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Home My WebLink About0253 BOG ROAD - Health 253 Bog Road Marstons Mills —— A = 046 008 — 1 TOWN OF BARNSTABLE LOCATION -2 15'3 SEWAGE # VILLAGE �� rl/4SSESSOR'S MAP & LOT r- 'ANSTALLER'S NAME & PHONE NO. E SEPTIC'TANK CAPACITY # r ` LEACHING FACILITY:(type) 1 (size) OQ' NO. OF BEDROOMS . PRIVATE WELL OR PUBLIC WA ER f r BUILDER OR OWNER ,� a DATE PERMIT ISSUED: r DATE COMPLIANCE ISSUED: VARIANCE-GRANTED:--Yes -No. I r•:� .. 1 � � � , r��-i�� ` �� 7� ti + '� !� , .. � `S .'1..- � j« ! � i M �� • - __. ._._. J 77 LOCATION SEW - IT NO. VILLAGE Mal 0Y6 _ 60 I N S T A LLER'S NAME A ADDRESS J. CRC MEDE-iR4C>S 4f!�d I tit Coroorotaon Stmet 44J+ -D-E- 1- OR OWNER Kycmn l$t Mates. 775.M28 Drd/o� �s�. ♦SS-7 �.53 ,= 4 t�-�� - �V s -may s i✓1> >is DATE PERMIT ISSUED: : yr DATE . COMPLIANCE ISSUED /d �� lia- i s_ V&j ✓ dam. Svc" x ASSESSORS MAP NO: 10 Z16- ^J PARCEL NO: ' • F�a...., .� .....✓ THE COMMONWEALTH OF MASSACHUSETTS p BOAR® OF HEALTH ( o(Y 'd0� Ml C =ft8ti"DCP""nt TOWN OF BARNSTABLE thij weal Wi urbi Tomitrurttnn Permit Application is hereby t de f r a 'ermit to Construct ( ) or Repair (C/) an Individual Sewage Disposal System at: •- v. .. ..... . .-- ...-------- ......... - --- ----------------- v � v .... - \ddress ............................................ Lot No. d ncr Ad r s W C� j Oao7 p.---•------------•------- ------------------------ .....- --- -----------.............--- Installer Address Type 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. 3 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........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •---•- - - . Description of Soil t o �J•-••--•-----...... .ii�i---- ------------•-•-.--•---------. ----- ------------......---•............. x -- UW --•-•--•---•----------------------------------------------------------------------------•---------••----•-------------------------------.......----...----••----........................._...._......... Nature of Repairs or Alteratio —Answer when ap 'cable...-...._. .................. ....... . ............ . ............. �- A c. Agreement: Lac 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 Complian has en issued by the board of health. Signed ----- ..... ... ----..~.......... ............... .......... ... . Application Approved BY .... ... . .... . ..... ...................................... . �.. .r..... .J Application Disapproved for the following reasons: .....:.................................................................................................................................. ................ ................................... ......................... ............................. . ..................................... ...................................... ........................................ Permit No. ..-......a�.�r�..0---------------- Issued ...................................................... ate...... Date -M...��.....:..+�,�.......J'�.r�_.:..�.+,;��:'.'-«,..i•I....-� ��ti.,a�}t^-•^w��,"'y,�..�..�'��'R:..�^et�ik'a..:,w� ��...,•�.,.y,.° N,��^.t`a�<,"l.._.,tK',,. .+a:.r.�+:---•.... ! i 1 -=" � r 1 1 F s.... .. _�... THE COMMONWEALTH OF MASSACHUSETTS . BOARD OF HEALTH TOWN OF BARNSTABLE Appltration fur Di!3pniul Worlai Tomitrnrtinn Urrmit Application is hereby I dePermit to Construct ( ) or Repair (�an Individual Sewage Disposal System at: :. /.��/ �cvLocaCon-,Address2, c vst I or,Lot No. �. �l r O�'ncr t.,.i'. Address ------------------------------------••:-•--•----•------- --------------------------..._......--- ............................................. Installer Address UType of Building T s / Size Lot............................Sq. feet Dwelling—No. of Bedrooms_______ _______1_-----_ti.-____..__-Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building`,=-—_ -_-.!'___�-VNo. of persons---------------------------- Showers ( ) — Cafeteria ( ) 11' 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 ( ) 1.4 Percolation Test Results Performed by........ ................................................................. Date........................................ a 0-� Test Pit No. I................minutes per Inch Depth of Test Pit.................... Depth to ground water........................ G 4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' --•-....�----------------' ---`-------- • . ' .�tom!-J,/ G•-�--1...:::......:� ✓ �. C �i--•---•----......--•-•-------•--............----.....-----•---•---....---.......... O Description of Soil..............._.. x V .....••------•-••••----•-•-•----••--•••------------------------------------------ W Z. ----•---------- -------------------------•--••••-------•--------------------. ...-•--••--------••-- •----------------------------••--•-•--•-----••--•••-----•-•---•--................-••••-•••_ UNature of Repairs or Alterations—Answer when applicable-----------—_._________________________�._.__....�......t=,.._...:� ................:�-»,a^ J ....... , -- .... :: - ............. --- Agreement: The undersigned ag 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 been issued by the board of health. Signed..:...::..... ._ -�...� ....,.-- ---- ...^-'- Dare ..�I:3 ................................ Application Approved By ............. --- �� -------------------------------------------................. ....... ..�-'--�� Application Disapproved for the following reasons: ................................................... . .. ................................................................... . .. ......................... ................................................ .. ..................... . ........--........ .........--........................................ . ........................................ p Dace Permit No. -.-...... ---------- ............. Issued ........................................................ ...._...... Dare -- --_.mot— ----_.._.---v_—�y -- --------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�ertifirate of Compliance THIS ISJ0 CERTIFY, That ,he Individual Sewage Disposal System constructed ( ) or Repaired by , <s -2'.^^r-�— .--.... _---------------------------------- m.,�aun ------------------------------- 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. ..._...7--3... .....;.66 dated ......................................_...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---- ------ ` _ --- � 1 ..--.. inspector -\:1..: .„t...- . .............. ................. ---....... _....--._-... ._... ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH G TOWN OF BARNSTABLE ._.... FEE._= .......... Mynoal Work.5 Tin itrudion permit Permission is hereby granted .__ --C----`7. - " '-`-- Ti to Construct ( ) or Repair ( )an Individual Sewage Disposal; System at No. - 2- !: ..��----- ---•........'..-^may /...... ........ ........... Street as shown on the application for Disposal Works Construction Permit No. .ti-��__ Dated........................................... C Board DATE.......................... ---/_.� -- of H ealth FORM 36508 HOBBS 6 WARREN,INC.,PUBLISHERS