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0182 REGENCY DRIVE - Health
l �S� � - ��� �,�� . v� �o�� -�- ,__ TOWN OF BARNSTABLE 1-�')CATION .t Ori Ue� SEWAGE #�7 -•o��� VILLAGEAO/-Sy6ps ASSESSOR'S MAP & LOT���3-©7c� INSTALLER'S NAME & PHONE NO.c r-101041; �)6tg, (V- jo7�p :SEPTIC TANK CAPACITY 1600 LEACHING FACILITY:(type j (size) NO.. OF BEDROOMS PRIVATE WELL O PUBLIC WA ER BUILDER O OWNER` 1� P���1i�cS'Q DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes A 39ol U0' �13 J$1 jj�jqq r, LIVVCA. . ON _ SEWAGE PERMIT NO. ILL AG, E s s66 IMSTA�L R'S NAME i A� DRESS �•3# 5 1� e U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �, 1-Y47 OA .�s aJY �s '2 3 No CS 07 ` /icFni3...... ..................... THE COMMONWEALTH OF MASSACHUSETTS :BOARD OF HEALTH TOWN OF BARNSTABLE Dig wial Works Tomitrnrtiun rrmit V Application is hereby made for a Permit to Construct ( ) or Repair P�) an Individual Sewage Disposal System at: Location-Address r�J.00f No. ..._ ................... ..................................... ................................................. ��W7 g tne= Address w Gv -------- G'3------------ y..--.�--......-•✓1?!..rYJ..t1,........_..---•---- ,� Installer Address d Type of Building Size Lot................ q. 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.............. �0----------------gallons. WSeptic Tank—Liquid capacity-/M..gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... ' .... Diameter.....Za..____. Depth below inlet___---_�_------- Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) •" Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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.....:.................. 9 -----•-----------------------•••-•---•------•-••------------•---•-------------------........._-------------------------•--•-------•-•------...... ... ...... 0 Description of Soil............................................................................................................................................-............................ W V ................................•-•----------••---...----•--------------•-•--------•--------------••--------------•----•----•---•-----•----..._...----------------------------------•---••-------....... W ----------•--------------- ------------------------------------------------------------•-----------------------------------------.------------------- U Natur of R)airs or Alterations—Answer when applicable.--_--_ ____--_A"......._f 101�_._ - ...... ......... ..... .....•---•-- .... ......................... ......................... ^-Jar_=---•--•.•-•--•--------•---._ .........��__��..�-!?�...... 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 een 'ssue by the bo d of health. Signed ................ - ------- - ------------ ------- - ------ -- .. ........... ........ ........ Application Approved B vLYare Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------ ------------------------------------ ................ .................. . . . ......................................... .................................................... .. . . -------......--------------------------- Dace Permit No. �................... Issued ..............--. Date ———————————————————————-----——— —'------.__�--- -- -- ----- Fxs........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Application is hereby made for a Permit to Construct ( ) or Repair (_-%<) an Individual Sewage Disposal System at: --------- E-----' '''--c y---------J--------{-------------- ------'=------=-----------�s-------------------.--------------------------------•----------- Location-Address 7 / or Lot No. �Jr / vr�/ ! !�Jc_J�,�� /�c`� /`L �Cf�1. l7lL` /-2�, r'.. /-- Owner —7 _ / , a / Addres�� Installer Address U Type of Building `� Expansion Attic Size Lot___`....... .............Sq.(f eet .., DwellingNo. of Bedrooms___:_._---- No. of ersons____________________________ Showers — ( ) — p• ( ) Garbage Grinder aOther—Type of Building p ( ) Cafeteria dOther fixtures ---------------------------------- ----'----------------------.........-------------------...-----------•---•----'•----------•••------....._........ W Design Flow....................: allons per person per day. Total daily flow.-_........._��........___..._... Ions. g g P P P Y Y -- WSeptic Tank—Liquid capa6ty./69A_gallons Length---------------- Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......... ...... Diameter------emu._.---_- Depth below inlet........e�........ 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........................ f�. Test Pit No. 2................minutes per inch Depth of Test Pit--------------------- Depth to round water........................ �' -~,-� ------•-'----•-•-._ P . ---•P -••----- ----•--- ------- - P g D Description of Soil................................................. ... V -•-----•-•--•--•--•-•-••-----•••-•-•-----•••--•-----------•-••---•-----------•-•-•'•-----------•---•----••-----------•-----------•--'---•---•.....-•---•-•---------'•...................•••-------•--••- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable._._.._ _ O. --�._..__.___..�U[1-Q - .................. -.•/•F.!�r _-••- _. �%�j y a1�J� 7-3t — 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 hasyeen 'ssued by the board of health. L S... ........Signed -------------- -- - j1?00 Application Approved BY . -- --.... Date----------------_...-._.-..-... Application Disapproved for the following reasons- ---- -----------------------------------------------------':... ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ - - ------------ --------------------------------------- , Permit No. Issued ............ ... . . Date 1.. Date ------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 0-ler#ifira e IIf C11umplian e THIS IS TO CERTIFY, That_zhe Individual Sewage Disposal System constructed ( ) or Repaired -------------- by .................._.........................................� Installer n ��h at .....................................- - ./ o-----.-..-/�:�'4- fA-1 C -------->J(.._..... ........... .14 ------�.....GL.................... 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. ----/ ......a,.. . ------ dated _-._..----------------------------_._.-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE - -...1 .... ..'' ....T....: ... Inspector ...f1 � _... - THE COMMONWEALTH OF MASSACHUSETTS 2— BOARD OF HEALTH � ` - TOWN OF BARNSTABLE No......... .... FEE.---.....�.......... Gt�>> l�s,JS;6L*tc.�U Permission is hereby granted...................... �J -' to Construct ( ) or Repair L-�•}-an Individual Sewage Disposal System at No...................................... - 2 '.J C�j Z� ....... e44 ! ? /t I-5' - street as shown on the application for Disposal Works Construction Permit No.�l Dated... __ .__.---/---- _�......... . L.._.... / 1 Board of Health DATE ��� //J FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS �._ Nol THE COMMONWEALTH OF MASSACHU_PEMX5;.;t BOAR® OF HEALTH ....................OF...........s.... ......................L Apptiratiou for Bispuaa1 Workii Tnnitrurtion Frrutit Application is hereby made for a Permit to Construct ( J6 or Repair ( ) an Individual Sewage Disposal Sys .k2 .... hLlae , A dress .. ��....... ----•'-- Ow0. ner Add re a ..........................................S-`-------- •..........:............. �i ✓ .� Installer Address U Type of Building Size Lo .2�_� d..Sq. feet 15 Dwelling—No. of Bedrooms............."__.._..._. ....__.__.Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _._, L L... No. of persons...16.................... Showers ( ) — Cafeteria ( ) :1 Other fixture ......................................................--------------------------------------------- w Design Flow_______________5—S .................gallons per person d Total dail}r;flog_..__.. ........................gaons.--- �f- . WS yptic Tank—Liquid capacityA�7.gallons Length ._�'�._.. Width._3!�� Diameter________________ Depth-_. f'�._. x Disposal Trench—N/ ,, -o. .................... Width__-.?.' Total Length.......... _.,..... Total leaching area....................sq. ft. Seepage Pit No._-__,/_____________ Diameter._ _ ____ Depth below inlet..... ......... Total leaching area�4&A. ft. Z Other Distribution box ( ) Dosing ?ank ( ) Percolation Test Results Performed by.0 12 � r Date......VWX JJt} .,, Test 'Pit No. l._ Z_.minutes per inch Depth of Test Pit.._.. ....... Depth to ground water.... !Ld. 4A Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 4- ....... O Description of Soil------- , ......... / I �UV/ c � f� (,��,�� x c, - - ------ w �� �. U Nature 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 TITL% 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the board 9health. igned----- .'--------------------- ................... -_-- - ------------ ApplicationApproved B ...... . = ---------........................................................... Date Application Disapproved r t e following reasons-------------------------------------'---------------------.................................................. ----------------------------------'------......---------------------------------------.......-------'--•----...--•-------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued_....................................................... Date Department of Environmental Management/Division of Water Resources 7 WATER WELL COMPLETION REPORT WELL LOCATION, Address '01"I City/Town a'V SA)JE 07 1S G.S.Quadrangle Map Grid Location Owner TCC�'rlJ° Address ESQ 'e • LL USE CONSOLIDATED WELL Domestic Public ❑ Industrial❑ Type of Water-bearing Rock ' Other;z Water-bearing Zones Method Drilled ` 11 From To p" 2) From To Date Drilled 3) From To 4) From To / g CASING Length t�Q Depth to Bedrock Len g /1 Diameter__ Type_ P y(fl UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface Co7 Sand: fine❑ medium❑ coarse❑ Date measured 6 `: x Gravel: fine❑ medium❑ coarse[] GRAVEL PACK WELL Screen: Yes No Slot# length from to ❑ ❑ Split Screen(or 2nd screen) WATER QUALITY TESTS MADE Slot# length—from—to— Chemical ❑ Biological .❑ Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water! Materials From To o P*S,6D ° 4 eqP ` DRILLER v Cb y Firms Acldres&na City_''Y - Registration No. c ' p r or lgnature Please print irm y 04-MMER COPY 15M-2 84-176471 `No..�_. Fis....x!..' ............... THE COMMONWEALTH OF MASSACHUSF_4 TS BOARD OF HEALTH 4,0 Appfiration for Diipnaai Workii Too rurtinn Urrutit Application is hereby made for a Permit to Construct ( Xj or Repair ( ) an Individual Sewage Disposal System at: /07- ....... , ..L catio Address --••-••••• or t No. -- r .................................... •-•-•-....__-..f_... .----•-.----------•- Owner .•-Addre,�•__ a •---•--•-•-••--••-••--••••--•--••••••-•--•-••----••----••••.................••••-•-••.....--...... ....--•-•••••--�f.'.-5 p*!1. f'-. / _ GL.C/5, Installer Address d Type of Building Size Lot - .1 C��.-Sq. feet Dwelling—No. of Bedrooms___.......`.............................Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ___ 1. -`_. No. of persons...6--------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures .....................=------ W Design Flow................•_. _.......__..... gallons per person er day. Total daily flog._.....`_��-��_....._...___...--..._.. Ions. y1� WSeptic Tank—Liquid capacity .gallons Length �b�.`. Width__ �� Diameter________--__--- Depth__.''` x Disposal Trench—No. .................... Width- ------------ Total Length.........._..,..._ Total leaching area....................sq. ft. Seepage Pit No....__1__._________ Diameter-_�fGl.._...... Depth below inlet----- Total leaching.area5,3_0��`'r. q. ft. Z Other Distribution box ( ) Dosingtank ( ) '-' Percolation Test Results Performed by. AW.t!�I'. _4 l _ _ Date.__. �/- -- �� Test Pit No. 1._ '----_-minutes per inch Depth of Test Pit.../-Z--------- Depth to ground water-...-----__-_-___.C._. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil------t � ">� � 'S� U/C.. � _; x - -• ----- --------------- --------------------------------------------------------0....---- f,---------------------------•------••--------------•-------............................ U Nature 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 TIT1Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be 10.1 issued by the board health. Wgned---- •. • Application Approved BY -------------------• .......... ---------------•-----•-•-••-•-•--•----•-•-•---••. .. ._ _ ,._._ '�..-•-••- �_ Date Application Disapproved r t following reasons:................................................................................................................ ...•-•-••••-•••-•-----•--••-•.......----•---••----•-----------•-••--------•--•---........-•-•------•-•••---•----•--•---•-•---------•------------••--•--•--------•------- ------------------------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trrtifirate jaf Tlamphanrr T IS S T.. CERTIFY, That the Individual Sewage Disposal System constructed ( 4-of Repaired ( ) bY �=i --------------------------------••-----.........--------------------- .--• e (` Installer _. •� at `"=r ;- .:------------------------------------•----•----------------------------•-........................................ has been installed in accordance °th e provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Wor ruction Permit ----------------- dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................................... 1).. ......------•----- Inspector-•----. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................................OF....:................................................................................ NOV....•.•....-•-•--•••• R1111las��t.r� c9�anitrnr�ivit rrntit Permission is ereb ranted_.r''fir' :_<. - ---•- ----------------------------------------------------------------------------------- Yg to Construct ( o Repair. ) Individual Sew ge Disposal System at No c ' ..... ...V. •--- . :. . . ....... ...... .--•-------------------------•---------------•--._........---------------------................ Street as shown on the application for D spo 7o s Construction Permit /--------- Dated.......................................... .................. .-I ----•:.................................................................. DATE- ----------Ice---------------------------------- ••- Board of Health ••- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ;5 4 DIA' .4 y - 3�5 KNOCI<WTS 6 ";k 4;DIA 7�* ....Aw� 0 ,We ;7 OP A/AQ4 �7RA L>,E7 57/ -7 -eoX X rl '40 0 0 0 Ar -0 ic� ZI .9 ............................................................... _:7WV 0 0 . ..... 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