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Home My WebLink About0065 ASA MEIGS ROAD - Health Pqo►,.sT-)n:3 0;� 1 �00-7 TOWN OF BARNSTABLE Ae LCV.ATION 65 41-5A myi SfiWA'ag- VILLAGE M. fVl10-1 ASSESSOR'S-"MAP�LOT 03/—Oy-7 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 1 GOO LEACHING FACILITY:(type) 1-e2 �'� (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: li. VARIANCE GRANTED: Yes No By C-n - .� 6�� p�7eJ iYLUN7 G ��p00 �M' �� E��o� PST' TOWN OF BARNSTABLE LOCATION 66* A5A 49,0GS RD SEWAGE # VILLAGE M447'9NS ISM6S ASSESSOR'S MAP & LOT (31-bo`7 INSTALLER'S NAME 6& PHONE NO. JQF1N A A&7t) ¢ZS" 9rW SEPTIC TANK'CAPACITY /DDD G/{L LEACHING FACILITY:(type) L EA4-N PIT (size) 1000 6-AL.. NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: _ T '5 AT VARIANCE GRANTED: Yes No f T r, p i i r- W s � d . � o t:XtSriFdl. t��N PT � 31 - 00 `7 Nol ^.y... FES,30.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diti-V11iiM1 Work,i Tomitrurtiuu "rrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ......................b.. ..Tl�f 1Vle� s R ..._...._.... Lo tion \ drys i or Lo o. O vner Add 4570 Installer Address Type of Building Size Lot............................Sq. feet ,.., Dwelling—No. of Bedrooms.______.��______________________________Expansion Attic ( ) Garbage Grinder ( ) 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. Septic Tank—Liquid capacity------------gallons Length________________ Width--.-_.----_-..._ Diameter---------------- Depth................ W 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........................ 1:4 ----•------------------------------------------------- .............................................-•-•--•-•--•--•......................................... 0 Description of Soil........................................................................................................................................................................ x V .......................................................... ----•-•-•-•-•--•---•••-••-•-----•---•-----------•-•---------------------------•-•---••-------••---•-•••-•-- ................................. W ... ........... ---------------------------------------------------•-•--•-------.-.---_-----------------•---------_--------------.----•--•-----------•------•••------••------•--•--•--•- UNature of Repairs or Alterations—Answer when applicable.--.--..��t. r .�'1�0.�?-_..�_7r_...V,./.�_._-4 .0.%.............. ...----•---------------------------------•--•-•--••----.............................--•---•--------•. -- 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 h s en ' sued by_the board o health. Signed ---------------- 4 I..J --------------------------- ----------------------------- -------------------------- Dace Application Approved By -------------- ---- dJ 1......�. `9'v= Application Disapproved for the following reasons- -------------------- --------......------------........--------------------------------.......-------------------------------- ........... .................. . ..................... .................... ........ . . ....... . . .................... ........................................ CIS Dace PermitNo. ----- IS---------.5----------------------------------- Issued . ............................................ .. . . y Dare J i No..75.,.., -- /iFicia—.3.<.a.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiolt for Dhvip ial Works Tomitrtirtion lirrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ...................... S SGr �Vl P/ --•--------------•----•-.-•----- .-------------------------------------------------•---•--------------•---------------•------------ Gr B Lo lion-A�j1/dres / t r or Lo��j/N�;o. //�� -: Gi l t/dr .... L' GG/f� !a s �SGt /v�il S .. .. .1 f_i�!... ......... ...... ...... 'To//1 O vner Addre -._...-.. CJ... l.... � Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-------- ------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — 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. 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........................ Gs, Test Pit No. 2................minutes per inch Depth of Test Pit--.----._----_-__- Depth to ground water........................ �+ •----------•--------------------•-------------------------------------•---•--•--•---........._------......................................................... 0 Description of Soil........................................................................................................................................................................ x U -••-------------•-•---••-----------------•-----------•-----•-----••-----------•-•--------._.........-•----•-------------•---•----•----•-••------•----------------------•••-..................----------- x ------------------------------------------------------------------------------------------------------------------------------------•-----------------------•------------------•--•---------••-•-•••-•-- U Nature of Repairs or Alterations—Answer when applicable.-_-__. ._./rap4-)..._�.T....,1(J_16...4•__A._R____.•..•___. , y -- . ---- - ---- - --- -- -- 7�/o 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 h s en ' sued by the board oj health. Gi - s= s .s Signed .................. --------- ------..........------------------------------------------- .................................:...... te Application Approved By ............0 ...-�---4L .,4 - ..............- - - ------- ----I ....�.....- .. .%_. Application Disapproved for the following reafonf- ---------------------------------------------------------------------------------------------- ------------------------- -- ......... ................................... . ..._.......... ................. ...... .. . ............ -- .. -- .................... ........................................ Date Permit No. ".... ------.--- Issued ...... . .. ........ Daze -------------------------- ---------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOTTWN OF BARNSTABLE x1 ertifiratr of (11oriptianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�) b �'! +..._..../.!�l./r `------------------------------------- ........ y ................._.. .. ...... . \ lwaller ._..........................-................................................................................ at .. . ....., < A:.5-6.-- `i t't -------OA---------------------------M-----/q ................... ------------------------------------------------------ J has been installed in accordance with the5rovisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ._. .. ------ 5_7.----------. dated ----------------------------------------- ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. a-A- DATE.... ......... j -=-5--'/.g�7�------------- ---------------- --------------- Inspector ..... ._.1......---------•----...------------------------------------------- ------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE %yotial ofrko �onotrttrtion rrntit Permission is hereby granted..................} 11=- /err t, l-----------------------------------------------------------------------------•-•--- to Construct ( ) or Repair ( "an Individual Se ,Iage Disposal System atNo / r 2_S.7.'-- ALA '�n tj b4----- �---------------------------------------------------•-•............. Street ecpp _-- as shown on the application for Disposal Works Construction Permit No.l-__7--; ---- Dated..---I/.. -------------•---•--•---•------••----- . - ..................................................... oard of Health DATE..............�.... ...---�.��_.__••..............•- v FORM 3860E HOBBS&WARREN.INC.,PUBLISHERS No...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH, 0�I J ......OF..... - ---- -- ------ -------- Appliratiun -fur Ditipuutt1 Works Towitrurtion rrutit CApplication is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal Syst at Location-Address �t No. W G/ Owne Address Insta er Address UT pe of Building Size Lot............................Sq. feet ,-� Dwelling VNo. of Bedrooms---------------3---------_-_---_-----__-Expansion Attic ( ) Garbage Grinder ( ) `., Other—Type of Building No. of persons.--___-•-------------------- Showers — Cafeteria a' Other fixtures ---------------------- --- d -- W Design Flow.. ............. allons per person per day. Total daily flow.......... ..-----gallons. WSeptic Tank quid capacity� allons Length________________ Width__..__:.------ lliameter__.__.._._._._ Depth.__.___.__._...- x Disposal Trench—N . .................... Width_-_---_--- tal ,. . Total leaching area--------------......sq. ft. Seepage Pit No....... ......... Diameter_ @tep ow in et_.__________________ Total leaching area Seepage ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- a Test Pit No. I................minutes per inch Depth of "lest Pit-------------------- Depth to ground water....-.--_---.--.__.-_--- 44 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ -------------------------------------------- -- ........................... 0 Description of Soil-------------------- ' ......WV/ ------a----------------------------------------------------------------- ---------------------------------------------------------- -- - - --- - -------------------------- W VNature 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has - n issued by th bo d of healt Signe .---- --9•--- ------- ---------- :. 6...•. -.- .•-------- Da Application Approved By....... ....... — - --- ---------- ----- Date Application Disapproved for the following reasons:................................ --------- ------------------------------------------------------------------- ••-•••-•----•--•----••--•-•-•---••-•••--••-•-•-----------------------•-•----•-------•--------•--•---••--•--•-----••------•------------•------......- --------------------------------------- Date PermitNo......................................................... Issued...... " ........................... Da_te No....:.JI.. FEs .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE,�kLT 77 7�-� ... -- �.? Appliratiun -for Uiipuiittl Workii Towitrurtion . rrmit r Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Syst at i Loc/at_ion.Address or Lot No: Owne Address -- .................................. .......... Insta ler Address d T pe of Buildin Size Lot----------------------------Sq. feet U Dwelling�No. of Bedrooms_________________ _ Expansion Attic ( ) Garbage Grinder ( ) ._.. aOther—Type of Building ---------------------------- No. of persons_.-.._____-________-_-__.-_- Showers ( ) — Cafeteria ( ) a' Other fixtures _•-------------------- -- - W Design Flow.. ............ :.: ............... allons per person per day. Total daily flow____-_--_ -. ✓.._...gallons. Septic Tank Liquid capacit, gallons Length..... .......... Width---------- ----- Diameter---------------- Depth.--------------- v Disposal Trench—N _____________________ Width............ tal i . Total leaching area-----.--------------sq. ft. Seepage Pit No------- Diameter --- Depth ow 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---------------.__.-__-- fi Test Pit No. 2................nimutes per inch Depth of Test Pit.--______. -.._----- Depth to ground water------------------------ ----------------------------------------- Z = ----------------------------- O Descri Description of Soil ------ • .. - . C1! -------- ------------------------------- U 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in St ne -- jheal.to eration until a Certificate of Com liance has en issue• b t )b rd of / P P Ib Y -- --------- - - - Da g Application Approved BY----- - - ...' ..-- -------- ------.-- -- -- ----------- ��---�----. Date Application Disapproved for the following reasons-------------------------- -------------------------------------•- ---------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------- Date PermitNo......................................................... Issued........r.. --- �6' .. to THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......�� Q '1..............O F......... ii:: .. �......... ,... Owprtifiratr of Tompliaurr IS 1 TO CER VTFY Th hAfIndividual Sewage Disposal System constructed ( - or Repaired ( ) r ----- f. ........ M - Installer /' •-•-•-•-• - -- - !}� at........ . J...... �� fi'�`.�� has been installed in accordance with the provisions°of .Article XI of The State Sanitary Code as descr ed in the application for Disposal Works Construction Permit No----------_��_.�a;................ dated.-.°`rr� s> ....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FU CTIO SATISFACTORY. DATE................ .....(O Inspector-------- -----••-• ----------------- •-----------••-•--------------•---•-••-- THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH �� No.........-......... --- FEE. .. ........ T10-n t -tion ramit Permission is hereby granted ` '............................ "" ; -- ------------I Construe /( o Repair '�') a d`viduaI Sewage Di p sa System at No a- �, �"' . j� =� = ' `=------ � ---`---�-----�--/� . Street as shown on th/a,) a 97 ' tion for Dis osal Works Construction emit _: _____. 2.___ Dated... e` - .._._..._ P �/ . .a. . �-"4"ealth- ......-•---------•-�� of hIealth DATE. . / ------- ................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Y� A' �.� �-,Our..c..��.✓ v ON `.•,, rf« Crt fj . d ��