The URL can be used to link to this page

Home My WebLink About0265 MEGAN ROAD - Health �6s mer 9a i v TOWN OF BARNSTABLE LOCATION Meg ctcv e SEWAGE # 7/ — VILLAGE I' Ct ASSESSOR'S MAP & LOT wINSTALLER'S NAME & PHONE NO. k-66a 1 4j-68ts, SEPTIC TANK CAPACITY LEACHING FACILITY:(type) l.e" � (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER OR OWNER �10.��e S `rl`C` \ACir-a� ' DATE PERMIT ISSUED: -3 " ` b DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �. � � O 1 �� _� ��. � t �„ • . � ,. 0 v t Y, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE. Applirttfiun for Disposal Workli Tonstrurtiun Prruat Application is hereby made for a Permit to Construct ( ) or Repair ?A' an Individual Sewage Disposal System at: .......... .-Q..........:. ............................. ........................�--`.... ........................................................... Location-Address or Lot o. s :m�. ......� ......-.-... e -.-_ ( r0S �m ............. a 5... _._..1 .O-wne a �A'd1dress :3 -•------ � � :�:.�....� .. ..&.S� Installer Address U 'ype of Building Size Lot............................Sq. feet [. Dwelling—No. of Bedrooms........._. ----------------- --------- Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers = Cafeteria 0.' Other fixtures d . . 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 ( ) - aPercolation 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........................ O � Description of Soil............. r-..�.......... --- --...---•--•----------------------------------------•-------;---....---........_....---•------•-----•--------- x w UNature of Repairs or Alterations—Answer when applicable________ _ ____ ___k..�._ _ -._�_`.._._....... .� :. ..................... ----------------------------1.��............ _s...... -i -•--- ....--•-------....--•-•••----•••-•-----•--------------------......•.... 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 Compli'a-4 has been issued=boar d of health. Signed ... Gti-� ......... ...-...-j-� --��----- Date Application Approved By -------- --- Date Application Disapproved for the following reasons: ----- ------------------------ -----------------------------------------------------..................................... ----------------------------------------------- --------------------------------------------------------------------------------- - -----------------------------.........................---------- ------- ------....------------...----- Dare Permit No. --------- ------- �1l-... - Issued �� -- �-e'-�-- J No.....&--91i o r -THE.COMMONWEALTH OF MASSACHUSETTS'-BOARD OF HEALTH TOWN OF BARNSTABLE r Appliratiun for Disposal urku Cfunutrurtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair '�A- an Individual Sewage Disposal +-System at:` ........... : .............. ... �.�--.Z-------------•-----•-_... .............----•-••--.a-4-� --- - ......................... ( ^^ Location Address or Lot No. OWne Address t ; Installer f Address < Type of Building' Size Lot................ Sq. feet U g— ...........................Expansion Attic Garbage Grinder ( )( )� �`I)wellin �`, No. of Bedrooms___________ _ ______________ _ aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------••--•--•-•--•------•••-•------------••--•--•-••-•--•----•---•---•--•--•---•--•--••-•-•----••--- Design Flow............................................gallons per person per day. Total daily flow.._............_.................._......_.,gallons. Wrt .. 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........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W •----•. ---� ---•--•----------------------------------------------------•---------------._.....-••----•---•-•-••-••--•....._..•----...... xDescription of Soil----------•-�. _... - .....a................................................................................................................ C) ------------------------•---------------.--.---- -------------------------------------- ----------- .-------- •--------------------•-----------------------------.--------------- W U Nature of Repairs or Alterations—Answer when applicable________ ___ ____�, ._�. ,_�_�............. c,`„--_-_--•----..----__. ............------------------------•------•---....'-......................(v` aP. --.........I............ ...----�i7 ----•---•--••--------------•-----------------------------------------•------ 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-Com ante has been issued by the board of health. Signed . �` `�.. ................. -8--oa e 9--I..------ Application Approved By .........- f J,mot.... ,� Q- -- / .'-•"'..."...."....'." "..'. ...............'••.' —..' — f Dale Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------.................................. ...................................................................................... ..........................................................••----.................................................. .................---------------------- Dace Permit No. ........ ; !.... Issued s f Dare ---------------------------------- - t� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C6errtifirtt#P of (foutylianr.e J THI LS,T 0 CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( !� by............... .... . .... ' . .............--------------------------...............................---_......................... Installer at ------------------------ ........Y-�..-�...4..�............................<�--0.... .....---- ---- has been installed in accordance with the rovisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......7Z--- ---/ .. ................ dated ......................................---------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ........ ."...1-. .."��.... Inspect . ....ctwL ....... ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 2 No.. .�.-.,C1,.1...... TOWN OF BARNSTABLE FEE.. O:.LAD...... Diupuu .l Works Tunutrnrtiu erutit Permission is hereby granted.......`_.ca:.._.....1...�..�....__.. _....1 .. ..5�.: z....-•......................................... to Construct ( ) or Repair ( an Individual Sewage Disposal System r atNo....................................•...... ........... .....�1 t�y, •-- fl ....................._....--•-------•--•---•-•--........ (�"Iet as shown on the application for Disposal Works Construction Permit No.�_.l.fell_._.. Dated......3-_"')._k.17.1....... g. .....?ti.� 1 U--^ � �--•--•--....--•----•--------------•^.•• d Board of Health DATE......................... ..•-•-•-- FORM 36508 HOBBS a!t WARREN,INC..PUBLISHERS