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Home My WebLink About0918 MAIN ST./RTE 6A(W.BARN.) - Health 919 Main StreeVRte 6A (W.Barn) W. Barnstable A = 156 036 c i No. 4210 1/3 BLU U218 rumx SM) (Dm 0 10% U�, 0 0 0 No... .......>_ / Fss............................_.S 0 • THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH %/� ..../ .............OF............ �-- Allp iration for Disposal Works Tnnstrn.rtion Prrmit Application is hereby made for a Permit to Construct ( epair ( ) an Individual Sewage Disposal System at ---•-•---- .. / �' f+�rv�....................... .................................................................................................. Location-Address, ' or Lot No. Al i ,, ner Address ... .--- Installer ARG g Address Type of Building Size Lot............................Sq. feet �_q Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) PL4Other—T e of Building No, of persons............................ Showers — Cafeteria Q, Other fixtures ........................._........................................................................................................ WWDesign 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. 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--_-----_____-_-_.___--. r4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ a ......................................-..........................•-----------•---------------------- =...........................................•.......... O Descriptio of Soil p---------------- -------------�--------------- r.....�77i _ ............ ' ---1�"�" --•-•- U Nature 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 iITLL 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. Signed......:........ -- ..... -•--.................................................. - Aj./J Date Application Approved BY '✓u' ...... --- . •--•. ................... -`� $� Date Application Disapproved for the following reasons:......................................--•------------••-----------------------•------------------------•----••. ...-•••-----•----------------•--•--------------------•••------------•••-••----•------•--•----•-----•--•-•--..........•••-•••----•••-•-••••-••----••••-•--••-----•--••-••-•-•-••-----••--•-••--•----..... Date PermitNo.......................................................-- Issued..................................................... Date • � J No.... 8i� ?S > •� Fims... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH .:.............O F.............t� ............................................ Appliratiou for Dispnna1 Mirkii Tonitrurtion Prrmit Application is .hereby made for a Permit to Construct ( 4.) .@r-lte`�air ( ) an Individual Sewage Disposal System W t Ids olrn Location-Address or Lot No. .............r�....��._/YIe.. .s3..--'�" '-••...�....4..�:_ '4� :.. ...................................................... �� "_,w�ner �r Address W .........� a ------------•--•--------•-----•----------.. � Installer �� Address d 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 a Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic 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 ( ) �-_q Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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........................ ....................................................•• ...............•-------------...----...----••••-••-•••--•-••.....---:............--•-_••---- O VDescriptio of Soil................... r -------- e -------------------- - ---------------------------------------------------------- U Nature 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_the board of health. Signed.............: . -- f ...�A........--•---------•---•-•--- ... � Date Application Approved B .--- -_---- _�. '� .....---•-- n Application Disapproved for the following reasons:.........................................................................................................._..._ -------------------------------------------•--------••-•......-----•-------------•------•-••-•----------........._.....---•--••--•----•••-•--------••-----•----------••-------------•--•-•----------•--- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .:..............OF.....' ..... ' ...................................... Trrtifirtt#r of Tomplianrr THIS IS TO C RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ) by................fi t ...... -Cn,!t '------...........-------••-•----- . ------------.....------....-----•--•--------------•--......------.....---•-•---•--••-•------••. --�-•,� (� /✓�� Installer at............_ - ''?'`t"_- -•---...!�: C_✓ZA �. - �'°� 1!�L ' "`t '.---•---•-- ----- .......................................... has been installed in accordance with the provisions of TIT-LE5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N _..,! Z. .. z%1:__ .�.__..._... PP P :- - datedf THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. _1i—� DATE........................................ ......................... Inspector....- ---------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS . BOARD OF HEALTH > ........ ............OF............."......`� FEE. .....-•----•-----...................... ,T..-..•...:....... -�- N ,_ ................. ...... Bis;nuiu1 lVarkv Tontrnr#ion ernti# Permission is hereby granted = r -•----� +-----------------------------------•----•-------------...................................... to Construe ) or Repai ) an Individual Sewage Disposal System Street as shown on the application for Disposal Works Construction Permit No....s;Z _7- Dated....... :.��......... �. . = ------------------------------------- IZD-r// BoardHealth DATE.......... ---=---------•--•.......•---------•-•-•------•----•-------•------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS ALAN W,JONM &ASSOMAT'ES Consulting Eriginters yocr East Sandwich Mass, � l OF aALA I a�V 601,, SS�fr cz. -rA W/ 3 -11 wL C�+4c .90)- — u.�T 100 lNI.�T I o° $��Y�! 1�1N Vl►�� '^' �aTE�` `�� C44ToF F C'"TCJwr I t" 4%SIOvJ ; TONAL E� ,0. 'fi rl►`iG - L�4• FIQ� i " SUC540 0 -ro JBP T � INS , 4uT /ulht�hfaiR. TV l�•l!`tT/�!`E �F�711�� LOCATIONr/;A-- EWACE PERMIT NO. VILLAGE I N S T A LLER'S NAME i ADDRESS e c e'0 -74 s BUILDER OR OWNER s fe V DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ,�� q �6 X � o 7,A NFRIC............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................................._....OF....................--- ..------..........I................................ Appliration for Minpofial Works Tomitrurtion ramit, "Application is hereby made for a Permit to'Construct '( or Repair an Individual Sewa ge e Disposal System at: /J11 ----------------- 0 ................................................................................................... Locati or Lot No. /0..................... .................................................................................................. .................. owrl";* Address . . ...... ........ .10ft. ..........ks......Z...jL.............. ................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of. Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... ;i- Design Flow,,...*.........................).?.-...... all per person per day. Total daily flow.............................................gallons. fj��11 11 ns 04 Septic Tank Liquid capacity.,.........gallons Length................ Width__............._ Diameter._..._.......... thn-- ----------- Z Disposal Trench—No..................... Width...._` 9)....... Total Length...Z_t)...... Total leaching area. ------sq. f t. �: - Seepage Pit No iameter-------------�7�epth below- inlet-.,...�.. Total leaching area............7......sq. f t. ?4 Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date........... .......................... Test Pit No. I................minuiteAerinch Depth of Test Pit_._.__._............ Depth to ground water.._.....__...........__. Test Pit No. 2................mmuat s r i DZpth of Test Pit...__ ............. Depth to groun water.___.__............... ................. .. .............. ........... .................. .................. ......... . ... .............. ......... ......... 0 Description of Soil.......................... f- --- --- ----------___ - ------ ...... U ............................................................................ ......... .......... ...... ---------- ---------------------------------------- ------------------------------------------------------------------------- -- .. ... ....... . .... ................ ...... ---- ------ ------------ -- ----- -- ---------------- -Ive .......... U Nature of Repairs or Alterations—Answer when applicab ------------------------------------------------------------------------------------- .................................................................................................................................................................................................. Agreement: The undersigned agrees to install. the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTLE 5 of the State Sanitafy 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. Sig .. .... .........I................................................................. ......................... ... Date Application Approved By........ 7 ..... .. .. . .. .... ...................... Date Application Disapproved for the followingreasons:................... ...................................................................................... .... ........................................................................................................................................................................................................ Date PermitNo......................................................... Issued....... ........................ Date ................ Fps.... .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... ...............................OF......................................................................................... Applira#iun for Eligpuii al Works Cnunitrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................... .... .. ......�j&................................................................................................ Locati4, ,e. or Lot No. j� Own/e�r g .............................................................Address Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ _Expansion Attic ( ) Garbage, Grinder ( ) _______.... No. of persons............................ Showers — Cafeteria � Other—Type of Building _________________ p ( ) ( ) a � Other fixtures ----------------------------------------------------------------------------------------•--------•------_..----------------------•---._..__.....----- WDesign Flow___ ___..._~ " :..........:.. .... al s per person per day: Total daily flow............................................gallons. W Diameter... D Pth_ --------•--- Septic Tank Liquid capacity . .._._ gallons Length_______ _.�ti idth. x D> posal Trench—No_____________________ W>dth_._..__._ ._-.__._ Total.Length_. .t)....__. Total leaching area_ ...sq. ft. Seepage Pit No--------------- __�iameter.................... 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................miuutes per inch Depth of Test Pit._____.....__:_.: Depth to � P P --- p ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -••••-•--•-••--•••-----------•••-•••••......•---....•-•-•-•-•••.............................................................................................. _77 Descriptionof Soil........ - =----------------------•---------------------------------------------------•------------------••-••-------••--- Nature of Repairs or AYterations—Answer when W •---•-••••-•----------------• --------------------------------------------------------------------------••--------------------------••------- U P applicable. ..•-•-••-•-•-••-------•--•--••---------=----•----•----•-•---•--••---•---•------••-...._..-•-=-••••-•--••--••••-•••--------•--------•-----•-••-•••=••-•••-••-•-••.....---•------••--•---------•---•-•. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T-ITLE y g g p y S of the State Sanitary Code" The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the board of health. Sige ------- -------------------------------------------•••---•-----------•--•-•------ Date Application Approved BY -. --•- ...... i ----------------------- . .r.! Date Application Disapproved for the following reasons----------------------------------------........................................................................ --....---••-------------------------------------------------------------------------------••-••-•---_-_...- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH -*,_PrItifirtttr of Tompliana THIS TO CIRTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by----- -644.-- - ---- -- ........... .................................................... * st at"":. ... ..... - , .. ---•- --• 1 -- . -- _�-- ' I'! ................................... ------------ has been installed in accordance wi I the provisions of T r of The State Sanitary Code as described in the application for Disposal Works Construction Permit N ...... ._,_ ...... ..._.._ dated_ -.1P.. 'oil ................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE._... ` Ins pector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS a BOARD OF HEALTH ......../..........................OF...........�. allo , e'�''_ FEE.... ... iu�ruu�il rbi unu#r iun hruti� Permission is hereby grante - ......----••---•••-----•••.._-•---•••------------•............................•........_....... to Cofistruc or Repair ( Individual e ge , i p sal em �/�f at No ..... • y .* .... . ............. �_.__ ....��-... ..........._.._ _. f �' .. - Stree ,�„� 10 as shown on the application for Dis osal`'Forks Construction Per a -------- ._ _ d.....6' :..±/� ................ -------- - - Board o Health } DATE...... ...... { FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS °�+. 5 A fM Page: 1 f m:E CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Dated: 06/06/2002 Report Prepared For: Order Number: G0214540 Susan Maki Tasty Takeout P O Box 143 West Barnstable:, MA 02668 Laboratory ID#: 0214540-01 Description: Water-Drinlung Water Sample#: 14540 Sampling Location: 916 Route 6A,West Barnstable Collected: 05/20/2002 Collected by: Susan A.Male Received: 05/20/2002 Routine ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates 1.6 mg/L 10 EPA 300.0 05/21/2002 LAB: Metals Copper <0.1 mg/L 1.3 SM 3111B 05/29/2002 Iron 2.0 mg/L 0.3 SM 3111B 05/29/2002 Sodium 11 mg/L 20 SM 3111B 05/29/2002 LAB:Microbiology Total Coliform Absent P/A Absent P/A 05/20/2002 LAB: Physical Chemistry Conductance 158 umohs/cm 500 EPA 120.1 05/21/2002 pH 7 pH-units EPA 150.1 05/21/2002 Note: Based on the results of the parameters tested,the water is suitable for drinking but may present aesthetic problems(taste, odor,staining)due to Iron. Approved By: �-•--�- r�.��-.---- (Lab Director) Chh"oZ Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605