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Home My WebLink About0097 EDGEHILL ROAD - Health 9'7 Ed9eh� U R1., is a /03 s.• Ys..yR TOWN OF BARNSTABLE LOCATION 7 SEWAGE #�b VILLAGE 1 ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 4LEACHING FACILITY:(type) (size) Md NO. OF BEDROOMS 7 PRIVATE WELL OR PUBLIC WATER M BUILDER OR OWNERa4zdl"� DATE PERMIT ISSUED: DATE . COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No pal � d r 1� tN S 7 No......la&:J9 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ApplirFa#inn for Ili,gpnii al Workii Tomitrurtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( "--an Individual Sewage Disposal System at Lb •(fAosd_.....--�� -------•••---•-•.................•--------............-------•---------------...............-- V L ca' n- ddre or Lot No. W vi/x-(�dG[Fj •' � �-di/ io�L4G.� Address ... a Installer Address Q Type of Buildings Size Lot............................Sq. feet U Dwelling Z 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. 1:4 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 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___________-•-_•--_-___. Description of Soil..........V x U W -----------------------------------------------------------------------------=---------------------•--------------------------------- -----------•----...................................... U Nature of Repairs or Alterations—Answer when applicable......, —ll _------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TIT E 5 of the State Sanitary Code—The undersigned further agr es not to place the system in operation until a Certificate of Compliance has bee issued b the and o health. J / Signed r ✓-- t .------•••... - .. Date ' Application Approved By•-••••••---•--••••-•-•-----•-••------•••....._. __ _ .......a Date Application Disapproved for the following reasons:......... ........................................................................................`_:...._..._ -------•--•----•----------------------•---------•--•-------------------------------.....---•---------------••--••••--•-----•----•-•-----•---•-•-•••-•---••--•---•••---•-••--••------------••--•••---••-- Date PermitNo......................................................... Issued....................................................... Date No...............--.....-- Fini............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Uispvii al Works Tonotrnrtion 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair ( t } an Individual Sewage Disposal System at:- Al -------------------------- ----- •--•-• ----------.. .... ... .......------......------•....--•-......----- ----•----.........._...----------------•- Location.Address r or Lot No. Owner Address Instaier Address d 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 ( ) 04 Other fixtures ------------------------------•• w Design Flow............................................gallons per person per day. Total daily flow-------_....................................gallons. 04 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 ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water-----------------Date.---------------....._------------__---. ____--. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ...•••-•••-•----------------•--••-••••--•-•--•--.........--•••••••••-••-----••-------•---••--------.......................................................... 0 Description of Soil....................!.......... --------••--...-•------•-------•---••••-••--•--••-•-----•------•-----------•-•-•••••.................................................. w UNature 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'TILE. ; of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed---------------- -----' . .,... ... '--.:.: -` Date...?`..._._. 1 � Date Application Approved BY Application Disapproved for the following reasons:....__�___................................................................................. Date...............-- ...............................-......................-•••--•----------•---•--••......----•-••-••--•..•-- ------------------ Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' %' ...:' Ae TntifirFair of TontpH atta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ....__....: -•--••..................•-•--•---....---•--......•. -••••----••--------•-•------•-•-•----•----........-•-----•---•--•••......--•---••---•---•--•••- Installer,. at•-•---•--•-•......-----•--•••=-................ ------------------------------------.../............-- has been installed in accordance with the provisions Of TITIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... ......... dated------.=t:C THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................. i..-.)......................... Inspector.. --------•---------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , f r ..............0 F.::� •' °t s€sE"c<., x .'.p rF -46 I.............................. Bilivia .a1 o � o nr#io eranit Permission is hereby granted '- ..................... .. . 6.9 to Cons r �Re r and Ividuewas osal System ( ° P !� g P Y ati�TO. � .. .... — •--•------' ---------------------------------------- ....... • et as shown on the app ication fo isposal Works Construction Permit No�___��?�.�?__ Dated.._..°. _y�.� _... ................................................ .............................. - / 0 / � � Board t" ealth�•"� DATE............... •--•-•....... ............................................ /� r FORM 1255 HOB S & WARREN, INC., PUBLISHERS (f