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Home My WebLink About0072 MAIN STREET (COTUIT) - Health 72 Main Street -- -- - Cotuit - A=023 - 007 ' �i TOWN OF BARNSTABLE LOCATION 7� /i/1 %�.� cS�.�� SEWAGE #J — 5Y/ VILLAGE GG'TJir ASSESSOR'S MAP & LOT GdJ-- 007 INSTALLER'S NAME & PHONE NO. G-0t,15 ` . y�F-- F5,,6 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) /lT. /al ) (size) 6X (d NO. OF BEDROOMS .5— PRIVATE WELL R PUBLIC WAS BUILDER OR OWNER ZZ9 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: / - ., `-2 VARIANCE GRANTED: Yes _ s _____--_ _ _ I F I��/ t ,�� _�f f �l rIT� i T l ASSESSORS MAP NO: PARCEL NO��..-_S'�l : 00 7 Fxs.... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE M Appliration for Dispoiial Works T oustrurtin Application is hereby made for a Permit to Construct ( ) or Repair (34) an Individual Sewage Disposal System at: ...............7 ...r_ _.-ngs- V... 51. &-r- ......��t�r�=---•-------------- ....... -........ ..................... Loca' n-`ddr�s� r t N --•- �, OCC " ( �g . A..ess L /1� % CJ .... ®� j ---- --.....---..•-• ------------ .. ...Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms................. ..►-, g— ..............Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g -------------•-•--...------- -------- --- ( ) — Cafeteria ( ) Otherfixtures ------------------------------------•... --------------------------------------------------•-------------------•-••---•..........------ 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....._�2._....... 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........................ Gr4 Test Pit No. 2................minutes per inch Depth of.Test Pit---................. Depth to ground water........................ 9 ..........-........................................... -- -------------------------- ----------------------------------------------- .---- - 0 Description of Soil...............j..�.. .....------� '��d.....:.._ ®/G------..../_ �If - x x ------•------------•--------------------•---------------------------------------------------•--•------..----------------------------•---------•-----------------------------------•---•---------....... U Nature of 135pairs or Alterations—Answer wh n applicable__106C5�' ......... -5- _ -. s'�...-o.-��j 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 as en issu d b the board of health. Signed .......D. --------------- ��/� � Application Approved BY .............. ..' " � U Dare Application Disapproved for the following reasons- ----------------------------"--------------------"-------------- -- .----............. ................................... -- .... ---- --'--------------------------- ---------------------------- - -- ------------------------- -------------- -- -- -- -- -----------'--------.....------------------''---' -----'---------- ....---........:... C� �• Dale PermitNo. .......< -..-...V.. ./-- ---- ---' --....-- Issued ................................................... ------ Date No...l... .:.s y� 00 7 F&$....- U............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ' Appliratiun for Bispoii al Works Tomitrnrtiun rrmi# is hereby made for a Permit o Construct Applicationy t t Co ..truct ( ) or Repair an Individual Sewage Disposal . System at: .. 'G� Location-Address or,Lot No. •- .-- ............................................................. ............................................ owner Address W ,CS�rLiGLOB C_f,,LJSi2cx.i�� ?6�____c,J1Z Ct 41,/1!l/cCS ,.a •-••--•••---•.....•...............•---•----.....................••--..._•••-----•-••---•-•-------- ........ ........ ........ .........-• ---..•-•-- .. ...... Installer Address Type of Building Size Lot.................... .....Sq. feet U .. Dwelling—No. of Bedrooms..................� ..: ..............Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a'' Other fixtures -------------------------------•-•-•••• - Desi n Flow................:. S.__.__.___.___.___gallons per person per day. Total daily flow.._....__._: �t g g P P P Y Y ....................gallons. W WSeptic Tank—Liquid capacity.Z--0b.gallons Length---------------- Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------- Diameter....... Depth below inlet.......G......... 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit....................*Depth to ground water........................ 04 •••-----••--•••-•---•--•-••---•••-••------••-•......-----••-•••-••--•••..._......--•---•-•----••••••........................................................ D Description of Soil................d-........Z------------« �/1-. l x U ••--•-•••-•••-••-•••---...-••-•....._...-•-•--------••-••••--••-----•••-•••-••-•••...------•••----•--•••••-•••••---••----•-•--•---•••----•---- --•••-•---•••........................................... W ----------------------------------------------------------------------••••. •--•••--•-•••-•-••-••----••-•--••--............---•-••-•-•••--•---•-•--••-•-•••------••••----••--•---......•---•--•---•... U Nature of 1jepairs or Alterations—Answer when applicable.... � ti~ t___..j�_ U ?/._:: 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�'las b en issu dd b`the board of health. Signed .... L� ,�Z ' T.�% /flare �..-..--- Application Approved By Z U.. '"'`'``'"" ------------------------------------------------------------------------- Arete f Da I Application Disapproved for the following reasons: ------------------------------------------------------------------------.................................--------------------------- --------- ---------------------------- Dace PermitNo. ..----- / - - 5 ......................... Issued ............................................... - ...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�er#ifi a e of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( � ) by----------------------------------------------------------------------- _ c v G TTL-cl '?rG 1 Installer at --------------------------------- -- -- - -- --- --- -- ............. .�... .. .`-sr-........-`.-.... ------ ...--......C 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. ..... -Z .�/./........... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. _ jj DATE................t.. -...... - Inspector ----......------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9.�Syi TOWN OF BARNSTABLE No......�.........;...... FEE... Uispuia1 urk_u C�unu#rnr#iurt rrntif Permission is hereby granted.......................... ��.!_...��..._...L._G '' to Construct ( ) or Repair ( �}'an Individual Sewage Disposal System at No.............................................`=- ......>4.1J .. ..'------------------• =-Ia•?_.1..-/.T Street qq ��/// as shown on the application for Disposal Works Construction Permit No..1.r2,n Dated.......................................... ------••-----•-----•--- DATE_ . — r�y................................... Board of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS