HomeMy WebLinkAbout0072 CAP'N JAC'S ROAD - Health 72 ."AWN JAC'S RD. (CENTERVILLE)
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UPC 10259
NO. H1630R
HASTINGS, MN
"ti► R-ngrd of Health
Corhi of ,':trustable
P,O. Ei®x 534 �
N Hyannis, Massachusetts 02601 Fz�s.... ...............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® PF HEALTH
OF ... .. + i�. ............. ..... ...........................
Allpliration for Dispas al Works C omtrnrtinn rrmit
Application is hereby made for a Permit to Con�-
......... or Repair ( ) an Individual Sewage_Disposal
System at: �/
4��:�.c� --• ' ------------- ----- . . -- . •..........--------------•........-----
Coca ss ................. ............... or —r ............
-
r Owne,��a� dr s
W
..............
Installer Address
PQ
of Building Size Lo .S feet
V TYP g � -�-�-------- q•
Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder 4/0
'4 Other—T e of Building ............................ No. of persons____ ______________________ Showers — Cafeteria
P4 Other xtures
W Design Flow..... 440............................gallons per person per day. Total daily.low._. e.......................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.ki )
Percolation Test Results Performed by ___° t /9•-_'F
---------- -- Date
aTest Pit No. 1----------------minutes per inch Depth of Test Pit................. epth to ground water.........................
GT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a ...---•--• ...........................................................................
Description of Soil........ .."'.a+�...... �,� .___ _. .
x s� - ---
W
U 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 iITI.L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
ope t' n til Certificate of Compliance has been issued by the board of ealth.
Ced..... -•--lam.Cam.!- ...... --- -------------------
' t
Application Approved By....... ..____=: ....... .••---•--•--•----------------•-•-• --• - ��.
Date
Application Disapproved for the following reasons:..............................................................................................................
.............................................. --------------•-•---..........----------••--....-----••-•-•-----•-------•---------•---•••----•••••-----•--•--•••-----••••----•-•-•-•••--•-•-----...---••-
C
Date
Permit No.... --------------------- Issued.•-- - .. ......
Dat
t
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
O F !rf„� ✓ �C/ J..........................
, pplir4tion for Disposal Works Toustrn.rtiun JJ. rnti#
Application is hereby made for a Per it o to Constr r Repair ( ) an Individual Sewage Disposal
System at ^f�l b�
Loci on Mess
.� Owner J' ......... ................
Ad
Installer Address
U Type of Building � Size Lo �.�f..�rf------Sq. feet
Dwelling—No. of Bedrooms___________L____..............._':__________Expansion Attic 1066 Garbage GrinderAV0
`4 Other—Type e of Building No. of. ersons____________________________ Showers
P.� YP g ---•-----------•----•---•--- P. ( ) — Cafeteria
a )
Other
/l�ures = =
W Design Flow....... .........................gallons per person per day. Total daily flow..�
•_______ __ 0__.:.________________.___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 ' )
W Percolation Test Results Performed by ''--- ----------- --- Date - 1�� �+�
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........................
-•-• ..... ....-----------•-------------------__-•-- ------
-•••_ .�
Description of Soil............----`-'-'L...--•- -----�-• ---�•�--� . ..r .�-�-+�* .�---------- =-..........-----'----j`
UW ----•----------------------------------------------------------•...................................... -•-••--- .......................................-••--••-••-••-•-•-••••-•-•--..............
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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
opejaionetil Certificate of Compliance has beef issued by the board of health
.--•---�7
l... _____________•--•----- • �-•- a--- •----
I I. ' �r
A lication A .' roved B :_..._.:-- ��DatePP PP Y
Application DvisaPProvd for the following reasons______________________________________,_ = ..............................................
Issued .. •--- ----------------------
• � Date
Permit No.... .�? z� ......
<' ___----•••••-------
THE COMMONWEALTH OF MASSACHUSETTS
MS�
BOARD OF HEALTH V46.VE
..._„r ...... ........OF ..v f /....... ......
Trr#ifiratr ',af fauntphattrr SfpjqL aEig.7.
THIS I TO CERTIFY, Th-_ the Individual Sewage Disposal System constructed (`) .or.;;Repaired s
�--••� / � /` �t ter ................................................... A
C✓
has been installed in accorda ce provisions of TITI:r. of T e State Sanitary Code as descrl the.,
iapplication for Disposal Works Constriction Permit No _�7 . dated j ' =
• THE ISSUANCE OF`THIS CERTIFICATE SHALL,NOT BE CONST UED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCT� �S� TISFACTORY
1 DATE -�. LJ �.................... e Inspector.....-- ...............................................
tL\ THECOMMONWEALTH OF .MASSACHUSETTS
6r
BOARD OF: HEALTH
FZ 4�,i
No. .__._._..
Bis aarsat n nstrttr#intt rrntit
Permissionis hereby granted........... ----- •--------------••------•-----------•---••---•-•--------------•-------•-••--------••-_-•••---------- ..
to Construct (� o Re�a_air ( ) a�n Individual Sewage Disposal ystem
at No...............
_. -�'f '�- �' .................
Street
as shown on,the application for Disposal Works-ConstmGt-on a er it lid � .......... Dated_7�/ ______________
j( ") �/ Board of Health
DATE. :-"--.....------.7•--------------------------------------••---
FORM 1255 A. M. SULKIN, INC., BOSTON
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o SULLIVAN WILLIAM. CO.
No. 29133., N y"t., �'
No. 19334 0 r3
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LOCAT1'0N SEWAG PERMIT NO.
VILLAGE
' INSTALLER'S NAME I ADDRESS
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B U I L D E R OR OWNER
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DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED
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TH�OMAS L. WILSON and KAREN A. MASTRE)INAK01, as ukjx>te a a zl'I'M.im 10
grant to �
of 67 Sea Street, Apt. D-5, Hyannis, MA 02601
with tluitrlaim rLitipnanto the land in Barnstable County, Massachusetts, and
situated in Barnstable (Centerville), together with the buildings thereon, bounded and
described as follows:
NORTHWESTERLY by Cap'n Lijah's Road, as shown on plan hereinafter mentioned,
20.01 feet;
NOPTHEASTERLY by Lot 17, 134.37 feet;
NORTHWESTERLY again by Lot 17, 70.72 feet;
NORTHEASTERLY by Lot 23, 180.00 feet;
tlSOUTHEASTERLY by a portion of Lot 28, 100.00 feet;
50-LT THWESTERLY a portion of Lot 25. 180.00 feet;
NORTHu�ESTERLy by a portion of ; of 16, 9.28 fie et; and !
SOUTHWESTERLY by Lot 16, 135.06 feet.
1
Containing 20,694 square feet, and being shown as LOT 24 on plan entitled:
�I "'Highview Hfils' Plan of Lard in Barnstable (` . Barnstable - Centerville" Mass. for James !
Smith, •Scale 1" = 60'; C ct, 4, 1983, Rev. Nov. 25, 1983, Baxter & Nye, Inc., Registered
fLand Surveyors, Osterville, Mass", which said plan is duly recorded in the Barnstable County
Registry of Deeds in t 1an Book 379, rage 70.
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No portion of the fees in the ways shown on the above plan are herein conveyed.
W II Said nremi.ses, are conveved subject to and together with the benefit of all rights,
F �� r
z rights of way, easements, restrictions, reservations, agreements, statements and conditions
of record, if any there be, insofar as the same are in f orce and effect.
l{ For Grantor's title, see deed from James K. Smith et al, Trustees of }-l"Oh,view-
In
Hills Realty Trust dated September 18, 1984, recorded in said Registry of Deeds in Book j
4252, Page 228.
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Executed as a sealed instrument this 22nd day of November 1985
J.K.S. TRUST
n t
James K. Smith, Trustee
. X
Barnstable ss. 'N1 emb: .. 1985
�� "Then personalty appeared
LAYOUT hLAf\,JS WALL 5LGTION5
EX15TING BUILDING _
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