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Home My WebLink About0780 SOUTH MAIN STREET - Health (3) /K6--00 9 5 M E A D No.2.153LY UPC 12934 I-� smead.com • Made In USA SUSTAMW WNTL4 tttt IWTIATNE WAWAWOWMLNO rd THE COMMONWEALTH OF MASSACHUS BOARD OF HEALTH ........O F............. ----------------------.......------------------- Appliratinn for Diipuial ,arks Tomitrnrtiun Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ..... -•-- --- JLoca -Address or Lot No. • ..............A -- ---------- .... ..:....... •. --•.............................. ......................•--............................. `-Owner ' Address ............................. •-•-••-----------....... ............................. .......---••----•--....................-•----------------•--------•..........•.................... Installer Address d 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 v- Design Flow.. .......................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank-/—Liquid capacityleBOgallons Length_____________ __ Width----------------- Diameter__._-__--_____- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area............ .-._.sq. ft. Seepage Pit No...../_____________ Diameter-----Za........ Depth below inlet................. Total leaching area_ �.�?.._.sq. ft. Z Other Distribution box ([a- Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................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........................ 94 •--•-•••---------------•-••-••••--•-•••---•--••--••--•••-----••....•----------------••••-•-.............--•-•-...............------•-•-••••------..........•- ODescription of Soil....................................................................................................................................................................... "4 V ............................................4........................................................................................................................................................... W ••-••••----•----------------••---•--••••-•-•--•••-•••---••-----------•--•-----------•-•----•-•-•--•-----•- U Nature of Repairs or Alterations—Answer when applicable.__ Gt- _ ___- d!' .._____ ___ ..___... ---•-•-•-•-•--•-----•-•--•••••••-----•••-•---••--•••---••--•-•-••••-•-•------------•---•-------------•-•--•.....••••••-•--••----•-•-•••-••---•----•-•--•---------••---•-•----•-• •-••-------••-----•• 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 has been is e boarA of health. C— Signd---- ..---•-.-.-- ................................ Date C, Application Approved BY -•- �!�/a `�t 1.�1 2 — l Application Disapproved for the following reasons:.................................7 Date ........................... ..............•-----•--------•--------------•----------------------------...------------•----------------........................-...................................................................... //�� rDate Permit No......................................................... Issued-......lt.. 2 -- � ... .--- - Date lws- .. 0TOWN OF BARNSTABLE LOCATION �,�'p ® �'/�✓ice y SEWAGE # VILLAGE �.- �I( u l!lam ASSESSOR'S MAP & LO it r_7,PQ0 INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY �,/ 0, /V LEACHING FACILITY:(type)_ i- d® (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: z 6 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No _' �/ �� c.r�y.9� O �� C� ' I �, < � LO� 05-0 �a � � S GE PERMIT N0. VILLAGE INSTA LLER'S NAME i ADDRESS BUILDER OR O!�- - DATE PERMIT ISSUED, _ _ DATE COMPLIANCE ISSUED `-2-6-.-7� � �~r '`� . �.p� , i Y ' (�� _/ • �� ^ �e l �3. �a �y LOCATION SEWAGE PERMIT WO 7,f-d• fp VILLAGE INSTA LL R'S NAME i ADDRESS a �� . f l UN — Za e OWNER DATE PERMIT ISSUED 7 DAT E COMPLIANCE ISSUED 7��, � �f �, 3� 3`�` �� 3 �i� , 3 y. .�9 ,�� FY�n�� (Job F-• f FE$.._........ .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OnF HEALTH • -:.OF.-.-.. � Appliration '/!r ---•-•-----__ _ - ---- r for 11ivpuvFal .vrks 01nmitrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..........�... .......S a .J..'.7 ..._._._ . ............... ................................................. ------ . .--..._.......------ Loca io -Address ' or Lot No. c ?� r? ".................................... .......... --................................._.................................................... Owner j Address ----------------------- -----••------------•••-••-•-•••-•-•----...._..----------.........-••-••--------------------._.... Installer Address Type of Building Size Lot........:...................Sq. feet U Dwelling—No. of Bedrooms___________________________________________g_kpansion Attic ( ) Garbage Grinder aOther—Type of Buildiii'g __________________________-- Shower I ( ) — Cafeteria ( ) d 'Other fixtures .....................................................X..-•••••••-••---••---•---------------•---------••'••••-•-•••••••-•--•._......-•••••-------•-- WDesign Flow:..........................................gallons per person per'day. Total daily flow............................................gallons. WSeptic Tank•-Liquid capacity_/ pgallons Length.................`Width................ Diameter________________ Depth................ Disposal Trench—No;____________________ Width.................... Total Length'_:.................. Total leaching area......... Sq. ft. Seepage Pit No._.__�_____________ Diameter.._.. Q:___..._ Depth below inlet_____.6.._..__.___ Total leaching area._ _� ....sq. ft. Z Other Distribution box (J.�• Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2___ x'__._._minutes per inch Depth of Test Pit____________________ Depth to ground water........................ lll ---•--••---•---------------------------••-•----.....__..:..--------.........---•-----------------••......................................................... Description of Soil `= = -----------------------•- ----•--•-------------------------------------•- ,.,.: W _______________________________________ __�_'-----------------------------------------_------________ �t_ �' 07 �xj Nature of Repairs or terations—Answer when applicable__ A *gal r_ "'�-- ---)1. .. . I Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T ITa 5,of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is a b e boar of health. Sign d ._.... -•-- -•- ✓ Date Application Approved By..... +� ,....... _ ^" Date Application Disapproved for the following reasons.................................................................................................................. ------------------ Date PermitNo..................................•-------••-----------. Issued----------------------................................ Date THE COMMONWEALTH; OF MASSACHUSETTS BOARD OF. HEALTH ..........................................OF..................................................................................... Trrfifiratr of Toutplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or.Repaired ( ) by............---------------------------------------------------------=-----------------------------------------------------------------------------------------------=----------------•---------•-- Installer at......................................................................................................................................................................... has been'installed in accordance with the provisions of TITIF 5 of The State Sanitary Code as described in the application for Disposal Works,Construction Permit No_________________________________________ da.ted__.---------------------.__.._.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM"WILL FUNCTION SATISFACTORY. DATE....................•---------------......_......---••-••--•---•------•--•-•---- Inspector........................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OA HEALTH 7)? ........... 11� �...-.-......OF.......... .: rf!7!..• ...................................... . No._.... FEE.... ................. Dispolial 00 kis - .V .. tr ' it rrutit Permission is reby granted. =`" ... :.*.."" ti_. ._........ to Construct ( or R pai ) 4ndividut. .Se age Disposal s f at No_*------------- �r��_f.�?-�t.... -----414-- --•-----.--- � -- ..................... •-..................... ..._._......... 4 Street as shown on the application for Disposal Works Construction Perm- .___.___: ! __jr D d_.._ t ._'. c� Board of Health DATE..... -.............. -...--------•-••---•-- FORM 1255 "HOBBS & WARREN. INC., PUBLISHERS r , F Ville I 1-5 .160 9 No------- FInc..... 6-F"`............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �n .............OF..._T.". b!.v Appliration for %epos al Murks Tomlrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (*) an Individual Sewage Disposal System at: ......... -- 0---. °.Y�.....4�!_,_. Y�.�.S l^�3 ti Lit...................................... •� ocation-Address o�r�,ot N , e�!1�...�c._.._ S�' h1 � 'jSO �6G1k�.J+.e ...�txn_ Owner Address ............... �_.B... .1 3 4-- cisn.�S r_ , -t 4 ��/c�lrtxa� .,------•--•-----. Installer Address V Type of Building Size Lot.................... .....Sq. feet �-, Dwelling—No. of Bedrooms.............................__..__Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q, Other fixtures ..............•-••----•-.......-•-...-•-•--•--•-•--•-- W Design Flow............................................gallons per person per day. Total daily flow.--------...................................gallons. 1:4 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ....... ---------------------------------------------------- -.......... ---------- --•••--------------- ----------- •-------------------------- •-•••----------•--- 0 Description of Soil........................................................................................................................................................................ x t., ••-••--•--------•-------•----•-•------•--------------•••-•-•--...--••--------•--••--------•------------.........-•--•-••-••---•------------- ......................................................... -•--------------------------------------•--------•--------•----------------------•----...---------- U Nature of Repai Alte`r-a'tii n_s— er en pli able_____ .___._.. __ ....... l Agreement: F 1®p 402 pw�,K,+ )14 P ro The undersigned agrees to install the afoBedescribed Individual Sewage Disposal System in accordance with the provisions of L I:LL p 5 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 b a ealth. Signed.l..�_:2.�2.�. -• •.......... .--• --••............... ---- � Dat Application Approved By....�.__... D: � ---" ............................ � y� Date Application Disapproved for the following reasons:-------•----------------•---------------------------........................................................... ...--------•---------------•.......----•-•--....------------------------------ ---------------------------------------------------------..._. Date PermitNo........... ...... , ----------- Issued-....................................................... Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA l No.... FRBs ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................OF......:. •Y`l�....:......::...`:. Appliration for Uhgpvii al Works Tontrnrtion Famit Application is hereby made for a Permit to Construct ( ) or Repair (�4) an Individual Sewage Disposal System at: ................_................................................................................ ----.............------....---......-------•-•---•---•----------....._._...._...---------------•-• Location-Address ; , . orLrot No. rI T, ............................................ --••-----•••......--.._........................ ............... -------------.........- ---...----......__.......„....I..� ...--_......... Owner ` Address a = ............ .:................ Installer Address \ U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.__...n.............................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—Type of Building No. of persons............................ Showers YP g --•--•--------------------•• P ( ) — Cafeteria ( ) P4Other 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........................................ Test Pit No. 1................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........................ GG .---•-----------------------------------------------------------•--•---•-------------------..................--------------------------•- -•-------------- 0 Description of Soil........................................................................................................................................................................ x U .......................--•-.............................................................................................................................................................................. U Nature of Repairs-or Alterations—.Answer when applicable---�`�_c �•..__-__` _ <;� ____-_•-_•i(? !,__•.y.�_tt_____._, _ � i o U i '}r i ..............P1�1� Agreement: .P r o t c �,u CI,v� pe j' (a The undersigned agrees to install the afdredescribed Individual Sewage Disposal System in accordance with the provisions of TT'L p 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 b o Si ned �...-----' .. _ ----------D-a- A Application Approved BY-- . � Date Application Disapproved for the following reasons---------------------------------------------•---------------------•--------------------------------------_.... --•-••-•....•---------•-•-••-•-------•-••••---•----•••-•----•-----•---•••--••-••-----•.....-•-•----••••--••----••---•••--••••.._..•--•---•-•-•-•••-•--------•--••••••-••............................... Date PermitNo.....---- -------Z--------------------_ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........:......................OF.........`................ .. (9rdifiratr of Tomplittnrr THIS IS O CERTIFY at the In'* idual• Sewage Disposal System constructed ( _�`or Repaired ( -} bY------------- aJ� ......, nnA) ..--------------------------------------------------------.....----------.....------------.........--------...._..------ / U o � - , Y .--t r\ �Inst at................................................................................................. has been installed in accordance with the provisions of TT T IE j of The State Sanitary Code Is des ribed in the application for Disposal Works Construction Permit No.____....._iEE��..._../z�.. It -------�_��...._._._...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL F``U"��TI N SATISFACTORY. -' DATE.......................�:a ? i�. Inspector__...._.�.. .....----•••----.... . --•-•-......_..••-•--•-••••..........--•--•---------------------••. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NO. ............ 5 FEE........................ Disposal 19orkii Toots ion rrntit Permissionis h by granted--------------- :' .... N.--.-•••-•-••-•-•-•-•---••-•--------------••-•••••--•--•---•-••••••---••-•..........--•------...... to Construct ( or:Rair ) an Individual Sewage Disp.gs S step-, atNo.... .............................. ............Q.....;Z MG_..........------•-----•-----...............................--------...---•--------......-----................-- r Street ".f_ j 2&.� as shown on the application for D' o al Works Construction Permit No...._._C7^ __^s-, ted.•...-..__1 ._...... ................ G Board of Health DATE.. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS