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Home My WebLink About0107 ROUND POND ROAD - Health d�� v��r.P ��►� __ �I y _ TOWN F BARNSTABLE Op I®` LOCATION SEWAGE # Cj 3 VILLAGE ASSESSOR'S MAP & LOT All.y INSTALLER'S NAME & PHONE NO. �tT-z4 eoj,,3 S-T SEPTIC TANK CAPACITY St3 Z� LEACHING FACILITYArype) �'� (size) 1 , 0-66 NO, OF BEDROOMS _PRIVATE WEL R PUBLIC WATER BUILDER O OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED- VARIANCE GRANTED: Yes No �2? 1 jl ✓_ z 3171 t t Y No.. .-., .9 Fx$.... .................... THE COMMONWEALTH OF MASSACHUSETTS P 130 BOAR® OF HEALTH . -Towt�..........oF:... 0.v .a------------------------------------------ ApplirFation for DhipogFal Vorkii Corm rnr#iun runfit Application is hereby made for a Permit to Construct (4-**) or Repair ( ) an Individual Sewage Disposal System at: ................-.....�.0.----- .-�o a4....../.l�i'M �r---�---------------------•--..........------. -Location-Address or Lot No. Owner Address W Installer Address d Type of Building U Dwelling—No. of Bedrooms............ Size Lot.._____:_:.`_...._(_ ....Sq--e .................... .Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons_•__________________________ Showers — Cafeteria aOther fixtures •-•••••-•-•-•-•••-••--••...................••-•--- d ._..._..gallons per person per day. Total daily flow....................... .. . gallons. W Design Flow--------•-----•�5�---•--------oo--- g P P P Y• Y •--•-- ------- WSeptic Tank—Liquid capacity-L gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width___.... Total Length............ I------- Total leaching area--------.,._T_--__ sq, ft. Seepage Pit No----------- iameter------�.?__......... Depth below inlet................ Total leaching area......440..sq ft. Z Other Distribution box.( � Dosin tank ( ,I '-' Percolation Test Results Performed by--- _ ^!!! ...I N ........................ Date..... a Test Pit No. I------7�-___mmutes per inch Depth of Test Pit------17........ Depth to ground water.!?...................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---- i; - - - • - ----.- -------------------------•-•- --•------------------.----------•--_------ Description of Soil-------- �a J-- 1 s�O 1• ------------ U x ••••••••••••.............•----------------------••------------......•--•••......--•---...................................•----....••••-------•--•••-•••••••-•---•••-•--•--•--•--•-......-•---•-----••- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli e has been i,s the oar of health. Signed ------------- �.,,, -'.... ............................. ........... q.4.3�.Oni.-"-- Application Approved By ------._----- 73 7..--"�-.-- - - - ------..........................................................----'------- ----"--'- ce Application Disapproved for the following reasons: .-- . ................................. .............................'.-'------...........------... -- ---- -- --------------------' - - --- ------- ------------- -- tr -------.-...................................- ---------'-'-"Daze Permit No. ......-...C ..-.."...- -./.:. ....... Issued ........................-- Dace No................_....... Flm$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i� _ lfa1 .. .....OF.... '1.i�. ., -��._........---•............................ Applira#ion for Dispas al Workii Tontrnrtion ramit Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage Disposal System at ---------------•-.... �l c?i�a [.or��...�� r'.......--�� ' `---....-----------.........----�..::.--.-�......------------------........--------- Location•Address or Lot No. ..rVlvAtq 6_G V—JAA t.1. ._.... � ;�l Fd�� r�l�r� �-U2C% XLs'::.... Owner Address W Installer Address rI S AG Type of Building Size Lot...........................St-•feet.U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures •---••-----------------••-----•- W Design Flow...............�� ............ .._ gallons per person per day. Total daily flow......................._/.: ......gallons. WSeptic Tank—Liquid"capacity- Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length............I....... Total leaching area......... _... sq. ft. Seepage Pit No.___---- --.-__._ Iameter......��......... Depth below inlet...... Total leaching area............0-sq. ft. Z Other Distribution box ( Dosing-tank ( ) I ` _ Percolation Test Results Performed by..___- +�_Xz ._"�..:�q 91``.0.:....................... Date____ -_!__g._` ........... Test Pit No. 1....... ..minutes per inch Depth of Test Pit .... ------- Depth to ground .....- f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----------------------- R+' -•-------------.- -------------f•-•-•......---•••----• •• f . -------.---•---•-----------•---------------------.---•--•-----------•------------------•---- O Description of Soil......... n _..........&nn:nt!_. 4 _ _ .I_!� ®� ......................................._ x ----••----------------------••----......-----------•--••-•--------------•--•----•----•--•-•---•--•------•---------------•--------•--•---------•--•••-----•-•------•---•-•-••-•----------......---....... 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian as been iss e board of health. Signed --------- .......... - 2 ApplicationApproved By --------------- -`- ---ti--------------------------------------------------------------- .............. >�te Application Disapproved for the following reasons- -------------------- - -------------------------------------------------------------------------------------------------- ------- - - - -------------------------------------------------------------------------------------- --- ---------------------------------------------------------------- --- ----- -- -- -- --- --F'3 ---------------------------------------- e PermitNo- ------------- ........�.76 ---- ......... Issued .--- -------------------------------.....Dat........... Date THE COMMONWEALTH OF MASSACHUSETTS -- BOAR, OF HEALTH C /� OF .......i�J .. ` ...... .. ...... . ........ Certifirate of Toraptinurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( t'' ) or Repaired ( ) by ............................................ ............. .......................... ... ... ------. ---------------------------- // •� t at <l i Z. l CJ 11 .......................... ...............................r ! . 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.................... d v......."��.----.........-_-------_-------------_ Inspector ........ r�J•-�................. ......................................... THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH R r? ................ .........OF._. ............................... No....�s:..�.....2 FEE..4e2 Q....----- Disp000l Works 0on#r ion unit Permissionis hereby granted.............................................................................................................................................. to Construct ( or Repair,( ) an Individual Sewage.) isposal System / r --'t at No...........6' � tE ' '1�•---..7r_ z��l_ .-. , ..A,A ----------•--------••---......... Street ;(o)ard as shown on the application for Disposal Works Construction Permit Nol.— Dated.......................................... ......................................... r ................................................ pp e� ....... of Health DATE.............G�-="-AZ---�-`d----�........................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS • 1JES16�J -PATA _.-.._ siucF FAMIW '$t=ue�v iv� s4EEr I 4 a� - :,_DA1 L 5E?r1r_' TaNI; 440 flsYPP Ixe Soo 4L_r . _DlSPoSA L'PiT SEE 'PLA+.i ON f3AC.4 l-1EZ aF �l sraJE. 51DEVJALL ARCA 3zo.SF LOT 2 BOTTOM Aft, 100 SF IDD l•D %. IOOGPD, 71TTALZZ516N'; _ .. .gSo 6fp• M42STo4S MILLj TOTAL VAIL 44o APc> �.ok- PE¢4al.ATtoN A'rE :=1��iNIni: 0�2 lESS OFOF q s9 1 I M �o PETER F r v- .. 'SULLIVAN l No.29733 0- ISTV-11 Fss/ONALE��'` -.gay . 2/ , r �uv u GAL DK k GAL_. 56n TANL j C- �Iz° I u►z l I'..-At L;SrRucr . Es s� � W AS 1 AtIQ... sl-oNE tito¢E .�N 4!v� 2I Sr4A.L.. "SE 14-Zo r '1�/�1.OpQ7 'ptzOFl Lam-- _: Loc rlo�t MdZSToN'S MILL p GiG�1l.. '; = 5D "PATE=; QPIl(. IL 1q93. P PLAN ?—el REJJCZ 1 CFJzT I Fy T+IAT' 4S pw.eu_iQ , �((511ow l� Hezzwt4 CoMPu. S wrrA 7NE' 511�EL11Jr_ Lor �- 1 Wy CL `1D1M 4:OF +14,gr"c.� 2 A 40 15 14T ,�-o 4A'(�D 4vits{I tJ � Gov I�.L11 kl (,,C c, A 12� DA B 4 lL� q $QXTI:lz. No- IN;:,, ' . , �... .._: ,. _� - .-... P��f,Ic�rJdL �A►J� Su!?.v��nrz; I �TFIIS F ►,j I5 NOT" o A�3ASFJ N N 1� - u AdJ o ST1�c7�itE+J'T' c��i L E+JGi N�Et�S S rzl/ey T� rqF_ FF ETiS. 44t)oLx u Dr Be. O 5'[�rzv I L.LG MAS4 , f use ro G�TABU,5N >�Eory , .Lj Nc-5 'I II I QPFLICANT; 9AU �MA(Z-( l xc-v-AAt� y MAa4 T ( 14-4MAf4 ET J1( IL 60, Iqe 2 e)A, L�LA ti1D �. TN .. . \ 6o�•a o J A rANu z Piz `5a ' .. or .01 OF i PETER oe No.29733 STS AL Gr to x.T