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Home My WebLink About0015 LIMERICK COURT - Health 15 Limerick Court Centerville A = 169 — 079 �. TOWN OF BARNSTABLE \� LOCATION /,J' Ate= �G�,�,�' SEWAGE VILLAGE ASSESSOR'S MAP & LOT �,�-e'ti > INSTALLER'S NAME & PHONE NO. l/ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) —' (size) NO. OF BEDROOMS —J PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No � ? ` �� ,® y g � '� P� � � � �s - 1 i\ °RUES_ NO No................:.i...� Fps:.�O.GM.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - --------------OF.. ... d♦..G l"O.1w ............................. Appliration for Di-4pas al 10orks Tnnilrnrtinn thrutit Application is hereby made for a Permit to Construct ( ) or Repair (41 n Individual Sewage Disposal System at: .........4,0tZ ------------------------------------------------------•-------------------------•--- oca'o dr ss or Lot No. a............... •-------•-•-------------•.--•-.._....-----....._...............•---._...._....................._.. -•------------•--'..............Address ........V -.......... 44-c � le'-�------------------------ ---------•- ---------------------------......---------- Installer Address dType of Buildin Size Lot...............-------------Sq. feet 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. 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---------------_---- rX4 Test Pit No. 2................minutes per inch De th of Test Pit.................... Depth to ground water........................ � ------------ ------- ------- O Description of Soil------ ----- x 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 i i T L p 5 of the State Sanitary Code— The undersi ed further agrees not to place the system in operation until a Certificate of Compliance hahbDeen ' ued by the oa of he h.Signed -� Date Application Approved By.. {. .... ................ _ - Date Application Disapproved for the following reasons:........................... .......................... ............-........................................................................................................................................................................................... Date PermitNo......................................................... Issued........................................4............. Date y PJ 9/ No........................ \ Q�9' Fes$.. �_......�...... THE COMMONWEALTH OF MASSACHUSETTS j BOARD OF HEALTH Appliration for Disposal Works Tuntrnrtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair ( 4* an Individual Sewage Disposal System at 1 ......... f 1 i,Aocation Address or Lot No. ........................� °".. ........p a 4........................... r W / 4 Owner Address Ar, ---- . ..................... ------------------...--------------------•------------------------------•-------------------- M Installer Address UType 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 .---•--------------------------•--. 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 ( ) aPercolation Test Results Performed by---- -------------• Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (X, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... a = .................................................................................................................. 0 Description of Soil...._ ""` ^'••° _=� � ... -----•---------------------------••---------------------------•••----••--•-------......---- x U W ----•------•--------------------------------------•----------•-•-------•-•--•--...---••••-----------•-------•-----••-----------••------ -- ------------------------------------ •----•------ x Nature of Repairs or Alterations—Answer when applicable '`%''' '" '_ , ?________________________________________________ U P PP ram'`= --------•-----------------•--------....--------------------•-------•----------------------•-•--------•-•---...------------------------------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iTTt.. p S of the State Sanitary Code— The.undersigned further agrees not to place the system in operation until a Certificate of Compliance has beennf issued by tfhPpe�jblo far`.of /health. Signed-- ....... / Date � .: ApplicationApproved BY ... .........................rA_`--.............................................................. .............------ ................... Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------••.......... ...........................••---------------------------------•------------------------•---•-•------------•-------------•--------------------•-----------•--•------------------•------•---•-•.......... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �•'. /!r ,.� ...OF....oEi':: ::................ (9rdifirttte of Tumplianrr T Isho RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (a b �stfP; /' •------- ----------- ----------------------•-----------------• -•--------- Y :...._..... � v Installer 'f r r ti has been installed in accordance with the provisions of TT i' � of The State Sanitary C�d as scribed m the ........................ -application for Disposal Works Construction Permit No........................� _ _..__ dated-__..�`. .__� .. ' ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. lDATE ••� ......D...�........-•••-=-----•............. Inspector.................................................................................... r 6 01y THE COMMONWEALTH OF MASSACHUSETTS BOARD Off' HEALTHH No....&6` 1-�� FEE.. .�,.'-'•�-^.mow � '�,G; ........':`.r�.�r:��,..i`,�,,,,•�.......OF....�..�„re!��'�.'�..�-'. ...�:.�`.:' �....��.�................ ...................... �i��n��a� �rk� �nn��rnnr�irrn fermi# Permission is hereby granted.................. --............---•-••--•-----------•-----......----•------------------••--•--------------......----------.............. to Construct ( ) or Repair ( )'an Individual Sewage Disposal System atNo............................................................................................................................................................................................... Street as shown on the application for Disposal Works Construction Permit No.86=) -24 Dated.............. ._�j._.. Boa I123rth DATE............11-- 3.. _?L,.6•---•----------------------------------- FORM 12'55 HOB S.& WARREN. INC.. PUBLISHERS