The URL can be used to link to this page

Home My WebLink About0012 BLOSSOM STREET (CENT) - Health (2) I Z Qltfjom J'r ctAf ervi I I z y� o17 f S M E A D® KEEPING YOU ORGANIZED No. 12534 OINITLATIVE 2-153LORNAILE FOR AESfRYWMIN.RECYCLED CONTENTIO%® oCert asr1pr morSooroiag POST-CONSUMER wwwsfipropraorp S"12M MADE IN USA GETORGANIZEDATSd1Ep P" i TOWN OF BARNSTABLE LOCATION yCi�` vi e. SEWAGE # ~' VILLAGE � L�� '% j ASSESSOR'S MAP Cz LOTZO2'_`4,`B� INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITY &60 66i L. ' LEACHING FACILITY:(type) Pi (size) L NO. OF BEDROOMS P R PUBLIC WATER Put BUILDER OR OWNER DATE PERMIT PERMIT ISSUED: L DATE COMPLIANCE ISSUED: dd VARIANCE GRANTED: Yes No : G �� C�eau {.y �� i ��f S M MI6 � y - �� L)i° � ,Yr. ,. - q6 No..` /-_.f2.�,� Fizic .3 ..... i ' ..t��'..APPROVED THE COMMONWEALTH OF MASSACHUSETTS Barnstable onservation Oepattmen2 BOARD OF HEALTH :yTOWN OF BARNSTABLE si � lirtt# �t for Di-tipuuttl Wor1w Tomitrnrtiun Permit j Application is hereby made for a Permit to Construct ( ) or Repair (V) an Individual Sewage Disposal Zystem at: i , S --------------------------- ------ 4. . Location-!\ddress or t No. Owner - ddre s, .`'. ' c%� �f. Q Vic, sLtc ,. c..�... Installer Address UType of Building Size Lot............................Sq. feet t-, Dwelling— No. of Bedrooms.._..- a......................_..._..._Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons-_-.__.-_.-_____--____.-:--- Showers ( ) — Cafeteria ( ) 0.' 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........................................ a Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water-.--_-.-.--____.-----.. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ....-----•----------•...-------•-----------------------------------•----------------•. 0 Description of Soil-----------;- ------------------------------•-----•---•--------------------------------------------•------------------------------•---------------- x U .-----------------------------------------------•-•------------------------------------------------------•-----------------------------------------------------•--------------...---•-------•-•--........ w x U Nature of Re airs or A rations—Answer hen �pplicable.,__ _. plc-2._ a c�L ... ...►:. Agreement: t , 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 CompliAQce has been iss e »I o d of health. Signed �' ................................................... . .......................... . .D..lt .`..I Date Application Approved By ...... ..... ............ ..a- -.-..�`... JDate Application Disapproved for the follow' reasons: ......... ....................... ........................................................................................---...................... ------------- ---------------- Dare `-. Permit No. ........ .' ................... Issued ------.....................--------------------------------------- Date —=——— - - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Trrtifutt#e of GraplianrE THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired by ------ r c? '�_. r-.c-z� - - -- - --------- .... ---------------------- ----------------------------------- -------------------------------------------------- ----- Ins[-nll-e-r 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. ----- '/------------ dated ..................-...._---------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTI UED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ........!�- - / Inspector „^ ." / ---_-----------------------------------------—----------------------------------� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c� TOWN OF BARNSTABLE No......! FEE..,—.3U........... %postt1 Works Tuns#rudion rlerntit Permission is hereby granted._.__._cJC --....."....................................... to Construct ( ) or Repair (V) an Individual Sewage Disposal System atNo..... \ Q \C�. .S�!M.--•• '------••-----•----•-------------- ---------- ------......------------------------------------------•---............. :r= Street / as shown on the application for Disposal Works Construction Permit No._ ___:-(�._�y__.. Dated........................................... = / ............................... ( Board of Health DATE.................-�1.--'=--�-�----c�--. FORM 36508 HOBBS&WARREN-INC..PUBLISHERS 3. FE$... .C��.....- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 2 _� _5 TOWN OF BARNSTABLE Xpli iratiou for Diupuutti Work.6 C vastrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ('�/) an Individual Sewage Disposal System at: -----------------------------=---- Z Location-Address or t No. ,Wa _.C> Mr— .vncr ....1 ��_ adre�sS'1 C.3- Installer Address ' Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms....-- .t.................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures .-_---------- ------------- •-----..... -e---------...------------------------. ---------•---•--......-•-•---••----••----•••-•-•............. W Design Flow..................................--------gallons per person�per•d'ay:..Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.....; .gallons` `" Length_______________f 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........................................ �..1 Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Gi, Test Pit No. 2................minutes per inch Depth I of'Test Pit.................... Depth to ground water........................ -.--------•---------------------- ------------ 0 Description of Soil..........�.c,. J- x U --••---•---------------------------------------------------------------------------------------. ---------------------------------...----------......--------------------••----`-------------------- W ------------------------- U Nature of Repairs or A.t.qrations—Answer when applicable.-._.___ _ `Ca.� �_...__C V. .._. ..... 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 ce has been iss - of health. Signed - — -----------....... ...................... ..... a..� .�...� ..` �. .. Dace Application Approved By .............. .. ` ........ ....� .. Application Disapproved for the followan� reasons: ........ . .................................................................... . ...................................... . ...........----------------------------- Date Permit No. ........9 -------6------------------------------------ Issued ........................ Dace.. .................... No...•/ (IL'" —3 OQ 66— �76 ,^,Ff' 15VED 6arnstable Conservation DepartmenjHE COMMONWEALTH OF MASSACHUSETTS ,9y BOARD OF HEALTH igned Da OWN OF BARNSTABLE te Alip ration for Diripoonl Wi orbi Tonotrnrtion rantif Application is hereby made for a Permit to Construct ( ) or Repair (4< an Individual Sewage Disposal System at: ....... �............... .. �Gy�. ............ Location-Address or It No. ` f�� c�idL�/�.J� /J C . O:cngr .�� o� Address W 1 '= Gi'B!1!J``% 7 6 J L��?.�cci`� � . /_��. i �1 t GZ .� ./1�1' ---• ................... .��----••---•-......__._...._..•.............................. .........................................- ---' ._- -- ---.._........_....... Installer Address UType of Building Size Lot............................Sq. feet 1--4 Dwelling— No. of Bedrooms-----------_______________------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons----------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------•------------------------.._...-............................................................... W Design Flow.................�- �_............gallons per person per day. Total daily flow---------- .P...................gallons. WSeptic Tank—Liquid capacity400_...eallons Length--.-_- __--__-- Width--------------- Diameter._...-.-..-_.__ Depth................ x Disposal Trench—No. .................... Width_.................. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------- - Diameter......1�=P.--- Depth below inlet------- '._._--- Total leaching area.................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------- -------------•-•---•••-----•--•-•---•-•--•--•-----•--•---•-•..... Date........................................ Test Pit No. ]................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ Test Pit No. 2................minutes per inch Depth of Test Pit..----.._.______-._. Depth to ground water........................ 0+ --------------------------------- ----- ......................................................................................................... 0 Description of Soil..................... - .......................... --...... c +,r L-----------------------------------------------•--- ----- x ------f,, ------- --- ----------------------------- U Nature of Repairs or Alter tions—Answer when applicable.____. - 14 0---_-.-tea® �,,, �. 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 Complianc ha bee is ed b the board of health. Signed ......� s/ Dare Application Approved By ................ ................ ...... ..._, .a.. .� Application Disapproved for the following rearons: ............ ................ -- ........ --......... .... . ............................... ---. . ............ ..................................q.................. . ........ ......-------........................................... ........ . . . . ........................................ PermitNo. .........1.... ..�`S�..................... Issued ............... ........ ..............................te...... Dace THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE . ( ertifirate of gornplianre THIS IS TO CERTIFY_That the Individual Sewage Disposal System constructed ( ) or Repaired ( N<-') -------------------- ---------- ------- .......................................... h,:u« - - --00 at ....................................... ....... /n 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. .....�.Lr/--.6..�......... dated ... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE i. SYSTEM WILL FUNCTION SATISFACTORY. DATE... .'-'.....__._.... '�'".__. .. ....._. Inspector^..G ..........._.......... ............ ..............._ --.-.__,---------------.--_----------------_,__----------_,---_-----_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE -36-- No...1l7..7: - FEE........................ t n tt1 �ork,5 Tonotrurtion Wrnttt Permission is hereby granted------------ .--e-.'�_-.-.----C '�.---$--! --G'��1 ---------------------------------------•--- to Construct ( ) or Repair (� an Individual Sewage Disposal System at No..............-------------- �1 �5,�..Z o.i ;�G /ii..�F- f /!L....�.J. ��z w?'f.�J/ct Street as shown on the application for Disposal Works Construction Permit No.- -.y.66---- Dated......1-4, ------ a.7. ...... Board of Health DATE.................. ---- / -------------------------- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS t9� -�S i 3 - ooy o�- ,�G No.._! .._....... c� Fss....... THE COMMONWEALTH OF MASSACHUSETTS e2 )�2 9y/ BOARD OF HEALTH TOWN OF BARNSTABLE Xp4ifirativit for Diri inial Worlw C owitriartion tIrrmit Application is hereby made for a Permit to Construct ( ) or Repair 0< an Individual Sewage Disposal System at: ....... .. ....-- ..........I I- ... -- ---------------- Location-Address or Lot No. 66 •-•-•--•---••------------•-----••........................................................ -••-----.. .................................................................................. _ 0. ncr Address ...7.. c e�Ti 7 C!.....l i9 6G. Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------._-.__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ..................... ...... No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------------------------------------------------•---•--------- ---...........--------------------•----•••------••---------•- Desi n Flow.................. �_---_.___---.gallons per person per day. Total daily flow.._-____-__,. W g g< P P P Y Y -��v-------------------gallons. . W Septic Tank—Liquid capacityZ�4....gallons Length---------------- Width---------------- Diameter...-_-.-.--_-_- Depth................. x Disposal Trench--No. .................... Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No......... Diameter-----Z .t_..._ Depth below inlet....... -........ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed b ................... Date..........._............................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit--__-_-__-___--_. Depth to ground water........................ .................•---------....-•---••-•-•--•-••-•---.......-•----•-•-----•------•---•------•-....••......................................................... 0 Description of Soil..................--�� .........S-U�Ja �, C•G_A-,!i-j__.... -' t j ti,S ,.l�...�........ x - Cs £.1.-----•-----------------------------------------------------•---•-------•---------------•-------•-•-----•---------------.....----•-••-•----..........--- U �..: W x -•-•-•-•-•• ....................•---...----------•----------------------------...........---•----•-----••••. ...._... =•. ----•- / U Nature of Repairs or Alter tions—Answer when applicable �_.--__-- 9�a.-----.tf!. d-�.....!._* !nl -__._ .... ...............!elll.............W ........ T17! ..L......._7�...._.. IJ"T/�v ........ �G,4Vx ............................................ 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/h beeeta isssstied bbby2 the board of health. Signed ----- _(-L...2 ✓1-.........L<.........................................................} .�. '//�/.....��... Dace ApplicationApproved By ................. �... .............................................................:---------- Application Disapproved for the following reasons: ..................... .............. . . . .........................-- ......................... ...................................................................... ........................................ . ... ..... ........ .....-.. .- . . .... .. ........................................ q� Dace Permit'No. .... 1...y.........�...may............................ Issued - ..............----.: .........---......... . .... Dare i L O-C At ION VIL•LA6E IerU r IN;ST A 'LLER's NAME i AbbittS' a 01 L o E R on owME / � I ��- - 7 `?��.,? 4 .,rw•;.s. ,yx 3 r,;"�5, r•.r:�h:yzg,..4-.r re 4 P! + '�^'"�'^�i_ � t ass -.�..,+ t .��i .i-�:�.r-OuSae�k. t�..•i,' t `.fi, £s. s. n DATE !' ERMIT IS3 {iE0`', •�t t L }w�` 5 f?i. .K. : r, --'.7 ,,,+A-t ;.aF"ryr., �„3z'� ,., �' -# '7'. 'F' ..[, wrr�- r. 7 � k t t' S y � t W � .;k� +r 44 ' Rj r C� 1` k f r"".;tX r•'aE t^./i` a:t 14� %} s1 r { ✓$ #a , it r t Nt