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Home My WebLink About0066 MORGAN WAY - Health 7}1o✓fin U) C F BARNSTABLE io LOCATION t6 �d� � SEWAGE VILLAGE W� �°��^� ' ASSESSOR'S MAP & LOT/� "�'� INSTALLER'S NAME & PHONE NO. J•-�, DG 5co`j 7`71 ( 040 SEPTIC TANK CAPACITY I,mo l Loy s LEACHING FACILITY:(type) LC" Q l (size) Ij000 -abv,-,s NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER �7�ySIC� ��I��iin Ca �1 ' o% DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No I . I I i Lv� 160 i o i�1` y � Fim.......10-C)......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH V/,,�Mdf TOWN OF BARNSTABLE ,��li tttton for Di_np iml Works Tomitrnr#ton Vami# Application is hereby made for a Permit to Coristruct (,-Z) or Repair ( ) an Individual Sewage Disposal Srsw.t................... ` j oc io ddfl rC C Lot No. W , ncr Address Installer Address d Type of Building Size Lot...... c_...Sq. feet g— p ( ) Garbage Grinder ) Dwelling No. of Bedroums._______..-3_ Ex ansion Attic a Other—Type of Building� f"� No. of persons---------------------------- Showers ( ) — Cafeteria g I dOther fixtures ----------------_------ ---------------- . -----•---•-••---••......•-------•---. W Design Flow...................��----_._..._____--gallons per p per day. Total daily flow.........3-�d.......................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........................................ a Test Pit No. _____minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1.�.� fit Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 0 Description of Soil----� - ---•-----......-•-----------•-------------------------------•-----.-•---•••------. . ...... --•.... --.-•-- x x ----------------------------------- --------------------------------------------------------------------------------------------------•--------••--••-------•-•-•--••---•-•••......•----•-------'------- 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 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% .• . .. .... .......................... ...... ............................ Date Application Approved PP PP B ` Y �� .:-..:Date ..� Date Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------- ------- ---------------- g Dace PermitNo. --1 ----------------------------- Issued ........................................................Date...... Date Faa......lac).......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ltrttttla for Utz ltitt, � 1 lVor1w Towitrtirttnn rrrutit Application is hereby made for a Permit to Construct lZ ) or Repair ( ) an Individual Sewage Disposal Stein at: /// ic> --------------•---'---.......----------------------------.... 1L9oc t'oi \ddre s /�f 02 Lot No. /.......>./ ..................... ••-•---•`'"='S-•-•--------•--••---.....�----.......----••-----............................. a �. /J..O�ner "�n� Address Installer Address ' 3 b ¢L S feet d Type of Building Size Lot............................ q. Dwelling—No. of Bedrooms--------------------------------------------�-_______________________________Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of BuildiugW :616AR.,tk_. No. of persons____________________________ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - � oWDesign Flow..................Z40.................gallons per pen per day. Total daily flow.........- 3 .......................gallons. WSeptic Tank—Liquid capacit,d 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. �._____minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1_:-�. G%, Test Pit No. 2................minutes per inch Depth of Test Pit-_-___._.-_-____.__- Depth to ground water........................ D Description of Soil... _ f W _ ,- •- U ......................................................-••-•-•-••--•-•-••-'•--•-•-•..................•---•-•----•--------'-'-•----•-----•••-•----'•-•---••'•"•••--•••-•••-••••'............-•--•--'----. W •-----•--••----------------------•----•--------•..........•------------•--------•-•--•------------------------•------.........----•----••----------------•------------------------•----'-•----••-•-••-- 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 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/li' -. - r .--------------------------- ---------.-----.................:------ !' Dace Application Approved By �� .,, .-}..... Z Dne Application Disapproved for the following reasons: . . ... ......................................................... .. .. ..... .......... ....... .......................... ........................ . . . ....... ...................... . . . ............................. .................................. cqy Dace PermitNo. .. 1..- ------------------------------ Issued .....--------------------------------------------....--------.-.--. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE �� ('1-ertifiCate of V((��TT�III<aylianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ✓) or Repaired ( ) by --U-IT-4).2 JSCU L(- - -- -------------------------------------------------- --------------------- ---------------------------------------------------------------------------------------------------------------------------- a, .4-; . 16�.��-...��-GYr��...--�"' l(,hN � ..-.....� �.11.��/I�JG�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. .....FLl---::e_q.....--.._.. dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.� - �r�. �4 ,- DATE.---------.`� .... ........ ............_1... _ ---------------------- Inspector-.. - '-.+� . --- /�. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE / NO.-, l.-"�'8.... FEE..... •----• Rojiviitt1- urkii Tomitru#uart rrmt� r �SCdLL Permissionis hereby granted_.._......_��.-.��..�..----•--------------.........-................................................................................... Ito Construct Vf or Repair ( ) an Individual Sewage Disposal System at No.. - f� (3 ?�/1 z � l( r J / n.�J,r�G�. P y ................... q� as shown on the application or Dis osal Works Construction P it No._!-"_&:c��a�ted�................................_.....__. .------l�l-- ................ 9 Board o Health DATE-•'•-•--.....--'•...----_.•--.;... FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS i TJSs16 N -PA-rA' _ a 5106L E FAMIL( 3 $EGi�caMs . . T Sp j Nty hA1Z�AGE 6)ZINVEK ... . 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