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Home My WebLink About3531 MAIN ST./RTE 6A(BARN.) - Health 3531 Main Street A=317-077 Barnstable , f�. TOWN OF BARNSTABLE LOCATION 5'3/ <+.4LI SEWAGE # %2- S9,P VILLAGE ,BA,p,,�, ,4�/,c- ASSESSOR'S MAP & LOT ,° INSTALLER'S NAME & PHONE NO. ,p,,q„� SEPTIC TANK CAPACITY /,Soo asY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNERQ�� Q DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: l9Z --r VARIANCE GRANTED: Yes No �— T_w 0 ' I f� 3 r �1 SSOr, ,C No..9a c00 �7 0•-7 � Fz$..../2a t..: . OMMONWEALTH OF SACHUSETTS BO F HEALTH WN OF BARNSTABLE ,A pliration jor Disposal Morks Tnnitrn.rtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (�an Individual Sewage Disposal System at: a ' ....3.3. ---._c�iA ;K7 .............l vvv 5�7`A.�. ..... ----------------------------------------------------•---------------.........--. Location-Address ... or Lot a . �' - s 1_....E!-t�4f .. %------.. .ftjeA.)6:75 lZ.------------- ---------� r41_-E---.P......�146. 4----------------------------------- Owner Address ...9.4-;A. ) .� r�s .C�c G .......................................... `1.2__ ., J_...16AO-O.--A'--.........-- etAY-1---------------- Installer, Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............ .....................Expansion Attic ( ) Garbage Grinder ( ) '4 e of' p,� Other—T yp Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures -------------------------------- -.............-- WDesign Flow.............//V---------•------.-- ---gallons per person per day. Total daily flow................ff�...................gallons. W Septic Tank—Liquid*capacity.l9Vcz.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................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........................ a ------------------------••-----------•----.....-----••.............----------------..--......_...------...---------------------------............----------- 0 Description of Soil................................................................................:......................................................................................... x U -•-------------•---•---•-----------------•-•-----•--•-•---------------------------------------------•-•-•-------•----------•--....----------------------------------•-----...----•---.._.._-------•-••-. -----------•---------------------------------------------------------------------------•----------------•------------------------------•---- ........................................................... U Nature of�pairs or Alterations—Answer when ap licable______/_XV0____�a._V.__®__QttX-__----rwo..... ..S`Ajr,,u' --o.j....MJ-----AF----&9ck....0 -6 �---..L0.�4-A PA---W_1A....$T.w-E:--------------------------------•------•---- 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 oard of health. Signed ............ -----G- y. ---- ---- ------ Vv_I/� Z....-- { Application Approved By ...............�' � '�..*u+ c-, ----- ; . ... `CDate !... Application Disapproved for the following reasons: -------------------------------------------------------------'------------------------------------------------------. ---'-------- -----------------------------------------------------=-------------- ---- ------------------------- ------------------------------------------------------------------------------------------------ ---------------------------------------- a r Permit No.-------C�f--g - /.. -_--_--------- Issued ------------------------------------ ------------- te------ ---.-5-..--- Dace 213 ,No� ....`..7� _ 3 — / Fr,s_�/l a .....0... t THE.COMMONWEALTH OF M.ASSACHUSETTS -BOARD--OHEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Cfonstrttr#inn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (yr an Individual Sewage Disposal J System at: 2 ------------k!-A.:�:�!.s:1:!4.l c....... ........................................................-.............................----------- Location-Address or Lot No. .................................... Owner Address J --------------------------------------------- --. ....&P- ,4-e..mot -----------�'--,.....-------------- -------- ------ Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-__-------_�Qt!_�.....................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building .............. No. of ersons...._....................... Showers — Cafeteria a YP g ---------r--- P ( ) ( ) Otherfixtures ............... .........................................................•--•-•-•- .............................................................. W Design Flow............&V.......................gallons per person per day. Total daily flow................Yl!�-------------------gallons. WSeptic Tank—Liquid capacity J:f4-_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. f 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........................ G Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ ---•--------------------------•----------------•-----------------------.........-----------------•--......................................................... 01, Description of Soil........................................................................................................................................................................ 'V ---•---------------•----------------------------------- ------------------------------------------ ._._.................... --------------------------------.-------------------•----------- W VNature of Repairs or Alterations.—Answer when applicable--------IShp----- Ir .....�{41 t�_._._�� i;...4-� . .... �.....'ram 0 C.14....^-#-_& A....La x e= l. E�__>ai_f 7": �T��e��-----------•----------------•--------------- 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. y Signed -------- �t : ' - Application Approved By ................V ,-- � � = �� ?�..- _r y---------. Application Disapproved for the following reasons- ----------------------------------------------------------------------------------------------- ---------------------------------- ------------------------------ -------- r_ Date PermitNo. ---..�.A---"... ................. Issued ........................................................ ------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Terlificax#e of Cfomyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by--------------------------- -------:----- ... -------- ¢�S l ------. ... - ----------------------------------------------------------------- Installer at -...............................................................-------�35.3]...-- 1�------vr"�-------------- ,�.1��J�* ` �t�r -------`------------------------ 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. ....... --.5_76".`::.. ^ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE j�' (' '" ------------------ ------------- Inspector ..-�.�------------ Cf THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE / ,00 No......................... FEE.....&0........... Disposal Works Tons#r ion rrutit Permission is hereby granted............8AJA, ).... � 5��.�d.. ................................................................................. to Construct ( ) or Repair (V) an Individual,Sewage Di s osaSyst atNo................................................... �• •�l r Street-.... tree? j�f tr.............,..........--•--......----------..........-----•. as shown on the application for Disposal Works Construction Permit No�%TZ, _.. Dated.......................................... _ ey n Board of Health DATE.._......._.�.�.....d�....�:�.. /-----_..•................................... FORM 36508[HOBBS 6 WARREN.INC..PUBLISHERS