HomeMy WebLinkAbout0066 GLEN ROAD - Health 66 GLEN ROAD - L
HYANNIS
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TOWN OF BARNSTABLE v
LOCATION _ SEWAGE # � — 316
VILLAGE I .4riJaV LS ASSESSOR'S MAP & LOT<�V
INSTALLER'S NAME & PHONE NO. W �771 S3Qs
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) _ - (size) dye /6 s
NO. OF BEDROOMS -==7L— PRIVATE WELL OR LIC
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:L
VARIANCE GRANTED: Yes No
i -7
.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH AMrovEo
TOWN OF BARNSTABLE
6smshbl Conservation aPatt"nt
Appliratiuu for Diapuattl Works TToulstrur -�
Cate
Application is hereby made for a Permit to Construct ( ) or Repair (k) an Individual Sewage Disposal
System at: 4 /�.�
• ..... .�.... . '-- � . -•..................... ^�.....-----•. ---•-••--........-•-------................
cation- dd ess or t No.
de-
C—� dress
Installer Address
d Type of Building Size Lot./`,,c.61-10--Sq. feet
V Dwelling—No. of Bedrooms.................................... .Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P., Other fixtures ............................... . .
d
W Design Flow__________________-� _ gallons per person per day. Total daily flow__._._..._...............gallons.
WSeptic Tank—Liquid'capacit}' Q.gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. ......Z.......... Width.......__._.... Total Length...Z.7-...____ 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.........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P .-.----•----------------------•---------------•--•---••---------------------•--•-•--------•---------------------
O Description of Soil.................. L......... �t1 C � d� ----------�. •------- --- �i
x
U ---------••-----•----------------------------------••--•---------------------------•---•••...•----------------•--•-----------------------------•-------------•----•----------------•---•--•----•---•----
W ---------------------------------••--•----------•-----------•--------- ---------------------------------------------•-----------•--••---•----------------------------• .................................
7,45
U Nature of Repairs or Alterations—Answer when applicable------ .10.........c_ _........,17A. �-% ,�..
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 be issue t of health.
Signed ......... o . . . ....--- ......�.��
Application Approved By ..... .... .. ... .. ... .. :.. . e
----- -- ..... .--- ...
Application Disapproved for the following reasons: .................................................
.... .
Permit No. ...... Issued .........7. .. �..........................
............Date ....
. .. ............ ...... .. ..... ...... re
q�No._.. z
I c7'1
r F�-
THE COMMONWEALTH OF MASSACHUSETTS
' BOARD OF HEALTH
TOWN OF BARNSTABLE
Appl ratuan for Disposal Works Tons tun
Application is hereby made for a Permit to Construct ( ) or Repair (k� an Individual Sewage Disposal
System at:
Location-Add ess or t No.
-------------------
ncL,�`J-ST ,�% �L�
Installer Address _,e
U Type of Building Size Lot_-���o eSq. feet
Dwelling—No. of Bedrooms------------------C�_ --•__-_--.__--_---Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) Cafeteria ( )
d Other fixtures -
W Design Flow--------------------S_•- -___.gallons per person per day. Total daily flow----------4 ------—-----gallons.
WSeptic Tank—Liquid Length---------------- Width---------------- Diameter----------------Depth---------------
----
x Disposal Trench—No------- ---------- Width-----7_._.._.._ Total Length---17 _ Total Total leaching area--------------sq. ft.
Seepage Pit No----------_--------- Diameter.,------------------- Depth below inlet-------------------- Total leaching
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed bY------------------------------------------------------------------------- Date--------------— - - -
4 Test Pit No. 1___---__•_•--_-_minutes per inch Depth of Test Pit-------------•__---- Depth to ground water____•_•_--_------_-_-___
rX4 Test Pit No. 2---------------- per inch Depth of Test Pit------------------- Depth to ground water-------------------_--_
a ------------------------------------------------------------------------------------ - - - - -- -- -_-
Description of Soil------------------n_- =='Z GU,,4zil/J Sl _S�i� — ' C
_---------------------------------------------------------------------------------------- -
s ---�----------a -
x --------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable-------.�_6.--______�__._ ...1 lG�`e
�-� -----�-ac%3�/�eb� L - � t' i?t/
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 b issue t e- o of health.
Signed ------ / �-. - ---- ---------------------------------- ------ty
a
�a
Application Approved BY ,----- ----; - l
Application Disapprdved for the follounng reasons-- -------------------------------------------------------------------- -1------- -----------------------
------------------ --------------------------------
- - ------------------- ------ ------------------------------------------------------------------------ ------- ----
nae
Permit No. .. -------------- Issued -------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
alertiftrau of (go" iancE
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( -N<—,')
by----------------------------------------------------------------------------:' __Cv__:�np60�
------ --- ---- - - -
Imale
at _... � � '--���
------------------- ------------ --------------- -------- � --has been installed in accordance with the provisions of TITLE 5,0(�he StateYn onmental Code as described in
the application for Disposal Works Construction Permit No. ......._..__.. __r dated -------------------__------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION S�jATISFACTORY.
DATE - - ------- - ---------------------------------- Inspector .-----------------�'-____—--- ---------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE N �G
o. F-
. Disposal Works Tunshitr ott Vrrmit
Permission is hereby granted------------------------_/�U1 :-D_GD_i%7
to Construct ( ) or Repair ('�>,) an Individual Sewage Disposal System
at No-----------------•-- e.J Q
Street
as shown on the.app';T
tion for Disposal Works Constructio 'ermit No._ __ ted
��—
DATE-- T r
v- - - _ —
FORM 38308 HOBBS h WARREK INC-.PUBUSHERS