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Home My WebLink About0005 CENTERBROOK LANE - Health 5 CENTERBROOK LANE Centerville A = 172 - 237 S M E A D No.2-153LOR UPC 12534 smsad.com • Made In USA OIasB mNym Im lic LK �� WWWWROGRULO No. cpc)15 —6(D Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpliLation for Misposaf 6pstem ConstCUttion i3ermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System V Individual Components Location Address or Lot No. .S C Lc-4 - Owner's Name,Address,and Tel.No. C.A.^-*,cSv t xkc /� Assessor's Map/Parcel QL Installer's Name,Address and Tel.No. Designer's Name,Address,and Tel.No. GRIM VM Type of Building: y�— Dwelling No.of Bedrooms N/ I Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Q Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board ealth. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 0 " o l o Date Issued i a�lS - 610 Icy No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS i 21ppf Cation for MispoBal *pstem Construrtion 3dermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System Nd Individual Components Location Address or Lot No. -r C�n Cf c o �"'�- OwAner's Name,Address,and Tel.No. ,. v C�.�crv�lti� . Z2L-�L 1-AC, S+4� -C.. w Assessor's Map/Parcel 4 , Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Sco�\Gcc�-- Type of Building: 'Alt //�' -'' Dwelling No.of Bedrooms Al r Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) t Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �Q�(�`Go_t �1�dX c o V_ *v Z) QOK Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of - Compliance has been issued by this Board ealth. Signed A Date I "� Application Approved by Date 1 /L{ - Application Disapproved by Date for the following reasons Permit No. 6 d y Date Issued — Lr — �5 --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(1/� Upgraded( ) Abandoned( )by c7 co�\ C-UL ."_yc at S- Ct_r k-V(10�r O ra VL `- 0- -t-1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.120 15 610 dated U -/S Installer Designer #bedrooms Approved design-flow ,A gpd The issuance of this perm' tl not be co stru �gnarantee that the system will nctio• e nedd. ate Inspector f i ✓�� t ---------------------------'---------------------- -------------------------------------------`-----------------/-----� No.c�o 157 ` 6 1 b Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Misposal *pstrm Construction permit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at .S G r 6 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. � r Date _ L' ' L Approved b PP Y TOWN OF BARNSTABLE LOCATION S✓ C tf\ s OrttV t cj,,Nq,, SEWAGE# hot b 0/0 E VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. i SEPTIC TANK CAPACITYX� .f LEACHING FACILITY:(type) (size)," NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: r Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet -Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) -/A / Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY AG «C 3(10 I � d 140 A q z r • No. .-1l. ,,. Fpnc j {� ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Qwl!d.......OF.................. �5T4k ....... i. 1 Applirativia for llhipmFal Workii C omtrur#ion Prrmit Application is hereby made for a Permit to Construct (,,eor Repair ( ) an Individual Sewage Disposal System at: -� ................---•---------.................I � ---••-•----•---..._..........._...•••. ........-•----•----•-----...........------.. ....._.._... ..._.........- - Location-Address or Lot No. ,[ -...... _.. �'l�,F!!✓ e��c* ---------------------------------- -•----•----••------- ( .fit...S..l_._S?....... .........ram../-.------ r. `— Owner 1/ Address Installer Address Type of Building Size Lot__l5.,�, _57....Sq. feet Dwelling—No. of Bedrooms............... _.......................Expansion Attic ( ) Garbage Grinder Other—Type of Building No. of persons............................ Showers — Cafeteria f-4 Other fixtures .•-• ................................................ Design Flow....................5 ..........gallons per person per day. Total daily flow.........._-3_.3,a.................gallons. WSeptic Tank—Liquid capacityl.IOGVgallons 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 (j) Dosing tank ( ) r- `" Percolation Test Res Its Performed by... :: _l. f!l� DateZ-- 14 Depth to ground water...... f Test Pit No. 1_---4minutes per inch Depth of Test Pit__._�A�T�.___ p gr /j/ (s, Test Pit No. 2......>�..._minutes per inch Depth of Test Pit.................... Depth to ground water... .................... O Description of Soil................................................ -2 i._L -------------------------------- ------------ ---------------------------- t"=`�� '� --••---------------•---------•-•---•--•-•--•----••---------•-------•----•-•--•------. 2/ = �! . .��• --------. . ....... U Nature of Repairs or Alterations—Answer whe ap icat5le............................................................................................... 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 agree ,not to place the system in operation until a Certificate of Compliance has been issued the board of lth. / ed--------------• �� ------ .... D te Application Approved By------. ..... 0---- --------------- Date Application Disapproved for the following reasons------------------•-----•---••-------•-------------------------•--•--------------------------------...........--- Lr r _ -+� Dates--` f Permit No '_, �4 -1�-�•`�----------------------- _J'—bate_.`^- ---^- w ........_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --`....---OF.................j.. . .. 's 'I--/--------------------- ApplirFation for Uiipoott1 Work, C9onstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: # ................__ ......... ......................................... ................................................. .. -----•--- Location-Address or Lot No. _.1 .................................. Y fir, .._ . .... Owner. Address �. -It Installer Address U Type of Building Size Lot.` :�. ......Sq. feet Dwelling—No. of Bedrooms__...._..............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures . ............................... W Design Flow...................5.$___.__............gallons per person per day. Total daily flow.........__x 1,,y.0..................gallons. WSeptic Tank—Liquid capacity(_fgallons 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 a Percolation Test Results Performed by........................F_1:............., .d :_..___. Date_.______..."Vz- __ Lrrx � Test Pit No. 1_._�.._.. .minutes per Inch Depth of Test Pit_____ ___________ Depth to ground water_._.,,,_�_f_ __ fs, Test Pit No. 2..... .._minutes per inch Depth of Test Pit______ ..._.. Depth to ground water._,[v..�� •-------------------------------------•---•--•••---•f ::.... Descriptionof Soil............................................... //- c, :... !"a'---- ----- s-.&?..------------------------.... ......A.f .---.----•-•••••_--..----•-.•-•_--•_----_•____ ______________________________s.^.�...If:J. !�,_______.__. �. ..�.'•"�_ ____ _�.��i C./y, ____ :3_! sa!' UNature of Repairs or Alterations—Answer whe ap�fPilica 1 ................... ...................... ----•----•-•---•--••---•••-••--•---•--••----•--•-••--•••-•-•........--•••••-•••••••-••..............•-••.......•---•-•---••---••-•--•----••-----•••---•--•-----•....................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in PCompliance P Si ned_______________ �� the board of realth. operation until a Certificate of Com Tian g has been issue - ,o��_:....--•------------- ---��-�'-�•-- Date Application Approved By--••'`-Z :�-=---- . .................... ----- }l-+ems------_------ / Date Application Disapproved for the following reasons----------------------------------------------------•---------------------------------......................... -----------------------------------------------------------------------------------------------------•----•-•------••---••--•--• ---••---•-••--•----••-•-•------•--------------`------•-------....-.--- Date PermitNo.................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,......OF.............111.�.440'�X tIW-i�.................................... Tn#if iratr of Tomphatt r THIS IS TO CERTIFY, That the Individual Sewag osal System constructed,(�) or Repaired ( ) by------------------------------------------------- p -. ..... t �--- Installer at----------------- -------------------------------------- (s 7.............3................ � �-r'ft � �.a-�la� �-•� �: ��s ' '. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the c� ,.�i O application for Disposal Works Construction Permit N�y___________________________________ d�'8��-�.__.._._.._..._...._..._.._..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. J ci DATE._......�..�....1---•--��---------------------------------------------- Inspector _`_��-:_�-•�.._._....�--�.._:..._.___l�_:� ..------------•------•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........OF...:.................g . / .. No......................... .............. Elioposa1 Workii Tono#r ion mit Permission its hereby granted-------------••---•--.....D s �,t"a 5. � �' L�� :.;� to Construct (. ) orsRepair ( ) an Individual Sewage Disposal System at No. .._.. - �S et C............................ /. / t as shown on the application for Disposal Wor o Per ! Dane PP P - - 3- �t----••-----•---•--•--•-•- Board of Health DATE................................................................................ FORM 1255 A. M. SULKIN. INC., BOSTON ' J N LOCA4ION SEWAGE PERMIT 0. VILLAGE INSTA LLER'S NAME i ADDRESS B U I L D E R OR OWNER C-eV\Jk Q DATE PERMIT ISSUED 1 � 0� gg DATE COMPLIANCE ISSUED f y 4M a V b s 47/ v o. a o-r 4 .4 39. tlI9100 � �10 N v ? >. FK Ail l's scF s M e � � o ° iy 'c�o`'! w LAGS vF /DA✓En%7 /\10 T7 i Al 0 AIA M. i'rz vE wn/ ` 11VA a F Aygs E ORSE n �,� PNGi v9�Qi,��e Is , ssIONA\- LEGEND ,L 1.�'TIN® SPOT ELEVATION OAO y F EX9ITiN® CONTOUR CERTIFIED PLOT PLAN ' R# SHED SPOT ELEVATION (� �; - �`` �'' '� FII�#.SH.E® CONTOUR Od s + � Lo 3 Na�,�i�✓��. , �,7.1 �' �C �' 1/ice =_ ,NOTE: The location of any. existing undetg-round.,s,ewerage, wells., or other utilities shown •on this plan is approx- LN mateonly as d--termined from records and/or verbal �� \ information:-.The contractor is responsible for the, ver.iftcation of the .existing locations in the,,field. SCALE, / 3 0 DATE /o/3),%';' .DREDGE' VEERING CCU. IN CLIENT. CIIEN? I CERTIFY THAT THE PROPOSED EGI3YERE REGISTERED° JOB NO.-(6407.& BUILDING SHOWN ON THIS PLAN 11/ + _ CIVIL LAND CONFORMS TO THE ZONING LAWS. I:NQ.LN�ER RV OF .BARNSTABLE , MASS. 7I2 MAIN STREET CN'.BY� �• 3.C. �� HYANNI S, MASS:. /, Z 8 XREGI� SHEET, OF~ A E 'LAND SURVEYOR M//V: K /1f0TF /F /TNE�4 THE.SEPT/G TAN OR LEi4C/,I/ivG PIT ARE MORE .TY,IA/V la"ONLOW /O FT• M/N riR.R OE, A 24",&/il M E7'ER COyC'R. 7'F COVER ` SNALL &,F 9R04;4A17 TO 6/�A®E.�AN CXTRr4 CON TE C.�� 4�PNC P/PF t,►EAVy Ci4 ST/RON COVER SHALL DE USE.O . COVEJ�S MIN, OITCN /F/N DR/VEWA Y 2 MN. CONCRLrTE a Gi�pE CO✓ER' CLEAN SAND- Q 0 LEVEL ►. r z`LAYER d "'CAST . - •'.`a o QF Y49 JV S / DN'P/PE. p D G/1L. ° •d� 1 • • • •♦ • n tea• ASHPO S7L'INE PEA rrT SEP!"/C TA/VK • 4 • • . . • • , e . ; BOX o • / ®t • r • too •gyp • • • i • • • prPTN • • • • v o WASHED STOiYE • jl 3 ,�_ "/,a .._ / • ' PRECAST SEDGE o oa • • • • • • • • a• P • A T • e RT EL Ei�r�7%BNS c�n9c�Ty90 f+l�. �E� 7 1/Jli� G�+�w a • • • • • • •`� OR EQU/ T. • e Q l/YYERT-, AT ®U/LD./NG F'T / " 3 r 6 sT. D/AM { zs: rAaut..4T�0.0 /NL�T :SEPT/C T�Notrr OlJ41- SEPT/C TANK FT a D! TR/ lITiQN-BOX ?Z° FT CsROuNo J JTEI�TABLE l/V,CET S.. OF SECT`/®N tJAlTR/B lOAfBOX FT vI5 I7 A rt'.a !/YLET AfM`ING.'.'I�tT 7d�$: F7' �?`�t�dJ1.ATAWV f 7 ..: i: .�., '.i b. •'` .. /��/� ..LEAG'f�/ DESISAr cm/TE FIA t DWAWSMM. 3 Nlll�?BE/'l OJT BE�RA4�9S ''. - - ._ SOIL. 1-0& GAROAiGEP/SPO. BL UN%T TaT.4Lsri/ T �.Ftow 3'3 o G.at./D.av°` SOIL TESTI ° SO/L TEST2 5 r S®!L TEST 1 Ml/Af�.EA? 09'4a'RC tNC .o/%S / fEte�t! 7¢ �z Y, oATw OF 50/1- TESy' 8 g,4GHil0,6 PE/t P/T,7-519. 'PT. -p Z z R�54/ArS AVITNLaSSED dY�Dl.P C%�FF�Ro 3 ®Q TTOM LEACHING PLsR P/T '17 S4i r_. T $ L Doi�'( . AWNCOL r�T/ON R.�T 1 G 'Ss Mtl NCK. TOTRL -Al ESQ, iT vl33SoIL 1WRC0LAT/ON_RATE/�2 ��MI,N�INGH .�E.��RNELEACH//Y6A�4EA ZloS Sig. FT. fit. : -T crs-T of M,i jai SA NO `;,p:T- 3 A/o 7'7 !lG k1-4AI v GORSE'.;~ RE Plo.10951 4 yr c a , � per. /ST �? �LyCF? 2' 8 y �a •�t ,� � Ja, _ $ 'Q t x.. ' �- ��VwT�� t'.[. c. 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