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Home My WebLink About0186 SETH GOODSPEED'S WAY - Health 0 ejc/* (c�a /na,?—o in , C OWN OF BARNSTABLE LOCATION IS t G o.1he a SEWAGE # 473 VILLAGE Ox le-ra"lle .ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. C/e,R,A CrA4 f 39 E1--le/Z SEPTIC TANK CAPACITY LEACHING FACILITY:(ty (size) 6 .x /?. NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER09,, BUILDER OR OWNER- ` DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: , VARIANCE GRANTED: Yes No if y o L :m� No................_. ! FE$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE , pphrativilt for Uiripwial li ar1w Towitrttrtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at rr alA . ..........05 kl-),Ae 4 ............................ itinn- s or Lt I J"Ci o. ------- - - ---•-- � ----.-----------.........Installer Address °q g � �.....Sq. feet Type of Building - Size Lot_.Q ._......_. Dwelling— No. of Bedrooms--------- ------------------------------Expansion Attic ( ) Gafbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' 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. 3 Seepage Pit No..................... Diameter.................... Depth below inlet......_............. Total leaching area..................sq. 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ....................................................-........................................................................................................ 0 Description of Soil........................................................................................................................................................................ V ---------------•----------------------------------------------------------- ------...... ----------------------------------------------------------------------------------- r........... ---- . U Nature of pairs or Alterations—Answer lwhe `u appplicable--___-_ .A S_ A._ ........Y � ? .........�:..*7 ------. lr?�...l.T � - �' 1: IION I _.TB... _-ar e. . c ..........t.'.._ ......s..../ /...1� .... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental ode—The undersigned further agrees not to place the system in operation until a Certificate of Compli c h been issued by e boa f health. Signe �t�t)- . ----- ----.................. .... ......... ....................... .....�....Dare ...... . Application Approved B :..._ .� Q... /-...` � . 'tip' �.-� ✓� Date Application Disapproved for the following reasons: ...................................... ..............................................:.............................................. ....... .... . ....................................................... sJ<....................... ... .............. Permit No. '...........r� Issued ----- ....... ....... Date -------------------------------- Il No................---`7` J Fss...............1-�...............� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE AVVfiratinn for Di penal Hlork,i Tontitrnr#inn Vermit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System ,0. �L..T. .....----- -oo� PP�QI -------0.5�`e1�.�-l-........................................................ Location-Address or Lot o. ...................... ............................... - f M ............................................. ON%-n ddress /� •--•--- -------------------- -- .-•----•-----------... Installer Address Type of Building Size Lot..C;oy..10...Sq. feet .., Dwelling— No. of Bedrooms.._._... ______________________________l..Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons____________________________ Showers — Cafeteria aOther 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........................................ Test Pit No. 1................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........................ 0 Description of Soil.....................................................................---.--_----------- --------••-------------------------------------------------•---......••••. W V ------------------------------------._...._..--------------------------.-------------------------------------------.------------------._.........._...------------------- W ........................................................................................................................................... ........................... . U Nature of Repairs or Alterations—Answer when applicable....... ........ ----- r 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 Compii. ce h s been issued by e boar f health. )Signe �,_.. ...... Zw��t -..... .... .... ......... ....:............_..... � c /... . Dace Application Approved B --- .�'r............ ......f......................�.../. er�--...� 's-tea �.^...... Application Disapproved for the following reasons. ............................................. . ........................ -- ......... ................................. ...................... ............. ....................... . ... . ............................ . ... --.......................... --'- .......i....�.c.e................... Permit No. Issued ...... .-:...... .-.. :.-, ..... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ce>rttf rate of TIImylinure THIS 1S TD CE TIFY, That t e Ind' idual Sewage Disposal System constructed ( ) or Repaired y� .................. ..-.. b ................ �... ._... _._.. - _�_............ at ...... .... .. ............ _��.7- _..........1?-..Q.�..�...�..P !''` " ---------. ..:5 l t'. ..�.� P....... --.. has been installed in accordance with the provisions of TITLES of The State Environmental Code as described-in the application for Disposal Works Construction Permit No. (-._ ...'7..................... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION,SATISFACTORY. /I/,�_ �� DATE...................__.........._....--- -... ;` �, ......................----- Inspector ..._.___ i !. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE -� No............'...... . FEE. .. �-�t Raposal Morkii Tnntrution prmit Permission is hereby granted...----.. ------CA------- ............................................................... to Construct ( ) or epatr /,),—an Individual .ew. e Dis sal•. st < g at No... Co.......__..4�_-.DQ e ......1'--------------- .......................0.. ..................... V..1. f� PP p strcctfa � ' � f . as shown on the application for Disposal Works Construction Permi�o_____________________ Dated.._,,__.._.._._..__...._.._......_......... DATE •- '' - -1-----•-- ......................... Board of Health / FORM 36308 HOBBS&WARREN.INC..PUBLISHERS