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Home My WebLink About0155 WINTERGREEN CIRCLE - Health u � ljg-o ql TOWN OF BARNSTABLE LOCATION .r -fte11`Ncirc SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. cam-_ l� Maeoy,•, LC4 :�. SEPTIC TANK CAPACITY LEACHING FACILITY (type) � J�°� (size) tl NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: j 310 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No i I � 0 t ` jc�4- 1 6 �a� Fss... ... .30.00 No...........�....... .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for Disposal Works Toustrurtinn V.rrmi# Application is hereby made for a Permit to Construct ( ) or Repai&XXX an Individual Sewage Disposal System at: ..195...W.._i_n_te-rgreen Circle Os terville _ -----•--•--•------------------------------ ----------------------------------••------------------------•-------------------..............-•-- Location-Address or Lot No. .Mark Kozma ......................................................................... ----------------•----------•-•-•--..--.........-----•--•----•-•--•-----------------.........---... K _ Owner Address W J,•P.Macomber Jr Installer Address Type of Buildin Size Lot............................Sq. feet Dwelling�No. of Bedrooms___..._..._..............................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers ) — Cafeteria ( ) a Other fixtures ------_---------------------- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1_______________minutes 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 ----•------------------------------•-----------------------..._....--------------------------------------- ---.....------------------........ •---------------- 0 Description of Soil----- W 9anc� & Gravel --------------------------- v .-----------------------------•------------•----•----•-•-----------------------------------•--•-------------------•----•-----------------•------------•-------- W U Nature of Repairs or Alterations—Answer when applicable- ............................................................................................. 1-leaching pig. 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 has b e�� O issue by the board of health. Signed .. ......... ....7/91--9 ....-- ... J ' ce v 7" d Application Approved BY .........------- ----------------- - - ---------..�------.. -- - Dece Application Disapproved for the following reasons: .. = ......................................... - -------------------------'---. .........------------------------........---------- '-------- .......................................................................... -------------- ........................ Permit No. - . ------ 57 ....... Issued ..........."-- G------�4-- 1-�... Dace - 4it . r NO---9�s_ .��...'A/ Fizz.... .... ...?0.a00 THE-COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE , yptiration for Dispoiial Works Cnotw urtiott Prrutit Application is hereby made for a Permit to Construct ( ) or RepairXkX: an Individual Sewage Disposal System at: --.:,55.••TnTifatajZj, ga__Circle Osterville -------- ------------------------------------------------------•-----•----------•--•---•-••---..........--- Location.Address / or Lot No. ..M..PkMa ........................ber .Jr.......•-•.................•-••------••......-----f .I.. ....... .......... ...---------- ..... W Address r Owner ` A t 7r/ / G/ ........ Address..... Installer r Type.of-Building � �f � Size Lot--=------------------------Sq. feet g_ r p j�33 Garbage Grinder ( ) J Dwellin X No. of Bedrooms........._.4................. j!'t_Ex ans on(Atti `t Other—T e of Building No. of, ersons............,............. Showers — Cafeteria dOther fixtures ----------------------------------- - - .........._'------------------------------•••------•----------•----------------•......--------- W Design Flow--------•------•---•-•--•------••---•---•••.g4 n P r Pie sori�pe'rld'ay f'Total daily flow - ]dons. 1:4 Septic W Tank—Liquidcapacity g 1 Diameter..--•----------- Depth................ i •Disposal Trench— o c.. acrt ------.Width dthns.....Len Total Lengthldth--------------T. talleaehrng area...................sq. ft. il Seepage Pit No--------------------- Diameter.................... Depth below mlet.�J.,........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.grow d water........................ o .---.--...•----•------••--•-•-•--------------•.--•-•-•..•-------.-•-..-••........••--...•.•.....•..._.......___...._--•.......___.--...____._......._A S( Descriptionof Soil.--------••-••-••--------••••----------------•-•-----------------------------... x Sand Gravel r V --•---------------- --------------•--•----------•--------------------•--------------------•---------------------------Y._-•v--------------------- ••-------- W ----------------•--------------•-----•-•--•----•-------------•-----------------------•------•-------------•-•--•---••----•----•--------------..... .----._......._._...._............... UNature of Repairs or Alterations—Answer when applicable......................................................V,1_.._______.__.___._______.____.__. 1=1eaching ].it. Agreement: a The undersigned agrees to install the aforedescribed'Individual Sewage Disposal Syste 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 boardof health. V Sf ned v a /�� --/�----------------------- ? n^................ V r Date Application Approved BY = ��+rj � ....... ! .. ,/ V.r. ......... ........... '" !'..��...e w � Dare Application Disapproved for the following reasons: /------------------- ---------------------------------------------------- --------------------------------------- Date Permit No. �" �1 Issued .......-_Z-� �------'� _ \ .. .Date i THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH .YI/ TOWN OF BARNSTABLE C ertifirate Df Cantylinurr THIS IS TOCERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired r by --------------J F_.Mc omb er. Jr Repaired ' - -------------__-------- ------- • Installer at ............... -5.5...W nte.r reen..-Circle....Osterville......_-__.._....________..____..--.-____......... -------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code astAescr bed in the application for Disposal Works Construction Permit No. .....�� '..��± � dated .. �'.1/J... .-. ' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE[) /A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............•..................... ----------y................-----------------------...........--.. Inspector .rr, .!I ' 1 s:.::..:d THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ((�� TOWN OF BARNSTABLE 30 00 No..A..��..:; .�t� FEE.............'......_.. 4- Permission is hereby granted....J.P.Ma e ombe r Jr. .................................................................................. to Construct ( ) or Repair,-,( an Individual Sewage Disposal System at No.... 55_.WinterF_reen___Circ.le Osteryille •. . .••-- Street / as shown on the application for Disposal Works Construction Perm�itt..Noo&f.g�--®+l�! Dated..... —y Board of Health DATE----.�.........-� _----_'_..----------�-----.�-../`).. FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS