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HomeMy WebLinkAbout3600 MAIN ST./RTE 6A(BARN.) - Health • e . r Fsa... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / - I . ............oF.. ... fzaJ r ....................................... Appliratiun for Diupuuttl Workg Tunutrurtiun 11rrutit Application is hereby made for a Permit to Construct/ or Repair ( ) an Individual Sewage Disposal �G System at: gy74* 4l e ............. - ono �"t�!�..s:t...........r . - ....................................!-�r ! -- -- -- ._. . ................... -. Location-Addreessssor Lot No. .................. .. c�T. f"1 ................ .... ........ .................•. Owner •••-- IAddress Installer Addr ��gg.. ''''nn Type of Building Size ZrLot.... .W- ....Sq. feet Dwelling—No. of Bedrooms........... ............................Expansion Attic ( ) Garba�e Grinder ( ) ` Other—T a4 YPe of Buildin g ••-------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures .-----------•---••----.....-•------- ---- W Design Flow...............--(-Q..-.. . ......gallons per jepesa per tgay. Total oily��ow---..............�,?.-3.0.......---..g�on§( WSeptic Tank—Liquid capacity ....gallons Length.'?._ ?..... Width:.. ,_ 0.... Diameter................ Depth...�../,�r. x Disposal Trench—No--------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......[............. Diameter......0........ Depth below inlet......_...6?........ Total leaching area- -11--c.sq. ft. z Other Distribution box Dosing tank ( _ !!/[.at Percolation Test Results Performed by........ ....F)J..t�.4�!4i 1r .R.E.............. Date....ll. 1.0 ....... Test Pit No. 1..!� ..minutes per inch Depth of Test Pit....i�'fa`U. Depth to ground water.. -- ..�V. .. G� Test Pit No J? v minutes per inch Depth of Test Pit.....1 fa.u. Depth to ground water. ..................... L� ........................ .. ........ ........................................................ x Descri on of Soil.._! .•- ---.- �0...... IT:4►. ....[. --• .. •.._ .... W .......................... p..-'.24 rs u .'�o Salo��5 i�T 6 ,Cte�(a av s�Nc urnb -tab --------------------• -•--------- •-•---.....----- .....---......................... V Nature of Repairs or Alterations—An r when ap licable.-•-.�pb-fZP .f �rl .................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:ITLZ 5 of the State Sanitary Code— The undersig ed further agrees not to place the system in operation until a Certificate of Compliance has en i d b t boar f health. Sined ... ... ............. .... .•--•- ................ .......... ............................... -- - � � � Date - Application Approved BY ... yI'h...• L .`......-••-.._ .....--. ... .............................Date_ Application Disapproved for the following reasons:. .. ___. . ...__. . _ ._. . ••,•.•.__ .......................... .................... ...... ......... ...Dau ............ « Permit No..........:..•.-.-.- / . - r - Issued �• _. !_ �--.......... Date No.._.�......�LI FEB... THE COMMONWEALTH OF MASSACHUSETTS- .z BOARD OF HEALTH t ------ ....--1..�`L)IQ.......of..........-..... /� l %. � -� ......................... Appliration for lispoiittY lVark.5 Tonitrurtion Permit Application is hereby made for a Permit to Construct^( )) or Repair ( ) an Individual Sewage Disposal System at: ba k Al,>-74 b/e �?U---S7-...e----�l 6A ...........-------------4�'� ..wr i7..•...-----.......---................... Location-Address or Lot No. ................ ........................................... ............•..•............................. Owner Address a ..`".........L-- . ................................. •--•--------------...................--------..............---- ........................ Installer Address Type of Building Size Lot.... .r�.l.l._I...Sq. feet Dwelling—No. of Bedrooms....................................Expansion Attic ( ) Garbage Grinder ( . ) 04 Other—Type T e of Building _..._..._.. No. of persons............................ Showers w YP g -----•--...--•--- P ( ) — Cafeteria ( ) dOther fixtures -----------------------••-----....... . ..................................................................................................... Design Flow-------•------ --- ---------------- --gallons per per-son.- p I y. y gallons: W ! r on per day. Total d�il flow________________ �> .._..... WSeptic Tank—Liquid capacity ..gallons Length.�..4._;.,..... WidthA.. Diameter................ Depth...... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No....... ........... Diameter.....AQ........ Depth below inlet................ Total leaching area.?407.:_fl.sq. ft. Z Other Distribution box�(�) Dosing tank ( ) /<-1191 b,6 aPercolation Test Results Performed by................... !��.L�l.�����_!�_._P-t................ Date.....1Z_-t P?��__(....... a Test Pit No. l...!E�.f.--..minutes per inch Depth of Test Pit.... Depth to ground water-If...inx (it Test Pit,No -,_4_Z-...minutes per inch Depth'of Test Pit...... Depth to ground water.1vV -- ...... ............ D -Description of Soil.. _._Fl►J ... .._....r.....'I �-31 __ a_7__ - - ---------------------------------------------------------------------------------••. W ............ 2� Lr✓I�tu, StYS ?_9-_ J tlfvr ��a►`7 4 R 6 (jAq A 00 5AOJ0 1 -15F� Gct Nc1� . U Nature of Repairs or Alterations Answer when applicable..... 11�!�-1�� t/c' ice C��?....................... ----------------------------•-----...--------------------------------b'rrl1?C��t Y� r1l�Dl7r r�+t) 7c 'r!�? --------------------------------------- Agreement: The-undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL- 5 of the State Sanitary Code— The undersig ed further agrees riot to place the system in operation until a Certificate of Compliance has biten iss fed by tth boar- f health. Signed - ...........I........... .......................... .........._.._. Date Application Approved By............. .....:�,...._...__Z..Z.i....... ............ �/ Date .........._ Application Disapproved for the following reasons:- " ! J} . ._.___._. !_�/._ Date Permit No.._..._�-7...._-7..L(t------------- Issued..------....--L t 6..........��.--..-...... Date I .e:s�c,T_*4ti• _, �•• .+:s--e...- ..�a. ...��r...—.o—..—...o..<•.a•+•oase. "ae•rc aeo r..s6 wa-V-i-----woes----------a tle .......oc.e.a� THE COMMONWEALTH OF MASSACHUSETTS �....1-- BOARD OF HEALTH (Irrtif iratr of Tompliuna THIS IS TOO TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired' ( ) C, by = L- �- ----•---•-• -----------•----•----•-•.. .................. .............. �7 1nsSaller /_ n at.......... C)...................................r ..........��— ..._j......._...-----.....-_... ............_..'t-....................................................... 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..___....z_—i . .I..... dated....... ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA ANTES THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..... .--....... tf•••................................... Inspector � .......... P d _ --- . ya.....,,.�e..••••c�E+n.n'�o=avo v�waVc:..s•ps�.�.'e�b.bbammc+es-a m.,r.<.A...,._.-. -- .. - _^ep'y••ecc^m'*�sem-�a®v'ba+osa-N sovc Pol.m4.+e.pw.e.... _ _ _er••�?vco••�rr _­-TKE—COMMONWEALTH OF MASSACHUSETTS BOARD OF- HEALTH os �-1 ---� OF..........................1.:.-..-- ..............................................�•--_ Q�-- �!l ahglo ad orkn Tonstrurtion Vamit Permission is hereby granted... .:. !-- ?. ................................... to Construct ( ),or Repair ( �!A n Individual Sewage Disposal Systemrs atNo.................. �� V �. k�u �Jlr►---•---- .................�...............• ---•-------•-•---.......--•--•-•-•-•.............•--•--••-----•-------.....--•--•....... Street as shown on the application for Disposal Works Construction Permit No.51_1 2•--.-f/. Dated............:� �' � �1 r7 Tt . . .......... •..............•--.....----•-----•---.....----------------------------••---•••-----•--••---•--........._ Board of health DATE.................................................=............................- ' TOWN OF BARNSTABLE LOCATION 0 Aally SEWAGE # �• VILLAGE .;,,, d 16t ` ASSESSOR'S QMA, LOT ' r ""' ` 1' INSTALLER'S NAME & PHONE NO'. `SEPTIC TANK CAPACITY 4 S,�LEACHING`FACILITY:(type)f 1 0 `�� �" (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATE ®L., Aj BUILDER OR OWNER e r DATE PERMIT ISSUED_: DATE COZiPLIANCE ISSUED: 7. VARIANCE GRANTED: Yes ' "' No I/ A���- PP ij�• 1 J � ,iY"f1�, TOWN OF BARNSTABLE s� LOCATION dAA N SEWAGE # VILLAGE ASSESSOR'S MAP & L ' OT . INSTALLER'S NAME Cz.PHONE NO. SEPTIC TANK CAPACITY i�n(i ;;,, , LEACHING FACILITY:(ty )—loop �� (else) F NO, OF BEDROOMS PRIVATE WELL OR PUBLIC WATE BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED� I VARIANCE GRANTED: Yes ; ' No 0 - a •`i� • k4 rib ..,,,.► ve w� - - I ,N 01 zo- �3u I L D j�.l Sa �f�4C�LS �'!. �w a2 .4 1) �o j �©qEZ oV E,7- A d�T u�ors l2U1L1T' 30� a o' o r--- Z� _ 4v � � � I.oaM LOAM � �0.4 n� 1 S' , -.� - �?" ¢- 46" g,4 �� A) - Jo"NAT" u-f.-;E r (a te � GAY o�c 5�Ftf�E C�ITC� _ �I4 I FT Gu�{ _, _ .- � I.GV�� (,A•`!c r'S � '�1 E'�(S'f�r.lti.,. �.�'G2'• �.._ .�BE L�-�C�.ti+_ •, . Yµ�+ � _ �:�+ �38 92 \- T2°Fs 'r�i"�°�, t,LL �S-TPI Lk-7-1>4 �``k l_S o� o� � I A'Gr���.k' l�t""-+- �l ASS tr..!-4 tRp►.[itil E NT��. F T+TLF- 7 2_a.4 )`41� �U�1 FG Z I.��A ,,: 1 �-u e�k DSr✓; ioZ53 P 'oZ 9 Limy ,�` BEST ++o�ey i A,,.►v 2 TG-�-r �oLE 3 ' ✓'7AT`E' ;I/19�� DATA Iz-�la�°� I;l�C�4r16E> L•�Ate �J1L P� .l(a'c iF E'_ -Ale?+c QL P£ ' ry Wl"C�lE�, r..l. LE(Tt�l�e ;,;IT► 1FI�'. f.1 l�lTA►E2 'FF--2C,oars �Ai. v 0.L 0XTE iti1 LLIeA ki AND / 47 FF�� f k , �- �TE: t:,k- f:►r?irk.+a•. 40,44 F?r�TTCM OF -_raj - ----�,� ,ir�: c�a-.� PTi C- (t` GCssraL q'�j �,oCAT'J� 'D i :_ � 7G1E'� E4-f Pa> tW LA uuSti P-, 9 � c � p�j . , . . P ,� �. 5 %% �` i0' �'=��,►., L A—C + *',�..- A�.i�i" SE�1G.�L1F.11L ?(oc�o Ma _ `' � � r j :_'' .� �` L4.�..�G 4-EF i-,[�-E W 17`: G�E.A�.i M E ice.;,J ice! 1� ��aa �� -•� ! r Ahli� � X 4 � yS �� (71sL �thiL-l��� f d►�. I�G} MAC jov ,4t�Ek`'-'Y'` ST•dFF�P LE A Gl4 f KI ,- ,ga lt.tb-Cy 7-1961 44IC �G �,� 'IG3,c SF `1 ' y, t1..1`-- T 1 C7 E cF 'D►LAM X 4- AF, 41ECIVIL eN.LG4I+`IF,EZS