The URL can be used to link to this page

Home My WebLink About0032 OVERLOOK DRIVE - Health 3a (,Ve,�l00e C"4-e�Vi( (4e, i i s M EA® KEEPING YOU ORGANIZED No. 12534 2-153LOR AINAIII FOR M MIN.RECYCLED INITIATIVE CONTENT 10I. Cordfied Fibor Sourcing POST-CONSUMER wwwAprogram,grg SBOW0 MADE IN USA GET ORGANIZED AX SMEAR COM TOWN OF BARNSTABLE ®� LOCATION D,/,e/1 SEWAGE # VILLAGE ASSESSOR'S MAP Q LOT - INSTALLER'S NAME & PHONE NO. /A/ SEPTIC TANK CAPACITY f C)p C5 LEACHING FACILITY:(type) FIOUJIX/ ,A Ait?,l (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER PA Raj f—d� DATE PERMIT ISSUED: -7 - _. L DATE COMPLIANCE ISSUED: ?2- VARIANCE GRANTED: Yes No t/l z17 I .............. No....79. _2D.�L F in iB3 3a.— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Application for Bhipviial Workii Tomitrurtion runfit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ------------------------------------------------ ..........az................. .....................cg'� jp ocation-Address or Lot No. t 5/*-m te ._7 . ..jead.......................................... ..........Sri owner Address ;U.................................. .................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-------j................................Expansion Attic Garbage Grinder kOta�) Other—Type of Building ---------------------- No. of persons_______..._.............._.. Showers Cafeteria Otherfixtures ....................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity/04(.gallons Length................ Width....._..___..... Diameter__._.._......._. Depth................ Disposal Trench—No...................... Width..-..__........__. Total Length.__................. Total leaching area....................sq. f t. Seepage Pit No___________________„ Diameter.___.___._.......... Depth below inlet_....._.._.....__... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................ Date....................................... 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.._.........-......._... ....................................................................................................................*......."------------*-----------" 0 Description of Soil........................................................................................................................................................................ W U ........................................................................................................................................................................................................ ------------.......................................................................................... --------------- -- - ---------------------------------------------------- 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 Environ I Code—The undersigned further agrees not to place the system in operation until a Certificate of Cornpliae ha be n isueby.t"oard of health. Signed .................... .................. . . .......--------------------11........................ ......7n......... Dare ApplicationApproved By .......... . .. .. ..............................................................................I.... .... Date .Application Disapproved for the following reasons: ...................................................................................................................................... ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------ Date Perm,it No. -------q.;t.......2).-0. ---------------- Issued ..............................----------.......................... Dte F No....�g.:.7�2L ZF --' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' TOWN OF BARNSTABLE Appliratiun for Disposal Works Tunitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -•--- .2 y»_Q. .�'.�._. a2 /- ---!7.�....»----------- --------------------- -- - �. ..---------------------- ----- ------ ----------------- ._ // Location-Address or Lot No. ..»�fa �._»» �_G�1..?<'.GJ? ...................................... ........» " ...................................................................................... �n Owner Address a .......'--'--- .........0.0 C G/Z//l ... ------------------------- Installer Address d Type of Building Size Lot----------------------------Sq. feet aDwelling—No. of Bedrooms-------- --------------------------------Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow.............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/!!.gallon 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. I................minutes per inch Depth of Test Pit.__-__----- ------ Depth to ground water........................ LTr Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ ------------------------------------ ---------------------------------------------------------------- --------------------------------•------------------------ O Description of Soil-------------------------------------------------------------------------------= t-� ------------------------------------------------------------------------------------------------------•---------------------------------------------------------------------•------------•-------------- W --------- ----------------- ---------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable............... 1I_/_�t ______________________________________________-_-.___- --- --------------------------------------------------------"----------------------------------------------------------------------------------------- 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 be Issued"by t -board of health. Signed............------'_?-�✓ - G^^ _ .......................Ch ' Date Application Approved BY ----------. �--.� - ----------- Date Application Disapproved for the following reasons- -------------------------_-------------------_--_--------------------------------------------------------------------------- ------------------------------------------------------C,-------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------- Permit No. ------- 1 - �'------------------- Issued -------------- -------------------------------------Dare Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE alertiftCatC of (.9antylia i.CP THIS IS 0 CE TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by------------------------ --4--------- � ----------------------------------- Insta-----ller--------------------------------------------------------------------------------------------------------------------------- -_............. at .---_----------3._! -`-- = 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. -------- 1-_.._ .0 8----.--- dated ------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---------------------------------U ------------------------------------------- Inspector --------------- 1 --------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH q� TOWN OF BARNSTABLE Wiupuuul Works .Tonstrurtion f rrmit Permission is hereby granted = � »-!_C1- 1---------------------------------------------------------------------------•-----»» to Construct ( ) or R r ( an vi`�ual Sewage Disposal System at No----------- -- - n J—�� l�w�� street pp�� as shown on the application for Disposal Works Construction Permit No.�� ! --- Dated------------------------------------------ - - -_»�----------------=-----------------------------»- -- -- Board of Health DATE--------------------`----7---- `--------------------------------------- --- FORM 36508 HOBBS Q WARREN.INC..PUBUSHERS