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Home My WebLink About0075 OLD FARM ROAD - Health ce,4 v i 1� 0131� b�3 SMEA6 KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT10°!o Cer6Se1Fbl a ourcno POST-CONSUMER wwwcsfiproa�enwro M,L MADEINUSA GET ORGANIZED AT SMEAR COM r , c, TOWN OF BARNSTABLE T LOCATION J SEWAGE # VILLACE ASSESSOR'S MAP & LOTS! —(5-)-3 INSTALLER'S NAME 6z PHONE NO. ,`-,/-f� L 717 SEPTIC TANK CAPACITY si LEACHING FACILITY:(type)197 -- ( i -� ' (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OOF ERA 4PJ Z&4w-4, 1 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 13 VARIANCE GRANTED: Yes No 1 -7,r fro No.. ..'. Fas ........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiuit for Diriputiul Wurk.5 Tonfitrurt"tun Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (t-<an Individual Sewage Disposal System at: .........................................................Ir�� ----------------•--....-- ------------------------------. ---- ........................................... Location-:\ddress CAJ _ osncr n ress W ,4 Gd711 pa d Type of Building Size Lot................ Sq. feet Dwelling— No. of Bedrooms.._... --------------------------------Expansion Attic ( ) Garbage Grinder (Ad-4 04 Other—Type of Building -?QS_%4__ere_e----- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 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. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1--4 Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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........................ ;4 •-•-----------------------------•-------------•----------------------•......----•------..._......••.......................................................... ODescription of Soil........................................................................................................................................................................ W V .............................................. -•----------------•......•-------••••-----------------•--------•----•------------------•-••----•-•---------------•-•----------..............-----•........ W x •---•----•----- ---------------------•-•-•----•-------------...._..........----------••---------•------------------•-..------------•------------•---------------------------------..................... U Nature of Repairs or Alterations—Answer when applicable.-_X)-'I --------I-----------4s. e .__. `.r.......?'r>.............. .......... ...61?.ep.4 -..................•................................................................................................................................................. 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 ndersi ed rther agrees not to �1 q the system in operation until a Certificate of Compliance has been issue y b r Signe1. .. ............. . ...............:.. ........:.:..:....................... - Application Approved BY �rn_ .. 14_�' .— ............................... .....�� ..ate .. Application Disapproved for the following reasons: . .... .................................................. ................................... .. ........... ................................................. . . ............................................ . .......................................................... ........................................ Date Permit No. ........................... Issued ........ Dare i FEx ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diripoial Works C omitrurtion Frrmit Application is hereby made for a Permit to Construct ( ) or Repair (l,<an Individual Sewage Disposal System at: -------------••----...--------- Location-Address ,.( .e,,h tj W zC � r Owner �`l/�U -- _ vv--�-1-1•L `7 Ajdress - .. ...... -- ......•--•-••---� � - Af - AstWJ@r,J � UType of Building Size Lot----------------------------Sq. feet ... Dwelling—No. of Bedrooms._-_- _..............................Expansion Attic ( ) Garbage Grinder (&FO) Other—T a ype of Buildin �r�1 g _� _� ___ r_e.._.. 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 ( ) 0-4 Percolation Test Results �, Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1T4 Test Pit No. 2................rr mutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' -------------------------------------------------- --------- •........ •-----------.....----------- ------------------- --••-••-••••............. .---------------- 0 Description of Soil........................................................................................................................................................................ x w U Nature of Repairs or Alterations—Answer when applicable._Pi ----------1..........11�AQ!-4.......O./.7".......�w.............. ..........L...61M/Z- 4-----------------------------------------------------------•---------•----------------------------------------------------------•-•------•----------------•-•---•--- 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 lace the system in operation until a Certificate of Compliance has been issued/Wyheloard rea..--. Signe ............ .�_ .. - �............................ -- ....M.. ..D�re-..... ... Application Approved By ................�"........ ... ,, t . ' Dare Application Disapproved for the following reasons: .............. . . . . .. ........ . .... .......................................................:...... C� Dare PermitNo. ......1....�J..-._�f.. ,.<�........................... Issued ......................................................... - ----------------------------------- THE COMMONWEALTH OF MASSACHUSETTS . BOARD OF HEALTH TOWN OF BARNSTABLE C�e>r#ifirate of C�omplianre THIS IS�TO. CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ............................. ............. �� _ _.7 c C..t,r�ri,........_......................... �..... `�� Insr:dlcr � at ., ....--'�/. .----- ... - ,--------- :• - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in '.......y;�..� _ dated -------...._.......- the application for Disposal Works Construction Permit No. .__`7�....3.-...._, THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SSATISFACTORY. DATE........... ...'... ...... a....._�� ....._.......... Inspector ...... .-- -----------------................................................... ---._,---------.-------------_,-------- ----------__.-----,---_------ -----,--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ccam�,,, TOWN OF BARNSTABLE FEE.... d ....... Ropos l orkii Tonotrurti.vtt lirrmit to Construct or Repair an ndividualySewa n _ ( d/L/G ! - -----•--(' ,�5':.'/Lelc�erJ.......... 77 Permission is hereby granted__ ( ) p ' ( ) Sewage'Disposal System at No............ ........1/- ------ i? .Q !"fl ••mAilh__......-•----------------•-- street Q� �. . as shown on the application for D' posal Vorks Construction Permit No._ 12( ��,- _ Dated.............. -..?..a..__........ �/ j Board o Hcaltht "r Y✓.-�i�l/ ....DATE------------------------------ -- --•-::7--- ,-•-�---------.. FORM 36508 HOBBS ar WARREN.INC.,PUBLISHERS LOCATION !� SE AGE PERMIT 7 NO. 7,57 ioq VILLAGE IN.S LLER'S NAME & ADDRESS c�US a B U I'L D E R OR OWNER D. DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r 1 .� ��Y � a _ ,.�� n � �� . SO No...................1._Y Fps....... ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH Appliration for Uhipoii al Workg nnitrnrtinn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Syst at .... 0.... . -----2D........................................ - .� .......... ------------------------------------------------------------------- Lodress................................... ..........................or Lot !TJ v ......... .....�...._ !c/ f .............................. Owner Address W �✓�� a ................. .. -5 ....._..... Installer Address U Type of Building Size Lot-_ 5�!/:10-:6..._._Sq. feet Dwelling—No. of Bedrooms.........._.��..�............................Expansion Attic ( ) Garbage Grinder (AV '4 Other—Type T e of Building . 4t" p,, yp g /�"7____________________ No. of persons....... ............... Showers ( ) — Cafeteria ( ) a Other fixtures -------------------------------- . d ............ . ..•---• W Design Flow.....�S.............................gallons per person per day. Total daily flow------ .3 ......................gallons. WSeptic Tank—Liquid"capacity.b-gallons Length........:...... Width................ Diameter...---...------. Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No,l �. '. Diameter.................... Depth below`nlet.................. offal ching are a.._...............sq. ft. Z Other Distribution box O Dosing tank ( ) � G '~ Percolation Test Results Performed by....................Ag.._ __ ...- .. Date......r:_`�'. �__.___.... W Test Pit No. 1................minutes per inch Depth of Test P.it.-.----- ....... Depth to ground water..--.................--- (z, Test Pit No. 2................minutes per inch Depth of Test Pit................. Depth to ground water----.................... a 1. . O Descripti f So ....`' ,Q. ... .1`.'� t� w __ Nature of Repairs or Alterations—Answer when_a... U e. ......................................................................... ..............P � 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 h e is the board of health. Signe • ----....... �� / /�1?7. Date Application Approved By..... • . . ------ . .7.... Date Application Disapproved for the following reasons---------------•----------------------------------------•----------•---------•--------------------------------... ----------------------------------•--------•----....-•-----------•---.....-------•--------•-------..............--•------•-------••-----------------------------•---------------------------------....... Date PermitNo......................................................... Issued_...................................................... Date - s §'4 4 N No........... ... Fns... ..4 .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH Allp iration for Bispaa al Work nn 'trnrtinn ranfit Application is hereby made for.a Permit to Construct ( or Repair ( } an Individual Sewage Disposal Systely at: ores t /V or Lot Ffi ... ......................................... .......__ --•-••-•••---••----- ..•--.. ......... ............... ner Address wp ............................................... -•---------------------------•--------•-----••---•...-----•----- Installer Address Type•of Building M Size Lot.., �t.0.0.1._._...Sq. feet. U Dwelling—No. of Bedrooms........... .........................Expansion Attic ( ) Garbage Grinder Other—T e of Buildin iy,�, a yp g/ !_...�`______________ No. of persons : Showers ( ) — Cafeteria ( ) Other. .............. ures ..---•--•------•-••-----•-----•-----------------•---••--•-------•--•-•----•-------•---- -••--•--- Design Flow..... .. __. ._.. .gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity .gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No........I......_.... Width....................Total Length.................... Total leaching area.....................sq. ft. Seepage Pit No .. Diameter.................... Depth belovu�inlet...___...__.___._ 9tal Ching area..., ____.____._.__sq. ft. Z Other Distribution box X) Dosing tank ~' ..._.... ... Date r � 7�r, a Percolation Test Results Performed by................:... .. .. . Test Pit No. I................minutes per inch Depth of Test Pit-__ ---- _....__._ Depth .to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ is Des ript of S i. d a 'jam .t /Z-z w -.Ir ....................... .. ' •.•-- - ...................................... V 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 T ITIZ ; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance e is the board of health. Signe = --------••----------••--•-------- ' �p - ate Application Approved By..... ....... � '�'' - ... ................................ Date #fir _--__'. _ . . Application Disapproved for the following reasons: ............................................................._.......... Date Permit No.......::.............•------._...._.._..........•-----_. Issued.............................. ------•----- Date j THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trr#ifiratr ei Urr THI IS CE FY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ...Z_6 / �'".... .....• Ile / at--.................... .. has been installed in accordant with the provisions of F j of The State Sanitary CQde as described in the application for Disposal Works Construction Permit N . ............ dated-__... `"'.f `_! _ ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM W1�� FUNCTION SATISFACTORY. DATE----•---- .............,1........../..��- ..... Inspector.................. ----- . ---------•------------•---•-•---- THE COMMONWEALTH OF MASSACHUSETTS BOARD O/F HEALTH y .. .. ..OF........... :: ....Cej... ..__...................,................ i No..........�..•f•� FEE...f..V...2t••� irla �a1 l�r n � Uan antic Per imssio i .hereby gra ted.�. ' ........... to Const. tc ) o ep ( In ry ual S . i e i Systemfj Street as shown on the application or Disposal Works Construction Per 0.......... ........ Da d_._:_.` " .... __�.......... ......-•--- -•--_ i� f""�! !! .............. d �rl Board of Health DATE v. ................. >� = ., FORM 1255 HOBBS-& WARREN. INC., PUBLISHERS r J i 0 3 _ .'�vs _s.lCc-T�1'-/ sCff►cE /��.Z000 ti "/gyp z3/ P.��CEG Z4 �27,76 5 G f0 P � fjig qD � A, 1$ I - /p 7- Vow 0p� I k J Oi�U Lo Ci SFfiC� ' 1 LE A�.�j/T .0 ly •rn✓ti ®/ / '..\ Box F/nusro�vl �AS j To7AL EST/M�9TE� FGoN! = • 905.0 OO GA�CoNs�DAy 60TTawl ZeAC glAIG X)ReA /5.D S�-FT. �°o°r 7- -1,L>C Z6ACf//n/G AZee 3 - Zo7 5,p FT 1P/T Gent TvT/iL 1_6 CN/n16 "7e4f g tout. MwuabLE CevEZ"S „EApe ii , D/� orz F�,,�j b'c�U,�i�G`i1L7-;V '36" D�n oG �"Ga✓r✓.) EjC157 /��s / % r-i- { HHu �rS7/++�Cc �I�rJ � Tar. �rsrl++.ce �,eoH `� I � ,�vr3N G/vrpe /o S 4- / / ia o � i :/i/_-i .�. r -277 Jar Pry �- =4o,e <_trv- :',E�o/JO�i�`77 �fD-.,:�.c.° iS,oZ L / �U�•3� (4 CgST /Qa"/ erVt2T \�, �, [ _1a �✓ ZATV- / N i /0iT OZ EPv/✓, tL Jr0 /NVE"Z 7" /SOO SAL 7%!ST• P u EL,= iZ,Z <rs/D GiC/M 9 SE7�T1C 7ANIG I •'d Y BOIC � ► /` � � 'a/4- ' /�7 �if�wVfX.. HiYE-D 5?;- �. INHiTt SA*1D I 44 Pao/=/GE OF Rebpin-' ep�NU warm �7�4/34,C S/5/77 a N G Sc,h c �. i �''h Y S /7 7 //- 30 ' ell .5 ."e Very oC A