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HomeMy WebLinkAbout0154 OAKMONT ROAD - Health 1 f A= 349-060 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS , Yes Application for Mispo8af �6pstrm (Construction Permit Application for Permit to Construct( ) Repair( Upgr d Abandon( ) ❑Complete System Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map arcel. 1p 4Z Installer's Name Address,and Tel. o. e-A" Type of Building: Dwelling No.of Bedrooms y Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ). Other Fixtures Design Flow(min.required) gpd Design flow provided — gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. y Description of Soil Nature of Repairs or Alterations(Answer when applicable) IYl eA) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt . Si - Gi U Date f®6 � Application Approved by Date 0 Zf12 Application Disapproved by Date for the following reasons Permit No. UZ(— 7 3y Date Issued No. 7- At/(� Fee (/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: w PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS3 Yes m �S 11pphration for-Misposal 6pstem Construction Permit . Application.for a Permit to Construct( ) Repair( Upgrade Abandon( ) ❑Complete System Individual,Components f 6� Location Address or Lot No. 1 IQ Owner's Name,Address,and Tel.No. Assessor's MapTarcel —71101 AAI O � ^� Installer's Name,Address,and Tel. o. W ` 4 i ( De�si .�FareaAddrss.a ei Na. 47 //54 r, ------ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building + No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd -'Desigri flow provided AJ gpa'- 4V^' _ Plan Date Numbei of sheets Revision Date Title Size of Septic Tank ^. , Type of,S,A.S - :; , Description of Soil i Nature of Repairs or Alterations(Answer when applicable) K 4��a, eA) G t VIC Date last inspected: r °� Agreement: The undersigned agrees to ensure the construction and maintenance,of the,afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and no to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Signed� °, G Date, f/ Application Approved by Date Application Disapproved by,�'' Date for the following reasons . Permit No. C� az ( jU m Date Issued THE"COMMONWEALTH OF MASSACHUSETTS } BARNSTABLE,MASSACHUSETTS i Certificate of Compliance THIS IS TO CERTIFY,that the Qn-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by'',, j<,4 i G (Jf G at /-70 has been constructed in accordance - f with the provisions of Title 5 and the for Disposal System Construction Permit No, ated Installer 'ef [ 4,q j Designer #bedrooms 4 A Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will � Diction as designed.Q Date �j'/ /�? Inspector -------•- ---- - - ----- --- ------- -------- No �t/L..� ' �v f Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair(ts� Upgrade( ) Abandon( ) System located at 1?0 oloei"Pn �t. and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date l _ t�U 1 �OZ- Approved by f �Ir�H1rl aw�r��OWN OF BARNSTABLE LOCATION2&r 4ga6 OA SEWAGE # Wd VILLAGE &U/JCI UI ASSESSOR'S MAP & LOT : ( U INSTALLER'S NAME & PHONE NO. ,b.1(/ZE 'YJ,; cS/79 SEPTIC TANK CAPACITY y4� LEACHING FACILITYAtype) , / (size) 3� . NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER PU 11e BUILDER OR OWNER C71OZ10 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No i i i� , - 1 `� 3 r / , i F:z$...../Q.0......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE -" 151 Appliration for Uigvuiittl Works Tonfitrnrtion Vamit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: .oL\1C c -?'.............. ..!"1 :...... .... ......................................................... 1-Location-Addrg� � or Lot No. .......J IA...... z�..... �'�... �.....�? /I c............... ...........--•----•-•--....•-----.........--- -----�jo-----------•...............------ / W Q�° 'ti...... j L - /y/.��{ ow ..... b U !..Aa r-rlt. N .!'l, G(!!c� a Installer Address Pal Type of Building Size Lot.._ gZq�v-._._..Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ W Design Flow............... .....................gallons per person per day. Total daily i flow--------3.. -.........................gallons. WSeptic Tank—Liquid"capacityiPPo...gallons Length.&_!o�.___. Width:�.f3...... Diameter---------------- Depth...-57--._. x Disposal Trench—No-----------------_- Width.................... Total Length.............. Total leaching area....................sq. ft. Seepage Pit No....._t------------- Diameter.....AZ_......... Depth below inlet......_........ Total leaching area��a��l�sq-frFy�� z Other Distribution box Dosing tank ( ) Percolation Test Results Performed by....!I�-�. .._.°'.._�� �`k� 5............. Date.�t' `.�.....tz) ��....... ,� Test Pit No. 1.....�.....minutes per inch Depth of Test Pit-----l.............. Depth to ground water........................ rzo Test Pit No. 2......4.._._minutes per inch Depth of Test Pit---..i '____-_-- Depth to ground water-----h?c_114.._.__ �+ ---------------------------------- •---------------------------------------------------- ............. ... .----------------------- -----.-----------... O Description of Soil................ x 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia n i ued by t 'oard of health. Signed -- ---- -- ----- --- - ---------- ............................ ------- Dace ApplicationApproved By ----------------� - ----- -- . ------.... -----------...............------. -------- V �.,y Dace Application Disapproved for the following reasons- ------------------------------- -------------------------------------- ...........--------........... ........... ------------------------------------------------ ------------------------ ----------------- ---' --- ---- -----.-........---------------....-......-------.-......--------------------------- .............................. Dare Permit No. -..----- i�.. ��?�s -------------------------- Issued .................................. ............................. Dace c xo... /..:._ ...0 i FEB.... L0.0......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE a Appliratilan for Disposal Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct (!X) or Repair ( ) an Individual Sewage Disposal System at: .........GALM1!�gr�I �1��.. _ k Z ?. =----•. --•--•--------•----- ... ......Lt . .__.�.. ...................�...R. L,Locat*o rNo -- .....------ ,-. --------------------- t ---- .... .....w....,. A % ...07 A.ly6�/ ................... �---�4-g DU ev/ � ( ........... j-------------------- �---------------- Installer � � Address UType of Building Size Lot__ Z� .......Sq. feet Dwelling—No. of Bedrooms.............................................................................Expansion Attic ( ) Garbage Grinder ( ) pa-I Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures ............................ . W Design Flow................ .....................gallons per person per Iday. Total daily t flow--------:5 ........................g-41ons. I it Septic Tank—Liquid capacityl.0QQ...gallons Length.l a._... Width..�.l ___.. Diameter................ Depth... ... .... W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------t------------- Diameter------1Z.1-------- Depth below inlet...... I........ Total leaching area.5*04—Sq-ftAill� Z Other,,Distribution box (>() Dosing tank ( ) '-' Percolation Test Results Performed by..... Date- t"?._._(..._ _(.............•..... W Test Pit No. 1__...�-----minutes per inch Depth of Test Pit-----ly'-......... Depth to ground water... ......... 44 Test Pit No. 2......4------minutes per inch Depth of Test Pit......N.,'........ Depth to ground water----- ...... P4 ---------------------------------------------------------------•-----------............•----•------.......................................................... 0 Description of Soil---------------- ...• ----------------------------------- ------------------------------•--------------------------------------------------•-----. V --------------------------- ----------------------------------------------------------------------------------------------- -------------------------------------------------------------- •--------------- -------------------------------------------------------------------------------------------------------------------------------------------------------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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia ee- f"'e issued by the bard of health. Signed -- ----------------<if/ - �L'G '�........................... -- --------------- ....... �V� A lication Approved B ------------- Date------------------ Pp Pp Y �I--- Date Application Disapproved for the following reasons: -------------------------------------------------------------------------------------------------- ­1 ------------------------------------------------- - -- ---- -- - --- -- --- --- ---- ----------------------------------------------------------------------------------------- ------------........................... Date PermitNo. -------q11- ---- ------------------------- Issued --=-----......-- -------- ------....--- ..---------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of Cfoutyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by �� -------------------------------- 4M -------------------- -------- Installer at . ......91. .S.. ..�??° <<=� .--� ---------------------- ......- ... - --------------------------------------........................................................ has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......�, ........... .......... dated -.---------------------.------------.....-....- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. Inspector C7 �. ..................................................DATE. ..- � .—...... '"... . ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ;Disposal Works Tonstructiou � mit Permission is hereby granted.------.. .---•--•-----------=-------------------............------.........------....... to Construct ( or Repair ( ) an Individual ewage Disposal System atNo... Z-. ... d = _ P :..�-------------------------•-- Street as shown on the application for Disposal Works Construction rmit No._���_k1716�Dated------- ................................ -----•---.... Board of Heal h / DATE.. '"..: � (/ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS +- FIG- . l J Go Existing deck to be converted to screen porch. „_... 444lc 1�i} • � � sky ' � ` � mac., � ' %• , �� 77 a !� �• � Pao �' ®�'1 i'Z '� U, Ic ktAIW �/tom J Jf AsBuilt, Page 1 of 1 TOWN OF BARNSTABLE o LOCATIONZl d6 llAkAfl&t d SEWAGE ' LOT VILLAGE(/ 0/ ASSESSOR'S MAP & LOTy INSTALLER'S NAME & PHONE NO. 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