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Home My WebLink About0044 GOVERNOR'S WAY - Health 44 Governor's Way Barnstable A 258 029 f f I �i � � m��y�a ma��✓%� _ r+Mr.= .K- .13kw -,• +. *k. � �� t • Yd -rR b"�'' rF+�f�"t �� `'§� +.'? x�k { Y a.,, �, +. ,� 3 R s" g � y r rt � }.,� fi c t A.' :•}.jx -1 . tt ; •r'K .*fsu. « x°$.• dy, - '� '�. a'W y''nn'�.....a"'^r a a°s «"�� a �r",c.� t�ra,,x •�:� 3 "x ,'* ti �y'fr -.c �,+r : �� 't '(r.. C'�. : s 't � +^ V «3+ fi ''� ak•� - a K r a :q y,R .4y. My.y•.L r,%t ic, -'� t ..5 �� ,.`, �` : ��' fi '•; },.t 4 '}t , 41 .-r a, •`"�Ac* "'`` .t'-a'j'.-�s. i F, .tY'alost,o- :+' .•> a, , "� ry4 xR °,.^�:i'F x M1 t rFyr'`-_,;gt`�o "•# �R. S `� _ tA wage 42 x �" � .r.,, ?,;;" .� -} '�}• f� e' , $<+ },i` L'3r tr .a .Y JgF r •g-.a sa;.r,. "'tfn d •t `�1 ,>,,'1�5a"�" r -•+a� .Fjk F., ' ; .Y w is 1 - qkr a 'f s a ,,, t,''': is ��'x h CI' da sas tK 7"k .t`ii .b Fa �" Y..' e�'�,."rf' ...2 `w a f .a3° '� ,.+ s` d.yY v• t r¢ .r e * r u fi. 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"• .� E: k,t�� i. �4 '.Y� �i}. +:.I� .it.+�t`N`• w:r..�3rx.��':�t7`'ii,�c ,y�" r K ?`"'4 �.c'�S� �. ' z '-�'r" ;.rq` 4. `.:'�4 :��.t. *,"' 'ssr"in:��`u�r, TOWN OF BARNSTABLE f LOCATION ► G er N)0 W Q I SEWAGE # VILL ASSESSOR'S MAP & LOT158 �twLck, ,_ INSTALLER'S NAME & PHONE NO.�� tt 01 SEPTIC TANK CAPACITY I O D D LEACHING FACILITY:(type) (size) ®�O -NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER � •X, BUILDER OR OWNER h Y r ^DATE PERMIT ISSUED: s` d n 7 DATE COMPLIANCE ISSUED: 1 ~ eZ O 6 'VARIANCE GRANTED: Yes No q . 171 a 3 I � 3.01 Nov 25g � -/G vaz� ozS F Art job 'Lot +'-o da No... .� FEB. .0c THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r TOWN OF BARNSTABLE Appliration for Di ipasal Works Tonstrurtiun 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair X an ,Individual Sewage Disposal System at: - J -. a tion-Addr or Lot No. l S Owne Addr s Installer Address Q Type of Building Size Lot----------------------------Sq. feet V Dwelling No. of Bedrooms........... -----------------7..........Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of.Building ............. No. of persons................ Showers — YP g ---•----------- P ( ) Cafeteria ( ) QOther fixtures -----------------------------------------------------------••-••••••-••••-••••••••-••-•---•••--••-••-••••-••--------.........-••--•----•......_--•-•- W Design Flow............................................gallons per person per day. Total daily flow...........................n...•.....•..•.•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 ( ) aPercolation Test Results Performed bY........................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water...................... .- f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ---- -- o -- Description of Soil------••••-• - .......,..... •-- --•-•••••---•.•••••••••---••••-••••••••--••---------------•--••-•--•••-••••.......---•-•--- x W ------------------------------------------------...... --•-••-•------------•-••............-••----•••••• �( - I U Nature of 4pairs or Alterations—Answer when applible_....&.�5 '42 a Agreement: - The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Env' o ental Code—The undersigned further agrees not to place the system in operation until a Certificate of Co li ce s been issued b the board, health. Y P P Y � g Signe . . Dare Application Approved B PP PP Y - //-- -/.:�... Application Disapproved for the Date following reasons- ...........................................---------------------------............................................................... ------------------ ----------------------- ............................................... ........................... .............................-............................................ ........................................ Permit No. �C 1�� Issued -- , -�--�.�----�--Q-� �. ----- ----------------------------- ---.... ...... - - Dace a7' s t, If , No... Fss............................. THE COMMONWEALTH OF MASSACHUSETTS } ..BOARD,. OF HEALTH TOWN OF BARNSTABLE Appliratiion for Disvoas l nrk Cnon rnr iun [�rmi "X Application is hereby made for a Permit to Construct ( ) or Repair. an Individual Sewage Disposal System at: +. t..� D �' e •r - __-- s,•-5= vP�- w 5 - ........................•----•-•-•-•----- - Location-Add res or Lot No. -••��:'? C.+;5 ...1, .,� =---.... -_--- --•--- -----•-----.._i �' r �... ................ ... .S• - �Q Afires Installer Address Q Type of Building Size Lot.......................:....Sq. feet V Dwelling—_No. of Bedrooms------------ ..........................Expansion(Attic ( ) Garbage Grinder ( ) aOther—Type of Building .............•.......__..... No. of per ns.........(............__.___. Showers ( ) — Cafeteria ( ) Otherfixtures --------------------------------------------------------•••--••-----•----••-•--------------------•-•-•--•-•-••••---••-•-....--•-••......••-•••--•--•. 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 I................minutes per inch Depth of Test Pit.................... Depth to ground water-_------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... x �` - -------------------------------------------::�................................... O Description of Soil-------- ' ...........0 \x ----•••--•---•-•-••-•••••••-•-••-•-••--•-•-••-•--•.........•--- U •••••-•-•-•••••...••---•---•-•.............•---•••-••••-•-••-•••••-•-••---•--•--••••--------•---••••••-•••-••••-•-••--•---••--••.....-•--•-•-•-- W ________________________________________________________________________________________________________________ U Nature of Repairs or Alterations—Answer when applicable.______c__ �. ..._._.___�� 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 as been issued by the board of health. �l^ • g Signed�.�------------- .. ....�t'? 'M. ----..... -JJ--^�-'^ � 4 ` Dace Application Approved By ................. .?-n.. -`��--�. - ............. ......: / - �- ----------------------------------------------- Dace Application Disapproved for the following reasons- ------------------------------------------------------ ------ . --------------------------------------------------------- - - -- ------------------------------------------------------------------------------ . ------------------------.------ ---- ....------------------------------------ QQ Date Permit No. ..... �� ----------------------------- Issued ._�.� ^ a`+ .------.P..------------- ...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE s Grttftrate of Comyliance THIS/6 TO CERTI Y, That the Individpal Sewage isposal Systein constructed ( ) orl Repaired by ................. ......�.�('`---k ---------------- �-- - Installer at 1..^.�� 1. �" ....... .....f ..� 4�_l`..r•2.o. . .'-.... - ..................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. ........ �-..4.��....9.............. 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 BOARD OF HEALTH TOWN OF BARNSTABLE No._R..`�..-_�,r/.,.��.... FEE..��............ lgiijivs�l nrifi Tnnotrnr#i.on fermi# Permission is hereby granted...._. _.`�_.�_ .............. - - - _C� _.............------......_..-..........__ to Construct ( ) or Pjepair an Individual Sewage Disposal System at No..........� j._.....--.`n. _1 ....._.`! 'C .Q_.. .5. ......... Street ........ �a ! ,r-C .tl✓..... as shown on the application for Disposal Works Construction Permit No�"- _/ ..................... Dated.._.......�_� 1 b - ''0---------------------------------------•-... Q DATE....//.. •••-- oard of Health ....;. r---- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS j = 1 ^w F7 a to G • t °t��.i f . t • A# it 5 • a� � ,. � �� VII /��' ) S r A 77 s i e r „ r � ♦•x u _ > ♦ y t w � , n 4' 0.---- ------------------ .............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD HE A T � OF..... .. Appliration for Diiiv sal Vorks Tomitrurtiou Vvermit Application is hereby made for a Perm' to Construct ( or Repair ( ) an Individual Sewage Disposal stematPLe --•-- . ..... Z.....� ...4�.�..��........................................ _----------------•- L Address ..... .or.Lot No. .... .. ... .. ............ ............. n Address , . . . ......... .. �/�.............:........... ....... ..., .................................................... Installer Address d Type of Buildilgg Size Lot............................Sq. feet U Dwellingl� o. of Bedrooms........................... . .....Ex Expansion Attic a .._...._.. ..... p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures •--•-----------••---•----•-•-•--•••••-••---•----------------•----••---------...-----•-•---•---------------....._..............--•--------...---•-•--- 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........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit_-._.___-___-___-___ Depth to ground water................_------- ----------------------------------------------------------------..-----------------------•--------------------------- •-------------------- -.............••... 0 Description of Soil............-•-------••----•-•••-••-••-----•---•--•--•-•--••-------•---------- W ....................•------•--------•---•......---•--•--•--------...------••-••-•-------•------•----•--....�... `. f f---------------- x -------------- -------------- k/00 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 aI 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. Sign .............. .. ......................•••.............:.................--._.... ......... .....__.............. . 01' t Date Application Approved BY ; 1,d / .y D to Application Disapproved for the following reasons:............................. ..................................................... -------•---•.....................•---•---...•----------------...-•••••-------•---••--•---•-••••----------.._..••---•-------•-•----•------------ ................................................... Date PermitNo......................................................... Issued............................. .......... ........ .......... Date No.......... --. Fizz ....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H EA T _ OF.....,. `° � � ............ Apphratiott for i-qVviial 19orkii Tongtrurtion Voirufit Application is hereby made for a Perm to Construct ( ) or Repair ( ) an Individual,_Sewage Disposal System at k f Lo address or Lot No. ... .. ....... .............. .............. :- ...---....... ...,.,------- -...................------- "�g Address .. °•e; -.... ............................. ......... . :•�c•r..-. ..................._.......................... f Installer Address Type of Buildi Size Lot............................Sq. feet Dwelling- No. of Bedrooms...... .... ..................................Expansion Attic ( ) Garbage Grinder ( ) "4 Other—T e of BuildingNo. of ersons............................ 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---------------.:.... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution '.box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................rninutes per inch Depth of Test Pit.................... Depth to ground water-.-.-_-__---_--_-- _-. �14 Test Pit No. 2................minutes per inch Depth of Test Pit-----------------... Depth to ground water_-___._.______-__- ---------------------------------------------------------•-•-•-----•--••------•-••-••••.........•........................................................... Description of Soil R ' �9 ••. •••-----------------------• .......--•-..._...•. ..._•---...... .......... ---•-------.---------- --------• ------- --............................ •••.••.... U Nature of Repairs or Alterations—Answer when applicable__ _____ ______,f, ................ ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed' Individual Sewage Disposal System in accordance with the provisions of Article NI 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. tSign d ... -- ••--•-•••---......-•••-••--•••......••••- "�� Date -- Application Approved By......�,. i �' '? < ----•--------____-- . ._ `._ -- ----- - � D to Application Disapproved for the following reasons:............................. :................................................................................ .................•---•---............------......----------•----•---•..._•-•-••-•••--•-- .................................................................................. Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT 1 �+ f�prtifhair of Tomptitturr VM4 IS`TO C RTIF That the Individual Sewage Disposal System c = ructcd ( ) or Repaired I.stallei ' at has been installed in accordance with the provisions f Article XI of T e State Sanitary Code as described in the application for Disposal Works Construction Permit No......____________ ___,m,d___ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................. ........................................................... Inspector................................. .................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF,.++EALTH a ;�. ............................G .. ...OF............ ". ''Grp.:..... . .. '�.,.-�.. No ...... ...... n'.. FEE.. . ......... Permission is hereby granted.... 1: ._..,A .......... _ to Construct ( i or R••��e.�,�air, an Individual Sewage Disposal System at No._._.......... i.. 2. i44,4-i:,. ....... .......................... Street r' �p as shown on'the application forlDisposal �klor;,S'Constraction pe init N Dated p'z�r ,, ' , ' ,dal ra , .�/. ... Buaid of Health ........................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS � L : , • ---- __ - - IT -COW 1 V h• � Y 4,\\ \\� IN . r dc 4 Joymev \ r Mir .......... it t a ban- tw Lk' a a I. 'HA -� _ __ N � putt��» � c� ffftoJAJAjaq +44 'nI i N i I g ol Ism - -z -__. 'Ole — }