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Home My WebLink About0008 RALYN ROAD - Health 8 RALYN ROAD —i Cotuit -- - [ A = 022 - 042 r ASSESSORS MAP No: '0�� b Aa. -0 PARCEL NO.. No...... �.1...... Fim$......,r.�p?.."... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...710W. 4 __................OF...ILXJt ! Lam.......... _..... Appliration for Bl-sp.aii al Works Tomitrurtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair (4) an Individual Sewage Disposal System at: eovw.�..................................... ------------------------------------------------------------------- --- --------------- �^ cation-Address or t Iv .................................................... n � � -......................................... Owner ddres W gI .&Y.isn................................................................... 3,Sa_1Yla�h..S`► "�...��Ra _ g��►td _.... ,.a Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms.................................3.......Expansion Attic ( ) Garbage Grinder ( ) -ALI.1 Other—T e of Building No. of persons............................ Showers — 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—I\?o. .................... 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........................................ W 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-.--___-_-__-__--------. P1 ----------------------------------------------•-••-----•-------......_._....--------------------......--•---•--------------------------............•--------- 0 Description of Soil........................................................................................................................................................................ x W x ---------••---------------------- U Natur of Repairs or Alteration —Answer when applicable.__!n.P ...l�oQ .� �tf. .c�?- i4..___. ¢ ......................................................--------------------------------------------- Agreement: U The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT!:3'. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed....... C -&2 ,''� l 9D to ------- Application Approved BY 7 --- .Date Application Disapproved for the following reasons:------•----------------•----•-------•--•--------------•------------------------•---------------------....._...-- -----------------------------------------------------------------------------------------••-•-------...-----------------------------------------•-------------------•-----------------------••-------- Date PermitNo..... ..........................--��---- j ._.. Issued....................................................... Date 1 - THE,COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r. ....., � OF !. ......... r Appliraftan for Ui_gpus al Works Tonstrnrtinn ami# Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: `) ('�............. .. 1Cc�.�r� �.x si� Location-Address or Lot No .-m/Tf6 •T • h,n _r cd !I1 ��rr.. i lff ------------------------------.............-----------._...------..._..-----------------..._... �---!.....--...--------------------�.:�:....�:...------------------------....._...------ Owner _ I Address (�1 �� f! 'elil +�71:i_ foV-.1 (l :r.l T'! ................................................................................................. ..................................... - Installer Address v UType of Building Size Lot............................Sq. feet I-� Dwelling—No. of Bedrooms__________________________________.._......Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria a' Other fixtures ..................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter__-_____________ Depth................ Disposal Trench=-NTo. ................... 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................................1....... 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........................ ----------------------•----•-•----------...............---...---•---•--._..__........._.:..........-----••---------------....... 0 Description of Soil...................................................................................................-................................................--------------•-- U ----------------------•----•----------•-••-•----••-----------------•----------------•--•-•-----•-•-••••-------------•--...-----•----•---•----------•----•---------•-•...........__...------•------_.---- W U Nature of Repairs or Alterations—Answer when applicable .t-,, �.r .__ f 6,n r:.it /0 .-1, „ ram/n:l- r Agreement The undersigned agrees to install the aforedescribed Individual Sewage DisposaI.System in accordance with the rovisions of T 1 T E.lw. ;p �of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. J........ �. .................. ................................. •-•-f f.................... - - Application Approved By... . ..f ------. l r................................ ---- --•- .................... Date Application Disapproved for the following reasons:.............---------•---------------------------------------•-----------------------------------•--....._..._ ---------•--......---•----....---•----------------••-------------•------.....------------....-----------------------•---•----------•-----------------------•-----•-•----•---•---------••-•-----...._.... Date PermitNo-----................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................c, OF...I<: ^....t::�...'........................................................... �pr�ifirFat oaf TompliFanrr THIS TO,. ERTIFY,^T�at the Individual Sewage Disposal System'constructed ( ) or Repaired (>�! h. Jul= by.:.. ..--••-•.......- I----------.....-•--------------.---....---............--------------•-----•--•--•-•-- ---•-----...---------------•---- } s y Iotaller has been installed in accordance'With the provisions of ?" ''_ 5 of The State Sanitary Code as describe d in the application for Disposal Works Construction Permit No.___. `'�_�-.�_'Y.__. da.ted__---__-1 .�1��t_________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA ANTEE THAT Y HE SYSTEM -WILL FUNC IONSATISFACTORY. DATE - ............................. Inspector. ------------------------............__......------....--------.......-- f�Ir THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. ......1. -. ..._.._#.''._� ..._._.._........__._..-._...:........._...._._.. .; s No......................... FEE. ............. Elispr sa orks T.Instrnrtion rrn'tit Permission is hereby granted................. --- 1 f�•'.;�� ------............---•-------------._.....-----••-----••---•----- to Construct ( )_or•_R.epair ( ) an Individual Sewage isposal System, atNo----_---__--------—, ,...._....._._..._�` ...M� ...._.. �, .. ........ ................................ ..__ ..___.._ _.___ ________-___-..-----.____ SLSeet /i n as shown on the application for Disposal ftrks Construction Permit N �...__Dated_f y ........... .... _ ______ ........................ ._...__...._ DA r - Board of Health %12 -- -•---- ................................... FORM5 HOBBS & WARREN, INC., PUBLISHERS - - AsBuilt Page 1 of 2 TOWN OF BARNSTABLE LOCATION �' / i✓ /�/� SEWAGE # VILLAGE C o4�Ci/ ASSESSOR'S MAP & LOT INSTALLER'S NAME& PHONE NO. A & B CtIM 775-6264 SEPTIC TANK CAPACITY LEACHING FACILITY:(type)_�i®y0 (Size) NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: �" �" Jul/ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No x http://issgl2/intranet/propdata/prebuilt.aspx?mappar=022042&seq=1 9/28/2016 TOWN OF BARNSTABLE LOCATION / i`� / l� SEWAGE # VILLAGE L o�� ASSESSOR'S MAP LOT INSTALLER'S NAME PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY LEACHING FACILITY:(type)_�i D1�0 (size) NO. OF BEDROOMS_,_�PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �"��` Y-7 VARIANCE GRANTED: Yes No \: �3�� i a� �;� �� I � �� L �lo I' 411 � 3e�r�csei`1 . c E> I ..� •gyp ,...,.__..:::_: , 00 4 ia�AR� D�1vCc wA� wv'rifo i -•RfzpL,hc.a Au- via�a��sts wtlo a, rievq �QC'1ea�1►i � �L�L,�C� $3C1Si'►slG �g�� Wtla'H � ly �lac�r�,�et� la�s� Trt,orst�l`t(n _`l 11 � (:-,f3jmr* /lac 1wj&u-s � ei�?��aPs�. 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