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Home My WebLink About19&21 SEABROOK ROAD - Health *3 ®I o v� C) 1 ® THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn fnr Diripniul Ul ark,i Tnntrnrtiun Vamit Application is hereby made for a Permit to Constr tict ( ) or Repair V an Individual Sewage Disposal System at: ...... ---LIL g,-.j......... .....................LOA...a........................................................ ..... ocahon�i\ddress� --'--------•---------------------•----•...or Lot No. ---------- --.... .....------ �cner Address Installer Address U ,Type of Building Size Lot............................Sq. feet ,., Dwelling—No. of Bedrooms.--......��------------------------------1 spansion Attic ( ) Garbage Grinder (1.4 ) A4 Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 04 Other fixtures ----------------- ------------ - - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity/4'DJJ.galIons Length................ Width----------------- Diameter.-_----------- Depth................ x Disposal Trench-- No. .................... Width...:..........,..... .rottl 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........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit...--............... Depth to ground water........................ P4 ---------------------------------------•--•----------------------------..........................-•--•-------•--••-'-•-....------------..... ---------•- 0 Description of Soil................................................---•--•-----....------•-------------------•-------------•-----•----•------------...----........................--•••••- x V --'-••........-•-'--•-"-•-----•••-•••••-•-•'--"'•-------••-•----•...............•••----•---'-•-•-••-•••-•-•"'--'---•--'---••••-"--"•--•"-••--••--••••-•---•-----•................................. � ....••'-•-.........••----•--....---'-----•--•---•-•-----------------••--••••---....--""'--------•'----'-- ---•--------......------------•-----............_•-•---............ U Nature of Repairs or Alterations—Answer when appli - .1C1(,�Q-----.�`G-� n.�.. .....C�1.51�.......... - cam.,. . ..... -"-•• �%� Q�� +� - 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 bee y e board of health. Signed ....... ... ,.... ............................ .................................:...... — e Application Approved B - .. ....._................ ..�.`n.� '" . .... ............................... ---. .. Dace Application Disapproved for the following reasons: .......... ... ... .... ............................. ......... ... ..... ......................................... ......................... . . ... ....... . .. ....................................................... . ... . ... -- ..................... Permit No. / - T. .----- ............ Issued ........--- ".1------------ -�............. Daze T.r,,,•�-Y•,,.-...n..ti��,-•may,. ...�'1--�^..,.:`.,.,.`...> ..;,.�r,-.. �,r—...�.e �% ----�-..Y�-••..-�,.w v«•..-.--�..�.� - ..�.,,--• ,.,,....-.�; .--re..--..-..,rr•w .. �,,,•-.. -�.,1�.. -...—�.—�j - ..... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diripogul World, Towitrnr#inn rrrmit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: .... ..a ..... c�ar_�jc�.K.Rj i . .....` ----------------------- ..........------------ ---------------•---•....................... o�cationwAdd�cs/s ( .------.-.- ------------------------•--. _.....`WIS��.__-Y-4.1_a or----•-••- Lot No...-•---...--•............................ Owner Address w .v �-S-r t --- ......L� 1 �� + 2 N 1J Installer Address UType of Building Size Lot............................Sq. feet ►.� Dwelling— No. of Bedrooms......_..�------------------------------Expansion Attic ( ) Garbage Grinder ( ) QOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------------------ d ................................ .. w Design Flow................................./............gallons per person per day. Total daily flow....................J.......................gallons. Chi Septic Tank—Liquid ca acity P p !a�-�O.gallons Length---------------- Width---------------- Diameter................ Depth................ 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. 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.............................................................:....................................:n................................................................... x UW •-'------------------------------'-'-------••-----•--.•---'---------'------------...---•-•---------'-------- ............-----•--••....... Nature of_Repairs or Alterations—Answer when applicable__ . ...� C......_(C S- .0.01 3.......ui.'�_.......... - t .1c►t r�G --------............... Z� r.. L• 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 system in operation until a Certificate of Compliance has been sstrred` y t e board of health. Signed ......;; ... :..� ...... ............................. .................................::..... Dace Application Approved B ............ '� +-� ..... .......,. � / � - Dace Application Disapproved for the following reasons: ..................................................................................................................................... ......................... .... -- ............................. ...... .... . . ...................................................... ........................................ Dace Permit No. `s.... Issued ...........,r7..r' /---- 1�..�a�................. Dare ---------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 011er#ifira e of Cfomylinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (111/1 by ............... ....� c.../`-1v/----.....------ -----.........:... - -- _....... •;� Installer ' at .. 1�,►.-.. .1.__ .P.. _ .s'Q.U_ .C?. -----".yc�^' 3 --------------------- ......._............... ..................... . .. ....._....... has been installed in accordance with the provisions of TITI. 5 o The tate Environmental Code as described 'n� the application for Disposal Works Construction Permit No. ".... _� .. dated t'`..--. ._..`. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---_. ........ .................` '....-P.... �... _. ... Inspector -------------------t �.... ..-:.--------............----------------..---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No. ••••... �in�no�l nr�n �nnotri�rtinn �rrntit Permission is hereby granted..........�S vk� --c��✓��----------------------------------------------------'---...........--------•--......._ to Construct ( ) ,o Repair ( k/fr an Individual ewage Disposal System at No.----'-�� ...�-1-------r C?(�_Lt.tC? �Individual ...... --------------------------------------------------------•--........--- Strce as shown on the application for Disposal Works Construction Permit�o�`- _._-��_ Dated.._I_""'J.".........-'........ ----- -........�� 3 Board of Health DATE------...... - ------7------------------------------------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS