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Home My WebLink About0260 BISHOPS TERRACE - Health QG OTen- TOWN OF BARNSTABLE LOCATION SEWAGE # ,R-`Z VILLAGE 4kjO 0 w ASSESSOR'S MAP & LOT ��-�&jg INSTALLER'S NAME & PHONE �t,SEPTIC TANK CAPACITY or-� JO LEACHING FACILITYAtype) ��C\. `� size) Ot"► 6 !'I NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER .D-BUILDER OR OWNER Me- DATE PERMIT ISSUED: a-] " 9 {I DATE .-COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r t i � � � g �1 � � -- ---- N i f JSESSORS MAP No: 'ARCEL NO.: . �^ -No ..._... `-' I Fus.t:.. ...: ........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -------------OF....................................... a AV iratilla for Di-gVvii ai arks C onstrurtion jJrrufit Application is,hereby made�_.o_r'a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ley ,��. � • �'� � catiLn• dress � �� r Lot No. �1 ..............�..... ................................ ...... ---------- . Owner Addree a Installer' Address UType of Building Size Lot...........:................Sq. feet Dwelling—No. of Bedrooms...............:..................•.._......Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building A.. _ YP ,g '-=------•------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures W Design Flow..-:..V,- ..........................gallons per person per day. Total daily flow........_7>... . ..............gallons. WSeptic Tank—.I squid capacity .gallons Length................ Width....._._.__._._. Diameter................ Depth................ x Disposal Trench :�?o. ........ 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 T _...:.,minutes per inch Depth of Test Pit............... Depth to ground water_-_________.___._.-_-.-._ ;\0 1 .__ 44 Test Pit No 2 _.. ..._:_._niinutes'`per inch, Depth of Test Pit............ .... Depth to ground water..................... ... -------•--••----•..----- O Description of Soil............ _. .........,,� ---- - - V . Nature of Repair's or Alterations Answer whe applicable __ _ ____ �• _.______C�.S__ ___-_-_ ___••-•_ Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of F.:c" p 5 cif the State San* a Code—The undersigned further agrees not to place the system in operation until a Certificate of, Compliance as en iss ed by the board of health. �. �................. .. ................ ....... .. �- ate .... Application Approved BY -- ......... �'✓ ...:..... ........... ..................... Date Application,Disapproved for the following reasons:.••• -- ------....--•-••••------•••--•-----------•-••--•-------------------------------------_ ------------• •-•--- ------------•-----------•--•-------------•---•---------......... ------------....--•----•------- -----•----•................................................... Permit.No. _.. �......�.---•/...0.. Issued Date -- -- --1-� a No................_.. rA� F.s .::'...... ....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........................... ' ....----....OF................................_....... Apptiratiuu for Disposal Works Tunutrnstiun thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual.Sewage Disposal System at: ! .ba ,# t 1�3 i- hocat?on Address i or Lot No F Ownez' Addr�sNrl � / (y ................................ � --` •-------- -----------•-----._. ..Installer---._:_. ._.......----- -•--- Address ---�-•----•----- d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......... Expansion Attic ( ) Garbage Grinder ( ) 4 Other.—T e of Building No.. of persons............................ Showers — Cafeteria 04 Other fixtures ............. W Design Flow.._Z2L ...........................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 ( ) aPercolation Test Results Performed by.......................................................................... Date...................................... ,� Test Pit No. I..............:.minutes per inch Depth of Test Pit.................... Depth to ground water--•____-_____--_-_-••_-. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water._..._-____-___-______-. - s D Description of Soil.......... .�..�" a'Zi� ^-• -- - ------- .--_-_--.--- U W -•-----•----------------------------------------------------------•-----------------------------•--- U N�ayture of ReRpairs or Alterations—Answer wheq applicable.._ � �� .__.._ ° ........C!'__:4 j ?? �i .___ :_... „„ 4 .:� ..",F......... ..... .... ..... ... ................................................. ..... ...,....... �5.. .:... ............:......... ........ ............................F.............._.__._..___._._ '-_--__..____.._.___..._ ..e ._.L).. Agreement: The undersigned agrees to. install the aforedescribed Individual Sewage Disposal System in accordance with �T T' 5 of the State Sa itaY.�y Code— The undersigned further agrees not to lace the system in the provisions of 1 T t:. , g g p y operation until a Certificate of Compliance ask been issued by the board of health.g � j �4 ✓La.,... 4 9 »w g� rt :db,.q,.yq "2 ...................................qq ......... ....... ................ ._. r ._ _... { t t 0 IMF i fb pate f aJ9 t9 Application Approved By l ' J Date Application Disapproved for the following reasons:------•--------•----•-•----•----------------------------------•----'--------••-•---------------•----------•----- ..-•-------•--'•-•----••---•----------............................I - Date Permit No..........EL_------ -----------F Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS ...-- .-•-•-BOARD._OF HEALTH Y \ ................ ........r.^'iJA................................... Trrtlfiratr of Tompliaurr T "` I TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } by ��> k_. ._.. _.i: 4'...... 1 _r is L`-----lC`C'�-................. ............. ....•----...............-----•..........-................ " i Installer at =•a r:? k...._.... has been installed in accordance with the provisions of TiT,.IE, 5 of The State Sanitary Code as describedin the application for Disposal Works Construction Permit No. ------ ,------- _. dated ':; --- ' .____._ ------------ TFIE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. 'DATE..................... ----•-•------------=------------------------- Inspector,..------............---.�_.-------------------------------------------------•--- !11 2 r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF.OF,. HEALTH r K J !.... ! i.. .:..............OF..... ..... ........ -::_..... i\O�=• rl:.z. FEE........ ......... Disposal Works Tuunstrurtiun Prrmit Permission is hereby granted.... f....._........[t . ...- , to Construct ( ) or Repair ( ) an Individual Sewage Disposal S ; tem .__ » •Y.� 'ti -Street { , � � a - as shown on the application for Disposal Works Construction Permit N� �4 Dated _ b, —....................., _._ R• ,,,. .............................. ....---......... .. _..... _.._...._ ............. r� -» .• Board of Health DATE - _C:1_ )-.A''� ' ---•-.............. `. FORM IG55 HOBBS & WARREN. INC.. PUBLISHERS ' t