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Home My WebLink About1162 SHOOTFLYING HILL RD - Health rPl ✓ilie SMEAD No.2-153LY UPC 12934 smoadxA m • Mods in USA FORRESTI7Y INMATM f @ditwSww9ino w�wrbraei�� F G TOWN OFF BARNSTABLE LOCATION .. i,�� ,.S�n opt lv�..r-� .1�'i. SEWAGE .# " / /10 VILLAGE QL,�) S ASSESSORS MAP & LO � INSTALLER'S NAME & PHONE NO. (Aa, M<, SEPTIC TANK CAPACITY �4 C"�► LEACHING FACILITY:(type)�,� f L (size) o7 Fe(I cS NO. OF BEDROOMS v PRIVATE WELL OR PUBLIC WATER 1-cJ BUILDER OR OWNER Sc)cxj\r-\z E 3t� C}-/-N DATE PERMIT ISSUED: 14 ( a<,�(c DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �/ d� �.. s r �� / 1 ` W � i � � � � . `=�/ v a -� ��o� c.<y ��,� ��t� �c1 1 Ci- of c No...q Ll. »I 9& FRR.........0..00...... APPROVED THE COMMONWEALTH OF MASSACHUSETTS rn ble _ BOARD OF HEALTH TOWN OF BARNSTABLE Signed Oats ,�ppliration for Di�ipaiial World, C�owitritr#iun truth Application is hereby made for a Permit to Coiist-uct ( ) or Repair (L ) an Individual Sewage Disposal System at �- L�atyy Addy ss or Lot No. a •-- v-1�---l._.�-r�. !.l �r--••-•-'r-•i -"•�----"- --- t--- ' -- -dress �C.1.n.�..�.. ................. d Installer Ad Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms......___________________________--__---._.Expansion Attic ( ) Garbage Grinder ( ) a Other—Type per of Building ---------------- No. of persons_.--________--.:_-_------- Showers- ( ) — Cafeteria ( ) d ............. ------------•-•-•---•-•-. --..._._......---••••-•••••-••••--••---•••----............... W Design Flow.......__.__.."...� L-•__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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 Description of Soil l`/-------------------------- •-•-•-••-•-------------•-------------------. ----------•---------------- -----•---------•----------- V .....--•--•----••---•-------•-•...............•-•••-•-••-------•----•-------•-•--••--------••---•••------------•-•-•----------------••--••------••-•-•---•--•-••-•--••-•-•----------- W ............................................................................................................... . ............................................•....... �........ x U Nature of Repairs or Alterations—Answer when applicable._....._... _ 1�G�,. c _.�5 _ Q ,5.�....w� . 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—T,JiL undersigned further agrees not to place the system in operation until a Certificate of Complipqce has been issu the oar of health. ined ...` ...................... ......... _ Dare ApplicationApproved By ...................... ..................................... ........ ........ .... .......... Application Disapproved for the following reasons: .................... ... ........................................ . . ................................................................................................................ ....... ............................................................................. .............. .. ................... — �1/ Date Permit No. .....5Y---- --1... 6.......................... Issued ................................ Date No........................ Fss...................�.... THE COMMONWEALTH OF MASSACHUSETTS i / _ BOARD OF HEALTH �'�TOWN OF BARNSTABLE Appliration for 7li!ipwial Wi or1w Ton,itrnr#inn jiumit Application is hereby made fora Permit to Construct ( ) or Repair (V) an Individual Sewage Disposal System at:� -...�............................... � :...._. .�........... .............---•.-•--•-•--------•---------•----•.........-••........................_........... Lo ;it y�•(Addr es n Q or Lot No. n -------•-- ..... X.--•------ ---------- ----- .......... � +�' ^ ............_.....................................--.......... -.. PQ Installer Address r VType of Building �`. Size Lot............................Sq. feet ►, Dwelling—No. of Bedrooms____________________________________-_--.--Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther lures ----------------------------------------------------------------------------------- ------------ -------------------------•--------------------. W Design Flow......t ,. ..___.. �A -____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. 3 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........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 11 l ............................................................................................................................................................ 0 Description of Soil........X CLY.............. V ....--•-•••-•••-•--•..............•••---••-•--••-••-•...•---•-•-•-.._..-----•-••-•...--••------•--•-•--•--•-••--•---•-••-•...-•------•-------•--•-••-------••--•.._...••--••..............----••-••--•-- •-- •-------•-- .......................................................................................... j.._.._.. '------- U Nature of Repairs or Alterations—Answer when applicable 1�.C(_._ _.. 5 . .2Q _. __....w 4-� e. 1�.....�5'� G G-LUn �ct�..,V= ` `�? 4X .. v� \- -5br. - !..tf s . 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—T undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu by the oard`of health. Signed �-..................... �-- Dare Application Approved By .... —..-.-. / ............................ . ....................... .-- ......--................. ....--...... ..._j./...ZS�y ........ Dare Application Disapproved for the following reasons: ........................ ...... . .. ........--........................--........ ...._.......................... .... ............... .............................. .... ..... ................................................ .... . . -- --........................ ....--........--........................ PermitNo. ......../..----._156......................... Issued ....................................._ -.................Dace..... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cfer#ificttte of Compliance THIS IS �(O CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ...:......... _... -r1i -..--.-..-.:(` . .5------- ...----------._.....-.-.-.-... ................................................................................... - at ------------k-k...C�.01-------------Sin-c.� ...�r...1�-- ...-\�-1-1...- ..c)......--....................................................................................................................... has been installed in accordance with tfe�rovisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ...`'J.(-.---..-_1...................... dated .._.......................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................... ... .. ^...L-._..: ...�... .. ..........._.............. Inspector .. V,...-,.\ .... _-...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T/—j14 TOWN OF BARNSTABLE No .................... FEE........................ Disjum ll Worse Tnnotrudinn "amit Permission is hereby granted ��.C... ,�...�^-� •----- �= 4 C C�, -�.. to Construct ( ) or Repair (V) an Individual Se),age Disposal System at No........ .�.! .. Street as shown on the application for Disposal Works Construction Permit Nol. y_!___._..__ Date _._..y 2..��`�................ --------------------- --� ,, �----- -- . ................ 1/Z Board of Health DATE------ .. .............................................. FORM 36508 HOBBS&WARREN.INC..PUBLISHERS