The URL can be used to link to this page

Home My WebLink About0235 CRYSTAL LAKE ROAD - Health ocl� TOWN OF BARNSTABLE LOCATION C��'�-j 4 `� SEWAGE �' � VILLAGE ��- u� / (�. ASSESSOR'S MAP & -INSTALLER'S NAME & PHONE NO. SEPTIC TANK;CAPACITY LEACHING FACILITY:(type) �`7��.__ /�� (size); NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 5 5 eV DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: '� VARIANCE GRANTED: Yes r No �� x vv t s. r` p^ 0; �� r` No.............1.� 7 ® Fts.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD/�OF HEALTH ...........OF.....$�-,... ..... t-----------...............-.................. r Applira Lion for Bigpniial Workii Tomarnrtiun ramit Application is hereby made Aor :a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal S s J at: eV. ........... cat ion-Address or Lot o: ... ............. ......L... ' ............................... ................. --------•---------....................... Address ......... :..�. ............... .�. ............................. --.-••....................._•---.. Address 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 ( ) 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. I.................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........................ Q+' •••---••••••--------••••-••-•-••-•••••••-----•-•-•-••-••---•-••--•----•-----•--------------------------------------••------•••-•-•-•••---...._._....------•-- 0 Description of Soil........................................................................................................................................................................ --------------- ----------------------------------•---------------�......•----•-•-••••--PP••••----•••............------------------ .....-------------------- /� V Nat we of RWir r Alterations— saver when a livable.--: { .' 1/ 0 . -U../!------------------------- ----1 4. .-•.• . --.-----------•---------------•-------•--------------------••---•--•-------------�---•--1---•-•---------••-------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation_until a Certificate of CompliaShasen'isued by e board of ea .. te A lication A roved B ER 7PP PP Y----•----- -' - - .1'E•=LLL'_�.._��_.�__...-----•--- ---------------Date----! ----- Application Disapproved for the following reasons:-------•--------------------•--------------------------•---------------------------------------•--••--•--------- .............................•---.....•.....---------------.......---•-----........--•----_.•-------•-•-. Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ✓WK. ....OF...... .� ' .............T.;�.... . ... ................. .............................. CInrtif irFatr oaf Tuntphattrr THIS 1 TO C TIFK hat the In ' idual Sewage Disposal System constructed (� or Repaired ( ) by - -►-� .!�` °.._..•--------- - --- -- .......................... --------- --- -----. --------------------- Z...... ......... ,...... has been installed in accordance withh-ie rovisio of T �5•of The State SanitaryCode as described in the application for Disposal Works Construction Permit No. ...........1 -� .............. dated ...17_zZ`__.?._'?_-_-_---_--_--. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... No.. .._.._.. ..J/.. Fss ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD . OF HEALTH ... .............OF.... .. . ............................................. Appliratillu for Dhipasal Murky Tomitrurtivit runfit Application is hereby made or a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal Sys . ... .. .._.. ..: ....i� z - Mi'y!.ems . ... ` cation- ddress • or Lot No. � .......... ......... .... .... .. .. ......� ner - ----------------- - --------------------------4, Address ...................................... ................. Inst le; Address :....S� Type of Building Size Lot_________________ q. feet aDwelling—No. of Bedrooms _________________Expansion Att>e ( ) t Garbage Grinder ( ) 04 Other—Type of Building________ __________________ No of persons-_ .__-_____ .._______ , Showers ( ) — Cafeteria ( ) 04 Other fixtures .-- =•-� `-•-•-:=-__--_-- i � v WDesign Flow.............................................gallons per person per day" Total daily flow............. .___gallons. t4 Septic Tank—Liquid'capacity `gallons Length................ Width �Diameter Depth .......... W > x Disposal Trench—No_ ____________ Width_'.'.`.".' F_____ Total Length Total le aching area 2%............sq. ft. Fl Seepage Pit No...................... D>amefr N _-� ___ JDepth below inlet-_ ' Total''leaching area___ .. ....._.....sq. ft. Other Distribution box ( ) Dosing Z . --_•_-•. -------••••_. Date-- -•••-•. Percolation Test Results Performed by__ `.. ._ { - -•....--. Test Pit No. 1................minutes per inch DeRtl kofo-Z st Pit . ________ Depth to gr�ou d"water� `r Lz, Test Pit No. 2................minutes per inch,,,, Depth of .Test.Piti __ ............. Depth to group water_.................L...... -;- --- ,, Descriptionof Soil _...-•-_. .......................................................................................... W ___________ ____ _ _________ ______________________________ _________________________ __________ u ____________________________ _________ ____•__ _______ ___-______________________________________... ___._. j _ _.._..____________.._.-__. V Nat e of Re it r Alterations— nswer when applicable.-.__�r_.� ;---1--+`-""-- �-- -- -- --a------------•----••------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has enj ued by e board of 1 eaKV ; '`� d { ,.Signed ' .,: ... -... -- Application Approved BY---.._'� .. / �....#--- --- `-•---•------- --- �_ _. !'� •,y D to -- •--•-- - ,-.''� Date Application Disapproved for the following reasons: -•---------------•-----. ........<.. A 4. i Date PermitNo................................................ Issued_...................................... Date ^° �. THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH - ........ , > (9rrtiftrttte of flaunt ltanrr THIS 1 ,TO C 'TIF ;Oat the In idual Sewage Disposal System constructed o Repaired by-"" •--•-•--- i) .: - has been installed in accordance with., ze provisio of T T f 5 of;he - State Sanitary Code as described in the application for Disposal Works Construction,Permit NX ____-__ -� -.-_•_...-___ dated_....:'. - `__ 2-_ '______________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector........................................................... - .................. ,..THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No. ...---- FEE......:................. Disposal urkg 'PUS nrtiun rr it ... Permission is hereby granted _.._.. ''..:_.'.-.-: -_ - -- - __-.. tp+±ad� ,1! _- ._. --•-_-. to Conkkruc ^�( � ) or epair j vidua Sewage Di osal S t "` - an I d• � f a at No...--•-•-- - 1.._� _. �'•�' �`�'c ___�. ......... reet f �G 7 as shown on the application for Disposal V�orks Construction P it No... ___ _: Dated______ ................... ti. Y j hBofHealt DA �� y; FORM 1255 HOBBS & WARREN,.INC P„UBLiSHERS - t+ a � F._ ASSESSORS MAP NO- G? PARCEL NID THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratioaa for Di-tipw3 al lVark,i Towitrurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (,'an Individual Sewage Disposal System at a .............................................'3'S G v r �L_L ... . ....0.�------- --------------------- ' Locationdd ss Lot No: ....:3_ Owner Add a ............... ----- V?_ --------------- -----------4�--- Installer Address UType of Building Size Lot............................Sq. feet .� Dwelling— No. of Bedrooms.---'I-----------------------------------Expansion Attic ( ) Garbage Grinder .( ) aOther—Type of Building ______________________-.--- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - ---------------------------------------------- DesignW Flow___-__:��....................gallons per person day. Total d,Lilry flow..._..��_-________-_-_--------__gallons. WSeptic Tank k-Liquid capacitv_(04Vgallons Length.-. _-____.____ Width-_.�--------- Diameter---------------- Depth-_--____--__---- x Disposal Trench—No. .................... Width.................... Total Length........... Total leaching area....................sq. ft. 3 Seepage Pit No......:I............ Diameter.__.._J,Y..... Depth below inlet................ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a ,.-I Test Pit No. 1................minutes per inch Depth of Test Pit..------------------ Depth to ground water....................... �X4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------------.......................................................................... ...:.---------------------- .--- ....---------------- ._........ .-------- Descriptionof Soil.....................................................................................................•....-----------------------------------------•----•.........••... x j ...........................--------------------------------------------------------........................... ----------• -=r --• .....--- ------------------ V NaturWf pairs or Alter ions—Answer whe applicable.__ T .1._..�i� ..._ Z- .. t!!" y .. r [ ----------------------------------------------------•-------------...............--- 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 urther agrees not to place the system in operation until a Certificate of Com lia b ar f h lth. Signed ---- .. ...... . --------- -------------------------- ----'-------.V:;.', r ��`'''`�� ..... ............................................... . . Dace Application Disapproved for the following reasons- ---------------------- ---------------------------------------------------------------------------------------------------------- ....................°----------------------------------------------------..............----...--------------------------------....._....--------...-----------------------------............ ---------------------------------------- Dwe Permit No- ------------76. ----- --�13 O�--------------- Issued .-----------3. — Dare 114, No..._,..,.._. . F>s....c2........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Ui!ivv!3a1 lVar1w Tnnitrnrtinn ramit Application is hereby made for a Permit to Corstruct ( ) or Repair ( an Individual Sewage Disposal System at: ...............................................f. ........--.......-........ .---••- --------------------------•-------------•-----•-••------------------•--•--------....-•----•------- /�r- ( Location-Address or Lot No. --•------•----••------------------•------------ Owner Addre ....................... .........-�=----- � -------------- �....................... I Installer V Address UType of Building Size Lot___________________________ q. Dwelling—No. of Bed Attic Attic ( ) Garbage Grinder feet aOther—Type of Building _________________________. No. of persons-------------------------- Showers ( ) — Cafeteria ( ) Otherfixtures -------•------• ----------------------•----------------------• -------------- --- --------- Design _ gallons per person � C� W g .. ------- ------------g P P per day. Total d .ly flow gallons. WSeptic Tank\—Liquid capacity_(_nbgallons Length---(1...-_..._ Width---=?__.------- Diameter................ Depth................ Disposal Trench h—No_ ____________________ Width.___._ __...... ................_._. Total Length Total leaching area--------------------sq. ft. Seepage Pit No-------I............. Diameter......I�._-__-_- Depth below inlet...... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ a - ,� Test`Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water___---__-________--_-. f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... w ............................................................................................................................................................. 5 0 Description of Soil....................................................................................................................................................................... x U W UNatur of epairs or Alterations—Answer when applicable._ :177!�`-T4 �4__-_ _{-• -:` i"f---�--... ?...-`' /G`--e--•-•-------------•------------------•--•--•------•------------------••---•--•---.---- Agreement: l/ 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 has been-issued-by-the-boards f health. Signed `_ k- . . - -....... ---- ............................ ,- Dace Application.Approved By ...... ... - J3- /.1..- .s Dale Application Disapproved for the following reasons- ------------------------------------------------_----- ..............................--------------------------------- ------------------------------------------------------------------------------------------ ------ ---- -------------- -------------------------------------------------------------------------- ------------------------- ------------- Dace Permit No. - � �-------------- Issued .............� ..:'.1��..`.� �� Dale THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Prtifi att, of Q-1-a plianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( / ) by --------------------------------------- !, --------------------------------------_ ------------------------------------------ �- ---- Inc�aller � ac ---------- '.- GV` ------_.ra_L----. h =C? 1 --------------------------------- has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code as described in the application.for Disposal Works Construction Permit No. ....... 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 BOARD OF HEALTH /� TOWN OF BARNSTABLE ... �(o FEE.....- )_........ Mipwial Workii Tunitrnrtion ramit Permission is hereby granted l _ � ! r%11 : l . _ to Construct ( ) or Repair ) an tInc�lrwi`d�ual vageCDisposal� Sy---- i ! n atNo.•••....---•••......••••....-•••••-•-••-. rr" 1/ �[ .. -----------------------•-•-- , Street qq.. as shown on the application for Disposal Works Construction Permit No/'. Dated----�.__��_��5. ........... 1/ Board of Health DATE ��..-/ ....: ............................................ FORM 3830E HOBBS,&WARREN,INC.,PUBLISHERS