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0028 OTTER LANE - Health
� 28 OTTER LANEy N NI BARNSTABLE A = 351 541 ry Am LAI ri ...-�-- ,e --..--�.�—�.---�•e.-;—.=.y-tee.-��-.;, ,�gas"., � .- .. ., r _ , , } : a y n a rm i.ry + r� t • : 4, , , M r. a ! e a a ^ v • . f H n 3 N z r ry - a " E" a f d e , - rc n r r r vx .r .. ',v: v.. •., �:i � .. .. ...a .�' 1 i � i s � ' A 0 r- : , s; 1 + v .$ y a'.. .fir. ;:' , e - �. i y. :y V�'• � � t, � s ¢N�s{'. -�..,� .��� a �, ,.. , �`f7 �.. » a} ', ^d" .}. ',art ' n• � � , y 6 i s. 5. t r r; l Fee U V U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: \� Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pplicatiou for Migozar *pgtem Cougtruction Permit Application for a Permit to Construct( )Repair( )Upgrade(Abandon( ) ❑Complete System [E Ir ividual Components Location Address or Lot No. Z$ O y//gr ner's Name,Address and Tel.No. // G Assessor's Map/Parcel �.� ��( elfty J�� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. `7 7i �6Z Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder Other Type of Building G524 910e No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow I1 D gallons per day. Calculated daily flow 40 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank low P4' /)'1c9� ifs Type of S.A.S. —;�Da if � Description of Soil /27+ KJ'1 t2©1 t / Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by th' oar o alt l Signed �' Date Application Approved by Date �7,/w Application Disapproved for the following reasons Permit No. Date Issued No.7,mU f--s— Fee -So( THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: LLe:Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for ]Digpo2;a1 *pgtem Congtruction' Permit Application for a Permit to Construct( )Repair( )Upgrade(Abandon( ) O Complete System [P41vidual Components Location Address or Lot No. O ,L �r^ ) / wner's Name,Address and Tel.No. Assessor's Map/Parcel G ���(�/�� lleo/esly e�c 1�1 Installer's Name,Address,and Tel.No. Designer's?Name,Address and Tel.No. /� 771 Z - i3z 3 Type of Building: Dwelling No. of Bedrooms Lot Size p' sq. ft. Garbage Grinder Other Type of Building No. of Persons ° Shower�s�(( ) Cafeteria( ) Other Fixtures / Design Flow 1 /l0 gallons per day. Calculated daily flow ��� gallons. Plan Date Number of sheets Revision Date Title , Size of Septic Tank /©Op jW /1/,.->Z tl9 Type of S.A.S. Description of Soil y4�e a4 to Nature of Repairs or Alterations(Answer when applicable) r� y, Date last inspected: Agreement: / The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system I in accordance with the provisions of Title,5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi Boar•o ealth Signed n `r � Date Application Approved by T. Date Application Disapproved for the following reaso s Permit No. Date Issued ----- ------ ---- 1_ THE COMMONWEALTH OFi MASSACHUSETTS �ff 0 C) BARNSTABLE, MASSACHUSETTS y2 $a C)bd� (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( ) Upgraded(ell Abandoned( )by at 1 7 ?-d /"$Z t<_61AV 4"a G// has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.—6,6V/S"`f 1 dated Z 1" G Installer Designer The issuance of this pee 't sh ll not be construed"•as a guarantee that the sys ill f do s design ,010 Date 3 d ZdD Inspector No. Fee Su THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Migpogar 6pgtem Congtruction Permit Permission is hereby granted to Construct( Repair( )Upgrade( ��Abandon( ) System located at Z g eir"� and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction ust be completed within three years of the date of 77'e— .57t. Date: 7 �r Approved by , `1`�4P�' ^3, u �'Vr`n ♦ ��y m ,•`1- �. J JP r ' '�b�tsz,T � '2 .M1e s � . TOWN OF'BARNSTABLE L( CATIOhF'' t�TI'�r Gh , SEWAGE # VILLAGE G Lf dYI%'�1�'Q!,!I ASSESSOR'S MAP & LOT 35/ INSTALLER'S NAME&PHONE NO ��1'7`0�rT /I�/ y� -896 SEPTIC TANK;CAPACITY LEACHING FACILITY (type) : �1&6:4 anvi'2:g (size) NO..OF BEDROOMS -BUII..D.,�R 0.R OWNER PERMIT DATE. COMPLIANCE DATE: SeparationDstanc.e.Between the: Maximum Adjusted Groundwater Table and Bottom of Leaclun ,Fac�L g ty xim , eet ' j Private Water Supply„Well arrd Leaching Facility (1f.any wells e.st , ` on site or w�tlun 200 feet of It facility) Feet Edge;of Wetland and,Leaching Facility (If any wetlands exist within 3G0 feet of ieaching facty Feet , Furnished by %/� ��'� ` F s . t r 6.2 3a' �9 —7-7 c 3- y9.' i c y, 3S- ' a3 19f-SS' I ef- .I6 A SO is t -.. . __ _e No... .. ............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ................OF..... !/i' ........................ ApplirFa$iou for Uiip.w i al WorkoC�l�a� $r r$tuat ermi Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: ocatid Address or Lot No Owner Ade ss ......-� �-�x .................................. f KJ „ ........ sssx. . Installer Add ess Type of Building Size Lot_&.s!.r_< .....Sq. feet U4.1 Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................. Showers ( ) — Cafeteria ( ) Q, Other fixtures ------------------------- -------------•--------•- w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Gd Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ "w Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. <x 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........................ r-14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •---•---•------•------------•-----•••---•-•-•-•--•••-•-•-•.........---•-----••- = -•-------- •------------------------------------------------ 0 Description of Soil......................................................................................................................................................................... x w U Nature of Repairs or Alterations—Answer when applicable..Xi _./ ir?.S1W- ...•C ' ' Cc ------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITTIE 5 of the State Sanitary Code— Th undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d�b the b rd of health. �� y Signed. ....... ......................................... ...................... .... `. Date ApplicationApproved BY..........-.......................... -•--•• =-•---............................................. .................. ................... Date Application Disapproved for the following reasons:................................................................................................................ Date PermitNo......................................................... Issued........................................................ Date No...t ,...:74-2/ FEs..._Q................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................O F.......................................................................................... Applira Lion for Diipooal Works Tonutrurtion rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....--------•-•------...•-••--•-••------•---•---------------•---•----------------------••--------- •--...._......._.......--•-------------••---------•---------------------------•-•...........---••- Location-Address or Lot No. •---......-•--•-------................••----..--...........---•--------...............•.......... ..........--...................................................................................... Owner Address W a .......-- -------- Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................................. d --------------------- 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........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' ......--•••--•---•---•------------------------------------------------•---------=-•-•---------_.._....----•---...............-----•----..............----- ODescription of Soil........................................................................................................................................................................ x U ------------••--•-•-------•-----------------------••---------•-•-•---•--•--•---•-------------•-----....---•-•----------------------••---------•--•-----••••------•----....--•---•----------••-----•--- W ---------------------------------------------------------------------------------------•--------------------------------------------------------------------•------------------------------------------- U 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 TIT1Z- 5 of the State Sanitary Code—Th undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed the and of health. Signed _._.. r" Date ApplicationApproved By................................---....... ...........-----------••........................... ........................................ Date Application Disapproved for the following reasons------------------------------------------------------------------ ---------------------------------------------- S ------•-------------------------------------•------------••---•---•--••---------------......------------..-•-•----....._..-•-•---•-•-------•--•._...•------••--------------•----------------------....... Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Cprrtifiratr of TompliFaurr IS RTIFY That the Individual Sewage Disposal System c strutted ( ) or Repaired ( ) by--- ----------------- l.- ........... ':..._.............---------...-•--••......-----•------•--•-- --.. .... I a at..........--t- .. ------------------------------------------ has been installed in accordance with the provisions of TITLE of The State Sanitary C d s d rib in the application for Disposal Works Construction Permit No.- I__. --__ ----------- dated- .._ _fr_-Zlkl. ................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS ® AS A GUARANTEE THAT THE SYSTEM WlkL FXINCTION SATISFACTORY. DATE.... / ,--•---....-•--•................•-•-...........-•----... Inspector -- --- ....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Ncd. ..:. j .... ...........................................OF..................................................................................... FE ................. �i� orko �oa$�#raioat. anti# Permission i ereby grante = ; �1( ------. to Const y r R air an Indiv'clual Sewage Disposal System atN --- - --•-- •----•................----------.....- ..-- -........ .............. reStreet .as shown on the ap licati for Disposal Works Construction Permit No............... ..._____.__ .__....................... •.................................. ........ .......-----......................................... DATE_ �/ and of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS TOWN OF BARNSTABLE LOCATION A. SEWAGE # 2,40l VILLAGE uI ASSESSOR'S MAP & LOT 357 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /0,06 d�za L LEACHING FACILITY: (type)rAo4d Aveh e%yn (size) /J NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: 7/Z `®/ COMPLIANCE DATE: =-7 --VI Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private.Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)' le' Feet Furnished by e-&Ie 5Zv,,X c � Q 0 4 ( � Q w I J I L 0 C A T ION AGE PERMIT NO. VILLAGE INSTALLER'S NAME ADDRESS 4 001 S� S U I L D E R OR OWNER I 11&-sir DATE PERMIT. I S S U E D e �_93 DAT E COMPLIANCE ISSUED �s��3 lid l��lfl Xi � r ICA 0 1 3 0 y `O i Ll,CATION SEWAGE PERMIT~ NO. L U 7 0T7 It L/U VILLAGE INSTA LLER'S NAME & , ADDRESS T U 2 ,//Z'o %ry CIA- Cr i l\- BUILDER OR OWNER VWL4— DA T E PERMIT ISSUED i DAT E COMPLIANCE ISSUED L� W7t No........................... ,.� ., F�$...........~¢`t1 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ......... .. . ...��` 1 ....OF.....--.,Y� .r�/-�.�1�4 Appliration for Bispao ai Works Tnnstrnrtinn ramit . Application is hereby made for a Permit to Construct ( /) or Repair ( ) an Individual Sewage Disposal System at: (J7T e0f Location-Address or Lot No. ....�sl/ 41�9 I........ ........s � ........................... '� .: .......... Owner Address T� 1./ P...... � ' .r................. ........................................ Installer Address U Type of Building Size Lot. 2,j1!50(5._.._..Sq. feet g .....................Expansion Attic ( ) Garbage Grinder (Af®) Dwelling No. of Bedrooms....................... aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fix1pres ...-----•------ •------•----------------- W Design Flow._......�4...........................gallons per person per day. Total daily flow__._._...�-10.......................gallons. WSeptic Tank I Liquid capacity/«® -gallons Length................ Width................ Diameter---------------- Depth........... Disposal Trench—No .................... Width-_.........._...... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_________________ Diameter..4___�O..... Depth below inlet...-................ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results . minutes per inch Depth of Test Pit............. Depth to ground water Performed by.......................................................................... Date--------------------------------------- Test Pit No. 1---: a ....... .._._._____._.._..._.__. _. ;a.. frA Test Pit No. 2................minutes per inch Depth of Test Pit.................... /Depth to ground water.............. Jam` Description of Soil-----._...__ i l :^�? _.._.:5.............•------ ? -- _t x UW ----------------------------------------------------------------------------------------•--•--•----------------------............................................-----------------------•----------------..._..----------•-•------- 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 TITI.L 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued y the board o l3palth. g ",i .. .l Si ned_ ... ..................... to Application Approved By--- y t�l °F ..............•. Date Application Disapproved for the following reasons:............................................................................................................... .........-•-•--•---•.........................•----••------•-•-•----........-----•-•...-•---•-----------...----------•----•-----•-•--------------•----------••--•---•------------•--•-------------••----- Date PermitNo.....................................................0--- Issued..................................................... Date Y-Y 4 THE-COMMONWEALTH OF;MASSACHUSETTS ; . BOARD OF ,HEALTH OF "+ ° w ._ ...... r .:. Y - ................... ------- d . Application is hereby made for a Permit to Construct11 or. Re air an Individual Sewage 'Disposal Syst a r ._....... •--..._.. .---- ....... .................. ........ ......... J�cati� J.I'"'A •-^-•• � ✓7�7�A•�jr Lo AT,� ------• --- T...+ ................................................ ........ ..-- . -- ......... ...------ ` «�y� r�{ram �_�::.�+ .. . _ R W 4�v704.zdovo, � -S Address ..... ................................ ..... .....__........_______.... .... ....................... Installer Address � f QType of Buildin Size Lot_ ` ("�'i-------Sq. feet. Dwelling V—No. of Bedrooms ________________________ Expansion Attic ( ) Garbage Grinder (*p) Other—Type of Building ________________ No. of persons............................ Showers (- ) — Cafeteria ( ) aI Other xxures ._ < -•-••-----•-•-•---•---•--•-----•----•-- ---•-------•--•------------------------------ --- ......------....-----••. Desi n Flow, ___ ` ___-________ _ ; allons per person per day. Total dail flow________ gallons. W g g P P P Y Y ---------------------gal f�i , Septic;flank rf Liquid capacity�QP.gallons Length______ ________ Width................ Diameter................ Depth____ W Disposal Trench NV - WkUh...................... Total Length.................... Total leaching area....................sq:ft-. Seepage Pit No .__..: Diameter..._.X4..... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution'box O Dosing tank ( ) Percolation Test Re Performed bY ------------------------------------------•----------------- Date a ,.a Test Pit Nof l............____minutes'per;inch Depth of Test Pit____________________ Depth to ground Water........................ Test Pit''No 2................minutes per inch Depth of Test Pit _._ �. epth to groun water ___________- .r. • O Description of Soil `" t -- `. -- ___ U ............................................ r __ _.t ________.._._...___....____..___ W71 UNature of Repairs or Alterauons Answer when applicable _________________ µ.. Agreement: The undersigned agrees to install the aforedescr bed Individual Sewage Disposal System in accordance with provisions of TITTIE the p 5 of the:State Sanitary Code'—" .Tie undersigned further agrees not to place the system'in operation until a Certificate of Compliance has been fib ued y the board. lth Si� 1 g � ne ate .... Application Approved B , .tc ...•---------- ------------ y "'1r •��. Date ' ,. Application.Disapproved off' tKe following."reasons:..;:,'___;_.:_..... PP f f 9 __- ______________________________________•__....................... ........................................_....................................-.................................. Dais .i. PermitNo.. - .......................................... Issued-....................................................... ;. Date THE COMMONWd*ALTH=`OF MASSACHUSETTS BO OF . HEALTH R ... 0 .. ... .. ............ ............... CETjiat the Ind;vidual Sewage Disposal System constr'uc,ted ( ) or Repaired ( ) by ......... ....... . . --- •-•---....._ . has been installed in accordance with the provisions',of T,* e State Sanitary �dd�ed in the application for:�D'isposal works Construction Permit Flo .'- __ ............. dated THE ISSUANCE OF..THIS CERTIFICA EE. SHALL,'NOT:BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY: ,'� , . DATE....................................................... :--- " Inspector--- --- ................... THE COMMONWEALTH OF MASSACHUSETTS � 5 BOARD ® E��yAyj�LII�T�H/.) .......................... O F.....: No......... . ...... Y,- FEE.--•-•- ` Dtspos ork � remit Y w Permis ion eereb granted- ..:_.... ----f ----- ....•... ......... •. • .................................................. to Consfru t ,. o e ai I eve sal at No. .... ••- ............................. -- Street q as shown on the application for D> posal ��orks Construction Permit N ! Dated.._ __ --_....._. ................. .. -- ' e Board,of Health ,�- FORM -,1255 HOBBS & WARREN. INC.'. PUBLISHERS.: