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Home My WebLink About0727 MAIN STREET (COTUIT) - Health (2) -43 1 �I R-A-, (,t�U4 0�6--66 TOWN OF BARNSTABLE LOCATION `7�-� 1�►249N S� SEWAGE # g� 1�-- VILLAGE GPlT—y 1'7— ASSESSOR'S MAP & LOT 024,—DDT INSTALLER'S NAME & PHONE NO.r2;'G1lt�—(�w'77-7 SEPTIC TANK CAPACITY LEACHING FACILITYAtype) C/&J (size) x�i• NO. OF BEDROOMS v� PRIVATE WELL OR 1 LIC WATE BUILDER O OWNER DATE PERMIT ISSUED: DATE . COMPLIANCE ISSUED: °� VARIANCE GRANTED: Yes No� 9 F- v_� A'�' '/ 0136 00� No...1.�j. ...:-...�. Fxs.... d .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uinpwial Mirkii Tomitrnrtion Vermit Application is hereby made for a Permit to Construct ( ) or Repair J>4 an Individual Sewage Disposal System at: .......��7._._..�'4-i of �5 U -- -------- ----------------- -----•------•-------------•---------------------••---...---•---------------------------------•--- �q ............. ISoca_ tioti-Addressor t No. WT Ow�r j ��U 614 it ress l-4t Installer Address Type of Building Size Lot.. feet ►.. Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons---------------------------- Showers — Cafeteria a4 Other fixtures ---- ------------------------ - - W Design Flow................_------------gallons per person per day. Total daily flow-----_-_----�-3v-.-------------- ---gallons. WSeptic Tank—Liquid capacity/S _-gallons 4ength---------------- Width---------------- Diameter---_-.---.-.__-_ Depth---------------- Wi x Disposal Trench—No. ......./........... dth___--4�1........... 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------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-_.__--__--_-_-_-- Depth to ground water........................ 94 ------•-••---------------------------------------------•------------------•-----•---........._------......................................................... 0 Description of Soil........................................................................................................................................................................ x U W ------------ ----------- ------------------------------------------------------------------------ ------------------------------------------------------- -- U Nature of Repairs or Alterations—Answer when applicable._.._1_ r -__ ....P 4.. ..........� .t-:..__.. -------------------- �An1�-..----...01Z:-�--t------ROIL �----- - ----.... ------7L/---,- ..................................................... 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 h be n isV t oard of health. Signed ........ .. �y�-- . ..... .� ....� y /v.-.... Date Application Approved By ---------------- ---- ------------......................--------------- �... .{/� �� Application Disapproved for the following reasons: . .... . ............. ... . . ................. . . ...................... .......... t' ......... ................. . ..........a---------------------------------------------------------------........................................................... Permit No. .....96 -------L-....�---------------------- Issued ............... ....^.. ...-... . Date ——————--—————-- r No... .............. THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH TOWN OF BARNSTABLE t Appliration for Bi-ripwial Works TouBtrurtion rrrntit Application is hereby made for a Permit to Construct ( ) or Repair O an Individual Sewage Disposal System at: .... ............................................................ ....................... Location-Address or Lot No. __ 67 ...................... .................. •/ _ .. U.�......------ r`�l-/ ..... r .................................... Owner _,_. .--_... Ad ress � fl t ' �: i� 'Lt,11 L�/OX) 1eD J i4' J3�1 ✓1il, /1�l /its Installer Address d Type of Building -� Size Lot..` �.G��-_..Sq. feet Dwelling—No. of Bedrooms______________ -?___-_-____-__-_-_:-.._Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 04 Other fixtures ------------------------------- - - W Design Flow.................. .. _........__._gallons per person per day. Total daily flow--------------- .....................gallons. 1:4 Septic Tank—Liquid capacity/ --gallons Length---------------- Width................ Diameter..._............ Depth---------------- Disposal Trench—No. -------Z.......... 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........................................ aTest Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water..____--------__-----._. (i Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P --------•-----------------------------------------------------------------------•--••-•----•••----•-......................................................... 0 Description of Soil..............................................................................................................................................,......................... x V ....-•••-------••-••----...-----••-•••......•----••-•---•--•---••••••--•--•-••--•••--•------•-------•••----•------------•--------•----•-•--------------•-----•---------•---•-•------....--•----------•-- W - ------------------------------ .......... ......C......... U Nature of Repairs or Alterations—Answer when applicable._...-/.. S_ �:�.-_.�____.�5�4.. �. '7 L _ ---------------------- 7- — r--.._....IAJ)�i_[_T%lJ1 '. _..._..l-�T/>UU.L..._.J_ rJE_ 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 be n is ued the-oard of health. Signed ... ------ ----- ---------------- ---- /yl-- �Due ApplicationApproved By ------------ --------- ........................................................ Application Disapproved for the following reasons: ..... .............. ...... ... ....... ---............................................... _ ................................................................................................................................................................................................................ ...../ r Dace Permit No. ..... .......^ 1. .................... Issued ...... l� `---�' `✓ �. Dare ../------------- ——--."•—————————————————————— —————————— —————————————— —————————-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE N"LlIe tifirate of (Cantylinna THIS IS TO CERTIFY,That the Individual Sewage Disposal System constructed ( ) or Repaired L ,' c rr7........ G�.t.t�s.� /Lv car--.t-i-..-........................................................................ by------------------------------------------------------ -..: at ........... .................... --. , . . ......... ...... has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code as described in the application for Disposal Works Construction Permit No. ------�,..r�....._--------I.... ._ dated --------._----------- -----------_-------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. --- �j Inspect r,.... .......... 1CG /f,[ �(- DATE. ............. ... ......... � :. ---------_J ——— ------------------------------------------------�--------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..�:.2.---� 1 a— FEE_36............... Disposal pr�_ ii Tonn#rudiott "antic Permissionis hereby granted...................... .................................... ............................................................r�.riJ to Construct ( ) or Repair (;/.) an Individual Sewage Disposal System at No-------------------------------------------------------------------- ----- Y►� ice.----->-S-'./L�ET G!�""L + + --- •............. Street � �- as shown on the application for Disposal Works Construction Permit No.__-_----_:.�------ Dated....... ....... ................................. .................................................. Board of Health DATE..............�-- �� C)��> ....................-••-•---- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS