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Home My WebLink About0810 SANTUIT-NEWTOWN ROAD - Health E i `I , TOWN OF BARNSTABLE r LOCATION 916 �N� 7-QW 4 Ad SEWAGE # 95-- 9/8111 VILLAGE migniro"I Wills ASSESSOR'S MAP & LOT !L - O 9G INSTALLER'S NAME&PHONE NO. y7,7-a3 419 04 8arro5 SEPTIC TANK CAPACITY 1000 LEACHING FACILITY: (type) 2 - �9e14 is (size) NO.OF BEDROOMS ? BUILDER OR OWNER A,1J5 ' PERMTTDATE: ?- D-Rd' COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Frao ` 4� 51' N,_;_wrou/h i2� . .W No...... Fmc' ..It.. ........ .....t....................... 09 THE COMMONWEALTH OF MASSACHUSETTS BOARD OE HEAL.4TFJ 0o, ............ ......111:2 . (,^ ------- OF ------ ............... Apphration -for Uhipviial Works Tomitrurtion Vrrnift Application is hereby made for a Permit to_Construc or Repair an Individual Sewage Disposal System at: 7/0 Sant a )t-- New/oaj,-,x A cl ...................................................... ........................ ................................................................................................ Location-Add essNo. ....................................... ... . .... . ..........&.0.-!::y.....W,... nu t . gi�!..... ...... ...................... Owner A d .......... �l,wa . ...................................... ---------------------------------------- ....Installer' Address M.(:�'� U Type of BuildingA Garbage ------I---------Sq. feet DwellingSize Lot_ No. of Bedrooms--.--_-_ -.N..E--_-_--_-.___---_Expansion ttic (X) Grinder ( ) PL, Other—Type of Building ---------------------------- No. of persons.._-_-_-_-.____--_._-__-_-- Showers Cafeteria ( ) P4 Other fixtures ............................................. .< -------------------------------------------------------------------------------------------------------- Design Flow............................................gallons per person per day. Total daily flow............................................gallons. P4 Septic Tank—Liquid capacitv_I_Q4Qgallons Length________________ Width..-___.-.._.._-- Diameter___--...._.:--_ Depth..._._........ Disposal Trench—No---------------------- Width._._.....___..-_.._. Total Length_._-.-___-._-______- Total leaching area----- ---------------sq. ft.-., Seepage Pit No_____________________ Diameter------__---_____-_-_ Depth beloyniril T I leac19-iiig area---------------.--s(l. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed by------------------------------v------ ----------- -�7Z?1,-,Date-------------------------------------r.... Test Pit No. I----------------minutes per inch Depth of Test Pit-.__-___-_._-__--_-- Depth to -round water...L Test Pit No. 2................minutes per inch Depth of Test Pit.__..__............. Depth to ground water_-_-_-______-_---___-._. O ------- D . ....... Description of Soil---- ------------------------------ ......... .... .. .. . ..... ...... - --- -------------------------------------------------------- -----6-1--------------- ..........- ----- ----- -- ---- - -- ---- -- - 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 Article NI 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. igned Date -- ----- - --------------------------------------------------------------------- -------------------------------- 7 Application Approved B _7 Date Application Disapproved for the following reasons:........... ............ ............................................................................... ------------------------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------- ........................................................ .... .....1 .Date Permit No. Issued .......... ... ... Date ----------------------------------------------------------i----------------------------------------------- No...... Fimic .............. THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF, HEAL.01 r7 000" OF........... ................Appliration -for Dbipoiial Works Tonfitrurtion Vrrufit Applicati61n"'is hereby made for a Permit to Construct (X) or Repair an Individual Sewage Disposal System at: 11 .............................................................................................. ....W.�A_k y.....(R-8------------------- ............ ...... .... Locat ra--re-'s ---------........... ....0 M Owner ............... AA----04.5. _��..O.Ke.o* ...........C.94-W. -a.........Address , k� ................................................. ......M.1 ...................................... Installer Address U Type of Building Size Lot..&K,_9_q_7__Sq. feet Dwelling X No. of Bedrooms-_.._---_.- --------------------Expansion Attic Garbage Grinder Other—Type of Building _---.__it_--_____;_____¢___ No. of persons---------------------------- Showers Cafeteria Other fixtures ------------------------------------------------- ---------------------------------------------------------------------------------------------------- Design Flow............................................gallons per person per day. Total daily flow----------------------------------- ........gallons. P4 'SOtic Tailk—Liquid capacity-10P.PL-allons Length____________-----------.... Width-.-_-_.-..__.... Diameter------_------- Depth.-_----__--.._.- 19 1 Disposal Trench—No. ...,--------------- Width........._._..______ Total Length_--_________--_-__-- Total leaching area--------------------sq. ft. Seepage Pit No_____________________ Diameter.................... Depth beloly?inlet ....... otill 1 1 eac l g,i area----------_----_sq. f t. Other Distribution box Dosing tank T 7- Percolation Test Results Performed by.......................................................................... Date---------------------------------- Test Pit No. I................minutes per inch Depth of Test Pit..._.............__. Depth to ground water.._..-5--_.-..--_-- 4, Test Pit No. 2................minutes per inch Depth of Test Pit.........._.....___. Depth to ground water........................ .............�4..I-------------4A._............. .C 91-,----—---- ---------—- ............................................................... 0 Description of Soil---- 0, -- ----- ------------------- ---__---------------------- --------------- -- -------- ......... -- - ---- ------------------------ -- T------4•-- -- ---- -----0...... .............. ........ ................ ------------------------------------------------------------------ --- - _- - --- ----- .4.. ....-------- -- ---------- 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 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. igned......... ..................... ................................ _: Date V�w...7 Application Approved By..--- y Date Application Disapproved for the following reasons:------------------- ........................................................................... ........................................................................................................................................................................................................ Date PermitNo.......................................................... Issued.-----..._._..-------- ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... ........OF... ........... OWrtifirate of (TAMilianre I t ndividual Sewage Disposal System constructed kl) or TH Ij T� CER cte Repaired �7 F Y, by.'.n... ...... ... ... ...... .. ................. &rrt it ------------Z1._._0 ---------- ----------- Insta r ...... ..... Xj of The as describeiL. has been instalIA(l in accordance with the provisions of Article State fanitapry Code.. - in the Ow application for.Disposal Works Construction Permit No...__.___..!. /;;!�.............. daied......Id--------7--.-ZY........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............. .................................................................... Inspector--------........................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT 4 lc�: 0 F........ .................. N ................. FEE-- ............ Permission ii /ereby granted.... ... ... .....xTe. ........t _ . ---- to Construgm( or Repair a �d ifal Sewage D osajj System1 at No_�V..Wry......W;......... --—------A _40A __ .. - ........... .------- 0 Street as shown on the ap plication for Disposal Works Construct/i�onrmit . ....... Dated./O._.Z7 fi/. ------ ------- ----- __4o - -----------------------<�......... ffoard of He: DATE.......... ....................14V .............................................. A. FORM 1255 HOB13S & WARREN. INC.. PUBLISHERS ` pej (A t We I/ q o ASSESSORS MAP N0: 4 �"-_ PARCEL N0: N0.1.1 ........... � FRa.3 ... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Di-ripw3 al Mirlo Tomitrnr#inn Urratit Application is hereby made for a Permit to Construct ( ) or Repair (_�) an Individual Sewage Disposal Sy tem at Location-Address or t No r 3 oZ�s .... ---- ---- ----- -------- - Address Insta er Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms-----—3----------------------------------Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type 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_)60Q-_.gallons Length---------------- Width---------------- Diameter-----........... Depth................ x Disposal Trench—No. .................... Widk .�.______.__.._... Total Length____.....J_.-_-____ Total leaching area....................sq. ft. Seepage Pit No.-__.'___---------- Diameter._.__ _--._._____ Depth below inlet...6............. Total leaching area..................sq. ft. z Other Distribution box (X) 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........................ ........................... ----------------------------------------------------------- --....... •... ........................................................ ODescription of Soil------------------------- -------'-"'-'------------------------....-----------•---------•--•--------•-'--•------- .................................................... x U ----.....""'----'-------------•--'-......-----•--••--'-'------------------------------------------'---'---------------•-"----•---'---•-----------------------------------.........------.....-------- W .................•----------'--------------------------------------------------------------------------------- f UNature of R airs or Alterations—Answer when applicable._._-14 I ..... ---------........................... !Y1.S1,+1n!(T....... -------------- -!i . .... ...------------........-----•------'------'---•••-•-•---'--•----•'------'------------•-•----------•-••----........._..------.................-'---------------.--- 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 sy rem in op rati u it a Certificate of Compliance has been issued by the board of health. gag s Signed ;'' -.... ----------------------------- --- ../�....._------- Application Approved BY --- - -------------- --------- ---------_-..............._... "" /` Application Disapproved for the following reasons- ---------------------------------- ----------------------------------------------------------------------------------------- -----------------_----- -------------------------------------------- Permit No. ----- -- , � '��." Issued ------------------------------- -------------- Dare Y s THE COMMONWEALTH OF MASSACHUSETTS " BOARD OF HEALTH TOWN OF BARNSTABLE ` Appfiratiutt for Diu u!tti Work,6 Cfuttutrurttun rantit Application is hereby made for a Permit to Construct ( ) or Repair (__') an Individual Sewage Disposal, Sy tern at: // ......1. !v-.,�-----------------�---------------------�----------�--/- ------------------------- --------___-------------------------------__-____------... �/ Location:Address or t No may, Owner Address W L!lJa�.V`!-? = v......... ------------ I / Se c- [�.✓_!2.klL!'� aS��C v��/�..__..__. nstalp ler Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms----- ----------------------------- ----Expansion Attic ( ) Garbage Grinder ( ) aOther'—Type 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.l0.6Q__gallons Length---------------- Width----- ---------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width ------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No------ ............ Diameter---------------- Depth below inlet---6.............. Total leaching area..................sq. ft. Z Other Distribution box (x) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a 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 ---------------- -------•----•-----•-----------...----••••---._._-•-•••••--•••--•--•-••••......................................................... , DDescription of Soil........................................................................................................................................................................ x VW --------------------------------------------------------------------------------------------------•----------- -- - - ,-} ................._ - Nature of Repairs or Alterations—Answer when applicable.___.� ___.. .�.__.. ____... ._... X/.SQ.I_n! ...............----1 Fi_.. .).. -••--------------•---•••----------•-...._..--•-•----------••--•-------•------...--------------•••----•-----------------•-••••-•-•-••-••-••••......••-------•-••--- 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 ' sy tern in operatic)I uytil a�ate of Compliance has been issued by the board of health. a Signed �ti� -------------------------- 3 . / Application,Approved By - - ----- -------- ------ - ------------- ---- / Date Application Disapproved for the following reasonr: .....................�77----------------------------------------------------......---------------------------- ---- --------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------- --------------------------------------- Permit No. ----- ^ 1 .; ...._........ Issued .......................... ..f Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE vTTertifirate of CIImpliante THIS S TO CERTIFY That_the_Indirvidual Sewage Disposal System constructed ( ) or Repaired (X ) by ................. _v ,� - -m V s... - - - In Mallet '�...........�� ..-- r y /-------------I-------------------: .. .. ........ ............_at .. I .. /VE.GU....oW N - On/ i 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.�..... .....r... ... ...... -- dated .:.... 4.<- rt� _ THE ISSUANCE OF THIS CERTIFICATE SHALL NCiT BE COKISTi�UED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE----------'----------3—.Z.0..,- .r---`------------------------------- Inspector ----------------------------------------- ----- 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE... �t �rnru urk� unitrurtiun "pamit Permission is hereby granted----- !Y1. ----------------•---•-----------------•---•--•••-......•••--•............. to Constt ct ( or Rep�tr �) a, I ivldual Sewag Disposal System Street20", / �! V:5 as shown on the application for Disposal Works Construe€iorTs Permit 1'�c%�✓.7�_+_ ..._ ____Q LJ_ Dated---------------- ----..._...._.... ___ • r � Board of Health DATE..... =----- ---- FORM 36 508 HOBBS R WARREN,INC..PUBLISHERS TOWN OF BARNSTABLE SEWAGE# ,, 98G ....:::LOCATION — VII.LAGE i�� '/�s —ASSESSOR'S MAP&LOT, 02g' 09G Jo 5gP4 V e /3eee, WSTALLER'S NAME&PHONE NO. 4172 03 619 — :`:SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 2 - �i90 p'Ts -(size) /D00 Gn >:.-:140i OF BEDROOMS 3 'BUILDER OR OWNER Gpr'/ PERMTTDATE: ?- 3 D-4,5 COMPLIANCE DATE: ?- 2,1- 9� - _ ' Separation Distance Between the: Teet .:..Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) exist :;`:Edge of Wetland and Leaching Facility(If any Feet within 300 feet of leaching facility) 01 ;'laurnished by r. i Krohn y.3 1, kwrouh . �1�