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Home My WebLink About0175 PALOMINO DRIVE - Health ns Pa�o,�»rno p: �/ cuv E i I 11PUPC 12534 O IM3LOR NASTINA8.UN I TOXN OF BARNSTABLE r &eM4TOVUL LOCATION t> Qm-pt-,,vJQ SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. l c c.�c i ! �y i "S SEPTIC TANK CAPACITY 1 LEACHING FACILITY:(tppe) �'� . (size) NO. OF BEDROOMS -7a PRIVATE WELL PUBLIC WATER BUILDER O WN Z Ate`Z C��J� �'�k-v-6 DATE PERMIT ISSUED: -2--j 52 DATE COMPLIANCE ISSUED: 1&"Z3 VARIANCE GRANTED: Yes No (� r SIAO � 3 �Iz Sze No. - Fim THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 8arnStable CAPPROVED SeryeUol, -----T� 0_(V_A ..........OF_....... Appliration for Dispati al Works Tonotrurfioj tom= Application is hereby made for a Permit to Construct (U1 or Repair ( ) an Individual Sewage Disposal System at: ................_-.............. .ALOw�� ---- 7- -......-•---.....-----------------•--.....fig cation-A re s or Lot No. ......................-... ..... � . iN -----------•-•-•- •---•--------••--•----...._---•' ------.........------------------.-•-•-------...---•__ Owner Address W Installer Address UType of Building Size Lot___ i 3 ._Sq. feet Dwelling—No. of Bedrooms..__.________________________________Expansion Attic ( ) Garbage Grinder ( ) _l Other—T e of Building No. of persons............................ Showers — Cafeteria d Other fixtures ------------------------- ----------------------•-----'---------------------------------'----•------------••----------- ---------------- W Design Flow................... `S......._.....___gallons per person per day. Total daily flow____-___-___-_•_-_-_.-_-- _..__.. ....gallons. WSeptic Tank—Liquid capacitytOC; gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—N�_____________________ Width..................... Total Length................,... Total leaching area....................sq. ft. Seepage Pit No_____________________ iameter-----.��-__..... Depth below inlet.....3_5_.... Total leaching area.__��.__.�...sq. ft. z Other Distribution box ( � Dosing tank ( ) '-' 93 Percolation Test Results Performed by...... {'_ . ....�. ...................... Date---A� _` Wj Test Pit.NI'l....Z_._...minutes per inch Depth of Test Pit..... Depth to ground water.._..4-'____..._-. (i, Test Pit,No 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------- • ............... -------- -•--... .................•------- ----•----••-._........---_----- 0 Description of Soil �`=�"� lEUSO/L 3-/® � s ANC x -•- -•---•--•-•--•-.._..-•---•--- V --- ----------- ---------\----------------•--.........._..........---------=-----------------------------•----•-••_--- UW ---------------------------------- --------------------------------------------------•------------------=-------------------------------------------------------------------------------...._...•••... Nature of Repairs or•Alterations—Answer when applicable............................................................................................... ----------------------------------------------------------------------------------- -------------------------------------------- •-------------------------------------- ------------••--------------- Agreement: 1 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with- the provisions of-T+TLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the bo d of ealth. Signed --- ....................... -- ..... ..................... Dace :..z Application Approved BY - -'---- ' Date� Application Disapproved for the following reasons- --------------------------------- ---------------' ----------------------------------------------------.----------- ................................................ --------------------------------------------------------------------. ------- -------------------------- --............--. }..- - 1 W Permit No. Owl= - -7,�----------------------_ `�� Issued ....... Dace No...................... FimB............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................OF............F,)A4 J Z) X............................... Appliration for Disposal Works Toustrurtion 1hrmit Application is hereby made for a Permit to Construct ( or Repair an Individual Sewage Disposal System at: 1)....................... .................................................................................................. R .0!1....................................... I Location-A or Lot No. 1AQF_ . .................. .................................*................ ................. ....................... ........................................................ Owner Address .................................................................................................. .................................................................................................. Installer Address Type of Building Size Lot----4kt.T�._Sq. feet Dwelling—No. of Bedrooms---------- U .............................Expansion Attic Garbage Grinder ( '_l P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( Otherfixtures .................................................... .................................................................................... Design Flow allons per person per day. Total daily flow..._.__.._..._.......__._W ...........g .... ....... ?...__gallons. P4 Septic Tank—Liquid capacity.lf_Y�allons Length................ Width................ Diameter---------------- Depth....__.._...._.. Disposal Trench—N Width.....,......._...... Total Length......._........,... Total leaching area....................sq. ft. Seepage Pit No_____________________ ---- iameter......[An...... Depth below inlet_... ...... Total leaching area---!.Q.?6....sq. f t. Z Other Distribution box ( e Dosing tank ( ) 7& 93 Percolation Test Results Performed by.... yr4':�I�e........44_6.....1A.-C........................... Date.._.I Viz Test Pit No. ......minutes per inch Depth of Test Pit.....�_Q........ Depth to ground water------- ............ fi Test Pit No. 2................minutes per inch Depth of Test Pit.._................. Depth to ground water_--_-__..._..._..._.___. ............ ------------------*..................................------------- ...0... 77 A"'A'g' ]''6'.... --------------------------- I,_." _57V 45014� ... .............. 0 Description of Soil........0.-1........ .5.......................................................................... ........................... x U ......................................................................................................................................................................................................... -------------------------- ............................................................................................................................................................................ 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 Compliance has been issued by the board of health. Signed .............. . ...... ........................................................................ .................E)- ------------- ce Application Approved By ------ ------- ------------------------------------------------- ...... Dare Application Disapproved for the following reasons: ----------- ---- ----<-------------------------------------------------------------------------------------------- ............................-------------------- .. .............................................................................................................................................. ----------------------------------- Permit No. ----------------------1 ............................ Issued ..................------------------- 1:7V........... Date THE COMMONWEALTH OF MASSACHUSETrS BOARD/5)F HEALTH ------------- --------- OF ........ --------------------------------- -------------------- ... Certifirate of 101,11mplianre THIS IS T CERTIFY, T t the jndividual Sewage Disposal System constructed or Repaired by11 ------------- k- /P/ a --I/ .... .. ................................................... ------ ---------------------------------------------- k-701 �frStaller '7,.3 ........ ell .7 ....................t ............. ...... ......... .......10--------- ....... . .... .............................. has been installed in accordance with the provisions of TITLE f he State Environmental Code as describegi in ''1 A-91 141e ... ... ...1-1---I------------- dated the application for Disposal Works Construction Permit No. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAI%T ?i SYSTEM WILL FUNCTION SATISFACTORY. DATE----------------A.1;.. ... .............�................................................. Inspector .............. ------------------------------------------------------------- THE COMMONWEALTH 07MASSACHUSETTS BOARD OF HEALTH ............ *.....A ........0 F... ........................... ............4 FEE.Z�� I Disposal Rarks inn triulion rantit Permission is hereby granted----------- - --------------------------------------------------------------------- to Constructair an Individual Sewage Digsal S stem at No....... e4 ... - --------- Street as shown on the application for Disposal Works Construction Termit .. ..... Dated. ...... A:?............. _%�4..�4e.�. ......... ..... ...... Board ealt'h DATE...... ................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �` YJESI l�N -DATA 1 OF. 2 51116LS F"I�% �3 $Ei wMv o i T }Ja . . 6AY_�3AC� GRIIJVEK i _' t ..5E?rIC TANV 3� )O— � _ G ,. DlSPoSQL. ply i- �c�?GALf 4srou x RAI4 64 51DEMLL A>E, IE SF i LnT OM I ?mom , teA . -!�¢sf y � }. `�g b -bT-AL.VE5516W = �-3 • TOTAL QA►IM PE¢GaC.ATt oN .: tvRz tAX 2R k � Ski DIVA I ! + _03 �G-silo � TF-- Ln�M Pie f � : .#, GQL' to 3 I 6K r�JJ r Lo0 ; ENV i�✓J qy 5 17C- T M: Tipl CL Sir -s (� �� "PEyEl.apq� '�I cam-- , �'Cd N IJ D ' s • Lodgn - l EGA L�� Flow CFY�IEy 'A -T CE �144 _ tJ HEzwN :CoM'P�S yvt1'� T11 c e° idD 15 oT'.LoCy4D W �. pax pq4 •LAW D TfAlS FLaN `:.15" NOT' .?A is a.l tiN l�J4'lY-�WtE�YT'.- Su�/�yoPzS U`? : T'DSTABUSt�4 , 5t'E2vtc.c.s titASS ; flzaP 'y N5 _ IP �iC _ P AN'j"S ACE LatJr�lN�a • ,� f �� i r1 � .s r r i W-I rj a oll AV ' ' q / I Rio , / i / I /• ol ' +_ 'Az 7 spar OF PE �{!r V � �:•`S iitCdL4AD f �'• Tl SULUVAN q s BAXTER ,