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Home My WebLink About0017 EBEN SMITH ROAD - Health 1/7J �a Sm : rtG, Root d C. 8 •TB n 'J' L. 1' �0� Fee •�O THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitatlon for MispoBal ,*pstrm Colt8trUttlott permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No.%- !V1 STAAV. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel%-11 CA14.1p Zq-6 GT1 ot Installer's Name,Address,andd Tel.No. Sc �r (-7ran< Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms ,v/�Y Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) asy\e4 G..P_ A Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date �A .\`j•Z'2-- ApplicationApproved by 4. Date` .� Application Disapproved by Date for the following reasons Permit No. Date Issued S^.Y" 1 I D n w \\A 50 No. � �' L /A Fee A a C� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes TippliLatiott for Bis.poBal 6pstent Construction Vermit Application for a Permit to Construct( ) Repair(111upgrade( ) Abandon( ) El Complete System ptInd vi idual Components Location Address or Lot No. '� ;h SrA4%'�?, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 111�1 ► � F (114-tD 2L1i'G G 1 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Y {�,, lLiol LC4� Type of Building: / Dwelling, No:of Bedrooms' / Lot Size sq.fl. Garbage Grinder(' ) r, Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title . Size of Septic Tank Type of S.A.S. Description of Soil 'Nature of Repairs or Alterations(Answer when applicable) c--,�' A s. Date last inspected: ! " Agreement: " The undersigned agrees to ensure-the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environwentai-code and not to place the system in operation until a Certificate of Compliance has been issued liy'this Board of Health. ,r Signed QDate �{ ,t`C1 r�• ' Application Approved by N-1/.4 A ,., Date ' Application Disapproved by Date for the following reasons Permit No. `�'�`� 1� ` Date Issued". THE COMMONWEALTH OF MASSACHUSETTS"-, V1 tl'` BARNSTABLE,MASSACHUSETTS Certificate of Compliance 4 THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(k-1 Upgraded( ) Abandoned( )by <.r!'t;.� g.� ..• _ -_A at 1 "7 1 r_1 _5 M,•+C4r1 AN C`1 has been�consttructed.in accordance �* , with the provisions of Title the for Disposal System Construction Permit No. a ? Id Installer Designer ,�.w •'3 #bedrooms `Sr Approved design flow gpd The issuance of this permit shall °ot be construed as a guarantee that the system will+furiction.ass designed. Date / Inspector No. ; �.�_~ r -� \,.Fee THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction j3.ermit Permission is hereby'granted to Construct( ) Repair( Upgrade( ) Abandon,( System located at �� , r+ ,, n �� and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisionstor special conditions. Provided:Construction/must be completed within three years of the date of this permit.[ Date L/ /��1 r� Approved by 17•!��fii. LOCATION 4 (j SEWA E PERMIT NO. -► it/ �7i% ✓ 0' _ VILLAGE • _ _ �a��x��w INSTA LLER'S NAME i ADDRESS I U I L 0 E R OR OWNER DATE PERMIT ISSUED /go DATE COMPLIANCE ISSUED _e_ �g / o�S I 31 f' 0 , 6 D 3< J 5 a M THE COMMONWEALTH OF MAS.-SACHUSETTS �} i BOARD ® r 1 SALT �.�. ............OF..... .. Appliration for Dispatial Works Tom3 rnrunn Jhrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal syl Tt,/ Locatiion-Addr ss orhot ...........- ........................--••.................................................... Owner '.w ddress ... _......� ........ f - •--.... .....: �............... O- ..Sq. .........-'-- Installer Address d Type Buildin Size Lot_____ _�. feet welling No. of Bedrooms.___________ ____________________Expansion Attic ( ) Garbage rinder (14/6 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixturgs •-•--•-•••-------••------••-•---•--••-- - W Design Flow.......... ��___________ _____gallons per person per day. Total daily flow.-_-._.��'_„ ......................gallons. WSeptic Tank—Liquid capacity �galIons Length................ Width................ Diameter--------_---.-__ Depth'___-_______-_-- x Disposal Trench—No. ______ _____________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.____--.--�'k.. Diameter.................... Depth belo inlet_.__......__..�V _� ft. � pag � p ._ Total leaching area._2 d .-_sq. Z Other Distribution box ( ) Dosing tank ( ) - �" 1 •��,,,, a Percolation Test Results Performed by.... .!l_-...........�:___ ..�_" 5:.._____ Date.___7..�- a_____________ ,-� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ... --•••- of ........ Description of Soil__._._-_ ___ P U ..................... -----p=---- -------------------------------------------------------- -.____-____-__-------____----------------- w UNature of Repairs or Alterations—Answer when applicable. .........................-.............................................................................................................................................................................. Agreement: The undersigned agrees to install the aforedescribed Individu Sewage Disposal System in accordance with the provisions of TILT�.;,,. 5 of the State Sanitary Code—The unde gned further agrees not to plac the system in operation until a Certificate of Compliance has bee ued by e bo rd of h h. tgne -•--••_•_.... ••--•-....................... •---•---- .._. Date Application Approved By............. -- ........ •-•.:............ `✓�•-�... Date Application Disapproved for the following reasons__________________________________•_-_____---___------__•-__-___-___-_-_____..._____-______.__-__._.....__....... ------------------------------•••.....__......__....•-•--•-•_.....__.._......-••••-----•--...•••••-•---•'-------------------------------------------..----------•----------------•--•---•-•••••••-•--•-- Date Permit No......................................................... Issued-- ..... Date .7..... FEz ................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................ ..........1_'..0 F..... Appliration. for '"V tspaiiat.18arks Tonstrurtion Permit Application is hereby made for a Permit'to Construct or Repair an Individual Sewage Disposal System,at: 1°f4e ..................................................... .................................................................................................. Location-Addresse ............ I k_ft ...........4.................................. ....... ...................................................................... Addressr Owner Installer Y ~ Address Type qfBuildin_�/ Size ot....Z4_ A...Sq. feet' Dwelling . No. of Bedrooms.__......_._:i........................Expansion AtticGarbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow..........9.. .....................gallons per person per day. Total daily flow........ ._............_...._.-gallons. Septic Tank—Liquid capacity allons Length................ Width.._............_ Diameter................ Depth........ Disposal Trench—No..................... Width.................... Total Length......._............ Total leaching area....................sq. f t. Seepage Pit No................k. Diameter.................... Depth belo inlet._..... .._.... Total leaching area..:tik.ej_I...sq. ft. Z Other Distribution box -Dosing tank Percolation Test Results —Performed by..-!!!...ty.Nn........... ......... Date.....7-AZ.mE4............ 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..._........._......_.... ....................... 0 Description of Soil...... .7:...... ..... ........... ......0�f......)N i.4.444d.s................ ...................................................................................................... ...........................................................................................................................................................................**........... ------- U Nature of Repairs or Alterations—Answer when applicable._.............................................................................................. ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed IndividuqA Sewage Disposal System in accordance with 1.1 the provisions of T 1T LE 5 of the State Sanitary Code—The undersigned further agrees not to I the system in operation until a Certificate of Compliance has been issued by the bo I/d of I lath. yx I p 7L,ign .... ........0......��3 ........................................... Date --------- ----?� Application Approved By.... .4..4.4 Date Application Disapproved for the following reasons:................................................................................................................ ....................................................................................................................................... ................................................................. Date PermitNo............................................................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ..........r4o.- ...........OF..........i a-444 ............................................. Trrtffiratr of Tompliatta HII re�' Y, That the di ual Sewage Disposal System constructed 41__O�r Repaired by......17...... .... .... .. y //;---------------------------------- ...... ............... . ..... Install ------- ----- ----- jW ....... ..........I ... ..... RXI 44 at A'W_,�- ------ ............... has been installed in accordatice with fhe provisions of 5 of The State Sanitary Code as &scrij)ed in the application for Disposal Works Construction Permit No----...........%7-((..I......... dated__...? ... 6--V............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE,CONSTRUED As A GUARANTEE THAT THE SYSTEM 1A/I4 FIJfiCTION SATISFACTORY:. ,." � �®��%s� DATE.......Ul- ........�-O........................................ Inspe'ctor...,6_�.4'............................"41.THE. COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. .....OF.........--- ..... ......................................... No.........�7 r-7 ................ FEE...%JA!..!.......... Roposa r trurYfi....n rrmit 0- 0 ....... . ..... Pernusj'on)!,�ereby granted........ ..... .......... . ....... ........ 5r.ej7d� .... .... -1................. ......................... to Constr* or Repairvid an Ioivij ewagePi3p 3 y�s to'J�� I VV , ?# ! . 11 12 . 4 . . ..... ............................................ at No..PTow......A.d.En!.... ...... r 4ft I . .................... Street as shown on the application for Disposal Works Construction Perem,1 ,_ __ �ated.... -------- .......... P--- ------------- alth DATE........................I......................................................... . ... Board of He FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 0 {�- T:�'�t ti_'-( �-t-uw = 4 t b � 3 = >3 b G•P•�. 9 7.5 1c��Tt c `t"��-.t K. = 330,E 150 % • �-�i S �.�D. � � N r�N P`,° c� Pep? _ S' (C>C>C) 4.G J• ' 'p �ySWF ,vi r o�vt ,cue t=n= � sr-: c�p Ste. TOTAL. -c�eSic ki = 425 T"oTA t_ PMfZGUt_LTIC,L l Z&TE CIO SMI W 02 LF-SS. � t X/ \ -\,J 41 (��'11\\�A 6 . •'�'''��G f� tit � ..� .f T �f`+�.�� / , t Tor V*,l L+oo.C. 97•0Ocx-f-- 77, o A wt d ppe loco !uv- 'n S RSn� . 4'�p� f -Box f5 G SEwrlc 95 2 iuv t T-At4 loco 9S.o ,.,�, t►ry :• PE�C T GAL. 95.Z ys4 PIT ' WASb1ED I STO" C_e~C-TtFIED t_OCA T I o tJ C E�TL'C a/�t.t_E✓ 6G85• IL ►.10 ScA �.�- �aCAt_ � I ua �A-r� 'I to ?Sp Flo W*7rrL I Gt�tz� tF=�{ Tt-(AT TNE- Fou�tvvATlot�T 5ttowu PA- atJ �i=F��c►.1 c s= t4 ;:L t_Oj-j Ga,tikPCI-IS \A/ ITt-k Tt-t`: St>Jrzt_t►-tE. !eT �Z�a A w r> ':E T t3A C IG V r j!Z u i Q e AA E-►-1TS O t= T N L= 167 UATG 1 to $a C �l,/" ' �,.t.r" ' 8/S.XTt=<< IZcG1e r IZGX�- `j't-•11 S h L A E-1 i� t..1 OZ' L:A;C C7 Ut.i /Jal 0STE..zv�L-t..C- u.1st"�J �_w �,uc_.it_�{ • Tt(c� c�t=� ��tom, �tlowt pL t r1T Cat:, u•:.Uc> I-C) Or Yiat-'M ,4C Ln'T ��'✓t�r�.-�C-