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Home My WebLink About0082 TERN LANE - Health 82 TERN LANE CENTERVILLE A= 212 -009 S M E A R KEEPING YOU ORGANIZED No. 12534 2-153LOR SUSTAINABLE FORESTRY MIN.RECYCLED INITIATIVE CONTENT 10°k Cartified Flier Sourcing POST-CONSUMER w .Oiprogram.org s�4otivn MADE IN USA lZET ORGANIZED AT SMEAD Cam! F, ' 'C I TOWN OF BARNSTABLE LOCATION 82 TERN LANE SEWAGE # Qq— '( 7� VILLAGE C E N T E R V I L L E ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ELLIS BROTHERS CONST . CO . 362-6237 SEPTIC TANK CAPACITY � u LEACHING FACILITY:(type) I ty'Fjt-Tw-vy 'e,,-- (size) '3 X G NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER }�� BUILDER ORZVRER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED• --. qZ` VARIANCE GRANTED: Yes No wj, Sp �,p SIDE of 144�� i u 8 00 No... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Xplifiration for Dijrpomul ]Vork!i Tonotrnrtion hermit Application is hereby made for a Permit to Construct ( ) or Repair (/an Individual 'Sewage Disposal sy � VOW Lortti dress 7 ,,,, l 1t �N�o. �9�( 'e/ ._-------------------24. rr.rn-Ste!-.........._..._ ..: lY=C/ ..e!!!: IV—A IZ/� O cr C�J'l/Qddress Installer OKddress UType of Building / Size Lot........................... q. feet ,., Dwelling— No. of Bedrooms------------9' .._`--------------------------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. OG 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 ( ) 14 Percolation Test Results Performed by.......................................................................... Date........................................ ,.a 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........................ 0 D,escriptibn of Soil........................................................................................................................................................................ W --�............... ................................ - V Nature of Repairs or Alteratio s—Answer when applicable ___.`� Agreement: The undersigned agrees to install the,aforedescribed ividual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmen Co —The undersigned further agrees not to place the system in operation until a Certificate of Co plia h een issued by the o r health. Sign1................. ... ......... .e Application Approved By .............)4 .� e ..-,.......................................-----------------------------. ........6.-- Date Application Disapproved for the following reasons: ............................... ...................................... ............ ................................... ........................................ .........qq........................v............... . --.. .... ............................ .............. ...................... ........................................ Date Permit No. .........`.. ......... ..... ................ Issued .......................................................... ................................... ...... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired has been installed in accordance with the provisions of TITI.E 5 of The State Environmental Code as described in THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SAT5FACTORY. DATE................... 6-7-7---------------------------......... Inspector ........ .......... ................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Permission is hereby granted-- — Sewage a 'hown on the application for Disposal Works Construction Permit Dated......... �� - / /� _--__. ^' Board DATE................... ............................... TOWN OF BARNSTABLE � LOCATION 82 TERN LANE SEWAGE VILLAGE C E N T E R V I L L E ASSESSOR'S MAP & LOT J;�,-60 INSTALLER'S NAME & PHONE NO. ELLIS BROTHERS C O N S T . CO . 362-6237 SEPTIC TANK CAPACITY � a + LEACHING FACILITY:(type) I N'FlL.Tw_AT60%- ,(size) ,I)< (o NO. OF BEDROOMS PRIVATE WELL OR PUBLIC;yWATERAAL�c- BUILDER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: n qtll VARIANCE GRANTED: Yes No e {.Rt SiDE OF E-Eoosc' r I � 1 I a' 00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF, HEALTH TOWN OF BARNSTA,BLE" Applirtttivn for Diripwiui lVardw Toluitr'urtiun.r0niit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal /V <�&� ---•- .....••-- Locati it \ddretis yr Lot ` �''L:.1� t/�r! moo! ' 'o '/ �'"°' =' ..---°�=�....,f..................,�C {✓..�-L;c'/....... _.__ �- 0 wy.her Address � Installer y^�s �� UType of Building Size Lot.............................. q 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 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. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ � T Gz., Test Pit \o. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ it+ •-•-----•----------------------------------•---•----•--------------••---•---••-----------•--•-•..._.......................................................... 0 Description of Soil........................................................................................................................................................................ W ••--•--------------------- ----------------------------------------------------------------•-••••......•••....--... --------•-----••-•••............................................................. UNature of Repairs or Alterations Answer when applicablejy��' S !�1_..r ..�.t.. . etc 4. •. ... '-• .t. rt !l!_._��L_ .jl fat —� Agreement: The undersigned agrees to install the aforedescribeedI•ndividual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Coda—The undersigned further agrees not to place the system in operation until a Certificate of Compl_ian�ee has�been issued by the/board'.f health. Signed �.............................. -`" %� ------- ``�........D............ /J (� Dace Application Approved By ............. 4...M-��.,.....\. -..-,..,,.� ....... ............................................... ........fez_- Dace Application Disapproved for the following reasons: ..........................................................-- .. -- ................-- . .......................... ................................ ............................................. ............................................... . . ........................................ ........ ........................................ Dace Permit No. -----q �'.(.......{.....-.. ...�..7..�t ................ Issued Dare