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Home My WebLink About0029 MONOMOY CIRCLE - Health F nomoy Circle . - 160 �t !4 i UPC 12534 No.2=1�53LOR HASTINGS, UN l on e-N No-7/-132I... Da table Conservagh2RgRRRt�!L�!� THE COMMONWEALTH OF MASSACHUSE BOARD OF HEAL; Signed Date TOWN OF BARNSTABLE Application is hereby made for a Permit to Construct or Repair �0) an Individual Sewage Disposal System at: 0 Address Installer Address Z Other Distribution box ( ) Dosing tank ( ) 0.4 U Nature of Repairs or Alterations—Answer when applicable.__��_ - ---------- ............!,,.SkPq CAkAD�0 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 Com�Liiance has been issued by the boar.d of health. Date Application Disapproved for the following reasons: ............................................................................................................................. -- ................................................................—.................. ....................................................... ....................................................... ...................................... lm��6 --------------_---- � | Da° --------- ----- ------ ' TOWN OF BARNSTABLE LOCATION SEWAGE # /tee / �;'I,LLAGE (. , ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) Da MJ NO. OF BEDROOMS- _PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER L!AO44 A DATE PERMIT ISSUED: '7' DATE COMPLIANCE ISSUED: zz VARIANCE GRANTED: Yes No �� i � i '�-� �., .. �, ,. // . c `/ I J �,} l i � l � �. No.7-/_L� Fzz THE COMMONWEALTH OF MASSAC T BOARD OF HEZT�IU"I'�'� TOWN OF BARNSTABLE Appliration for Uisposal Works TottohwtWn famit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ----- Location-Address or Lot Na Owner Address ----—------——--------- Installer Address Type of Building Size Lot_----------_ Sq. fed U 3 Dwelling—No. of Bedrooms-__ pansion Attic Garbage Grinder P., Other—Type of Building ---------------------------- No. of persons---------------------------- Showers Cafeteria Otherfixtures ------------------------------------------------------------------------------------------------------------- Design Flow------------------------------------------gallons per person per day. Total daily flow------------------------------------gallons. jX Septic Tank—Liquid-capacity------------gallons Length----------------Width---------------- Diameter----------------Depth--------------- 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------------------------------------------------------------------- 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____-________________ 19 --------------------------------------------------------------------------------- 0 Description of Soil------ -------------____�>----—-------------- ---------- -------- W ------------------------------------------------------------------------------------------------------------------------------------------------------------------- U W to -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable----w3�,�-----------�40'1s__---------IT-U-00-------- ------------ --------------- --------------ZA-----------sa)tAI-—---I------------------------------------------------- Agreement: The undersigned agrees to install the afci-redescribed 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 opeTtion until a Certificate of ComIiance has been issued-by the board of health. Signed ------------------------------------ ---------------------------------------- A p pplication Ap roved By --------Z ---------0- --- ------------------------------------------------------------------------------- ------- A M, Application Disapproved for the following reasons-- --------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- PermitNo_ -----------?/--------- ------------------------ Issued ------------------------&;�-------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS -BOARD OF HEALTH TOWN OF BARNSTABLE 09ertiftade of (90myliancle THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by-------------------�_k a_y__C-Cc---------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- at ------------2y----------------f------o n O_t----Q_`r------------Ct__#f - ----—--------------------- C-Iff 10------ � a 4--�------------------—--------—-------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State nvironmental Code as described in the application for Disposal Works Construction Permit No- ------?/---------3--;L,/----------- dated ------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-----------------------------7- ?/------------------------------- Inspector ----- -------------------- ------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE %pasat Works Tonshitdim firmit Permission is hereby granted------�Lt4Z-t -------------------------------------------------------------------- to Construct or Repair (?0) an Individual Sewage Disposal Syqem at No-------2-1:` qA C) C_#Is-, ---------------------------------------------------- Street as shown on the application for Disposal Works Construction Permit No.,//`;1=,. _/--- Dated___-_-___________-____--___._. ---------------------------------------- DATE. - — ATE-------------- Board of Health _�/------—------——------— -- FORM 365M HOMM&WARREN-INC„PUSUSHERS L 0 CAT ION a9 SEWAGE PERMIT NO. -� VILLAGE cc.-1 �,-�v; INSTALLER'S NAME i ADDRESS B U I L 0 E R OR OWNER LfA DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED ' 3 �. �W C Y 0-j/77 No. - FEs....l. s:Ll.�... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -•--........)_04� ,.01 .....OF......... �--G,�"Y?.�-�Zl- 1 ..................... Appilration for Uiipuia1 Works Too"i Arurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (lean Individual Sewage Disposal System at: ..........o .�...MI, CCU YY��a.Y--'.......abr....-) .---...-•••---•--------••......-- -•----•--------•--------------•--•-•---•- ocationL Adl t No. &------------------------ ........Ci..... .. ............................................ W ....a_J._.J..... (..�f LVe�/,/. L. .� �_......_ _SsX.�_✓..1.�L.{l��A dress M Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ------------------------•------•-•••-•--••-••-••--_... WDesign 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........................ fz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 29, Description of Soil......................... IV.mil----------------------------- --.... ------ ------------ . ...... -•-•--- x ----------------------------------------------•-----------.._..------------------------------........................................ ..................................... Nature of Repairs or Alterations—Answer when applicable----------- .=_f 11��___ .__ _j_ '________________ ___•-...___. ...•--••••-•••••••••-••--•••---••---••--•••-•••••-•-•••-•-••-••-•••••••••-•-••................••••-•••••••••••---•--•---•--•••--•--••-•••••••••----•••-•••••••--••••-••••......•-•-•••••............._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITS 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has.bee issued by the boar health. Signed.... - .... ..•• -.----•. __. Date ApplicationApproved BY-------------------------•---•-- •-••.........---•-•-•-•••..._••---..... Date Application Disapproved for the following reasons:.....................................\,.. ................................................ ........... ----------- ----------------------------------------------------------------- .------------- ----- •---------------------- -------------------------------------------------•-••- Date PermitNo......................................................... Issued..................................................... Date No.._ S.?: FEE.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... �.!.....OF.............................. ...._........-.......... ApplirFa#ion for Disposal Works Towuurtion rrnti# Application is hereby made for a Permit to Construct ( ) or Repair ( —) an Individual Sewage Disposal System at: ................_................................................................................ --------••---•--•-.........-•-----...------------------•----••------------------•.........-------- Location-Address or Lot No. ......................_......:.....................:...._...------^--_____..__..__.._......._... ._.....-------------....._..---:..._._.._...--•--....-•-•---••---..........................._..... owner Address W Installer Address UType of Building Size Lot_...........................S q. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of ersons____________________________ Showers � YP g --------•------•---------••- P ( ) — Cafeteria ( ) Otherfixtures •--••-•--•-••-- •-------------------------•--------...-------------------------..__:_._.--------•--------•---------------...••----•--•--•----•---•--- 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........................ fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------•----...-----......-•-------...__-----------....---------._..._._......................................................... O Description of Soil....................................................................... x U ---------------••-------••----..-.--..----------••---•--------..._._._...-----------....--•--------.....---------------.•..•--------------•------------..__...----...__......_•--------•-••----••--•••. W --------------- --------•-----------------------------------------------------------------------------•-------------------------...•.-•----:•-••-•-----•---•-•--•...•-••••••------•----•-----------•-•- U Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ ----------------------------•-------•-----------------------------------•-----------------._.......-----....----------------------------------•----------------------•-----------------............_._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary 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.. f :-•--------•--•--._..._...._.----••---•-------•---•--••----__••••-- -------------•--- -------_----•- Date Application Approved By...............•------•-•--•--- ' Date Application Disapproved for the following reasons:.............................................................................................................. ........................................................ ••-•----••---••-....----•------....••---•-----...-•----•--•---------•-••-------•----------••-------•••--•------•-------•--•••--•----•----------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 115ALTH ..........................:...............OF............. .......!....-%......._... ........._.:.._'•_••__....._.............. rdifiratr of f�oan liaanrr . : : THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) 1 ..............................:.......:�........:.... ••--•-•----•--..-••----------.....--.----•-----••--•-----------.......--_.....---------......._----•--- by--------------------------.. Installer .' has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated----------...................................... THE ISSUANCE F THIS CERTIFICATE SHALL NOT'EE CONSTR A GUARANTEE THAT THE SYSTEM WIL Ft TION SATISFACTORY. DATE...... ............. Inspector THE COMMONWEALTH OF M SACHUSETTS BOARD OF HEALTH OF............................:... .._...._......._....._.._...._.... NFEE........................ Disposal Works Tonotra ion rranit Permission is hereby granted..................................................... ' =/ = to Construct ( ) or Repair ( ) an Individual Sewage Disposal System as hown on the application for •is-osal Works Construction Per / ._ ......_ Street PP P Permit No...... �: -•-+�................ /j Board of Health DATE.............. •---•-•• ..................................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 1 5EW&C4E PERMIT U O. IL. GE - - - - IWSTQ R tt" ADDRESS BUILDER 'S Al &"F- QDDRE SS DATE PER"VT ISSUED .- - - - _ -•_ DATE COMPLI &MCE ISSUED : _ - _ n z i No........14 f.... Fmc .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ---------------OF.......................-...... ... - ......-......... Application -for Uhipooal Workii Tomitrurtiun Vrrufil Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -- .-�1---..... -- ---- - ---------------------------------------•--•---•----.------ Loc ion-Address A or. --•. . ........ ..... S................ . .............. ....w ....... ----------------------------------------- aOwner ....Address..- z-- ----- ........................................ --------------------. ... --'- 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 ( ) dOther fixtures --------------------------------- ---_------------------ ---------------------------------------------------------------------------------------- W Design Flow......� _�� --_gallons per person per day. Total daily flow............................................ allons. WSeptic Tank—Liquid capacity_i allons Length---------------- Width.............-. Diameter-----........... D pth._..____-___--- x Disposal Trench—No. .................... Width...._...... _: T t enAvhet!�_ _. Total leaching area__ .sq. ft. c , Seepage Pit No.... Diameter. . '_._...____ 1� e ow .... ...... Total leaching area....__.___________sq. ft. 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.-----...__,__.__._.-_ LT, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water_--_...________._____-.. Ot r {. -------- Descri tnf Soil-----= L- � " �Ow i , x U Nature of Repairs or Alterations—Answer when applicable..__________________________________________________________________..............._------------ ----------------------------------------------- -- --------------------------------------------------------------------------------------------------------------------------------- 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 undersign further agrees not to place the system in operation until a Certificate of Compliance has been ' su d,by the and health. Signed-- ----- --•----- 7 � �. Date Application Approved By------ .. = -14.4 _ ----------------------- .�- ��Daa.-- �1 te Application Disapproved for the following reasons:................................................................................................................ --••-----•---•---------•-•-•-----•---•------•----•---•--------••••-•••-----•--.•-•••.......-•••-----••--•••--••••-•----•-•-------•••----•••-...•-•---------••---------------------------------------- Date PermitNo......................................................... Issued----_-------------- -------.......................... Date No. { .... Fmc.A ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ `r7 . ._.... ---OF.............�: ....-............ ,�lsplirtativa� -fur Uhipoiittl lVarks Tomitrurtivaa Vrruiit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ® -- ,c...G..--------- Loc o • ........ ...... p..a ...............j � o'r --------•14 -C-_..r..-----•................._.............1 \ 1Owner Address .....� .p'...!.:�................... .. ..--.........._....................•.. �--••----------•-•-•------------------------------------------- Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms------------ ----------- ------------------Expansion Attic ( ) Garbage Grinder pa, 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 capacity..��llons Length---------------- Width--............. Diameter_--..-.....----_ D pth.--.._._....... x Disposal Trench—No. .................... Width--------- _- Total eOinee� g!t_47// --.-------- Total leaching area_.007 --sq. ft. Seepage Pit No....` ----- Diameter.. .. ___-.... e ow __.__. Total leachingarea------------------sq. ft. z Other Distribution box ( ) Dosing tank ( ) ��^ � / 7" 7G aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------- ------- Test Pit No. 1----------------minutes per inch Depth of Test Pit...----_--___-___.-. Depth to ground water......--................ fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ J - Descri tion of Soil------- O! ---- f------------ ------- - - UNature of Repairs or Alterations—Answer when applicable...--------------------------------------------------------------------------------------------- .---•-----------------------••------•-------•----------•---------------•----•-------- ---------------------------•--•------------------ 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 undersignef further agrees not to place the system in operation until a Certificate of Compliance has been i ued by the lb/ard o. health. Signed. . --- . . � ..ACC... �. /azx./ -- ----- ------- •.... -•------------•------------ J Date Application Approved BY f t/l/.1 --•--------------------- �� 1 " Date Application Disapproved for the following reasons:.--------------------------•----•--------------•---•--••----------•-•----------.... -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date �I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT Qrxtif irate of 0.1111utplitaurr TH S CE IFY, That the Indi id 1,Sewage, posal System constructed ( ',�or Repaired ( ) I s ller d.... •• � at a ? ! ''� � ......-�--------------- ----- "� has been installed in accordance with the provisions of Arti6_17--l-ItIf XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__.._. ............. dated-..-_-_' ................. THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM Vd/WIW FUNCTION SATISFACTORY. DATE---- - ------- -------------------.... Inspecto _ -- •------ ........................ THE COMMONWEALTH OF MASSACHUSETTS �"'' BOARD O/F� HEALTH No � �j /... . �>'t..........OF...........,1�..4-1 ...-•-------•---•--•-. E FEE---- •............ - I �Permission is hereby granted __k bf. fY -Q to Construct (,) or !epL ( ) an Individ 4al,S vage Disposal System f' Street as shown on the application for Disposal 4 orks Construction Pergatt No. _ ._... ...._ _ Dated..... `.C---71..•--_-------- � � � DATE............................................................. -- Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS i3Y QA:TE SUBJECT SHEET NC`� OF rt- CHKO BY DATE JOB NO. AXo �jo AA D D .V + 5.F tIn it or RWHARD •V A -+ 8Ak7F-R Nv. �.t48� G sutaE.1 {S,7v �vG."-z r��•: C�Ur��lt�,i.cy. Gd LZ = dv U� Ta L OT Ce A1,d T 1-1 - >.t1 r4 7'i ' � w P(, ve- Z72 ;H� J? / ,�'TiF'/ r' T � /'c r � n WL / r 0ST7C-e,1 tL-+-a �. A -- TtT 1JG-