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Home My WebLink About0170 MAIN ST./RTE 6A(W.BARN.) - Health 170 .Main Street West Bamstable A= 134— 005 "f AsBuilt Page 1 of 1 TOWN OF BARNSTABLE L` LOCATION .{- SEWAGE #, 'Roc-se- VILLAGE ASSESSOR'S ASSESSOR'S MAP & LOT ' INSTALLER'S NAME & PHONE NO. I FY?.rt�j �' tCl �l SEPTIC TANK CAPACITY LTyy C LEACHING FACILITY:(type) .(Size) /c" c"e NO. OF BEDROOMS 2- PRIVATE WELL OR PUBLIC WATER_ r BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED-, VARIANCE GRANTED: Yes No � T Wel ' e� � 3 i http://issgl2/intranet/propdata/prebuilt.aspx?mappar=134005&seq=1 3/4/2013 7d TOWN OF BARNSTABLE ey � LbCATION r IVIa�� }- SEWAGE ASSESSOR'S MAP & LOT 1pr INSTALLER'S NAME & PHONE NO. j SEPTIC TANK CAPACITY ` LEACHING FACILITY:(type) cl-c (size) /ate NO. OF BEDROOMS2_PRIVATE WELL OR PUBLIC WATER_ BUILDER OR OWNER DATE PERMIT ISSUED: - (� DATE COMPLIANCE ISSUED: VVARIANCE GRANTED: Yes No ,� a ASSESSORS MAP N0: No.... ."�-�. PARCEL N0: - Fm$.....rr2-�P�......... i THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............ ..... .......................OF.........................................-----------•--------------------........_........ 11 ' Appliratilan for Bhipasal Workii Tonstrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at 6716,24 ....----�!`!�� __ r hJ� � !l_..�...�f d l.� — �Yc Lot No;— .......................... - ............................. O er Addr ss w L�J........ -•-- Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.................................. _Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons___.-_-__-__.__.____._______ Showers ( ) — Cafeteria ( ) �►' Other fixtures ............................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............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........................................ aTest Pit No. l................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........................ a ----•---•----•••--------------••-•••-•-•------•---•-------..........----------------•--••---..•-----......................................................... 0 Description of Soil........................................................................................................................................................................ V ----•••-••--•••--•.....-•--•-•-------•-----••-•------•-----------•---•-------------••---•--••-•-•-•----------••--••-•------••••-••••-••-•-----•-----•-•-•----•--•-•••---•-•-----•------•-----•---......_ •-•--•-•---••---•-------•-------•---------------•--------•----•-••---._......__...._...........---•----- --------* N ure of Repairs or Alterations—Answer when app 'cable.._,_ _q__ ____ � - ..� '...'...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTTIE 5 of the State Sanitary Code he undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee u by the b d of h Ith. Signed..... - --- ------ ----------•---..V11- .......................... Date ApplicationApproved BY ---------------------- •-----•--•------------------------------ Date Application Disapproved for the following reasons:---•------------------------•---------------------------------•--------------------------------------........._ ---------------------------•-----•----------•----------•----•-------------------......---------•---•----.--•--•---------------•------••-------•-----•••---•-----•••-----•-••----•-•--•-•--•••--------•-- Date PermitNo.........f 0, -__1�s/.-......----•-----------. Issued........................................................ Date N FEi& .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... ......................OF_....................................................................................... Appliration for Bhipasal Work.6 Tomitrurtion Prrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at, Y.................at ----6,4----------------------------------------------------------- ............. ......A-0.7....Z................................. Lot No. ....................... ........................... .... ........................... .................................................. ---15' er Address L Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( ) 44 Other—Type of Building ............................ No. of persons........................... Showers Cafeteria ( ) 04 Other fixtures ....................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width._.............. Diameter----_-_________- Depth_._..._._...._.. Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. f t. 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........................ Test Pit No. 2................minutes per inch Depth of Test Pit............._...... Depth to ground water---_-_------___----__-_. --------•--------------------------•---------------------------------------...........--•-••---..---........................................................ I 0 Description of Soil..................................................................................................... ................................................a........... U ....................................................................................................................................................................................................... --------------------------------------------------------------------------------------------------- cF �- blature o� Repair� or Alterations—Answer when ap2!Lcal U ................... ------------------ t4- ... .. ...................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTLE:2, 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n * s by the b4rd of lwalth. -------------- /_1------- -"_4-------- -------------------------------- Signed_ ... ..... . -1 - 0 e Date ApplicationApproved By....................................................................... ----------------------- ---------------------------------------- Date Application Disapproved for the following reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo.._..... ......................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF......... ..................................... %TF.Wrtifiratr of Toutphaurr THIS IS Te CERTIFY, �Ta the Individual Sewage Disposal Syste"m constructed or Repaired by........... ... ....... ................................................................................................................................. Installer at.----------- .......)............. .............All,. .....A -1j. __--is _--------_------------ -, ... .... has been instilled in accordance with the provisions of TITIE 5 of The State Sanitary 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 YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................ ............................. Inspector.................. .............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF........ ...... .. .I................................... No.17* ... qFEE...0.2................. .. ............... fit Disposal Work %ownstrud la ion "pntit Permission is hereby granted....... ftv ---_ ................................................................................... to Construct or Repair><) an Indivi(rual Sewage Disposal System atNo........�,.!:�J...... ...... ...... ...........Al...... ....... kl'e�n. ............................................ Street as shown on the application for Disposal Works Construction Per No?-- -2----k Dated.......................................... .................... --- ---- Board of _eat—, .i DATE............. ............................ 0 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 1, i ./�; �, OIx �~ t x; ', a /� _ t SZ :i+ '' J j ;l 'C 7' l�.e�ib"�/ �CE�i'Ix1 .9J . - J i I •�. 1 ., /bit a pE' p,C . ► Y ; .. 4 :G : ; , �. ,:, - . '--�C7i7;�r,!il arr c :i . . . . '. .O _t 1 s r t. , -' 4- li 'r # •� . 1�. 't i y L �.t 7, ' t t , / ` iF 4 t �' i '4 ,.4 Y4 � ` s, 1 4 t 1 Y 1 .� a' " t ,tr 7 x-' T V ; 'r t t r t 5 t t t° t x� . O r .r tli 1 t, 1 i,r, " '-V 3 \ d r Y i V -� �- Y t J i. !(` t It 1.. J , y a - .: '. '. _ ( �i yr' + n \ 1 e s ; 4'. r �`�, j+� �T " " . c i r i N x . - ,a, i r m 1. t. \ 1 `t\ 5 �. pf �' .'Q' :.s 4 • .� h t }, r ■^' i. t , r . �' 7' 1 (�� .. 1 , 1 1. i �. '� Pt d 3 ` `v i- A '�//'.�/y�� rya 1 ` r 'i ,, .i W/V ��// b 1 '' 1�:. (yj l �' i 9' 1VA / yf k 4. 1 YR '. `\ i \ ... ,� .r r v i ; 1 J { _' 1 ri i� - i a V - 1 0 N, ,t •f S}/ O \ �, * i , - i { a t. ,1 t .t {1\\v I I f t . 1 ;; 4 ` ' + '. - - ,. :a t t J . 1 ' 1 t i i f n b - a� ' �,f r ft 2', L 1'..i _ . - t ,;r NoA�- FA,5.,4no......._ THE COMMONWEALTH OF MASSACHUSETTS BOA RD F HEALTH ...................�O.W..i0..OF....... G[J./ 'G ---------.-.---------------- App iration for Uiipnna1 Works Tomitrnrtiun Vantit Application is hereby made for a Permit to C nstruc ( ) or Repair (ter an Individual Sewage Disposal [ System at e // �� "1 n ................_ .....Cap.. ........................ !)'1. � ......�� .'..... ........._.........---.....----•---..... -_-- ..,faroovati1o,nv-Address ot .... No. ............._..... Owner Address f .e�a .1r �.c.......... fr1�r!/e ---------- -------------------------- Installer Address " Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures --------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................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.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank.( ) '., Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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........................ R+' ------------ ---- --------------------- . O Description of Soil....... -fd`'�u U .-------------•...-•--------------------------------------------•----------............----•---•---------------------•-••---•--•----•-----.......------------...............--•----•-•----------•---•.... - ---------------------------- ------------------------------------------------------------------------------------------------------ -- ---------------- --- ........._.._......... U Nature of Repairs or Alterations—Answer when applicable..../-_h _.17cl.�ol2 � ................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLITIE 5 of the State Sanitary de—The undersigned further agrees not to place the system in ' operation until a Certificate of Compliance has ee issued b the b rd if In lth. Sign - - ---- ----------- lr�1 .._ .... ....... Datte� Application Approved By--- -- (= �7 F- ------------- Application Disapproved for the following reasons:.......................... Date............_ -•-------------------------•---•-------•--•-----------------------------------------••-------------•---•----------------•-----•-----------------...--•-------•------•---•-------------------•--•-••----- ,/ Date 0 PermitNo......................................................... Issued_._. t` ................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i '11 .....>..o F........:..:��1.... ,_:. ......................................................... Appliration for DisOns al Works Tonstrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ' an Individual Sewage Disposal System at: •..............._ a.' ��%. .- .....•..__•_._•• .•_.•-__•••_•.••••• ............. 1�----------------------- ----------------- ...... 1 ;(j i Location Address or Lot No.. 1 a t Je�� r l r :_�` ....�' ✓ f .... ............ ..•......................................... a Owner " � Address ` . ` � ..` ,I1s�� L---.. _-_ ---•-._ ....... /.!..� .._....... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms.............................. _....Ex Expansion Attic a g— --------- p ( ) 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............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........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ (T Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ----•-•--......................................................... O Description of Soil........ =... %._ -=-•-- '_.:�::r: x ••---------------------------•------------....------•---...................---•---••---------•...-•-- V .....--••-•-•----•-•----•---••--••-••.....-------•--...--••-------•._......---•-•••-•.....•___---•-•-•----•------•..............•-••--•-------------•---•••-•----•._..__.....----...---••--------•-•-•••. W U Nature of Repairs or Alterations—Answer when applicable....... .` `+ 1._.t !._.ear Agreement: , The undersigned agrees to install ,the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State'Sanitary C e—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een sued b the board li Ith. Signe ..... - - __-- •---- _ 1� ......h ?�! .- .................. (} Date Application Approved By....�-....' { ......--••�--•-••................................................•---..Date Application Disapproved for the following reasons:....____. _ ._-_--_______ Date Permit No............... .: Issued - ................................. Date THECOMMONWEALTH OF MASSACHUSETTS ; BOARD OF .HEALTH 1. `'-' �' f ' dr.' .>'�� % %�, ::f i....,......OF. l , Trrtifiratle ,af Tout rliFanrr THISVS TO CERTIFY, That the Individual Sewage.Disposal System constructed ( ) or Repaired by........•--. ..: .._._ .... ................••------.........-----._.._..._.._. ....._ -•-••--•--------- *�t- r Installer d f d d f f s , -•---•--- has'been installed in accordance with the provisions of T + j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..- ..- Pk if—.......... dated---"---- ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...... ` �1 > --------------------------------------- Inspector.. :.:.... THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH 79 .................... ...OF.. r1�........................ . No......._ FEE......X..:..... .... Disposal Works Tonstrurtivit ramit Permission is hereby granted....., `"" .V to Construct ( .) or Repair ( I) an Individual Sewage Disposal System ti at No.............. . . ............t: .......... ------ :... Street as shown on the application for Disposal Works Construction Permi No.___. ._..-:.______ Dated..... . `'7. ............. .......... ... G: . U ..•-•-•._....Y`-.... DATE_ �Jj �` .................................... Board of Healthf� FORM 1255 HOBBS & WARREN. INC., PUBLISHERS .y,