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Home My WebLink About0022 RACHEL CARSON LANE - Health (2) C za n4--- KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT 10°/a e Certified Flier Sourcing POST-CONSUMER www.stiprogram.org SFI-012W MADE IN USA GET ORGANIZED AT SMEAD.COM r qOLC&Nt� OWN OF BARNSTA,BLE LOCATION a• Cd.tSO SEWAGE #93 o `o e VILLAGE �( j (y;`\ ASSESSOR'S MAP Sk LOT 9O ' 05 INSTALLER'S NAME & PHONE NO. ' SEPTIC TANK CAPACITY O O O ` LEACHING FACILITY:(type) Q (size)�� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER now BUILDER OR OWNER Q S DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �0 e iq° _ THE COMMONWEALTH OF MASSACHUSETTS BOARD R F• HEALTH, O ® O .................OF.................... ApplirFa#ion for Disposal Works Tonstrurtiura rumit Application is hereby made for a Permit to Construct ( ). or Repair V<an Individual Sewage Disposal System at: Locatio - ddbess ��r Lot � � p Owner Addre Y1 t "-`�v� t�-- -------•••-•• --•---.....-•------•------•--•--•--.l3v � s .�-cam - .... ................ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa,, Other—Type of Building ______________•_-_-.________ No. of persons............................ Showers ( ) — Cafeteria ( ) Pa 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_______-_--:---•-------. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__-___-_................ a ..... -- --`-�==`=_�_. .--------------:----:-•--....----------.....-•--------._...-----..__...---------•----------------•-•---•-•------------ 0 Description of Soil--------------- - x . ... ..............•---•------•--••-•---. •-•-••-•------ ----•---•-•---•---. ------••---•----••-------------- V --------------------------- •------------ -------------------------- •------ ----------- -...... __-- UW --•------------------------------------•---•-••-•--•---•-------••---•------•----....-••-••••-----------•-•-•--••------------•....._--••-•-------•••.-••- Nature of Repairs or Alterations—Answer when applicab ...___.____ 4'� ._____o-�(�.______-._-'_-__-__��............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f•-1 T f1�.-. the provisions of i:.::..L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een issued by the board of health. Signed.. ---••------------- ---.z...............® -- Date ApplicationApproved By............. ..... ....................................... ........ ...... Date Application Disapproved for the following reasons--------------------•--•----•----•--•---------•-------------------------------------------------•-•---•--•....._ •--------------•----------------------.....--------------•--•-----------.....--------•-----••-----...-•-------•----•----.....---•--------------------------------------------.......................... Date Permit No-----WOZ—_i- .7 gq••••------....-••-••-••-•- Issued......1---------------------------------------------- Date t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair V<an Individual Sewage Disposal System at: . �� i Cat Lo. . a .. ........ - •----•-----•.......................... ...------...-....•--..=--......__....... .....-------•------•--------•...---•••--•- Locatio - dd5ess ;r Lot .T _..--------•-•-- t Owner 1 ,�1 f Address W ._r"✓' ` V l�,+.- � \r . �"-t l U YY1�._ 61.i 6 ...--•-•---••-••• ........... ....... •••••...----- a ---••-----------•---- --------------- .. --- =-•-••••••.._.._......--••-- ,' Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............... ...........................Ex ansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures -----------------•------------------------•-•--•-------------•-••-•••••---------------- ---------•--................................................ Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 0� 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.......................................................................... Date........................................ 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........................ 1:4 ----13 - •••--•••---••---•-••-- O Description of Soil---••-•-••-•... - ----._...---•--•---------------------------------------------------------•----...-•----••--•----------------•••--------•--- U ---•-------------------_-------•----------------•------------------•-----•-•-•---------...----------.._..--------------------------•-•------ ---------------------------------------------------------------------------------------•-----••-•-------------------------------....---•------------------•-•••-------- U Nature of Repairs or Alterations—Answer when applicab q...._.__.._ e v ............ _____ y •_------•-_: _ .............. ..------------1.000---• t--~------------(---- --� .............................................. Agreement: The undersigned agrees to install the .aforedescribed Individual Sewage Disposal System in accordance with the provisions of TT T LE i of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een issued by the board of health. Signed---a.,`'. `^'�......�a-�'-,-`,'";�` " --•-•----------- l ....................... Y ' Date Application Approved B ,� _____, E r,�,. _ -------•,� ,_,_•-Date�Date Application Disapproved for the following reasons:.............................................................................................................. -----•••••-•-------•-----••--•-•...-----••--••....--------... •••••--••---- Date PermitNo----- -------------•------------ Issued....... l-•------�--- -------------------•-------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... ..................OF..........��.'^...!-.`......:........_..............:................. Tlertifiratr of TI-Implitturr TW IS TO RTIFY, That the Ind" id 1 Sewage Disposal System constructed ( ) or Repaired (�) by ..._..(.. ' `� '`... ` `l�.... `--- a_ --=-------•---••--•------------------------------------------------------------�--0--- Installer at...... ..........q a" e.�. - r' p 1"----- f t ah'' ' has been installed in accordance with the provisions of TIT— 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... _. �f.___ dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCT�PN SATISFACTORY. /rr� DATE.----- l ..._..--•-(D-(DJ..................................... Inspector.--_....... t��- � T �/l�L'�!j ----•--- v THE COMMONWEALTH OF MASSACHUSETTS BOARD-OF HEALTH J( c.....L.:`......'.................OF...-------....................................... _--•--...•--....--•.......... v No......................... FEE........................ Diavo l Works Tuuutrurtion thrmit Permission is hereby granted...... .._ - ___.. --s__________________ w\\ to Construct ( ) or Repair K an Individual Sewage ispos Sy temat No.•---•--••-----------••-•••---..._-•---- ••-••-.._._...----••. --------�6,.l.�_��.. -Ccc c s o•�----------L .:.............. Street T as shown on the application for Disposal Works Construction Permit Noel-_6,21___ Dated..... �_�'_ _..._�.!S ___________________________________________________� �+ Board of Health DATE-------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS LOC O - 4-0-r- EW&CE: PERMIT- uO. VILLAGE Ih! L ?5 P/lE AD RESS , BUILDER ' 1 J L1 M ADDR S - DINTE-PER"l-T 155UED ,7-�-=-- -__ _O ATE - COMPLI At�ICE ISSUES ;- . =� - _ 17`0 No.- -13••-------- THE COMMONWEALTH OF MASSACHUSETTS ROAD® HEALTH ._ . ...... ... ........... .OF.......-. -. ......-.........- ..---- Appliration -for Uttipoiial Narks Toustrurtion Vrrnift Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at,: -•-- --• -•------•--- ---.. ............................................. ........................................ -- -jon- - ress / '� o . Address a ---------••-•---------••••--- Installer Address / Type of Building Size Lot_._1-.__-___� _Sq. feet ------- v Dwelling—No. of Bedrooms.............. er- ........................Expansion Attic ( ) Garbage Grinder p ( ) , Other—Type Type of Building ............................ No. of persons..-_____--.__-____-_--_----- Showers ( ) — Cafeteria ( ) a4 Other fixtures --------------- ------•------ W Design Flow_ ______________ _.__..�,._._._.__..gallons per person per day. Total daily flow_._.._____..__._-.___--_-�__- f.-.--.-...gallons. W Septic Tank Liquid capacitrilameter /�°`D_..gallons Length................ Width................ lliameter__� P4`Depth...__.__....-. x Disposal Trench No. ... ...... Width.............. ----- Total Length-_-__-_-_--_-_--_-_ Total leaching area--------------------sq. ft. Seepage Pit No.�QJ4 _.___ ____________________ Depth below inlet_..______. _ ._ Total leaching area._._______.___.sq. it. 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....-----_-._--__.---_ rXq Test Pit No. 2................minutes per'inch Depth of Test Pit.................... Depth to ground water-_.__-_---_-.--.-_--.._. 0 --------- ----- - ------------ ---------------------..... ... -•---•. --- ---------------------- O Description of Soil .. '_.... - •----- �---• - --- - ------- -- --- V -� �r dd' i F -- W 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 \I 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. Signe . --•-- .................... .....`--``....`. .......................... ��..K�- Date Application Approved By � �--`----•--------••-------- f - - ---,--/�--�G�-�:;=' Application Disapproved for the following reasons_____________________ -----------------------------------............................................._.._...... --•••-••----------------•--------------------------------------------.....------------------------------.-----------------------------------............................................................ Date Permit No. Issued:�---= / ! Date --------------------------------------- THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA j �s Fss.... i ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r t.....�C. �.- - .OF.........�.........................------.---I. ... ...................... Applirtt$ion -for Di�ipugttf Workii Cnonstrurtion Urrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at,, ___.. ., h_ , -/ !?I''""r I I(4' /-- ......... •-----`------------ ------------------------= -f-1-�- •---••--••-•------•... ---•-------------•-_.-..---...-.__ ------�n............................ � Location•Ac} ress s ! .-or-Lot No. r / .................a 19 . � ... f/ ( ' I.........................................................- F� Owner-- Address . -- t------ Installer J Address f !j j 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 ( ) Q' Other fixtures W Design Flow--------------- -------------------gallons per person per day. Total daily flow--------------------------------------------gallons. Septic Tani Liquid capacity.......__._gallons L th Width_.---_.-..__._._ Diameter__j. .�.. epth---------------- 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 ( ) t Dosing tank W Percolation Test Results Performed by--------------------------------------- -----------------------------•---- Date------•----------•--------------------- ,� Test Pit No. 1------------_---minutes per inch Depth of Test Pit.................... Depth to ground water...-_____-__--_.--._.... ° �14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water__._-_.--__----.____.._. D Desc't iption of Soil .r-= ... `- .....✓.... '-'� x ••••• -------;---- -•----•---•--•----•---•-•----------------••-•--•-•-------------..............--------------------'' ' V --`= W VNature 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 undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. - ned --t�:.tt✓ � .'t. .I j Date ,.Application Approved By � ................................................................ Date Application Disapproved for the following reasons:................................................................................................................ .........-•-•••-•••-••------•---•--••------•----•---•---------•--------------•------•--•-•---•-••---......-•-------------•---------•--------------•--------•----•---------------•--------------•--.----- Date Permit"No: --------•- ......................................... Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS ' BOARD O/�EALTH ..................OF..................................................................................... Trr#ifirtttr of IVITIM littnrr THIS S O TIFY, h e Individ al Sewage Disposal System constructed ( ) or Repaired ( ) by ;_. ,: ---• ............................ --• . --------••- E " at_ = � --- -- --- - ---- In ler - mac= ohas been installed in accordance with the provisions of Ar ' e XI The State Sanitary CgdL as descri�d„�t the ,r application for Disposal Works Construction Permit No. �.�-------------- dated...._`'---1�.--':.___...,----_•-------••- 1. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A ARANTEE THAT TIME SYSTEM W2�/ FUNCTIO SATISFACTORY. DATE--------- ... ?..� ------- .......7!�.............. Inspector..... ------------------------------------•------•------- ------•--•-•---------- THE COMMONWEALTH OF MASSACHUSETTS fa BOARD 9f HEALTH xI Q`�i�fLyL............OF....... .. �..---....-•-•--......----••............. /J No. ' --••--•• FEE../ ------------ LIT trrti�aatrrtif Permiss-on i y granted_`-'-._... •---- • =-� ------------------ .------•-•---------------_----•-......... to Cons r or Re ( ) a ndrvld A�age isposal Sys em at No.- / ` � ,.� .t �. - ----------- --..__.. j Street as shown on the application for Disposal Works.Construction r it No. ated_ ' "" Board o Healt DATE........................................................- =--------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS s •y - Z.h ''.4. jriK � 4 ' -• PL®T PLAN,SN�7Wt6V � IC�CA1"4t36� ®F 'I N T,; �, C E NTERVI LL E � ASs� ..F'O/� j I� ALAN E S.MALZ .: INC." SCAL. 1.." 3®� ®AT.E °MAY CHARLES N SAVERY INC REG. C .a L S 112 'MAIN ST'_J'IYAN'441 , IA58 R t ;LOT 477 sx 19� �:.o...` ✓s. I c. �f ..r ��"N .S 3 7 / a 1 f 2 2 r ,z� 771 Faurjdaf ion - ..', +`` f �'S•1/ ,a :i ,� xh pI LiA L 4YFYt't'. iv ti 35 A= 59.5j r I ,� - watt •.c i,. u +a '2k`I •7 $ � Cis _ 14 .. f r?,. — � — L + II 9 c�y cerfiN that.the building exists H Q'! . aft .gro:;radlai shown on this r3 ��p r s , with i '� � • . zoni n ,�. sao �np t ^ot�410 Town of Barnstabl aMl `S 1 ♦ i$VLOUM IN A F'EDER, Q�IGNAT6 FLOOD PL AIN 20k. } N y