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Home My WebLink About0047 SEAGATE LANE - Health y7 SoA TOWN OF BARNSTABLE " LOCATION � qrz S f:±=14 e_ L SEWAGE ! "� VILLAGE W ASSESSOR'S MAP & LOT "l � INSTALLER'S NAME'& PHONE NO.CCtrj�y,. � va�.t•;cIG� �p9 SEPTIC TANK CAPACITY 1600 S 4�,j(c. LEACHING"FACILITY_ :(type) (size) 1000 I NO. OF BEDROOMS J PRIVATE WELL OR PUBLIC WATER ! BUILDER,OR OWNER. DATE PERMIT'ISSUED: DATE COMPLIANCE ISSUED: VARI9NCE.GRANTED: Yes No a :' w. F e O � o NO-----------APPROVED FIms.:...-= ..._,l .......... 8WnWW9C4nservaIOn0epanm@ntTHE COMMONWEALTH OF MASSACHUSETTS % BOARD OF HEALTH Oats TOWN OF BARNSTABLE Avvftrtttivu for Di-wipw3al Ourks Tatuitrur#inn Vrrmit Application is hereby mad for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal systems a� ' `�.... .........:...................................... `,�( Loea o \ddress ... or Lot No. �f .....!glf 1� `s... -------- • . 7---------�'Vl<�� f'!fl' Z'------.—`.. -.-.... --.- Owne 1f� A ks .x�. . ......... `!�5 C.C. _-------4 fit. Installer Address d z Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.............................. .. _Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' 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-..__________-__-_.----- fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 .....----•••---••-------•----....---•........-•--•----•....................••----------......------.......................................................... 0 Description of Soil........... --.-•--- --------------------------------------------------------------------------------------------------------------------••--.-•--- ----------- U ---------------------------------- . -----.... ---------•--•-_....•----•--------------------------•--••----••-- ---------••-•--•--------•--•-•......••-•---•-••----- W ..........................--------------------------------------------- ------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable------------- Cam_ ._.. ......_. .._... ,_..___..._._............_... -----•-••-•---......--•--....--•----•-••--•--•--------••...........................................................•- .__ . �.�........ --r . -+--J -•--•---•---------•---•--" �" Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Envir mental Code —The undersigned further agrees not to place the system in operation until a Certificate of Co pii ce h s been issue, by the oard of health. Sig] -------------! ........................ Dace ' ApplicationApproved By ......... ...D.. ........................_........------------------------------------------ ---- ------ ... nay Application Disapproved for the following rearons- -------------------------------------------------------------------------------------------------- ---------- Permit No. ------9--.L/ ......X--?------ ------------- Issued ----------- ....".,�.. Date k� No................_.... F $.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE - Appliratiun for Diti-Voiial Work.5 Cnunutrurtiun Vamit Application is hereby madeffor a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at, 1� of , ` , f / ge4L..q `- ---- -•••-••-------_--�'"1�, !g_,4!,!G!� �-.- � , Loc�son-Address t or Lot No. Owner (Q ..•�• A dress Oi 4rV1 G� o ``aG S(J Installer � Address ' UType of Building Size Lot............................Sq. feet .. Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type 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— 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........................ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit--.--_--_-.---_.__-_ Depth to ground water........................ R: ._....----•---------------------------•---..._.....--------•---••-•-------'--•••••..........----•---........................................................ DDescription of Soil...........C�•-•• - ------..( ••••-----•'•-••'•-'•---'••-••-••--•---------•----'------•-•-------------•'•-•---'--•--------'-'-'•--••"-•-•........_._ W ••-•-•------------------•-- ------------------------------------------ I--- ----------------- --------------------------------------- U Nature of Repairs or Alterations—Answer when applicable.------------- ,v.._t.-- --------- !_._._.._._.___.. -••--------------------J N------....(�__ � `'- . 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 Complia'ice h s been issued by the oard of health. Signed'..0_ f v - - � Daces r f Application Approved BY --------CJ-------------:,D--- .�'�`•,---------------- -------------------- ' ......--- Application Disapproved for the following reasons: .------------------------------------------------ ..------------.-..-------.---.-. ---- .. -4i ------------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------------- ------ ---- ------------- Dv Permit No. ..... 1 �j a" Issued ------------�,t - G w Dace --------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE &rtifirnte of Tompliance THIS IS TQ+ CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by !t. �-- ___.- ----------.._--------------------------------------------------------------------------------------- .r^ `�� ........... au - nvfr--nmen-----------......-- -- - -- In has been installed in accordance with the provisions of TITLE 5 of TheState o t l Code s described' the application for Disposal Works Construction Permit No. ---__7--- __.... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------h .. ------�--.'7--------------- ------------------------------- Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L� TOWN OF BARNSTABLE FEE.. . u.`.. 3�iu�uu� urku`��unutrt�iu,,n Permission is herebyranted ' `� 1s: C: ` .... --- g ,�.-b._ b s to Construct ( ) or Repair O a - Individual- Sewage Disposal System at No.... --•qL � �-------- t�!'� � ^': ? G" ' ---------- ••--....... .._ Street ? p as shown on the application for Disposal Works Construction Permit No.N:.Z?— Dated---.____-_..4_!�.._�.a....~ : ............................................................. r ... Q Board of Health DATE...... ........................................... FORM 36508 HOBBS ac WARREN.INC..PUBLISHERS I