The URL can be used to link to this page

Home My WebLink About0025 LIGHTHOUSE LANE - Health 1 a i v n LOCATION 5EWAC4E PERMIT UO. V I LL+AF- iMS-TW,-LE S ► &ME ADDRE BUILD R ' IJ /�,IJIE � ADDRESS DNT'E P.ERKAVT D N.-TE COMPLI &&ICE ISSUED , �' 1 �w r y l i 1 J ............ THE COMMONWEALTH OF MASSACHUSETTS / J� BOARD OF HEAL TH �vdultU OF...........- ...... � - , pphraation -for Uiapastal Works Tatwtraartioaa Vrrmft Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .............. c : ..1 e _1 - � - - --------------------------- Q ----1 Location- dress or of No. Owner ---------------------------Address ------------------------------------------ Installer Address Q Type of Building Size Lot_-__�1 0610________Sq. feet Dwelling—No. of Bedrooms______3...............................Expansion Attic (Al' Garbage Grinder ( ) Other—Type of Building __________________________ No. of persons_______-______.___--___-__ Showers ( / ) — Cafeteria ( ) Q' Other—fixtures ----- -------------------------- W Design Flow--------___®...........................gallons per person per day. Total daily _Q_U_____._.._:.........gallons. Septic Tank—Liquid capacitvf440gallons Length................ Width................ Diameter---------------- Depth----------....... xDisposal Trench—,j�T0_ ..................... Width_____ _.__.____-_. Total Length--_--------------- Total leaching area--------------------sq. ft. Seepage Pit. ___________ Diameter------------ Depth below inlet____________________ Total leaching area------------------sq. It. 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--_______________-_-___- (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_____-_____---_-________ ----------------------- ----------------------------------------------------------------------•--------------------------------------...-------=----------- ODescription of Soil------- J-0 ------------------------------------------------------------------------------------------------'•---•---------_ -•--•---•-=-•---;--- x ----------'� /D^/"T_ S E r?s T Gia t.� ----- ------------------------------------------------------------------- WE UNature of Repairs or Alterations—Answer when applicable._-________________-----------------------------------------------------------_----------------- ------------ . Agreement: The undersigned agrees-to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary 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.-K --------------- --`--------------- I Date ?� - - - - ApplicationApproved BY------------ --= .............------------------------------------------------------- - •----- ----------- -------------- Date Application Disapproved for th following reasons------------------------------------------------------------------------------------------------ ------ .................................--..................................................................................----------..__._.----------------------------.._-._------------------------------•- Date Permit No. .y f Issued. --"-5-----•• L� � Date No. Fizz.................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH x .............. Appliration 70 :11-nu ial Works Tonstrurtion PPrtit Arplication is hereby made for a Permit"' ermit to'Construct ( ) or Repair ( ) an Individual Sewage Disposal System at '. ...--•---. !G .. .A_� " _ , ✓ ------ --- -- --------- �-----.400! .... .................... r 4 Location- dress, ac g43 M or Lot No. Owner Addressf Installer Address d Type of Building Size Lot----/4:�4?40t-______-Sq. feet U: Dwelling—No. of Bedrooms-------.?---.---•____________________---Expansion Attic (A4 Gartbage Grinder ( ) a=t Other—Type of Building --------:................... No. of persons_-_---•.__--__._--___--_.__ Showers Cafeteria ( ) ` Other .tures _ !W Design Flow_____ ..V.................... gallons per person per day. Total daily flow-__-__._-��.�__________.____..._-gallons. W Septic Tank—Liquid capacity l ._-_.-_gallons Length................ Width-__--..-....... Diameter..................... _.... __ Depth.._.__.-_____. Disposal:•Trey ch o'� Width____. _ Total Length-------------------- Total leachingarea s ft. Seepage Pit No .. ...... ..... Diameter.. .._.... .._ Depth below inlet_................... Total leaching area..,! _.._----._-sq. It. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by.______-_._..._ ............................... 4 Date-- •-- ' Test Pit No 1----------------minutes per inch Depth of Test Pit.................... Depth to ground ' er--------------------- Depth • minutes per inch of Test Pit...................: Depth to round water....._-- - f 4 Test Pit Nog .- ' Description of Soil--''-... ;�'.+�I�, -- ...................................................... ---..-.----- -------------------- ------------- 4 W UNature-of Repairs or,Alterations Answer•when applicable------------- ---------------------------- --------------- ---- --------- ----_-..,.: _________________________-_-__-_------.--__--.-------.-_------...-._•---______-___-_-.-_-___-_.-____--.-___-_-___ _.--._.-._.....------------------------------ - greement. ` The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the"provisions of Article XI of the State.'Sanitary Code—The undersigned further agrees not to plplce the system in operation until'a Certificate of O-Whpliance•has been�is�sued•�by the board(of•health. 'YY pa � � y i N. Signed. ---------- Di.� ate Application Approved BY------ ---: � -------------------t------------ -------------- -------- Application Disapproved for tl f ollowing reasons::------------------------------------ .__.... ...__..........._....._.___.._....._ nate ---.- ............................................... ....... ..........................•-------•--•---•-- --------------------------- . • ......------------. . --------••- . Date Permit No.... .. �' Issued- ?-----.. ` 4-f•--•-•-•---- r y Date ,0 - - c THE COMMONWEALTH OF MASSACHUSETTS BOARD .OF HEALTH .., �£.lrrL�.r............ O F:...'. ............ = �rt �prtlirtrf' untli�tnrr THIS IS TO`CERTIFIT, Tliat.;the gdividual Sewage Disposal System constructed ( ) or Repaired ( ) by L�l F� 9�Y} ------------ ------------- --- ------------- .................=---------. --•-- -- --••- ----.....--- y Installer at._. _ yy��.. � ,f has been•,mstalled in acco �ncelvith the provisions of !�rttcle XI df Tl'ie State Sanitary Code as described in the application for Disposal Works•Construction"Permi�alo, _____________________ dated................................................ THE-ISSUANCE OF THIS CERTIFICATE SHALL NO BE CONSTRUE® AS A GUARANTEE THAT THE -SYSTEM 1J4, UNCTION SATISFACTORY .: rx v DATA 1 / ; ; -@ `S� Inspector ------------- --•-- z` THE COMMONW EA' L"TH OF MASSACHUSETTS . BOARD .;O"F; ;HEALTH .......�TGt�� Stc* ... N041.4_!•----------. FEE........................... . Permission is hereby granted_. ......................... to Construct (/,) or Repair ( ) an Indi idual Sewage Disposal System /.yam �I,,,� s- y� 1 - - -- w Qas shown on the applicatton,foy isposal Works`Con�struction. per it No _ __. ... ±. �• } �f '. DATE.__. ._f�Z.i. i. �77 ---•----•------• � soa f Health � t _. FORM I 8 HOBBS &. WARREN. ItVC ,?�1BL1' HERS , r e _ '�z' ��_ ��r� �a'.��aTF.`_��1-5.r..,..w•,+...ya.[-� ,[�....5:�±''Q' ! _+ .. .,5:,.`t''.�i��i:.,.* 'F�'. � _ _..�rYc - lz E 4 -L �� J �p i U` \ 1 TOWN OF BARNSTABLE LOCATION SE3iC: VILLAGE �c�, a.wo,S ASSESSOR'S MAP & LOT INSTALLER'S NAME 6i PHONE NO. &,t5 /5ad-), CerwSc. 36a- o-37 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) (o o o NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER vg&"- BUILDER OP�OW�IER L�l1�/ � A L A.S DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No .- _ ��_ �-- �l .9 � '�! . � '� � �� 3 �-' `� ,� / �� s No... Fi$..,f..,�..-�....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ............OF......V6. Appliration for Biiip viittl Works ( owitrurtion Urrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ystem at: All, e`C Losarion r- 00 ress t No B!i Owner s�,y� O Address ,W1 ---�-�/ :..• �� ...............................•--•-••----------•---•- tom=i f A-�• --��1 Installer Address/ Type of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms_._;-- _______________________________Expansion Attic ( ) Garbage Grinder ( ) a, Other—Type of Building -_.---__.--_-------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures --------------------------------- W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tcink—Liquid capacity ----gallons Length---------------- Width......------.•.. Diameter................ Depth.----._-_------ x Disposal Trench—No..................... Width.................... Total Length--_-_____-..____--_. Total leaching area--------------------sq. tt. �. 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. 1----------------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-------------------------- -• ........................................................------.....-------------- -------------------------------- �4 ' V ---------------•-•-----•------------------------------------••-----------------------------------------------------------------------------------------------•--------- ................................ ---------------------------------------------------------------------------------- --•------------------------------------- ..---------- -•- U Nature of Repairs or Alterations—Answer when applicable...._._ _�.. . ... .. .. ... . . ---------------------------------------------------------------------------------- ....... t------ •--- ----R ............. --------------------------- m Agr ; ee ent: - The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Cod —The,and s4ned further agrees not to pjK9he system in operation until a Certificate of Compliance ha ee sue he o 4f health. Sign e ' - ------ "� ------- . D�te ApplicationApproved By-------------------------------------------------------------------------------------------------- ---------------------------------------- Date Application Disapproved for the following reasons-----------------------------------=----------------------------------------------------------------------------- -•--•--•••---------•-------••--------•-- -------------------•---•..........-•----------•----------------------------------------------...-----•---•------------------ .................................. Date Permit No......................................................... , Issued... /at THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H LTH OF ... . ... .... ........................ ....... Applirativit -for M-4posal Works Tomitrurtion Vrruift Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at Ty. /6V 0 -wr ........../ ............................................................. n 0o. i..Vt..1 5,t i 0. e—--------- --------------- ...00 or of ....A.014 ltzr &I Owner 01 A-P A r e ss. ........ ... #.A................................... .... Installer 7 AddresFx/ U Type of Building Size Lot............................Sq. feet 2 — Dwelling—No. of Bedrooms.........w.............................____Expansion Attic Garbage Grinder a4 Other—Type of Building ---------------------------- No. of persons_.--_=----------------- 'Showers Cafeteria P4 Other fixtures --------------------------- ---------------------------------------------------------------I I----_----_---- --------------------------------------------- Design Flow.......................... gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity--gallons Length________________ Width_..___.._...._.. Diameter___._....-_.____ Depth---------------- Disposal Trench—No_------------....... Width__._._....._.._.__.. Total Length........__:_........ Total leaching area--------------------sq. f I. Seepage Pit No_____________________ Diameter......_.......__..._ Depth below inlet__________----_-_--- Total leaching area------- ----------s(l. It. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................ ---------- Test Pit No. I----------------minutesperinch Depth of Test Pit_-___.__.........___ Depth to ground water...---..--------------. �Tq Test Pit No. 2-_------------minutes per inch Depth of Test Pit----------_------- Depth to ground water_-.--_.___.___--__-_.__. 9 -------------- ........................................................................ 0 Description of Soil ................................................................................................................... �4 ----- ------_---------- 7 U ---------------------------------------------------------------------------------------------------------------------................................................................................. ----------------------------------------------------------------------------------------------------------------------------•i4._ t ---- 0? U Nature of Repairs or Alterations—Answer when applicable....___ 77 44 ........... ------------------------------------- ----------------------------------------------------tpot.aq------ ... - - ------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Co5—The and si ned further agrees not to e he system in b f e operation until a Certificate of Compliance I a;L��s the f healfth. SignC7�. .... .... ..,............................................ .. .... _:5�............. Date Application Approved,-By--------Ze 4 ........................................................................................ ----------------------------------------- Date Application Disapproved for the following reasons:........................................................................... .................................... ......................................................................................................................................................................................................... Date PermitNo----------------...............7--------------------------- Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD Of, .. HEALTH,, .1...../ OF........ I; .0.4.. .�. ..4.�.. ................. rdifiratr*of TlImphatirr THIS IS TO C 4E#Y, That the Individual Sewage Disposal System constructed or Repaired by.........oL--- -- .... .. ................................ ...:- ---------- Installer ---------- ......................."----------at...... -- - -- - - - ----------- ------- ---- - A-------- - - has been ins alle- in accordance with the provisions f Article XI of The State San ary C de as described in the application for;Disposal,Works Construction Permit No.....JZk�----------- ...... dated'. .. .. ..... ..f.... .. THE ISSUANCE OF THIS CERTIN ATE SHALL NOT BE CONSTRUED AS A GUMANr EE THAT THE SYSTEM WI�F �T S T11FACTORY. .....7 DATE............ ................................... inspector.. . ............................................... 7-----------------------------�V ' TKE,COMM.0NWEALTH OF MASSACHUSETTS BOARD 0 �E�LTH ;.4 4,. . . . .... ....... 0....j .. ...................4ze ....... ......OF........... ........ �i FEE.o2................. a iitrurfivit Prrmit Permission is hereby grant ....................................................................... to Con5truet-.%( ) o Repair- Ln� ua Sewage.Dispa;p�§ystem at No'_.r..C16LA... ---- . ......... &_J(A0--------054t........... -- ----------------------------------------------------- Street 4s,,shown on the application for Disposal Works Constructio �krmit .......................... ? t.Vd-of Healt DATE.. ----------------------------------�t....... V FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS . b. T 4 , fi