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Home My WebLink About1437 RACE LANE - Health 1437 Race Lane Marstons Mills 6 y , A= 064=075 r TOWN OF BARNSTABLE LOCATION - 1 1 1-17 SEWAGE. # O - VILLAGE ASSESSOR'S MAP Cz LOT INSTALLER'S NAME & PHONE NO. (LJ 7 79 SEPTIC TANK CAPACITY 16-0"b � LEACHING FACILITY:(type) Z2 � r / l r (size) f 5 E' NO. OF BEDROOMS PRIVATE CE-LPOR PUBLIC WATER BUILDER OR OWNER . °'.-K DATE PERMIT ISSUED: / �{ DATE COMPLIANCE ISSUED: ® ✓�LI ./Z� VARIANCE GRANTED: Yes No 143J Sd 7 3'� VOL q No..aD_ .�..`.� Fzs..... .`.._ THE COMMONWEALTH OF MASSACHUSETTS ,loll- BOARD OF HEALTH a TOWN OF BARNSTABLE Appliration for Uiiposai Workii Tonstrnrtion frrutit �Su,s Application is hereby made for a Permit to Construct ( ) or Repair (f j� an Individual Sewage Disposal �Vystezn at: /�� r -... ..��----••••--........--. .. 4.- -•-_... -_.. A, ,! q`� r Locat -Address n^' X Rpr Lot Igo. '-- --- • •....._/.. f_� `j.... ,--- ------------------------•...------...------------ ...........---------. -7----------CA'....-......(-%G...... . ..... 11 .lr"' Owner .. Installer Address Type of Building Size Lot............................Sq. feet U g— P ( ) g ( ) �t Dwelling No. of Bedrooms........................................... Showers — Cafeteria Other—Type e of Building No. ofpersonsnsion Attic Garbage Grander Pa YP g ••--••--•--•-•-•----------- ( ) ( ) Q' 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.....Q�............. Diameter....l /�.. Depth below inlet....j�4_.......... Total leaching area..................sq. ft. Z Other Distribution box (SC) 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........................ P+' --------•-------------------------------------------------------------------------•-------•--•-•----......................................................... 0 Description of Soil........................................................................................................................................................................ W V -----------------------•-----------------•- ------- ----------------------------------------------------------------------------------------------------------------- -------------------•------------ 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 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 issue by the board of health. Signed .. -- . �2 3 �� Date Application Approved By ........................... ....... ----- . ---- ---------- ......-----.................................................. ...... Application Disapproved for the following reasons- ---- ---- ------------------------- ------------------------------------------------------------------------------------------- ....................................----------------------------------...........................------ ---- --- -------------------------------------------------------------------- ------ ---------------- ---------- LDate Permit No. ---------------------- Issued to ? 1� ----------.. `Date No.. ?0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal sal orks Tonstrudiun ramit Application is hereby made'for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal �Vystem at: ......H3 _._. - ... ................... /� dl� .... - s_..... - ....... .......................... Location-Address U X 3 epr Lot ....---•- -•----------....................... ............................................... ._....--------•--•----•--------------•---•--------•-•..................-----•.... W /� Owner K 3 Odress t'// a -.........- �_ ........................................................... ---•-•-••-••----•--�-� .. Installer ••----.... ...-----•------................-••-.....-----•----- � Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( )U Other—T e of Building No. of persons._...•_.....•.•...•......... Showers — Cafeteria fl, 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......2�............. Diameter.... Depth below inlet..... ........... Total leaching area..................sq. ft. Z Other Distribution box (X) Dosing tank ( ) 1.4 Percolation 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........................................................................................................................................................................ x W ----------------------------------------------------------------------------------------------------------------------------------------------------•--------------•--------------------•-•--••...------ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... 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 has been ue�d�by the board of health. / Signed / -------------------------- ----------------------------------------------------------- -----�--�.......14 Du Application Approved By .... � I-:-- .,,•--------------------------------------------------------------------------- ------�. e ?.. Application Disapproved for the following reasons- -------------------------------------------------------------------------..................................... ........................I—................ ........................................ Date Permit No. ..... - ..-�4 ---------------------- ----- Issued .................w----�-?-..w-- .............. ce i THE COMMONWEALTH OF MASSACHUSETTS /�� /r 74t ( fG BOARD OF HEALTH TOWN OF BARNSTABLE Tertifi ate of (fampXianre THIS IS TO C'EgT.Er, That the Individual Sewage Disposal System constructed ( ) or Repaired 1j -1/�...---1--------------------�........................................................In�---------------------------...................----..........----...---------... .............--------- Installer l at --------------� �3 7.............. �� ---------- C ``�.................................... �.. 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. .... . _ �5 ....... dated -..4".a1?-,4/,I0---------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU/A/RA°NTEEATHAT THE SYSTEM WILL FUNCTION SATISFACTORY. � 4 DATE....-..1. n[.... Inspector ...............................fir.. -------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE � ✓ •.. No....�h.-4 �.� FEE....�7�.......... Disposal Works Tonstrurtion rrrmit Permis i n i hereby r __ �/�/ /,f' &Y� ... ......... e eby granted ---- ....... ••-- ------------- to to Construct ( ) or Repair ( Q�) an Individual Sewage Disposal System at No.........1. "7..........1?Zt //�7v ' .: `�__.; Street / as shown on the application for Disposal Works Construction Permit No..I...( `� Datte�ddl..1-`1-?.:L....................... �,e ....`` -------•--•----••---• ---•--•_ / ..... ... ........... L—Board of health V j_... DATE..--��"--�'�r--��----------•-•----....---- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS