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Home My WebLink About0015 IRVING STREET - Health S Icy Ins s7 zz6'— tZq ASSESSORS MAP N0: , - No.. ..... ._._.`.:..�L✓�' PARCEL NO' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirativit for Bi,raVaiial darks Cnwititrurtion ratuit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal system t. 1 .In ------------- ---------------- ocat' n-Address or Lot No. af •....-•� a.11 �.1 . ................................................ ......................................................... �CT'�1 lZE:�.._. /Owner ddress Installer Address UType of Building Size Lot.................... q. feet ..� Dwelling—No. of Bedrooms.._-_3_•-__-•--------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures -----------------------------------------------------------------------------------------------------•-•-•--------------•-•--•-••----•--••......-•-•- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacit/,00..galIons Length---------------- Width---------------- Diameter.--------------- Depth................ x Disposal Trench—No. ...__..._....__.. Width---- -------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.l________ ____--- Diameter......-_._._.--- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit..-_---_-__-__---_- Depth to ground water........................ a ---------------------------------------••--------•---------------••-----------••••......-•-----••---------•._.....--•-•--•-•----•-•-----.......---••--••--•. 0 Description of Soil.................................................................................................... -•----.......-•--•-•.............................................. W V .............................................. .......................................................................................................................................................... ----------------------------------------------------------------------------------------------------------------- ----- ................................................. L U Nature of Repairs or Alterations—Answer when applicable.._ /A- .. �, <$ .<.?.--_-__- /.7 fit - ......... L ............................................................. Agreement: ✓ � The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental —The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha been ssued by the and of alth. Signed ...................... -- - ---- ............................ . . .�.L -------- , ' Dare Application Approved BY - . . ------ `-- l lf/J.. .. ........................... .................................------ J Dace Application Disapproved for the following reasons: ...../......................... ... . ...._....... ..................... ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- ac Permit No. ............4....'�.... ...�, ......_ Issued ........: '..-.4'° D Dace TOWN OF BARNSTABLE r LOCATION SEWAGE # s 6 b VILLAG ASSESSOR'S MAP & LOT' INSTALLER'S NAME & PHONE NO. j /�/!y� 3��-r 3666 SEPTIC TANK CAPACITY ®8 -LEACHING FACILITY:(type) . i "B't (size) y eel NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER PA A Ssl ' DATE PERMIT ISSUED: 1 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No T 11 T e c 3 �c - 3c/ c- 3 A = 3� 3<9' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tertifirate of Compliance TN IS IS TO CERTIFY That the Individual System Sewage Disposal stem constructed ) or Repaired P Y by ......../ ... .........! IU�1. lti .------------------------------------------------------------------------------------------------------------------ ----- --------------------------------------------- at ........ ,!.. ' '7---------------------- Installer c - 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�'� .. E'. ...-------- dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT/BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... r� ..... .... .1.., --------I----------- ---- Inspect .c ..../ fttj ...................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � TOWN OF BARNSTABLE . No-----�- -t=. •-Cs � FEE.................•--.... Permission is hereby granted----- !rla!? ------------------------------------...................................................... to Construct ( �or Repair (.- ) an Individual Sewage Disposal System at No...................1..,/�-�.1--!V 4 �'f- .... ............. �- � Skr et s. as shown on the application for Disposal Works Construction Perm�/it 6----_�c� Dated.....................�C.. +..._.._........ Board of Health / DATE----- ........................ FORM 36508 HOBBS A WARREN.INC..PUBLISHERS No.. 1..... '" FRz...r r� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphration for Diopoitti Wbrks Tomitrnrtion rrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...............✓�. /Z/(/......... ..----... ..............--=-K------------- ------•-------------- F { ocadro i•Address or Lot No. J� . , Owner ddress Installer Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms.__.-3---------------------------------Expansion Attic ( ) Garbage Grinder ( ) P4 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 capacit/_ O..gallons Length................ Width__--_...._______ Diameter................ Depth................ x Disposal Trench—No. _................ Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. 3 Seepage Pit No.�----------------- Diameter.__...4___._-_____ 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........................ fZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:+4 •--•-•-••-•--••--------------•-••----•••-•-••-----•----•-•-•.._...•---•-•-•-••.......----------........._....................._-----------...........--_••-•. 0 Description of Soil......................................................................................................................... .............................................. x V UW Nature of Repairs or Alterations—Answer when a licable. A?n.1._ _____.. u .fS______- !J�. � P PP _.. 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 hats been /issued by the board of health. Signed ....... �..-�.�..........�,��s�'.�.�" i Da cc Application Approved By ------------ �t�'Zl� ------------ ----------------I--------------------- Da cc J Application Disapproved for the following reasons: ..... ............................................. . ........................................ ....................... ......... . . .......................................... . . .......................................... ............................................................. .--------------------------------------- Dace Permit No. ----- �� ------------ Issued ------- '..`��. Daze