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0302 BRAGG'S LANE - Health
302 Fraggs Lane Barnstable A= 298-107 d o s N a t u r, a a Ex)r. � aEW Lowtrt _ ��J✓.. _<)(J�^ y - PtW dPx485rEEL At s�ro Aso ao,oti i GvT ht LeS DIntI. L .t 1 GLOyF OPF vI�tw yx ,T,PnsTS I 'O° ;Ds;a c R. y .IAT P.-r. 0 2EAR- "� .LEDeE2 B�W, dXlo p erL .l° e�xlo5 DPE2 [� /d"OC. V `' W Sotr n OLOLK I NV-32Ow w�SOLD SLOG f + �Q i vH ` P mm) 4x6 PWT ATOP i P9 I eJL,.2�so k,TCHeIJ n O Q 4'4'4700" CN )-v'/a" O 4"CoISC. •$LA3 � L £?Lh RG en 2-sL , 6.R. P •�O SLopev -,v DOOR\ 4\2 '• GN 7.7" G ..?54 9.LT DOOx: O C1Ws Y//J \ � o G33 j wlbxn .S-p'N/oN S"CO�C.WALE) no LnILL ry - 1� W),IG"x 8"CoNr. FT6. o 1 COnY.WAu.f © \I ® O Aaoo.D. ODORS W/Ib'x8"CsJ mt.. OW FRO,f'r WALL.. Ci ELOLa �. 8I/a LnItL :y O Dcort � GIyS a'd°•Jxa-G„N�i,7�.r•N i _ 1tiT 04 LAc 9000.� OPM ro'• � - rJEw dX11 4 4,• Rr o&r ra'- S•3.. o. I I 114"�- !/n"'i-.CT.•t O.J D6 E- .. 7-Orr , •, hwrw Id ._.. - FF/R/T' ELF PIA%') ElJ �. TllU.rrDATiDw1 PLA rJ S�C_yi? F:.o R P.+ - a14 RlobE '..I; 'l ASPw>nr ADoa /SM GELr = { OUe K. P5.11 /rh OLEy)OFF IT VENT�O/A.hnp OFF/r VENrINL 7-O £xryTioC ' rt /}Lu/+� CaUTErts . /j poUT/ -'iZ Ih Mttk �(♦,TjD - L Ix8/x3 RAKE Ix jr FA�C/A t- DOoE 3.= T2r ELE IJ/J�J?AIL MLOL, - V \ FCOORf /s rr dJo FLOOR$ GACAC E Oft `• �.�R II ...: WfuDOU r..Oo2. CKED V'.,G t L ._ 5roSu0 LL r- dXY SHot B NUM hEK... 20., [SCh f... L/rE oTN ER 1An a L'$G s.Lr. IP e/ 'bC, w eu 9soGFi.vs. "'D box A. _ .... .... a-8'x a$"+1-7/ d.eeW - RA7G.q/EKNANC. CorvrlJUEf Ae2vff Af- .3 G33 I/ !Lx.rw S'DI LA FQONT .S•oE5 REArt - . CLAP6o AK.o 4°LT.W• C cN a3,,S.. W GRILL x IX5T-&,.- p 9x7aU.GA2vooR. It 'x s cBD'9 g- ew _ T'7"a OVER °CDx PL 1' V r ' V -a NUrTERJC F?ONT ry k,&,4r 5'DE OPTIONAL °o S�q'sue GL F-Z !nA a x yo cso x� /n^1y�'A ? RI 'o 'OC.Lu Soup tpct/nw Y dxb RT. SIL w/SEAL rCAOE+- row Duct orL .6oL WkLL 8"Coro T, - 10"SUNA�JyV(3Ef � p cox, 4'N/vr1�iyR) WALL T FTG. " 1YV r `. •r: O; 4"LONC,.3LA3 I,LOPED TDDoo2 -M wa , L/ —.'.. ". B3TEP DAMP PRDor- 6FLow .GRw OE I L•Q` U- V' /f r ea SUBSURFACE SEWAGE DISPOSAL 8Y8TZX INSPECTIO ORX RECEwEp - Address of property 2�.��� (�,,.�-'cy,)y' t'`.` - .j �c�(j' JUN 2 Owner's name i iztic:<� j,.k�� _. , 3 "1990 Date of Inspections w PART A CHECKLIST 8 5 Chec if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined.. Note if they are .not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. e The site was inspected for signs of breakout. A11 system components, excluding the SAS, have been located on the •/ site. w The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. /The size and location of the SAS on the site has been determined based n existing information or approximated by non-intrusive methods. ' T d he facility owner (and occupants, if i fferent from owner) were provided with information on the proper maintenance •of SSDS.' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential number of bedrooms _ number of current residents _.� garbage grinder, yes or no' . laundry connected to system, yes or no seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: Last date of occupancy GENERAL INFORMATION Pumping records and source of information: System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Typ of system Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) * Other (explain) Approximate age of all components. Date installed, if known. Source of information: Sewage odors detected when arriving at the site, yes .or no SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: (locate on site plan) depth below grade: material of construction: 2concrete metal FRP other(explain) dimensions: sludge depth i distance from top of sludge to bottom of outlet tee or baffle scum thickness distance from top of scum to top of outlet tee or baffle distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet. invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: (locate on site plan) depth of liquid level above outlet invert Comments: .(note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) PUMP CHAMBER: < (locate on site plan) pumps in working order, yes or no Comments (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : t (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits and number - leaching chambers and number leaching galleries and number leaching trenches, number, length .leaching fields, number, dimensions j overflow cesspool, number Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations.for maintenance or repairs,etc. ) CESSPOOLS (locate on site plan) : number and configuration depth-top of liquid to inlet invert depth of solids layer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc.) PRIVY: (locate on site plan) materials of construction dimensions depth of solids Comments: (note condition of soil, ,signs of .hydraulic failure, level of ponding, condition of vegetation,- recommendations for maintenance' or repairs,etc. ) . ; SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ,?ORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L:SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' L Al , G� DEPTH TO GROUNDWATER depth to groundwater method of determination or approximation: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined" , explain why not) Backup of sewage into facility? Discharge ondin of effluent u� g or p g ffluen to the surface. of the ground or surface waters? Static liquid level in the distribution box above outlet invert? Liquid depth in cesspool <6" below invert or available volume< 1/2 d. flow? Required pumping 4 times or more in the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: below the high groundwater elevation? within 50 feet of a surface water? within 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh- (cesspools and privies only, not the .SAS) ? within 50 feet of a private water supply well? less than 100 feet but greater than 50 feet from a private water 9 supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analy .for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector � ��` �`'` Company 'Name CV "P'r.V(AOD-51+v Company Address � ��•�; � Certification Statement I- certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and maiitenance of on-site sewage disposal systems. Che one: _ I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15. 303. The basis for this determination is provided the FAI URE CRITERIA section of this form. Inspector's Signature � . J r" Date Original to system owner Copies to: �.Q Buyer (if applicable) . Approving authority". No.- 1.Y.:.y. _ V� F$$....c w THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `r.o.c�...1�.........oF ...�i, -.................................... ApplutttUan for Disposal lVarks Tonotrudion Frrntit Application is hereby made for a Permit,to Construct ( ) or Repair ( L),-In Individual Sewage Disposal Sya�at ............... ............... 4 -w'• u�- ? !v-�p:.....----...........»......_......._.. »...•--».X.!%45S..... atio ddres\t1',.— - •^-•............. ;•--tee-or Lot No.._..-•-..............»».. ........ 51 n Own - Address � •..................... ..........P�..O.�...! 2` -- U.�S:k. _..!!...�?.�:��5........ Installer Address Type of Building Size Lot............................Sq. feet 1.4 U Dwelling—No. of Bedrooms......../..................... _Expansion Attic ( ) Garbage Grinder ( ) 1.4 Other—T e of Building No. of persons............................ Showers — Cafeteria a yP g P ( ) ( ) d --•-Rr Other fixtures ........................•-----•--••••..:....... •-.....--•--•--•---•---...---- W Design Flow.........��......................gallons per person periday. Total daily flow.._.._..1,4jQ............_......._._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._..___ ` r 3 pag ,�__....._.... Diameter..... Depth below inlet.__..___.._..._. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0.4 Percolation Test Results Performed by----• --------------- •-....................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gi. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------------------------------------------------------------•--................._........_._...........-------•-------------•----............. 0 Description of Soil...............................•--•-----•-•-----•-•--••-------_...:....---•----...._..------...----.....---........-•----------.........._....._•-•---••..._.......-•-- W V -••-------------------- •---------------------- •-•------ -•-------------------------------------------- •....... ------•----•---•--•--------•-----------•-••-••------- •............ --------- ---------------- -••---•----••----------•----------------------------•---------•-------------------------............----••-•------------------------•-•--•----------•--...............-•-_....__.....-•-...----•-_-_... U Nature of l epairs or Alterations—Answer when applicable........ _�_.....D.0-e-._____lcr__2� Q.......s? -- - aSt' ..... �--T-S—c...:S --------------••--• Agreement: The undersigned agrees :to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'i I'�U 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 heal di. Signed--------- -- -- ----`� ............... ................................ 11 Date Application cation Approved By..._--•------ V _�c.r..�.� �.<- ..._....... -•------�_ ._:�. i Date Application Disapproved for the following reasons:........................................................._.................................................... - .....................................•--......__......----•----•--••••----•--•-•-._._..........._._...._...........----------•••-••••-•••....-•-•....._..--••-••..........-•--•-•--••.._...•---........._ Date PermitNo.---•-- . .................. Issued................................................. Date s= ,,. .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Application for Disposal Works Tonutrurtion Frrutit Application "ereby made for a Permit to Construct ( ) or Repair ( (,,,).man Individual Sewage Disposal System at: -•---e .---•-.fZ. :c� �..C..a :tea.►-<............... ..............' �:..- .........................-•----- Location-Address or Lot No. ... ..._.�.r\. ?�......�Lt..:�:51 K),- � --^- ..... -• ....... ........................................................ Owner a .t�.�:.....-s.;�.�'i:? ,P _11L� ��.(2. U .....4�a4($'�....... :._��,.1.�.�.._.._.. ......... Installer t' Address Type of Building. Size Lot............................Sq. feet U Dwelling 'No..of Bedrooms ................................Expansion Attic ( ) Garbage Grinder ( )t-, t a Other-Type of Building ............................ No. of persons............................. Showers ( ) — Cafeteria ( ) j d Other fixtures ........... W Design Flow....-....4-_ .•................2--gallons per person per day. Total daily flow........L ......................gallons. WSeptic Tank Liquid capacity............gallons Length..............6.Width................ Diameter................ Depth................ x Disposal Trench—Nq.____y.............. Width.................... Total Length.................... Total leaching area....................sq. ft. See a PitNo........ . Diameter...._/ /�? ` Depth below inlet........ ...... Total leaching area................sq. ft. �. Pag 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 PONo. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ a ------------ .--••-•••••..................••--•-••••-•-•-...--------...__................•--••.......•-••••----•------•....•-••--•-•---••----'•-.......... 0 Description' of Soil.......................... ............�.......... ---------------- •-------- -------- —-------------.........— --------------------------••——----•--•------------—— .i'--......._....... ----------------------------------------------------------------•-•-----•--------...--------------...----------------------------•-------------•--••---........•---. --- ----- ---.......---.•- U Nature of Repairs or Alterations—Answer; hen applicable........0. --__-_.r.?1N�... (�.----���t-._ p ------•.... ............................ Agreement: J i The undersigned agrees to install the laforedescribed Individual Sewage Disposal System in"accordance with the provisions of iITiS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance lhas:been issued by the board of health. " Q a i _Si ried-C-- .. � ryw ication Approved B .: -•••-•-•....._....--•-•••- :_ ..... te.. .�� A . PPl PP y..'..........�. Date Application Disapproved for the following reasons:...................................................... .........::_ ................................... ................................................................................................................................................... �. y Date PermitNo........ ...._.. --------------••-. Issued...................................................... _1 `! Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �0w V� 0F..�.l �lA� .......... .......................... Trrtifiratr of Toutplinnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�)� by...•--.......... Cs�t I,, a4 will . ........- � - -----Y'' R... �.. .._.Installer _-^••-•-•--•-•-•--•....................................•---•-••--------•_ at................................. 0........�?Y°`e��3� �L, �-----. ................................................. has been installed in accordance with the provisions of TITLE ` of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........._g��•.._.�.�;�... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SAS FACTORY. DATE.................................... ........ .............................. Inspector..........•••-•..........C�l:.....:......--••••................................. J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH vv IL/ -� v OF��.V.�1.W- �1.....--•.......................... No./Lc.t - FsE..r?<D........... Disposal Works Tonstrttrtion Errant a Permission is hereby granted.........6.+� e L._.... ..... ....S .Q.J. to Construct ( ) or Repair (%.-)an Individual Sewage Disposal System . � atNo.:...................:.-?�d.� ._.. .. � ....... .' .,.. ............................. Street as shown on the application for Disposal Works Construction Permit No.p::_�Qoar� ?�_/--. Dated.......................................... . •----------------------•-....---....----............... of Health DATE. ........................................... �v/ LOCATION , SEW ERMIT NO. r, V'1 L L A G E ASSESSORS NO: PARCEL NO: Ik INS A LLER'S NAME & ADDRESS R U I-L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED , , -78 1; _, *� ,���h ��� h o ���, � f � J No.......... . \ Fus............................ THE COMMONWEALTH:OF_*MASSACHUSETTS BOARD OF HEALTH 17 ....... N _..............OF.... .h.4....---...................------ ApVtiration -fur Dispsal Warks C atuitrurtion Vaniit Application is hereby made for a Permit to Construct @ ) or Repair ( ) an Individual Sewage Disposal System at: .1......�R�c,G s------..=A �------hP�c s�.t t3 Cy Lo ation.,Address or Lot No. ...._ - Ml — -------------•----••---•----.------ �1_..KAKIST��I_�----------------------------------------•-......-------- Owner Address o ---••-..lU----------------T�rz-1 iJ ' 2os SCZ�,15`r At. _C...................................................... Installer Address Q Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms.--.------.-J_______________________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .•----------------------------- - - w Design Flow._________._`J -------------------------gallons per person per day. Total daily flow________33�-__-•...................:gallons. W Septic "funk—Liquid capacityk� :.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 ( ) aPercolation Test.Results Performed by------ -------------------------•---•----....................._....---- Date.-----... ------------------------------ Test Pit No. 1....a--------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 Description of Soil........0-_3tp l��w�. x -------- ---•Suc3sot_..----1----3 --- 1`�y=--------�'�---rive-----5� ..-•-------- w V 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 Article XI 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. r Signed.---1.�t-.las.u�^t ?-vw 5 -------- - ' ff 7 l Date A lication Approved B PP PP y----)__'At_ ;a� Da te Date Application Disapproved for the following reasons:................................................................................................................ ------------------------------------------------------------•-•--------------------------------------------------------------------------------_......._....-----------------------------------•--------- Date Permit No------- -1. _--.- %f 1r' 7 7. Issued . •-----------••-•-•••-----•-------------- Date No......... .............................. .^ � THE COMMONWEALTH OF- .MASSACHUSETTS BOARD OF HEALTH 0.kz�4 ---- .---OF... "" .. ................................ 14 �.11pliratiun -for 15ifyotial Vorkii Tongtrnrtion Vrrniit Application_-;ts hereby made for a Permit to Construct (I/) or Repair ( ) an Individual Sewage Disposal System of"-; tea — ....__ Tt ................................................. Location-Add r ss or Lot No. ...... pti�6�......�5,,a ..T.Ws................................... --- -------•------------.................................... owner Address ,Wa .......... T. .. ----.- !f...................aw ...................................................... Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-----------------___________________________Expansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building -_------------------------- No. of persons.... ------------------------ Showers ( ) — Cafeteria ( ) al Other fixtures ............................... . . W Design Flow_.._____.__.'S.M+T.......................gallons per person per day. Total daily flow......... � ---------------------....gallons. W Septic Tank—Liquid capacitA, --gallons Length.4........... 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 Tes PiTest Results Performed by---------------- --------------------------•------•--•••... . Date................................... -___-:--minutes per inch Depth of Test Pit-------------------- Depth to ground water....----.-_---__-.--.-. w Test Pit No. 2................minutes per:.inch Depth of Test Pit..____.----________- Depth to ground~ water-_---_---_..__-.----.. W „ O Description of Soil------ "- x 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 Article XI 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... ......... =- ---------- ----- 't-t ay , Ye ApplicationApproved By--- •---------------------------•---------••---••--•--•-....._..... ........................---------------- Date Application Disapproved for the following reasons:...................................................;........ ----------------------------------------------•----- w . , Date PermitNo....../ t '................................... Issued.....----------•---D --------------••-•-•---•--•---. Date f u THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 4v 4va-A ..........................................O F......a...................................................................7.......... 101rrtif iratr of 0,11mViftata THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed or Repaired ( ) by . ....0 . 04_I.P.0...%ZOSO�-----------•--••----------------------------------------------•---------------------------------------------------------•---•------ I ller at---------- .�..�'------ ...�._. - .Q�� k �,.► ---------------•----------•-- ............................. has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No--------------------------------2�-------- dated..:............................................. THE ISSUANCE OF THIS CERTIRCATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM PILL FUNCTION SATISFACTORY. DATE.......... --- I•�-----------------------------------•------•---- Inspector--- --- ------e!94 �--- ' m: THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7� / .pt ............. ..OF..... r............................. .... G No............. :. FEEA----- ------ Bur;Votittl nrk inn trnrtinat rrntit Permission is hereby granted....... C_{�� ... 0 ----------------------•----.................----------.....--•-------------...---•- to Con truct ( ' ) or Repair ( ) an Individual Sewage Disposal System atNo ....... � -•--•- "$� ' ...................................................... Street r / 7 7 as shown on the application for Disposal Works Construction Permit No--------------------- Dated.......................................... d:. ___ DATE---- - 1 � ...7-`�-------------------------------------- Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS i , TOWN OF BA]R.NSTABLE LOCATION SEWAGE # mil j j VILLAGE_ 3�[t� 3�,� 5e. ASSESSO.R'S MAP & LOT INSTALLER'S NAME PHONE NO, Li1R1(r L AiA b Ca itiC " SEPTIC TANK CAPACITY _ eA, r_�j l 0-Fb to& LEACHING FACILITY•(type) AZe--6�4Sr Pf"r (size) (pX( <fo?Q v-J2 NO. OF BEDROOMS— '3 _PRIVATE WELL OR C WATER BUILDER OR OWNER 0AA_cS \ rctiZ a�t DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 0. JO i •� V 0 f THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ....................T.O'Pm............O F..........Raln*table......_.......--•.................................... Appliration for Miputial Warks Tum5txnrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( X) ari Individual Sewage Disposal System at: ..3�g..$? s... e.�..Barnstablex..12A-..026 - • Location-Address or Lot No. Thomas Leonard ..._._....•• .......•--•- S4 0•.Braggs.Ln:�..Barnstable,_..�-....026�0......... .. Owner Address a A & B_Cess�l__Service 128 Bishops-Terrace, Hyannis.,___MA_._ 02601 --- Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...............6............................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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....--.............---. ---•--•-•-----------------=--------•---....-----...................------------......-•--•----......•--•-•-•-•-•-•--•------•--.........-----._.....---..---- 0 Description of Soil---- Sand........................................................................................................................................................ x x ----•----•------------------------•--•-•--•-•-•-------------------•----•. ........-•••-••--------•--_.... U Nature of Repairs or Alterations—Answer when applicable----- nstallati-Qn...of--a...1,0.0.0..gal i.................. ... re-cast---stone...p&cked..leach--pit---(-nors.rfl.Or)-----------------------------------•-•--•-------------------••---••-•----------------..-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 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 boa-d o alth. rgned ......... ... ............... 1... .....5/.?q/.82......... �j .t� ��t-i'� Application Approved By. �d11.<..... % �247 82.....•------ Date Application Disapproved for the following reasons---------------------------------••--•--••--------------•----•----------...................................... -•------------------•---......-•-••---------•---------------....••--•-........-----------..._.......----•I----------------------•-•--•---••--------•-•-•-••-••-•--•-•-•------•-----------•-••------------ Date Permit No.--..-----8 2- .... Issued.......... �24�82--•----•------------------- Date No.g2-... 5....... �._ . ..�5..00... FEs. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................Tawn............O F..........Rarnstable......------.................-----...............----- Appliration for Disposal Works Tunstrnrtion "rani# Application is hereby made for a Permit to Construct ( ) or Repair ( g) an Individual Sewage Disposal System at: I .... ...............•--••---•-•--••---•--••-•--•-------•---............------------•--...........------ Location-Address or Lot No. ....--- 3k4.. � .t tea._Fax stable,... A 02630......... Owner Address a ..A. 3---Cesnml-..5ox!v.Q0............................................. ...2�3•-F_i�hoPs-'rexxace�..rT�y�nnis.�...�....02601.... Installer Address Type of Building Size Lot............................Sq. feet U ., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type T e of Building No. of persons............................ Showers f-4 YP g --------•----•-•------------ P ( ) — Cafeteria ( ) W 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.....................__. Lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•---------------------------------------•-------•----------..............•...--••--•-----................................................................ Descriptionof Soil......Sand ............................•-•---•--•-•--•---••-•---•--...-••----------------•----------------•---------------------------•-•-.....-•--•----------•- U -••-----•---•-••-••----••-•--------•...........................•-------•--...........---.......-----•---...••-----•••-•----••-••-----•-•--------•---................................................... W ••--------------------•-----•--------•-••----•--------••------------•------------•---•-----•-•------------------------------------•----•----••-•-•--------..........•------••-••-•-•----•--••--•-•••---- U Nature of Repairs or Alterations—Answer when applicable.-----ln8t,&7.1&t1Qri._.Qf..a_.. 1911_.................. ... re.-cast.,.--.stone..packad-_leach..pi' ...(ov.erflov)............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ' the provisions of TiTI E 5 of the State Sanitary Code— The undersigned furtl:er.agrees not to place the system in operation until a Certificate of Compliance has b�en issued by the boaxd of- ealth. .� GLc r / r-yt_ems/a c . ,� 5 2� R2 _ Signed------------------•-- ... 4..-C-•-- ........ I ......�.--/ . f ' / . Application Approved BY�--^ \ { 5/2D2 Date Application Disapproved for the following reasons----------------------------------•-•------------------•----•----------------------............-•-•••......•..... •--•-----••---•------•-----...-•----•---------------------------------•----------•------•--...---------.........---------•---------------•---•---•--...--------------------•-•---....Date••-----•----. 24/82 Permit No. �2-......•-••--••••-••---.......•---..... Issued 5l ..! Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH \ ............................Tawn...OF........1 natiable.................................................. (Irrtifiratr of ( ompliFanrr THIS IS TO CERTIFY, That the Irldividual Sewage Disposal System constructed ) or Repaired (x ) by A & ... seq oof Service , 128 Bishops Terrace, Hyannis, MA �2 ----------------•----•-- ----••--...... ......-••-•-----•••...............-••••----•-•-- 0 PraF. tatter at........ ------------'�s--L......---Barnstable, 026 - Thaams Leonard has been installed in accordance with the provisions of 6jLY, 5 of The State Sanitary C c � -scribed 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 WILL FUNCTION SATISFACTORY. , 5/24-/82 ` DATE... ........................... Inspector........ . - ........_.......:. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town .OF.......... Barnstable 82- ........................ .......................... ............................... .00 No..•-•---•.02...d... FEE......... ........ Disposal Works Touts ilan rranit Permission is hereby granted...........A..&__B Cesspool qe ce, ---------------------•-•------•----.......----------........................ to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at No..._. 0 1?ra �s Lane, Raxnstable, ''P, 0Z630 - Thomas Leonard ..-•...................... •• --.....--------- ----•---......__... Street as shown on the application for Disposal Works Construction it No._F................ D ted,_.._._ l/?�'Vi z._.._............ ....................- '/ -°�-------------------------------------------- 5/24/82 ar of Health DATE.__..... •-••----•----------•----•--------------------------------------- FORM 1255 HOBBS & WARREN, INC.. 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