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Home My WebLink About0045 FIELD ROAD - Health ksD- os1- 4@07 �Y) k�1� c�r yTTo 1 s C� TOWN OF BARNSTABLE LOCATION qS r/SI1jS SEWAGE # VILLAGE- gspnjs :m LLS ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 8&,A J ),6:55(1r;1 SEPTIC TANK CAPACITY %ovo GST pgz;CA LEACHING FACILITY:(type) size) o NO. OF BEDROOMS 2. PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: 7 1 7 l 7 DATE COMPLIANCE ISSUED: .9z /9y VARIANCE GRANTED: Yes No 0 1S9 Dop) 9�r147� e r ta� �J v � N �`.. V t� � O No... Y--.37P Fxa..."'t-�---------d ---- APPROVED THE COMMONWEALTH OF MASSACHUSETTS ns Is Conserve' DeAa 79n BOARD OF HEALTH OWN OF BARNSTABLE Applirati>atial for Diovoottl Work,i Ton,strnr#inn Famit Application is hereby made for a Permit to Construct ( ) or Repair (cij an Individual Sewage Disposal System at '...Ys-. � .................................................................................................. Location-Address or Lot No. ..... ---------------------------------------------------------- -----------------------------•------------------------- ------------------------------------- Owner Address Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...........1741_0....................Expansion Attic ( ) Garbage Grinder ( ) < `4 Other—T e of Building ---------------------------- No. of persons____________________________ Showers — Cafeteria P4 Other fixtures _______________________________ _ _ W Design Flow............../L .•_________________gallons per person per day. Total daily flow....................X_�_v........___gallons. WSeptic Tank—Liqul capa1itvJ.Qva.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 ( ) `-� Percolation Test Results Performed by.......................................................................... Date........................................ 1.4 Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ r. Test Pit No. 2................minutes per inch Depth of Test Pit-_-.----____..____:_ Depth to ground water........................ P4 ....-•-----•-----------------•-••-....._._......._...---•--•--._..._._.._•••••-•-•--._....-....---••-•-------------------------------•----------------------- 0 Description of Soil.....................................................................................................-•------------------------------------._...--------•-•••--------_.. x U ---••-•-•-•••••---•----•-•--••••••--••--------•------•-•--••-••--••--•-•---•••---•••.............•-•--•-•--•-••••-••-•••-••--------•-----•---•-•--••-••---•-•--•-•-----------•••--.....••-•------•--•••- .......................--------------------------------------------------------..................................................................................... --------------- , U Nature of Repairs or Alter tion nswer when applicable...-.�4_Vr4L�T-";- ..�1��-�ql- �.Su��-••�� -.- 2 --,c�25.1.._Aoy..........................................................................................._........................ 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. Signed --------P .�. ......................... ........ /. � �. .... Dace Application Approved B '�..-7.^- . . PP PP Y ................. .. ^^ " ...... _.... - Dace Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------------------------------- ------------------ ---------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ........................................ Permit No. ....... 6 -- ---- .... 7d - - Issued _.........._ ....................------ [e--- Due No.._l..y_ ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ti 7/ TOWN OF BARNSTABLE .Z pVftratiou for Diti-V gal Wor1w C omitrttrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (t,--y an Individual Sewage Disposal System at:4-�" gar ys- Fig/,✓1 aA�. ........... . Location-Address or Lot No. ... tat' .......................................................... Owner Address W Installer Address d Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms------------ _____________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QI Other fixtures ............................ Design Flow..............JJA .....................gallons per person per day. Total daily flow.._.....__....__..._:4_z.�__---._-___gallons. W �;x,at:a3n W Septic Tank—Liquid capacity-en?. _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........................ �14 Test Pit No.. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ 0+ ---- •--------------------------------------------------------------------------- •------------•-•--.---..•-.-.-----.---.....------•--.•-....-••........ ....... 0 Description of Soil........................................................................................................................................................................ x U ..................................=...................................................................................................................................................................... w U 7,,t4ature of Repairs or Alter tionq—Answer when applicable.---_-r__1 ' 4_t t ?k, __--a-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 has been issued by the board of health. Signed -------- C - C.. �+.. -. ...... - �1 ---- �- Dare --Application Approved By --------------- _..... c c��- ---------..----.------_-------- .....7' -- �1 - _ Date Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------- ......... . .............. ................................. . ........... ... ............ . ... ............. ... . . . ........................................ Dace Permit No. ........?y---------3 0-------------------- Issued ----------------------. ..-------------- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARl.�NSTABLE CertIfirate of Complianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( t� by . (� ..:_1 .,. .�.�.,. , - ------------------- ----------- -_.... .... .. . ... ..................... . •``�- Insrdlet 11 at ......................................... _..... `�.,5` --F�tr� ��i!c�.... -- -ti't'" �:"^. �rt��"---------------------------------------- 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. .... -q......'3...7Za_..._--- dated _------------------------------------_..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. . _ - n �� DATE-------------------------------------------- t-...... - - Inspect .r_-M: ... -- ------------------------------------------------------------------ ---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTHNo. G� TOWN OF BARNSTABLE ��--(j �y- ��v Dispasal Workii C oni3trurtiott "Prrmit Permission is hereby granted-------_--------------- :��_� .lsS--r='-��=9------------------------------------------------•---------•--•--------•-•-•-- . to Construct ( ) or Repair an Individual Sewage Disposal.S)ystem at No. `r i/M 1 •�1 - ± : -I :,�'.. �* /1.5..................................... Street q as shown on the application for Disposal Works Construction Permit No 9`��+3�1_ Dated--------2--_-i�_-"_l-l.._._...... ..........................................z — . ................... ----------- DATE...............7-.. -.. ---•-------------------------------------- rd of Health FORM 36508 HOBBS&WARREN.INC..PUBLISHERS (508) 778.0444 SACK HOE' - t CAVATING SEPTIC SYSTEM tiCAVIOrS z a BRIAN C. KIS•'LWG 97 1 OVcv,' BROO— C Owncar/Oparn4sr WEST YARMOUTH, COAJI y'E'� -�' le 4 _w rA•` I � 11 b Y 'u `{C•'ei��Y�b q � YiS�'4K ,