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Home My WebLink About0955 MAIN STREET (OST.) - Health 955 Main Street Osterville A= 117-163 �` r TOWN OF BARNSTABLE LOCATION cl i�f�l�, S- SEWAGE # 90 4/// VILLAGE ! , �s ASSESSOR'S MAP � LOT INSTALLER'S NAME 6z PHONE NO.� /yJ c, Z5 2 7 6,0 SEPTIC TANK CAPACITY -t /uo o LEACHING FACILITYAtype) :�21 T (size) l vc)0 6w1 NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER «.r (j U 'tt v- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: lII&190 _ VARIANCE GRANTED: Yes No N-1 }, 1 1 f 3o e s R - 11 No3o.-4 Fus.. ........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for Dispasal Morkg Tonotrur#inn' amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ' et�v� ........�....... -m�� 5-�- ............... ...........---....... -•--•-•••---•-------------••••--•-•-•-----. -------•--•-------------................. ocation dress ..... .or Lot No. .............. ................................................„..... �., owner Ad essss tp 1.4 Insta ler Address �. Size Lot_______________________.._.. q. feet S Type of Building U Dwelling—No. of Bedrooms.............. -___-______...-____-___-Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building _ No. of persons �T.................... Showers + — Cafeteria Pa Other fixtures -----------------------------------•-----•---- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W W Septic 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........................ Test Pit.No..2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a ............................................----------------------------•--•-•---------•----------------•----- 0 Description of Soil...............................................................................------------------------------------._---_---------------------------------------------- x V ----•-----------------------------------••-•---•-•--•--•----------•-•-•-----••---------•-....-------•--•----•---------•----......•-••-----------•-•-----------•--------------------••••----•------------ 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance s been issued by the board of health. _. Signed ------..... ----- -----------------`------- ---------`�....... ------- Application Approved BY E % : '""� . ----- g / -Z Application Disapproved for'the following rea ns: .............................. ` ------------------------------------------------------------ ----------- -------------- ----- e Permit No. ------------ Issued ............ .... Dac 9 e � 4 0 No.. .__....__...... ' Fps.. f ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD, OF HEALTH - " g TOWN OF BARNSTABLE Appliratiun fur Uiupuual Works Tonutrurtiun ramit I Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: C�0cvv 11C ................�_ -__......... -- - -----------------.................. ... - .. .......... ------- Location-Address or Lot No. .................................. ......5<,�Ian f -- ._..................._....._ Owner _ 1 rrA1ddress .............. 4�-��ric I...... ,., ✓ . 1(, C..)aC .....5\4�,�. Cc .. _ v....�� Installer Address � Type of Building Size Lot_______ S___________________ q. feet V Dwelling—No. of Bedrooms...............o..._.._.__._.__._._.....Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons.....5..................... Showers r —Cafeteria a' 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. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Otlier Distribution box ( ) Dosing tank ( ) P-rcolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water_____________-__--___._. ti, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water............`......... C4 ...........` -'................................................................................................................................................. 0 Description of Soil...............................................................................=......................................................................................... V -----------------------•---••-•-----------•-•--.....-•-•-•----••......---•--••---••-------=--------••--------------••••--•---•-•-------•-------------•-.._...----.....---.....--•---••-----••••-------. W -------------------------------------------------------------------------------------------------------•---------------------------------------------------------------------------------...--•........ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------------•---------------•-----------------------------------------------•-••----•-----------•----------------------------•-------•••-•------------------------ ......................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with I n ��. the provisions offTITLE,5 ofXthe StatefEnvironmental Code—The undersigned further,-agrees not to place the system in opera until a Cerfificate of Compliance has been issued by the board of health. Signed . _- ----••------- ---------- Application Approved BYk !r// 1 . ..d.. Application Dis pproved=for7the follouwing r'earon.r: ';' ------- - - -- ----- ......................................... ......................................... i - % ;- - 1 - --.f l IC Gl; ti✓ <�•-r�`�o 'i Date Permit No. �? ( - -' Issued yD,re f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C.elrtif rate-of C�0rayliaure THLS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by-------------, .14 � 1- ... nQ '°..... .---:--:----------- 1psta Ner at ......... ... d -.1-?p-1 --------� f Q �.. .-�.�...�-1 ------,�`L -- has been installed in accordance with the provisions of TITLE; of The St- t nv'ironmental Cod as de cribed in the application for Disposal Works Construction Permit No., /� %1.�..... dated -----1_44 ..PP P ----Y ----, .0----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT .E CONSTRUEDAS A GUARHAT THE I 'SYSTEAA WILL FUNCTION SATISFACTORY. Z?f it, DATE �............ ---- -P-----------------------•------------------------...---............ Ins pector ..... _ ...1 '�`'i. V ------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ' No.. ........... ...! 30...FE E.....................iuuu��t-�" u�rrj, T a�ujiun �prmi#�J' Permission is herebyrant d............__A.i.!f.`1�. ........d....-!u. ..... �J to Cons��,��ct )..or eF it ( �ap4n .ividual Sewage D s osal Syst at No...`➢./�.. ..... 1.��1..... ��.. �.--�..�;/,,�_��i�;-c. .... ....... .......%. _. ...�........ JJc�— ` y -- / Board of Health �• DATE......... . ..1._._... -1_ ................................... FORM 36508 HOBBS Q WARREN,INC..PUBLISHERS