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Home My WebLink About0236 COMPASS CIRCLE - Health �i�e�yll v ,� � 7 TOWN OF BARNSTABLE ' LOCATION � � �r->N'k sib.,S5 C,tc4G —SEWAGE # 00> VILLAGE 6-('-(t-6 ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. C ��CD Swc fL SEPTIC TANK CAPACITY LEACHING FACILITY:(type) �{� (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER .., DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �/ •1� — � VARIANCE GRANTED: Yes No �� I, • •r W \� 6Q O O • a 07§ LOC TI N SEWAGE PERMIT NO. WIL ACE liY &N�/lS INSTA LLER'S NAME i ADDRESS 0 U I l D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED '102 /t7 j vo � d Al �1 i i� L, THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH w� �- .. _ ...... .........."".."._...-.OF...A!2A!.`�..1'i9-�--=-----"...............•-"---"------------ ApplirFa#ion for Dh4pog al Workii Tonstrnr#ion ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at ....�-si9.. '. S ................ ................................................................................................. Location-Addctss r Lo�No. ..7..".Qu .T..t.o..e�... -4... ......................................S - wner Address .....-•--------------------•-•- M Installer Address Type of Building Size Lot___t 4_#.Aal-------Sq. feet U Dwelling—No. of Bedrooms___________________________________....Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building 1? !l �_____.. No. of persons a Other—Type g 4' '6 P G Showers (� ) — Cafeteria ( ) dOther fixtures ---------------------------------------------------------------------.------------------------..-.-.----.._.._..------------------..._.._..._......•-•- W Design Flow......S S.............................gallons per person Ver day. Total daily fiow_.__._.__I._3 Q_.-______..._______.___gallons. WSeptic Tank—Liquid capacity__/DG�tga]lons Length_T__.`._.____ Width. _.. _.____ Diameter................ Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......L............. Diameter.................... Depth below inlet.................... Total leaching area...Y!!� 7.___sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results -Performed by.A60",0Y/%!✓.. _________________ Date._4 _s,!_ ............. ,aa Test Pit No. 1.....I.........minutes per inch Depth of Test Pit____________________ Depth to ground water.._'Vo!!'._ .-.. 44 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................t 9 , O Description of Soil �Su 4' L y--60�v�_��tt .,_J�t/9 << -------------------------- V -------------------------------------•-----••------------•-•-•------------ / �_____----...... W UNature of Repairs or Alterations-Answer when applicable..........................................................................._.................... ...................-.............................................=--------.•--.-------...........-•----••---------------------------------------------•--•----------------=-------=--------........---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with m the provisions of LITL L 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 thgoboard of 1 alth. Signed.`; t• ...... .-----••••.......:-- / _:_�._.....__ Date ' Application Approved By--__-••- - �=------------------•---...----------..__......••---••-•-.........---_•---•- ..- --•---............................ -Disapproved for Ze following reasons: = .................................................. ............. ------ ----.... ---------------- ............... -...... --•••----•--------...•------•-••-------•••-•----•--••-••---•---...•-•---•.... -•--•••••----••-•----•--•-•------•---- 4WW `--- �r Permit No.--_._.._� .. Issued-------- _ .. ........ Date T No.........:Z' .... F�$. 5: ............ THE COMMONWEALTH OF MASSACHUSETTS . BOARD fOF HEALTH OF.... ... .f.......................... Applirtt#ion for Disposal Works Tonstrn.r#ion .ernti# Application is hereby made for a Permit to Construct (_'�) or Repair ( ) an Individual Sewage Disposal System at: ............ _..(j].1.j. ...... Location-Address L lirJ�.._ 1 ,r f-, , /j f U .-J lJ �� C/ _____--- caner l _/'/� i / I.�N�G" O• / ��D�i/ / .. _... ............ ........................................... .............................................. ...._......_...._..........................._- (, � • ,�- ddress � / p A Installer Address Type of Building Size Lot.... Q_:_ ......Sq. feet ,., Dwelling—No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building ...... No, of persons.......(I................... Showers (! ) — Cafeteria ( ) dOther fixtures -----------••-••------- ---------------••--------.--------------•-•-••--••----•---------••-- ................................................ W Design Flow............................................gallons per person per day. Total daily flow..........:'_'_-......................gallons. WSeptic Tank—Liquid capacity..!^_:':_'gallons Length__Y............ Width..`....t..... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......!............. Diameter.................... Depth below inlet.................... Total leaching area....`!°_.Z_..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed ................ Date... .. Test Pit No. 1......1........minutes per 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........................ 9 .................................. ------------------ -------•••--------------------- ------- ----------------- -........ .•......... ODescription of Soil...... ..:. ... 1 /, 'd'-•f -1". .. �.......................................•-------------------••----•---------...--------.........--------------•-------------•- / W ---••-----------•-------------------------•-------------------------------------------...----------------------------------------------------------•-------...-----•---........._--------...----.---•-- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•-----•------••-------•---••--•----------•-•-------•----•••--.....-•--------------------------------••---•-------•••-----••••-----•-------•------..................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T p S 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 offhhealth. ,r `` Signed. . -.......... .�-�......�, �j_ y� ' --.... 1� ........ ......... �.. ....Date ApplicationApproved BY - ----•--•------------------------------------------------------•--••--------------_.... .....-••-•-••--•••-•D.. ....•••..--•--- ate Application Disapproved for the following reasons:-------•-------•.................•-•--------•--•----------------------------......_......•---------•----.....- -----------------------------------------------------•-••-----•--•-.......-----•---•------------................•-•-••-•-----••---------------•-•-.....-•------•--------•---•--•--•••••--•-••------------ _ Date i Permit No.......... -. Issued-------- Date THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF' HEALTH ✓ �rr#ifirtt#p of (�oot�rlittnr�e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( JC) or Repaired ( ) t= •-- -•......:................... = = ! .. / r' l r7nstaller has been installed in accordance with the provisions of TITILE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CON STRU AS A GUARANTEE THAT THE SYSTEM WILLFUNCTION SATISFACTORY. -17—7 DATE..... 7...... Inspector ..................... --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................... ..... L......_..... ............................................................... No......................... FEE........................ �i��o�ctt1 ork�'�on�#rnr�tmrn rruti� Permission is hereby granted._.. ......... .'-�J =`= ="--•----------------------------------••-•----...........................---- to Construct ( >) or Repair( ) an Individual Sewage Disposal/System r .............. Street re as shown on the application for Disposal Works Construction Permit No...:Zt__ ......_ Dated........./ .............................. ----------------------------------•-•---------•---------•-----------......----...-----.....-------_...._ Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS r ,. T-•, _ "_-,' - -.- •'t '� : ~ice _.r - _ r Ke .,4 ��.: .. .. •'°I '1't.' w ,r, `� 1�F...- .wrs t`..R" Yyw,tv��o 1 :s rr. 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