� d ax>... ll.Road 'Barnstable, .Mass. 02630_
------------- ---------•--------------•-•-•------------•-----------------.......--------.......-----••---.......
Location-Address t N
Mary Crean.................................•--- 59 Indian Hill �d 0 9 °�arnstable 9 ��a.
...............•--..•-. ...........................---•-----------------•---------••-•----.......-- •--....._
W Cashis Trucking Inc. off Union St.s �ddjes7! yarmouth.Portp tra•
a ........................•-•-•------...............•-- ..........._.� ....- • - - - ...................----.......---................- .............
Installer Address
d Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.......... ................................Expansion Attic ( ) Garbage Grinder
aOther—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............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.........................
�14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
-----------•--------------------•••---. .....................................................................................................................
0 Description of Soil........................................................................................................................................................................
x
rJ .........................................
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 TIT1L 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 of th
10/20/83
Signed_ . - ------------------------•--
Date
ApplicationApproved BY..............................................--.................................................. ........................................
Date
Application Disapproved for the following reasons-................................................................................................................
..............•-----------.........-•-------•------••-------•-------------.....-----•---..................---.........--••-------•------------------......--•---------......----•-••----•-•--••....------
Date
PermitNo....... ................................................ ----....:_ .... ............................Issued.
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALTH
�
��-✓.n� OF......... �� G c v......
Tnrtifiratr of Tontlrlittnrle
THIS IS TO ERTIF.Y, Tha the�vidual Sewage Disposal System constructed ( ) or,,.Repaired ( )
bY---•---------------_--- ('"�-
/ � -- •-•-- ...................................
Install /J
..........................................................
has been installed in accordance with the provisions of TITLE 5 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 CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
. � � ...........
yam:
DATE.........�':.... . ..��.....-•................•-•-------•----.... Inspector....... .....17-..------ _..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD
.c��HEALTH .
_ ...........................................0 F.....................................................................................
No:. ..3.......�... :. FEE........................
- �to�oottl ork� �o #� ion �rrrnti�Permission is hereby granted------------ ••-- --- .............
to Construct ) qQraRepair ( ) I ivi4ual Se e ))isp�,s�. System
atNo...••---- ... ••.... . ...--------•---•---....... ...lam/..-....... --•-•. .
Street
as shown on the application for Disposal Works Construction Permit No...... _......... Dated...........................................
.r .�
f� �?> Board of�Health
DATE ---------------••_... ..-,......................................
FORM 1255 A. M. SULKIN, INC., BOSTON
CASH, S TRUCKINq inc. r,,,STrn7 ,S.CAS�!
YARM0771,MASS. 02675 r
36'Z -322
33 663
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s ' a
MA.RY CREAPd
59 INDIAN HILL rd.
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