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Home My WebLink About0006 CINDERELLA TERRACE - Health Cc 1'1'1ctrsTonS m i I I n TOWN OF BARNSTABLE LOCATION ('c /Lf �"G� Cs�_ s SEWAGE # r2: VILLAGE M Q rSh ASSESSOR'S MAP & LOT a 1°7• —'U�}`d INSTALLER'S NAME & PHONE NO. Cj aSs 9 QQ,4 —\lei SEPTIC TANK CAPACITY 0 c LEACHING FACILITY:(type) [000 rcAL, (size) NO. OF BEDROOMS 7 PRIVATE WELL OR PUBLIC WATERpr-1,/�„�{ BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r use-- THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE ApplirFation for MijimFal Workii Ton.9trnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (Kan Individual Sewage Disposal System at: ...---..:btrr.._....�`!! ►.5.� ....... ...... . ........... Location-Address F - c1-c,.......1_�.�.�.LJ\4. �� ...................................... Owner Addres aCAS. .._. - -.`S.�.c-- ---------------- ------ �� -- ,- ... _ .._..C.a:. - Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......... _Expansion Attic ( ) Garbage Grinder ( ) 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 ( ) Percolation Test Results Performed by..................:'....•••-•-••-•••-•-••---••-----•-•-••••-•--•-•-•-••-.. Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-___-__--_______-----_-- fTA Test Pit No. 2................minutes per inch Depth of.Test Pit.:.::............... Depth to ground water........................ Ri _..._____-•_________________________________________________________________•-............_........_......................................................... 0 Description of Soil......................................................................................................................................................................... W V --•-•-•--•-•--•--•----•--••••-••••••-•-•-••••-•-......-•-•-•-•-••••••••--••-••--•••••---.....-•-•-•-••-•••••---••----•-•---••---•••-••••--••--•-•-•-----•••••••••-•••...............•-----•-••-••----••- W U Nature of Repairs or Alterations when a plicable------- ra�� .:�1.........Nh.._....\-(,— _0.... . --...... dh...... •. _---�-----94.... ...................... 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 Corn lian has been issued d of health. Signed ..;....... ....... ......... --- _ .......... r �/ Date Application Approved By .......... U.....1� ---------------- .......... .,---L... P.. Date Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------- ------------------------ - ----------------------------------------- -- -- ------------------------- ---------------- ------------------------------------------........................................................ -------................................ G� q Dare PermitNo. ...-I... .. .---.®Z/.... ......................... Issued ............-----------------.........................---------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Application for Dispood Works Tottohiution jlrrmit Application is hereby made for a Permit to Construct or Repair L-f an Individual Sewage Disposal System at: Location-Address It Owner 'Address _jC ). Installer Address Type of Building Size Lot-__-_--- Sq. feet Dwelling—No. of Bedrooms--------- ----------------------------Expansion Attic Garbage Grinder Pao Other—Type of Building -------------------------- No. of persons--------- -------------- Showers Cafeteria Otherfixtures --------------------------------------------------------------------------------------------------------------- Design Flow--------------------------------------gallons per person per day. Total daily flow---------- 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. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by----------------------------------------------------------------------- Date------ Test Pit No. 1----------------minutesperinch Depth of Test Pit----------------- Depth to ground water---------------------- !4 Test Pit No. 2--------------minutes per inch Depth of Test Pit_-____-__-------- Depth to ground water--___--___—_____. a ---------------------------------------------------------------------------------- 0 Description of Soil---________________---. ----- ----------------------------------------------------------------------------------- W ------------------------------------------------------------------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations Answer when applicable-------- ---------i-------- 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 Com lianK ha�been issued Py-� p wd of health. Signed-----__114S---- ---�__ --—-------------------------- Dm� Application Approved By ------- ppliCJ� --------- aw-------- ------------------------------------------------------------- ----------------------------------------- Application Disapproved for j., reasons: --------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------- PermitNo. -------------------------- Issued ----------------------------------------------------- Dim THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Olertifirz& of QImTtimm THIS IS TO CERTIFY, That the Individual Sew a ge Disposal System constructed or Repaired L4 ispos by----------------t -------- -- ---------- ---------1�_ t------------------------------------------------------------------------------------------------------------ at ----------------(,�---------- ------- --------'_Al� has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code 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---------_------------7--- ---------------------------------------------- Inspector --------------P__ ------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FWL_31:�2_— %vollat ks 'ff "d ferutit Permission is hereby granted---------5!ff-- ------ to Construct or Repair ( Van Individual Sewage Disposal System atNo-------- ------ ------------------------------------- Siftieet as shown on the application for Disposal IVATorks Construction Permit No�._7/J-./9a___ Dated------------------------___ Board of Health DATE------------ ---- --------- FORM 36WS F40885&WARREN,tMC-PUBLISHERS