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Home My WebLink About0177 BISHOPS TERRACE - Health i�"7 1�� Tarr - -- - - dSl �i�� TOWN OF BARNSTABLE LOCATION 17 7 -ZN Ao ns`r�I c.;c: SEWAGE VILLAGE S' ASSESSOR'S MAP LOT -T,,TLt_.s? INSTALLER'S NAME & PHONE NO. .�� S SEPTIC TANK CAPACITY t=2�o%c-~C ��i U-?n cf e i g%rvc t crop Ar LEACHING FACILITY:(type)__�� c a sr pj (size) 1 GpVv NO. OF BEDROOMS PRIVATE WELL PUBLIC WATER BUILDER OR OWNER . )2 DATE PERMIT ISSUED: - - DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No t/ 66 r _ or r1 s No .»...._. F$s�„b THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF ' HEALTH >..h^'`...........OF.....7&,Yly!t-.SQ qc` .-f........................................... Appliratinn for Bispnsttl Vvrkstvnstritrfivtt f rrntit i Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual. Sewage Disposal System at ............... ------- ;gA .......mc.efz �9=. ........................ -------------- --Locat'on-Address or Lot No. . 1f�Sty.0.............................. s ]>4 ...... Owner Address i ..r Installer "•:: Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms....» .Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No, of persons............................ Showers ( ) — Cafeteria dOther fixtures ........................................................... __.._........ .-- . WW Design Flow.::-..... .....................gallons per persbn',per day. Total daily flow........-�- _0....................gallons. WSeptic Tank—Liquid'capacity....._._....gallons . Length.............0.. Width................ Diameter................ Depth----------------- Disposal Trench—No._J-------------- Width................ Total Length.................... Total leaching area...................sq. ft. r 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. 1................minutesp er inch Depth of Te`st Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------------------- --------------- ...........---......................................................... ....._.... Descriptionof Soil. ... :................ .............................•-••-................... V -...------------------------------------------•----------------- W ..........................................----•--••-•--------------•------------......---------------- -•----...-------------- --------------.-------------------------------------------- UNature of Repairs or Alterations-Answer when applicable........... `!!�..........0.?ti............ '..... ................ ....... ...........270........ ..................... Agreement: The undersigned agrees to install the aforedescribed"Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code The undersigned further agrees not to place the system in . operation until a Certificate of Complianc issued by the bo � h. Sined........... ate . Application Approved By............... ... .....��_f.... .............................. •-•-•------- ............ a,e g� v . Date Application Disapproved for the following reasons:...................................................:...........................:............................... ..................•----•-•---•--•••-••--••••-•-••••••---•-..... d� ......---.....--•---...------------------•••----------------------------------••------------Date---........» Permit No..__- L b ----••----------------------------------_.... Issued..--•----------�.`: _..--------:..................._ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .w...-(.............OF......1�s..... K !'P Appliratinn for Disposal Works Tonstrnrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...............1- y)r.......T:f ! .( ..... I=' '_ 4: :: !_,c;......................._.................. -Location.Address ' or Lot No. ............................... ......................... 4.!:! ........................_......-------....-- `� Owner Address w \G� c a-------_._•------•---------------^_-_----- --_^............. d.r.:�.FS.C:.. .:1.._ .......__............^--................ ,-a --...-•---•--------. ------------------- -0_ s Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.__.. ..............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures ................•------............-----------•---•--..---...-•------=--------•-•••••-••-••---••-•--------•--...._....:..-•----....--•--•----......... WW Design Flow.......... __.............................gallons per person per day. Total daily flow.........3---. .n..................:_.gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................. x Disposal Trench—No:-----I.............. Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No......./........... Diameter.....1 h./.... Depth below inlet.......—n."._._ Total leaching area.................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by......................................................................... . Test Pit No. 1................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.........................•------•-•------•------------------•-•-•---•------•-----.........-•----•-••---•---------•-•-•------•-...........-----------------•......----•-- U W .............................................. . -•------•--•--••--------------••--------•----••--••-••--•-•----------•-----••._...---------•--•••..._...--------....---............................ - U Nature of Repairs or Alterations-Answer when applicable...........Y-1'rLD:�2......... .......... e!T..... Agreement: J The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliances has-•been issued by the boardof health. \ -- .._,_ c/ �`F:. �� ------------------------ Signed �'r . /.v, s�'- ------• --• Date Application Approved BY / �-_.--:.—............. . .........�'.��.......�....'. r Date Application Disapproved for the f ollour ng reasons:...............:..........................................................................................___ --•--....------•----------.•-------------------------•-•-•---•--•-•--.....--•------.....-----.................-----------------------------•......-----•-----.............-----•------------•--------•-- _�� i Date Permit No......= = r -�t�� ..... Issued-.---•-•--•-•-...� . Date ------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7_1�1—h l c� S-r- ( i ..........r. s ......................OF........ „-.p4........ ............................... Trrfif iratr of Tontplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by............. _--••----`. _�_ _� �'......... . ----- - ----•-----•......................•-•-••-•------••----------•---•--................_ _ v Installer at-- --•---.... .......1 y.S L C>C_...T�•,r y�_`= `=-------------•-- ..ti....................................................... .... has been installed in accordance with the provisions of TITLE j of The State Sanitary Co.e as"described in the application for Disposal Works Construction Permit No...... dated.......... .`� � ` ........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE. SYSTEM WILL FUNCTION SATISFACTORY. DATE - .. l Inspector....................t1� -•-•--.L._...cx------•.......................••-- �! _--.......---•- .._..._...._............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH7- 1 ( / No.r�............... FzE........--_ ........... Disposal Works Tntistrurtion Vrrntit Permission is hereby granted......--�......�AA� �.................................................................................... to Construct ( ) or Repair ( c..)�an Individual Sewage Disposal System at No.. t `7 f _ t� ,_ _TK ;_:Z_- � �tc�t'� _---------..0........ .............. _. 4 .....__._....._._..._•---•-----_-...._..._.+................-•-•...._..._._....._._................._.................. Street _ as shown on the application for Disposal Works Construction Permit No. ;�'-''P-4-D'ated.._�j`-.�/l`:.�.......... -�" ' ,. Board of Health , DATE .................................................-••---•-•-.