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Home My WebLink About0076 BRENTWOOD LANE - Health _ ,� � ' � e -- , s • - . ___ __ t WN OF BARNSTABI_E LOCATION G,7L :3q SEWAGE ASSESSOR'S MAP.& LOT INSTALLER'S NAME & PHONE NO. ,`yr SEPTIC TANK CAPACITY j U o LEACHING FACILITY:(type) fry-- (size) /Qo z9 r �. NO. OF BEDROOMS _ PRIVATE WELL OR UBL1C WAT T2 BUILDER OR OWNERS DATE PERMIT ISSUED:7 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes 4 Y Fps......Cam............ THE COMMONWEALTH OF MASSACHUSETTS APPROVED SOAR® OF HEALTH 0-if)Stabie conservation 0gwrtmct,jowt - O F..................................... ---- Appliration for Diipooal IVork Tomitrur#ioNe rMi _ Date - Application made for a Permit to Construct "� or Repair an Individual Sewage Disposal Application is hereby a e o t ( ) p ( ) g p System at: lz.—.3�k ................_ TfR?pvb. .-L-......C- ti�nA Pb........-----------------...-•---... ................................... Location-Address or Lot No. ..-•--••---------^--------•..................................................................... ................•--------•••-------••-•---•----••--------•----------------......................-- Owner Address a _ ......... Installer Address Type of Building Size Lot__�YtG!r_...... Sq. feet U Dwelling—No. of Bedrooms...................Is............. .Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons-............................ Showers — Cafeteria 04 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..........1-.,.. Depth below inlet........ ...... Total leaching area..,vy.._sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results ; Performed by.......uxlvlml.r._�.....67,.....V._Yt-.__..___y.......... Date.........7 ..._�........._.. aTest Pit No. 1------ .....minutes per inch Depth of Test Pit--------OZ..... Depth to ground water......."-_-_------ G Test Pit No. 2................minu'tes per inch Depth of Test Pit.................... Depth to ground water-___-_---•_-___---_____. a -•••----•.....................•---•----....-• --- -•-----•--.----.---------------------------------------------------------------- 0 Description of Soil.................................a 3.......... -lYt U W •-••-•............................................. ��. ----------- -0................................................................................... 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 b n issue by the oard of health. Signed - --------------- --- ----- ----- ---------- ................ . --------� Date ApplicationApproved By -----------------� - -- - ------------- ---------- ------------------------------------------------------ .... " �-tte,= : Application Disapproved for the following reasons- ------------------------------------- ---- ------------------- ---------- -- - ---------------------- ---------------------- ----................._------.....--------------------------------------------------------- ..............------------.......----------.................-----------.......................... .......................................................... Dace Permit No- --------------?D�.......Z�------------------------- Issued .-- --..................... .....--- Dace 333 - o a-9- No....7,9=3u) FEB.......&rP.........._ THE COMMONWEALTH OF MASSACHUSETTS _ BOARD O�F HEALTH _0U!1}.........OF............?--�1.aJ..... —.4..6 e6..................................... Appliratiun for Disposal Works Tonstrnr#iun ramit Application is hereby made for a Permit to Construct ( °#) or Repair ( ) an Individual Sewage Disposal System at ... _...± QLP {l (� 1" • `Y9%r,'tr1lttp�df "1l�/ .� --.... ,. ............. .......-•-•---•----......................•... .14........................................ Location-Address or Lot No. ---••--••............._.............---•----•-••---•-•-•---...................................... ..........--...................................................................................... Owner Address W Installer Address � Type of Building Size Lot.... _ ...Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixturesf W Design Flow......................-S..'N................gallons per person per day. Total daily flow.......................-- __:.._..galIons. WSeptic Tank—Liquid*capacity,46 .. ..gallons Length................ Width..l............. Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area............. _-._sq. ft. Seepage Pit No------------I_...... Diameter........... Depth below inlet.........:_..... Total leaching area.._?�? _7----sq. ft. Z Other Distribution box ( ) Dosing tank ( ) _ `-' Percolation Test Results Performed by....__. .. ��'`�P........_ ...._ 'y" ~ _.... _ 7� ?.� Date aTest Pit No. I......... .....minutes per inch Depth of Test Pit........�7..... Depth to ground water-___-_________-_-__-___. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ..........- ----- --------- D Description of Soil ?. `... :grr3 € - - ............................................................ U ------•••--•------•................................................. •-----••--•.....•••.....-----------------------------•-•------••-----•• ......................................................... W --••------••••-----------------••-•------•--•-•-------•-••------��-......J _ -----------------------------------------------•-----......--•--.......-----...--- VNature 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 ..... ``l .. --... -� t-- I `,2_ '/ Date ApplicationApproved By ................... ------ l --- -------------------------------------------------------------- ......1.. Date Application Disapproved for the following reasons- -------- ------------------------------------- ------------------------------------------------------------------------------ ..... .. ............................ ................................................:.............................................................................................................. ........................................ Dare PermitNo- -------------- -----..---� ........................ Issued ....---..........------------------ -- ---.........------.. Date THE COMMONWEALTH OF MASSACHUSETTS 1; BOARD OF HEALTH -J ..........................................�.�t� OF ----- ....1. �.....l!..�..... -.! !..-.-..- ...-............. t.LPrtifiratr of V.IIzntyliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) by . ........................ - - .....------- ....-_ .-........ l in aller <. ?, _ l / / at .................................................... .. -- ............. .. ... .......................--....._...... -- .-----------------------............--.............Y.... " 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. ......,tea:.-....3..--- .-----_.- dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. g , t Inspector----------• .......1P. . a„ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ tom..+. OF Z No.... .9t-._ FEE...f Q C�........ �i��uu�1 park$ �un��riun �ermi� Permission is hereby granted-----------------I....-----......`3== =? ......-•------------.......---........_........------------......---....-•------- to Construct (V) or Repair ( ) an Individual Sewage Disposal System r * � 4 c� at No..._..... = ..... ...............................•-••••-------•• C -- Street as shown on the application for Disposal Works Construction Permit No._ _ L_-_ Dated.t'....................................... �j and of Health DATE................ ... .................................... g� FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - 11'�511,16LE FAMIL-Y 3 $ n�cs � Il r I OF �o GAZ5At E 6JUVEY, 'PAID-( FLOW •3zlta=.33o:1 c. t1�k'oR` ' 3�GtL FIB G SE?FiC TANV 330.I5o,=4qS 6Po k f f to Po V lSFM L pi T I oao Gac-/3 - S l D -WALL AREA 22� SF BOTTOM AaZA z 113 S TOTAL_ DAILY T�E¢�aC.ATIoN Q?M = li�� LI MJq 102f ?I EDJIJ V-c�y r a -�2 P�T R ULLIML F��Cy�g11 j'Got �� TF:Fl =los - Lot/,A 6QL 988 3' {{ :tu✓ DUST tur. - �gG S rlc�; - � .;� _ . • IGpo IIJV'. 94. BOJ'C: $=7-' tit, .r./LNV-•; •.- _ , ^�L _ � �r- "A �k J, 4• F. .:. _ �,' � :tom - ., SAQD �pES WA69pP `' - _f. 4_ � '-TONE ''. t . - •`.._ e +t - '.I �` �" '.T' - ,5 CeZFI1 I© a•.1 LA1,. V=M-V `tom Loc�'T10t . �U�I I�QQIJiD T-IQ E"Spin �lO SGpL - - t IZ.` , �r �: liG�l Lam: �I_ �0' 77ATr✓ ( �'�l. 1 C Elm FY , %0WW NE2EoN <-MO S WITA -ME 51D-tAE Q- T I& `DA OKI T3A21J TA�Lc 100 IDA XITETZ tJ(E NC P `ffo+JdL LAu Sue-Ve c>Z5 --Tf-lK FLAQ IS NOT i3A/iEt> oN -/aN (tJSTQO�GtE+.rl- c�.�t L �4 EiJ61 N EEG5 4UWeef AND THE ORF ET5 -�40uLD uuF '&2 O'sTEfzvIU-G MA^S4 UZ Tb u oeS r L,EIeaT- Ow • ��- • :. . fly. y -` K. //. -97 . . - UN_ � -/� lao SAY\ F • "` ' ," '��' y � � , / N 6cp. r ,: oY PME R A " =i St1LLlVAN o _a IDI S i C.f / 1 / 6�\ r k a M. 2�733 1 9�9� ` �1 p 544 b Qj 18,J � \ � 10 � � 1ri 11• I a �_ O�� F^F. Ym � to .5 �� Io;7L;!M .y\\�\ > B� f� i � (� aOD �\ -10L•3 t to ,o'i.: loq In 4fy, R�N _to6:S t `_ Io5 1049 I o�.o. i w u t G1�'Tz(i T THEI au�c�iu� F�,O - 7 /O1L/ C.4L7 A/ 7CQ1.�/Ty/,�/7-BASE"O d� ,SA X7;=-,e.y� /2EG/S7"E.eE� ,G.�C/Q SU.e/%C'Yag �`STE.21i/.C.C�a �J.4SS. �l/i(/E .L!>T L./�t/�S �Oi�.L/C,�/V7" . �f?/SIDE �U�LD/(JG Go•.