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Home My WebLink About0015 BRETWOOD LANE - Health 15 Bretwood Lane Centerville A= 168-118 5 M EAD No.2453LOR UPC 12M smssd oom • Umb M UiA towm,) mmY11SmR u a�sMi m us m IOFI ,�� r� �� - � �� FRim ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............X.Ourn ............. --------------------------- ---------_.........OF...... ._4.. - Appliraftau for Bhqpasal Warks Tomitrurtiou Prrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal sy tem t: ....... .........-..--.-.-.-----;-1--.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.- -.-.- ... e --- - - ----- . .-.-.- -- -.--.. -.c..on-A dress- ..d. ..4-.A... .. Owner . . ......... .-..... ..... ...... ..�Iefl ... ...... Installer Address Type of Building Size Lot____-S.........0...0---0......Sq. feet Dwelling—No. of Bedrooms......... ..............................Expansion Attic Garbage Grinder (00) Other—Type of Buildingl# No. of persons............................ Showers Cafeteria Otherfixtures ----------------------------------- _.......................................... ............................................................. Design Flow.............../ZO....................gallons per per-W i)er da y. Total d daily ....gallons. oDow...........:�i3o Liquid capacity/49PL)..gallons Length.S.'16...... Width.. Diameter- .............. Septic Tank ............... Depth.f��'Y...... Disposal Trench—No. .................... Width_._......._.._.___.. Total Length.........._.._...._. Total leaching area___.._ . ........sq. f t. Seepage Pit No------/............ Diameter...JO.1......... Depth below inlet.._....!?........ Total leaching ar;�.. .....sq. f t. Z Other Distribution box ( ) Dosin tank Percolation Test Results Performed Date....k--d7-ql ............................ ........ Depth to ground water-----IV-0-AIK—. Test Pit No. I-5A..4-----minutesperinch Depth of Test Pit----- ---------------- 4q Test Pit No. 2................minutes per inch Depth of Test Pit__.._____......__... Depth to ground water.--___-_.-_-____--___-_. 94 .C .........................................................................?................................................................................... 0 Description of Soil....Os2 ...—. �.. ....4-014 4420� 6V85014� �0 1 ............................ ......C?......./...Pt........ . ---e�� ................................ U ....................................................................................................................................................................................................... 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'T'11 5 of the State Sanitary Code— The undersigned further agrees not to place the system in A.-� operation until a.Certificate of Compliance has been sued by the board of health. Signed....... \ . ...A— I . ... ........ .. ................................................. ...AP.. Date Application Approved By.............. ... .................................... ...........41 Date Application Disapproved for the following reasons:.............................................................................................................. .......................................................................................................................................................................................I................. Date PermitNo.......... -------Xn...................... Issued-------------------------------------------------------- Date No....�I__-•� Fxs.... .U_......_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL H • .L Appliration for UiiposFal Works TomlrWivtt rrrnti# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal Syltemlat ! f J�j) 1 oc ion Address or Lot N W '' -• ................................. _• C f f---- d-f$Owner ""1 �I .a4�d e s f W / i - �" �`f.. 4"+ --•-•---••......................•----••--•-•••--•• -- � g`,�,, `' '% �' ' w ------------•----- 6.�t„ Installer Address 1� � Type of Building � Size Lot___A_.r_!____. _ t......Sq. feet Dwelling—No. of Bedrooms_________ ..............................Expansion Attic ( ) Garbage Grinder (;u) Other—T e of Building >aCµl=' �' ` No. of ersons____________________________ Showers — a YP g =='-------- P ( ) Cafeteria ( ) d Other fixtures ---------• ��: J Design Flow..............Z`" .............. ____gallons per few,@* per day. Total daily flow_______ .....gallons. 1:4 Septic Tank—Liquid capacity�V !__gallons Length_S_:_ _.'____ Width__ r__.9E._ Diameter- 4319W_.__ Depth-.. r- W Disposal Trench—No ____________________ Width.................... Total Length Total leaching area____.___________....s . ft. x P , . p g ...... Total g ... 9 Seepage Pit No-____-/............. Diameter___ t).__.___...__ Depth below inlet...... .......... Total leaching area_._'..........sq. ft. Z Other Distribution box ( ) Dosin�tank) Percolation Test Results Performed by. } _ -__ _______________________________ Date_____�'�_..�a_ ..._ _ ....................._ ;4 Test Pit No. I.-". ____minutes per inch Depth of Test Pit..... �......... Depth to ground water-----rll-- M'_ f%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ _.___._____i *a - Description of Soil_- '! �a .r �!`'< �' .' -r---• l .`.t. �� 7 'f x ------r -------- -------- -------- -- U -•--•-•---•--------•-•---------------•---••---••----------•----••-•-------•--------•._......----••---------•-----------•---•-•-------------•-•-----------------•--••----------•------------._..._•--•-- w M. Nature 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'T'LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been -ssued by the, oard of health. Signed-- ..Tl:..'-ls' ..........................� r 'Jj f Date Application Approved BY ------- - ---- - ---------------------------------------------- - = / Application Disapproved for the f"king 4n*—_ .. ---•----•---------------------- -- ---- --- .................••--•----•--••-•-------_._...__....---------•-•---••-----------•--....--------•-_..__...._..._.__...._....-••----------------------•---•-•-------------•---•---••-----••-•--•--..._-•-- Date Permit No......... ...... I ---------•-•----------- Issued------------------ - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f �, ' it�. ,. j CIrr#ifiratr of ToutpliFanrr THIS•t,,,,,S T CERTIFY, That the Individual Sewage Disposal System constructed (A or Repaired ( ) -. has been installed in accordance with the provisions of TITIE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----- �,_{________ dated________________________________________________ LL Z THE ISSUANCE OF THIS CERTIFICATE SHAT`BE NSTRUIED AS A GUARANTEE THAT THE ,SYSTEM WIL FUNCTION SATISFACTORY. DATE........... .....^.......I.Y' ....................... Inspect •-W_ 7 THE COMMONWEALTH OF MASSACHUSETTS BOARQ OF HE,�LT.H •, G ..................OF.. r�:: : (.',,....... � ._...__.....-._...... No.._4�_._rti.. .-....... FEE.--- 6 ..... i fro I Works 'Tonotrudion trod# Permission is hereby granted.........):_j___...... _•__ to Construct or Repair ( ) an Individual Sewage Disposal_Systenj, Street as shown on the application for Disposal Works Construction Permit No.C.'?. .�__ Dated........................................... ---------------------•-••-•--- - - ----_-_------------------------------•--- DATE_________________________ jrd of Health FORM 1255 HOSES & WARREN, INC., PUBLISHERS I►.1Q_:.GAtZ7E3AG� -IzI Tadt 1.�{ t`Low s 110 +c 3 . �3b G•P•D. I b o o n c•�. /o� � �V � 1"tG TA�1LC = 33pv,ISO % • 4-99j 6.P.o. 1000 ,.. �.;_; � /mpg • -1:A5P0So&L PIT u5t=. loot G&t.-, �S� boo Z.S • �S G.P.D. ExP so 9�- lao.� O 101f4 TOTAL TOT&L 'C>A"L*-( FEW = SW 6RD. �T TAA X — PMCIDL&TIOIJ OI&TE : ll� 2�rt1t.!'02 L--SS. wFur, PPTwyf ata+aao P:T:R a i SU'LIVAN { „ v AJ WER 97.1 !' 777$ TE't PoL as .. .. a- �Y L044l. . "�PE tool I{N I�ly`/Od.p .SUB,SOIL f�P� Z• 4 Tn57r. IW. 6AL. '$cx 99,E Sc-Qrlc IWV. 7 A�lK loop lug t►N GAL. 992 .. 494 t• LH A STOaIE' z 3 • CEQTtFiED pLoT' PL,/�Iv LOCATIOtJ C.C=NTC- yi LC1� �L=138 f3 u o SG Q►�.�- S c.AL M II AT I GGIZT11=�j 7i-(AT. .Tf-1G I-oL) -ma-" iDt1 Ss", O uW, PttkQ Rr_—pGZEk. C-a WF:F`L'•014 Cc;>&\PL--(S W t1't-t TI-l`; 51.DG.t1►-lEr � A aura 5e'rLnclG �G4ut�E�(it�:uTy o� T�+� off" lS ITOWtJ' orjaArzlJ5rAf' c Al tb IS hOrLoGATC-Z) . WI- Wt4 TN•� FLO a . n PLJO . ' c B,4XTCtZ, �`,. Ir.1YE 1a1�_ ' RcGlS'rclZ�� t-�►.�a 5uevcYocz� Tl-Il5 C7t_AI-t t� aJOT` LyA��C.'t� Ua.� AN OSTE2�/11,.L.G o /�r(AS�, NSr�w.�c��.l, �u�•i��' T+1C. UFG 5�(-�, 51�Gwt.D ApPLI G,e.wT %bl r BE.' U5CO TO "I aVEZMI�4C-- LOT l_tWES 16, WN OF BARNSTABLE r LOCATION Lr4 Qice wDa d AI,* SEWAGE # t Z g VILLAGEii,.•k� (�p ASSESSOR'S MAP 6z LOT / ti NSTALLER'S NAME & PHONE NO. •'� , ��iS�al� �`��- (0�0 �EPTIC TANK CAPACITY I ,DSO 5a Uak S LEACHING FACILITY:(tVpe) (ZAC L. (size) 1,600 44 1415 NO. OF BEDROOMS 3 PRIVATE WELL OI�PUBLIC WATER BUILDER OR OWNER 4�/S�� gy "�u►.s , DATE PERMIT ISSUED: 7 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No y; �� c' �o. �_ v� 1 1 . � /� V, . Y�_✓ 'J ��V V V J 1 `�'�� I