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Home My WebLink About0359 STRAWBERRY HILL ROAD - Health 399 -s-r raw 6`rr y "t►t_ r a z4S - 1047 f SMEAD No.2-153LY UPC 12934 amead.com • made in USA �E FORESTRY WITIATIVE CaNfl�dRbuSourefno i I ASSESSORS MAP NO: No..91 L PARCEL N0: Fus... .:... ....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Uioiao 3 al Work.6 Toatotrair#ion Permit Application is hereby made for a Permit to Construct ( ) or Repair (&,0') an Individual Sewage Disposal System at: c Loca'on-Address or Lot No. Owner Address - . --. _---------.. ............ Installer Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-----------77E--------------Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ___________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------- -------------------- - - W Design Flow---------------IZD.....................gallons per person per day. Total daily flow------------— .....................gallons. WSeptic Tank—Liquid capacitv../-QQD_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........................ Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a ••--•••----•-------------------••-------••------•-------•---•-•--•••-•-•••••-••-•--•.._..._..-------......................................................... 0 Description of Soil.................................................--------------------------------------.. ............................................................................. x x ----------------------------------------------------------- -----`� -- ----------------------------------------------- U Nature of Repairs or A teratio_ns—Answer wh n appli ble Ivy J -----/060----4 �1.....A. oX...... 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 issued by the board of health. Signed -----8 J ��` lC -.. - �/-�//,?-57_ Application.Approved B �----- --- -- ------ �'`=_ . ........:................. .. ---.............. LYare Application Disapproved for the following reasons- ------------------------------------------- ........................................................................ . . . ......... ....................------------------------------------------------------------ ........................................ Daw I � � PermitNo. ----------------_--------------------------------------- Issued Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH "r TOWN OF BARNSTABLE Appliratuan for Di—tip t ial Works Cnnnitrnr#'ion amit Application is hereby made for a Permit to Construct ( ) or Repair (cam an Individual Sewage Disposal System at: ............. 4..y'....- � '� ------.C^E t i2!' VR--------------------------------•----------- Location-Address or Lot No. Owner- Address a P= ' ---------•---------------------------••--••--•-•••--••-•--•-••----•- ---f�----r:A,�a.--��a �„rJ ,c� :.. _:............ Installer p Address Type of Building Size Lot............................Sq. feet Dwelling=No. of Bedrooms-----------77 F_E---____-_..___Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building .__--_---_-_______-____- No. of persons____________________________ Showers ( ) — Cafeteria ( ) dOther fixtures ---------------------------------------------------------------------------------------......_...----•---•-•••••--•-•-••-•-----•------•••--......--•• W Design Flow................//0.___.___..........._gallons per person per day. Total daily flow-------------- WSeptic Tank—Liquid capnity_J0112gallons 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. I................minutes per inch Depth of Test Pit._______------_.-__. Depth to ground water........................ (J. Test Pit No. 2................minutes per inch Depth of Test Pit__.______---__._.--_ Depth to ground water...____------------._--. 9 -------------------------------------------•-------•----------------•-----------•-••----------..............=.......................... ----. -------- --•-- 0 Description of Soil......................................................................................................................;............................•-...................... x ...- -----------------------------------------•----------•-----------------....i•--------------- - U .ram✓ ft'o �� U Nature of Repairs or Alterations—Answer when applicable----n_entt- _.15�...._--- ....... _ 1`oX••_-. ----_-•----•--•--•- •---- 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 issued by the board of health. Signed .....F �-� a' 5� ,.. t r -�t: �<t f.�----------------------------- ...... Date' Application Approved B �....._..� t:.-2�a ��. � K r' .""'-;F/-. PP PP ` �,J Dare Application Disapproved for the following reasons: --------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------/---------------------------------------------------------------------------------------------------------------...... .................................. PermitNo. ................................................................... Issued .........: ....-- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ITI-e>r#ifi a e of C�omplian.ce Sewage,Dispbsal System constructed ( ) or Repaired by THIS IS TO CERTIFY That the Individual � f �A �J Insi I1. lc / ....... .... ....... ... , has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in ''• � � .. dated the application for Disposal Works Construction Permit No. _ _..._..�, _. -.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. __ -—, DATE---- -----------r1 F .........!(.' 11-..1. Inspector f= -.... _............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / TOWN OF BARNSTABLE r ( D Disposal Worhp Ton stnu t on "Vrrntit Permission is hereby granted................h =!�• c_-//W.�;.-----------------------------------------------------------------------------••--••-•-•--- to Construct ( ) or Repair (k-) an Individual Sewage Disposal System/ at No......................................... •... 3S"7---- 5�;r, ' ..._._..-C :t.....E .: ................................ Street as shown on the application for Disposal Works Construction Permit oo;.- i� � �.� Dated ------••. Board of Health DATE------ ........................... FORM 36508 HOBBS R WARREN,INC..PUBLISHERS vG` TOWN OF BARNSTABLE LOCATION XY"aA.43:e Mill_��SEWAGE # e► �/� VILLAGE _astur%t®, ASSESSOR'S MAP & LOT 9 j/, INSTALLER'S NAME 6& PHONE NO. <)? ��'�o y y SEPTIC TANK CAPACITY zooc) C.4u-- LEACHING FACILITYA ype) p,QMCdSZ: (size) loos Ge e NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER t-:44l c» a/JdeL Its DATE PERMIT ISSUED: 3 �?,S" DATE COMPLIANCE ISSUED:_/D VARIANCE GRANTED: Yes No �/ N N N _ 1 �. � ire �