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Home My WebLink About0118 LOOMIS LANE - Health 118 LOOMIS LN Centerville A; 231 014 . 5 M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR n SUSTAINABLE FORESTRY MIN.RECYCLED jQ INITIATIVE CONTENT 10% CarUfied Fiber Sourcing POST-CONSUMER www.Aprogram.org scwixo MADE IN USA GET ORGANIZED AT SMEAD.COM 4 t" TOWN OF BARNSTABLE NN LOCATION 4'b () &41 e f L (- SEWAGE VILLAGE �(��,��, y i �� ASSESSOR'S MAP & LOT, -!j-JP� s , INSTALLER'S NAME & PHONE NO. aOQc�_ a h C) f L f - - SEPTIC TANK CAPACITY / ® O az:4,. LEACHING FACILITY:(type) (size) ;2 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ?1C)\Qo A- DATE PERMIT ISSUED: 05�1' y `— DATE COMPLIANCE ISSUED: -7-- � VARIANCE GRANTED: Yes No. 13 as Barnstable Conservation Deinrt eir No.. Ficis COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �,u,�� Ak � Signed Date TOWN OF BARNSTABLE a Appliratiou for Diripoqul lUnrk.5 Towitrur#inn Fautit Application is hereby made for a Permit to Construct ( ) or Repair (Individual Sewage Disposal Systemat: w!_y�--- ------------------------ .......---........................................................................................ t No. Loc:�tion-- s5----- or Ap Owner Address ------------------------- --------- ------ .� -----.� Installe Address UType of Building Size Lot............................Sq. feet ..� Dwelling— No. of Bedrooms.-.<;L-----------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons-.-___--_--__-_._--_-__.--.- Showers ( ) — Cafeteria ( ) d Ott fix ures -------------------------------------------------- -- ----------_.-._...._ ......................... _------ W Design Flow......� ............. �_..gallons per person er day. Total daily ._......._......._...gallons. WSeptic Tank$Liquid capacityl._.....___gallons Length.. . .......... Width---5......... Diameter----------------- Depth........_....... x Disposal Trench—No `!�G_. Width....e.-.......... Total Length-----I.)......... Total leaching area....................sq. ft. Seepage Pit No..............._-._ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by........ ................................................................. Date...----------------- .---------- •-------- Test Pit No. 1................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 W x ------------------------------------------------------------------------•----.w..---.a..-------•----•---...... .... .....----... Nature of Repair r or Alterations—Ans ver h wen a licable...._. . -------------- �'.....--.5��`'�. �a- y��. 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 ha sued b the rd o health. Signe �`a7�� --- ------ ------ �....... ...... ..... ......--------------------------- .......................................- Dare J Application Approved By es .......1 ........... ��.... ...................... ...... ...... ........................................ 7 Dace Application Disapproved for the following reasons- -------------- ................................................................................... ........................... . . .......................................... .. . ............................... ................................................................ . . . .. ........... ........................................ Dare Permit No. .. ��:...... ._�-�................... Issued .......... ..'......................... dam ... .............. Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f14 ' o TOWN OF BARNSTABLE (fer#ifirate of Cfuntyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired G�1.. c._1.-t i t.: 5�-•I�`L..-L - ...-------._---------------_-----... - by ........................................... --- G� �' .. rills .�G V at ................................ . �� --nl�.��..:-5 ----r'-------..."... -----—. . .'... — _.............................. ...:.......... has been installed in accordance with the provisions of TITI.E 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No.9W -.i .. .._.. dated e, -2,--�.Ai'... d --._._... ' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT Bi CONSTRUED AS A GUARANTEE THH'E SYSTEM WILL FUNCTION SATISFACTORY. ✓ y DATE................ ".... "..r _..._------_-------------- ----.. Inspector4- ��'. ,/ --_------------------- __ �----_—_.__-----_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No��.'�, FEE..: la,f-!�';.. Ropmal Works (gonstrurtion Vami# { J Permission is hereby granted /'111�1 v ` ` - ..�........................................................................... to Construct ( ) or Repair (,,,,.-an Individual Sewage Disposal System atNo..................................... 1...... �` '�= ......-`'-----...--- ----- � ......-•----•-------------•--- street / as shown on the application for Disposal Works Construction Permit 0,6. -- --- Board of H�dth - DATE------. .............•---.....-- FORM 36508 HOBBS a!WARREN.INC.,PUBLISHERS No.... Fss. ........................... THE COMMONWEALTH OF MASSACHUSETTS - (,�N Z W BOARD OF HEALTH TOWN OF BARNSTABLE Apphration for Uinpnml Wnrk,i Towitrnrtiun ramit -Application is hereby made for a Permit to Construct or Repair (�an—Individual Sewage Disposal'`� t System at: / �00yYlt ...................... ...�— ........................----- ......................................... Location-Address or Lot No. roc) 1�� v 1 S /lr�� ......................_......................................................................... ........--••--.............. ••.............................................. Owner Address �ry Installer-� Address UType of Building Size Lot............................Sq. feet �--t Dwelling— No. of Bedrooms__:Ir_�...I I..............------------------Expansion Attic ( ) Garbage. Grinder ( ) aOther—Type of Building ----------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ......................................................---------------------------------...................-•--•-----------••--•.........•-----•.-•-•- W Design Flow......`:_:.?________-_•-._-•-••_......gallons per person Der day. Total daily flow_. ......................gallons. IY4 Septic Tank!Liquid capacitytMO_.gallons Length__ --------- Width---'x......... Diameter................ Depth................ Disposal Trench--No. ... Width....9............ 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 ( ) ~t Percolation Test Results Performed bY-------- ---------------•••-••••••.....•-••-•........_....---•-•......••_. Date........................................ 11.4 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........................ P4 ....-••••••--------------------------------•--........--••-•---....•••••••--........------................-•-•--•-•••-••---•••••-•.....--•--.........--.--••- 0 Description of Soil......................................................................................................................................................................... W U ----•........................•-....._....------•--............_........-----------------......------••-•----------------•---------------•-----....-•------------••--•--..............-•-.....••---....._ W U Nature of Repairs or Alterations—Answer when applicable_ 7 7 ` .?_..5 :j_........................ � -------------•----....------------------------......------•••. 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 .':... ..... ...: ��/ ........................................ .. ... .................... A lication Approved B - �. .;. .... - ._U ,... -..�`�1T PP PP Y ......... .............. ....... Irate Application Disapproved for the following reasons: ...................................... . ............................................ . ...........-- ............ ....... . ........................................................ . .. . ............. .................................................. . -- .......- -- - ........... ........................................ Date Permit No. �,�� _.....�Issued � Dare AsBuilt Page 1 of 2 t TOWN OF BARNSTABLE LOCATION �5 Z b o yy /_ y SEWAGE #_ �3 PILLAGE j4; 1 t ASSESSOR'S MAP & LOT,'.:;?J-w�1 INSTALLER'S NAME & PHONE SEPTIC TANK CAPACITY o 0 p LEACHING FACILITY:(type) / .-f (size) NO. OF BEDROOMS ;? PRIVAT1E WELL OR PUBLIC WATER { \ 6 BUILDER OR OWNER E—T DATE PERMIT ISSUED: 7— DATE COMPLIANCE ISSUED ,7- 7— VARIANCE GRANTED: Yes No ►3 , asp http://issgl2/intranet/propdata/prebuilt.aspx?mappar=231014&seq=1 9/22/2017