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HomeMy WebLinkAbout0060 CENTERVILLE AVENUE - Health 60 CENTERVILLE AVENUE CENTERVILLE A= 226 - 113 S M E A D WEEPING YOU ORGANIZED No. 12534 2-153L©R 0 SUSTAINABLE FO► STRy I RECYCLED INITIATIVE CONTENTID9L CWjadflber Sourcing POST-CONSUMER wwwsflprogremwg $"I wo �p� �MAADDEnW�UUSAA�����/�/� G M1�i�/N\I(sf_M/M 17r1�/WAW JN r�: 2S--- �'�` 1 Fizz.................t�....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF.......................................-................................................ Appliratinn for Uiupuuttl Works Tomi#rur#inn Urrmit Application is hereby made for a Permit to Construct (jam--or Repair ( ) an Individual Sewage Disposal System at: A va -• - - ocation A ress or Lot No. GI mo- :......... �t,n .S........................ . ..................---.....---......_._.............--•-•----.......--•--•----...................-- Own z Address (� v --------------------------------------------------- Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bed ... Expansion Attic ( ) Garbage Grinder 0111 pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) A4 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..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 4 Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ --••---------•-• --•••••••............... .........• .........•-----...----.._...-----------........ . :: 0 Description of Soil_._.'_=�✓�.�..�_._.s�t.2� _�....... jp.,.� �d � �'................... x W ----•- .......-----•---------- ------------------------ -----.._..- •------ UNature of Repairs or Alterations—Answer when a pliq. le.___A�'_�a ....- ..._art ? ._... �Q f Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI'LU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate 9f Compliance has bomissuelby e rd of health. Signed-- .......... -- C ...._.. ................................ L DatR AAlicn Appr ved BY-..........•----'� ................................. -•-••--••- .................... -------- Date Application Disapproved for the following reasons________________________________________________________________________________________________________________ --------------------------•---------........_._...•--------------•-•-'•----'--------•---••-•---........•.••---------------------•-------.....---...-----------------------------•----------•-----'-'•'-- Date PermitNo........ .......�P�1•---•---•---....... Issued..............................................--------- Date do No................-....... Fss.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... ............O F......................................... . pVftrtttion for MgVonul VorkB Tomuurtion thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: i .....--•--•--••------...-•----•----------------------------------------------------•--------...... ..-------•--..............._..----.....-•--------....---------.....------------......----------•-- Location-Address or Lot No. ......................—.......................................................................... ................................................................................................. Owner Address W Installer Address Q Type of Building Size Lot............................Sq. feet U DwellingNo. of Bedrooms............................................Ex Expansion Attic— p ( ) Garbage Grinder ( ) aOther—Type of Building ------------------_--__-__ No. of persons--------------------------- Showers ( ) — Cafeteria ( ) dOther 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--_---_------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation 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.--__-__-_-__-------_--- P4 ................... .....................................-•-•--•----•-•-•---••.....----•-----.............................................................. ODescription of Soil----- ------------------•---•---•-----------------------....--------------------------------------- .....----------------------------------------------................ x U w UNature 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 operation til a Certi to of Co pr nce has been issueby(the board of health. G _ ------ ._:--,_ = ................................ Date Application proved By........................ ----------------------•----•••••-•---•-- Date Application Disapproved for the following reasons:--•-----•-----•--• -----•-----------•--•---------------•---•--•---------------------•......-•----......•--•--._ -----•---•-•------------•----•-•-•----...---•--------------•------•-------•-----------•------•-•-----------•-------•-.....-•-••-•--------•-•• -•-•----•--- ............................................. Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................... Trrtifiratr of Tontpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................................................................................................................................................................................................... Installer at.................... •--•---•-----•--••...............•-•----•--------•-•--•---•-----••-----•--------------------•-------•----------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----------------------------------------- dated---.--........,--------.-_-.--_--_----.--_-----. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONS TISFACTORY. DATE..-----•-•--•-----••--•-•-•-• �...._ ,�L� ���-•---•-•................... Inspector-----------••----------------------...------......----------•-•-••-•----•-•---•-•--- THE COMMONWEALTH OF MASSACHUSETTS f jgdj►j e-er- ctr'► I[IrA 4iO11 BOARD OF HEALTH ........................................'OF............--------............---.....-------•-................---................. No......................... FEE........................ Uhipooal Workii Tonstrttrtion ramit Permission is hereby granted......... ------•---------•----------------•------------ •------------------------------------- ...__................... ..._ to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No.----- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... /? -------------------------------------•-----------------------------------------------••-- 2 Z Board of Health DATE-------------------------------- ---.•--- FORM 1255 A. M. SULKIN, INC., BOSTON CE- tA: t- 3, tail a1 " Z. eIR X7 x Z, = 9 2 e)Z Q. Ile CIO, k7r� ti Tor Mgss . RETFR �N SULLIVAN Pdo" 29733 w 4�v ;�y' J APPiLICATION' FOR PERCOLATION TEST AND.. OBSFRVATION PITS ~ LOCATION M A \p Z�ZGa t—orr � L k. NO. VILLAGE i 7 /�I ��. V C—: _ DATE APPLICANT • C I���cK��ILI�.� FEE _ ADDRESS TELEPHONE NO. (Non-refundable) ENGINEER TELEPHONE NO. DATE SCHEDULED (Applicant' s signature) . . . . . . . . . . . . o . o . o . . . o . . o . . . . . . . . 000 . . . . . . a . . . o . . . o . . . . 0000 . . . . . . . o . o . . . 00 . o . . . . . . SOIL LOG SUB—DIVISION NAME DATE 6,kk, k-7 \98Q� TIME 1 , EXPANSION AREA YES 1( NO _ENGINEER DOWN WATER_k_PRIVATE WELL OT\4j 1-t"ij 6f� > 0 BOARD OF HEALTH AL E e z- EXCAVATOR �.tss Ira � �yati,P pig, ., i .22 A. 70 t� PETER SULLIVAN ': ' Q A e J G. Xv�u�"tAr,- t �No. 2973 Vx�. . �. wit`. CESTG�� <y• i C� • F ZONAL YsA�,g4�tc t.J. \1 L.lr C�. f tea✓ T r LL S.4.1 l,L C4A41 AlVNC.\.,t.L 1 � � •.�_/ `�a�►•�ca�t� ll�u5�a►'cam �S dot:. 'ERCOLATION RATE: 2 M1 4 LA ?G%Z_ �' 60b&AL s�IT 'EST HOLE NO:"(�}- ELEVATION: 2 - - 3 3 5 1 4t6tVIUL.E 5 6 6 8 8 9 9 2.s' 11 � �► 12 12 13 13 •14 14 15 15 16 16 UITABLE FOR SUB—SURFACE SEWAGE: LEACHING FIELD LEACHING PITSE ��`4G'� tf LEACHING TRENCHES NSUITABLE FOR SUB—SURFACE SEWAGE. REASONS: �- BAXTER & NYE, INC. Registered Land Surveyors and Civil Engineers 7 Parker Road/Osterville,Massachusetts 02655/Tel. (617)428-9131 WILLIAM C.NYE,R.L.S.-President RICHARD A.BAXTER,R.L.S.-Vice President PETER SULLIVAN,P.E.-Vice President-Engineering May 6 , 1986 Town of Barnstable Board of Health P .O. Box 534 Hyannis, MA 02601 Re : 60 Centerville AVE - Craigville Builder: C . Mickunas' Dear Board: In accordance with the terms of the permit , I have inspected the septic system at 60 Centerville Ave . , Craigville. The installed system meets the minimum standards set forth by the Board of Health and Title V. Very truly yours, Peter Sullivan, P . E. Baxter & Nye, Inc. PS/fmj • 11A OF 9 <R PETER �GN SULLIVAN No. 29733 0 FSS�ONA L MEAMERS OF CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS/AAERICAN CONGRESS ON SURVEYING AND MAPPING MASSSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS LU CATION , f SEW G E PTRMIT NO. ViI_ LACE co- I M aT A L F f S MA YA x ADDRESS ot ON OWN fit 60 AT CD PLIANCE ISSUED � �� i i �' _ �� ` � I �� , '� j ���._. .� � L ,, ,� '� �� .� ` 6� \\ � 4�� l