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Home My WebLink About0152 CHESTNUT STREET - Health i5a Chcs�fncc� Sf.� /�cnno e3o9 — 03 3 C TOWN OF BARNSTABLE LOCATION — C ��, SCE" SEWAGE # 367 VILLAGE ASSESSOR'S MAP LOT aj® i INSTALLER'S NAME &. PHONE NO. C-44; �7— _ SEPTIC TANK CAPACITY /l j�vc✓ LEACHING FACILITY:(type) {'`�� '� (size) 6e4— .� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER c BUILDER OR OWNER DATE PERMIT ISSUED: '2 a / 23 DATE COMPLIANCE ISSUED: 3 VARIANCE GRANTED: Yes No i_�" I � � l( �' v J 0 � 0 � ?. . � 33 No.. ..- .! V THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOAR® OF HEALTH 8arnstahie G r,sri vatton Deperumni •� OWN OF BARNSTABLE �-a Sign � ltrtttt �n for Di�i�. wial Norlk. To.mitrurtinn jinmit Application is hereby made for a Permit to C011St'nCt ( ) or Repair ( an Individual Sewage Disposal System at ..................i ........ �..w ..----- -t�.---•-------- ------------------------------`-�•---------- 55.. ---------- ----•- Loc-ition :\ d � or Lot No. ...................... .._._'--------- ......................................... Installer Address Type of Building Size Lot............................Sq. feet .., Dwelling— No. of Bedrooms.__•_-3_______________________________Expansion Attic ( ) Garbage Grinder ( ) Other---Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------- --- - --- - d . . .... -• ------------•---------•--------- W Design Flow._.__...>`� - ................ ..gallons per person e ay. Total daily flow....--- � _............_........_gallons. WSeptic Tank Liquid capacitv,&Ml al Ions Length-_- ----------- Widt - Diameter................ Depth................ x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No.-_-..-�........... Diameter...`Q.......... Depth below inlet__6_.�......... 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........................ fit Test: Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil........................................................................................................................................................................ UNature of Repair,or Alterations—.Answer when applicable.---_:• ........... 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 iss d by the board of . ealth. S S'igne ............. _..�/�............ 1 . ............. .... Application Approved Bye............... _.. ..1�. .. ............. . ''1.. r' � ". .-Dare .'._J • Application Disapproved'for the following reasons: .. ........ .............. .............................................. ................... . ....................... ... . ........... ... ...................... . .....--............. .-- . .............................4... .......... . .......--.......... Permit No. .......,G..3. .... .�.�?-- ................ Issued ...... -- ........--......................-- ....Da.e..... ' Dare f �y�:,�a,,;_...,....�.-.-�«..�....b,•+�.,.`.,:yir'^.,y'�wi.^.•�-�rv�..�..v'S.,y�r•v",•vr'..--i:� .,,.v-': '•d7.f u .,.v >.e u..,v,. F, :- .W'. �...�"',.f "��u/•+-r.:+f"�.. ..v:. _. - -: .r- - -. � . .w i THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH TOWN OF, BARNSTABLE ,Nppliration for Dirip ial Worlo Tomitrnrtion Ilernfit Application is hereby made for a Permit to Construct ( ) or Repair Individual Sewage Disposal System at: ...... -----•----...................................................................... ---------------------•-•---•--------------------------•-----•----•------•----------••----.....--- t�-- Lorin/un-Add ress � or Lot No. �ti! !.� d L�_ .!_f I uF!:e.... i' ..............................................� -__ ..._...._._ ...._ ................_........................._. owner C Address , a �c�1 ✓1• - b�+lJ ?silr_lf' ay.-r �r <i'�/l � /��i... .............. ........... •- 1 Installer i �•-�-... Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.__._ ---------------------------------Expansion Attic ( ) Garbage Grinder ( ' ) aOther—Type of Building ---------------------------- No. of persons----------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------------------------------------------------- '---•---------•--•---•••-•---•-••-••......•--••.........----•- Design Flow.......''. a_._"?......................gallons per person per_day. Total daily flow...... gal WSeptic Tanker Liquid capacity&M�galIons Length...:------- Width .......... Diameter --------------- Depth................ x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. j 3 Seepage Pit No-------/........... Diameter--0.......... Depth below inlet---/,_!.......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test I Test PitNo. suits minutes es per inch Depth of Test Pit.................... Depth to ground water........................ GZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........._.............. a --••••-••--•------•-••-•--•--•-•----••••---•-•---•--•••----•---••••---•..............•--------•-••-•......................................................... 0 Description of Soil...................................................................................................................................................................... 4. W c..................................................... _ .... ....... ? .. - .......................... 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 bythe board'•'of health. Signed ._;.... --'......................-.-..-----------... ` f f .........................f `i mow, �..-.`.......�;..----....--- Dare Application Approved B � - .--... .. .�.:. .... Pp PP y ................... '.. - e . Application Disapproved for the following reasons: ............................................................y . ............................. ......--...........----.......... ........................ .......... . ......-- -.. -- ..:................... - .........--................:....- ......... ........................................ .. .................................... Permit No. 2 _ �'-- ------------------- Issued -..-..---------------- .........._.........--......LYare...... 1 Dare N I THE COMMONWEALTH OF MASSACHUSETTS -BOARD OF HEALTH TOWN OF BARNSTABLE THIS-IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by .....-.. �'`�.. ,! /z-?•'• ..( ....................., �,, r i -- - .... .... .. ....... ....................................... ....................... at ....................................:................./..-`�': -.. t a.r- j1:(--..: has been installed'in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the aPP Itcation for Disposal Works Construction Permit No. dated ...---'f,;. ..... ....._........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. -. ------------ ... Inspector -._ .. i- `, mn.................................. �.�•�.e.�:�..��..�..�mr�]e�i��J i�J�J�� _��.�e.�.�.�..�iv.�=s!raa4r..c'tr�..>��.��w��i��a�r��rr�J��y � �•��.�:�.�..��.r—.. ��.��.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .s. TOWN OF BARNSTABLE No....7-3:Jo 7 FEE. ._4:r .... Biopoottl Works Tonotrurtion Vrrntit Permission is hereby granted-----------------<�...! _ ___.0 . - '� -?- _•-.•.-------...... to Construct ( ) or Repair, (L)-an Individual Sewage Disposal System �( Street Q as shown on the application for Disposal Works C nstruction Permit No.__ Dated.......... ................................ ......................... -----------------------------•------------------------------- C/ Board of Health DATE------------------------------------ ....... -------------------------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS