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Home My WebLink About0074 PINE LANE - Health La'he �A-' 118-068 I TOWN OF BARNSTABLE LOCATION SEWAGE # �d V I L L A G E 'le 1je- ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. (`70140Wj 4�s . 4bzp-k SEPTIC TANK CAPACITY 14'MQ LEACHING FACILITY:(type) k,//7�rov�l-,3 (size NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATE BUILDER R OWNER //��'1`' D� DATE PERMIT ISSUED: / - DATE COMPLIANCE ISSUED: � VARIANCE GRANTED: Yes Noll, a ,�. � i C, w � o. �` No.:....�. ?� Fps............._............... O THE COMMONWEALTH OF MASSACHUSETTS r� BOAR® OF HEALTH a- 93 TOWN OF BARNSTABLE igned D8t8 Appliratiou for Di ipwiul lVurkii Towitrurttnn rprmit Application is hereby made for a Permit to Construct ( ) or Repair (64�j an Individual Sewage Disposal System at: ocction-Address �"or Lot N O�rner A dress Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms........................................... Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building No. of persons............................ Showers — Cafeteria a' Other fixtur _-. --. _ ..........................._.________..__._._.__..__.___.__...__.._..._......__...-_. J ..-_-----.--------.-.------- Design Flow..................... .:. ..................gallons per person per day. Total daily flow................ -�'�.�'�.............gallons. W - - WSeptic Tank—Liquid capacity/!Z(:?__-gallons Length---------------- Width---------------- Diameter................ Depth................ x Disposal Trench--No. .......J......... Width.......7_. ...... Total Length.2��.-� otal leaching area....................sq. ft. 3 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. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ LT4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a ............................... ••....._..-•-••••---•••-•-•--•••--••-•-••---•---•------•-•----•-•-•---• .......... 0 Description of Soil............................. °�'s�-........... .IStri-L==--�-- ---/a--•---•-------...-----...-•--- V ...---•-•••-•-----•------•--••-•••-•••------•--•••-••-------•-••••••---•••-•---•••...----•-•-•------••••••--•••-••-•--•-•-•---••-•-•--••--•...._...•••._...••••--•-•................................................. W ------••---•----------------------------•---•-••. -•--•---•-------.........•-----------•••-•-•---•-------•---••------• ................ -...... ......................................... UNatt e of Repairs or Alterations when applicable._._/ : :° ... �hj� °'....-.._. ' _. �� .:-... 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 n is ue y t oard of health. ��••`` Signed ...... ..... ------------- Y ..... ... ............................... i.........:....... .. ' ..... ................. ..Dace Application Approved By ......... ..,....... ------ ._............: � =�1� ............................... I?are Application Disapproved for the following reasons: .......... ... ....................... . ................................................... ................. ....................... ................... .....--.............................. ---------------------------------------- Due Permit No. ----------------------------��r�. ................... Issued .........111�1-.1.02.."..f�., .. Dare a -' Y• -..�.�+i�---.+tar`/�m,'J^' - '-ii.r4L^�,�1` '' ' t 7i.. iu - 't -F t d - _.r .:� `v+_•. - r.- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diripatial Works C owitrnrtinn rumit Application is hereby made for a Permit to Construct ( ) or Repair (iV,) an Individual Sewage Disposal System at: U . Location-Address or. o .............._..-•-•- ----------------------- L t No. ......................................... Owner ress W Gr2 UL.G 7i 15 'j `5 7- -76o G-,� aL Installer Address UType of Building Size Lot............................Sq. feet ►, Dwelling— No. of Bedrooms---------------- 3_..-___..._-__.__.__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons..-------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures •----------------------------- �_ ___________________._..__..._______.__.______.______..-___.__.__....._._._.__J ........_._...•.....__......__.. W Design Flow........................................____gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacityZU<-�'.�_---gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench— No. -------/_........ Width..........._._------ Total Length.:%?t.7-s 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................mmutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------------------------------------------------------•---•---•--------.........---•----................................................................ DDescription of Soil--------------•--••----------.....................................L .---��-•---= ............................q3 ,- _c_...-- �`� `"s/��==0..... U --------------------------------•--•-----------•---......-------------------•-----••------•---------••---------------------•----•----------..._.....----•-----------------•----..........._-•-••--••-••. W ..---•----------------------••-•-•••----•-----•-•••-----------•----••---•---•---------••------....-------------•---.._.-_......-- --••--. •--•------- -------•--••- U Nature of Repairs or Alterations—Answer when applicable__?!.3_S �_�.-_-•/CU 0�,t..� ii'tN�_ t0 t,S_.......... 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 Compliancc7�b en is ued/ y the-board of health. Signed .......... .................... .. ....../..............rZ /i� �� Application Approved BAle 9`t�!�..---. Date Application Disapproved for the following reasonr- ------------------------------ ............. .. .......................... .... ............................................................ ....................................... Permit No. .................... � `'� -------------------- Issued ......... � Date - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE TErtifi ate of V l!..��•IImplianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( by ................................................................ Ali `. at .........................._.__....-....._...........-7y-...._......., /"�� G./I :-------------_.D.Si:.�/viu...e............. . .... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. - M.-. . , dated ��- ..,/.2.. _. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ....� - 1. Inspector ............._. .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE.... Q...�... Disposal Workii Tuntrudinn rrrmit Permission is hereby granted.......................... .....%f�'—�!_.v.T/ �...--J`S.i_Tl.../C to Construct ( ) or Repair (>Q)jan Individual Sewage Disposal System atNo. y.............. ir`1 ----------------------• Ji 1 L Street as shown on the application for Disposal Works Construction Permit N > - ` �� Dated----- �'�t"'....... J Board of Health DATE....... FORM 36 508 H088S&WARREN.INC..PUBLISHERS l G TOWN OF BARNSTABLE LOCATION Z019p, I SEWAGE ASSESSOR'S MAP & LOT -{)( ' INSTALLER'S NAME & PHONE NO.&PSI©W; 2' g 4�j-� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) , /7p /` (size % NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATE BUILDER R OWNERR �)/`� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No y�- �v 3y' f i r M c WAS I jis`f1d L! e,TO 6- 19 M r' I � a � car a-hDs i• A/ • . P V I � n. � • _ I t i . �A 101, � ivI3t a r fP., '� � � yip • - � � .� '� <,. .' Xe $! VIM 'TOWN ff r i ) 14 r° i k r rt r r o , I cam- • p J , a �r , A/0 �MS -4 o - w l Alo-r6GIe6as uovu)s 36,11" Ir 0 4 LAUNDRY ROOM. . BiEEP O 1 b r 1 r sa>rr_sam 1 1'-11"�95"04 7-5 113W 1 w g z�� rs,sg --- ---- 0 NEW CEDAR CLOSET MEDIA ROOM b O OFFICE O C Le E7(ISTINGCEDAR CLOSET - 2S-0"