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Home My WebLink About1376 OLD POST ROAD (CT & MM) - Health �,yn .^'.«"ems ryr^ �,tar5'�'a�•4^�w �� s:� T/tM`,�'�� }"�# �w. @g P 4 y�v� :. ," AOA," k k * C '� �y R� ��A COtUlt �� V Y 1 TOWN OF BARNSTABLE LOCATION � �(� CJ�(� ��' D�� SEWAGE # VILLAGZ(5 j� ASSESSOR'S MAP & LOT Ol,g INSTALLER'S NAME`& PHONE N4.�(''�j�O��dYkS� SEPTIC TANK CAPACITY_` y� LEACHING FACILITY:(t ) JD / (size) NO. OF BEDROOMS PRIVATE WELL O(:PU:B:L:llC::WA:T3.E�I BUILDER R OWNER" _ DATE PERMIT ISSUED: I C2—9— DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No Fro v� 37' Ax a APPROVED No.h `A ... Barnstable Conserv�•r�ePartnt�e- �, THE COMMONWEALTH OF MASSACHUSE BOARD OF HEAL�'-'� ,-9C�3 Signed Date TOWN OF BARNSTABLE Apphration for Uirpwml Worbi Tomitrur#inn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (b4 an Individual Sewage Disposal System at: -•--- ----••••------•-------------••-•• ------ •--.....-••--•-•-•--------......--•-------•-......---.-•--....-----•-- Lor,ion- �dalrcss or Lot .....� Del/ �lL�So /&�� O't,� Pcxt>`,/1�--...--•--- e de �T O c,Fr Address Installer Address Type of Building ..� Size Lot............................Sq. feet ..� Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------- -- d -----•-••................ W Design Flow.............. ... ...............gallons per person per day. Total daily flow......... .....................gallons. 1:4 Septic Tank—Liquid capacity-1 P.gallons Length................ Width---------------- Diameter........-..----- Depth................ Disposal Trench—No. .................... Width.................... Total Length.....-.....�_..... Total leaching area....................sq. ft. Seepage Pit No......� ---- Diameter..... /C-(.... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 1-4 Percolation Test Results Performed by.......................................................................... Date......................................14 .. Test Pit No. l................minutes per Inch Depth of Test Pit.................... Depth to ground water........................ GZq Test Pit No. 2................minutes per inch Depth of Test Pit..............--.--. Depth to ground water........................ 0+ •...•-•--••-------------------•--•-•---•-•••----•---••---••-•--••••-----•---•-•-•---•••.....------•-------•-------••--•---••-----•................. ODescription of Soil........................................................................................................................................................................ W V .................. ................................. .---------------------- -------- ------------------------------------------------- --------------------------- ............__...-------- ----------- W Nature of Repairs pZ Alterations—Answer when applicable..-. �?�.....?..;....... ®'� 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 ' s by board of health. Signed ................................. .. ::':: ... .....�%�a ................. � . ApplicationApproved By ....................... ... -- .... ------------- .......................................... ........................................ Dare Application Disapproved for the following reasons: ..................................................... ..... .................................................................... ............. .... ........................................................................ ............ ........................... ............ .............................................. ........................................ Dare PermitNo. ......73.........�?.13.... .............. Issued .................................................................... Dace �46 f cc�� -7 �r No..l..:3.::�. Fa$....:�.... .... THE COMMONWEALTH OF MASSACHUSE TS BOARD OF HEALTH H�� TOWN OF BARNSTABLE Appliratinn for Ui!ipuinl Wor1w Tnnitriirtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair (111-1) an Individual Sewage Disposal System at: asJ---------------------•---•--------- ---------------------�-----------------•or----Lot-•---------------------------------------•------ Location-:\ddn•ss No._ - ..... -------------- ----- ---- owner Address Installer Address UType of Building �- Size Lot............................Sq. feet ► Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a1 Other—Type of Building ---------------------- ----- No. of persons.......--................... Showers ( ) — Cafeteria ( ) 04 Other fixtures -------------------------------- W Design Flow.................. �..............gallons per person per day. Total daily flow........ d....__...............gallons. t� Septic Tank—Liquid capacity..l�s o.-gallons Length-.-.-----.-_--- Width---------------- Diameter................ Depth................ W Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No..........' ...... Diameter.------ZO.-.... Depth below inlet.....A........... 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........................ a ---------------------------------•--•--...-----•--••----•-••---•-••-•-----••---•............._..._........•---•--•-•-•...•--•••-•-•-•---•••......--•---...... xDescription of Soil.......................................................................................................................................:................................ V .....---•---•---......--•...•-----•..........•-•......•-••---•----•-•-•••---•---•--...---••..........•-••--•---•----•--•-•••••-•--••--•---•-•----••••-•-•-••••-•••--•••-•.............•--•...••.......... W -------------------------------------••------------......--------------------------------------•--- ---------------------------------------------------------------------••---••--................--••- U Nature of Repairs or Alterations—Answer when applicable.-.-..-1.,.t1.5`%. -..-' :_...�.>T��.r .... > � ..•...... 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'as been ' su ed by��the,board of health. Signed ------ // /.._ �' G � ........... ........ Dare ApplicationApproved By ...................... . "- .................................-!....--................ Date Application Disapproved for the following reasonf. .... .. ........ . .................................................................................................... ....... ............................. ....q- ... ..................... . ... .................................... ......... .... . ........................................ Permit No. / -.3._-....��../3. ------------- Issued .....---'---------------------------'-------.....-..- Dace....- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C erttfticate IIf C ontylia ce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired at .............................. / 7� ..... =��..1-b....r� 117=.6.:�...... - Cl -/��-' 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. _--4?-3—.....6-.7 5-.- dated ...................--............-...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. L.:j ...-..... 1.. 4. _.--.....-... Inspector ........ - `... _,------------_._ j,. ,_.- __-- - -- ................................. � _,_�oo,=-- THE COMMONWEALTH OF MASSACHUSETTS 05� —2 BOARD OF HEALTH VV -7 TOWN OF BARNSTABLE No. �?-... .1..3 FEE-: �...... Disposal WorksTonstrudion Vernfit /� _.lL�G7"�G f Permission is hereby granted--------------------------- �/�� /.�1..•C�l.�----•-------- --•----------------•-------------------........... to Construct ( ) or Repair (INe) an Individual Sewage Disposal System at No..................................... !f` y --•••-•--•• 1�. ._...... _ ,` ••-- Street (� as shown on the application for Disposal Works Construction Permit Nol3 73 Dated-__ ............ --------------------------------------------------------- qc� Board of Health DATE.............. ............................ FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS