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Home My WebLink About0155 TONELA LANE - Health 155 TONELA LANE BARNSTABLE o . TOWN OF BARNSTABLE fi LOCATION • f j( 4 I�S Tay�(.G nil SEWAGE # r13'30/ VILLAGE C f�2 �^+ ASSESSOR'S MAP & LOT a 8a INSTALLER'S'-NAME & PHONE.NO. Ellis CD, 3Ga SEPTIC TANK CAPACITY 1 Se o LEACHING FACILITY:{type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER PV6L%c— BUILDER OR OWNE DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: d e /3 VARIANCE GRANTED: Yes No l� o e a°� 3 3[6, No.1..3. ....... FRs............................. THE COMMONWEALTH OF MASSACHUSETTS . nm BOAR® OF HEALTH TOWN OF BARNSTABLE .��lirttti�r�fur �t►��uuu1 �urlt� C�u>tt��rnr�iun rrmi� Application is, hereby,made for a Permit to Construct ( ) or Repair (Vj"an Individual Sewage Disposal System at: • -'fi e- ...........................� ��- f Y��_7 � ........... L-c lion• ddre � or Lot .... I//•� CSC 7 `✓ .Q ---...... ._----------------- •---•••••--••••-------••-•-•-•----•--•----•----....._ 1�t a»cr 3 Address -------------------------------------------------------------•----•--•tea.-•-•--•-----•--- .................. �� :�.. .. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling— No. of Bedrooms-----.-----t-----------------------------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 capacity------------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 ( ) Dosing tank ( ) '~ Percolation Test Results Performed b ............................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit_____...---__-____-_ Depth to ground water........................ fZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P'r ----------------------------------------------------•-----------•-•-----------------..............................---•--......:--•---•-•-..........----.--•-- 0 Description of Soil........................................................................................................................................................................ x W ••••-•-••••---- .....---•-----------------------••-----------------•••--._...----.....-------------•--------------- .......---••-------•----------•-• •-•-•---••- UNature o Repairs or Alteratio —Ans er w n applicable._._.1. "C �__ _ ' `.�._�..a.�. � .�._ . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmenta Ve l —The undersigned further agrees not to place the system in operation until a Certificate of Compliance an issued b the board of health. Signed . 7........................------ ....................... `r`�i :....f ................. pDate Application Approved By ---------------- ^-. � --.�-. �........... ..... .....----.............---......__-----------------*...... ..Zj....... 13-n... ��. 3 Date Application Disapproved for the following reasons: ......................................................................... ............................................................ ...................................................................... -- .................................. . ................................. .......................................... ........................................ Dare . Permit No. ---------�.. ------�j...Q�-------------------- Issued ......................................................... ........... Date No..l.-..3: .U.�.. Fizz.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE • pphratinii for Diripmial Wnrkri ( onxitrur#'inn Prrmi# Application is hereby,made for a Permit to Construct ( ) or Repair (►/�an Individual Sewage Disposal System at: i l I \•� T,j C�Ul/!�►I�vt �l U!V C� r -� L c uon-:Yddrrs - ,.� �— O cncr Address ------'-"' .. ........ Installer Address UType of Building Size Lot............................Sq. feet �, Dwelling—No. of Bedrooms..........t.............---------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) QOther 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. 3 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........................ (? Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a '-----'--------------•---------•--.....-'--•----•••---••"--•-'--------•-""-"............................................................................. 0 Description of Soil....................................................................................................................................................................... x w Nature of Re pa' s or Alterations—Answer when applicable___. ` 4� �— f ....:.. - •--./ C �-�_. ...�r .......�:Irn -........-----•................................................•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has tseen issued by the board of health. ...........Z....23 Signed ................. '�,��'1,..................... . � _ (� Dace Application Approved By ...._......._l ,.N�5 ((( Application Disapproved for the following reasons: .................... .... ............................................................. . ........................ .. . .... ............... . . . ...... . ................... ... . . ................................................... . ....................................... Permit No. .......... ��-- � '..�.................... Issued Dace -------,--_-4--+-_-+ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE �erti irate of (11amplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ---------- .:Z+'.:.t.. ....../" I ` --.:... ._s. f`..._--------------------- at �.:`' _`i.. 1:..�..J 1. ...� / ......... .. ...........wtLJ. I. ...+.....----------. ... -------.------------*..............----- has been installed in accordance with the provisions of TITLE 5 o The State Environmental Code as described in the application for Disposal Works Construction Permit No. .._.._ .a�...�___�a�..L....... 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 �Ot �j ,l TOWN OF BARNSTABLE / 3 of FEE. -- �is�rnn�il nr�� niin�r�r#inn rrmit Permission is hereby granted-- --- '�-S .... .!1C= ---•-------- ---------------------------------------------- to Construct (�) or tepair an Individual Sewa e Disposal System (( Uj4_-j at No. �� 5 1 --------• - .. Street ( `.3 \ as shown on the application for Disposal Works Construction Permit �o...,.�-._5.�.�... Dated......:�_-�.��_.-�J�........ ........ Board of Health DATE................. l/ FORM 36508 HOBBS R WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRR�ATION f55 MAP NO. PARCEL NO. l V Oalvinwo ADDRESS OF TANK: ✓ •./ VILLAGE: Number MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : s' OWNER NAME: ~ f' 1 /% � PHONE: r7` INSTALLATION DATE: 7" r—BY:`t I INSTALLER ADDRESS: � CERT.NO. *TANK LOCATION: fA/ r'AIA/r,. \ �/ -.. - -� - CD60QRI'! YANK LOCATION. WITH, 1"1i®RMCT- TO HIJiZL`D7SfVm CAPACITY TYPE OF TANK .� AGE 5 YRS. ` FUEL/CHEMICAL TESTING CERTIFICATION C I PASS C I FAIL DATE LEAK DETECTION 141 CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C ] YES C I NO DATE TO BE REMOVED • FIRE DEPT. PERMIT ISSUED C I YES C I NO DATE CONSERVATLON C ] CHECK IF N/A DATE , BOARD OF HEALTH TAG NO. [ 6 ] DATE PLEASE PROVIDE, A SKETCH SHOWING THE TANK LOCATION ON THE . HACK OF THIS CARD '. r r� �� /�• 1 I _�_ _ _ i �OI` l P�ofTeeto�y TOWN OF BARNSTABLE OFFICE OF DAHI9TAHLE, =MAeQ. BOARD OF HEALTH t vooA 1639. `,�F a 387 MAIN STREET A• MAY HYANNIS, MASS. 02601 , 1989 p De r e' vat ��_r Enclosed is brass valve tag #_ _ _ Please attach to the fill pipe of your underground tank. You must do the following as indicated_ ---- Remove your tank. I have enclosed information for you regarding tank removal . • W - Have your tank tested starting !� . You must test during the 10th, 13th, 15th, 17th and 19th yNr and annually thereafter . Removal in the year I have enclosed information regarding tank testing . ** In I,I order to have your tank tested you must first contact an engineering company (see attached) to have a monitoring well installed. Once the monitoring well has been Installed you can then call 362-2511 , Ext.334 and ask for Charlotte Stiefel or George Heufelder at the Barnstable County Health Department, to have your tank tested via the Soil Vapor Analysis Test. Currently, the test is done free of charge under the auspices of an EPA grant. ____ Due to the unknown age of your tank we must presume it is twenty (20) years of age . You must have it tested every year and remove it by the year 1993 . To have it tested please follow the procedure as indicated above from the ** (asterisk) . on. If you have any questions please feel free to call meat 775- 1120, Extension 183 . Thank you, Donna Miorandi Health Inspector