The URL can be used to link to this page

Home My WebLink About0111 BUMPS RIVER ROAD - Health �� w` s lie% , , �� , � �� 13 � � � r-� _ . ___� Cz/40"N TOWN � ((��OF BARNSTABLE LOCATION L o4 15 J�^^ . ' \�1�v� Q-&j� SEWAGE #�Z5- -ZR VILLAGE Os-f(,JA� ASSESSOR'S MAP Q LOT INSTALLER'S NAME & PHONE NO. II' SEPTIC TANK CAPACITY If 066 20400 LEACHING FACILITY:(type) �.�jG� (size) �yd javW� NO. OF BEDROOMS 3 PRIVATE WELL O PRl UBLIC�WATER BUILDER OR OWNERG��S �� IJ �d��N� 771'0�9`� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No �" II I P"eve, Ll Sy � �l3f7 �$� F AS9SSORS MAP N0: PARCEL NO: No......................... Fps. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Allp iration for Biivipwml Works ( owitrurtinrt ramit Application is hereby made for a Permit to Construct ( Ll<or Repair ( ) an Individual Sewage Disposal System at: M �3 ...............�..------------------.�..�/Z�h----•-----..........--•---... 0: n :1ddr nJ^ or Lot No, ;. W � w er c��e ` J--Address Isis ller Address �/ ff d Type of Building aA'h5 , ;C"fW Size Lot_.... A.,?--�/...Sq. feet/ U Dwelling—No. of Bedrooms............... _Expansion Attic (kO) Garbage Grinder (A10) `a Other—Type of Building a yp g W_ _KLA"- No. of persons............................ Showers ( ) Cafeteria ( ) 04 Other fixtures ------------------ = -- W Design Flow...................110----------------gallons per per day. Total daily flow--------------3. ( gallons. WSeptic Tank—Liquid capacitv_l..�.�_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 nk ( ) Percolation Test Results Performed by-.-- %mil�f.-�� :,[ ---------;----------------------- Date...._`� Zl-� - -----.._.. Test Pit No. 1... -----minutes per inch Depth of Test Pit....f. ......._._ Depth to ground water.... UI� Test Pit No. 2................minutes per inch Depth of Test Pit-__.__--__.________- Depth to ground water........................ - - - - Description of Soil----- ------------••---------------------------------------------- -------- ----------- ---------------------------------- x W VNature 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 TITLE 5 of the State Enviro mental Code—The d igned further agrees not to place the system in operation until a Certificate of Com i ce h s ee i sued t e oard of health. Signed .... ................. ... .. ------ .............-- . ..........._. Application Approved G - .�1.�r� - ------------- ---- --------- -------- D e...... .. �� Application Disapproved for the following reasons: .......... ............... ........................................_..........------------------------------ ------------------------------------------------------------------=�-------------..........-----------....._----------- ---- ----- ---------------------...--------------------- --- ----- ---------------------------------------- Da Permit No. ....�- _�--------------- Issued ................... .. ............. -, � Dace _---_—_---_._-------__._—_-_---__._.—_—._—.—_--�--- 'R I� 13 Fps.: THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �\ TOWN OF BARNSTABLE Appliratiou for DioVo!3ttl Works Cfouitrur#tun ramit Application is hereby made for a Permit to Construct ( L11"or Repair ( ) an Individual Sewage Disposal System at, 4-� /A .... ....... ... ---._............. ...--------••----- -•-•-•-•-.led._...._... 'bcat'onF i\ddre or Lot No. I Address Omer -- Iusall 1 ------er------------------------------------------ -----` ---------------------•-- Address-----------------------•------------------- Qa l�l �� / d Type of Building �o�rl �G - Size Lot-----..__..�______________Sq. feet aDwelling— No. of Bedrooms____--_-_.r ............... . . Expansion Attic ( (i) Garbage Grinder (ruv) lth'KI�✓.1 -- No. of ersons--- ----------•--_--_-.--. Showers — Cafeteria p-, Other—Type of Building _ _ . _ .__ ._.._ persons-,, ( ) ( ) Q' Other fixtures ............................... . . d .. ------------------- ----------------------------------------------------------•-- W Design Flow...................//0..._............gallons per peon per day. Total daily flow--------------3�_____.___._---__•--gallons. WSeptic Tank—Liquid capacity.MM.galIons 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 t nk ( ) ~" Percolation Test Results Performed by.---'/ --..-?G.=`.•r---------------------------------- Date-----1E---Z� .��--------- � a Test Pit No. I... .._..minutes per inch Depth of Test Pit----/_2_t__....... Depth to ground water_._A10ME__._. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_.____....----_-----___. --- ,, /�' --- D Description of Soil <4 Pi! �--•-----------------------------•-----------------------------------------------------------------•---•------------•-------- x 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 TITLE 5 of the State Environmental Code—The d igned further agrees not to place the system in operation until a Certificate of Comp`ilnce has bee issued b t e board of health. Signed ----l_-h}:.----- ------- --------- ------------------ ----------- Application Approved y -----.--G - a- ----------- --------- ''. . Date Application Disapproved for the following reasons- --------------------------------------- ------ . ..... . ...... ...................... ------------------ .... ......... . ............................ .............----------------------- -----------------------------------------... .. ........ ....... � - Date �" Permit No. � .r�. l----------- Issued ................................................� ...... Date ------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE >t (Ilertifi ate of 11�IImplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ✓ ) or Repaired ( ) by .f�12/SCO ... - ------------------ --------------....-------------------...--------------------- ...---- .---------- ..--------------_ ............................................... h,t:utt at -----G, _r....._13----------�..�- _. ._1 -... f............r�' ......... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....... .....a�._�._ ... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACT-ORY. _ ;�- - - � �9 DATE. .. . ..... Inspector '.. �•�',��-..,_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ............... �io�rno-tt�—l� ��ano�r�tr#�ion rrnttt Permission is hereby granted ��J...._ •.�- - U� --------------------• ---------.. .............................................. to Construct (L/) or Repair ( ) an Individu 1 Sewage Disposal System at No..�_d....•••Z-a------��5T W= ? 2 .............Ab....... .0STEP-V f-L -- ------------------------------------------ Street ,4, ��ated__ :'� �. . as shown on the application for Disposal Works Construction Permit ................................. --_��-----------•----------------------------------------- Board of Health DATE....................... _"------- $ ........................... FORM 3850E HOBBS 6 WARREN.INC..PUBLISHERS vATA SM� F�•GtIL_Y 3 $t=-cQcr�n�ts ��' . PA I L-( FLOW -3x 110 SEPTIC TANS 3 c�Xfso s6PD DISPoSA PIT j-loppaL Z r 57p,�,� 5IDEW4L AwaA 166 sF . 1�Y�. 5F X.Z S :•�l-�o �p� 75 SF x 1.o s -Tg _ -43LWtp5 Z Vram.. ZAt> 1 ¢�ioLAT1oN ATE. = j"Mqml) /�f OF orD RICHIRD 0AXrFR PETER No.240;0 l; SULLIVAN ��Cra"T�F4� : ;•'; ' N0. 29733 Go l N a_ TF LoAal Win— dKT lD� � r�J IN V. .. j sarr�/ 1vco' INS r�� B �u� (wv• S6A „g s� SG d CK 5L e i WLT {. WA49®. kr -5rzLx zc-) SST -TOU 'OE nWsl 44•'DES. 6 :24 I� -rL EL=-4;, �1 o scams Lo 'r_ Igo I ei Li Fk)pbS C I �-GZTYFY TJAdT TKE -bLuE--,r_ 4 W, PLAN =RQJCE�. �ow N N�oN c..oM'P�YS yvrt't� T41�PamG 4, afi , &�1` D N op�aS�( 813LL-o 2, X' E2Z "7 E s • 1, NYE 7�IlS I�u ' 1S Nat- �3ASEJ a.1 AN �� . •SSrorJe.L"cdl�...st��✓Iryces :. sutv✓�y �JD rN OFF 1�15T�tE�T'SET" 4 4ouL,D our a ��vIL_ MJ41NEEz5 �STQ ,L'5' PErzry �.,uE5 ST Y=-r2-/Il-LE MAS4 . dPPLIcQN-�-;�R�{SiD� �cJ1LD)�1G C�, �� o _ 2 2 _ J - �f t3�►LaitJG Co• I S/ \ c 10 i o Ln Ade ,p q P� °P ELL ., rr Q ,_ 4Ae� I f 2¢I.7s ' Id / . I � OF y PETER RICHARD SULLIVAN A a,C v BAXTER �'�'' ISO. 29733 No.24043 r ON EN 7r ;;,