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Home My WebLink About0222 CLAMSHELL COVE ROAD - Health dd s -- 00- r & �► TOWN OF BARNSTABLE LOCATION m, O-A(J-m Shell 400e SEWAGE # VILLAGE AMWV ' 042101 t. ASSESSOR'S MAP & LOT 605- 00iz INSTALLER'S NAME & PHONE NO. L N 9 "/ SEPTIC TANK CAPACITY \00 O LEACHING FACILITY:(type) /j V f �/ (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER, lnbr) DATE PERMIT ISSUED: 1 DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No � �-rvn r ' x w C� Clr(LC `n .. ; AIVP No. :: � Fss THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......-..�.1`)tru.► ........OF..e�4 --------------------------------------- Appltrattun fur Disposal Works Tonstrurttun Prrtntt Application is hereby made for a Permit to Construct ( ) or Repair ( L-Jan Individual Sewage Disposal System at: i ... .. . ..__...... ----•........ • -Coca ion-Address or. Lot No. ......... . :..1 i! 2?y�Y... __________________________ _•----•---------mil v!!'.. ---.......-•--•--........---------•-••---•.......... W Owner Address / Installers Address Type of Building Size Lot.............................Sq. feet Dwelling—No. of Bedrooms.....3..................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) —'Cafeteria ( ) dOther fixtures --------------------------------------------------•---.-----.......-----------------•-------------•.....-------••--------:----•---•-----•---......_... Design Flow.......... r....................gallons per person1jer day. Total daily flow 3�4. �. __. ............................gallons. R: Septic Tank—Liquid capacitylQ_M_gallons Length___ __________ Width_._ ........ Diameter................ Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No.......I............. Diameter............. Depth below inlet____`Ard........_. Total leaching area..................sq. ft. 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........................ fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R4 ---------------------- --••---------- •---------- •---------------- -------- ------------------ ---------------------------------------- ••... •----------- •-- 0 Description of Soil.............................................................................................................................................-......................... W --------•-•-•---------------------------.......------•-----------•--------------•--•-----. .................................••-- -.......-•-- x •---------------------------------------•--------------------------•--------------------------.....-------------- --------------- --•-•-••-- ..............................f....... U Nature of Repairs or Alterations—Answer when applicable.-_.—' -k_----Lamb..--___r,00K_- ___-. !!!- - -------:a : �u - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h issued b the of lth. Sin - --------------------------------•-----.-_.- ? D ` i e .�Application Approved BY-•--•- �...::. !'!:!! ""_--------------- � --..._ ..._�� ' -=.. ..'----..------ Date Application Disapproved for the following reasons:---------------------------------------------------------------•-----------------------..-......------•-•••-•••- • ......................•------.._..---••----------------.......--•---------------•--...------------------------------------------...............................................................Date�--- Permit No.... . .................................... Issued_...... .. No.'E--S___ ... .'`�` J,t 7 Fss THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for 11ispouttl arks Tonstrurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ( Lj'an Individual .Sewage Disposal System at: ..... »»» .... ••-------.... -Loca/tion-Address or Lot No. .!�:__ ..!......_•�..f•-�..... ............ ..........•--.....�V� ---.......---------.........................._..... Owner _ Address �.._ W - '+ I�ka- s - P ------►—r—� - S ..^S �1 `......-f✓L r c7 Installer � `� 's'f':3 Address Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms.....3.................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -----------••-----------------------------------•------••------------------...-----•------......•._:�------------..........---•-•-•---•-•---------- W Design Flow........ ." .....................gallons per person per day. Total daily flow.......... ......---......................gallons. WSeptic Tank—Liquid*capacity. 1l`11:1gallons Length... ......... Width...` ........ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length_................. Total leaching area....................sq. ft. Seepage Pit No.......I._._.._.__.. Diameter......L:;n Depth below inlet......W......... 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ....... •---------------------------- •............. -------------------- •----------------------------------------- ----.......... --------- •------------ ....... .. 0 Description of Soil............•-----•-------------------•--------------••----•---...-----•---•--•---------------------------------------•-•--------------------••-•---•••................. x U ..................................•----...-•---......----•--••-------------.......-•-----•-•---••-•-•-----------•--•----•-----•----••-------••......•.................................................. --------•-•-----------------••----------•-•--•-•------•--•----•-•-•-----•-------•--•----------•--••-----•-•-•-•---------------•-----•.........................................................:'....... U Nature of Repairs or Alterations—Answer when applicable...... S1e�dl_......I zn ... .rai.rc .T h 1`( ..........................f'LA-r1 lf?� 1-I ••..� �_..._Safi, c --......... .----•--------------•--,...-•----............------............. Agreement: Thee undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ,.., m T 11L the pro'isiohss`of iI 5 of the State Sanitary Code— The undersigned further agrees not to place.the system in a operation until a Certificate of Compliance has been issued by the board of Ii Ith. --Signed-----•-�-=� r � _'�'.Y.S � i w �� .. C7- Date ' APPlication`Approved BY •. .........-•---------- --- u Date Applicatidii,Disapproved for the following reasons:.................... --••--•--•-•.................................•--•-------..........---•-----•--.....-----•--•-•-•---•-----..........................-----------------------------....•..-•----•--...•---•--•----•-•-•----- Date Permit No......................................................... Issued........ Date--•--•........................ -------- ---------------------------------------_---------.----- .__..------- THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH K- (9rrtifirate of Tompliana THIS IS TO CERTIFY, That the Individual Sewage-Disposal System constructed 6) or Repaired (�) by................. �" ::..._.. r .�._ C 5 / �.- �I.�� ',Cs P 6- — ( �.. ._,•.f... ... ;_ - W................•Q................................................•.............._.......... r Installer at...........................................'� ---------------------------- t '. ........... has been installed in accordance with the provisions of IT'LE 5 of The State Sanitary Co e_as.jdescribed in the application for Disposal Works Construction Permit No......................................... dated................j_Z �.I ....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A,GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � � r DATE.............._/ �A .. Ins ector---•-----gPAA '0 a M4IL r" P 1 ----------=----------•----•-'"- ..................... -------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF '.HEALTH _ � .. 2 Z 1....0 F......1�.c.. J1. s`t . . .............................. 2 No...:.....-.. =.... FEE........................ �iu�uu�l urk� �un�triun ��ernt� �,� Permission is hereby granted C..._.. �•I--•-------•-A.................................................... to Construct ( ) or Repair ( L-)-an Individual Sewage Disposal System '..�('- at No......... - ...........< • ./ ...-�.._ Street � ^-a as shown on the application for Disposal Works Construction Permit No....................ZDated.._... ? ...................... ...............{..._...._._..`.=.._.....:.'�2__ A!!A.__............................................ �� Board of Health DATE --�------•-v ---------------- Legend Road Names c< ttSS ,. 7.w�t >iJ,r ::"k r 005001 •i*v_ � P. a ,w '� �, c .`� a• ,� fv`.';�' rV' '�� it ' •1 � v , it -z- 1: 1 �-. ,�. .t. :, r" `t�/k' � 005024? d z j ti r' 005006 r ,�' 's + � r 'X'ZY' R�'� i� ,y ■ .�■ � ,` U�� rf}'41T ��,*."', 5025' *„iF' � ❑-� .e Map printed on: 2/12/2018 This map is for illustration purposes only.It is not Parcel lines sho-a on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Stnx't,H}annis,MA 026oi 0 42 83 n on-the-ground survey.It maybe generalized,maynot accurate relationships to physical objects on the map 508-862-4624 reflect--cut conditions,and may contain such as building locations. Approx.Scale:1 inch= 42 feet O cartographic errors or omissions. gis@town.barnstable.ma.us