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Home My WebLink About0212 ANNABLE POINT ROAD - Health FF 212 Annabell Point A= 211 -036 Centerville S M E A D No.2-153LOR UPC 12534 emead.com • Made in USA 4 mtIOImr6IgD i =W* UMMSOLWOO OFIi[SRPIIOtiRAAA ffcummeas IOFI WWWSFVMOGRMAOW 1417-36 ..Q.......... All THE COMMONWEALTH OF MASSACHUSETTS MOVED BOAR® OF, HEALTH. Barnata Department TOWN OF BARNSTABLE --for Ali►ipwin1 Wi urk.6 Tnntrnrtinn Permit 2"Application is hereby made for a Permit to Construct ( ) or Repair (k<an Individual Sewage Disposal System at � . f Lomtinn-Address d or Lot No. n Owner Address........................................... Installer Address UType of Buildings Size Lot............................Sq. feet .� Dwelling-�No. of Bedrooms---a------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.____-.__--__-__--_--..... Showers ( ) — Cafeteria ( ) Q' Other fixtures -------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter---------------- Depth................ x Disposal Trench-- No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (Z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ ----------------------------------------------- .--.---------- •---------------------- ------------- ----------- .----....----•--------•...-------------------- Descriptionof Soil.................................................................................. ..................................................................................... c., x ---•--••--•------------- -----------------•---•••------. ---------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable.___. . . ..s .........................0.................. ST//i7 /0 o� !_ ..f--- ...... ../ ................ ........................•-•-----•-•------- ,�...o.. .. 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 y the board of health. Signed . ............ ....................................................... ../..��/ ..��.... 1�'5. .... Application Approved By ................ " u�.r..G..e-.9 ..... ......................-------...................................-------- Dare Application Disapproved for the followi g reafons: ...................................................... ............................................. ......................................................................... .................................. ........................................................ . . ............... ........................................ Dace PermitNo. ................... ........................................... Issued Date 1 O. Fas.. 1c)........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF. HEALTH 93 TOWN OF BARNSTABLE Apphratinn for Diripwmi Wvrkt5 Tonstrnrtiun "permit Application is hereby made for a Permit to Construct ( ) or Repair (k-<an Individual Sewage Disposal System at ...: .i.....�1 .ta............................................................� !r..... .......--'...-----•--'.•------------•-------------'----.............-------•----.._...----------• Localion-Address —or Lot No. O cner Address ............................ ----••'-•-..'. " 1 v Installer� Address UType of Building Size Lot............................Sq. feet ., Dwelling Building of Bedrooms---a................................_..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ......------_----------- ............................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. t7: Septic Tank—Liquid capacity...........gallons Length................ Width.........._..... Diameter---...... ...... Depth................ Disposal Trench--No. .................... Width.........----------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) � Percolation Test Results Performed by.......................................................................... Date........................................ ,.a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gr Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P+ ----•--•--•------------------•--•-•-•••-------••••-•••••-••-•---....----•----••-•-•---.....--------•......................................................... ODescription of Soil....................................................................................... ----•-•---------...---------'---------•--•-•••--'--------•-----••-•--•--------•- V ....----•••--•-'•••--••--------....•-•---------••---•-------'•---•---•---•---•••-•-•---••••-••-••••-----------•••'--••-•--•-----------••--•.............•--•---•--------••--•--•--•..................... Z .................................................................... ........................................ -Q. . ... U Nature of Repairs or Alterations—Answer when applicable...;1'!?/j!._< ssT ____-__________ _ ________ __ ____ )�7n/1iri /0()a I_.�9!�./<t. _...3 <1 r lT2. oeg - r 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 ..4..f. ��Gf�. ....................._....---................... A4 . k�ff3 g ire... ... ...._. Application Approved By _ — 9..---- `�.. ....�....-..1.�............... D�re Application Disapproved for the folio reasons: ...................... ...................... . ......................... ....... ............le.................. ........ ......................... .................... ................................................................ . ........... ..........--....................... ........................................ Dare PermitNo. ......................... ........ ......... Issued .................................................................... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , ,t TOWN OF BARNSTABLE C'IEr#ifi ate ut C11omplianee THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by C, o rz - �p. ... ^^ v. ..................... ...... rr la wkr - � .`..._ ..r.......N. ..f......�....._�...... �.......'.... �. _ __..........._ at ... 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. .._9.-3..-.....�.c.�?........ dated _....__....._......__..............._. THE ISSUANCE OF.THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.........._......��.... ......LO ...•�=�.................. ............ Inspector ----..._---------.........!._....... _..... .---...__... d' THE COMMONWEALTH OF MASSACHUSETTS 0.� 0, -- BOARD OF HEALTH L J� ne- - 93 d TOWN OF BARNSTABLE Mipmat Workii Tnnstrurtinn "rrmit Permission is hereby granted------ to Construct ( ) or Repair an Individual Sewage Disposal System at No.....•31......o �_{: f�n[�[��Yf IPA C't 11�_ II Street as shown on the application for Disposal Works Construction Permit N .... Dated........................................... U Board of Health DATE �I� ' r-•---••------------------------------ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS , t OWN OF BA STT=BLE LOCATION SEWAGE # 93-c�od VILLAGE ASSESSOR'S MAP & LOT ' (l . O36 INSTALLER'S NAME & PHONE NO. GoPoo.-76v "v-)- Ld8-&61(O SEPTIC TANK CAPACITY I, o o o p, LEACHING FACILITY:(type) Zn ��' '� (size)3= ao x (, r NO. 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