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Home My WebLink About0114 CENTERVILLE AVENUE - Health ENTERVILl , 114 CENTERVILLE AVE.,, A=226-109 I No. 42101/3 ORA Lr- (B)nd&lqDp ESSELTE 10% 0 0 0 0 a No. lO �® / Fee V 61 THE COMMONWEALTH OF MASSACHUSETTS tlz PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[pp[ication for Miopogai *p6tem Cougtruction Permit Application is hereby made for a Permit to Construct( )or Repair( ),an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. �,�� ' ,�. � �'oJ�—� �14, l ►gyp .� V 1 114 C.v�eiw i VL- A.V I CrI.A v v Installer's Name,4dress,and Tel:No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flower gallons per day. Calculated daily flow gallons. Plan Date "�`� Number of sheets Revision Date Title Description of Soil Nature of Re or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure a co auction and tenance of the afore described on-site sewage disposal system in accordance with the provisions of itle the Enviro en ode and not to place the system in operation until a Certifi- cate of Compliance has been iss this Board of H lth Signe V Date — G Application Approved by Application Disapproved for Me fol owing rea ons Permit No. ! 6j -?n Date Issued No.�O — � Fee THE COMMONWEALTH OF MASSACHUSETTS r PUBLIC HEALTH DIVISION-.TOWN OF BARNSTABLE., MASSACHUSETTS : ., Ap0Yicatiott"for ;0igpogat Op$tem Undruction,-Permit Application is hereby.made for a,Permit to Construct( j or Repair('.,;)'an On-site Sewage7Disposal System at: Location Addressor of�No. Owner's Name,Address and Tel.No. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �YVS C -3— b 3 � ,�{ ,� csl... :�1 , K. Type_ofBuilding: l i ' 'Dwelling No.of Bedrooms 3 Garbage Grinder Other ' ;' Type of Building. No. of Persons Showers( ) Cafeteria( ) 5 Other Fixtures Design Flow.. 3 gallons per day. Calculated daily flow J gallons. Plan.Date — ~ `�`� Number of sheets ~""" Revision Date Title ' 'Description of Soil NaturMe- Date or Alterations(Answer when applicable) last.inspected Agreement� , t � - The undersigned'agrees to ensure a con ction and tenance of the afore described on-site sewage disposal.system. in accordance with the provisions of le 5 the Enviro ent �de and not to place the system in operation until a Certifi- cate of Compliance has been issu s Board of He ;_" 5 :Sig n e V Date --� Application Approved.by Application Disapproved for t e following reasons Permit No. �f� Date Issued ?` } ? THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE, MASSACHUSETTS , • Certificate of 'Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed,( )or repaired/replaced( )on by for 4E as, has"been constructed in accordance with the provisions of Title 5 and.the for Disposal System Construction Permit No. o-7 �. . dated 4 Use of this system is conditioned on compliance with the provisions set forth below: -mom ..:ey�C.a.+y.,wr- No. q q .1 O 1 Fee � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS -Mig�pogal: *pgtem �lCongtruction Permit Permission is hereby granted to �Vmo- to construct( )repair(�}an On-site Sewage System located at ! n444 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within.two years of the date below. Date: - 7 Q Approved by V S/TC &11W .sif s LOCATION ,* VSrX L!E Mq. FZ N�E7 1a !3C SCALE . �. . .3o DATE ".o Z /998 474L&v W1771 PLAN REFERENCE LoT 7- 95 S 4W,v. 0 1.v f'Z8Ae-T, cYESspiooL /6G. 28 - I �cN 00O I 2�3t VuG i c&7sspoo" A,ecR= l7 L8G ° lip of ED 4L EY o. 26100 E,p �fC1STEa�o s� L LA��$ �— EL..Zo,Z/.... Sf�E�T Z TOP OF FOUNDATIO14 �•� CONCRETE COVERS e OR SCHEDULE PER.FT PITCH 1/4" 40 4SCHE 9,MIN . DULE 40 P.V.C. (ONLY) ' P.V.C.PIPE MIN. PIPE- MIN. 3611 MAX. ,•i� PITCH 1/4"PER.FT. LEACHING TRENCH (......REQUIRED) WASHEDPiSTONE t%z� EL...... 7.. INVERT INVERT - SEPTIC ,TANK INVERT ,:. INVERT EL/7- �' BOX EL/7:o4 3 4"-11/2"WASHED STONt= 3" EL.!Z:.86.. /' Q. ... GAL.. INV�RT INVERTINVERT ' EL /S.S7 • ELI.l.:y ,. FLOWDIFFUSORS INVERT •,' 6"CRUSHED STONE EL4t ( REQ EL.�[•,SZ .� So ,3 Z,* j� p0 3 PROF] LE OF cz. /o.s . '• �'•!• < .4V7- GROUND WATER TABLE SOIL LOG SEWAGE DISPOSAL SYSTEM TYPICAL CROSS SECTION DATE OC7- t7/ TIME NO SCALE LEACHING TRENCH . TEST HOLE. I TEST HOLE 2 NO SCALE �eO, ELEV. .!7.BS. . . ELEV. . . . . .. . ... DESIGN DATA : 9-"MIN. 1/8"-I/ ,WASHED t 7„ q"Savoy !oR*s NUMBER OF BEDROOMS MAX. . . . STONE „ �. /7, 2'] TOTAL ESTIMATED FLOW . . .,33o GALLONS/DAY ¢,. BOTTOM LEACHING AREA 'B�,o 4Z i� 8y-Ssreoy Lear, SQ.FT./TRENCH/`.ZB Pt7 0 Zo SIDE LEACHING AREA EZ./� / . .. .��'.Q... . SQ.FT./TRENCH/1'¢¢ „ r C."o •-_ 3/4-11/2.WASHER GARBAGE DISPOSAL !V A? 4'- ..(50% AREA INCREASE) STONE SsHy�, TOTAL LEACHING AREA . SQ.FT. 9 'PERCOLATION RATE 5. ?r!✓,LHi�!� PER. INCH 6 , r LEACHING AREA PER PERCOLATION RATE :�h. rk. SQ.FT/C',,o, AST GROUND WATER TABLE APPROVED . . . . . . . . . . . . . .. BOARD OF HEALTH Z7..•WATER ENCOUNTERED DATE ... .. .. . WITNESSED BY : AGENT OR INSPECTOR • • �P��N Of Afgs ��pISH OF BOARD OF HEALTH . . lof� ��. '9�/D .Z.B ED..WAR o yN Frd7.3o!1!.:e".! Ali- /Z S. ENGINEER /�¢ G•��,�, ,�, �LLE A(/ • E 5 V, '26100 a &71WA,en 1! ^-44EzcL-/ eR4S. C c1/.tLL�. .. . . . 9F �o STEPS i s LISTER ' / µPETITIONER _ /��/G/P. �o s��11L LANOg X017A 'e'� TOWN OF BARNSTABLE 114 98-707 LOCATION qpqp V166 aye. SEWAGE # VILLAGE S€ �€l��- � € ASSESSOR'S MAP & LOT .INSTALLER'S NAME&PHONE NO. ELLTS RRnTHFRr, r ill C9 263 232 SEPTIC TANK CAPACITY 4 S� LEACHING FACILITY: (type) -3 fLo-bI FFko^ (size) /of r)C 3,6' NO.OF BEDROOMS BUILDER OR O �IP �O o / c y PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by CENTrr—r'""-6� tq y'E 1 1 � t a � oT' � �aB TOWN OF BARNSTABLE r , Z, 114 � 98-707 LOCATION CpITTgR aye. SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ELL 1 S RROTHFR-, rQ�ISJ CA- 262 622;Z SEPTIC TANK CAPACITY ( Sc o LEACHING FACILITY: (type) fLO tSI fI?Ulron— (size) /01 rK 3aCY Ar � NO.OF BEDROOMS BUILDER OR OWNER ��/U Lhv �O o / e y PERMITDATE: ,f- 3 -4' K COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by rc M r� . I� e� U qar �/'� 94, e It lit. � 1 Az ,t }y. 3 L(b Pi 1 _ _.moo pl� re Vol l wo �} of � ._.._ ,zfz� I � ,�--f=- ,i'P' '•, -_ .-.. _ _� 1 k i n! '