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Home My WebLink About0246 LAKE SHORE DRIVE - Health 24(o (eke Sho,(e ,✓h -� � o�Joy TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE yr�l dt�liLt�S ASSESSOR'S MAP Cz LOT Q,3D-06Co INSTALLER'S NAME & PHONE NO. &,�&/4TDLI7,r &IAS T y � SEPTIC TANK CAPACITY LEACHING FACILITY:(type) C _(size) 4 NO. OF BEDROOMS PRIVATE WELL OR BUILDER OR OWNER (1.53e --a"iF DATE PERMIT ISSUED: IF19/ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes N 4 ;: S r 3�� _. . (9 o � �ood� . ��+� . r �.. � a Gt9�c� cS��l1�' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstrnrtiun Vamit Application is hereby made for a Permit to Construct ( ) or Repair (k an Individual Sewage Disposal System at: ...........�..L'_6.••••- ...�'Z�W.��.. ...........1 �.�/LC S„ -.......................... Location-Address o Lot No. Owner Address ....... --- ------...-.. ..............................................__ a Installer� Address UType of Building g Size Lot— --�•----:_..Sq. feet Dwelling—No. of Bedrooms----------------v..................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria Il, Other fixtures --------------- -•------------- - W Design Flow....................s37 ............gallons per person per day. Total daily flow.._..-_-_L ....................gallons. WSeptic Tank—Liquid*capacity/l1®.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 ( ) �., a Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................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........................ a •------ --------- -----------------•-•••------••----••-••--•••••------------------------------------ ; ..---------- ---- -----•-•----........_......... 0 Description of Soil...............0---_--- ...... a�..._�S _S l ----- ..-1 .............. v ------- �g .L x ••-•-------------------------------------•--------•-----------•--- ...' l ..�i---------------------------------------------------------.....--------- U Naturee�of Repairs or Alterations—Answer when applicable_.�Q 0 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 een issu d he board of health. Signed ------- -------- --- --------- .................... r1.1-/l Dale c� Application Approved By -------- --- -----�--- ...-- 1/.. / ---- , Application Disapproved for t e following reasons- ----------------------------------------------------------------------------------------_-------------------------- --------------------------_.---- --------.......-------------------1-------........----..........------------------....----------------.......---------....--...........................------------ ........................................ Dace PermitNo. ........... 1.... ..d....................... Issued -.. -------------------------------- ------------ -----= Dace No....7/il�_ Fxs. .._. THE COMMONWEALTH OF MASSACHUSETTS .BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Dispniai lVorkii Tonstrnrtion V.araft Application is hereby made for a Permit to Construct ( ) or Repair (( an Individual Sewage Disposal System at: ........... ......� �`:.... .. .............. -= /LGS.........-•--=--------•-•--- --Location-Address or Lot No. .._...� . _._.. '��1- .....r �. a/.�.4 ... ---------- Owner Address ,Wa �.........✓ �%2�1 .�............... Installer Address d Type of Building Size Lot� � J _._Sq. feet U Dwelling—No. of Bedrooms................ .................._._._Expansion:;Attic ( ) Garbage Grinder ( ) 04 Other—T e of Building No. of persons............................ Showers — Cafeteria P Other fixtures ------------------------------------- ........... W ,Design Flow.................... .. ........_...gallons per person per day. Total daily flow.........-• 6.............___....gallons. ` WSeptic Tank—Liquid'capacityZi.l,.�.4.•gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area...............1:...sq. ft. Seepage Pit No..........y/----- Diameter.---,.!0--..... Depth below inlet.......6..r..... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank (. ) f Percolation Test Results Performed by.......................................................................... Date.........................................r aTest Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water....................... 44 4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 --=.......................................................................................................................................................... 0 Description of Soil-------------- ......�..� Z........ 2'w..�d1�..... — �..�.. . x - ---- U � ;� - --- I�T --------------------------------•--•-----•---------------- -----------•---- ------------•--- --•-•--•--•-------•--------- -- .. ----•----------------------------- ------------------------------....-------------------------------------------- Nature of Repairs or Alterations—Answer when a hcable_.___ -tA�QF.. ,�� .l.�shSlC�......�/��2�i �tQ U - P � PP � ---- 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 een issued by he board of health. Signed .. ....... . ..... .. ..... ! . ------ ..................... .. 1 'XD� re Application>Approved By .... -�� fi - ---------------------------------------- --------------------------- -- y� l C{ T -te Application Disapproved fort e following reasons- ................. ..........................................................---..................._...--------------------------- ------------- ---------------------------------p...---- ............---------------...---....----------...--------------------------------.......---------------------------...........---------- ---------------------------------...... Permit No. ........1.1.. 1 (-------------- Issued ........................................................Da a....... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 09rdiftrate of (garaylianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (x) by................................................................ �-r—� m 1........ > Ns f'�J rr1a. .....................................................------- Installer at ..................................... � - - � � .....-ram 1..(��r' ... - - .,1 / S has been installed in accordance with the provisions of TITLE 5 oj,The State Environmental Code as described in the application for Disposal Works Construction Permit No. ...--. �....,-....�.. ...��....... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIVUN,C„�T O�N S T S/FACTORY. � � � DATE........... ...-------.............---.......---................r --------------------------... Inspector .------------............................... - -------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Disposal Works Tonstrnrtuan "[amit Permission is hereby granted..................1 �. 1� C'1. .......C'd!v �7 4}............................. to Construct ( ) or Repair (<) an Individual Sewage Disposal System at No.---------•---------------------.- �..4......... .5j VeDP5---._--�� /��J------------ ,-ram?/..r! -----------------.-- Street as shown on the application for Disposal Works Construction Permit Nor. . Dated.......................................... -5------•----------------------------------•....•••••.--••- _ �i Board of Health DATE �(-------------------------- FORM ��//// FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS B®USFIELD SANITARY SERVICE V 17 Burbank Street Sandwech,Massachusetts 02563 �, A-0 Name ly ' (� ��ie cc I D 4 � Sewer Permit z Location: . a YL �.a-'r�G a.�. �� off• ��. Buil Name and Address 6s a9> Date Permit Issued: 72, .Date Compliance Issued: 7-4/2 l �� s i 0 (00 b O 000 _0&b Non.G�....... Fick S=d J THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH ------------ )n............0 F............. ...R.�l..------------............------._................... Appliration for Dwvosal Mirkii Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sys a ---.... ,1 ....�,� .s�lo '...��,c.� ......... -- ---- ................. ocation•AddrGs or Lot Owner, dress L S+ Installer Address / Type of Buildin�g�/ Size Lot#_.Z1.g.....Sq. feet Dwelling-YNo. of Bedrooms...............9_.......................Expansion Attic ( ) Garbage Grinder '4 Other—T e of Building No. of persons............................ Showers W04 Other—Type g ---------------------------• P ( ) — Cafeteria ( ) dOther &xtures ••-•••......••. --•---•.............•••--••-•------••-•---••----•-••-•••••-•-•-•--------•------•-•--•-•-...--•-•-... .----•-... W Design Flow...... _45.25r...........gallons per person per day. Total daily flow.......35 d2_ 77.>......gallons. WSeptic Tank-Liquid capacity/,OPji�tallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. . Seepage Pit No........,1.---------- Diameter.._.f!------- Depth below inlet................ Total leaching area-_.49. ------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----j4�........ Depth-to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ................ ..................... ......--•• - ----• --- O Description of Soil-----....�.4 -------- -- •-----. --•---�� ---- --- x W UNature of Repairs or Alterations—Answer when applicable...................................................•........_..._......__..._.......•.......... ---------------------•---------------------------••-•-••••-•-•-•-••....••-•••................--•--•---•-------•-------•-•••••-•--••----••-•-•••--•-•----••...••••.••--••--•-••-••-------...•--•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi-;::. 5 of the State Sanitary 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. Signe ---••-••----••---•------------••-•-------•...................... Date Application Approved By......- f �1 111 ...................... ----.V ............. Date Application Disapproved for the following reasons--------------------------------------------------------------------------•-••--------....................... -•-•••-•••-------••--•.....................•-•-•-----•••••-••...-•-•••---------•-•-•-•---------••••--•-...-•-•••--•----•--•-•---•------•------•-•...•-••--•••---•••--•---•-••-•••----•---•••-•••....•---- Date PermitNo......................................................... Issued.................. AI �CR No.................... Fing.... I................ THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH l rtt i�an fnr i� u �a1` ark Tonstrnrtion ramit Application is hereby made,for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal s St ��: A. ......... ...............jit., z4.-- ...... ----- ocation t Addr or Lot ... &°�.-.. ................................ .......................... Owner ress Installer Address d Type of Building Size Lot.#._ ....Sq. feet U g .....................Expansion Attic ( ) Garbage Grinder Dwellin No. of Bedrooms.__.. ..... YP Other—Type e of Building ---------------------------- No. of persons............................ Showers Cafeteria � ----------- --.- ( ) — ( ) Othe . tures . W Design Flow...... ......... .......gallons per person per day. Total daily flow...... 4� ......gallons. 40 WSeptic Tank Liquid capacity/PP allons Length................ Width................ Diameter ._... .... Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.._.......__........sq.ft. Seepage Pit No........,/.......... Diameter...../_A....... Depth below inlet..... ........... Total leaching area.__,..a..4......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.... S........ Depth to ground water........................ 44 Test Pit No. 2.......:........minutes per inch Depth of Test Pit..._................ Depth to ground water........................ t .................... - •... ...1 ..._•- O Description of Soil......... ._''... ......... x - U ..............•-------........-----------.........-•----------------------.........--...................--••••-•...---.----•- W UNature of Repairs or Alterations—Answer when applicable.___;-.......................................................................................... ............................................................................................................... --------=------------......-------•----------......-----•-••-----••-••-•--.....•--• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by'ihe board of health:, Signe. -•---•:............................................•-••---•-•--••-..........-•-.••... .........................._.... Date Application Approved By•••- � ........................ --. .: . . Date 4-------- Application Disapproved for the following reasons:.............................................................................................................. ..............•-•-••-.......-••••••---•----•••••••••------•-•--•-••......--------••-••-•---•••-••••-•-•---••••••.....--•---------•-•--•---•-•-•-•-••-------•--------••••-------•--•••............-•--•- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . � .1 ...... ..OF.......6.4' ::..................................................... Tatifiratr of Tlamphaurr THE 16 CE IFY Tha e j dgal Sewage Disposal System constructed ( �or Repaired by1 ------- ns ller has been installed in accordance with the provisions of TI 5 f The State Sanitary Code as described in the ,... application for Disposal Works Construction Permit No.. :._.{�:0.___ ..... dated_ � �_/.: 7�............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE �SSYSTEH UNCTION SAT �'ACTORY. 7 DATE............ - . - � p THE a COMMONWEALTH OF MASSACHUSETTS BOARD OF- .HEALTH 7 >�. ....OF._-... '". t , !:......................................:.....d ....... No. .................... FEE........................ Disposal nrk ` n r ty rmit #' Permission is hereby granted............ . fir..w� ' to Constrycj or Repair ( ). I >vI ual SXxa ,��D)posal ystem r Street ted as shown on the application for Disposal Works Construction Per o.___.. ._. ............. - . ........................... Board.o ealth . � y DATE7_- --------5•--••-••---••. . ................._......... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS e - n a . � «`tea•° r rye• ,��.g � � � «,� .��r,�kt ot�ii� t �- - ter C�VJ � MN �R "•?le Al ; 2 5 F t� �� Hfi1Nt�62• _ 3 t!O - '_- t.. T1G -r)glK YGL• �5�p� 3�0,t l,tr �, G-sl »� r .. .,N116 �'�►�1't`f ' �� xi0 x 2.gD = �"yl .fir,. 4A R� _ r R i 3 i i tt� Air v�t}AI` Ll�4tJ11�•d� _ J a� 1•7 'i �1Ls:- y1�L- _ -f�/•t'.— !?G. �w t" N`!• tom--G I kJ.en ' o -AW _.. t7 1 � I v,te r'' i r• i ril ,.R,*- Tev