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Home My WebLink About0150 GUILDFORD ROAD - Health (2) /50 C-at lc(r-ord QeL, Cen,� _f I, qq 171 — THE COMMONWEALTH OF MASSACHUSETTS BOARD -OF HEALTH TOWN OF BARNSTABLE Appliratiun for DiupuuFal lgorko Tonotrnr#iun Vrrmft Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: vb� Lo tion-Address or Lot No. Address Installer Address Type of Building Size Lot............................Sq. feet V Dwelling No. of Bedrooms._.-3_______________ _..-_Ex ansion Attic U g— '--------------- p ( ) Garbage Grinder ( ) 04 Other—T e of Building ______________ No. of ersons._.________.___-.____.__ Showers a YP g -•----•------- P. ---- ( ) — Cafeteria ( ) Otherfixtures --------------- ------------•------•-••-------------•••-•---------•-••-••----------•--------••-----•----•••-•-•--...-----•-----••----...._......•--- W Design Flow.__..__-1f�......................gallons per person per day. Total daily flow---7 3.6..........................gallons. W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........I Diameter..... . . .r....__ Depth below inlet...&.(.......... Total leaching area..................sq, ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY----------------------------------------------•-------_------------------. Date 14 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........................ C4 ------------------------------------------•----------------•---••---------...-------._...........--•......................................................... 0 Description of Soil........................................................................................................................................................................ x x -------------------------------------------------------------------------------------------------------------------------------- ----- ---- ----- ------LE--- Nature of Repairs or Alterations—Answer when applicable_.Z A—:51:�__:._I __ t9,� ____ _ _.__.. ----- ... r� ---•----••----------- ---------•----- 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 iS5� of th. Signer ..... - `- '- PFk Application Approved By ....-- - ---------- ... _ - e �. . "F Date I Application�Disappr ved for the following reasons- ------------------ - ---------------------------------------------- - - ---------------------------------- ------------- ...-. ...--'-----------------------------------_....................--------------------------...............................'----------------------...--....._.......--.. ...----Da................. p Permit No� ..--I............................................................ Issued -------............................ ................... - � Dace i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Agpliru#ion for Uiiipnsa1 ltirk,5 Cnnnitrurtwit firrutit Application is hereby made for a Permit to Construct ( ) or Repair ( Individual Sewage Disposal System at: - _....... .....l! ......Five—L------ ------ --------------------�.r .c!�Z e v 1 ....---------........----•-........... .. ..... Loc tion-Address or Lot No. .. an.L0.�....................................... ................ S__.�!��wv�� vvww Address Pa Installer Address UType of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms-___3----_----•.......................Expansion Attic ( ) Garbage Grinder ( ) aOther—T e of Building g ____________________________ No. of persons-------------------...------ Showers ( ) — Cafeteria ( ) Otherfixtures --........................................................................................ W Design Flow--------- .....................gallons per person per day. Total daily flow--- .........................gallons. W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No._._.__�------------ Diameter....../.0....._.. Depth below inlet....62(.......... 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........................ rIC4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 9 --------••----------------------••••-•-•-•-•••••-•-•--•••-----•--•-•--...........--•••••••-•................................................................. Description of Soil......................................................................................................................................................................... x U .....---••---•-----•-•-••---••--•-•---•...••••---•--•-•••------•••••••••------•---••-•---•.........--••-•••-•••-----•-•--•---•---••-••----•-•---•------••-•---------------•......•-----..........-------• w .................................................................................................................................. ................................. 1 V Nature of Repairs or Alterations—Answer when applicable.___- ------.....0 ......--0 - ...... f ri 7�� ------------------------------------------------------------------------------•-------------------. 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 is-sued-by-the board of health. Signe �-.._ .... ... -------.k -- ............. -----5-.7-�'-c!.' " Application Approved Byc= ��Y..... ........... - /.l .. Application Disapproved for the following reasons- ----- --------------------------------------------------------------.......-- .. --- ----------- --- ----------- ----------------------------------------------.......................................................................................................................................... --- .................................. Date PermitNo- -------------------------------------------------------------------- Issued -------------- .......................................... Date THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( �---� byA 4 (/G......................---------------------------------- ----------------- -------------....................----- --- ` // Installer at ..... ................. / �� CI (/lG Ui ...........-Y------------- ----- - ------- . : has been installed in accordance with the provisions of TITLE 5 of The State Environmental C de as described in the application for Disposal Works Construction Permit No. _ _2 --- dated .. �'.f...7.2------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................................... oL-------.. ...... Inspector t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � 2 2 i3 TOWN OF BARNSTABLE - � No...................... FEE......... Diapas tt Vorkv Tungtr i.un rrutit Permission is hereby granted----•---•G?��4i4!�:Lr4 yS lD%d • ........... - r e4Disposal System at Nonstruct or Repair �� Individual Sew ag- C�K T to ( ) P )a9 -U..._G 4l l�.z�,,�. ./ •. ----�._... ----••-------•--•---•-•---•--•......----••......--•-•................ Street as shown on the application for Disposal Works Construction Permit No...R.2...: Dated----------- / S� p-----•--t................ ........................... --.................................. ��2 Board of Health DATE............. --- FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS No.. ............... F$$...... ..............._ THE COMMONWEALTH OF MASSACHUSETTS � BOAR® Ir HEM► �f H ...............OF..... ............................................................... Appliration for lkspasal Works Tonstrurtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst at A(� ...�'.................. ation-Addres ... ...... ... .... .. .... .. - ......................................._.. AAd "�orLotNo. �� ..... t1�2 Qom..__ M ............... s...... ... er a ........ . ----- --- ............................. --•kgAdes"ser Installer s �+�� T of Building Size Lot.....-.5...................Sq. feet Dwelling—No. of Bedrooms............ ...........................Expansion Ate, ( ) Garbage Grinder ( ) P4 Other—Type of Building C. dvz-- _ _______ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Otlier fixtures ------------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow.......... ............................gallons. P4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ xDisposal Trench—No..................... W' t ....... Total Length.................... Total leaching area.._..-__------- ,,sq. ft. Seepage Pit No-------- ------------ Diameter'--- below inlet.................... Total leaching area.,P......sq. ft. Z Other Distribution box ( ) 4sin�gnk ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I.................minutes per inch Depth of Test Pit.................... Depth to ground water___________--___-______- GX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•-- . -----------••----------------------•----------------......................................................................... 0 Description of Soil____ .. x 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 Article XI of the State Sanitary Co —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ed Abye rd health. Signed ---...... at Application Approved BY ... .. 2 =----------------•------.._------•- ---f 7- f/ Date Application Disapproved for the following reasons:--------- .............................................................................. ---.....--_-.. ...-•.................•••••--•------•-----------_._......•-•--•----••--------•••--•---....---••-•-•-...--•------•--•---••--••-•-•••-•---•-••--•--------••--••-••-•--•--•---..._•--•.................... Date PermitNo........................................................ Issued........................................................ Date ---—----------------------------------- _..___---------------------- ----------- ------------------------------- p 1 THE COMMONWEALTH OF MASSACHUSETTS '4 BOARD F HEALTH ...... . .... ..OF..... r�t *° "° '`. ppliration for 15isposal Iforkii Tottotrudion -ermit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal i Syst a t .... ... __ ' .. ........ .......... o ation-Addres ..,... .�d. i ::.. ...... .ld:rs ....... rk..................... .... :... ..... .�::� a "Lot No...... In er Ad 1 ...... 6:• .�..�.......r arrf: . .'�_... ...................... �...y... `....�.. .... ........t..od`ea: :.��........ '. Fal ... .. ..... Installer U T of Building Address . g Size Lot-__ --•-� :._...-Sq. feet Dwelling—No. of Bedrooms.•............ .:..:.......................Expansion is ( ) Garbage Grinder ( ) aOther—Type of Building dP..4 No. of persons............��............. Showers ( ) — Cafeteria. ( ) 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......:.............. W' t1 ------ Total Length.................... Total leaching area..... sq. ft. Seepage Pit No..................... Diameter_..._. Depth below inlet...................: Total leaching area. _._.._.:_.sq. ft. Z Other Distribution box ( ) Ising tank ( ) aPercolation Test Results Performed by........................................................................ Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ riq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 Description of Soil = ....ts �''" ... - - - - - - V .....................................•••-•••--••=••..._..•••••••••••--••••••---•-••••••--•••••--••••••-••---•••••-•-•--•••-••••••--••••••••--••--•••••---•----••••••••-•--•......••••..............•••••- 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 XI of the State Sanitary Co The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ed by e mrd f health. � F Signed ate Application Approved BY -------------- ---------- -••-••_� _ � .. .:- Date Application Disapproved for the following reasons--------------- -----•-- •--•--•-••••..•••-- ......---•---•................•........------•-------------•----........-----•------------•••----------...------------......•-----------------------------------------••--------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... ....................OF... .. . .................................... Trrtifirate of Tootplitturr TkH IS TO CS IFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by. ?jam. '` ` ----------. { 61 Znstallei f at..........-- --- 7 t '.. ._. ... has been installed in accordan with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... ................ _3.... dated_......04: , : tr` _ ------------ 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 9F H .AL 11. w ..........OF............................: No.........r >'.„ FEE.... Rohr Wark4l n potrurtiott thrmit Permission is hereby granted...`.:_ .................... ....... ...... •••.................................... to Construct/ o epair" O - In 'jdual age 'Dtsp S. atNo. yf . .................. >. ' .................. ''• rStreet 2 as shown on the application for isposal Works'Construction Permit No. . ........:.. ...✓ t ............................... Board of Hcalt DATE.....................................-.......................................... ..»• FORM 1255 HOBBS & WARREN, INC.. PUF.LISHERS }'�