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Home My WebLink About0011 MONOMOY CIRCLE - Health 11 MONOMOY CIRCLE CENTERVILLE A= 190 -159 SMEAD KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE INITW VE CONTENT10906 CertifiodFherSourcing POST-CONSUMER® www.tfiproprom,wp swim WIDE W USA Qff AT 6MEQM LOCATION : fcr�onaoy 5EW6,C4E PERMIT UO. VILLAGE — �n�J — — — — — II`ISTQLCER•5 U&t%AE F ADDRESS BUILDER'S IJ &MF- A D-RESS D1.,%-T'E PERMIT ISSUED DATE CONMPLI &MCE ISSUED - -Z1 � _ -76L-- Y• z 2 i 1 • clei L LOCQTIOKI ''; � SEWo,C,E PERMIT VJO. IW5TNLL�'F2 5 U&L AE ADDRESS -- -$UILDER 5 Q-& .AE_ ADD.RE.55_ _ _ . DI-\TE PERMIT 155UED ' j. D ATE COMPLI &, 4CE- ISSUED : . °� '� r �.Y_. � � k .. � y � �" � - � r __� ,,�-- ,;�`�� . . ,, -� �' ,� � , , R No.... ................... THE COMMONWEALTH OF MASsACHUSETTS BOARD OF HEALTH rA.0 7,e,o.1, , OF..... ...... ..... ( ....... ....................... .... ... . 1 . Apptiration -for Bitivaiial Workii To'witrurtion Vamit Application is hereby*made for a Permit to Construct or Repair (1,-' an Individual Sewage Disposal System at�..._--• ......... .... ... .. ........... ......................................................................................... o atio Add or Lot No. . ..... ... ..... ................... ....................................................................._.......................... r Address -7 4/_W_ �%j-------------------------------------------- ...................................................... Installer Address U Type of Building/ Size Lot-----------_---------------Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic Garbage Grinder Other—Type of Building ---_----------------------- No. of persons..-------..-------.--------- Showers Cafeteria Otherfixtures ------ ------------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacitv------------gallons Length................ Width................ Diameter................ Depth..-....__.-_. x Disposal Trench—No............--------- Width.-----------.--.---- Total Length..---------.-._-_-- Total leaching area--------------- ....sq. f t. Seepage Pit No..................... Diameter---..-..-..-..-.-.-- Depth below inlet....------.......... Total leaching area................-.sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------- ---_--- ........................................................ Date---------------------------------------- Test Pit No. I----------------minutesperinch Depth of Test Pit.................... Depth to ground water------------------------ 1:14 Test Pit No. 2................minutes per inch Depth of Test Pit..--...........---.. Depth to ground water-----------.------_-.-. a - ------- -- ------------------------------------------------------------------------------------------------------------------------------------------- 0 Description of Soil---- _41 ----------------------------------------------------------------------------------------------------------------------------------- x U ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------- --- -- -------- -- ----- --- -------------------------- :------------------ ----------------------------------------------------------------------- U Nature Repairs o Alt ,tic�)ns saver jen applicable... ------- ................... ---- V, . .... ................................ ... ------ /---------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hasoissued by the.board of healt, .... ..... . Signed-- ..I................. Dat� ApplicationApproved By---------... Z.4..............................................................------ ---------------------------------------- Date Application Disapproved for th ollowing reasons:................................................................................................................ --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo..... ................................... Issued------------------. .................................. Date ---- -------------------------- ----------- -------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTK"'-W ..................... .......................................... err#if iratr of f�ompliaurr THIS IS T CE TI hat the dividual Se age Dispo System constructed ( ) or Repaired ( • -...... by ---------------------------------------------------------•-----•---- / S tal ----••---------------•---•-----•-----•--------•-•--•-----•-- ------------ at has been installed in accordanU with the provisions of :article XI of The State,Sanitary Code as described in the application for Disposal Works Construction Permit No_________________________________________ dated........................................7....... THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......... Inspector_______ ._. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,t �.'.►.�.-..........of.- ...1..:%F'� ��dKi��''£�--'---------------------------- ...,,, No.... ....... FEE---0"-------------•--- Permission is hereby ranted------- ............ -Wu, . to Construct ( Repair (Z<a &v d 1 Sew D- osal em street t as shown on the application for Disposal Works Construction Permit No.._...!� _._____ Dated------/�"__----- ...................... �...e�if ��- r Board of He-Itch DATE.....�� J ; ....... -----------------•-- ; FORM 1255 HOBBS & WARREN INC.. PUBLISHERS r No.. .... Fmc.....,a ...`�........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . . .........O F......�%.. ................................ Apphratinn -for Uhipvii t1 Workii Tomitrnrtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair ( f'an Individual Sewage Disposal System at r _..• -. , . --------------------------------------------------------------------------- ---•_. o do Add Lot No. ........................•--••-... W caner Address ..re—I.. y--•-•.......................•-----..........---------•-----._-_------------•-------•--------•-•--- Installer Address Type-of Building Size Lot----------------------------Sq. feet Dwelling No. of Bedrooms................... _-_------__.Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ___....................:... No. of persons............................ Showers ( ) — Cafeteria ( ) P4 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 ( ) aPercolation Test Results Performed by-------- -----------------------------------------------•----------------- Date------------------------------------._.. a 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-_.-_._..__----.-___---- a' O Description of Soil.... . x x ----- ------- - --- .,... ,) V Natur airs or Alt <tio4- Theswer hen applicable 1'�`--/�/`r"`f Q: .-..---------•-•---- Agreement:undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ee issued by the board health. Signed-- • ........... -•-- Z.C.-E 1-11, • !.-. ord � Application Approved By---....----- = ---e--------------------------- ----------------------- ------------._.. • Date Application Disapproved for th ollowing reasons----------------------------------------------------------------------------------------------------------------- _....-------•-------•------•----------------------------------------------------------------------------------•-----••----------------------•--•--------------------------------------------------•.---- Date Permit No.....G� �� r� =................................ Issued--------------------- -------------------------•--...-- Date TOWN OF BARNSTABLE LOr:A':"XuN %r r�=►, � �L,�s �l SEWAGE # 91 VILLAGE C'giU r W/Ld L� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. H- 0(E� (b4SX- 60, Cr SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL R PUBLIC WAT BUILDER OW 1-►�1G� Tfd/�r+� DATE PERMIT ISSUED: Zll.b/ DATE COMPLIANCE ISSUED: . VARIANCE GRANTED: Yes No i No.....�l.:._ll � Fxs...... p....... ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrnrtion JIrrutit Application is hereby made for a Permit to Construct ( ) or Repair (� an Individual Sewage Disposal System at: e d ctw __. -- ..... 1._. .... .................. Location-Address or Lot No. Owner Address W Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ _Expansion Attic ( ) Garbage Grinder ( ) ...._..... No. of persons............................ Showers — Cafeteria p`�, Other—Type of Building __________________ p ( ) ( ) 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 ( ) aPercolation 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........................ --------------------------------------•-•--•-------------- .....-----............-----...------------------•-----•----------............................... O Description of Soil------.. =z---------• ------------ -•----eL�`�--------`-`-�------.'S' ` -----•------------------------------- x --------------------------------------------------------------------------------------------------------------=--------------•------------------------------•-•-------------=------•-•--•-------------- U N ture of Rairs or Alterations—Answer when applicable_ ,.'__..... ....... -----------5_---Z_vA ---------------------��-sue----�------ ?3 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 . Application Approved By --.........o U.. -- ......... ,..-.. Date Application Disapproved for the following reasons- ------------------------- -----------------------------------------------------------------•--------....----.............--------- ------------------------ ---------------------------------------------------------------------------------------------------------------- ------------------------------------------------- ----- --------------------------------------- r Date Permit No. — / c ......... ....�-------��-3--------------------- Issued .............................................................. --- Date 4 No Finc s THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrurtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (,)e-) an Individual Sewage Disposal System at: ,� .�_ S _�v5 �..a ��tom---Ro -e erj 1- ....----•r'...z_.--- vie - \ L Location-Address or Lot No. l. . .... •...... .. Owner Address W Installer Address dType of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) p' Other fixtures' ...................... Design Flow....:.......................................gallons per person per day. Total daily flow-. ........_.........._..._ gal W ------------- Ions. 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-.___...--_-_-__---.-_..- rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ g ---•---- -••-••-••-••..•... ..............•----------._.......-•-•-•--••--••-•--•-•••••--•------••-•-•••••------•-•---•--•......--••-•-- 0 Description of Soil........ -2 S 2 C,Lt+�J V Is, x ----- •- ••-----... ----------------- W UN ture of Repairs or Alterations—Answer when applicable- � .........--� ._.......�L-..,---\�atio.._-_...... . ........................�•-•-•-----•--•--2\-----------S �v..�---••-...�-------- X..T7....._------..54-S ................................................ 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 .-r o - - ,.--.............................—Za Q`�..-------- p Application Approved By .......... r-;... �. ,�0.x,. ------------------ :... Application Disapproved for the following reasons: ............................................-----------...----------------------------------------------.----........---- -- --- ------------ ------------------------------------------------------------------------------------------------------------------------------------•-- . ................................... ------------------..................---- Permit No. ........ " � 5 -------------------- Issued ......................... ....-----...----------..- Date ---- Da atete THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of C antylianre THIS IS TO CERTIFY,`T,That the Individual Sewage Disposal System constructed ( ) or Repaired,( ) b .......kA\C X_--t( Q..-...5......... � l& S`'rfl;✓Ml. �'LI f 0 Installer at ----------------------- ---....----: - .L._Z`NTLAX\1 AST................... ---k-�- =.................................................... 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. _,5 ...-...,/��.j.... dated ........ ...................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILT FUNCTIQN SATISFACTORY. DATE................. .-- .... ..............-....-......... Inspector ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9/ '" T`WN OF BARNSTABLE No- Disposal Vorkii (gunstrnr#ilan rprmit FICE Permission is hereby granted.... ._..___.�o' s`......_ to Construct ( ) or Repair an Individual Sewage Disposal System at No......;L Jh.......S.SUwt � A T R- �)b-to �-t?�r^1C"' �................. Street >> as shown on the application for Disposal Works Construction Permit No .---L� _---- Dated.......................................... <--------------------•--•---.............---•.........._.......... .r 2 ....................................... �) Board of Health DATE..................... ....-••-.-% V FORM 36508 HOBBS&WARREN,INC.,PUBLISHERS - i a 1 11'Op-YlO Jc^ _ .' ...fir^ '� ��,�`^'^'` ��'�''"`' �.•� Gf�.c"r L C k