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Home My WebLink About0053 PINEWOOD AVENUE - Health 53 i Atwood R T 9 - o E . . • r � , " 8 t t 6 r r r n a t s 1 TOWN OF BARNSTABLE LOCATION SEWAGE # `��/ VILLAGE ZZ!� AJ/S ASSESSOR'S MAP & LO'I`� 67y INSTALLER'S NAME & PHONE NO. eO SEPTIC TANK CAPACITY Z�®a o—Z LEACHING FACILITY:(type��i`�%L7X ,3)(size) NO. OF BEDROOMS PRIVATE WELL O UBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: �� DATE COMPLIANCE ISSUED: .91 No VARIANCE GRANTED: Yes �4 e IF No... �............... THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOAR® OF HEALTH Barnst a conservation DeOWN OF BARNSTABLE lilau .3 -Alipatial Workii Tomitrurtion Butt# pplication is hereby made for a Permit to Construct ( ) or Repair O�.4 an Individual Sewage Disposal System at: Lot ...1.. — �5.�4�/ tion-Address �.✓✓rp �^ ........l..r..l No. .----1"4- . • ... ---------•-- w �r�_ ...�5r�11 4,5,E ...... Installer Address f 14 Type of Building Size Lot_ _�.--_Sq. feet ,_4 Dwelling—No. of Bedrooms...................................Expansion Attic ( ) Garbage Grinder ( ) '-PLI4 Other—T e of Building No. of persons........................... Showers — Cafeteria a' Other fixtures _________________________________ w Design Flow................. .--.._.___..gallons per person per day. Total daily flow................5�_-_..................gallons. WSeptic Tank—Liquid capacity/M.k+' allons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No............/.... Width....._-7....... Total Length..G.".2-5 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fT4 Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water---_•______---_-----__-- 9 ----------------------------------------•-------------------------................------------------......................................................... 0 Description of Soil...............................................................................------------------------------------------------------------------------........._.-•--- x W ------------------------------------------------------------------------------------------------------------------------------------------------------------- x U Nature of Repairs or Alterations—Answer when applicable....../ � ______ a . .......... ./........ . 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 ha �nissu e oar of e th. Signed --------- . - ---------------- --- ------ ............. ... Date .../v Application Approved By ----------- �, ............. ......... ... ........... ----- Application Disapproved for the following reasons- -----------------------------------------------------------_---------. .....----------....------................................. . --- ................................. -------------..................:--. ------------------------------------------------------G.y.....................�.y...........---..------.-.-...... Date !az..----- .�../..................................... ................ Issued ---....................................................Permit No. ------------ Date �y -71 No.__�...... Fss. ..._..... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE -3 -9a �. alirtttinn for Disposal Works Tonstrnrtiun Permit ,Application is hereby made for a Permit to Construct ( ) or Repair (>.--) an Individual Sewage Disposal System at: ---,_WSJ i�//�� GtJOGD %Csi�Ji�/:S«/ /L•1~ nc Location-Address �`�`/ /✓<-_C G.�JI S5 ...-_,%�/!r/ G c1GCiD .. Q..__...«/45,:3....V/S;�G'c7.....�'.' .... .�.....«................... W ,.,�G/ LD/// CUn .." ."�'�/1 /ass i - Ad Installer Address Type of Building Size Lot_ « #.Sq. feet .-t Dwelling—No. of Bedrooms............... -..------.--____---Expansion Attic ( ) Garbage Grinder ( ) Other—Type a ype of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria. ( ) d Other fixtures --------------------------` - W Design Flow.................: ---------.__gallons per person per day. Total daily flow__-_.__..-v Q3b___..._.__......_.__.gallons. W Septic Tank—Liquid capacity.Al`�_x_.'gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No............f/.... Width.......77_......Total Length..rn -7-5-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---------------------------------------- 0.4 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----------_------------ Ix -------------------------------------------------•---------••--•----...-----•-•----•---------...-•--......................................................... O Description of Soil.......................... W U ------------- ----------------------------------------------- •-------------------------------- •--------------------------------------------------------------------------------•--------------- W V Nature of Repairs or Alterations—Answer when a plicable-_-___/�t.2--4",1.....�Qe9Cv 1_6�._. C � . ------------=----- Aj ..................... -- --------------... -------------------------------------------------------------------------------------- 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'b/een issue d/by th boar of .ea th. Signed --------- /=-�1'i _ Dare Application Approved By -------- ` -...-�.> ......w. ---------------------------------------------------------- ----- "=; 4_____________ ___ Date Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------------------------------ ------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- Date PermitNo. .........c�,/.. v J ----------------------------- Issued ------------------------------------------------------ a" Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tex#ifirate of �umylianre THIS IS TO CERTIFY, That.-the Individual Sewage Disposal System constructed ( ) or Repaired ( L) by------------------------------------------.................... ?�7 ... ---------------------------------------------------------------------------------------------- Installer at -----------------------��-- �J/--i�c�JOd(j .� ��.Qnhl�-- ----- -- - 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. ......... ____.._1.I..9_.....--- dated __________------------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. l �� DATE----------- -----------------------.� ' � ', = cf--, Inspector ----------�1 - \-�........................................................ J t -- / 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No......1�................ FEE........................ Disposal Varks Tonstrnrtion Permit Permission is hereby granted ------------------------ -- to Construct ( ) or Repair (u) an Individual Sewage Disposal System atNo. -----------------------•- --------------- ---------------:------------�y-------v-------------------- ----------------------------••---- Stree as shown on the application for Disposal Works Construction Permit tNo.._.,_?.__.1 Dated.......................................... ...............................':�_ - Board of Health DATE.................... `• ��=C� FORM 36508 HOBBS Q WARREN.INC.,PUBLISHERS