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Home My WebLink About0030 CROSBY CIRCLE - Health 30 CROSBY CIRCLE OSTERVILLE A= 116-02-2 Page 1 of 1 TOWN OF BARNSTAJBLE 11' LOCATION "S O I i/O S �J y /V�PSEWAGE �Z VILLAGE �/ ( ASSESSOR'$ MAP 6 LOJ� O 2 2 INSTALLER'S NAME&PHONE NO,!A9 Z/=6t1�C —moo SEPTIC TANK CAPACITY— O OG LEACHING FACILITY:(type)f;� _(size) NO.OF BEDROOMS ;:7 _PRIVATE WELL OR PUBLIC WAT BUILDER OR OWNER DATE PERMIT ISSUED: ' DATE COMPLIANCE ISSUED: �l O VARIANCE GRANTED: Yes No https://itsgldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=116022&sq=1 6/26/2020 TOWN/OF BARNSTABLE LOCATION � D _ Q S °✓ I'MIQSEWAGE Q— IVILLAGE(�/k i/�� ASSESSOR'S MAP & LO/, INSTALLER'S NAME & PHONE N0. 9 ��FG[>t �I -`�6 qj SEPTIC TANK CAPACITY_fO G& _ LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC W_ AT�}3_ _ BUILDER OR OWNER tom' DATE PERMIT ISSUED: /,Z __— DATE COMPLIANCE ISSUED;,/7`—_�� VARIANCE GRANTED: Yes _�No_ l V u I �� No......� '.fYi.� Fxa ..... . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEATH r ---------- F.. " . �- -1. , - ... ApplirFatiun for Dispute al Works Tumi rurtiun runfit Application is hereby made for a Permit to Construct ( ) or Repair �a" Individual Sewage Disposal System at: /.?�. .. el - � ��— Location Ad ress or Lot No. ddr -----•---------------- ------ ' ., f- .>.Iess Ile- Installer Address d Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) C4 Other fixtures -------------------------------- - - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------••--•-•-----••------•-••--•........................•--------•--........-----..................................................................... 0 Description of Soil........................................................................................................................................................................ x U •-•••-•--------•------------•-••------------------•---•----------------------------......-----•----•-.......-----------•-•••-----------------•-••----------........................................... x U Nat�r of Repairs or Alterations—Answer whe pplicable__._.i�iE'fLl..... __.F' ___._. f,c ---------------------------------------------------------- Agreement: � -- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTr1-^ J.—:� of the State Sanitary Code—The undersigned further agrees not to place the system in operation until.a Certificate of Compliance has been i boa f health. ., Signed---"- - - -••------------� .............. v --?---��_�...--- Date Application Approved By.................. .... . Date Application Disapproved for the following reasons---------------------•----------•------------------------------•----------------•---------------------••--•----- .......---•----------•-------•-------------------------------------------------•...------------•. .................. Date PermitNo........ ------------------ Issued-------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS j BOAR OF HEA TH . .......... ---------- ------------------------------- AVVlira#ilan for Disposal Works Toustrn.rtiun Vrrntit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: r rle./.� --------- .-If-�c�i-------'--------•-----------------------•------------ �- � �Lo tion� ress or Lot :�o. .........,............._.......-- .l�l'12..._ ?. ................................. --•------------------------....._..........- ---------.---.----------------------•------------ / wn�. / ddress a Installer Address ------------ Type of Building Size Lot............................Sq. feet V Dwelling No. of Bedrooms............................................Expansion Attic Garbage Grinder Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures --------------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter________--___- Depth................ 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 ( ) aPercolation Test Results Performed by.......................................................................... Date--------------------------------------- Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water--___________-__.._-__-. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ ....................................................................................................----------------------------------------••---------------...........------------------------•-------......................................................... 0 Description of Soil...................................................................-.................................................................................................... x w ----------------------------------------------------------------------------------------------------- ---- --------------------- .--------- - -- UNatise of Repairs or Alterations—Answer S/ C�f�9 w h lab l ..._._. � i ' ____ ............................ . ----- _ ...... o..--� -----uA Agreement: � � .. . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'I T;.,K ;of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been isa f health. �, � ��Signed-. i'l � Date Application Approved By................... ........ ... `-==:_:.. �6 - ' Date Application Disapproved for the following reasons----------------------------•--------•-------------------------•----------------•----------...--•----------•---- --••----------------------------------------------•----------------------•--------....----•-----------...............--•-------------------------------------------------•-----•--•------•--------...... Date Permit No........ > ................... Issued--•--------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH fy.... ..........OF ..l..l... ....Zle......................... T rtifiratr of Toutpliaurr Jf THIS S 0�`c RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ------------------------------------------- Installer atu "` L' Cr1.. ........................ . r vll �-^-------------•---------------•------. has been installed in accordance with the provisions of TITLE �of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__......_.6'—.&.1.--;,--_. dated-.----------------------- ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH r rdi .............OF...... ....1 _......l. rG�.�. P........................ ... C C> 6 ! ?L.� — FEE....` .. ........... Uigpos tl. V nstrurtion amit {� G/i Permission is hereby granted-= .....-----•--�----------------•---------------------•-----------..._.......---------....................---- to Construct ( ) or Repair ( e)'an Individual Sewage isposal System at No........ f' -� �-�--�TY�-----•---[ ._� Street - as shown on the application for Disp sal Works Construction Permit No.--�? _:l�� ' Dated.......................................... ------•---------• ..... ,.J ----------------------------------� � •-•• Board of health DATE....-•---------- -•E ' - ....-_. t= FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS