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Home My WebLink About0080 COUNTY SEAT STREET - Health 80 Countyseat Rd 291-112 Hyannis i i a . i TOWN OF BARNSTABLE ` c'' LOCATION 6044 `S 4 SEWAGE # lug r VILLAGE ASSESSOR'S ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. rl SEPTIC TANK CAPACITY_ S LEACHING FACILITY:(type) �n C__W AW-�S(size) r, vn ®'�L NO. OF BEDROOMS l- _PRIVATE WELL OR UBLI WATER BUILDER OR OWNER DATE PERMIT ISSUED: loci tc, DATE COMPLIANCE ISSUED; ' 9S VARIANCE GRANTED: Yes No y� G 51 v ASSESSORS MAP NO:� �J . PARCEL VOL _ l . -51 N011 FEB.... �. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Divjipuml 3Vnr1w Tontitrnrtion ranfit Application is hereby made for a Permit to Construct ( ) or Repair %., ) an Individual Sewage Disposal Syst at: S CJ�r ..................ocation �dd}•;s -----••-•-- -- Lot No. ' ...... �- Owner - Add ess � � ......................... ------------------------------------------- --� --PJ ....r.---c 1 ��?---�y .......... Installer Address UType of Building Size Lot............................Sq. feet t Dwelling—No. of Bedrooms._...__._. ? apansion Attic ( ) Garbage Grinder ---------- - - - aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' 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. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-----..-.----__-_---....- f? Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ --------------------------------------------------------------------------------------'-•--'--------......................................................... ODescription of Soil................................................................................................................................................. ...................... W x --• --------- ----------------- ---------------------------------------------------------------------------- -- --(��----------------------------- -•----• - U Nature of Repairs or Alterations—Answer when ap licabl ...._ �- e�5s ¢al.rs......................................, -- - 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 Complia e has been is of health. Signed ------ � Dare Application.Approved By ------------------ Dare Application Disapproved for the following reason . .............._-- -------- -- .. . ................................. .................. -------------------------------------------------------------------------------------------------------------------------------------------------------....-....-......----------------------..---- ----------------------------------- Permit No. 1 � ------- Issued ........��...r ---- - .....: Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cer#tf rate of Comptiance THIS IS TO CERTIFY, That theljidividual Sewage Disposal System constructed ( ) or Repaired ( " ) by ........................................... ...... ................ .. . ....... -------- .r. ---------------------- ------------------------------..........-------------------------------------- eInvralle at ............... %.0----------cot.>n. ...y.._... 2Cs SC. -T��✓�','`-N... .... has been installed in accordance'with the provisions of TITLE 5 6t The State Environmental Code as described in the application for Disposal Works Construction Permit No. .- '1 A.- - '. dated ._,? --- --- "�--•--- PP P _ ,a 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 OF HEALTH TOWN OF BARNSTABLE No....... FEE....�...1..yam.. 13ispoal Workii Tuni#rurtwi n "rrmit Permission is hereby granted.,..�-----------------------------.------- --------------------------------------------------------•----•-------•--•------.......... to Construct ( ) or Repair ( n Individual Sewage e Disposal System atNo..---------•••............. 1)----. --------------------------------------------------.......................... Street ^� i as shown on the application for Disposal Works Constru�cti"onDated.P rmtt - _c. '�5.. ��• C�� Board of Health DATE-----••-------------------------•-••-----------------------•--------C---•-- FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS (✓7 t 27 FEB.... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Alipfiration for Dig w3al Workii Tinuitrurtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair `(✓) an Individual Sewage Disposal System at: + ocation-r\ddrtes -------•---•..............................or Lot.No. Ad ,-1 •T\ r� -----. s-'C-- �4--�ICM S-- a-- dr�!`essc Installer Address .. UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms.._.._..._. Expansion Attic ( ) Garbage Grinder (6 a -------------------------------- Other—Type of Building __---__-_:tl�.......----- No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- --------------------------------------------------------•---- W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/ _,O .gallons Length---------------- Width---------------- Diameter---------------- Depth................ x Disposal Trench— No. .................... Vidth.................... 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...................... ri Test Pit No. 2..........:.....minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ IY4 --••----•--------------------------•---------...----•-•---------•---•---••------•-•-..............--............................................... -......... 0 Description of Soil....................................................................................................................................................................... x U UW ---------------------- --------- ---------------------------- ----------------------------------•------------ Nature of Repairs or Alterations—Answer when applicable,.. �_C1Pke._C�_ 6e3sopal _ -,o( ,` •1 `�"Z� ? !`?C � �,.�!C36 `� . .' r�. ,�k'-`� 5------_tom. 7.4..--�.... 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 Complia e has been is -ad t-lie-buaid of health. ,,� y S/ _ Signed $ ------------------------------------------------------------ -----------.........------------------- Application,Approved By ......... " ` f/?-✓l--- . -------------------------- Dare Application Disapproved for the following reasons: .............................................-.............................................................. ------------------------------------- -------- -------------------------------------------------------------------------------------------------- - - - .......... -----------------------.--------------- f•--/ ~' � L/ ^f Date_ Permit No. _....- - Issued ...... ..-.... 5...... Dare