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Home My WebLink About0135 GROVE STREET - Health 135 Grove Street A= 019-023 Cotuit TOWN OF BARNSTABLE LOCATION rS SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. f7re4 Miss C,ae '7 � SEPTIC TANK CAPACITY 6w &6,L- LEACHING FACILITY:(type) —14 cllt (size) ? F- ,e NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATER BUILDER OR OWNER�Tc�,�CC`/ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No / MoqV- ZL � I viv- 1 e d Fizz.....2�.o......"- THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Diipuiitti Works (11� 4Individural Application is hereby made for a Permit to Construct ( ) or Repair ( Sewage Disposal System at: ......,...... s'.._..0 � ...� ,_•---------��.�... -••----------------------------------------- ...--- -------------........--------- cation- ddress r- or Lot No. ` ...........11.E 1L=S .. .__..... 5 -` ---------------------------------------- --- .. �P�:a/e....S:7:...----�.arl.,.2,. ._......__. Ow Address a .. .. v� Ci f ------a-=:�---� ..5�. ...------.�` �^n�� -•---� -- Installer Address Type of Building Size Lot.................... .....Sq. feet U �--� Dwelling—No. of Bedrooms.........................................:.Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No. of persons............................ Showers YP g ---------------------------- P (----)._— Cafeteria ( ) Otherfixtures ------------------------------------------------------••--------••-•--•--••---....-•-..-----------------_..... ..._-•-•-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity.00gallons 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 (V11')_ Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �X4 Test Pit No. 2................minutes per inch Depth of.Test Pit...:................ Depth to ground water........................ P4 •-•-•••--•---••-•------•--•-•--•.................•••-•-••••........•---•.....••--••••--•••-•-_---•--......................................................... 0 Description of Soil........................................................................................................................................................................ x w x -•---- ---------------------------------••••-----•---------------•--•-•-------------•••-•----•----•---------------------------------••-•---------••••--•-•-----------------•---••--•-•••-•--•-----••-- U Nature of Repairs or Alterations—Answer when applicable----� -------- -_-__. Y�-----t---I...._ t`3 n .«_ ,11`-.�c'. ® _ _....:wi-r_G�..__._ > ._sf ^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 Co plianA has been issue --4--f health. Signed ...... -..... ... ..- o..�i. .Z..f r1..42... ------------------------ Dare Application Approved By --------------_-- - - ----------- -----� �? r�'-r Application Disapproved or h �� . PP PP f the following reasons: ........................ .. ....... .... ..................................... ........................................... . -------------------------------------------- ------------------------------------------------ -- ------------------------ --- ----------- ------------------------------------------------- -- ......................................- Permit No. ��. ' ... Dare Issued ............ Dace No..9. :.... 7.a�— Fzcs.... ......� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works, Tons urtion rruttt Application is hereby made for a Permit to Construct ( ) or Repair ( �an Individual Sewage Disposal System at ...... s ._. �.. . s-�:........... ��. ............................................ --............................•.......... FLocation-Address r or Lot No. ` Own 1 l n ►W-a .....�C:� 1—� /��/� I �G S Q�.S'3C f�C� pCdress Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..........!,/............................Expansion Attic ( ) Garbage Grinder ( ) NOther—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_-_O..1_�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 (/j Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (x, Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ a -------------------------------------- --.............. --........... _------• --•-------------- •------------------- --------------- ---------------- 0 Description of Soil........................................................................................................................................................................ x w UNature of Repairs or Alterations—Answer when applicable.___ .►� - ._`.�...._ 1......\.� O....GG-L..._S _•-�%" --.: Al...v----- .C.... �s4�.K.....j ._ {.._.' nSt�\ � ?S'_...__ _�.n -?_C. ... t-4 (n ....` .............E-•sft3 --- 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 has been issued by the-boa-rd-of_health. /�Z Signed ! .......4 ........................................ ----- Date Application Approved BY r r •�--- .... are Application Disapproved for the following reasons- ----------------------------------------------------------------------------------------................................----------- -- ......------------------------------------------------- ------------ ................................---------------------.......------------------------------ Date Permit No. Issued ..--------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Gerlifira a of Toncylianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ..... C``Sri P- Cc,r\S--- ---------------------- -------------------------------------------------------------------------------------------------------------------------- Ip,taller has been installed in accordance with the provisions of TITLE 5 of State Environmental Code as described in the application for Disposal Works Construction Permit No. ...-------- - LQ,...--...�.LZX� dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------ ......................... Inspector ---------------------------=--------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No...7.2 - -•- 7-9., FEE----....... -••........ Disposal Wanks Tontrudion ruti# Permission is hereby granted.... M�-�_S_S....-�� -�- �onS'F C �.- - - --._...._.. to Construct ( ) or Repair ( 01 an Individual Sewage Disposal System at No.................. ------- -------:--�-_4..---....C_s�.''' �> -�� Street ��! as shown on the application for Disposal Works Construction Permit No._.____�._____.__ Dated.......................................... •� Board of Health DATE--------------------5- 9._a_ FORM 36508 HOBBS Q WARREN.INC.,PUBLISHERS