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Home My WebLink About0277 BAY LANE - Health 277 Bay Lane Centerville A= 166-058 SMEAD No.2-153LOR UPC 12su • us"M usn �IrN1�WIRTW ISFI _ _�� TOWN OF BARNSTABLE , LOCATION SEWAGE # 95 'f7 VILLAGE�j� ASSESSOR'S MAP & LOT/�fL,,0r INSTALLER'S NAME & PHONE NO.V 0%?DOrt-3 v 5eo SEPTIC TANK CAPACITY 15V 0 LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �Ohr� t�v Fts DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �" �'"' VARIANCE GRANTED: Yes No j-�0 nT 1 j—l6 ci Fel ASSESSORS MAP NO,:. �66 No..f_............f PARCEL NO: FI;:$....-��- .THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Di ipwial Wurkii Toutitrnrtinn lirrmit Application is hereby made for a Permit to Construct ( ) or Repair (//jan Individual Sewage Disposal System at: ................ .---...Cif-&( .•.. catiIII- \ddress ......•.... .. Lot No. �j� Owner Address W ....................••� vl _..i�trNl ll�. .......................... ----•-----------------------••---_..--•------••-------•--•--•----..................•.............. Iustallerq Address d Type of Building �,,// Size Lot............................Sq. feet U Dwelling L-No.-of Bedrooms._--/........................ .. .....Expansion Attic ( ) Garbage Grinder ( ) ply Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' 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. Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by------- --------------- ----------•-------------------------- ............ Date........................................ ►.7 Test Pit No. I----------------minutes per inch Depth of Test Pit_.................. Depth to ground water........................ f= Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ R+ ---------------------------------- ------------------------ ••----------------•----•---•---------•----------------------•-------------.....------------ ODescription of Soil---------------•---------------------•--------------------•-.........---•--------------.....------------....----------•-•-•-•-------------------•--•---••............--- V ........-•-----•------------------••---............._•-----•-------•------•---------•---------••--•-•--••-----------------•-•--------•-•-•-•...-•--••---•----••--•--•------•--------•-.......-•-...•---- W •-------------------------------------- �------- - U Nature of Repairs or Alterations—Answ r when plicab �4QL .�E,U_......_. �'J._._..__. --------------•-----•-----•-•--•-••---... lam'/ — D O — r. -_... .--- 15... ��A/T rl ....----�_�r�`�/�'rnT2�__..../�.-s7arr-. ---------------------------------------- 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 Complian e has bee slued by board of health. / Signe /lf .:.-.... Date ApplicationApproved B ............ .. .......... . ... ............ ........................ .......�-�.---- Dare Application Disapproved for the following reafont: ... ................. ....... ...........--..................................--......... ..................................................... --------* ....................... ---------- �-^— Dace � Permit No. ... ...-"'-....... .. .-....-. Issued .�� - �`�. �. Dace _, NO3��!��w THE COMMONWEALTH OF MASSACHUSETTS, BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diopooul Worlw Tonotrnr#inn jkrmit Application is hereby made for a Permit to Construct ( ) or Repair 4,-ran Individual Sewage Disposal !, System at: /� 7 ...............................( E.cf�---• --•-•••-----------••--•---•--•-----•-•--••----•••-••-•........................................... Location-Address or Lot No. ........................r( (?..!T--------------------•-•-----------------• ........................-......................................................................... �^..��1 Owner Address -� ►J' ................................................ -•••----•------.......----•-•-•••-•-•--•------._...•--••-•••--•-•--•-•-•---.._._...•-••-••-•-•---• Installert Address d Type of Building L Size Lot............................Sq. feet Dwelling'=No. of Bedrooms____/ ............................. ... Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a Other fixtures ............................... . . W Design Flow............................................gallons per person per day. Total daily flow-...........................................gallons. W Septic Tank—Liquid capacity............gallons Length------------ ---- Width---------------- Diameter---------------- Depth................ x 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 ( ) 1-4 Percolation Test Results Performed by..................... ---------------••-----------------------------•-•--- Date......................................0.4 .. Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Git Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ A+' •---•-•-•-------------------•--••••••-••---•-•--•-•-----•••••-••--------------------.........._.__.......-------•----------------....__...•--..........._.__. 0 Description of Soil...................................................................................................................................... -••-------•-••.................. x ••••-••----•--- ......................................................................................... U Nature of Repairs or Alterations—Answer when a,,QQplicab �/! �._..- tL�.rY/................................................... S�•%�/�- Sbo Gam/ 7n/T tS-ZC? /?�.IT�1� 1 = ��- .......................................................... 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 'sued by he board of health. !��/' /� Si ne %//,/i c .. �!. C��......... ..o? / :�-:------ g d.:: .1.:....-..........._ .. . . _........ /� Date Application Approved B `� / �......... ........ ....... ........ _ ��`� ..`.-. �`J Date Application Disapproved for the following reafons: ........................................ ............... ............_..... ... ...................................... ....... .............. ... ....... ................................... .... -- ..... .............................................................. ........................-- ---------- Dare Permit No. ... `? ....''. `..:..`�.... Issued...... X. ...�`�' ....--. .. ... ............... ........-- Dace c ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ITPrtifirate of (11ampliatiCE TAIIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired y ................._....__... .. .....u..,.. '7�J....._....... -...... - - -- :............................ � Insrdlcr at ....... .> .... 1.... -....1 )..-.... ...... ......._......c...t..1...._.......... .............. has been installed in accordance with the provisions of TITL 5 of The SttAte Environmental Code as described i�` the application for Disposal Works Construction Permit No. _..._ _�-1.. "... ..... dated _ .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOf B CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE .... .'�... .` ... ..._._.... ... ............ Inspecto`r......... ----.-----------,_-.--,------_-_--,--------_----.-_---,---.-_--------------_-_-_-- I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 94 TOWN OF BARNSTABLE FEs._:3�f � .........�_`...__•••-- �i��,as�1 nr�� un�tr�r#inn �rrmit Permission is hereby granted__.__._C�_o2�o_^ c�I�vJ____________________ to Construct (1") or Repair 1�_) an Individual Sewage Disposal System at .-":..... ....................................................... -StreetC� as shown on the application for Disposal Works Construction Permit 1KIo._.__. v/`----�ated....�n Z777_._�� Board of Health DATE............................................. ---�� -•----------•--------- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS