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Home My WebLink About4429 MAIN ST./RTE 6A(BARN.) - Health 4429 Main-Street, Rt. 6A, arnstable. A=356-401 o ASSESSORS MAP PARCEL N0: No..... .... ........................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE App lir tiu,t fur i Vuuai Eurlw C�uuutrurtiuu �ruti Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...rya.. ►: ....�_.4-�-•---�- ^- -. -------------------------•- Location-Address or Lot No. ------ ------- Owner Address w Installer Address Q Type of Building Size Lot............................ feet U Dwelling—No. of Bedrooms-------- - ---------------------_---Expansion Attic ( Garbage Grinder ( ) pa., Other—Type of Building -----------------------------No. of persons.-.---.--.------------------ Showers ( ) — Cafeteria ( ) a' Other fixtures _---------------------------- - - - Q ----------------------- -------------------------------------------------•-•--------- w Design Flow--------------------------------------------gallons per person per day. Total daily flow.......--.---..---._---_---=..-._..__._._..gallons. 9 Septic Tank—Liquid capacity------------gallons Length---------------- Width--------.------- Diameter---------------- Depth----.------.-.-. 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.............--......... 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P4 --------------------------------------------------------------------------------•-------------------------------- •-------- ------------------ -••--------_----- 0 Description of Soil........................................................................................................................................................................ w U Nature of Repairs or Alterations—Answer when applicable.-L) bE.-.TU..-.-T(Z44.,7......I.SC.`k?...- pe& l?<C- a Z -- -----v ?- - ----- « Z - ' 1_.. �u .._�a•�. ;fs Agreement: �� e'1�a)UItif 4AACe-, 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 hWbby the bgard oof health.Signedg-- ---A roved B r----------------------- Application. PP Y .. ...........: .... ... ------ ----- Dace Application Disapproved for the following reasons- ---------------------------- ---------------------------------------------------------------------------------------------------- .................... ....-------------------------- ------------------------------ -------------------------. .................................................. --------------------------------------- '. Dace Permit No. .� '✓............ ��. Issued ....... .... �`:.. Dace Q 4G l THE COMMONWEALTH OF MASSACHUSETTS BOARD OFF HEALTH TOWN OF BARNSTABLE Appliratintz for Diti-Vntitt1 Works Cnnnitrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syste,Ym/ at,: �F•- J �? Location-Address or Lot No. ..�.�.n .p.: . J.::.., - ,�..•�S'rl. N.r ---Aeh.?T l./ -----------------------------•---••=.-............................................ -------- owner Address W Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms___.._��________________________.__Expansion Attic (�I Garbage Grinder ( ) ` 4 Other—Type of Building ............................ No. of ersons.-_--.-__-._____-__-___-._-_ Showers a yp g p ( ) — Cafeteria ( ) ,d Other fixtures --------------------•---------------------------------------......--------------------- -------------------••--•-----•-•••-••-•--••••-•........------ W Design Flow..: ..-_ _•________________________gallons per person per day. Total daily flow--------------------------------------------gallons. W Septic Tank Ligliid 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........................ fT�f Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................ �+ --------------------------------------------------------------------------------•-----------•--•••---................................-.........- --------- ODescription of Soil.............---------------------------------------------------------------------------------------------•--•-••-••---•----•------•---•---•••......•-•---------------• V ._..•••••-•-••••-••------•-------••--------. .................................................................................................... W ------------------------------------------- ---------------------------------------------- ---------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable.-�,�1�l�1�F____�"��-_.?..!_7.L-!� �._...1_�CX2____ �.c--e �-�1 C A reement: G e u�uu/ance, g � 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 be isrfe by the board of health. SignedG(� - ----- ----��lC ci rq.l; ---- Application, A roved B - ........ --- - ---- ----- ------------------------------------ PP Y ��e ...._... �� Application Disapproved for the following reasons: ---....._.......---------------------------------------------------------------------------------- --....._------ -- ------ Date�� Permit No. -.�`� -------------------------- Issued .......r.... D��° Z_ Dare . . -----®®m®—o®—<�,ca<.s .a a �.� d�_...a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cex#ifirtt#E of Cnomplianre T IS TO CERTIF , T the vi u 1 Se a e Dis oral System constructed ( ) or Repaired ( ) by ..... -------------------.._---------------------------------------- / j nsn er at -----T... .�..... ..ti .... b.lL.._�rP..__._L ��------ ------------ -------------------- 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. .fJ%.. f. ... dated r- .',F.. ...��. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A RANTEE THAT TA SYSTEM WILL FUNC O SAT FA TORY. , DATE. _�L...... . ....9.... ------- .... Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 9 �G TOWN OF BARNSTABLE No................... FEE... �z3: tn. Biopnnttl Varbi Tnnotrurtinn "amit Permissionis hereby granted-------------------------------------------------••---•-•---•--------------.....--••---•-•--•...._...---••••------•••••--•••-.......---...... to Construct ( ) or Repair ��-�aaj Individual Sewage pisposal System at No. i � c c -.a�°''�y1� Street as shown on the application for Disposal Works Construction Permit No ------ .,y .... . I ..--------•-----•----•-------------------------------------------------------------------------•----•-•-. Board of Health DATE................................................................................ FORM 36508 HOBBS&WARREN,INC..PUBLISHERS !' TOWN OF BARNSTABLE LOCATION SEWAGE # S- ,$— VIIIrAGE i3A R 11 S�� t ASSESSOR'S MAP& LO INS't-F.R'S NAME&PHONE NO. SEM. C:TANK CAPACITY LEAC.IIIIVG FACILITY: (type) �e� l L� CG'�L cerYl'�i� size) e NQlDF::BEDROOMS j BUIIpER OR OWNER T °�- PERMTI DATE: Q-a — COMPLIANCE DATE: Sep, Distance Between the: MamAdjusted Groundwater Table to the Bottom of Leaching Facility A� Feet ' PrlYate'Water Supply Well and LeachingFacility ty (If any wells exist onste:or within 200 feet of leaching facility) /�. Feet { Edge-f,Wetland and Leaching Facility(If any wetlands exist wittun 300 feet of leaching facility) Furnished by Feet -10' E �5�,! a.o� �✓ aft. .