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Home My WebLink About0165 WARWICK WAY - Health (2) VJ =� ASSESSORS MAP NO: PARCEL NO: No.. .1.&_ FEs.......................... _ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOW O RNS�TABLE ,��lu�fnx �i��l��tt1 Iark� �l�ri,��A�I�iltri ��nti# Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: ..._w e.� Location-Address or Lot No. `� ..........�N21Ur`.T----------------------- ......�vTs..��J'�u.� Owner Addres -5 '—. 1. J °1k 6�3C �' t� ................ •-•-•• .............................................................. Installer Address Type of Building Size Lot.............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P� 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GT., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------------•--•-------------------------------•---•--------------------•------------------.------...-------•-----••---._.._..-•--•-.............•--- Desccr�iption of Soil C - Z.._._._SU-r�---•............. .^- Y � ... '- ......5 ....------------ V ......---••---•----•-----------------•---•-••-•--•-------.....------------------------------------------------------..........•.....--------------••------.........---- -------------------------------------------------------------------------------------------------------------------------------------=-------------------------------•-•----•-- -••----•:...------••••. U Nature of Repairs or Alterations—Answer when applicable________ �� .........6�?. ---------- 4.4 ....._�� `a"O ................................................ ...... ....Y\St.....-.....---•-----5`CS'f ..... --------------------------------------------------•--------...---•---•---- 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 .....Cl .�..-.....-�-------------------------- ----- --- ..... �°Ib Date Application Approved BY J ... .. 4^ ;�,e.................................... Dace Application Disapproved for the following reasons- .................................................................................................................................. ...-------------------------------------...---------------...............................'...............................................'................................................................... ............-----Dace----------...... PermitNo. -------- d -------------------------- .Issued ................................................ -------------- -Date L !1 Fim............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `{ TOWN OF BARNSTABLE , pfirttti�a�n for Biipnsa1 Workii Tomitrur#iott ramit Application is hereby made for a Permit to Construct ( ) or Repair Q<) an Individual Sewage Disposal System at: ' LA .Location.Address ' or Lot No. ��h �-..... ».c.................... ... ....v..u:.....----------------------------.....------------------.......--- Owner .. r, . % 'L « .........---(--•-------- ..._ __ N v � Installer; Address UType of Building " I• f f Size Lot............................Sq. feet �-. Dwelling—No. of Bedrooms................................f__.,�. Expansiorr Attic(- ) Garbage Grinder ( ) p, Other—Type of Building............................. Vo. of person's........... .....-,..._.___. Showers ( ) — Cafeteria ( ) ;,r yam. y � Other fixtures'---'e-------------------------------------------------------------------------- ..- WDesign Flow... .......................................gallons per person per day. Total daily flow_.._.._.._........_.........................gallons. WSeptic ank j Liquid capacity............gallons Length............... Width................ Diameter...`__._._.___. Depth......... x Disposall 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........................ 44 Test Pit No:, 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •- ------ ---------------- ------------••-------•---.---.---------- ------------------------------------------•----=-------- xDescription of Soil------- 2' SU Q 2 y mg-='��- --t o.. ` S ..... U ----------- -------• ------•....................................•--------------.-----------------------•---•------- U Nature of Repairs or Alterations—Answer when applicable_......_�`»__-_____.- E___......` Oozy .\AL-�ovO Witte��•'"�`-----�•��----------�••-•-•�X ..-� w ---------S�tSTLF±!�---------•------------------------------------------------ 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 Com liance has een issued by the board of health. Signed-C c� ---�--\ - --------- ---------------------- t �y `�d�\ 2 l � Date ApplicationApproved By ........... R ......--------------.------------------------------------------------------------------- --------- A p plication Disapproved for t fo g reasons: ........................................................................................................................................ ................................ ..... ............ ....---------...---...----.....-- ---.....---...---..... Dace PermitNo. .......... _f a .......................... --------------- --- Issued ...--- -- ....------------------..........-- --..--.......-- Date THE COMMONWEALTH OF MASSACHUSETTS. - BOARD OF HEALTH TOWN OF BARNSTABLE Ge ttfirate of (11"Untylianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by........... .... ...... Installer v at .......65.........E t`�CL...J_\C\L.--- -.--..5 Pc Cal .►V'TE .w... Cl ------------------........... ------------4-------------------------------------- has been-installed in accordance with the provisions of TITLE 5 of The Sta e;Environmental Code as described in the application forlblVosal Works Construction Permit No. ......... - - dated -/.J........................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C6 Tr�t -ED AS ..dated THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......... ...- Q..........._------------------- ------------------------------- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH }} TOWN OF BARNSTABLE FEE.. v......--/ Disposal Varkg Tonartutiaart Orrmit Permission is hereby granted...... ....... S`T......-C'O%�`�c-............. ..................•-•--. to Construct ( �) or Repair ( an Individual Sewage Disposal System at No...........�S_ W P-��cK %, ` -•--•-•-• ..................... ;.....-•••••......•--•-.......... -•••••--------•------••••-•-.....-•------•--•----•--••------•-•......--••----•-- Street as shown on the application for Disposal Works Construction Permit No.___0a..1rk^ Dated............ _..._2..: . ....................................... i ....... ................................................. Bo f Health DATE..........................................•-•-----------....--•••--•••••••.-•-.. \l FORM 36508 HOBBS&WARREN.INC..PUBLISHERS