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Home My WebLink About0226 INDIAN TRAIL - Health 226 Indian Trail Barnstable e A = 336 - 093 n LOCATION / SEWA E PERMIT NO. VILLAGE Yes ZY��) � � � o INSTA LLER'S NAME A ADDRESS YC ® U I L 0 E R OR OWNE R ER Req Y G ou K a .DATE PERMIT ISSUED � l DATE COMPLIANCE ISSUED o / T l 1 d � d i a -� ra 00 Fe HE At rTtrlol Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal Location-Add r Lot No. ow 4r Address ........................]��........I.C.�' _ ............................. ..................................................................I................................ Installer Address Z Other Distribution box ( ) Dosing tank ( ) Test Pit No. I.......Z...minutes per inch Depth of Test Depth to ground water... ------ TO The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTL, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been isy, d b alth/ ------------- ` ---'-----'--'-----'—'----'------'-------- »at" Permit Date \ ' s o� No..� !v,/...�tf. -....- _.. FEB ............... y r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................... ...................OF......-...--.-..--.........-............. .............. Applirativit for Dhipoii al 10orkg Cnontruriinn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: •---Lod`------f•-- ..__ ' .>'................ r.► .1..a�g "Vic ...... ............. Location-Address or Lot No. Ow Address .........................---------- -�....... ......._... Installer Address QType of Building Size Lot............................Sq. feet V Dwelling—No. of Bed rooms.____.......................................Expansion Attic ( ) Garbage Grinder Wo) U Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures ___________________________________ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W . Septic Tank—Liquid*capacitylfgallons Length................ Width---------------- Diameter................ Depth................ Disposal Trench—No_ ____________________ Width.................... Total Length...........J_._._._ Total leaching area....................sq. ft. Seepage Pit No_____ _____________ Diameter._ __�______ Depth below inlet.... 0._. Total leaching area_9140_f_a_sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1'4 Percolation Test Results Performed by----------------------------------------------------------- ___ Date........................................1.4 . a Test Pit No. I....... ____minutes per inch Depth of Test Pit.-12----------- Depth to ground water___Fl.Z_____________ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil.......Y,? /I,�I�1'1-------f4i•----J'i •-c-.......--'"1--�,� -------------- •---............................................................... x V 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 Ti:i. p 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 health. Signed...................•-------••--------------......_.._.............._••--•-•-•-•....••. ................................ Date / Application Approved BY- ------- --. •- • •-'••. = ✓< ��/ f Application Disapproved for the following reasons:- ="--- ------------•--------•-----------------•-•----------------------------------••--•-•••••-••••--•--•-_.. ----------------------•--------------------------------------------•--•--•...•-•--- f Date PermitNo--------------------------------------------------------- Issued.........................% THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......../.... :'?ti................OF.....-" � ....................................... �rr�if irtt#r ,af �unt�lt�anrr � - THIS IS TO CERTIF hat the IRd�ividU Sewage Disposal System constructed ( ) or Repaired ( ) . �TA............................................................................................................ r ♦ staller at.. /........... rr. '.. has been installed in accordance with the provisions of T = E r of The State Sanitary Code as described in the application for Disposal Works Construction Permit No ..Z-________________ dated_..-_-___-_-____-____________..__.__..___.____ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................................. t, ��•------------- Inspector...................ffren ��'A_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / --..................O F..... ' N / cI,�Z FEE_5�--.......... � rrmi Permission is granted�n ----------rk� ---.� -•------------------------------------------------------------•--- to Construct or Repair L ) an Individual evc e Dis al System at No.--•-••• /------------} 23.4nee..!=---- g..----.._. .. Street as shown on the application for Disposal Works Constructions Permit �No.___.___..._y___._____�Dated.......................................... ------•----------•-•----•-------••••___- d —4 rd of Health DATE........................ __c •-••/•-...•--.....••----•••--•-_.. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS tov r I • . fir.r.rr'.� v � e top c� G�l -. OD eTIS Iwo t� 5fetos nm do o r• Q:CI�Qc T l.Q r� • _ 2.4 r oo s ✓;S'q. fJ�' ;\,Cot 4 vT �9 nl 7'2A!A, AWG ZOOT , W �{ S�g t t f a � 1 v , g ,1 r zx4 Si�1 � k e /C} CGS rr _ •' , Y /U C� rt C.r, - i , t � G � -�J`'_ cv/ wv✓M c}rYl..a � //O f.CJ i 113 ` CAI ACC ^- 7--Y�lC �L SECT/f�/ Zecu=A/r? �/ �h�c7�v� c�� I � s ' �3 6.7 sk x ljjls;,= '5-6. rs -- ._._ ,,,,,_,�. ....:.,_- ;;vim �:. • _ .�/��,,,�, G,'..YeCx . � �- _ ' _ . -�-- ,�- __• `�. '^w,w...:.:.:4�`�...• .,y `sf �. iC.�U.V _ t - �S _ __ a��" ++• rac/c. 25"Q �8 �2 washes � *+..�.:.--'„' `' � � '�:, e _ � �,� t `9 h�• J7 S C r e E 1"3 e� S Tt'u n G �2. � I S Jnv el. 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