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Home My WebLink About0020 CHECKERBERRY ROAD - Health Q61c b k 1 .. TOWN OF BARNSTABLE LOCATIONc?-DC�Ze---kG2.be2,�2 V RJ SEWAGE # i VILLAGE �` �� '� . ASSESSOR'S MAP & LOT :L6 , 0&3 INSTALLER'S NAME & PHONE NO. CNo'yi, dbiX/Sy SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ?4,� CAsr )?T (size) NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER/pU'z/,)/: B R OWNER /ASS T T DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: J VARIANCE GRANTED: Yes No n � � �� f �� q� J b '� V �`7� L�� $30 . 00 No.._. �?....y� FEB.............................. APPROVED THE COMMONWEALTH OF MASSACHUSETTS rn b1e,Consery n Depa a7 BOAR® OF HEALTH TOWN OF BARNSTABLE Signed �� ,Z ppliration for DisputialAVorks Towatrurtion lirrmit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 20 Checkerberry Rd Hyannis ...• • ------------.............. -------------------------------------------------- ...............-.........-........:................-.............................................. Mrs. Basset Location.Address or Lot No. w W.E. Robinson SQeR Service P O box 1089 Cen esrville ----.....-•-----•-------------------•------••-•---.....----........---•-•.......----------.------ .......-•-......................................-.........................-....................... Installer Address PQ 14 Type of Building Size Lot----------------------------Sq.,feet Dwelling No. of Bedrooms..........................................Expansion Attic ( ) Garbage Grinder ( ) `k Other—T e of Building No. of persons............................ Showers — Cafeteria Otherfixtures ------------------------- ----------------------------•••----•-•••--•--•--••••......--• .............-•-............. --------------------- 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. 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 Description of Soil................. ..........................................--•-•••••. x v ........................................--•-•••-•---•••••-- -••-••••---•-•••••-••••••-••-------••---•-•••-•-------•••••---..............---........................................................ w UNature of Repairs or Alterations—Answer when applicable............................................................................................... ......install---2...s.Qaepacke.d. g allies.--•--------------------- ----------------------------•-.............................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee is ed by the board of health. �i `Signed l..k l- ------ ------------------ ------------------------------------------------- -----�"/-- -u r� Date Application Approved BY .... Date Application Application Disapproved for the following reasons- ------------------- ........................................................................--------------------- ---------------- --------------------------------------- - -- ---------------------- ------------ ---- - ------------------------------------------------------------------------------------------------------ --------- ......................... Date Permit No. --------7.��....`.....Lf...?F------------------ Issued Date A-. s i � � �/ Q $30.00 No....��.........�. Fps .............................. ' THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE_ _.. A Iiration for i n tti ? park Cann./ �� xnr�tlan Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 20 Checkerberry Rd Hyannis ..... - ....- .._.... ....................................................-------------------------•....... Mrs. Basset ... -....... Location-Address or Lot No. ......................--.......................................................................... ..........--...................................................................................... W W.E. Robinson Soep'tic Servicd P 0 box 1089 Centerville Installer Address UType of Building 3 Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) WOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures .. WDesign Flow............................................gallons per person per day. Total daily flow.................................:..........gallons. W Septic 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.,................ ft. Z Other Distribution box ( ) Dosing tank ( ) `� �_l Percolation Test Results Performed by.......................................................................... Date......................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water____•--.-_-__•__-------- f14 Test Pit No. 2................minutes per inch Depth of Test Pit_-.____.---______--. Depth to ground water........................ Da •-•-•-•----•-•••-•--•--•----•-•••.....----•--•••••--••••-•••••--••-•••-•-•••-•-••--••------•------------------------------•--••......---- _----------.------ Description of Soil................sand................................................--------•--••---•--•-• , U .............................................------•------------------•----------------......-----------•-----------------•------------------------••-----------•------•--•------•••---•-••------- W U Nature of Repairs or Alterations—Answer when applicable----------------------.......................................................................... .....Ias tall--Z---s-tQ epacke-d... allie-5-------------------------------------------------------------------------------------------•----.....-•--------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hWbeeis. d by the board of health. Signed---- -t ... ..........- :...1— Date Application Approved By ............. � ^�a----- . ...--------------------------------.`......--- ---- Date Application Disapproved for the following reasons- ---------- ------.......................---------- -----------------� ........ -------------------------------------------------------------------------------------------------------------------- ----------------------------- ........................ ----- --------........................ Permit No. ....... .--`--- -. '---------------- Issued -... Date Date ----------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (�erttf rate of (�omplianre, THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x ) by W.E. Robinson Septic Service ---------------------- ............--------------------------------------------------------. ---- Installer at ....20---- he.ckerbexry----Rd--------Hyanni-s-_- -------------------------------.-........--.....-------------------------...-------------------.--_----...._---------... has been installed in accordance with the provisions of TITLE 5 o he Stat Environmental Code as described in the application for Disposal Works Construction Permit No. --------- - -----.-I--- --- 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 3_1'7F TOWN OF BARNSTABLE $30.00 No..... ................... FEE........................ Rspo 1 n � inn nr$ilan anti Permission is hereby granted_.-W.E, Robb.?L 4?J2_..Septir._..Smartt:i.-aA......................................................... to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at No.._20...C•••eckerberry__Rd-jjy_ann s_________________.- Street n_` 7� as shown on the application for Disposal Works Construction Permit No.. .............. Dated........_................................. ----•-------....................................... `� Board of Health DATE �( ( 3 3 FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS