HomeMy WebLinkAbout4010 MAIN ST./RTE 6A(BARN.) - Health �!o �n St
��oBX
TOWN OF BARNSTABLE
LOCATION% a, ° ►A`Q SEWAGE
VII.IvAGECv M rn a te_ ASSESSOR'S MAP & LOTAF�G �
INSTALLER'S NAME & PHONE N6.2L.-IL C
SEPTIC TANK CAPACITY S 00 b..,
LEACHING FACILITY.-(type) •,)n RQECCi` (size) '
NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER R%u,
BUILDER rft- a�.R QV-La
a
DATE PERMIT ISSUED: -Z-kk
DATE .COMPLIANCE ISSUED: -_
VARIANCE GRANTED: Yes No /
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No......................... ..........
THE COMMONWEALTH OF MASSACHUSETTS
_ BOARD OF HEALTH
L.4w. ........................OF.... %1�..j � ...........................................
Appliratinn for Bispoiial Works Tongtrnrtion rumit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at:
.........1lQ1Q _T!_ A.---COMM40 A. ..............
Location-Address or Lot No.
1.v.✓ A.... . '._..
Owner Address
a -----------------------•--•-•--•--•-•••--- -•---•-----•-•-•----•-----•--•----•--•-•--•••--•--------------•--------------•--•---••--••-•------
Installer Address i
Type of Building Size Lot... ......Sq. feet
Dwelling—No. of Bedrooms.____.3_________________________________Expansion Attic ( ) Garbage Csrinder ( )
4 Other—T e of Building ............................ No. of persons____________________________ Showers — Cafeteria
POther fixtures ----------------------------------------------------------------------------•--------------------•-----------------------------•--..................
- Design Flow...............................S_Y_...gallons per person per day. Total daily flow.... .............................gallons.
9 Septic Tank—Liquid capacityf__SA4_gallons Length---lQ°L Width._S.`X_ Diameter...._—....... Depth__5`A
Disposal Trench—".\To_____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No----------/________ Diameter.__.._._ -------- Depth below inlet...... _.'........ Total leaching area...Z.41......sq. ft.
z Other Distribution box ( r� Dosing tank ( )
'-' Percolation Test Results Performed b __�{-�-4-_. l ' ..L� %�C � - � +
Y - - - - - -- - -- ---s�•--••----._. Date.-��---�-�--'•-----------•-------
,aa Test Pit No. 1........;4....minutes per inch Depth of Test Pit___- .`_ Depth to ground water------ ..........
(i Test Pit No. 2........Z...minutes per inch Depth of Test Pit._._�`�". $a_`. Depth to ground water________________________
a ---------•---------------•---•-•--••=------•-•------•-••-------•--...----•---•---------------.....-----------•-•..._.......-------...._....__...........--•-
O Description-of Soil... -?. 'y �li7 !�' �� �St �� .✓ia---•-----------------------------------------
U ---•------•-•-----------•-•-----••-•--•--•-----••--•---•-••---••--=••-•-•. -----------•-------•----•-•-------------------------•-...••--------
W
---------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------
UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------
..........................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TZT?E 5.of the State Sanitary Code—The undersigned further agrees not to place the system irr e
oper ion u til a Certificate of Compliance has b n issue by t and o ealth.
Signed..... •• -----....••-•••-• '�'7y -
AV� � t at
Application Approved jBy..J � /"' �' ,{
- ---------------a---------_--------------- - d`1
Date
Application Disapproved for the f ollowi reasons:-------•-----------------------------------------------------------------------••-•----••-••-----••••-•-•-••--
7 -
Date
��,
PermitNo......................................................... Issued_.......................................................
Date
No FE:$...... ...._...�........._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
•........................................OF........................................................................................
Applirotion for Disposal Works Tonstrnrtion Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Location-Address or Lot No.
`--•---• ......_....................:....Owner........................................... .............................................. •-ress---•-......-....................................
Add
c.. .......................................... -•-•--•-••••-•----•-•-•--•.....---••---•-•. -
Installer Address
Type of Building Size -------Sq. feet
Dwelling—No. of Bedrooms______ __________________________________Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
a' Other fixtures ...._.................................................................................................................................................
W Design Flow______________________________S. ?:_____gallons per person per day. Total daily flow... ..............................gallons.
1:4 Septic Tank—Liquid capacityZ !__gallons Length__!��__r__'_ Width__.` .. :... Diameter...__--........ Depth_:`_. :._..
Disposal Trench—No_ ____________________ Width......._............ Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---------/.--------- Diameter________ ________ Depth below inlet.... _............ Total leaching area__�A1__......sq. ft.
Z Other Distribution box ( ✓)® Dosing tank
aPercolation Test Results Performed by____________....._-=__•--.........-=----.................................. Date--.l.=n--==-----d-'----•--------
a Test Pit No. 1.......__'__-----minutes per inch Depth of Test Pit--- ___ Depth to ground water----
fi, Test Pit No. 2.......2_----minutes per inch Depth of Test Pit.... Depth to ground water........................
----------------------------------•-•--•------•-----....... ------------•-••--•------- ---------------
__---•--...-------
•---------__----
D Description of Soil....T ........... .i •-/ � _v��r/ 1�`'......= �.�.�
-----••••••--•j_._._ .............•• --•••• -••• .................••--•-------••-----••-•-••---
�i
...........=............................................................................................................................................=•--••••---•-•-•---------•----------•--•-_....
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 T1TLIZ i of the State Sanitary Code—The undersigned further agrees not to place the system in
oper tion until a Certificate of Compliance has been issued by the board of health.
S
f�� Signed----....... ---------=--------------------•---•-----------•------------------------- ---------------------•-•--��} Date
APPlication Appro By_ '' ^. -L. lr:."...:...:'1..... _ ` ::_: b
i bate
Application Disapproved for the f ollow�reasons:----•---------------•-•---------------------•------..--•---------------.................................
-•---._...----•--•---•--•--------•--..__.._�.-----`-•-----•--•-------------------------•-•-•-•--------------••-••-•--•-•---••--•-••-----•••-•-•-••-••••••-••---•••••-•--•-------••-•--•--•---••-••---•••-
Date
PermitNo......................................................... Issued_.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS'
BOARD OF HEALTH
..t' .:b�. ...................OF..... .. `." :.............._..............................
Qurrtif irate of TompliFanre
THIS IS TO RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( }
bI\- -------------------- - ----------------------------------------------------=-----
y...._._.- �/ Installer 1 t
�. hrr.................K_�_oL!.Y'e....__ 1l,rv,�/YE i.t s.6? `'lls .�`r� ---
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has been installed in accordance with the provisions of TITT 5 of Th. ')tate Sanitary Code as described in the
application for Disposal Works Constriction Permit No.........___.._____.-: - —`'''
••--•• dated--- - :�y_ ..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................... 7_.._•--•-........•-•............. Inspector..... ..... _
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.° lbw a
( No.__f.._.._..--•--.'Q FEE ..... .....•••--
DispooFal Workii Tonotr ion ermit
Permission is hereby granted-------(-_✓1z.. ..............................................................................................
to Construct ( ) or Rep,-r ( ) n Individtual Sewage Disposal S stem
at1V 0__________ ______ x ._ __.___._rot•_._:_Cs__......__._ __' . _ ____ .......................................
f Street ,
I
as shown on the application for Disposal Works Construction Per t No _ ___ .5: __ Dated__.___.._'"r------------ ____ J ..
Ll n'.. �"� § Board"oYealth
DATE ' �..
FORM 1255 HO.BBS & WARREN, INC., PUBLISHERS
Ste¢,
9
100% 1 1-61,G 6 '.Pit -
£��. `•� !!'/1 � S-torte. � M1
20
o. 100•ttn 4 47.7 =427 gpd Sl.o
2s-•
scale 111-40
date 3-17-87
0o t 2 i i I Stoney
20,08 3 S9 hoist
0� r.1oad
round. 1500 I Q
5 13 S F��-� CaP e 'nc�cnep�u►u
n_ I p 49 �da/cbo�c goad
;ad
4S4 t I watea ^' ldyanni i, Ma. 02601
5o.zoSO'0 �. ���.it � i j �5 t � qate
T 0 _
.r s 84 Z-h�e po�;500; 3/I 9S w 11ea e.ya tem
rl Id
i
49.6 12owte 6 A L10 l wide
I.LC un�.u.�tab•le ►rca�Prlic,L
r ,'),co�it e No ;S ecaz to be ate w u ed l 0 aaoand
— R A CZQC-' pat and 220.faced with
nd. 1500
TNr S.o,►�,� clean i l,�.
�aF l�P�dOti°.
�S `� a. )=r ,. �.� 1-6 �� 6 spat
W/1 1 atone
No. bed-toont4 3
ga thaq�e d•iA. no
Slo-tat eyt. stow 330 qpd
.4 e c,,chinq� a tea 201 a� Sketch Nan o l and in Atn.-.W t e,.(CurmcK� d)(ia.
Pe"-,cve " 20/ a.¢ got Davin ,9. Patte�
Capacity 427 ypd ISeinf tot 2 " shown on a ptan -teco�tded in
13a,�.te r"eq.izttq bk. 2W pq�. 60.
f tevat ,om. 4hown a to- on an alum-ed dattm.
�cte �-er1.t ''a�rn:�;table i�ocuta-o T�ea�tTi--
?er,.t pit #P-502 3 gh i tot ate. not w.i t/u n the f, Dod hap&d done.
<iade- I 0-8-8 S
C'on)xn glw �oundat i on 4.hown on -th i-. plan i4. toca ted
A'o water encounte'ted on •the s ound ai dlwv)n heaeon, and reed, the
Peter. care 2 nun. ea I" act-back �ecyu�celisen. of the down of 6azndtabte. .
49.9 47.7 Date 5-9-87
-top top �
q5.9 46'Z
nsedium r ,yt .
nand to
coa/&d,e yA Of JAL
ltterLtv✓N "u 1 MANE : r
r,.
No.32490 ( z
9ECISTER P,�a Rom. 4
O 5y
9i0NA! LAND
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