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Home My WebLink About0156 MEGAN ROAD - Health (2) r�lJ(o Oe n 1. nib TOWN OF BARNSTABLE LC;'TAe-UN I kclG Gl V\- �� SEWAGE V"�.LAGE� ASSESSOR'S MAP &LOT NAME&PHONE N0. SEPTIC TANK CAPACITY I Ezra 21 a, LEACHING FACILITY: (type) kA S (size) OC39ZCA NJ NO. OF BEDROOMS _3 - BUILDER OR OWNER 6,,.A PERMITDATE: "" L"' DATE: . r .. Separation Distance.Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on,site or within 200 feet of leaching facility) Feet Edge of-Wetland and Leaching Facility(If any wetlands exist within 300,feet of leaching facility) Feet Furnished by U< Q i rr, ,A f. -TOWN OF BAnRNSTAABLE .4LO�:A 10N ) 'S� -e(� ►V I ��C SEWAGE # D,72 Vli:LAGE Al*- l5 � ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. �� -�-- S-e -` C, SEPTIC TANK CAPACITY 42�cZSZ-V •U\ V0'?J D C LEACHING FACILITY:(type) '�'-'�- °� (size) 62e4 q-1 ;)r NO. OF BEDROOMS gS _PRIVATE WELL ORA�ER BUILDER OR OWNER P-Lo ., \C Gr &,t4 DATE PERMIT ISSUED: IDATE COMPLIANCE ISSUED: 3 ��- VARIANCE GRANTED: Yes No [� oar 0 tn Fics.....J 4. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliraftait for Disp.aiitt1 Works Tomitrurfinu 1hrutit Application is hereby made for a Permit to Construct ( ) or Repair (—�'an Individual Sewage Disposal System at: Location .- ddre�ss. or Lot No. Q 1�c . .....�. a� � � •a - ----•-•--•------•---------•....--•••-..... Owner Address A a �i. !' 1,�!Sr !� ----.. ep__:� z- . = v -. `�:�J...---1!!`T��•�L.... _ . �..__ r.... Installer Address d Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms......... ...............................Expansion Attic ( ) Garbage Grinder ( ) Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixture -------------------- --- --- w Design Flow___.____s.............................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.._..VQ........ Depth below inlet.....(a......._.... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1.4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ x -------------------------------------------------------------------------------------------------------------------------------------------------------•---- 0 Description of Soil...............................................................................---------------------------------------------------------------------------------------- -----------------------------x w U Nature of Repairs or Alterations—Answer when applicable..__�� Tl ��_____L_(7 __L................. !ci—......... S-(l_-w-` ..---•. t-.e ---------------------------•--------_------ 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 bee issued b boar of health. �-y-ya- Dace 9.0 Application Approved By ---............ Dve Application Disapproved for the following reasons- --------------------------------------------------------------------------........................................--------------------- --------------:----_---------------------------------..-... .---- ------.......................... ........................................ Due r.Permit No. ----- --------------------------- Issued ........................... -------------------...-Dace.......................................... No.....Z2nlao Fss........ . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE for Bispaaal Works Tnnitrnr#ion rnmit Application is hereby made for a Permit to Construct ( ) or Repair ( —f"an Individual Sewage Disposal System at: ..... .._..1 '.�,_ �; ...... .................... ................. _.._...... -- -----.......- .. ------•--.._.. ...... ..----•.Location'�Address � ----........ ....or•Lot•No---------------------•----................ 4 ................fl �e-�J .e-1• v�;....................... ••........7--- cf c!!!� �y -�j•�-- Owner Addr'eysPs {(, t!t: 1_=( ,aJ(�1.--..............................................- ..............P A-- -=---•-'- "------••"•`-`• ........u—VIA, --•- • AV Installer Address d Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms..........3..............................Expansion Attic ( ) Garbage Grinder ( ) a`-4 Other—Type of Building No. of persons............................ Showers YP g ---------------•-----------• P ( ) — Cafeteria ( ) Otherfixtures --------------• -------•-------•-------•......---•-•••--••--••-•--•-•--. ---------------------------•-•--------------•-----•........---•--......---• W Design Flow........�� ....................gallons per person per day. Total daily flow.._ d .....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......W-------- Depth below inlet.....ln............. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date......................••--•-•-•---•---- � Test Pit No. 1......_.._..i�minutes,p'er 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.......................... R+' ----------------�--------------------------------------...------....-.---.-•--------•-----••-------..---•-------•-----------••-----•-•------ D Description of Soil------------------------t = x W U Nature of Repairs or Alterations—Answer when applicable._____.-1=' Z «__--- .OEM-._��" 0,-_T---------- •---....... ....-- .'� e-----•• > •�' ----- �c'r c t d' `- '`. .----------•------------•---•-•---•-------•-----•------.....' 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, ssued by,the board of health'. Signed T-�'-..........�e...\`............................................ -J —�1—G/�- Date Application Approved By .... -r. _ _:. ---------------------------------------------------------------------------- ----- _ �S 2 --------------------- Date 1 , P- ` Application Disapproved for the following reasons: ........................................................................... ----------------------------------------------------- ---------------------------------------------- ........................................ Permit No. ----- r - -, ?,�} Issued e Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certi£irate of Cfomlaliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed.( ) or Repaired by---------------------------- -- . t. tA[ S— f kN Z.. Installer at ----------------!.5�------------- e--�--"'"'------- ...............zo r---`- "`-='-` --g----------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. -------7gL. ----)-_3�.------ dated .....................................:.......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------------------- =C'^--------------------------------- Inspector ........ ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No....7 . �� ..• FEE....:aC ....' Permission is hereby granted........_t'i. _Q1......... `...._._.......".�l......-:........._ to Construct ( ) or Repair ( )aan-4ndividual Sewage Disposal System atNo....................•----•......-------------•---------....... .........t- ---...................................t----•--------•----.....---------------•---•-•--------•--------........ Street as shown on the application for Disposal Works Construction Permit No........ __.. Dated_._.._.__•................................ ...................................................................................................... r ` p Board of Health DATE --------------------------•---------------------------.._..... FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION (p MV W -R®AX SEWAGE# A015 -all VILLAGE Vy Qys ASSESSOR'S MAP&PARCEL` INSTALLER'S NAME&PHONE NO:QQF-Low E&am'asEs UC, SEPTIC TANK CAPACITY 'k i Oao G U-04 LEACHING FACILITY:(type) 500 C4AL dM&G (size) 12 4 23� �. NO.OF BEDROOMS 3 OWNER 4®$CE CaLso MAMA PERMIT DATE:8'1 f`'02015 COMPLIANCE DATE: a s;20 m DL0 l 5 Separation Distance Between the: No G kJ Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 0&5 �V" Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within //�� 300 feet of leaching facility) A Feet FURNISHED BY CAV9;WCk7C �S l > > yD 7! -3 )7 !S W 4r a N — N1, 1> NJ r6o a