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Home My WebLink About0072 ROSEMARY LANE - Health 17 ;, � 14&qm0-/ Lc fle N S M EAD KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE AWRY MIN.RECYCLED INITIATIVE CONTENT10% Certified May Sourcing POST-CONSUMER wwwApm0wm.or0 SF101290 MADE NV USA GET ARGANIZEn AT SME,ARCOM LOT NO:': a ADDRES 2 � � 014NERS NAME: SEWAGE PERMIT NO. : NEW:I(,LREPAIR: DATE ISSUED: DATE INSTALLED: Z �S INSTALLERS NAME: I Lod, INSTALLATION OF: o Db f R It I WATER TABLE: FINAL INSPECTION DRAWING OF INSTALLATION ON- REVERSE SIDE: v� i'k ''�'� �� I � �U,J�,; ,�'` � � 1. '� of No.. _..._. _� FIMs...... . . . " ....0.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di►ipwial Worlto Cfonotrttrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �d-... Z - ----------"--------------"------------- ttnn-i�ddres' or Lot No. .......... G S- tom --"---•"--------- ----- --"----------------------"----"•--"-"".....""-""--""-"---- Owner Address W Installer Address •�•-• - UType of Building Size Lot....e_14a.AK_.......Sq. feet Dwelling— No. of Bedrooms-------------S-------------------------__LXpansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ......................................................-•-•------.._....---------------- ----------------•------•---..._......................-----•-• W Design Flow............................ gallons per person er day. Total daily flow.... _..........................gallons. WSeptic Tank—Liquid capacity/Car2;?_gallons Lengtli__ -(p____ Width___+--oF__ Diameter----- Depth_. n1r... x Disposal Trench-- No. .................... Width.................... .rotal Length.-.................. Total leaching area....................sq. ft. Seepage Pit No............... ... Diameter-----//.......... Depth below inlet__--_�.......... Total leaching area.._;nll....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed ..�A'14_'#je ...................... Date...._ ............. ,.� Test Pit No. ILLS-.,r_.-minutes per inch Depth of Test Pit.... .S.'.._. Depth to ground water-_-............... Li. Test Pit No. 2...... .......minutes per inch Depth of Test Pit---1.2........... Depth to ground water..._�........... W ---...--•---......---•--•...-----•••---•--•--••------••----••--------------•••.......__-----._............................................................... 0 Description of Soil....1-- 14,S-""- ............................................................... W 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp'i aac4as been iss d by e board of health. Signed ------- -- -- - ApplicationApproved By ....... .... .. . ........... ...... .. ..... . a------ ... ... . r-------------- �! Application Disapproved for the following reaso .. ................................. . ...... ... ........ .:........ ........... ............................ ... . .... . . . ..................................................................... .. - ---. ----*...... Permit No. - -.- ...a....7_ -----------.... Issued -------- - .../ ....................ate �1. g,te q Co THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diripwial Work.6 C omitrnrtiun VarAft Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 7 ,a ..................•---•--------•......._.�.-: -yam ----- •-------•--------1 ....................................................... -Address or Lot No. - .. � _�. .......................... -------------------------------------------------•----...-•-•-••....---------------............--- W owner Address Installer - Address UType of Building Size Lot.... __-._9{_•---...Sq—feet- a Dwelling—No. of Bedrooms...... ...................................... Attic ( ) Garbage Grinder ( ) p., Other—Type of Building --------------------_----- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) al Other fixtures . W Design Flow...........................�:. -___.__gallons per person er day. Total daily flow...334?...........................gallons. WSeptic Tank—Liquid capacitylVP_a-gal Ions Length.--�___- Width....-�__ Diameter_-- Depth..S^-'__. x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...............1.... Diameter....4/. ...... Depth below inlet....... Total leaching area.... :3.15 ..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by... �4-__ � �.!= 1.2....................... Date__�Z: �-:-�¢..___.__..... Test Pit No. iZ,0-r._'z_...minutes per inch Depth. of Test Pit--- '._.. Depth to ground water....--""........ Lz+ Test Pit No. 2...............minutes per inch Depth of Test Pit---- _2....._..... Depth to ground water..... --'::-......... O - - --•- --.............--...... . . . xDescription of Sot1---- � ---------------•-------------------------------•--.........---• Uw �.. ----•------------------------------------•......-------•----------------------.....-----•-------------------------------------------••-••------------------------------•---•------........_.._._....... 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 Environmental Code—The undersigned further agrees not to place the system in operation until a-Certificate'of Complianas been iss» d by "e board of health.c�. Signed ....... It /-E Application Approved BY ...... . � . ------- "-...� _.....:........... ....�.r /�.j......: T e ` Application Disapproved for the following reason..._....._------------------------------------------------------ --- ............... ...--:------------------ --- ..... .... . .. ............................................... �---------......_-------.....-----------_--------------------------- -- Date Permit No. _ . .......... 1.... Issued ---------- --------- ....... �...-... .............. I Dace THE COMMONWEALTH OF,MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ,. Tertif ra e of Tontylinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) .... ............................................A....---------------------------.---------- o� / y� / ,rye k _71--- _9A/----In�fi llcrn n/ -} - e.. --------- - has been in�talled 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 BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. + DATE ._..... "". .........._ .. .. Inspeccr ----------—------,_.-_--- --,-__----_-_-_._-----__-___- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9a ._0735` . TOWN OF BARNSTABLE ff,No.. .i.............. FEE........................ Dispaiial Workii Tonotrurtilnn "rrmit Permissionis hereby granted............ ------------------•- ----- ..........................................................-.............................. to Construct \ ) o Repy ) an Individual Sew e Disposal System at No. / .G'? m : !. 1��.�- -----------.-!--- ---------------------------------- w. ... / f.� I_ J� Street 1'�??,, as shown on the application for Disposal Works Construction -Permit o. ..____/J._ Dated....._,��...-1�`'��_.._. DATE------_----------------- �'- � Board of Health �.".�� 4 ......... -•---- FORM 36508 HOBBS R WARREN.INC..PUBLISHERS i } j t ' i , • 31 & May A,' e I tI 40 ! wide 0.36 ac. ! loco P�•t ` I t �( �. . . I I C 3107 _.. $4a GIST 30.0 3�e r 25.7 �ept c 40 wide I i i { I I� Jl7 No. bed�oonvs. : 3 R , } J' po Pw �-i to No Scc e , k `�dt#i rated .Caw 330 �pd 3Z.1 i :lZe�eiwe " 233 ap Iva � w 1 ' E 1000 s 4Q I , , S ' N N N N�; pit I { _ +1 X. I i Slzet A Ptan o;�. .Pa>td in. CPn tutu i l;L e, �l4 . � tat � f n ,t� 70a nGaf4ei3. ��- E 8ein4 Lott 18 jc4. i1wwn' ooi '.C.#4144 5 A dh 2 , �Leuc t i o*i ate on an a44v*w-d do tr usc: i } 1 ! l'}-30 ! ' date 12-14-94: At 1 �•_i clap a EWceeh-i.yu' I i Id y 0260'I ' ' '('`lade 12-8=94" Wit. Ed 6ctW. r No wa,teh encounteted1 -, jl ehc. ted. 2 ►win p ea p 9 P 2 , c31 J .5 9 & . • J b I I I ,IS ! j ! i r I 1 A-- t , _-__ _:_..L I�,1 I ( 1