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Home My WebLink About0025 TODD WAY - Health 2 TOdd�� a c � TOWN-OF BARNSTABLE LOCATION � �D�� SEWAGE # '74/--2-7DA- 1 �_ VILLAGE Ly 2" ASSESSOR'S MAP & LOT I INSTALLER'S NAME PHONE NO. ` � e SEPTIC TANK CAPACITY 1 �?�'O S e � t (� -�p✓rjiC LEACHING FACILITY:(type) PQ-��CSt� (size) JJ I� NO. OF BEDROOMS 3 PRIVATE WELL OR UBLIC WAT BUILDER OR OWNER DATE PERMIT ISSUED: ��/� DATE COMPLIANCE ISSUED: 23y VARIANCE GRANTED: Yes No r 3 v1" -J �i TOWN OF BARNSTABLE LOCATIONS lauD j.UA`I SEWAGE # VILLAGE C n TO I 'r ASSESSOR'S MAP & LOT ` INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS , PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yesyr��S�'�No �� IdrnQ GtpNE(L 3 °-IV 1� 14 1 - -1 14 �Y 30 .. .a /F) ....... it THE COMMONWEALTH OF MASSACHUSETTS ...; BOARD _OF HEALTH TOWN OF'SARNSTABLE►ini� rtt�t r Uipn1 Works Tonfitrnr#inn Famit Application is hereby made for a Permit to Cotis ' all truct ( ) or Repair ( ice Individual Sewage Disposal AC System at: .... s... 000---- ---------------------••-•-• .......................... ----•-•------• ..... .............. •--...._-••---._.......--•-•--._•------••- Lp a6, -:add y•ss or Lot No. rw pv ��J �0wY'Zl5 6 ............�. _..` ...---- •-••--•----•--•---•---•••--•----•-------------------- •-----•-----••------• ----••--•-••-•.... ...................................................... On-nc �ircss a (° �e`'� ---- -- - G j--------------------------- Installer Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms............................................ "Xpansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures _______________________________ _ _ W Design Flow........5.7.�______________�_,_�__-gallons per person per day. Total daily flowrZ�_._��•Q.........................gallons. WSeptic Tank—Liquid cap city..wallons Length... Width`'J------------ Diameter....._.......__ Depth................ x Disposal Tr c i--No_ ____________________ Width__l. —......... Total Length...... Total leaching area....................sq. ft. See e it o... ............... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit--------_........... Depth to ground water........................ L% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil........................................................................................................................................................................ x U .............................. w •-...._...... U Nature of Repairs o Alt ations—Answer when applicab e.__�- ........ .. .... . . . t -.._._.... C (900 s- T ,✓� • .. ..................•-••_. �0'P � �.v...c�a� ---5-��`" - Agreement: r , 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 undersigne further agrees not to place the system in operation until a Certificate of Complia iss oar f health. Signed ........ ..... . .......... .......... . ....... ......................... .... Dare c� Application Approved By ........ .. ........ ' -..�o2e.��..'-�./ Application Disapproved for the following reasons: ............. ............................... ............................................................. ......................... . ....... .......................................................................... ....:.----. ........................................ Permit No. ..... q...--------- - a—74�.................... Issued ...............-....................................... ice...... Dace ..ro......-,•.kia..+t..."FP""-`.,�."'-+�nr ..r,.:xa3�nb;,`�a.r:.jlvt,f-^+F,fp�-'yyn'+.�� v�va...,ra..v,.w �.�v-tea*. .�w-a•-' .�r•r� �; nf� ....,, �__.v:wr —r 7d A Fas....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y TOWN OF BARNSTABLE �VVIi ation for Diopoottl Works Tonotrurtion Famit , Application is hereby made for a Permit to Construct ( ) or Repair ( v an Individual Sewage Disposal System at: TOIDO ... _-------------------••-•---•------- • ........................... _----•--------------•-----•--••-••-•-••...-•-•.....__.-..............•-•----•-•----....-'------•-- Location-Addr, ss or Lot No. \ (^Ciao .. �t .c_.: � (" 2--UV C Address l LF1 c �j �- l c /r \\ _.__.��. ._.. "`InstallV1 ----••--•----^ .----�n-�•---• — ------------Owner Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms....5..-.-.••..........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons------------------_......... Showers — Cafeteria 04 Other fixtures -------------------------------- W Design Flow........ _ _____________________gallons per person per day. Total daily flow-.7S, d.........................gallons. WSeptic Tank—Liquid cap city__/ allons Length... Width............ Diameter................ Depth................ x Disposal Trench—No_ ____ ______________ Width__h� ......... Total Length---__�_......... Total leaching area....................sq. ft. 3 Seepage Prit' o�............... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY---•-------..----•----•-•--•••------------------••--•-•-•--••-••P-••--- �te.__----•-----••---•...-----••••-••---- Test Pit No. I................rninutes er inch Depth of Test Pit-------------------- Depth to ground water........................ Lz, Test Pit No. 2................minutes per inch Depth of Test Pit... Depth to ground water........................ 04 ..... ------------- ------------------------------ ---------- •....... O Description of Soil........................................................................................................................................................................ • t----------•----------•-•--••--•---------•-•-------------------------•---------------...--•-------------•-._._.-......._...•-•••••-••• Y •---•----------•-------------•-•--._._.._....------------------....------....----------••---._...._----------•----------C�.._.-------..............................................................__........-- j1-- - t—tti�t tom« ....._._. _.... .... -- Nature of Repairs or Alterations—:Answer when applicable Agreement: C �1 d .....__. The t in tall the aforedescribed Individual Sewage Disposal System in accordance with a rees o s o ce g g P Y 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 e_h.as-be issu d-by-t e_board f health. Signed - y Date ApplicationApproved BY -------.. ......... .......................................................................... Dare Application Disapproved for the following reasonr: .................................... .. .................................+.............................. ......... ..... ......... ....................................................... ............. ...................... ........ . . ..................................... .............. ........................................ 9 Daze PermitNo. ............./...... - ----�L 7.��..................... Issued ..........---.........................................----.......... Daze THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Cnomplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( (� by G IA......� S ,[vr../. -.......... ..... . .. mst:'ue` at ._...................._..... .. .. ............_............ 70 .....K....................... .....C r� ' .__....................... 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. ..._.c�.��___..'� .7.C. :. dated .........------.---...._-------------- ... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE "" ..,r-.t -------------- --------- Inspector ------ - .....eZ . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No—/... .-12( FEE. . .-.. Rio oottl orko Tono#rudiott Verutit Permission is hereby granted---------------------•---------- .............................................. to Construct ( ) or Repair (�n Individual Sewage Disposal System atNo.................................---_---------•--------------P. -•-_?!1 .�'---12G-- __-------- G ='•-- street as shown on the application for Disposal Works Construction Permit No-ALjk_)7d&ted_._.__..�:_��_.^..��..... e� oard of Health DATE.... .. 'C? ._l. --------------------•---------------- FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS