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Home My WebLink About0234 LAKE ELIZABETH DRIVE - Health V' 23y La ct Fli to.ba1� �QA t of ifi//B s - Zzs - oq5 i c .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH APPROVED TOWN OF BARNSTABLE 88rnStable Cvr,;crvation Depanmem Appliratiou for Disposal Vork.6 Tour Act Application is hereby made for a Permit to Construct ( ) or RepairX) an Individual Sewage Disposal System at: 324 Lake Elizabeth Drive Cra.igville ................................................•-•--•--•---•--..............------...------...... .............------------•-••-----••-------------•------------•--•-------......---........._------ SchumacherLocation-Address or Lot No. Owner Address W . . P.Macomber Jr. Installer Address Type of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms.................... ..................3.----.-------.--------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ................ 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.---------.--.------ Depth to ground water.---.................--. LT4 Test Pit No. 2................minutes per inch Depth of Test Pit---:................ Depth to ground water........................ 0 04 ---------------------------------------------------•-----------•--•------•--.................._.............................................................. Des c ' do o S 1--------- --•---------------•-----------------------------------------------------------------------.....--------•-------------------------------------•------------- x �'pa.n� � �raveT v -----------------------------------•---------------.....----------------------------.......------------------------------------------------------------------------------......----•-------------_..... W x ---------------------------------------------------------- -- ------------------------------------------------------------------------------------------------------------------------------------------ Nq. U t f R air or l ations— swer when applicable................................................................................................ --t'��M0 Tar otNT d1 ussors --------•-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--....----- 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 b n/ssue by the bo rd of health. Signed . .. . ..... .. --'............................... ........................................ Dare ApplicationApproved By -----------------�.a ..- . .... .z .....--...---------------------......--............. ............ .....3 « �� Dace Application Disapproved for the following reasons- ............................................................. ................................................................... .......................................................................... .... ......................................:. q Dare PermitNo. ......1-�-.-_ --lob-..........-- ------------ Issued .......--------------------.................................. Due rFF •�" ,may�-G " 6 � �. - _ ," THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirafion for Disposal Works Cron r to e m t Application is hereby made for a Permit to Construct ( ) or Repair �X) an Individual Sewage Disposal System at: �24 Lake Elizabeth give Cr.....�,e ......__-•--•••--•..........................•--.....-•-•••----•-------.........________________--- Location-Address or Lot No- 7Sc huma,c h e r.....................•.-......-- -- -----•-- -.........-- Owner _______________•---------.......Address J a P.Ma c omb e ' J .:_ =--•----•-----••--••-- Installer Address 111 Type of Building Size Lot............................Sq. feet aDwelling X No. of Bedrooms___________________3_________________.____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............................................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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................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........................ 9 --•--------•-•••----------••----•-------------•--------------••------•......--------------••-•--•---........................................................ 0 Description of Soil........................................................................................................................................................................ W Sand & Gravel v ........................................................--•............................................................................................................................................. W U Nature of Repairs or Alterations—Answer when applicable--------------------------------------------------------------------------- 1-1500 tank 3 flow diffussors ----------------------------------------------------------------------------------------•-•--------•-----------------------------------------•-.-----.................................................. 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 b , /n sss ed by the board csf health. Signed 'lf �f� - 3 417/92---------- Application Approved By ----------------- --- - --- -.-. - .....a f---I-e---c>�._Z_ Application`Disapproved for the following reasons- --- ----------------------------------------------------------------------------------------------------------------------- ..................................... .. .q................-- -----------...................................................--.................------------........--...------------------------ ...................................... Permit No. /-0�..-......,. �. Issued ....................1.......... Date /Date ate THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cedifira e of C�omlalianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) by--J.®.R.Ma:C-Qmh e r.....Tr-•- ----------------------------------------------__-----_--.-......--_---------------------............................................................................_--------- Installer at -. 24 Lade .E -zabeth...Drive. Cra: - �r-i1l-'--•------------------------------------------------------------------------------------------------------------------ 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. .----.---?1R_----- .... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE,SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ---- ---- Inspector --------------_--------- y ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No....Z_: 0& FEE _.-3.� -..20.... Diapooa1 Eorhii ��anruan rruti J P Macomber Jr Permission is hereby granted_..__.___r___. to Construct ( ) or Repair ;,X) an Individual Sewage Disposal System at No._324-la.e---Elizabeth•Drive-_-Crai.::ville........................................................................................ Street c,� as shown on the application for Disposal Works Construction Permit No.19W l.�(vl___ Dated.......................................... l-----q------------------------------- Board of Health DATE. ..:. ' -- •- FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS r� TOWN OF BARNSTABLE LOCATIONS r.U� � I,z��GJ ;�� . .SEWAGE # _ VILLAGE ,c �t-�j�;�`;�!� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ,J. Kh2, ,tee,,,,, SEPTIC TANK CAPACITY l,G610 6c- LEACHING FACILITY:(type) n�i �rG�csv' _(size) ,C� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: b VARIANCE GRANTED: Yes No ems- ,h R 1