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Home My WebLink About0183 LONGVIEW DRIVE - Health l83 lor�a�vicw �•, F�m�s as i / any TOWN OF BARNSTABLE LOCATION " ri, j ,SEWAGE # N VILLAGE NNE f A' SESSOR S MAP 6z LOT k INSTALLER'S NAME & PHONE NO. 4f7,,,P - SEPTIC-TANK CAPACITY =�` 01 LEACHING FACILITY:(type) �� - '� (size) NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATE' ' BUILDER OR OWNER ' \A U c— DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No C-t e 'a'►t No... .:. L Fizs..... ......._ THE'COMMONWEALTH OF MASSACHUSE77S BOARD OF HEALTH Appliratiun for Dispas l Murky. Tonstrurtion Errant Application is hereby made for a Permit to Construct ( ) or Repair ( Individual Sewage Disposal System at .................L .3..... . ....... ..•.. ------------ ....�Ajr.C............................................... Location_Add or Lot No ti ........... �.� Q..iFI h.`t :.c am--- ------------------• -••--•--•---..F.i:�Q............................... --..............., •-- - Owner fwr.._=!-Y-Sr 'len17.. _..._..--^---•- ..................�a:� __Address...................................................... ddress---•..................................---•- Installer Address Type of Building Size Lot....._.....................__Sq. feet Dwelling—No. of Bedrooms-,_3----------_______•___-_-_____-___-Expansion Attic ( ) Garbage Grinder ( ) `4 Other—'T a of Buildin -___ No. of a Other—Type g --------•-•--;--•------- Persons---------•-------------•---- Showers ( ) — Cafeteria ( ) d. Other fixtures ------------- --------....-----------•--------•---=_----•'--•••- Design Flow_._-:_19._.6........................gallons per person per day. Total daily flow-----aa .......................gallons. Septic Tank-Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.........._.........Sq. ft. 3 Seepage Pit No..._,1............. Diameter.....;1_�--_.___ Depth below inlet-_-:��....... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by__......................................................................... Date........................................ 0 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...___...,..__._.__._.__ Od .................°.................................................................------------------......................................................... 0 Description of.Soil----•----•.................................... - ....................................................... ' -JJ-- U Nature of Repairs or Alterations—Answer when app livable__.__,.' ...... -------------------------- Agreement: _ The.undersigned agrees to install -the aforedescribed Individual Sewage Disposal System in accordance with the provisions.of TI'L 1E 5 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... -• --- -- - -- -• Date Application Approved By----------- - -----• ... .-�-�__^ Date Application Disapproved for the following reasons:......--------------------•------------------•-•---•-----------_ ............................................ •......................•----.....----•--------------------------•--...-•-------•------......----...._...:---•------------- ` Date PermitNo. _.. Issued-.'...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH. 7:�d. ti -.......OF-.... , ppliration for Disposal Works Tonstrurtiun Prruti# Application is hereby made for a Permit to Construct ( ) or Repair ( c—)—ari Individual Sewage Disposal System at: .................1 .......... ....... --`—'= "-S.!...OLyt'C".- -------•...:. .............................. f r Location-Address or Lot No. Li is............................ -••••••.._..••-•_:�.. lo-:e:..=•----• ........................................ Owner a Address ..... ....................• -- �tr .[. ........................................................... Type of BuildingInstaller V - - � j r •- Address ! Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms___:;?__________________________________Expansion Attic ( ' ) Garbage Grinder ( ) a`� Other—T e Building ______________ No. of ersons_'._____.___._____..__._.__ Showers YP g ••••••• P ( ) — Cafeteria ( ) d Other fixtures ................................ ------------------------------------ Design Flow.....:�=� .......................gallons per person per day. Total daily flow-----=0______..___._....._____gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No......_1_.............. Diameter.____1. ,._..... Depth below inlet____.�:O........ 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........................ 4� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 a -------------------------------------------------------------------------------------------------------------------------------------------------------•-•••• Description of Soil..................................................................:.....•----•-------------•--------•-------...--------------......----------....._••••••••--•-•--_..... x U ..............••-•••......•--••-•--••-•••-•=•-••---.........--•--•-•-•-••.....-•••--•••••---•----•••-•-••••••---••--••••-••-•--•••-••••••--••••••-•-•••••-••--•--•-••--.._......__..........__..._--•••- w Nature of Re airs or Alterations—Answer when a licable.__.._______ ....:!�_ ..........___-f— l T(_:'-.._f_?.�__. U P PP Agreement: ` The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE . 5 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 � Sign( .:.•,�._ �'"'` '�_,.. °.1_ R _ _. 4 ='"r Date• Application Approved BYy �'A1` `'''1\ ' -'!� .. ,'-^-•............. �`- V �i Date Application Disapproved for the-following reasons:---------•---------------------------------------------•----------............................................. ......................................................-.................................................................................................................................................. Date Permit No.---------- `l 1 LI -- Issued....................................................... • ._...-•- ---• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CIrr#ifirate of Bout Haurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by............................. .: �... ----L-..-----------............_....------------._._._...--•-•--••----------••---•---•-•••-••-------- Installer s f at ---•••-••17'3 - �-•- - ... -•••• r ••-•••. -----••••••••••••••-••=-•---••-••---•-••-•-•......-•--••......•-•-_........-•••--•••••. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-------- ........ dated-.-............................................. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..... f:.. ?.._.._..< f'�-----.. Inspector-----=------------------- .............. •••-'-••..---------.............----•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......................... FEE.... _.. '". `•---•••-••-_.. Disposal Works Tnnstrurtion Errant Permission is hereby gra(ed --•-•-. ------ r�. Q -------------•-----------...................................................... to Construct or Repair t-- n Individual Sewage'Disposal System street ,,nn'� as shown on the application for Disposal Works Construction Permit No.�1=___�.r� Dated__________________________________________ ......................... �__D-•-------•___________________•-----•------•------- -- Board or health DATE...................... '" --------------------------