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Home My WebLink About0280 GRAND ISLAND DRIVE - Health a$o �d is(.ate �►�. , �s�� a5a - olq i tJ TOWN OF BARNSTABLE LOCATION Ind </AJ '?00E SEWAGE # 49 - ! VULLAGE (3s z u) ASSESSOR'S MAP & L010SJ -0 INSTALLER'S NAME .& PHONE NO. cPTIC TANK CAPACITY J��g UACHING FACILITY:(type) 9f � � (size) NO. OF BEDROOMS PRIVATE WELL OR PUIC WATER - - / " BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED TT VARIANCE GRANTED: Yes No Aid -d Dow ye Sl S ASSESSOR'S MAP NO. 0-5-2 PARCEL U/'e> LOCATION SEWAGE PERMIT NO. -VILLAGE I N S T A LLER'S NAME & ADDRESS e U I L D E R OR OWNER /d/ /te / �Iz In ` DATE PERMIT ISSUED D A T E COMPLIANCE ISSUED o � 1 v� ' ��•` � � �� /f of � � I � � I r. T� F, ` ASSESSORS MAP NO: 5� �— Z PARCEL N0: 1 Fills . No.....-•-••-•--..�. E. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH . vv�. OF................................. .. ................................................ Appliratiou for Bhip oal Vorko Tontitrurtiou vamit Application is hereby made for a Permit to Construct-(�r Repair ( ) an Individual Sewage Disposal System at: �� „Ss�.:��r aE.. 11 d! v�r w... .......... ......... f w Looration-A.Vress or Lot No. ......................_._........ .f_[1.. :..../:. H-•------..............._....... _.._...__..LeC�/ :FJ_./!YR.___ .P__.....-----------...._.....__..........._...._ dre .... � ........................ ••--- � Installer Address /PC, t QType of Building Size Lot.......°.7Z.............Sq-feet Dwelling—No. of Bedrooms..........l-f................................Expansion Attic ( ) Garbage Grinder ( ) pW, Other—Type of Building ............................ No. of persons............................ Showers n( ) — Cafeteria ( ) d � G d --5 Design Flow.__Other fixtures ---- - �-_gallons per person per day. Total daily flow__ _______..............................gallons. W . WSeptic Tank—Liquid capacity/�_�?__gallons Length_.f_______..._ Width... ........... Diameter.____ ______. Depth._ ___ x Disposal Trench—No. ......' .___ Width....:-�+��'"_.... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------------Z.-- Diameter.........4?..... Depth below inlet.....4............ Total leaching area!1�4:......sq. ft. z Other Distribution box Dosing tank ( ) Gz Date..----- Percolation Test Results Performed by....� �� ____�-- __ fy_ _!'�_ ____________ �."_Z�-_'_��.____... ,aa Test Pit No. 1�__Xr_.Zminutes per inch Depth of Test Pit____-1_3.`G:° Depth to ground water.........- ........... , (T4 Test Pit No. 2................minutes per inch Depth of Test Pit....l.. _'_ '__ Depth to ground water........... 9 •----•-•---•-•-- ---------------------•--------------------------------- -----...---------------------------------------------------------•-•-- 0 Description of Soil.-------•••-•-.....A t�,[--g".--•- '' .......•--••••------•-•--•---•--------••-••-••----••••-•---•••----•••-•---•-•-•......-•------•--.........••--- x W ••----------------------------------------------•••-------------------------•...---••-•-------•--------••--•---•-------------------•--••-•--••......•••................. ............................... UNature 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 iIT :E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issird by the board of-h th. S. ........ ........ .•--Sf_.:_..._ ...---._.._......._.._...__...._.............. ................................ /Dat ApplicationApproved By••••••••-•------ --•••-•••-••••-•-••- ................................................. ate Application Disapproved for the following reasons:----------------------------------------------------------------------------------------------------------••---- -------------------------•---------•----•-•-------------------------------•----••------•-•-•---------....--•-----_--=--•••-••---•-•---------------------•-••--•----------••-----•----•--------•--------- / 7 Date Permit No........ .... Issued_--•----------- 4R......... D to r No.. 9 Fps......... -_ i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH v�1.........................O F......................... ............................... for Dhip o s al Vorko Tontitrurtiou Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 4 "- ----------------------------- .................................................... Location-Address or Lot No. ......................—.......................................................................... --.....---------------••-•----••----------.....--•---•-----..............---------.............--- Owner Address W PQ Installer Address Type of Building Size Lot--------- j�.............Stl--feet Dwelling—No. of Bedrooms.......... Expansion Attic ( ) Garbage Grinder ( ) 04 0 Other—T e of Building No, of persons............................ Showers — Cafeteria P-' Other fixtures -------------------------------- - - lt(l W Design Flow-------------------------------� ....gallons per person per day. Total daily flow._ a ...............................gallons. PG Septic Tank—Liquid capacity/ 4_.gallons �Length._�a..A.'. Width__Sr:�.._ Diameter----- Depth_._..-:.._ Disposal Trench—No -___. Width...--�.--, ...... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No-------------Z_.. Diameter.......... _'.___ Depth below inlet............... Total leaching area`�Zn......sq. ft. Z Other Distribution box (✓) Dosing tank `-' Percolation Test Results Performed by...�_L _.__,`'Ac =_.l=ti .....'ti......._..... --- Date. �.- 2-Z - ,.a Test Pit No. l�_c�._�.�.minutes per inch Depth of Test Pit..... Depth to ground water________________________ Test Pit No. 2...............minutes per inch Depth of Test Pit..._ 3.._�:._. Depth to ground water.._:............._..___. R+' ----•-----•-=---•--•----•-••--------------------•--•--•-•--•-•--------------.........._......_------........................................................ ODescription of Soil.........................................................................................................................................;-............................... x U ....---•-------•--------•---------------•--...--•---....•------•------------------------•-••--•-••......-•--•--•-----•----••----•-------•----•-•-•--•-................................................. -----•----••-•--...-----•----•-------------------•------•---•--••••-----••-•--•-------•------------------------- ...•---•••-------•---......--------•-----------•-•-•-••-----•-------•-----•-------•-•- UNature 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 TiTL, p of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. .............................................................. _ Application Approved BY - . ..........' —...=_ -------------- � ......_ C /2 ate Application Disapproved for the following reasons:------•---------------------•-•----------------------------------------------------------•----•--•-•------_...._ •----------------------------•---•--------------------------------------•----•-------------•---......-----••---------•----•-----------•-------•-••------------•---------•--••---•----------•----------•- Date Permit No......... a.... y Issued_ - - D to f R THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH nn N 0,/a i—h 1 l ..........................................OF...........` U....°....................� ..................... Trrtifiratr of Toutplitturr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...............:..t� P..------d---..............................................------------.....................................-----------------------------.--------------------- _ ]� ( / -- � ` 9t:SE ^ �./dL Ins1��`V�= "� at. � .,... .... - ----------------•----------......--•-•----•-•---- has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as escr'bed in the PP P ��7---•---- da.ted-------------` •� c'......--- a application for Disposal Works Construction Permit �o.____�.��___._��.__: �- - ii THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISF�CTORY. DATE................................ _'_ .�. ............................ Inspector....................... .............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................OF..........: .. `' ...?S..l ........ ....... No.� .•'. Y� FEE...... :.... ..�' Disposal Norhg Towitrurtion Vamit. Permission is hereby ranted............. to Construct ( ) Repair ( ) an Indivi `al S wage Disposal\System - a at No.--•-•-•-•----- ...--1 <_.� _._! �...(� -i �. ('-'-�----(�5-�-:. .(L -•--- -------------------- I v. a Street S. z as shown on the application for Disposal Works Construction Permit No.....S._�_.2 'llated.._.=�,/ �'/6 --..........................- -------------------------------- Board of Health DATE--------------------�-�'�:--�� • FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ,O xp ' ---\. C 1, :'.Cow Jedijn `_7edt Pit #6900 35 No. o f bedworti 4 bade 3-22-88 �z dt nra.te g•Low '1u0 qpd .'At. �.. >v�po .0 no l,'o wadi encouvte&ed 4-0 Xecdzij y at-ea 402 4,J Puce. te" Vidn 2 ati,n..; hem e�%ue " 402 a Capac-ity 8 S4 apd sip 1 _ - J p•2 l 46, 3�6 top 39 7 I diZ loam 3 3 35.1 35.E 4. Scale I"-40 � 5.� Data 3-29-88 100 dared dared i i 49,i 42' 3v z4.S rPt 24' z4.G �1500 3 ..� PROPOSED I Jr�i o> A ik. \ zy 2-0 �� 6 � p.r�td, $ i . atone 402 53• JAJVV 40.01 . I qIL m na. 40 , wade ,,a. fitt Cape �n nd 49 /4a4bo% ;goad Idyan , Aa. 02601 N �, 1500F 7 cMt�NEy ro �' o�= rn Ni ccate- SH etch Nan o .Wand'.i n C7ateAw•itce, Ala. �._ 9o2 A'ife hyan &,ijw, .lot ad. ahown on .,C'and Co'a4t p&n j Rwati-ond. ata on an a&uwecl da-tam. i ! ")ate: Gent: ISa4ndtab& boatdO� vat --- _..la:, :' H OF 60 EUW Rl) ,:. r O� HN sM No.32490 oF', /STIR TONAL t �N41lAy00 a I-- f No.--�------`I--- Fee--z- -. BOARD OF HEALTH TOWN OF BARNSTABLE zIpprication-*rVell Cootructiouiermit Application is hereby made for a permit to Construct ( Alter ( ), or Repair ( )an individual Well at: ---------------—---------------------------------------------------------------------------- Loc/ation — Address Assessors Map and Parcel / --------------------- Owner �u N s c� -Q l-=—ou�-Te r'0 --- ---- --- --- - -a$ - - - t / l Address 4 `u � -f------------------ -- ----------------- Installer — Driller Address Type of Building Dwelling ----- - — - ---- - Other - Type of Building ---------- No. of Persons----------------------------------------------------___ Type of Well Capacity--------------------------------- -------------------------------------- Purpose of Well --------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Co liance has been issued by the Board of Health. Signed g dafe — � � R Application Approved Bye-- -- - --- -------------------------------- ----- — -------------- - date Application Disapproved for the following reasons:-------------- --------------___----------------------____--------_-_-_-------------__ ate Permit No.- '- '� -------- ---------------------------------- Issued-------- ------- ---- ------------------ date 1' BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f I QCompliance THIS IS TO CERTIFY, That the Individual Well Constructed ( �, Altered ( ), or Rep aired n ( ) „ / by--------------01 e-J ------------------------------------------------------------------------------------------------------------ Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No�'�ss'`- f y -Wlzated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE — —--------------------------------------------------------------. Inspector- - - - -- -- --- - — - - No.----------------- Fee----=--------------- BOARD OF HEALTH TOWN OF BARNSTABLE I Application forIverr ConWuct ion Permit Application is hereby made for a.permit to Construct (v'r, Alter ( ), or Repair ( )an lndividuah"Well at: !I /s 4" �. /0/_.. - .. - _ I - --- -- -—-=- ----- - ---- -------- ----------------------------------------------- — - --- Location'l— Address;x" rs. Assessors Map and Parcel-_ lJ Q_►J t� P_/ /C!. w � �Q ' 61 c,"I /S�O n j Q/ OC jP l u f`/(rr — —-------------------------------------------- — — —— —-- -- — ----------------- /�/1 // Owner //,) Address / _A1!�__ _U/v_t_Ll�-Si 3 t (_� /�—�` N--------------- __C o c IcJG/4J --------------- Installer — Driller Address Type of Building Dwelling---------------------------------------------------------- Other - Type of Building--------------------— -- No. of Persons------------------------------------------------------- Type of Well ------------------------------------ Capacity------------------------------- Purpose of Well >---------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Corppliance has been issued by the Board of Health. Signed -- ------------------------------- ---- ------------ -date Application Approved By------ j ' - __ L✓`- _- - ---- --�— -��- — date Application Disapproved for the following reasons:-----_ _____________-_-___-----------------------_--------------_---_-- --------------- --- ---------------- —------— -- ------------- ------------------------------------------------------------- 1 date Permit No. .�� Issued - --- -I �f �.' ox date f BOARD OF HEALTH TOWN OF BARNSTABLE Certifitate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed Altered ( ), or Repaired ( ) by---------—n .�_.✓,_5- �' - r .,�,�� -- —-------- -- ------------------------------------------------------------------------------------------- Installer / �C'G (�/G_wC_J /S�4 . r� �� __• b�Tn/u (n �'1Ct at- —`- --- - - -- - - - - — - has been installed in accordance with the provisions of'the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No -! —6--/--f;?--_Zated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------------------ ----------- Inspector--------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Very Con.5truct ion permit No. r --'�- (�-- -•s ' � Fee—""---"-�-�-'-r_�__ Permission is hereby granted f/ to Construct (✓), Alter ( ), or Repair ( ) an Individual W j11 at: No. __c7 U- -G/� r1_ C Al_"s I -n/' -O S T(./,)"l- -/'Ll-q - -------------------------------------------- — Street as shown on the aE lication for a Well Construction Permit 1�` -`�'-�'� - - -— -- Dated----- - '"f ---A-�-- � ��----------------------- Board of Health DATE------ �'