The URL can be used to link to this page

Home My WebLink About0032 CRYSTAL LAKE ROAD - Health b- ��- / � �.. TOWN OF BARNSTABLE g LOCATION z �-ta) 1,4 C SEWAGE # `^ � VILLAGE _ i°r Vf a ASSESSOR'S MAP LOT INSTALLER'S NAME PHONE NO.�J, //ICE WV i- r3"' 4-Sc/n 1 or . SEPTIC TANK CAPACITY LEACHING FACILITYAtype) ; (size) ' NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER O -eN* R t-� DATE PERMIT ISSUED: r 14, ; DATE COLIPLIANCE ISSUED: � C ` VARIANCE GRANTED: Yes No `{" �r Loa s3 J 6 r. j Fis.... ....20.00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH To OF.......................Barnstable ................................................................... Appliratiun for Dispaii al Workii Tongtrurtiun ramit Application is hereby made for a Permit..to Construct ( ) or Repair �X) an Individual Sewage Disposal System at: 3• 2 Cr stal La..ke Road 0s..te...r..ville . ... ... Gur ldy ' ' Location-Address or Lot No. ......................-.......................................................................... ..........--...................................................................................... Owner Address w J.P-.Macomber Jr. ::.. Installer Address UType of Builrg 3 Size Lot............................Sq. feet. .� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type e of Building� YP g ---------------------------- No. of persons................------------ Showers ( ) — Cafeteria ( ) dOther fixtures ...................----------------------------•----------------------------------------------------•-----------------------•------................. WDesign 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........................................ 014 Test Pit No. I................mmutes 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......_................. P4 -------------------------------------------•------------------------------...----------•-----•-----...-•--•-•--••------•---------••-•--•--•---•-............. 0 Description of Soil...................................... xSand---&._G-rarre 1--------------------------•-------------..------•-----------•---------------.-..._..-•------ v --------------------------------------------------•••-----------------------------•------•...•-------------------------------------•---.-------•--.:.--------------------......_...._.....------------. W x m I=TIIOJ---gallon ..... 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 iITx 1 , 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 y e and of h lth. Signed.. � - ....=................... -•1 117/89........ Date Application Approved BY ... �.n� . _ �l p `°•--•-- Date Application Disapproved for the following reasons:.............................................................................................................. - ...............................-•-----------------•------------•---------•-•---------...---------------------------•---------------...---------------------------------------------------------------- Date PermitNo....... --�o•-•--y� �....--------•-----.. Issued....................................................... --- Date Q 4 21 f'a Fxs............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH IT:)iia OF. e tLri�sisF:h,S�ie Allpliration for Dispas al lVarkg Cnoustratrtinat ramit Application is hereby-made for a Permit to Construct ( ) or Repair lath ) an Individual Sewage Disposal System it: 1:i3.---------- ( �J�t:�X... _L1.h ......... ...................•....................... ----•-------........-•--•................. .. s.. Location-Address or Lot No. ,d't;i.Z".g di ,�' ......................_........................:................................................. ._.....,..._...........____......_............____.._.........____.......................:..._..... Owner Address y a ...................................._ .............................. ..........................................•----.............------..._............... ........... Installer Address art d Type of Building Size Lot............................ q.S feet Dwelling'Z—" No. of Bedrooms........ ..................................Expansion Attic ( ) Garbage Grinder ( 'j aOther—Type of Building ............................ No. of persons•---•_----__________.___-_-- Showers ( ) — Cafeteria ( ) dOther 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-..__-_.-__-____---_---. tz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------------ ------------•.....------.....--------•--••-----------•---•---••-•--------....---•-----------•----------•-•--....--------•---••-•-- O Description of Soil...................................... •---------- ---------.----- V ....._...--•-•......---•-•-•••••---------------------•--••---•..............•--•-•--•-•-•--••--•----•--•-----•-•-•------••••----•--•-••--•............................................................. W ----------- -- ------ U Nature of Repairs or Alterations—Answer hen aP licable_.`pg___________________"' ' .' _ .' e i` , (� ". r J. tf y -------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT IE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operatioif until a:Certificate of Compliance has been issued bye jPoard of health. ,56 SlgneCl mac':#.3F�,di _ '-- ir��x .a6"-� ....................•... --#-'"` to-----------•- � _ � Date t{ Application Approved BY Y, ; .......//- .)------- -------------- Date Application Disapproved for the following reasons--------------------------------------------------------•----------------------------------------------.......... ----------------------•--.....-----•-----...-•---•----------••------------------------.......------........-------------•--------•-----------------------------------------------------------------•----- Date PermitNo....... .............•....... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . s:�.,, ......:bJ ..........`•,�. OF ...........�....................... �rrtifiratr of IT"a pliaatre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X tbY-----... A2AY 1,1L,0 ? i...&:.X........................................••------ •••-•-----------..............-----•-----•---------.............--••--•----•-•-----------•-.... rr y ; staller Rr a,`_y s tee i ar. 4,: .�Lo,6 0, I,-,i'*f (.�'� . has been installed in accordance with the provisions of 'i"I T-1 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........... dated-_............................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. P-31 Q DATE....... ./.6'_ ,: :... - --- ..................... Inspecto -- &�--9 - �......-• .......................... .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ...........................................OF..........................................---.---.................................... 2r).00 FEE.. ?......... Permission is hereby granted. a ..........� ....... . .. .... ° to Construct ( ) or Repair '(iX) an Individual Sewage Disposal System at No.32 C r rs t 1.•T k e Road0 air _ -. : _-- . ==-=......I----•••._....--•••-••-•------•-•-••-•••-•----••••--•-•••------•----•----••-•--•................ Street as shown on the application for Disposal Works Construction Permit No§§77Gt6___ Dated.......................................... DATE................................................................................. oard o f Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS