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Home My WebLink About0028 TEVYAW ROAD - Health ag Tev�fw Rd., r LO .CAT ION Q SEWAGE PER IT NO. VIELA6E I N S T A LLER'S NAME i ADDRESS IUILDEIt OR OWNER 098z1v_I' y ZiaP,r� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ? ;' ��I v � U ° 3 ,� � 2 . 1. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Db3p ml Nork,i Tomitrurtinn Prrutit Application is hereby made for a Permit to Construct ( ) or RepairXXX) an Individual Sewage Disposal System at: .......................................................... -•-- = 1--•--•------------..........--...-----•---------- Location-Address or Lot No. John...Robbn- - --------------------------------------•--------------------- W J.P.Macomber Jr. Owner Address Installer Address UType of Building Size Lot............................Sq. feet Dwelling? —No. of Bedrooms---------3----------------------------------Expansion Attic ( ) Garbage Grinder qD ) aOther—Type of Building ____________________________ No. of persons-------4------------------- Showers ( ) — Cafeteria ( ) P4Other fixtures ..------•--.-.--•-------------•----•-----------.--------------------------------------- -------------•-••---•--•--------•-----•••-----•-•------------ 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. ]................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........................ 9 -----------------------------------••---•-----•----•----••--•-•--------•......--•--•....-••-•-•--••-......................................................... 0 Description of Soil........................................................................................................................................................................ v Sand...&-•-Gravoi••-•---•-••-••-•---- W UNature of Repairs or Alterations—Answer when applicable.-.--_Omit---C.ez_apoo?1_s...Ins tal_1....1=10.0.Q....... gallon tank.......distribution..bob.._1_-1._Q00___�:a_1.1on---le_a_chinc-...pit.................. 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 Complian e has been 'ssue by the board of health. Signed ....../. --- Application.Approved BY ---- ---.....------- --- --------- -------- ---------------- -:-- --------.---------------------------------•�s'� Dace Application Disapproved for the following reasons- -----------------------------------------I---------------------------------------------------------------------------------I......... ...... ................... . ....... ................................ ... . ............. ------------------------- ---------------- .... Permit No. `J ��Z ....._............ Issued .... ............................ Dare 9 ,./, 17- o � V No.2 !� Faa..19 3 .:.�? .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uitjipwial Wnrbi Tnnitrnr#iun ramit Application is hereby made for a Permit to Construct ( ) or RepairX:(;X) an Individual Sewage Disposal System at: 28 Te.vvaw Road .................=--..................----•-------•----...-•------------------......---••---•---. ----•-----•••----------------------•......-••---•--------••---•----------------•-•--------......-- Location-Address or Lot No. John Robb:i-ns ......................-.......................................................................... -----•-----------•--------------------•---••------•--••---•-----------••----------------------.... Owner Address W J.P.Macomber. Jr. Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling=.'—No. of Bedrooms......_..?---------------------------------Expansion Attic ( ) Garbage Grinder f(D ) aOther—Type of Building ---------------------------- No. of persons._...-.---..._.------------- Showers ( ) — Cafeteria ( ) a' Other fixtures .. 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. I.---_---_---.-minutes per inch Depth of Test Pit--------------_--- Depth to ground water........................ (Z4 Test Pit No. 2................minutes per inch Depth of Test Pit................---. Depth to ground water........................ 9 -•-------•--------------•---------.....---•--..........--•-------•-•--------•-----•--------------............................................................ ODescription of Soil........................................................................................................................................................................ W Sand_-&_-Gravel V --------------------------• ---- ------•--------------------------•-•-•------••-------•--•-------•------------...-------------•-------------------•••-••---...----•----•--------• W UNature of Repairs or Alterations—Answer when applicable.--..-Omit___ces s cools Install 1_-1 0 0.0 .............. ralion tank 1 -distribution box 1 -1000 gallon leaching oi.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 been��ssueby the oa d of health. Signed ......... % �' .. 2/2 /9 5 . -' Da Application.Approved By6____ ------------._---L --- _------------------- {-- Date Application Disapproved for the following reasons- ------------------- ---------- -------- ------------------------------------------------------- at - Permit No. Issued ----------------- - - � 7_1 .. ....... .... Date ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 01-11,erti rate of U.IIxttyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repairedy(XXX) by ------------------J....P-M!' coo bex....Jr--------------------------------------I-n-s-u_J.l.e_r-- -------------- ---------------------------------------- --------------.-----.--------------------------- at . 28 evyaww Road Hyannis- - ' - . .....------------------------------------------------------------------------------ . ............ - �.. .. dated .. 9 ' - in has been installed in accordance with the provisions of TITI. of The Stat Environmental C . e as describeedr, n the application for Disposal Works Construction Permit No. �. .... ... �� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE .--------= ... --. s .. - Inspector'. ----.._-----------------_r...----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 30.00 No...................... FEE........................ �in�n�ttl nrk� �an�#r�tr�i.�n �rrmit Permission is hereby granted..J p-.Macomber Jr. to Construe 8( T),--voyat�paRoa ) Iayarini Jual Sewage Disposal System atNo...--------•---------•----• ..................................... ---•---------------------•------ -------...... --------•-------------...--------•...--------------.......-•--- Street p � as shown on the application for Disposal Works Construction Permit]No.l..:.............,_ a d.._..:._�...............�.......-........... � DATE------..... �'' :. ................... Board of Health FORM 36508 HOBBS R WARREN.INC..PUBLISHERS �- TO3 BARNSTABLE ✓ LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOTi?S'9,a= INSTALLER'S NAME 6i PHONE NO. Z j �%,I C_, halae;- gclij 1_/7C� SEPTIC TANK CAPACITY (000 4 LEACHING FACILITY:(type) '1014-5 (size) (00 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No `� n. I � � ,� i y�� +� �% ! �� \ � �F �� ca- C, ��, �� , �