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Home My WebLink About0014 MAUSHOP AVE - Health 4 Mai zsh Drive Barnstable.-e A=298 ,01,4` <a -7 No....... 0.......... FEE. ILF THE COMMONWEALTH OF MASSACHUSETTS ' S LLL BOARD Pf HEA _. ..........OF ...... ... ... . ..... ............. ................ V V ApVhrtttinn -for Uhipv vial Workii Towitrnrtiou Prrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: C LocatioAddress or Lot No. ................................................. .........••••--•-••••----•••••-••-•-•-----•--•--•-•.........---•--............--••---•-••....•... owner ! Address Installer Address, �//' �C UType of Building Z— Size Lot....../....................Sq. feet Dwelling `Co. of Bedrooms--------------------------------------------Expansion Attic Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-----------1---------------- Showers Cafeteria ( ) dOther fixtures .......................................................----------•-------------------------------•-------•-----------•--••--•-------•---------------- w Design Flow__.... .__....................... gallons per person per day. Total dail flow............ ...... Z-- ___________________gallons. � Septic Tank iquid capacity_�� _gallons Length.........6.... Width....__.. Diameter..... .......... Depth.....____-.--_. w Disposal Trench—No- -------------------- Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. x Seepage Pit No---------------------_Diameter.................... Depth below 'nlet_-__--__-_-•_---_--_ Total leaching area-------...........sq. ft. z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by._� ._. 1✓1.a . -------✓ --- �`L-�---------- Date. . ...--- � - - Test Pit No. 1_. �.�_ minutes per inch Depth of "Pest Pit____________________ Depth to ground water...---.-.-.--.-----.-_-. f14 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water--.--.-.-__---.---.-.--. P4 ---------- --- --------�------------------ ----- •---- . ...-------------------- o Description o Soil- ----l— J - �2--- x w -------------------------------------------------- U Nature 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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een issued by the board of health igned- -• . •--•------------•--•-••••• ---- ----------------------------- --------------------------------- Date Application Approved By ---- / . ••---- ---- ----- �1 Date Application Disapproved for the following reasons:----------_----_.-----••- ---•----------------------------------------------------•------------------- .................•--- --•-•-••--•-............--•------------------------•••-••----•-•••--•-••------................•-----------•--•-•---•-----......----------•---....------------•--•....------....... Date PermitNo......................................................... Issued........................................................ Date A76 LOC&.TION ' `L� °� SEWil,C,E PERMIT UO. 7� � /� p — — — — — VILL E — AG — IWSTaLLER5 ► &ME ADDRESS BUILDER 'S Q &ME �- ADDRESS D47E PERMTIT ISSUED DATE COMPLI &&ICE ISSUED : ` ®f�� e No......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEA OF....... . . . ---!fA�............... Appliration -for Ubipviial Workii Tonfitrurtion Vrrnift Application is hereby made for a Permit to Construct or Repair -an Individual Sewage Disposal System at: :LL .......L*. .............. ................10 loi_ e-------- .............................CC, ..................... Location-Address I , or Lot No. LJ�_ .......................................... ................................................................................................. owner Address ................ .................5&k:..5...................... .................................................................................................. Installer Address C_C-R%k__ Type of Building Size Lot----- I-----------------Sq feet of Bedrooms----------—7-—------- Garbage Grinder Dwelling>Ne*o. -----------------Expansion Attic Other—Type of Building ---------------------------- No. of persons.. _____"I---------------- Showers Cafeteria Otherfixtures ----------------------------------------------------------------------------------- W Design Flow____....................... '111 W ';?— .----__gallons. gallons per person per day. Total dail flo -------- ... ----------_------g, an capacity1rav--gallons Length--------6---- Width_7..... Diameter________________ Depth---------------- 9 Septic T, -------Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area--------------------sq. f t. Seepage Pit No_____________________ Diameter___________._._...__ Depth below inlet____________._______ Total leachino, area---_------------sq. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed by.--Tr....01-J$ .......... Date---a. ------------- Test Pit No. 1__3_,kj_mInutes per inch Depth of Test Pit____________________ Depth to ground water------------------------ (I, Test Pit No. 2................minutes per inch Depth of Test Pit__......_..____._.._ Depth to ground water............._..___..... Ix ......... 0 Description of SoilZ — ]�Z, ;; ------------------------------------------------------ ----- ....... ------------------------------------------------------ U ------------------ ------- ........... .. --------------------------------------------------- ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable---------------------------------------------------------------------------------- ------------- --------------I...................... -------------------------------------------------------------------- ------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI 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 he ... ............................... .............................................. Date Application Approved By.-- / 4 .. .. ... M -I--------------- > ./---�1_174 67 Date Application Disapproved for the following reasons:................................................................................................................ ........................................................................................................................................................................................................ Date PermitNo---------------------------------------------------- Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.. . . . .. ..... ...................... . . . .. ................*. ......hem�- ..... Tutifiratr of OVI'lampliana IS,TO CE,8TIFY, That'the Individual Sewage Disposal System constructed or Repaired .b .... .I.YA ... ----- -----ir,s t i er---------------------------------------------------------------------------------------------- ................................... ...16A at �/--------- -------- ....0 has been installed in accordance with the provisions of A' rti I of The State Sanitary Qode as described in the application for Disposal Works Construction Permit Nc V7�4------7-Xt--------_-- dated-jo�_a4.,---- -- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. .�................................. DATE........ I------- Inspector. C:,�� ---------------- ---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH nn 6e_4�- Xz_�_ �Z. TH ..I ............ ........... FEE._/6�......... No...... . ... . ................................................Permission is hereby granted'..-. ..91 -------------------- to Construe (10< or RAeir. an/Tndividualre,,A,age DispoP System ..at No . j� Xeu�---- ----- -- --) ......................... Street as shown on the application for Disposal Works Construction Lermit. Dated-W- ,q-4..... ------------------------------ Board of ........................................... FORM 1255 HOB13S & WARREN. INC.. 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