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Home My WebLink About0055 ELLIOTT ROAD - Health SS � l�;ofi Rd Cf,n�e Cui�JQ zy8 - Zy6 SMEAD No.2-1SKY UPC 12934 smead.com • Made in USA fORESTit� 14MATIVE Car"Wba Qawoft r TOWN OF BARNSTABLE i.00ATION JS` F L.L1®V- �('� ,Id _SEWAGE # .9 iP VILLAGE C'c-N7yeul�f ASSESSOR'S MAP & LOVUy8 - � INSTALLER'S NAME & PHONE NO. �kiftzl. SEPTIC TANK CAPACITY T LEACHING FACILITYAtype) t-( G ,3 r- (-Ty- . 1 (size) NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER O OWNER. DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �= „. �� c_.. I(, _ �� d 61 LOC&TION ' SEVVW:,E PERMIT UO. INSTALL R 5 ADDRESS BUILDER 5 Q &MF- ADDRESS ME PERNA ISSUED '- T IT = - - - DATE COMPLI &IACE ISSUED : �® �' _-- i „� °� C� 6 �� i �:. -�._ � �� . ,,. No.- --_..... FE$...... ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE - J Appliration for 3liiltusal Works Tonstrurtiun Farm# Application is hereby made for a Permit to Constructer Repain Individual Sewage Disposal System at: .... "...... u.OT................... ..... ..... .... ................ -.•-.....L tion-Add ss V. .........--- � 1 V� C ` - V;`\ Lot No. lY..`. ..�_ . weerq a .......... -=`-�....... 'S? :3 �..d.. Addres/s ....... . � Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d 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. Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by.......................................................................... Date-----------............................. Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs, Test Pit No. 2................minutes per inch Depth of.Test Pit__.:-_----.___-__--. Depth to ground water......................... a ------------- ............................. O Description of Soil....... '_ __...._.�(GL3................6Z— x /'? S' &-------------------------------------•--------•-•---- U ------------------------- ------------------------------------------------ -------- .------------------------------------------------------ ------ •--------------- •------ ---- •---•----------- ---•- W x -••--•••---•-----------•-•---•----••--••---••---•••-•----------••---•--•-••----••------•••----•--------•-•--•--•-•--- U Nature of Repairs or Alterations—Answer when applicable..___1f�Z>�-__---___�999n-----_-1 o ,- � h(aotZ- • ��. . .................................................�)- 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-b the board of health. Signed I cs . - `�—... Z Y�.Qt--.... Application Approved By ..... . . ........ ................ eApplication Disapproved for the following re --.............--- ------------------------------------------ ------------------------------------------------- a DarePermit No. -----------------/--------------------------------------------------------------------------------------- Issued .-.. - I--------------------------Dto- l THE COMMONWEALTH OF MASSACHUSETTS \ BOAR® OF HEALTH \ TOWN OF BARNSTABLE l� , • Appliration for Uhipwial Work.5 Tnnv' trurtion Frrutit - Application is hereby made for a Permit-to Construct, j��r Repair Individual Sewage Disposal System at: .... --•--....��.! ..................... ............... x-b ..------.X, .......... Lp�ation•Address i1o'r Lot No. .... .1 ........ -n=�,S.� 3......................... ........��_ _1t��. .. `�` - •--•---•--•.......---•-•--......-------- Owner Address a e- ��-4 4 ..� ----- s 11. - ° -----•...fdo Wit. -= r` ... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............................. .. .....Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ............................ No. of ersons...._................__..__. Showers — yp g p ( ) Cafeteria ( ) A4 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 ( ) '-� Percolation Test Results Performed bY........................................................................... Date........................................ a Test ;Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-___-_________-•---.--. Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x -------------------------------------------------------------------------------------------------------------------------------•••---•----••--•-•...---••••-- 0 Description of Soil------.0--, ---------SLIB................j5L- ------------- ---------� -----------------------------•----------------------- U ............................•--•------------------•------------------.....----•-----.......---------•---------------•----------------------------------------------------............-•----•---•---- W 1 x ........................ .••--....._..--------•-----------------------•--------•--•--•-••-••••-•-•---•-•••••--------------------............•••.............. ii U Nature of Repairs or Alterations—Answer when applicable.... CE 9�X?...-......1 •........................................................ 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/ .o..... � ..-,�.1-`- ..--. --- �.��y.�.°?.Z Application Approved B lv� ------- . ..... . ........ 1e- pp PP Y �: �� Date Application Disapproved for the following rear f• . ...................................................................................... ............................... ..................................... ------------ ------ ... ... ................................................................. - -- ------------.---- . t a Permit No. re ssued ------ D,6te I o THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Gex#tfiutt#e of Tomplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ......_ (l<f L..............<!0-oh)-S. ....................................................... ..---------------------- --- ---------------. .--------------...-------------.................... Installer at -------- .....OA......I------------......E.NJ-._C------YZL-........................LO !� // has been installed in accordance with the provisions of TITLE of he St vironmental Code as described in the application for Disposal Works Construction Permit No. .- � � ...... dated ................................................ NSTiIU THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO D AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ................................. .I:/.�- ` ......................... Inspector ...r' ... :..�I..,�.... ji ,� - --------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH q TOWN OF BARNSTABLE NO.--.!...-. FEE-S0.. - T .... Disposal Works Tonstrudion Wrmit Permission is hereby granted...... .......Cl......s :................•._._____.................................................................. to Construct ) or Repair an Individual Sewage Disposal System at No.....:=�...•--•--.. ........Qo i1 ------------ Street as shown on the application for Disposal Works Construction Per o .�.. . Dat ....................... ... ,. Board o ealth DATE------------------ .-- --j � �' ----..........--- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS No......................... �FE,... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF........ ... ........ ... . ................. Appliratinn -for BitiVomt Works Tonfitrnrtinn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: A- ........... &.......- 5 � v"!- . ••----•--------•-----•----------------- `......-----------...-----------•--------•--.....------. Location-Address n or,Lot No. w _ .. ..lut, .& ............. Installer Address Type of Building Size Lot.f'.4�_4-'Y9...........Sq. feet Dwelling—No. of Bedrooms-------3------------------------------------Expansion Attic ( ) Garbage Grinder (MO aOther—Type of Building /........................... No. of persons..______------____.___---.-_ Showers ( ) — Cafeteria ( ) Ct, Other fixtures --•---------------------•--------------------------------------------------- w Design Flow------ ...............................gallons per person per day. Total daily flow...3_07 __-_----____.___-__-.-.--.---gallons. WSeptic Tank J--Liquid capacity/IV--a--gallons-gallons Length---------------- Width................ Diameter---------------- Depth------.--_.----- x Disposal Trench—No..................... Width.................... Total Length_-_-___-__-_----__ Total leaching area--------------------sq. ft. Seepage Pit No./__________________ DiameteriO.-A.I.P.. 0� _._._. Total leaching area---_---_-.---__-_sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 6 _, `7- 7 6 a Percolation Test Results Performed by.......................................................................... Date.................................... a Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water-----------.--.--.--.--. L7, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_---.---_-.-_------.... Ix ------ ----------d--��--�-----•-------A t----------- Description of 4oil------••-_..O.'a_��I -0. - � — = w UNature 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 ode— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issuedn�b�y )t board of health. igned. ---- . ---• 0 6=" 11_::ZY. 7(1... Date Application Approved By------------ { Date Application Disapproved for the following reasons: -----------------•-----------.....----•------------•-------•--•--•-••------- .._......-•--•--•----•...........•••---------------------•-------------•--•------•-----•----•--------.---•-------------------------•-----•-----------------•---•--------------------------------------- Date PermitNo......................................................... Issued........................................................ Date No- .... ............ A�- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .7.........0 F.......... ..............._...... Appliration -for M-4poiial Works TowitriArtion Vaunt Application is hereby made for a,Permit to Construct or Repair an Individual Sewage Disposal System at: & -I'# ct ............. ............................ ...................................... ................................................................................................. Location-Address or Lot No. a.. ...... . . ............................................... .................................................................. - ------------*------------ ..................................... .................................................................................................. Installer Address Type f Building j�' Size Lot.../. ..................Sq. feet U -3 Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic Garbage Grinder Other—Type of Building J--------------------------- No. of persons_._....._._.___._.___..___. Showers Cafeteria Otherfixtures ..... ---------------------------------- ----------- ------------------------------ ............5i��---------------------------------------- Design Flow____-- ..............................gallons per person per day. Total daily flow___-_----------------------------------------gallons. 1:4 Septic Tank-I-Liquid capacitv.n gallons Length________________ Width.____........_.. Diameter.__._...._._--__ Depth.-.-..-__._.... x Disposal Trench—No..................... Width-___-__________--_-. T-9tal Length-__--_ ........... Total leaching area------------_-----sq. f t. Seepage Pit NO.__[_________________ Diameter..�q:rq. Total leachiagarea-----------_-_--sq. f t. Other Distribution box ( ) Dosing tank .2 -1 7 / Percolation Test Results Performed by---------------------------------------------------------I................. Date__--.-----------------.----------.--.... Test Pit No. I----------------minutesperinch Depth of Test Pit.._.._........__.___ Depth to -round water------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.___________-______- Depth to ground water------------------------ P4 -------------------------------- ..........I.............. -------------------- O Description of Soil--------7�--- =_�3. ........ --- ----- ...... ........ --- --------- --------------------------------- U ---- -------- ..................2---------h...... o ... .... ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------- -------------- --------------------------------------I------------------------------------------------------------------------------------------------------------- ----------------------------------- Agreement: - _-ic The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary C de— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b issued by the rd of health., ................... ..................igned----- ----------:------OtT�----------- ---- r Application Approved BY--.... -------7 ---------------------- ......... Application Disapproved for the following reasons:------------------------------- --- --------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo.---..................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH QOF............ .. . ............... .......... 46 -a 01 rrtif trnfr of T"Tomphaurr THIS IS, OC T hat the Individual Sewage Disposal System constructed ( 1-�'or Repaired by.......... �: ------- -- ------- . ............................. ................ ....... ............... _Zft- ------................................................... Xy taller at.... .... ...... .............. -- --- has In iprovisions of Ar 'I of The State Sanitary Code as described in the s ha. been installeoin a r wit t application for Disposal Works Construction Permit No. __-7... ....I?---s. ............. dated........--------;Z ...... THE ISSUANCE OF THIS CERTIFICATE SHALL OT BE CONSTRUED AS A GUARANT THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ ................... Inspector--------------- ...... ----------------- THE COMMONWEALTH OF MASSACHUSETTS ir'li.er- ---- -----:_�0 TI-I �LL OT BE BOARD OF HEALTH '7& ..........................OF............... .. ........................... ............................ N .........49p�r... • FEE......................... 1 fit_ Norks onstrurti it r it Permission is hereby granted........... -_.. / .. ........................................................................................... to Construct or Repair a I I ua sat System at No 4e�.... ......... ... . .............. ------- Street ' --------------------------------------------*---------------------------------- as Aon th' e' apkatio al 'd' ./orfkascons r it Dated---------_--------------------.......... -- -- ------ Boa Heal DATE2;��..................................... ................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS To5GPH WARCHAI L. CT UX F1,84 227 PG• I IV I /oo• oo _ ` PC.BK 274 P&64 ' 4-► M 3L ±t %j Ex/577i MG m • D? FouNDATioN 0 0 �9 ® 0 Q R.BK 274 pG54 N vT to 080 69. F77 o M � a /o0. 00 W I 0 z 40T *� r Pl..6K 27¢ PG. S-4' , CE,e T�GiED /'Ge,7-' pG�9n/ �oc.v7%o� - CENT�>zv/LGE, M955. +4, 5cwc /'t2o' Dw& YwoeN/9, /976 'N . oN f! PI4nN /=olz Gv57-AV W, ALSER-TI ,IND RECoEDED iN PG4M 8,C 244 P6. /23 s c',erFY TNgr rNE ��o4Tio� SNov^/i✓ oN 71yiS 1::�UlA/ /S ZoC�9TED OtV T,q/Z- O"RouNO I'K SIYOW^l //E/W-OA/ qNo 77V47' /!'Ca✓Fvlz MS 7o T/,/E Z oMiNG Z4M/S of TINE Town/oF 9,#RiY67,,94S4E, LoulS F2AN6�oNE - T/oNEZ /�� STETSo v s',¢EE� ,NyAA//v/s M,4kcH /9/976 f'• R-C& e-f^llo Su"e✓Eyve—