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Home My WebLink About0108 PONTIAC STREET - Health 108 p®rtac. Street. A== 169.-194' r I a rro...46r ate' THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE ,Nppliratiun for UiipuiFal Warkii Tomitrurtion pamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System,at: , ...-----..l--�.. .._.-. .............. ..........................................• -----....................------------. ---- - --------------- Location-Address or Lot No. ........-•• -...--•-----•............................••-•••------. ...................................................=•............................................. J$vner Address a -----...--- .._ --•- .---• -- ............................................... -2 . .------•••-------••----•--•--...................--- taller Address S feet U Type f Building yy�� Size Lot___________________________ q. .. Dwelling—No. of Bedrooms.............I......................._-_Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures ------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length.....:.......... Width................ Diameter-_._____-___-__ Depth................ x Disposal Trench—No..................... 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........................................ - 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........................ ----•- ------ ----------------------------------------- ---------------- -------------------- ---------------- •------ -................................. O Description of Soil-----_ x VW -•-----•---•-----------------•-----------------••-•-----•-------•--•-----------------------•-----•--------- Nature of Repairs or Alterations—Answ r when p licable-------=---------- ------/------ .- ----------------------- 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 Compliant has been issued ypthboard health. Signed ----- ----- --- ...... - ---------- ----- ------------.-......_............. V Da re Application Approved By .... ----- ..................... ------------------------ ...................... =It � Application Disapproved for the following reasons• --- ---------------------------------------------------------------------------..................... -------------------------- ---- ----------------------------------------------------------------------------- ....------ --------------- - Date . PermitNo. -... ..-p�o ................................ Issued .................. Date Y j THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Towitrnr#intt Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ........... - ---'----- ..........................................or --_Ko.......................................... �' AddFe��; - or Lot No. wner Address - ---•--------------------------- staller ! Address d Type f Building s% Size Lot____-_--•-----------------Sq. feet U Dwelling No. of Bedrooms............ .Ex� sion Attic Garbage Grinder p., Other—Type of Building ----------------------------fNo, o�_perls, s.-------___._.,L._____...... Showers ( �) - Cafeteria (� �, ... Other fixtures -------------------------------•-•••r --------- - 1 w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth___-.__.-_--__-. x Disposal Trench—No..................... 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------................................. Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0.4 �} -------------••--•---••--•--- -------------------- •--------------- ---------------------..--------------------------------- ODescription of Soil........... . ........................................................................................................................................ V ....--•----------------••-•••--•-•......--------•-••.------ ----------•--.............................................................................................................................. ........................................................................... .............. . --- ------------- ------- ------------------------------------- - --- --- - - - U Nature of Repairs or Alterations—Answer when ap licable_____ .. .......1. __1(,Z��j_.�� ---- -•••••---•--•••----------•-.....-•---•--•-••----- G - --------------=' ; �. ------------------------------------•--------------•---•--•---------•-------.....---- 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 Co4_ _ as been issuedcby the board o health. p Sign . .......i---� -- -- --------------------- Application Approved By ---- ��ti ---- ---------------------------------------------------- ---- - �}eApplication Disapproved for the following ---------------------------------------------------------------------------------------------------------------------------------- ------------------ -- ------------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------------- /'� Date PermitNo. . ...�-------------------------------------- Issued .......------........--------------------------- --- ---------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ILlerttf rate of Tontlritanre THIS IS�4OVCFR TI,FY, That Individual Sewage Disposal System constructed,( ) or Repaired (� b ---------------------------------------------------------------------------------------r--Instiller ----------------------------------------------------------------- yG .. at ------------------------------------------------------------- - ----------- 1----------------------------------------------------------------------- ----------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Envirorimerital Code as describ-e',T_in the application for Dis..osal.Works Construciion`Permit No. -.-.- — { --. dated .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARA�V�EE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. f � P --- Ins ector �� ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �� TOWN OF BARNSTABLE �v No................ FEE.........._._........... Disposal Vorko Tonotrion rrntit Permission is hereby granted .__-J.b P l P L--------------- '� 1 to Construct or Repair an In w�dual Sevrra e D s osal System ! `/ at No.l l 7 1. ST:...... `t/GU C(............................................................... .._....... 0; Street as shown on the application for Disposal Works Construction Permit No..ga.-2�Dated....Lr'././ .Q�7...,.._.... and DATEJ� - ...................................................... FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS " ,Ordinance. .o'•r � ion � - �;' /o y :.• ' , ti Name of Of fender/Maria er �: h g -a f Address ;of Of 10.5 1 r W'IkB Reg.'# Village,/State/'Zip - �_ t�� A-`t *'1_r_ - - SS4 — - — r —r Busi�nes;s Naive ram/:pm, 0n20 .f r EBusness Address- _ _ ___- -_ 7 ''t ' Signature of;,,Enforc>ing, Officer' �� :.• a t ; 1•[y r ins hr " "yid if*a_"9�4yR'"I� ?" f?. e i Village/State/Zp �"' j �1'-S t+1 - — - J 1i4- +dr ,t r I Location, of Offers°e:- �"; no- r . _. . - _ . - Enforcing; Dept/Division O f f,e 11 S;e', :s 4 4;� .+` x '-kit t •LEI v� f° '� r lJ`��. l U, k.7 /i \'T t 4A, ' j. Vac_its: . Z. Thus wil'_I serve only as a .-:warning , 'Atthis� tamer no rlegal action has been ,taken µ It' is the goal ,of Town agenca:es toachlever; volun,gary =compliance of, Town Ordinances, 'Rules- dtf& Regulb Ens. lEducat on efforts a_nd',gg a=naming {ngtices aver x attempts to gain velSuntary c-gmplYmance1;: Subsequent s will ' resu ht n_ approp=i.<ate :lrega`l;+ action 'by the Town' ;I `*� �+ -, �� " 4 ; ' n `WHITE OFFENDER FCA�N'A{RY-ORDIREG'PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. -