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Home My WebLink About0147 POND VIEW DRIVE - Health 147 Pond View Drive `ti Centerville A= 229 — 031 S tit E A D No. 53LOR UPC 12543 smead.com • Made In USA t No.11 Fps. ` _...._........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Dispniial Works Towitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (60 an Individual Sewage Disposal System at: .........- ........................................ � ��-... - C �J ...._... - - -----...... Location ddress or Lot No. ---......... l r 1 c cv ------------ --' .............................................. atr caner Address (ST ........ Installer Address Type of Building Size Lojt.4�a._ Sq. feet U Dwelling—No. of Bedrooms_______.__� --------.................Expansion Attic ( ) Garbage Grinder ( ) ....._.. No. of ersons____________________________ Showers — Cafeteria per,, Other—Type of Building ______��' p ( ) ( ) P4 Other fixtures -----•-------------------------------------------- - W Design Flow................ ..--...__...._gallons per person per day. Total daily flow.............. .......................gallons. WSeptic Tank—Liquid capacityZl��gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Vidth.................... 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.......................................................................... 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-___-._____---------__-- a ---------------------------------- ----•--•----••-•-----•-•---- --------------.....--••------••---................ O Description of Soil--------------- -- ...... �!t SO/L - / Cl?�f�. U .................. -° -------------------------------------- ------------------•-----------• ----------------•----------------------------•--------•-------------------------------------- W UNature of Repairs or Alterations—Answer when applicable.�!>ti1P `- !� .___C�� 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 Complia n ha been iss d b e board of health. . --- ------------ ------ - ------- -- ---- ----- ------------- --------------- Application Approved By -- ,Signed Z ...`� .. Application Disapproved for the following reasons: ...................................................................................................--------------- ............. .................................I............................... /_ Date PermitNo. l ----------------------------------------- Issued -- --------------......-- --...----------.......--------------- Date TOWN OF BARNSTABLE LOCATION jj:Z ILU kZj C16 �7-14/6-SEWAGE # K}S' VILLAGE 0 L t- 7 ASSESSOR'S MAP & LOT62��J-t),, INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY k= LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL O =PUBLICER BUILDER OR OWNER r DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No Il_ _; �, �� .. �� D� 33 , �� ; I p f' i �� ` � �'`. f �� ;. t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , .• TOWN OF BARNSTABLE , Appliratiun for 11iupuuttl Works Tonotrnrtiun rantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............ .............. ...... ............ .... - - ............... Location-Address or Lot No. ............ 1�- ....--.G! !J/.... �f.�L1T.�.J/C.LF........-- Owner Address .................•••-----•............•-•-••• ------ -- Installer Address fi Type of Building Size Lots-49 aua.-Sq. feet U Dwelling—No. of Bedrooms............... .........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building .._..... No. of persons.................•.......... Showers Cafeteria a YP g ------ --- P ( ) — ( ) 0.1 Other fixtures --------------- -------•------• . W Design Flow................. ..................gallons per person per day. Total daily flow_____.._._ ...................gallons. WSeptic Tank—Liquid capacityZ.�06-gallons Length................ Width................ Diameter--------------__ Depth................ Disposal Trench—No..................... Width........ ......... Total Length.......f...... -..... 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........................ LL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ----------------------------------------------- --------------------- ---------•- ....... ----- ------------.-•---------------•--•------------.---------- 0 Description of'Soil-A------ d4,rl�..... ..� lSf1/L /1fs�'1• ' i v -------------�.5..4.� -•----------------------------------------------•---•-•---------------------------••-----.......---•---------------•----•--•-------•---....------------------------ W ---------- --------------------------------------------------------------------------•-----------•-------------------------------------------------------------------------------------------•---•---- UNature of Repairs or Alterations—Answer when applicable--- AI�------��-� --�/�..�d�rt�!_�?:z�/� 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 iss d by t-e board of health. .. Signed ..._. � � --�.............................. .... ' / 5-�--.. Application Approved BY ...... 'w- t ..... ........ ... Application Disapproved for the following reasons: ..................................................................................................................................... ---- --- ----------------------------------------------------------- ------------------------------------------------------------------------------------------------------- ---------------------- Dace .., Permit No. ( ..................................... Issued ............................................................ ...... Dwe THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE r C ertiftratr of (fontlaltttl:cre THIS IS TO CERTIFY, That, the Individual Sewage Disposal System constructed ( ) or Repaired (� ) by �''.. �710�/........ .......... ....................................................... at ....... 1 .( .000f J.... v ......0: E'E' viGG 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. ... -. - ................ dated , ................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT Bt CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE'3. . 4 - 9( --------------- Inspector �,e� �..:. l --�.------.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C � TOWN OF BARNSTABLE �Q No......�...-.••----.. FEE..............•--....... Disposal Norks Tonstrnrtion f rrmit Permission is hereby granted.............•. ............................................................. to Construct ( ) or Repair ('15t) an Individual Sewage Disposal System at No.................................... .......... --•----...... ]/LLf ----•...............••-- Street as shown on the application for Disposal Works Construction Permit No�� ... Dated.. 3a.--.--'..................... ........................••--_... ... --- ............ ................................. V�`••••----•---•................•-•-----....... �� 611".1joard of Z`Iealt1(l�'� FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS r TOWN OF BARNSTABLE LOCATION tom_; t EW, SEWAGE # VILLAGE /--Z ASSESSOR'S MAP & LOT4 ,� INSTALLER'S NAME & PHONE - SEPTIC TANK CAPACITY ; j LEACHING FACILITY:(type) i�-- NO. OF BEDROOMS ? PRIVATE WELL O PUBLILI DER BUILDER OR OWNERS DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No i r !ti tom. 0.7 e'.. oCIO � 2g j_�Oo Fig) �u ��=. .: K LE _.... _ __ ( (r (t ��j. t t}.L„�..........,.�.:<�,,..�....,..,.,.,,....:err�.m.�.r-7._.a,:.n..,..... ..._..�,..».w-.�,m+...��w�...:....,..,n..,....".....�.........,,.-.. -ry...d.f - - - ....I l/ l ! l • p r t� rig , i t pg ` ,.. _.,-.. -t: J.