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Home My WebLink About0297 STONEY CLIFF ROAD - Health Zq 7 Sfioney olf; Rd CenvcV(tre 17o - oyZ S M E A No.2.153LY UPC 12934 smead.com a Bade in USA ow- 0 gJgAKW FORESTRY INITIATIVE CortlBodHborBourcHp -7o�- 6�1'D, Fxs.......jjLr )...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Di-ripwial Work.5 Tuntrnr#iun Vrrntit Application is hereby made for a Permit to Construct ( ) or Repair ( L>--an Individual Sewage Disposal System at: i Location-Address oN Lot No. ---------- vner Address Za In V Address UType of Building Size Lot............................Sq. feet ,., Dwelling—No. of Bedrooms___._________________________________Expansion Attic ( ) Garbage Grinder ( ) A4 Other—Type of Building ---------------------------- No. of persons------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................. . W Design Flow._------ ."5......................gallons per person per day. Total daily flow----- ....................gallons. WSeptic Tank A-Liquid capacityL.�-.-_Qga]lons 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W ,.� Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 0% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •---•-•-•-----------------------•--••...•••••-.........•-•-•------•---•••------••-•-•-•-•-•.................................................................. 0 Description of Soil.................................................................................................................................................................•••... W U -•-•••••••---•--•--•----•-•-------------•-•----••-•••-•-------••--•••••--••------•-••--•--••---------•••-•••--••----------•-------••--••--••--••••-----•-------••••-------------•....._---------------- W x ------------- ............--.................................................................................................................................................................... U Nature of Repairs or Iterations—Answer when applicable_.- 1 __�k___.--Le).0o._c� r_a --'�°-"........ V 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 ance ias-be S' e of health. Signed ------ --------------------------------------------- ------- -------------------------------- .... �_67_@�7 V t Dace q Application Approved By . �. ......?.�--.1-7---[- ---- -..----- Dace Application Disapproved for the following reasons: .. ................................................................................................ . . ..................... ... --------------------------------------------------------------------------- ---------- ------------------------------------------------------------------------------------------- Permit No. �-�...-.... f ---------------- .. Issued ---Dace----- .i Dale t. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apptiration for Di-}putt Workii Toutitrnrtinn runtit Application is hereby made for a Permit to Construct ( ) or Repair ( L,),-an Individual Sewage Disposal System at: .. G'j 7....Sf O W e t J�'I,.l .t.,may �� . {��- ... •...---•--•-•--•--•-•...............•-•- Location-Address or�No. 5------------•---------- •----------• Av�T r t... ----••----- ------------•-....•........... caner 2 •- Ad,ddr�res/ss] Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms....S-----------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons_____..._.____________-_._._ Showers ( ) — Cafeteria ( ) .¢ Other fixtures --------------•----------__-.--•---••--•-•-••-•------------------------------------- W Design Flow.._.._ _-......................gallons per person per day. Total daily flow......,a..-�_.._.__...._..........__gallons. WC Septic Tank �-Liquid capacity vgallons 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 ( ) '., Percolation 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...._................... P4 ...-......................................................................................................................................................... 0 Description of Soil................................................................................................................................. x ........................................... w U Nature of Repairs orAlt�ea ions—Ap sver-;,h eUappli®�-�s-�`-�.��4 L��G��!� _��'�•_ 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 Cem-pliance h'as+ee ;is ued -the boa, of health. ed PPPP y ................ .......... ........ ........................... -, .`c7�.... Dare ApplicationApproved B Sign ..�.'. -, �................................. ........................................ . ....... [) Z y ,� �•'� 1 Date Application Disapproved for the following reasons- ------------------------ ---------------------------------------------------------------------------------------------------------- . ........................................................ ......................................................................................................................----------------- ........................................ Permit No. ........... ..L/....-...1� �� Issued .......................... ..............................Date...... F t....�.......................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�er#tfirate of Tomplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ...................... --------------------C.oa .5- .............�-�'�`---�-------------------------------------------------------_----------------------------------......------------- m.,tauet at ..................................C'l �1..7Z..... ... - - a has been installed in accordance with the provisions o I'I LE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. y...751, ... dated .--------------------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU .- AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY./ DATE............... - b ... ...... ..... -`- ------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �j TOWN OF BARNSTABLE No........1.. .__ I FEE.. .: ?_e !......... �t��nstt1 nrk� �lan�tr�r#Uan �Crrnti� Permission is hereby granted....... :T -l'4= 1 cry_►... -----•------------------------------------------------•---•--............. to Construct ( ) or Repair (� Individual Sewage Disposal System ••. ` Street q as shown on the application for Disposal Works Construction Permit No../. '.-I�__7yDated......X_._fl_......................... ---.....-•-...---••--••-------_� = � ----•----------••-•-••••-•--------•-•-•••-----••••... Board of Health DATEY C L ................................. FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION �D �b SEWAGE # 9(`4 VILLAGE ASSESSOR'S MAP & LOT/Zgy, /.? INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY td(o LEACHING FACILITY:(type) Qv-ccA757_' (size) la.�,G NO. OF BEDROOMS PRIVATE WELL OR P WA R</ BUILDER OR OWNER , c� DATE PERMIT ISSUED: 9fir DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No IL' Nt� p�� 6� No._41___241? Fss.... THE COMMONWEALTH OF, MASSACHUSE17S + BOARD OF HEALTH ........................................... Appliration for Dispsal lVorks Ton'strn.rtiun Fumi# Application is hereby made for a Permit to Construct ( ) or Repair ( L.�a.n Individual Sewage Disposal System at •_ 1'•"St - ------•........ ................:.... Loc( -Address or Lot . .........:. ..��n�.�^.: .. ..`uvw�. ----------..__._...-----•-. •........ Owner Address Addr a ..........-;;••t - .. S ` 1 ,,,.................. --- itQla.�_Ct !-�... ..Q ........................ .............. Installer Address.- Type of Building Size Lot.........................::.Sq. feet Dwelling—No. of Bedrooms__............................._......Expansion Attic ,( ) Garbage Grinder ( ) Other—T e of Building _.______ No. of ersons____________.................. Showers — a YP g ..............•----- persons ( ) Cafeteria ( ) dOther fixtures ----•-----------------------.------...-------------------------------_...._.•---•--------------•-•----...._.._..._......__.. w Design Flow......5 ________________________gallons per person per day. Total daily flow_______3_ ....................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench'—No..................... Width_:....... _._____:_ Total,Length.................... Total leaching are a....................sq. ft. Seepage Pit No......./------------ Diameter___j_0.`__._.. Depth below inlet_:_(V............ 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 Hof Test Pit...................... Depth to ground water........................ .44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... ----------- ..•---------------.................................------•------------._...-----............................ 0 Description of Soil.................... x U ...••-------------------•---•----....--• ----- ------ •-•----- -•...-------------•--•------------•------------._....-------•-••---_._... .---.._..._...._. w U Nature of Repairs or Alterations—Answer when applicable------l4' -----!0 .... ----------------------•--•-------•----------------------------•---•--.....-•_..... Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of MLE 5 of the State Sanitary Code -The undersigned further agrees not to place the system in operation until a Certificate of Complian issued by the board of health. Signed--,,.., = = --- ------•- �uC� 4 Date Application Approved By--••---- .......... . �5'�! • '.. r ate Application Disapproved for the following reasons:-----.............................................................................. ......................... .--• -•-_._.._ :_.... -•---•-- ----•••----------•----------•---_.......................................................................................................................... .Date Permit No....... .. _.. Issued....:. Date b pb FEs. ��. THE COMMONWEALTH OF MASSACHUSETTS �w BOARD OF HEALTH •..".......owi\r...._....._OF..��4el�iSC�.�)- .-: ................................... �Jkpvliratinn for Disposal Works Tonstrurtwh n Vrrmit .. Application is hereby made for a Permit to Construct ( ) or Repair (j..an Individual Sewage Disposal System at: LorSS ;Address or Lot No. Owner Address a G Ste- �O`z'1! ....................:�---.....-....-----•----- •--------- ----------...t0- . ............................... M Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms_3____________________________________Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ____.__ No. of a YP g ------•-._.._..-•---- persons........................-... Showers ( ) — Cafeteria ( ) 'Other fixtures ----------------•----------------....-----------....---------•----------..•.-.--------- --------------------------------------------- Design Flow......5�_�S..........................gallons per person per day. Total daily flow___.._ 3( _:.:.................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...�__n..._..___ Depth below inlet--- Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by --- --.._ Date.:....................:•-----...__._... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fX Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ......................•----•------•--•--••--••••....-------••-...-•----•••••••...--••--•••----••--....----••---------------------: -•------------ DDescription of Soil...........................................................•-•--•---...-•--•---•---------------------....-----------•---------•-----•----._.....•-•-----......._-•••-. W V -----•-••-•--•-•---•--•---•-----------------•---••-•--•----------•••••-••••-•-••-•-----------•-•-•-------------•-•••-•--------•-•---------•••---•----•-•••••----•--•-••----------- W . x - -----------------------------•••-•---- U Nature of Repairs or Alterations—Answer when applicable.•-- --_--o?^ -:____ ±�__ Y. ___w._�_. ____:5.... •-•--.....�_r,'� ��--�r ST �---.r_s.S. �J�--...-•.........................................--•------•-•-- 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 issued by the board of health. Signed... "' ! r .................. Date Application Approved By.......... �f, !. -`:,.., ............................................. -••---''= !..A.. .g'.... Date Application Disapproved for the following reasons:--------•---------------------••----••--------•---..._._.-----•----------------------•----••••-••--•-...-••••--- .....................................•--......--•-----------....-•--------------...-----.._._..---------•---•-•---------•--•------•-•-•-••-••---------------••-•-••---•-----••--••------••--_._...------ Date PermitNo-------K.K.......... 3.Q._.....•-•-----_..... Issued-....................................................... Date -------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................................... oF i 2��-s° .r. .�. ....................'........_.... (Irrtifiratr of Toutpliattre THIS IS TO'CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired y - ............. ^f -----------------•--...---------•---•--•--------••-----........•----••--•--•--••------•-•••- ` Installer (� has been installed in accordance with the provisions of TT?�'h�,,; j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-----n _5�_"��_�--------- dated....................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT•BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ...'�.. s •--•---•-•- Inspector----------------- - ~ .. - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0 19 No.... , ,. ...��......._. FEE........................ Disposal Works Tonutrudion "prrutit Permission is hereby granted C- ..'. =`-=...'•-S -F.---........................................................................ to Construct ( ) or Repair (fin Individual Sewage Disposal System at No.. ` 5`.�_.._S: ...7...._ �!G,� �k_v------•----1- "v``=- - b ...................................... Street as shown on the application for Disposal Works Construction Permit rNo. ` '__2.3.9_ Dated.......................................... -----------------•--•--••N,_:= ........................................................... t� J 1 (p' V L./ Board of Health DATE--------------�----�'-�---------=--......................................... • LOCKi 1UN1 SEWAGE PERMIT NO. a::cr-7. V 1 LLAGE INSTALLER'S NAME AND ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED Sol DATE COMPLIANCE ISSUED �� _� A-j OMD u1 '23� CAJ-e