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Home My WebLink About0050 BIRCHILL ROAD - Health 50 BIRCIIILL ROAD Centerville A = 189 - 026 S M EAD® Na 53LOR UPC 12543 smead.aom • Made In USA Y b I v(p t i Fims.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH `( Town..............OF.. .. . . Barnstable `\ .. . . .. ............... n .-.-....... Appliration for MipoiiFal Vorkg Tomit.rnrtinn Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( Y) an Individual Sewage Disposal System at: 50 Birch ill R_d. , Centerville, MA 02632 Location-Address.................................. ..•-......----•-.......................•—or---t-N. Norman Hawkins 50 Birch Hill Rd., eeAerville , ;MA...........02632 ....-•---._.--•...................................•--..................._............ .--•---------•--------•-•--------••••................................... W A & B Cesspool Service 128 Bishops Terrace, Ryannis, MA 02601 ......... ........ ........ Installer Address dType of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms................. ....._...................Expansion At c ( ) Garbage Grinder ( ) Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 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. Seepage Pit No..-_-.-.-.-.Iy...... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution boat;( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit..............----.. Depth to ground water..-_--------__.--.------ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------- --------------------------------------------------------•---...._._........_......................................................... 0 Description of Soil.......................S.And...................................................................... W U ---------•------•----•-------------------------•-----•------------------------•-----.........-------------•---------•-••-•----------------------------•--•-------••---•----------------......---------- W --------------------------------------------------------------------------•--------•-----------------•-------•------------------------------•--------------•---•----•----------------------.......---- U Nature of Repairs or Alterations—Answer when applicable.-.ins to 11 t ion__of_a__1,000___gall on......Pre-cast, ---fit obe._paQk%i._lea.Qb--pit... ova mow) .................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 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 It . ...................................... .... .....-.... D Application Approved BY.._.. 2 --•-.----• 3 Date Application Disapproved for t owing reasons- - ------------------•------------------------------------...-----------------------...-------•-----------_.... ----------•--------------------------------------•••------------...-•--••...---------.......•-----------.••-----•-•-•......------•-•------••----•••••--•-•----•------•-•-------------•-•----------_...._ Date Permit No............82------1 7 ---------•-------- Issued-.----•-•---•------8 f 30 f 82 -•---... - ------ Date ' Y 1 c� Noo2---` '` =----- FEB..:`!:...:'..'.0z?...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 own..............OF................rarns-`.ahle Appliration for Disposal Works Tnnstrnrtion vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 50 ii.rch rill Rd:. ; Centerville, CA 02632. ................_.............................•-•-----..................•--•••.................. -•-••..._...--•----•-------••--•••---••-•---........••--•--•-••-•••--•••......--•-----------_•-•-- Location.;Address f or Itot No s i,� ?v or-r.;an Ilawkins. 50 Birch ' ill Rd., Cen fervl lle , �' A 026 32 .................-....--............. -.........----............................................ ..........-•........................................................... --------- W A & p Cesspool �ervf e 12 Pi&opU -errac�adr�sYanris, '•A 02-01 Tl Installer Address Type of Building Size Lot---•----•-------------------Sq. feet 3 ag Dwelling—No of Bedrooms ...................................Expansion Attc ( ) Garbage Grinder ( ) aOther—Type of ,Building ............................ No. of persons............................ Showers ( ) Cafeteria ( ) P.I Other fixtures --------•-•-••-•-•----•-• ••.... - W Design Flow...............:............................gallons per person per day. Total daily flow............................................gallons. W Septic 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 bok'`(" ) Dosing tank ( ) Percolation Test Results Performed bY.......................................................................... Date........................................ ,a Test Pit No. I...:............minutes per inch Depth of Test Pit.................... Depth to ground water•___-___--______---____. Gi, Test Pit No. 2....::..........minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ............................................--.............................................................................................................. 0 Description of Soil.....:.................SA nd--------•------------••--•------...-•-----•-•-•-•••••-----=••-------•------•-----•-•-•-----•----------------••-----•-••-•---------•--- x V W -•-•------------------------------- --•--------••-----------................._..-•----•--•------•---------•----•---••------------•----------.......-•---•-•-•-----------•••......-•••.................. UNature of Repairs or Alterations—Answer when applicable__installation of a 1,000 ra?1 nn,_..p� st o_Ie packed leach pi_t (overfl ow� . .. ••..r................................ . -• . •......._.......--•••••••••-••••-•---•--•••-----•-•---•---•-•••••-••-••----•-•••••••-•••......---•--.._......_...... Agreement: The undersigned: agrees:"to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued�y the bo d of h(llt . r /,., ,, J,4 e,/3 0/,`_2 Application Approved' BY " Date Application Disapproved for tire ollowing reasons----------------•-•---------•---------------------------------------------•-----•--------------•--••----------- .......................................= .......:----•--------•••---•--••-•---•-•----------------•••••---•--•-•---•---•----------•------•-•---•••-----------------------•-••-••......----•--•--------- Permit No........................7._� _..... Issued.......................................................Date Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T curl ..O F.....Barnstable ........................................ ..... ........................... .........................._._.............. Tn#ifiratr of ToutpliFana T I I 0 CERTTIFY T at th ndi_vfd al Sewage Disposal System construe ed ( ) or Repaired x Cesspool Se v ce, ;i( ops '1'grrace, tlyannis, ,A �c6t�1 P ( ) -----••-•..................•......•-•-•------•.......•-•-••-----•-••-------••----------•--••---•---•----•-•.............•--•-----•-•--- 40 £irah Fill Rd Centerville vA InV 02 -- he .-,.an Hawkins_ C at. ----------•--------------------------------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TIT 5 of >;ihe State Sanitary gpde0�s 4scribed in the application for Disposal Works Construction Permit No.....................................__ at THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS R1 .AS A GUARANTEE THAT THE ik' SYSTEM WILL FUNCTION 5ATISFACTORY. 2DATE....--•-•.••... Ins ectofr- f •------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS ``, BOARD OF HEALTH �`''� i 2- .. .......:..T-°wn.................OF........Barnstable 11.00 No....................•.... FEE........------.......... Disposal Works TRonstrnrtion Vautit A & P Cesspool Service - Permissionis hereby granted...... -------•- .............-...•-•.....••.-------.............-................................................ �l\ to Cons u ( ) or, pair (x ) an Indiy .ual S,ewag >s osal System ..ircn ti ita., l:enter," e, A � �, Loor;lla.n ''awkins _ t atNo............-•--•--•-•--•------------•--••.......••---------•--•-•...................••-•-•---.•-••------...----•••-•-•-••--•••-•--..._.....--•-•-•---•-------•-•--•--•--••-••-•.............. Street /� e C "-. ,-82.- /301F':) as shown on the application for Disposal Works Construction_Permit No.................... Dated.._.....____.:_....._....................:,. � , / /'"2 G �� Board of Health DATE.__...-•------------� {�----•----•---••------•--••----------•---------------•---• FORM 1255 HOBBS & WARREN. INC., PUBLISHERS I I LOCATION SEWAGE PERMIT NO. VILLAGE C�n4o y r ISTALL R'S NAME IE A D b EIs N i U I.L•.®E R OR fl ER DATE PERSIT ISSUED DATE C- 0MPLIANCE I--SSUED Z ep LOCATION SEWAGE PERMIT NO. ,20 1161tul, Ali fl �yr '. VILLAGE Q INSTALL R'S NAME i ADDRESS 55 BUILDER OR AMNER { 1 DATE PER,N[IT ISSUED 3o', DAT E COMPLIANCE I',SSUED �� 3o� � *.50 lqCk, 461 i n INI S ' ® l It