The URL can be used to link to this page

Home My WebLink About0366 WILLIMANTIC DRIVE - Health 366 WILLIMANTIC DRIVE A = 203 —087 Marstons Mills / T®artOF BARNSTABLE, 14 KA 377 l.,:j1:--41 LOCATION 3�(.o 44ah.fi°C! 0C, AGE #. uK%VJ VILLAGE �✓�°c'�'"S � ` ° S! ASSESSOR'S 1bgAP& 1LOT j I'NSTA L. ER'S NAME&PHONE NO. j SEPTIC TANK CAPACrl-Y `QZ» i 41 LEACI-i.IN G-FACR..ITX: (tycce) E .� Wit).Z. () NO.OF'BEDROOMS 3 i BUILDER OR OWNER, PERMIT®A71! , CO1v1PL.1 YC1 DATE: j Separation Distance Between the: i Maximum Adjusted Groundwater Table to the Bottom of leaching Facility Fee' Private dater Supply Well and Leaching 1.~acility (If any wells exist on site or within 200 feet of leaching facility) Feel Edge of Wetland and Leaching Facility(If any we ds exist within 300 feet leaching,facility) Feei Airnkhod by 0 � . O ftl r_ r L L - TOWN OF BARNSTABLE LOCATION � � tk)t l (t*VI Q ICO[ SEWAGE # 9l —q VLL.LAGE /�1 �� -�L-L 5 ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) [ (size) NO. OF BEDROOMS r!) PRIVATE WELL OR(�PUp WATER BUILDER OR OWNER DATE PERMIT ISSUED: 7 Z-y/� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No c A Z/3 - y6 a � 6 Is � � r No.... -' Yj .. d THE COMMONWEALTH OF MASSACHUSETTS otd $ A BOAR® OF HEAL bjE:c AR 3 D TOWN OF BARNSTABLE s�� o�sOrYd� 04 Appliration for Disposal arks Tonstr WU Mi#e0 sio Application is hereby made for a Permit to Construct ( or Repair � ) an Individual Se a%Disposal Syst t• d LL 'rl � �� / �'Z��d Address S L or Lot No. .._....... ._... -•---------------•-----.......--•---•--------•-•--•-•---•---•------^-- - ---------•---------------------------------------------^---------•-----..............._ -Z dd es Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building No. of persons............................ Showers YP g ---------------------------- P ( ) — Cafeteria ( ) dOther 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........................................ � 1 a Test Pit No. I................mmutes per inch Depth of Test Pit-_-______-___----___ Depth to ground water--_-_-_-__-__-_-__---_--- f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-...................... 9 ............................................................................................................................................................. 0 Description of Soil.......................................................................•......................................................... ...................................... W x ----------------------- ----------------------------•------•---------••---------------------•------•--------------- ---a----------------------- -------, U Nature of Repairs or Alterations—Answer when applicable......... .....�_�_r.....W.Iz '____________. •-------------------------------•---------------•-•-----••-•------••----------------....------......------............................................................................................ 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 issu by the board of health. �J21�DqSigned ---- ---------------- -- -- --f . ---........ ....... Application Approved By .............. ...... .............. Application Disapproved for the following reasons: ................. ......... ...... ...................................... . .. ............ .......................... --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- 7 Da' PermitNo. �..... l.................................... Issued ............................................................ Dace ------------- Fims..�Izi�........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0.3 D TOWN OF BARNSTABLE Appliratiun for DiuVuuttl Workii Tomitrnr#lun ramit Application is hereby made for a Permit to Construct ( or Repair (,� ) an Individual Sewage 'Disposal Syst - : _ C. l 1-,1qX,1Z—Z10 - ._..... ......................... Address �.—� or Lot No. .......... ...._-' .... .........................•-----•............ ...•.. = =-- ..._.... .............................................. e� 2 C ddress/L-L C� ------....1i1/�.... zv .......................................... . ................... .. .......----...------. -.... Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther 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 ( ) aPercolation.Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ----------------------------------------•-------•------------------•------------••---••-----•--••--•......................................................... 0 Description of Soil........................................................................................................................................................................ W V --------------------- ----------- •--•-------------------------------------------------------------------------------------------------------------- --------------------------- ------- .------ W U Nature of Repairs or Alterations—Answer when applicable........... P1-T'•.----_r,J_-/Z.... _S 77J , ...........-...................................-........................................................................................................................................................ 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. /� Gc_ �y Signed ----(./..v/l/l�- ---------=---------------------- --------------------------------............... ----��-...-...........�...... Application Approved By _....----_--_ V � S° -'^�._-------------------------------------------------------'---'--- Date Application Disapproved for the following reasons- ---------- -- ------------------------------- -------------------------------------.................----------- ---------- - -.......................-----------------------------------..........................--- ..............------.-- .....---------- ---...----..--......... ... ------------ !fDate - PermitNo. -------- 1- Z.1/.................................. Issued ..........................--------- .......------------.... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (11Ertifi ate D �IIrii �t�tYiCP THIS IS TO E TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) = �.... by------- ----- ------------- ----------------------- -------- -- -- --- --- ------------- -------------- - ---------------------------------------------- 3 ) / � �' �� Installer ---- / 1Vn(p � � Y✓\ C— has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in 01/ the application for Disposal Works Construction Permit No. .........IZZ........Z/.1.._-------- dated -------------------_------------------......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS,A GUARANTEE THAT THE , SYSTEM WILL FUNCTION SATISFACT..ORY. , I DATE------------------------..........................................--------------- ....------ Inspector ------------------. ---- -------•----------.............------------------------... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE73 No.... -.. l ... FEE.... ........... �iuixu,��i w �urk�r�� rltr�iun rrmi� Permissionis hereby granted............ ----.-------•---------•-------------••-•-•----••-----•••••••--•-------......-•--.................... to Construct ( ) or f epair an Individual Sewage Dispos Syst atNo... ..•.-••. ---- ----------•- ep .................... •-•--•••--•••---••------•-•-•---•----•--.......---•-- Street C}� �// as shown on the application for Disposal Works Construction Permit No./\_.__ / Dated.......................................... D �.._.. 0 Board of Health DATE 1 FORM 36508 HOBBS&WARREN.INC..PUBLISHERS