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Home My WebLink About0340 RACE LANE - Health 340 Race Lane Nlarstons Mills A= 126 - 064 \\ I, TOWN OF BARNSTABLE LOCATION ;A.Ce SEWAGE #93 aS� .VILLAGE 101113 ASSESSOR'S MAP & LOT � I INSTALLER'S NAME & PHONE NO. Jo4v7 n. 942 tt SEPTIC TANK CAPACITY /000 LEACHING FACILITY:(type) /aW& (size) 6X/O NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER .57�-t C4 DATE PERMIT ISSUED: 9'°3 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �"" r /�� e �h_ ,� �� , _ � � , t ;� ��.`��- I ^�..- � � \ � � �` ydi� `�j� � �`�� 4 � �' f a (�� '1 /Ile,: a THE COMMONWEALTH OF MASSACHUSETTS p•'"„'01VED BOARD OF HEALTH Bar st ble Cunservation Department TOWN OF BARNSTABLE i nett .��"'°Itttt its ur �i�� tt��al �nrk� C�nat�#rttr#intt Frriti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....................................................................•••••••..._.........---•--•••• --•----••--•-----•-•-•...•---•-•-•---•-••----••-••----...-----•----••.......................---•-• w Lo ation-At dress i Or Lot No;r, '/ ! /��/;/�iv,!� 9! vSa... S�YPC t ucP "~P /l'�Gr •v ,t i S yo 1 }— �cner � Add • _ W Vt /mod / • W_I�- Installer Address UType of Building Size Lot............................Sq. feet ,., Dwelling— No. of Bedrooms----- ------------------------------_-.._Expansion Attic ( ) Garbage Grinder ( ) � Other—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........................ L% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil . �.... f�------------------------••-------•------ U .................••-•-••••--.................---•.....•-•--••--•••---•---••••-•----•••--•--••••----•••--•----•-•--••---•-•-•---•-••-•---••---.....-•••-•--•--•-••-------•...........................--••- --- --------------------•----------•-•---•--••......-- ------......................------•-----•---------...-----------•------:---•-••--•--••--•-•-••--••...----••-•-•••......•-----•--•-•--•......... Nature of Repairs or Alterations—Answer when applicable----- ...... --------- .... /a!�r�__ _'.sfu a . .� 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 ee issued by the board f health. Signed .................................�- '/ 9i,3 .. ...... . .......................................... ....... Date �y Application Approved By ............. .�.�..- ................. �r�--. ..-..7....... Application Disapproved for the following reasons: .................................. ............... .......•...........................---......................................c I ..............:................................................................... ...................:............................ . .................... .... ............................... ........................................ o, Date Permit No. ......./....tea.."".... rJ- y.................... Issued ........................D ate.a-t--------------------------------------- - f '�.r�"��v..7a..-..._.�.-..�.-..--..��,...:'-.�✓:R�-�..d:-r ti. ...r.- �r..."..._w�'\.^--.:��..-..�„�..�.,,. �.r......-.^�✓•.-......,. �.1...r-,...-r...�.�++-""r+r"'.`-"'•„y'.-'r^'.+..++...r.r.,..,yt. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Di;ipwial Wi ork,6 Towitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 3 yv /&« Z&AH,e .....--•---------------------------------------------------------------••. .......... ---••---•---•--•---••••---•--••-•-•-......-----....-••-----........-•--........--••-••......••.... Lo atian- \ drrss or Lot No -�}u ....... /G .... 5 --- ------•-- ...J -. a d l /1yrSv ....1.....s... tenet A /ti�,f ST !/�i....�......._... ! .................. Installer Address UType of Building Size Lot............................Sq. feet N-I Dwelling— No. of Bedrooms------ -------------.......................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ............................... . . w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length................ Width---------------- Diameter---------------- Depth................ 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ .4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a D Description of Soil.............94. V ...................................................... ---••---------------•--•••-••--•--•••••---••.....•--••••----......•--••--•••-•........--••-...-••-...........•---........ ...........-•-----------------------------------------------------------•-----------•--....---••--------•------------•---------.....-•-•----•--•--•----••---•--••-•-----...............------•--••....-- U Nature of Repairs or Alterations LAnswer when applicable.___ h ... c 7i+ . jJ�.•........... Agreement: The undersigned agrees to install the aforedescr•ibed 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 ee issued by the board f health. g3 Signed ............. .................... .................................:...... Dace Application Approved By ........ _'... ................... . .. . ................ ..../,,.-.. ..-...�... � i.Rti�-�_.q. Dace Application Disapproved for the following reasons: ...../...................... ... ....................... ... . -- . -- ................---...........-- ....... ................ .......................... ......... ............ . ............................................... . . ...................................................... ........................................ Dace PermitNo- ------91..3.— tJ L/.................... Issued ..............:.....;. ......Date...................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i TOWN OF'BARNSTABLE Cexttftrate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ......................Jam....... 7..... ... ... .... .................... . . ...... ............. . . ......................_....... .......... " ""'Jer at ........ 3yo.... u«...L : . .._..../Ll� _, ..a_... t,// ----............................................................................................................... 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. ------------------------....................... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ......._...................0 ...... _ ............. _ Inspector . .. ----.S:)------ ------......... . .......---------.------ - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... :�?. ... � L/ FEE...... Q --••••. i Disposal Workv Tomitrutuan ;Vrrmit Permission is hereby granted----- L --` 19u/&,..................................................................................... to Construct ( ) or Repair (v) an Individual Sewage Disposal System is atNo................. � • -----------------------------=------- ................................. Street Q / as shown on the application for Disposal Works Construction Permit No.1��__y. Dated........................................... , ......................... -.... ...............................----..................... Board of Health DATE---_--------- .................................... FORM 3850E HOBBS&WARREN.INC.,PUBLISHERS TOWN OF BARNSTABLE LOCATION .390 /P,Q /,G„.e SEWAGE #93 2S y VILLAGE �S ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 1000 LEACHING FACILITY:(type) 1g0& (size) i NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER i BUILDER OR OWNER / rrCIO" DATE PERMIT ISSUED: r i DATE COMPLIANCE ISSUED: i VARIANCE GRANTED: Yes No �-r— i —Fm - i i I",Z.�?• / I L \ I� Q,