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HomeMy WebLinkAbout3040 FALMOUTH ROAD/RTE 28 - Health (2) 3040 Falmouth Road A = 099 —030—AH8 Marstons Mills No....l. .- ..J.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H E A LTft able Conservauon Oepartment TOWN OF BARNSTABL Alip ration for Difpwiul Works Cnomitr groat Data Application is hereby made for a Permit to Construct ( ) or Repair (tX4- an Individual Sewage Disposal System at: f3v I tZ t-1 E - ....... ..••........................ cr7z 0-i tLz- . Locatiou,-� ddre- or Lot No. O crier Address Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling— No. of Bedrooms------------------c=: _---------- ----Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building __________ _________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) < Other fixtures ________________________________ _ d ---------------------------------------------------- -------------------- W Design Flow.................... �......__..__gallons per person per day. Total daily flow.........___ ............:..gallons. WSeptic Tank—Liquid capacity.,lL.t?D...gallons Length---------------- Width---------------- Diameter................ Depth................ x Disposal Trench--No- -------------------- Width____--.--f_-.-_-_.- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------- ------ Diameter.-.---.Za....__ 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........................ Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ p; ........................... ................................................................................................................................ 0 Description of Soil. - 1 0 `3r s--S�ICJ.......................•--- x -----------------------------------------------------------•--------------------------- ------•-.._........---•---- W --------------•-- U Nature of Repairs or Alterations—Answer when applicable._-_/� -f�C__1,0 _ 1L.1..,10..._ ....... U®0... .�°`---.........1. i .- .......jn,l................................................................................................................................... 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 ........ Compli4,yas i d t board o ealth. Signed --..... ------- . ....... .............................. Application Approved By ..... -- '��/..�..1� ....-. �.;t.-..- .1..-...� ?-.... Application Disapproved for the following reafonr: .................. ............................. ....... -- . ............................................------ ..................---..._.................----------._...........-----------.....................................-----.............. .................g[e...................... Permit No. . v ...... 3...g . ............ Issued .....................................:................. .......... Dare No......7,2._. d —THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLPfe�.,&,A, _',' Apphration for Diripasal I orkq Tomitrurtion JIrrutit 7-z' Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: s&e E �v I LtD i�1� �s0 �1D T c�2u� j� L-V ............. ---------.���_......... - .... a Location-Addrcs - or Lot ..... .. ... ... No. sl�C� i�t/L; 5 ------�-1�a�/ -hl ` fN-D Us�'Z�t �yJ, .��7 i i ......... --•-.•--- ----------------------•r ---------- -- - Owner Address ►a ...................................... installer � Address UType of Building Size Lot............................Sq. feet �-t 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_,6-_-L O..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 ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ i4 ........................... ------------..---------------------------------•-•-•--------.............................----.........-•----.. ....... . Description of Soil............. �--�'`�=�.M.........-- - ZY _ ....... V .....•-••-•----•---•---•••-----------•-•--------------------------------------•--------.........-----•-•-----•---- -------------•--••.................................................................. W ... -•---------------------------------------------------------------------------------------------•------------•-----------•---•----•-----•--••-•-••-----------•-•----------•--••-•------ U Nature of Repairs or Alterations—Answer when applicable._../ ST�_t. _..��IG__0. �� ..Z �., .... �J.�L r`�.......... ----`---•----r!=j-------------------------••-•------•----------------------------------•--- Agreement: -0 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., as been i sued by the board of health. Signed ........ - �..�•...:�................ r -.:.... Dare Application Approved By --------------Q�^^�p�,.vt.r Y�=f . .` ....f. v.�..../a.-..�� V_..........�.... Dace Application Disapproved for the following reasons: ..... . . . . -- ...... ......... .. --..... ...._......... ....................... ............. .................... .................................................................. ...... . . . ...-- ............................................ .............. ....................... Date Permit No. ......e�. .'-.-t��-��.- . - Issued ---------........................................................ Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 10lertifirate of Tomylinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (� ) by ........................................ G�2r ..... '.t�.^ 1 FL:t�.��t �.».1--------------- ---- ---- h,aue. r at ..................._.........� �.�1Q.........._ Cr?i�i.l1.TS�/�. ,......(z. ----------0.. .t/i.[.c. 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. -------�/,-�......6.0_0........_ dated ...................._...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... ........... .................... ..-17...113.........._.........._" Inspector ..... ..............-._,....._._.._..................._............................ _,_______________.-_---___.------ _----_-_------- _.--___t_,_,-_ ____,.---- THE COMMONWEALTH OF MASSACHUSETTS` BOARD OF HEALTH J U TOWN OF BARNSTABLE - No._��r� ................ FEE........................� Disposal 10orkii Tondrurtiori rrrutit Permission is hereby granted 4, L�-Q.c_C7-..—It......---•--�'GwS- �.JCS`rU,..1-----------------------------.... to Construct ( ) or Repair an Individual Sewage Dis osal System at No.......................... d•y0--------G f�v�'� ..... ---V--- ...'c AKA-j-------- Street yy�� /_ as shown on the application for Disposal Works Construction Permit No./r�_-•.c�'�.�.._ Dated........................................... ............................ -------------------------------------------•---- DATE............. ` / -----•---•----•-----•-----_-_-------- Board of Health 1-----•---•--•----�- - - FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS - No.. IL.'.� _ Fx$..�� .....:......._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstrurtiun 1krutit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: j�',gWo f r#le-6 ---- ----------------------------------- -------------- .....................--------- ----. ._..........----------- Lo}ton-Address (_d00. / or LLoot�No. ------- ---- �s...-•----•---•-- ..................v� .._y[...C...::_'�7.-•---------•------............••............ Owner Address W G.2lalaZ�7 �e s7`.-----..�1�� C� `l �. ,t/!/l r /!/I1GfS W ...... - Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.............. Expansion Attic ( ) Garbage Grinder ( ) ~ ......... No. of ersons____________________________ Showers — Cafeteria p,, Other—Type of Building ................... p ( ) ( ) 04 Other fixtures --------------------------------------- - e W Design Flow.................. ... per person per day. Total daily flow.._...... .....................gallons. W Septic Tank—Liquid*ca.pacity,/044.gallons . Length................ Width---------------- Diameter---------------- Depth................ Disposal Trench—No..................... Width_..__....`._......__ Total Length.................... Total leaching area.................... q. ft. - Seepage Pit No......../-------- Diameter------Z _____ Depth below inlet_..... ......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... W --•---------------------------------•-----•----•-----------•......----------....._.. -------•-;7--......................................................... 0 Description of Soil------...... .-...e . ........ .............. W ----------------------------------------------------------------------------------------------------------------------------------------------------- ................... U Nature of Repairs or Alterations—Answer when applicable------4M-____Z ._.. --- j---- ---••-....----•---------------------•••-•••--••--•-•--•-•--•------...----•--•-----------------....----------•--•-••-•----•-•-•---------•-•------------------•-------------------••--------------------- 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 Compliant as been is ue�board alth. Signed....-- ------ -- ---------- y��/...... Date Application Approved By ------------- --- --... / Date Application Disapproved for the following reasons- -----------------------------------------------------------------------------------------------........................................ ---------- ----------------------------------------------------- ........................................................................................................................ ...... ---------------------- Date PermitNo. 17/------f---J-3-P----------------------- Issued --------------------.....................................---------- Date No.. 1/_• Fss.--�_-_--��....... ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Diopnsal Wilrkli Tonstrn.rtinn 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair (X an Individual Sewage Disposal System at: ----•--•------------------------- ---------------- ------ -................................... j---------------------- Location--Address �i�fO�UI� or Lot No. .... v�u ... ��us .............. a�'4-- r � cf...., ........................................... Owner Address Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................... _________ _Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria a Other fixtures _______________________________ __ W Design Flow..................... per person per day. Total daily flow.........& _____________________gallons. WSeptic Tank—Liquid*capacity...�. Mgallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No........./-------- Diameter__._._/ Depth below inlet_...Z._ ._._. 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........................ Test Pit No. 2.................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -•••---------•------ -----------••••-----••----------------------•-•_.....--••••••••••------------------------------------------------- p Description of Soil............ i �-----".�....�:��?�1�.�.�1�..�/�__..:.—�__--_._,,l_r-�._-------<< ��!-----•-------------------------------------- W . c, --------------------- --------------------------------------------------------------------------------------------------------------------------------- ------------------------------------ x ----•--•--••................•-------------•-----------•--•------•---------------•------•---------•------------•----•--------•------------•-•---------------------...---------------•-----------••--- V Nature of Repairs or Alterations—Answer when applicable.__.y_ ----- /___:�'__s -•---------•----------------------------------------------••------------------------............--------------------------------------•--------•-----.................................................. 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 Compliancce.haass been is ued b. the board of health. Signed------ /ems/ '?' ------------------ 1 e Application Approved f1 B .../ ���- �- Application Disapproved for the\following reasons: ...................................................•------�---------------------------------------...------------...............--- Permit No. 9-1- -----_----------_- Issued -------------------------- Dare THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF HEALTH TOWN OF BARNSTABLE 3C9.er#tfira e of C�omylianre ``THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) g P Y k r by........................................................,��-0�-�a l��17. -.....<4'�.11��UG�rx^�1..............................------•...._.......................-------------- Installer at ....__....................................................�}O-1 ✓l+ .d1 1 -------............... 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. ..... .-....- -- - _�..-- dated .......Z� ................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS TR ED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------ r '. --------......................... ----------------- -------------------_....---------.... Inspector ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.. .......3 FEt.�. ............ Disposal Works Tonstrudinn "pamit Permission is hereby granted_______________'". ... to Construct ( ) or Repair an Individual Sewage Disposal System atNo............................................ ....... !J! f -4.......41r!�' !Ze.E--••----------------------•--•--•-••---•--- Street �y as shown on the application for Disposal Works Construction Permit No._ Dated.......................................... ............................... ..\` ------------------------------------------------------- Board of Health DATE............�>/ 6------ ....................................... FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS Z� TOWN OF BARNSTA LE LOCATION SEWAGE # �(��� G��'�►�+'T/S/ � ��� VILLAGES 6-9-21 %/'�� ASSESSOR'S MAP & LOT 099-- 636 INSTALLER'S NAME & PHONE NO. ; G/tT'eC&77 C6J-JX, SEPTIC TANK CAPACITY /,57J4 77Zn18e- LEACHING FACILITY:(type) P/ — (size) &x /® NO. OF BEDROOMS -;,7 PRIVATE WELL O-- 6 try WAT BUILDER OR OWN R` qo DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED:. VARIANCE GRANTED: Yes No� ry 'J 0 a99 . 6"o . ©a� �I Fx$........—��. �..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirativit for Dbipwial Workii Towitrurtiiau lirrutit Application is hereby made for a Permit to Construct ( ) or Repair V—) an Individual Sewage Disposal System at: -Location-i\ddress of No. ►W-a ��QW// ..............tvn ... L,r7( J--_... Y� ----•r+W/�'/"�f+ 4.. gyp Address�.�..- _,.� ......---...... -- -•-----• •-------_ ...._.... � Installer A dress Type of Building Size Lot............................Sq. feet g— -------------------------Expansion Attic ( ) Garbage Grinder ( jd�Dwelling '�10. of Bedrooms______________ 04 Other—Type of Building ---------------------------- No. of persons-_- ------------------------ Showers ( ) — Cafeteria ( ) Q' Other fixtur .-._-_ W Design Flow............................................gallons per person per day. Total daily flow-.----------_ ___.__..___.._...gallons. WSeptic Tank—Liquid capacity/fin_gallons Length--------........ Width---------------- Diameter---------------- Depth................ x Disposal Trench_No. .................... Width.................... Total Length------------I....... Total leaching area....................sq. ft. Seepage Pit No---------../......... Diameter------- Depth below inlet-----4........... 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........................ 1:4 .....---•--------------------------••----................-------•--.............----•-......--------......................................................... 0 Description of Soil......................................................................................................................................................................... W ------------------------------------------------------------------------------------------------------------------------------------------------------------- --- U N�atu^�re, of Repairs or Alteration Answer when applicable. ----/../JS` `- ..__ ..___ _--------- ._�__�.�.?�� (-�! VFL{--------- 7 ...... 6' --------f------ UC�J-rJ"` r��f� ---- / 'S' Tin) 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 s b en issued th oard of,health. Signed ......... . ..`.� - _ -- --... —........ ....... ----- Application,Approved B J PP PP Y .... - - - _Date -�.5.. Application Disapproved for the ollowing reasons: ---------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------[-�--..................----------- ------------------- ----- -------------- ---- -------------------------------------------------------- ....... . ........... Permit No. ------/ _x'�...7..9 Issued ----------- v� l ' �+5 Dace .................... J Dace 0 . F�s..............b............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE AV.Vliration for Dhi-V Sal lVarkri Tomitrnrtion rumit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: t ...y.,d......_._.. rvl o v�-f eQ (D o�1� 2 L.l0 4--) 6 s'� i 0 ----------------------------•---•--•---••--------•-•-• ------•---...•-----•••-•-•--•-•---••------•-•--...-----•--•---•-••-•------•-•---•---•••...-•_...-- / � j Location-address �o� dot No. 1.4......_..._._.... �N s.'..._... L'/(ju p 1/4 /ND�2�/ lc�E1 t/I4, 6 /l (S -------------•-•-.-•-- •---••�............................................. caner Address W ��/�.� i rJ� �7( 5 W,4 4'-R y '1 vl/1 1 ( �.5 -----..................................................................... ....................... ------••••--------------•------------••--••--•-•.-••----••-••--•••-••....-••--•-••••-...........--- Installer Address UType of Building Size Lot............................Sq. feet .� Dwelling—No, of Bedrooms...-..--.---- --------------------__._Expansion Attic ( ) Garbage Grinder aOther—Type of Building _------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Otherfixtu� ---------------------------- ----------------•--•-------------------------------------- -----------.-..------------------•-•-•---------•------------ W Design Flow...............-----5.........................gallons per person per day. Total daily flow-------------c- .------------_....gallons. Septic W Disposal Trench igtNdocapacity/SU Widthns Lengthotal Length Width............. Total leaching area._ Depth................ ft. x Seepage Pit No........../....... Diameter.......�q_f---- Depth below inlet..... r ...... Total leaching area. ..............sq• ft. Z Other Distribution box ( ) Dosing tank ( ) 0 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........................ a ....•-••-•------------------••-•-•••--•-•••••••-••••--•••-------•-•-•-............-•--•-•---•-----•----•---•-••-••---•. ----------------•---------------- 0 Description of Soil........................................................................................................................................................................ W U ••••••••-------••-.....-••--•-•-•••••-•-•••----•------•--------••-••-••••-•----------••••-•••••----••---•-•----------------•----•-•••---•--•----••-•-•-----------•-••--•••-••......--•--•......•-•---••. W ----------------------------------- ------------------------------------------------------------------------------ ---------------------------------------------------------••••......•---••-•-•-•••. U Nature of Repairs or Alterations_..—Answer when applicable. ....�I.JS'?. ------A /JZlQ_ Cc�___�zt?!7_ (090 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 issued thesIoard of health. � ,� - ----�� %����---- Signed - -.!.. 4/t C Application,Approved BY ..... ............ Dace ApplicationDisapproved for the following reasons- ----------------------------------------------------------------------------------------------------------------------------------- .............................................................--------------------------------------------------------------------------------- ----------------------------------------------------. ........................................ C Dace Permit No. ------? � ......... ..1...7 19------------------- Issued ------------ - ? Dace M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE V Ertifirate of Tomptianre, ti. THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ............. _............. ---------------- --__.............._.Inscallcr at ---------------------�V-L1 0-- - - �� j-.4-_,M--�11---�--..._:.,;��G--1�---�.LIJ-�--. r -------------------- 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. ..,rf�`.-_`�.. _.j...____. dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � �� DATE...... /....f - Inspector ------- ----————_.-a———————_.__.,...._,_,-_a_,..i__�__-_,.�T�.,,—_•— _`— P THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..•--'••5 = �r�� FEE.... o.� Dispii tl Works Towitrnrtion "Van it -mac v i� ,. i�z L/ Permission is hereby granted --lair----•------------- ------C e..----------•-------------.----- to Construct ( ) or Repair ('4) an Individual Sewage Disposal System at No....................... t'1 U r' 'r''1 11 t 4 ....a l,U J L &&,o' 1 �fi 1rJ Street r as shown on the application for Disposal Works Construction Permit No.-__.__'-- _-. __ Dated-----_a_.-... .c?.:.......'�._..... --•-•-----...-•-••••••--••---•-•-••--. == ------ --------•--•-•--------•--•-•------------- `� /�!__9( ._....._.... 0 . Bard of Health DATE. -•---- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS TOWN ge,va R a��- LOCATIONc3D D �/l7or� 7� � SEWAGE # '5 ASSESSOR'S MAP & LOTO/�-6�2& INSTALLER'S NAME & PHONE NOEL© SEPTIC TANK CAPACITY /06 � LEACHING FACILITY:(type) /"i pL 61 (size) NO. OF BEDROOMS PRI//VATE WELL tPUBLIC�WATER BUILDER OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 05!, VARIANCE GRANTED: Yes �Nc �0 aaCIL, m� err �3 LOCATION > SEWAGE PERMIT NO. VILLAGE 1_NSTA E 'S NAME ADDRESS + x Vol GUILDER . OR OWNER -- A-V DA TE P ERil01T ISSUED DATE COMPLIANCE ISSUED 7// I ' TOWN Ojz, BARNSTABLE- l LOCATION 3- WO �-4- f ovi* � SEWAGE # VILLAGE `Q��� -` ASSESSOR'S MAP 6z ILOT 4 `1'-0 2Q INSTALLER'S NAME & PHONE NO. &/e:77kf-f—l7 SEPTIC TANK CAPACITY /i uo �sT"!6• �r sTinr� LEACHING FACILITY:(type) ��T� �� (size) NO. OF BEDRO�O-M-S� \3 PRIVATE WELL OR BLIC WATER BUILDER OR DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes CN o f �LcJ ,Jf 3� r. O t. q �S . 30Y0 OWf //� OF B LE LOCATION' G �' SEWAGE# 099 VILLAGE- U l ASSESS 'S MAP & L T . 020 T_AY_.P&MR_%l LAME&PHONE N SEPTIC TANK CAPACITY 60 / LEACHING FACILITY: type) " C J . (size) f")OD�fi�P NO.OF BEDROO S o� BUILDER R OWNER PERMITDA 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 D-,pleK /S�' 38, o TOWN F BARNSTABLE LO CATION l3 SEWAGE # q� VILLAGE ASSESSOR'S MAP & LOT 99- d INSTALLER'S NAME PHONE NCk /'7�1y�' f SEPTIC TANK CAPACITY�iSZ�D,421 7 LEACHING FACILITY:(type) j0��/ ) (size) l NO. OF BEDROOMS-PRIVATE WELL OR, , BLIC WA BUILDER O OWNER n DATE PERMIT ISSUED: (3 p7� YES DATE COMPLIANCE ISSUED: t --v VARIANCE GRANTED: Yes No :, a« • � .. -. �3 �3, ,�;� �, .-.�. 33 3��� O 3`�� � � . �`� III ` • TOWN OF BARNSTABLE LOCATIOi+I SEWAGE # S- //�� VILLAGECJST��PUZZI_ - ASSESSOR'S MAP & LOT d �1, --30 INSTALLER'S NAME & PHONE NO SEPTIC TANK CAPACITY �S 0d - /G'/),� LEACHING FACILITY:(type) jai 7G C�f J (size) NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER BUILDER OR OWNE -� 6 �� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ��' •" VARIANCE GRANTED: Yes No -37 VIP' tO ' TOWN OF BARNSTABLE C°orkv�'.D LO. 3y0y' /� $o/coi� SEWAGE # 9/- VILLAGE ASSESSOR'S MAP & LOT 69,57-03 p INSTALLER'S NAME Si PHONE NO. 04r0aeoN7 CONS SEPTIC TANK CAPACITY /lJl1G LEACHING FACILITY:(type) (size) . ` NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATE BUILDER OR OWNER' Off--elJ144e RAJ S DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes 2q' :10� a' y S' TOWN OF BARNSTABLE F' " LOCATION �Yl9 ��+ a u ref ;� SEWAGE # — 00/1. VILLAGE ASSESSOR'S MAP & LOT 099 0i INSTALLER'S NAME & PHONE NO. ,i5---d2a,7Zco7i7 SEPTIC TANK CAPACITY 16-00 LEACHING FACILITY:(type) ,07�i Ll (size) NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER_ BUILDER OR OWNER //-y 10 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� D 3� .. d `� �� �� qqt� u ate - ©�v - Oa V, No....J.t1 /.gb /Rim ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Apphration for Diiripniul Workii Tomitrnr#inn remit Application is hereby made for a Permit to Construct ( ) or Repair fr,<) an Individual Sewage Disposal System at: 7-r14 t'Zb VL4)_ - -----••--•-------------• ...................... Location-Add re or t No. y �-I. +�-r ................... <s- a Vc✓t �u .......... Cr .............................. ....... Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-- ----------------------Expansion Attic ( ) Garbage Grinder tJO 04 Other—Type of Building __________________________- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ---------------- -------------- -- W Design Flow.......... _.. -gallons per person per day. Total daily flow..____----- - -------______-----gallons. 04 Septic Tank—Liquid capacity/��_gallons Length_______________ Width_-.--_.-.-_____. Diameter.....-__.--_--- Depth---------------- W Disposal Trench—No. .................... Width----_-P-------------------- Total Length_--____-__-________ Total leaching area.....................sq. ft. x Seepage Pit No----------/......... Diameter....-._,tQ ..... Depth below inlet...(a............ 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........................ G14 Test Pit No. 2----------------minutes per inch Depth of Test Pit.-.------------------ Depth to ground water........................ P4 ._...----•-----------------------•-•--------._..........•-•..__.._.................-•-•-•-••-•••••-•......................................................... 0 Description of Soil.......................................................................................................................... •---•----------------------------------------- x W -------------------------------------------------------------------------------------------------------------------------------------------------------------------- NLSJ- U Nature of Repairs or Alterations—Answer when applicable._.-.�......... _. _ .. ....._._l?.t. -_..... v ...i......_..looe�_- ----------�'i ___..---- �.A-�......�s�^j......._... ---------- --------- ----- --- 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 as been iss the board of health. Signed7 9� Dace Application,Approved BY ------------- �� c.�-. .- -------------- ----- ---------- ..-r�� ® � ... Dare Application Disapproved for the following reasons: ....................... --------------------------....._.........._....._----------------------------------------------------- ------------------------- ----- ----------------..............-----------------........---------...---------------------------.._._....------------------------------- -------------- -----------..._------------_--------- / Dace Permit No. ........ t� 4.-- -�\5.. I .. . ssued ........... =J ----------------- Date No.....`.-1� ` �dv F 1 r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE AV" lirtt#inn for Dig u!ittl Work,6 Tomitrnr#iun Printif Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: ':310 V u ��M UVV-4 /lbc ) -----------------------------•------------...------------------------------• ..C.....-------- •---.:-•------------•----•-....---•------------ ............................................. Location-Addres " r t No. a ............ Ts'r ' - ' y6 I"J-� - i.. ,^�► r �c_s Owner Add.ess W `�p/L,Uf�J.. 7-•-•-••.....l.�r/G.�c`:, / ...�J_.._ --7G�__...W.�:YG�:+� �YYO. ✓ll1 -- - --..................................................... Installer Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms-----------------1_2-------------------Expansion Attic ( ) Garbage Grinder IJO aOther—Type of Building ___________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QOther fixtures ----------------------- --------------__------------------------------------------ ------------------------------------------------------------- W Design Flow........... ---- �gallons per person per day. Total daily flow............v7�7-2_U..................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____-__10------- Depth below inlet____(_____________ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ a Test Pit No. 1________________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....................... 9 ...................................... ------------------------------------------------- •-•-•-------- ------------- -•------------------------------------------ 0 Description of Soil--------------------------- ----------------------------•-•-------•-------------------------------------------------------------------------------------••---•-----•--- x -------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ------------------------------ U Nature of Repairs or Alterations—Answer when applicable.-_-__�_r.LS I�'L ---A._..t Sbo . ........... -T ►NK_. 1.-5.r1 = Q __________/DOtl1'`t- �� f t ' `.L`Z"1�.................. f 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 as been iss the board of health. `/ 7 9> Signed -------- _.................. �� --/-- Dve Application,Approved B _- _ . 5_ ----------- --_--- ----- CD re Application Disapproved for the following rearonr: --... ............................................... .......... .. - .......... .......... ----------------------------------------------------....-......-----------------------------------------------------....------------------------------------------- .... .. .....--------------------- Da------....._-_------- _................. G re Permit No- ��.............. 6-------...... Issued ...~. d---�.[..`T.._.......... Daze THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of Compliance THIS IS TO CERTIFY, That the, Individual Sewage Disposal System constructed ( ) or Repaired ( X ) bs�'0.........±..�. ........-. /G --------- ----- ley�aue� at ...-- - _..s �..�'/..�_... 'd.°.w1 i-4 -( ..-.._ . - IDoky FC - C� � -U -�lL✓tuE �. has been installed in accordance with the provisions of TITLE 5 o The State Environmental Code as des c ibed in the application for Disposal Works Construction Permit No- ...-------7_57...... .- v.--- dated. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE, AS A GUARANTEE TH T THE SYSTEM WILL-UNCTION WILL-EUNCTION SATISFACTORY. --------?;�� DATE------ /�.. -------.- ��..-.-.. -- ... -- Inspect THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CC� TOWN OF BARNSTABLE No.....f..>�.._��g� FEE. J�--U ••--•-- �i��rn�ttl nrk� �un�#r�tr#i�n �rrnti# Permission is hereby granted_________________2��c p i 7 c./ nl-f 7 Xu cam:/r,a�J ---------- .................................Construct ( ) or Repair (X) an Individual Sewage-DisposaVSystem at No................••-••.. otfo �✓vr4u JT"-i !(6), �/`�-t1f01JJ _ L ( G S i v�d/I LC C Street as shown on the application for Disposal Works Construction Permit No._. .������Dated----------- �`__.._. ............................. ...... A�� lr ^/ -••-_-_•--•-•__________________ V Board of Health DATE............... ------------------_--- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS