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Home My WebLink About0077 CINDERELLA TERRACE - Health U 4��/ur C it I LT) CAT IGN = SEViA G E rERT MD. V1 L A G E MA�o C711704 � l4gC aw,s _�� , 1 A S T A LLER'S WA FRE ADDRESS #1 DE GR ""ER DATE PER ISSUED DATE c o m r L I A N C E ISSUE -� S { � .f S� � _ �� d ��,� � .. r� • '�a�` � Q�v �'� l TOWN OF BARNSTABLE I LOIvATION " 1 �J� L� 1�R� . SEWAGE # 171 VILLAGE •f V 1, ASSESSOR'S MAP & LOT`e z��d> , INSTALLER'S NAME & PHONE NO Q SEPTIC TANK CAPACITY I Ups cX tca-1 vc, LEACHING FACILITY:(type)?i T- (size)' NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER r BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No 0 ax ��i� 5 ' t0 C a4 qy �� i •--:: 3(0 q D'7 Z8 7l Y //11 - No..- APPROVED V OIV/Fas.......�- .. ...... Barnstable Conservation Depa,h MMONWEALTH OF MASSACHUSETTS "BOARD OF HEALTH 8ienw Dato TOWN OF BARNSTABLE Appliratiun for Di►ipooul Worlui Towitrur#tun Famit Application is hereby made for a Permit to Construct ( ) or Repair (t-<an Individual Sewage Disposal y s a , .......... .......... ....... ...---\----R ......... I. oc'ition-: d, css or Lot No. . -•-----------•--•----------------- ------•--•- v .... ......... -•-- O�rncr Ad r � a ......... ...k.. .----- -------------------------- ---mil- : .-............ Installer Address d Type of Building Size Lot............................Sq. feet V Dwelling— 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. WSeptic Tank—Liquid capacity------------gallons Length................ Width---------------- Diameter'-............... Depth................ x� Disposal 1-�o r idth:.... Total nn Total q SSee a e Pit No.. _ _—_.__ Diameter . De 1 below inlet..................Totalachigarea.._..............sq• ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed b Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ fx, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------•----•--------------------------•-•-..............----.........-•......................................................... 0 Description of Soil........................................................................................................................................................................ 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of CoPhanhas been ' ued b he board of health. Signe ... ... ----......... ..... ................................... �lbDreApplication Approved By ..... ...... -....................... ................... ....... �f-.-��,e5'...'�j' Application Disapproved for the following reasons: ...................................................................................... .............................................................................................. ........................................... .................... ............................. ........................................ Dale � PermitNo. ..........9......1... ...).7.f..................... Issued ......................................................... Date :�t.-ctr:;.WJi•.�..=:�:+.::��.,,,-.,,,.•,.�NkV:;�;�,;:.f itR"� � „r11�'e�,�;/,�L'�- �°�.'1. K.",�"d`., a. ,. 1- � "-4tu.^ti*.r..n'..inb�.0e:v-.,�+,,•4y.r..�.o-�./'—v"-v�«---.`.�,._t�.�µ..��r-� v�{`7- -1 � THEORMMONWEALTH OF MASSACHUSETTS S-K` BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Dilipwial Works Cfontitrurtinn 1hratit Application is hereby made for a Permit to Construct ( ) or Repair ( �-<an Individual Sewage Disposal System at;---I —Location-:address or Lot No. Ow ncr Adffs M Installer Address VType of Building Size Lot...........................Sq. feet„ Dwelling—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. WSeptic Tank—Liquid capacity------------gallons Length................ Width............--.. Diameter..------_---.-- Depth................ x Disposal Trench—No. .................... Width.................... Total Length..---............... Total leaching area....................sq. ft. 3 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. 1................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........................ 9 --------------------------------------------------.......................................................................................................... ODescription of Soil........................................................................................................................................................................ V W - ------- - ------ -Answer :..... U Nature of Repairs or Alterations 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 undersigned further agrees not to place the system in operation until a Certificate of Co lian has been ' ued by he board of health. `�� Signed - ------- ` �.��.............. ........................ : `.....��`� .. ...... i Dare Application Approved By ..............� .--.. -.- -- .......................................................................... ------- Date-...�..5....-..��' Application Disapproved for the following reafon.r: ....._............................... . - ...................---....................................... ..............--...-- ................................................................................................_..........-_....--........._..........._.............-----..--.---......................................... ........................................ Date PermitNo. ........... -------)..71.................... Issued .....--...--........................................................ Dace THE COMMONWEALTH OF MASSACHUSE17S BOARD OF HEALTH TOWN OF BARNSTABLE Tertifirate of Graylianre THISIS,TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( \ .�..t ,f4.. i '( ;. -------------------------------------- -------- (2 at .- :...._..........._. .. _..... )1A-----M._!._��._ has been installed in accordance the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....... -. ...- -f--71.......... dated ....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---- /.. Q.7........................... Inspector .. ._.. ' ' ' -.. '7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE FEE.-..:3-t=•'-........ 13hip sal War-kg Tonotr uan ramit Permission is hereby granted_ .\ - ---- cC ` --• ...................................................... to Construct( ),�or�Rep.a it ( � an In(liv1C113al—Sci&,age-Disposal System atNo..... i------------ 1Z . . ,. - _ .«�----------------------- �. street as shown on the application for Disposal Works Construction Permit No. Z2'1___ Dated------ j�l._. ........................ ; i ) --- of Z;alth DATE...........-�(� 'JC/ j •---------•---••---------------------- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS