Loading...
HomeMy WebLinkAbout4181 MAIN ST./RTE 6A(BARN.) - Health � 18/ 711w6n/Kie GA* 3S71 /647 J TOWN OF BARNSTABLE LOCATION 1�19� /T6 SEWAGE # !`t 07 VILLAGE ,/'OA ,i q(A ASSESSOR'S MAP 6i LOT3�-/w, INSTALLER'S NAME & PHONE NO: SEPTIC TANK CAPACITY LEACHING FACILITY:(type)"'TINO (.�Gc�i PST (size) NO. OF BEDROOMS PRIVATE WELL O BLIC WA ER-------------- BUILDER OR OWNER C0-19 0 DATE PERMIT ISSUED: :41"d +� DATE COMPLIANCE ISSUED: VARIANCE GRANTED} Yes ✓�No t�� r0 -419" Ll J \ C W � m iqi VA -� t CVO i q i No...... ---- APPROVED FEB......3,0 .......... g 1e HE COMMONWEALTH OF MASSACHUSETTS ° OARD OF HEALTH e red ate TOWN OF BARNSTABLE b A liration for Ui� itia �� � i Wvrk� Towitrnrttnn rrruttt Application is hereby made for a'Permit to Construct ( ) or Repair (­J-�n Individual Sewage Disposal System at: 4�l�l R-t614 dvmrn• ------------------------------•---•--_..._. .........---------...------... /t 1 oc io} des: or Lot No. .......�...-`.............._...............•...........•.........------•........................•..... �.......... � ` �� �z vi j Addre Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) a4 Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures .-._.__--__. W Design Flow---------------------------------- -- gallons per person r day. Total dail - flow_.-------------------_......................gallons. WSeptic Tank—Liquid capacityt.� gallons Length-_ ___._.__ Width................ Diameter..... .......... Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No----------- -------- Diameter-------------- ----- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (--1-- Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date...................................... :.. a 04 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........................ C4 ••••••••-•••--------•-----•----••••----•••-•----•-••-----•••••-•--•----••-••-•-•••••---•.....................•-••••••------••••......•--..._....••......--•- 0 Description of Soil...................................................................................... -----------------------------------------------------------------------------•---- W -------------------------------------- -- V Nature of Repai io ltera ' Ans}yer when pap ica ee_------'S�'--e.'.�j-._-___ � --.--�:n I......���....... ... :T- GU� �� 7•� ------------------------------------------------•-----------------•-------•------. 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 Comp ianc as bee i ed�e board of health. Signed ---------------------------- ---------- ------- ----------------------------------------------------- --------------------------------=------ e� Dace Application Approved By ................. 1� � ...................... ---+.�P.4-1y----- - ---------------------................... Dace Application Disapproved for the following reasons- ----------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------_.......--------....-........-.-..............---.__-------------------------------------....---............------- ................ ..... .... Dace Permit No. ...... 9�1------ a.--) ............. Issued ..... .... Dare 101-7 No:..----------- Fl�s.......?3....d.......... THE COMMONWEALTH OF MASSACHUSETTS 1 a BOARD OF HEALTH JTOWN OF BARNSTABLE Appliration for Divi-pniial Workri Tonstriir#ion ramit Application is hereby made for a Permit to Construct ( ) or Repair (-'ran Individual Sewage Disposal System at: -----•---------------•----------•-----------------------•-- ------•--•--•----•••----------••-•-----•---•--------•---•---•--•-------•-•----------------•-••-- ( 4api dlrLe or Lot No. .-... ...Owner---•--•---•.............................. ............................................Ad......... Installer Address 9 Type of Building ,� Size Lot............................Sq. feet Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-------------------_-------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - w Design Flow...........................................gallons per person per day. Total daily flow-.............__..._.______......_..__.__...gallons. WSeptic Tank—Liquid capacity6 ggalIons Length__!q______._ 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..............................................-'- s- ------------•---- Date....................................... a 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....................tDepth to ground water........................ ....................................................... 0 Description of Soil................................................................. = --f ; c, Wrc -... fr �,,,.�U---------------------------------------------------------------------------------------------- U Nature o Repairs or Alterations Answer/when applicable �_Sfc�---l -------5-�-----�Gct!Kt........�.0.3- ....... l.[ i 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 Compliant has been issued by the board of health. LA Signed . ............... .............. -----------------------......--------------------------- ---------------------------:------ Applicationr Date A roved B --- -,,.------�------------------------------------------ -------- ------------- .?a..-3�0 �(�4 PP Y Date Application Disapproved for the following reasons- ------- ---------- -----------------------------------------------------------i--------------------------------------------------- ' Date Permit No. ............. .�� f.. .. - -------- Issued .. ... .................. ---------- -------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Gertifir�ate of Co ttylianrP THIS IS TO CERTIFY, That the Individual Sewage D' sal System constructed ( ) or Repaired y .... - ......-.... -..... 1(( �-fJ ------- /�f at ----------------------------------- -------------- has been installed in accordance with the provisions of TITLE 5 A The State Environmental Code as described 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. DATE..... ............. ! - ....-- .,� ---------------- ----..........,.. - ....._ Inspeao -- --- ------------------------------------------ ------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � TOWN OF BARNSTABLE DifiVotial Workii Toni Artuton rantif Permission is herebyranted...............6 O�kJ),, ��L/(//� ................................................................ g --------•-•- 7 -- - r............ ------- to Construct ( ) or Repair ( /_�an Individual Se ge Disposal System r at No. 11f- w _.... - '( iJ!/1- --------•-------------- ----�---- ----- Street ��pp o as shown on the application for Disposal Works Construction Permit No._/--�\-ql_ Dated....._..^.3,-_).--/-. .-.... L -- Board of Health DATE. �� - -- ------------ FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS TOWN OF BARNSTABLE IOCATION ` � � l� SEWAGE VILLAGE _v vy�41/tl ra.Li�!1 ASSESSOR'S MAP & LO INSTALLER'S NAME PHONE NO. C l L14uD Sew L SEPTIC TANK CAPACITY I()-VD g l/cw�9 LEACHING FACILITY:(type) �' -C�5r-�,,z �� - (size) ,_ TK 6 it NO: OF BEDROOMS PRIVATE WELL OR LTBLIC WA t BUILDER OR OWNER /tAwW d✓ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: '" " VARIANCE GRANTED: Yes No � . ♦ � �ay`.* Y • •L Q � � , .� , N 4 W � , g � ',,' a ^` \ � Y QQQ� �r� r �. � � �.• � � 3,5/ APPROM a.G +. ... FIcs...� 7�.f ;..... HE COMMONWEALTH OF MASSACHUSETTS 3 sYned A RD OF HEALTH oa TOWN OF BARNSTABLE V' Appliration for Di ipm3al Works (>zomitrur#ion rumit Application is hereby made for a Permit to Construct ( ) or Repair (,--)"'a-n Individual Sewage Disposal System at: ....-- .......�-.•......2 - 0 io! or Lot No. W NUXV�''-"d''- l�x ----fl Installer Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms_________________________________------_____Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of.persons............................ Showers ( ) — Cafeteria ( ) A4 OtherAV es --------------------------------------------------i---------=-----------------------------.Design Flow___.____.__ ............... &allons per person day. Total d i flow_.__......�__�._._..................gallons. WSeptic Tank—Liquid capacityV..____gallons Length__-_ ..._.. Width__._ _____ Diameter________________ Depth____-___----.-_. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area..................... 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.--------------------------------------. ,.a Test Pit No. I________________minutes per inch Depth of Test Pit-------------------- Depth to ground water..___-_-__-________--_. G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 ---------------------------------------------------------------------------------------•-••••------..........................................................O Description of Soil........................................................................................................................................................................ x V •----------------------------------------------• ---------------------------------------------------------------------------------------•--....------------------------------------......•-------------- W ---------------------------------------------------------------------------------------------------- ---------- x s - y f tJ3 U Nature o Rep a r�, s or�Alte a-ipps— sorer w be p cable -- ___ 16....................._------ XC(C - --1----- ::::_:::-:::::__::-::::___::::::::::::::::::::::::::::::::_-:::::::::::::::::: 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 Si ned ---an has been issue by the board of health. Signed . ... - ......................... ...... _...... _....._......... - ..... ... - - Dare Application Approved By ....... ��e. -+.-� `� ...... .,Y.` -- - -'---- �C.+u."�'..w�----------------------------------------------------------- 3 Dare Application Disapproved for the following reasonf: ........................................................ ........... ................................ ...................... ................. ........ ...................._.. . . --- . .... ........................................ Permit No. ---------- .:r../A Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tertifi rate of lLIIIr plianre THIS IS TO CERTIEX hat t In 'v'd 1 - age Disposal System constructed ( ) or Repaired by ..................... ...............f-------- ....... at ---------------_..--------- -----------------.. --------------- ------..... has been installed in accordance with the provisions of TITLE 5 oC he State Environmenta Code as described in the application for Disposal Works Construction Permit No. _........ �j,-.��-..�-.._.... dated -------_------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE----------............--------------------------------------- ---------.....----------------- Inspector . ..----------------------------------------------------------------------- Non....... -_.� X F�s......�2�.........—'�j �/��47_ t;a"D WEALTH OF MASSACHUSETTS OF HEALTH 1E01 ` TOWN OF BARNSTABLE �J , pphration for Dhnp ial Work.6 Tun,titrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( -- an Individual Sewage Disposal System at: 1� � Un ...................................................� _.. �...................... �jcc/,-) 6_4MO7 w)n/elrC 5f�L/ or Lot No. ....V- _--- dress� Installer Address UType of Building 2 Size Lot............................Sq. feet t, Dwelling— No. of Bedrooms_____________________"___________-___._--__-_Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ___________________--____- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fiat res ____________________________ -- W Design Flow............ ........................gallons per person per day. Total di y flow-------W-- ....................gallons. WSeptic Tank—Liquid capacity_fflOUgalIons Length-----9...... 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........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit__._____---_____-_- Depth to ground water....___-_.-_-___--____-- Ri •••••-------------------•-------•-•-•••-------••••---•••--•-••--•--•-••---•--•--------.........•............................................................. 0 Description of Soil........................................................................................................................................................................ W U •-••-•-•-••-•••-•••----••--••••••---.....-•----••---•--------------------------•-•-------•-•-----••-•-•-------------------------------•--•--•----•------•------••--••----•--.........--------••-------•. W --•---•....•-----------------------••-----------------.._..•-----------------------...--•-•-------------•----- ..---------•-- --------•--•---•-••----•--•••-.-•-•••-•-••t = UNature of Repairs or Alterations—Answer when pplic7ble .f r1_.�_�` 4 /00 ��F�.. ...J f f .�1--------�'`--`=-�------..`-�� ---��1 .-•-- .. ��------.�` . --....------•---------•---------------------------------•-----................ Agreement: y 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 Issue• by the board of health. i Signed --.. ..... ...t. ......._... ---------------------------------------- re ; ....--.........-Da ..........:...... Application Approved BY _.... .... ^- Dace Application Disapproved for the following reasons: ......................_...........-...---.---.....................................- ----------------------------------------------------------...........--------------....-..............-..-----_...--.._----------------------.............---....---------------------------- ................................_...... Permit No. --------�. /...- ....................... Issued ......................................................... D�e...... Dare THE COMMONWEALTH OF MASSACHUSETTS 3 BOARD OF HEALTH TOWN OF BARNSTABLE C�ertifirate of Compliart e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by a&79 �-`/�>!�--(!1Cc 9 r� --------------------- - -- - - at ...................................................:� ..... ------------- - .. installed in a accordance with the provisions of TITLE 5 of-The State Environmental'Code as described in has beencco the application for Disposal Works Construction Permit No. -----...�y.`1.-./ .. ..._---- 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 HEALTH TOWN OF BARNSTABLE No...�!-;/.-.�.�:.� FEE... .©.....' :. Biapn;ottl Vorkq Towitrudivii rrniit Permission is hereby granted_.._.-. ( G /s to Construct ( ) or Repair (/) an ndividual Sewage.,Disposal System k/! .. J1 ....Vic ------------ --•---co C.......................................................at No.---••••------•...••••--•-••-•--•----••----•--•------- Street cc as shown on the application for Disposal Works Construction Permit No.-( .: !�K Dated.......... ?..�: .C-7 _ ---------•------------------•----- -------- - ........................................... (—� Board of Health DATE......................... r' ` - �"/......... `/ r FORM 38808 HOBBS&WARREN.INC..PUBLISHERS F.. R