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Home My WebLink About0778 ROUTE 149 - Health � �Iw._f ' �_l � �� f��sf��. i� ► / ��.� �� TOWN OF BARNSTABLE _OCATION 771" r e- 1 SEWAGE # ` VILLAGE Mi/CS ASSESSOR'S MAP 6i LOT INSTALLER'S NAME & PHONE NO. Ap' ,n../- Co SEPTIC TANK CAPACITY /&b LEACHING FACILITYAtype) Are C.sj-. k(size) &0 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER a BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r/ � �5, a I I , t 6 l3a � y� LOC Q-T-1.O-N-�� SE-W-Q-�E P-ER-M1T-1.10. I-N 57-AL l_E R-S-►JA1�/1 c 46- SS- -D-l�►`FE U-AT E GOK/T-L 1-W-,l CE. I SSU 3 i 4 777 CO .. CJ� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: ` y5 rM�.•rL:S �S l".,..15--------------------------------------------------•----•-••---.....---- ..... ..... --------• ..... --....._.. Location-Address or Lot No. P 1.i� .................................................. ........---•---•----.......-----•-----•---------------.......-•--•----------------•--•---••----... - ....-- Owner ddress co sh • --- `-=K—--------- .P = � 3 Installer Address � Type of Building � Size Lot...........................S q. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 'PLI_l 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..__........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 ( ) Percolation Test Results Performed by..........................................................-••-----••----- Date......................................6.4 .. Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-----------_............ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W -•----•--•---•----•---•----•-----------------------•-----•-•---------------------._..........----••.......................................................... O Description of Soil.......0=z sv. z - ........ 14_ V ........--•-•--•-----------------------------•-•--------------------------------------------------•------------------------------•----•---••-•------------------- W x ................. --------------------------•-----------------------•----------------------•----•---•--•-•--------------•-••------------^-_•--1------•-----•--------••--•-••-------------......... V Nature of Repairs or Alterations—Answer when ap licable____`�P�____-_-.0 3 l-_....... W! -_-__G�1.Q.o�..................... e.A7E.---------- !f-----------?f----------711-wi----------------------------------------------------------------------------------------------- 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 issued by the board of health. 016 Signed _ `1 �� -- \�`� C.-.....- ........................ .........(-...-�e-- ---...------- Application Approved By ..............f\ Da e Application Disapproved for the followiVng reasons- ------------------------------------ --------------------------------------- - ---------................................. ............................................... ---------------------------------------------------------- Date ----- -G�► PermitNo. / 6_- a.- g--------------------- Issued .-- ....................................--------------------- Date NO.. FEB... ....:.. �.- g THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstxnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: --- '7 Location-Address or Lot No. ._SZ.uE ��' ..............__..._ ----------------•----•••-----•-------......-----...•------••-----••••••••-••••-••---•--....__.... Owner Address a ....................................................... ---- P...= �� 3-4-.......� ""J7v1��L--•--- Installer Address d Type of Building Size Lot............................Sq. 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------------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 areatt�z............... ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ tz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --••-_----•--------------------------------------------------•-------------•---•--------------------......................................................... O Description of Soil------.9--a........ ----•--------- ............5 L_C—A'?........'=``-.......s.n, Sj x W x ---------------------- ------------------------------------- ------------------------------------------------------------------............................................................. U Nature of Repairs or Alterations—Answer when applicable____-r!9_s?........a??.E_.'____l4Q4s._....a �40�____________________ 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 issued by the board of health. t \\ r (, \�� Signed --- --w�lC------L--�-=-=--1'-`L---==-------------- ---- -------- `lb �--.. -�'-' Dare Application Approved BY C\ V Da/. Application Disapproved for the following reasons: .------. ---------------------------------------------------------------------------------------------- ---------- ........................................ ---------------------------------------- -------------------------------------------------------------------------------------------------- .......................................................... --------- Dare Permit No. ......... ��. P__&V---------------------- Issued -------------- -----------.------------------. ----------. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ce>r#tftrate of Tontlaltttnre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (/ by NkC..L ..............................................' --- ----------------------------------------------------- ---.------------------ ---- -------------------------------------- ------------------------------------- Installer at -----n�X b-------- Fzc�u `( r`'.�rL%-T0v.3-`5 'W_% --- -------------------_---------------------- - has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code as a scribed in the application for Disposal Works Construction Permit No. .....:�11-- ..�o.- .�.^.-- dated ..............:�................. ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED i A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.....--t�-�--��..1..�-------------------------------------------------------- --- Inspector .....---......................�-v--- ------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 9� No..7. FEE..... ?...`. Wan1 Workv ��an #rttr#ilan [rruti Permission is hereby granted------- `\C-.lC_L` ----CO3AA3---•---Qq•- ......----•--------------•-----------.............___._.... to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst? at No.------ ......... -c v -------------°=�, 21Ta N S Street as shown on the application for Disposal Works Construction Permit lAdd / -: _ Board DATE.............. --'�/'--�h---•----------------------------------- of Health FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS No....�.,�...gfr...... - Fx$. ., .... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH _ -------------- Appliratiaan for Mopovai Marks Cnvmitrudign .. r-i-ft Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual SewageZ�! osal System t: r ocation- ddress or ]E t •o. e ___ O Address W - I staller Address Q Type of Buildi Size Lot_ ._ ..�/Sq. feet Other—Type T e ns............:........(....)Showers g Cafeteria ( ) a Dwelling ylNe of Building ---------------------------- No. of persons of Bedrooms.............. p Expansion Attic Cafeteria a e Grinder ( ) p' Other fixturgs ..................................Q � ............................................................ --- W Design Flow..--.......-- i-- ions per person per day. Total daily flow -r gallons. WSeptic Tani Liquid capacity .-..- lions Length................ Width................ Diameter-----..--.-.--.- Depth............... x Disposal Trbnch—No VVidtl -- -•--- -.----. -eVh ,-- -------- To eaching area----.------.-.•----.sq. ft. Seepage Pit No.........� Diameter.. ._. --- e o .. --...... al leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.................------. Test Pit No. 2.....i.._......minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----.................... . -•. •-• ----- ------ ---- -----------------•-•---- A� O Description of Soil................................ --- --- ------- •.....i�y...- --• 4----------------------=------ ----....-- ---- V •-•--------------------•---•-................---•--_---- ------. --- --• .....-------------------------------------------------------------------------- W .-----•---------•-----•-------•-----....---'. :. ------.. . VNature of Repairs or Alteration —Answer when appl' ble-----------------------------------------------------_-.-------.----.-.-.----.--------.--------- -----•-------------------------••••-------------------••-•-----•-•--••-••-----------------•----•---------•-------•-----......•••---------------------•-----•---•------................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary 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. h. Signed ... /. -••--•....... ............. � Date / Application Approved By..... 'Z •---------- --•-•-- -/Z f Date ` Application Disapproved for the following reasons--------------------------------- ----•---------------------------------••------•-•-------••-----••-----•- •.................................•------•--••----------------------------•-•---.........---•------------•••------------------------------••-••-••-•-------....................-------•--------------... Date PermitNo................................................--._...... Issued........................................................ Date �6No.; ......... l' FE>�... .... THE COD O WEALTH OF MASSACHUSETTS BARD E HEALTH �," .. Appliratiun for Mopmal Works Tons#rur#ion Vrrnti# Application is'hereby made for a Permit to Construct ( <or Repair ( ) an Individual Sewage D-s sal System t: oca ion- ddres or Lot I\o. Address a ............ -- .._ .. •---- --- . ...... ......►....... ______________________________________________________________________•--- - -------•-- I staller i Address ey Type of Buildi "' Size Lot, � A - Sq. feet Dwelling No. of Bedrooms.......------------------------Expansion„Attic (. ) Gairbage Grinder ( ) Other—Type of Building - a YP g •---••--•-- •••••••••••--• No. of persons_______ ___________________ Showers ( ) — Cafeteria ( ) Otherfixtur s ---- --------------------------------- ----------------------------- .0-01 W Design FlowA "'".:......... lions per person per day. Total daily flow____._ ......... Design W Septic TanLiquid capacity lions Length Width Diameter Depth x Disposal Th N Widt __. e h Wtaaching area____________________sq. ft. 2-See a e Pit No.__:____ _. Diameter.P g e o > leaching area..................sq. ft. Z. Other Distribution box ( ) Dosing tank ( ) �',.. . Percolation Test Results Performed by........................................................................... Date........................................ Test Pit'No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No ''2.................minutes per inch Depth of Test Pit.... _._.................... Depth to ground water........................ ..._..._..-- O ,. w ---- � Description of Sotl .,F..---•-•-•----• --�....... _.:. :-• --- "�,.'_- --•------- ---- ---- ------------- --� Cj --------------------------- -- W --------------------------- ------ � = U ` Nature of Repairs or Alteratio —Answer when apphable_________ ___________________________________________________________•-__-___-___-_--.----•-. ---- ---------------------------------•----•--...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal'System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in o eration until:a Certificate of Com pliance has been issued b the board of h p ; Signed_ -_ Date G� Application ;Approved BY •• - �--/... ..... Application Disapproved for the following reasons----------------- ---•- -- --•-••••--------•-•-•-------••••--•-•. Date--------•----- ...._...-•-------•--------------------------•---------------•------------------...-------------..•---•--------------------•-----••-------•-----•-•-•----------------•------------------•-----------••--- Date PermitNo....................................................... Issued.......................................................t Date F. i - x 2 THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH rr#iir�a#� ut �uur�liaatrr �~ T IS S T RTIP the Individual Sewage sposal System constructed ( ) or Repaired ( ) by-•-- ....... = 7+t + ________________•------________••------------------------•--- --•--•- ns r 6 -------- has been installed in a cordance with the provisions of Article XI f The State Sanitary Cod as descr•bed in the application for Disposal Works Construction Permit No...............ri .......... dated___ _-r�4EE ZA ETHE ISSUAkE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS'A-.C� ARAYTHE SYSTEM WILL FUNCTION SATISFACTORY. ,n DATE ................................................................ Inspector............................................... ` THE COMMONWEALTH OF MASSACHUSETTS -: BOARD HEALTH -. y ' `f ..OF.__.._ No. .. FEE... + .......... Disposal r Unit. -pilau Nerd# Permission s�ereby granted....-- -- --- . ...._._ ---- ....:. to Construdor Repair ) an Indi •d 1 Sewage os stem at No.- �- •> r........ �.. Street l as shown on the application for Dispo:-W Works Construction,P I No.. _. ted_.__ i J/ ` i fro.... r of He DATE:..... .._. • �. FORM 1.255, HOBBS & WARREN,4 INC.. PUBLISHERS— `. ,