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Home My WebLink About0164 INDIAN TRAIL - Health ,� �. �,� ,� n I TOWN OF BARNSTABLE LOCATION" -7,141A -/ H/GL SEWAGE #_.90 -f VILLAGE C (/,y,� y/o ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. J�/' X4,1 Gox4tfewx5o,v 77f=533P SEPTIC TANK CAPACITY y LEACHING FACILITY:(type) ,2 . /T;9 (size) f aoo /ooa NO. OF BEDROOMS PRIVATE WELL OR'PUBLIC WATER BUILDER OR OWNER ' DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No f� , s 74 r Ficzl 30.00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE AppUration for Di"anal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair �X) an Individual Sewage Disposal System at: 164 Indian Hill Road Cummaquid ... __...__................................................................... •-••-----•---•-•---•----------•---••----......---••--••-••-•-•.......-.....................---••-- Roder Warren Location-Address or Lot No. J.P.Xac omb e r Jr. Owner Address a ........... ... -------- Installer Address Type of Building Size Lot............................Sq. feet U DwellingX—No. of Bedrooms...........3..............................Expansion Attic ( ) Garbage Grinder ( ) PLI4 Other—T e of Building ________ No. of persons____________________________ Showers — Cafeteria a Other fixtures . ------- __________________gallons per person per day. Total daily flow._____.___.._____...____-___-_______._..__._gallons. `I W Design Flow--------•----------------- g P P P Y• Y W Septic Tank—Liquid capacity............gallon s 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........................................ ------- aTest Pit No. 1................minutes per inch Depth of Test Pit________--__________ Depth to ground water_-____-_________,_____-- Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--_____________-_____-__ --------------------------------------------------------------------•-••••......--••••---•-•-•----•.-:....................................................... 0 Description of Soil........................................=......................................------------------------------------------------------------------------.......-•-•---•- v ........................................Sand...................................................................................................................................................... W -----•---------------------------------------------------•-•------------------•--------•------------------•--------------•-----•------•-----------•--------•----•--•--------------------•------••-----•- UNature of Repairs or Alterations—Answer when applicable............................................................................................... ...................................................2. 1.J��---gall..---�i t.. .------------------------------•-----------------------------•-----------------.._.._..--------•--- 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 Complia ce_ha b/ern issued by th boa of health. Signed -- ...... ... 7/23/90 ---------------------------------------- Application Approve. ----------------- -- ----- � [e D--------- a?e Application Disapproved for the following reasons- ----------------------------------------------------------------------------- ---------------- ------------------------ ...................... .......---.....---.------------------------................................................................------...........................-----------............-..-- ----------------Date------------------ PermitNo- ............................................................------- Issued ................. ....------------------------------------- Date �. No In Q ,... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ApplirMtiou for Disposal Works Toustrurtion Frrutit Application is hereby made for a Permit to Construct ( ) or Repair (KX) an Individual Sewage Disposal System at: E 164 Indian Hill Road Cummaguid ............ ___...._................. ................... - - ....: ....... - .......................................... Location-Address or Lot No. Rogex__W�rran------------------------------------------------•-......------. ............................................. ......•.......•................ Owner Address w J.P. acomber Jr. a _ --------------- ---------- - Installer ess Typenof Building of Bedrooms___________ ______________________________Expansion"Attic SizerLot.Garbage Grinder feet � well gY. o. ( ) g G ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) G4 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. I................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........................ P4 - I ----•----=------------------------------------------------------------------------------------------.....................................-................... O Description of Soil.............................................. W ----•------------------------------------------•----------------------------------------------------------------------------------------------•-----•---------------•-•------...--------------••--..... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .................j.................................2-1.00?0.--ap.1-10..xDi.+aw---....------------------------------------------•-•------------.--------------------------------- 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 Compliance has be issued by the boar of health. Signed.. w ►� l �?3Qn--------P' g �� _S.w jApplication Approv .....................................r -------- ........................ .........................----------------------------------------- ��2_3��D........-- .�...---------Dare.. Application Disapproved for the following reasons: .....` f j Dace PermitNo. ............................ ........ ..................... .... Issued ......................-------------------------------- ... Dare i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ger#tf rate of C�omplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X ) by ^T p-aM�c.f�mk�P r...xTr ------------------------------------------------------------------.........................................................------------------------------------------------------ lmtaller at ....164..Indian....Hill...Road Cummaauid.. ----------------------------- has been installed in accordance with the provisions of TITLE r5)of The State Environmental ��sdesuibed in the application for Disposal Works Construction Permit No. ``77 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WI�..L FUNCT��ION SATISFACTORY. L� � _ DATE--- ..... Yam-- 7 ,.................... -------- Inspector .........................................--...----�--------------- 4 THE COMMONWEALTH�OF MASSACHUSETTS BOARD OF HEALTH 333 TOWN OF BARNSTABLE $ 3000 No......................... FEE..............,.......... Disposal Workii Tonstrurttioxt "Vlerntit Permission is hereby granted....J•R.Macomber -Jr.................•-------............................-----.................................... to Construct )) or Repair ( ) an Individual Sewage Disposal System at N-.l� ----ndian Hi1�Road Cummaauid .... ....................................................... .............................•-----••--•----------r... ................ Street D as shown on the application for Disposal Works Construction Permit-No..�.3... __.._ Dated.._?/ /._.'.................... ? �y� Board of health DATE 7/2 ---•-••------•...............•------- FORM 36508 HOBBS h WARREN.INC..PUBLISHERS j