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HomeMy WebLinkAbout0058 CLIFTON LANE - Health 58 CLIFTON LANE, CENTERVILLE A=247-004 3 llll � 3 UPC 12543 No.. 53L R HASTINGS. MN �J r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF •BARNSTABLE Applirtt#iun for Biupuuul WorkiiC�>�At #r r#inn f ermi# Application is he y made for a-Perm to Construct ( ) or Repair an Individual Sewage Disposal ,�Io System at ......�.4- 1�r�'o i y- -�' •---- •....... ............ .......................................... Leea-ion• Add d No. Address or- t ............ ./ .L1 .. ........... ................ ......... ..._...... Owner ................... ................................. ........ram....•. % - .. ................................ Insta ll er Address Type of Building �/ Size Lot............................Sq. feet . Dwelling—No. of Bedrooms.....4 ..................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons.....--..................... Showers ( ) — Cafeteria ( ) Other fixtures --------------------•---..........----- -•-----•--------------------...----•----------- ........�.....•---....•............................. . Design Flow........`. .•• ••--••.......•••.•gallons per person per day. Total daily flow...I:.� (..........................gallons. Septic Tank—Liquid capacity------------gallons Length................ Width...---.......... Diameter...-_--...._.-. Depth................ Disposal Trench—No. Width.....?........... Total Length-7.3.......... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.,.........--....... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY.......................................................................... Date........................................ Test Pit No.. I................minutes per inch Depth of Test Pit...................... Depth to ground water...--.....---........... Test Pit No. 2----------------minutes per inch Depth of Test Pit--.................. Depth to ground water.............---........ ..........................................:.................................................................................................................. Descriptionof Soil---------------------=------------------------------•--•--•-•-----•------.......--......--------------....----.................---••-....----•-•-•-----.......-••........ ............................................................ ---------------•-----•----••-----------............----------...---i Nature of Repairs or Alterations—Answer when a plicable.—=P'_ .�A\..._c"5 .....-.. ----------------- ......-................ Agreement: The undersigned agrees to insfall the aforedescribed Tndividual Sewage Disposal System in accordance with the provisions of^_IT'. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b d �. h- lift. Signed....... y` ---- --------------------d-................ ........•. .....--•- ••--- (�...Q . Application Approved BY r .. . . ✓ / it ate Application Disapproved for the following reasons:---•.........................•-----...-•-----•-•---••-•••--.....•---_... ............---....._............ ...........••-•.........z. 1. �...._.... ......................................? ' Issued. ...... � ... Permit No.. .................. t .. Date � � No.._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF •BARNSTABLE Appliration for Uirpooul Workii Tonotrurtion rrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �.�` .�.s.y ................. T ....bi. A dre s '(� .... or Lot No......................_................... �Loca » .. GUt,I .. _ �._... ......................... U er /�y•// �///��J J j� .................. ..............Y.l: d3 .. :Y!!...AddZr9s�.:.. .......................... r, � Installer - Address 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 .---•-••---••-•-•-•--•••-------•...-•-•••-•••---•--•-.••--....--••-•......-••-••......• ............................................:...••...__.._... Design Flow.......... )5_________________________gallons per person per day. Total daily flow..../-�..................................gallons. Septic Tank—Liquid ca acitvkameter ._...-__..gallons QQLength________________ Width................ Diameter................ Depth................ Disposal Trench—:�lo. . J1 �_t___ Width._.._..q..__._._. Total Length._.._ ........ Total leaching area....................sq. ft. Seepage Pit No..................... _..__.._......._.... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................micmtes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ...------•------------------------------•----.._....----......--------....._•-••-...................-•-•-...__..........-••••••._.._......•-••--••...._...••. Descriptionof Soil.............................-----.._........------....__.._.....------....--------------•----------•----........---------....__...._..----------........._..._••-__•••• .........-•-•...-••••---••••-•---•--••....-•••....._..•--...---•.._..••-••-•••---•••--•-...-••••-----••••....--•-••...•---••_•...............•••....._....._........_..••••••.....................•••.._. ...._..•----------------------------•------------_........--------------------------------- Nature of Repairs Alt rations— we en plicable._ r � � - ` G .. ... •-.---- ...... Agreement: The undersigned.agrees to install the aforedescribed Tndividual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned fur-:er agrees not to place the system in operation until a Certificate of Compliance has been e board of lIe tl Signed..._....• •--- •-•--•-- ... ate Application Approved By ! t��C�' ' _ - ..-�� .......... Application Disapproved for the following reasons:...........................: L� `.. .......... ..--..................... -.............. • ••-------- _...._ ..... D PermitNo.... --- - -. ...........�/ ..... Issued......-••-••--_.... _ ...._ ....»aze. .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN of BARNSTABLE, Tertifiratr of Tomptittnrr THIS IS TO CERTr Tat the I ivid al Sewage Disposal System constructed ( ) or Repaired ( ) by............................................... �:1 ... .L. .. ... ...._.C� .......... ........ Insta e at................................:. ��. G ........ - a- 11 ......... has been installed in accordance with the provisions of TIT 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.----- -_T B-1--- - dated________________________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL OT K CN--TQtIED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFA TORY. DATE......... '' .................. Inspecto �... .. .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH III TOWN Of, BARNSTABLE No..... ... ....••--- FsE...:.. ... �io�oott� orko � otr�r#inn hermit Permission is hereby granted..............(� �` to Construct ( ) or Repair ([,,,fan ndividual Sewagff Disposal )T � �%, atNo------------------------------------------- ..... .0 '.. T Street as shown on the application for isposal Works Constructio emit No �`. ated..... ..........o..................0 r ..... =�� y ? - Boar o I�alth DATE..... r, -••--•--•• G T TOWN OF BARNSTABLE LF0CATION —SO C�7 F�c��r L � SEWAGE # f�^'2%' VILLAGE ASSESSOR'S G'�'NA SESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY /S-00 LEACHING FACILITY:(typek fr e((t r yd, S (size) 970�- NO. OF BEDROOMS- f� PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 7=yf. 9-yi f4 S DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �° VARIANCE GRANTED: Yes No 1� y -SrrS� FEB.$ so 00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................._T own-.....OF.....Barnstable-..... ---------------------------------------------------- ApplirFa#iun for DiupuuFal Workii Toutitrurtiun thrutit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: ........ ...West..1W:annispo=L....21L....02672...---------•------------------------------ - ...... Location-Address or Lot No. sZaIII�S.l's12.3b=P.-----•-----•---------------------------------------------- 2.�a��a LE_.lad•�..��SrSLkl « ._..- ... Owner Address a .......A..&..B...Cesspnm]_..Service-------------------------------------- .12-8._Biahaps..Texraace.,...liyannia,..Z&......ULdL. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..........3................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.......................... Showers ( ) — Cafeteria ( ) Q' 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.--................. Depth to ground water------------------------- Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----------•---------------------------•----•----------................._...........-----------------......................................................... 0 Description of Soil-- Sand---------------•--------•-----------------....------------•--••--------------------------•------•-------------- -----------•-------•--•-----............_.. x V --------------------------------------------- -------------...............................................-........................................................................................... UNature of Repairs or Alterations—Answer when applicable...installation of a__1ro00 �11on, �re-cast, stone packed leach pit (overfl_ow)_. ----------------------------------------------------------------------•--...--•-•--•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITILL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hias,been issued by the board of health. T 7/26/83 G_� - ��.. .......................... Application Approved BY n ....------•-------------------------------------------- 7� t / 3 8 Date Application Disapproved for t f o wing reasons-------------------------------------•-------------------------------------------•---------------•••......------. --•..........-•-----••-----------------------------------••-....------.......-••-------------------••----------------------••--- - -- - ---------- --------- Date PermitNo.----......83-...................................... Issued_...............2 6/$3-----•----------------- Date FE4...1.0,©4......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------------ -- --1�-otfar......OF.....Fa=stzble.......................................................... Apptirtation for Bhip ii al Works Taamuurfinn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: .......x.:..�r�� cr- :-. -oo�s 1spo#�; :fir -026'ix� ocation-Addr ss or Lot No. vt3t� E: =Y ice'..................... �t..S' 'I 't?Y�''_tiiCY': !ttiia...f;':iF.. ....._......................__.... Owner A riess aA B, Ges pr�a� e �t� ...••-•-'-----•-••---•--•-•--•-------• 12 Bis p� ei ac ;-Fl renn�is;..1 A---•-'•'©-2$ai'- nstal er Addre Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms..........3.................................Expansion Attic ( ) Garbage Grinder ( ) p.l Other—Type of Building ............................ No. of persons...4...................... Showers ( ) — Cafeteria ( ) QI 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1-__-_-_______-minutes per inch Depth of Test Pit.................... Depth to ground water-._.-._______-__---____. rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P .-•------------------------------------------•"-----------........------------....................•......................................................... ODescription of Soil---Said........................................................................................................................................................... W U -•-----------------•••---•--•-•••----•----•-------------••------------------------•-•-•....•••-•---.....•---•-•--------•-----•--............-•----..... ........................................... 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 TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. n ApplicationApproved By............... ....(- -... ------------------------................................. --.•........._712 ........ Date Application Disapproved for th f of in reasons: ....................................................... •-----------------...-•-••-•-•--...._......-----•--.........._...••--•--•••----••-•-•••••••---•---••-----•---•---•-----......•----•......------. Date Permit No...........N3- ` _...... Issued...............7/26/R -•................•---------------- ---•-----------•-------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............................Town..OF...........Barnstab e...........................................---• At wrtifiratr of Tnntpfiaa�re THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (x ) by_........ ..4e......_zQxy c , ?&.. sh4n .'_�xxa a. �aX tni. ;..,A.....QZ�Q1................. Installer 8 Clifton ,. 1 - - + ---•--------------------------- at... .......... Ln',...�:!est_•rixanizls _ort �_A 422 has been installed in accordance with the provisions of TITIF 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._8l-... ......... dated------------7/_203.................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® S A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......X.[.... 1§5.................................................... Inspector. ------------------------...........---•--........•••••._...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................`;a��rn..........OF......TRamstab.W._...........__..................................... No.....°3-._.1�__rS FEE_$-100 Dhipaaoal Vorkn Tnntrnrlilan rruti� Permission is hereby granted.........A-•&-•B--Casapaa: ..Bar iCp..-------••-----------------•-----•...... .---------.....................------. to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at No........S5---Uif: .OX1...TuI�._,..�:e s�..Apranna. �Q]c .--IAA._...Q?C7?,.-----------------••------- •-- �+............................................... Street as shown on the application for Disposal Works Construction Permit No&3' :.. ...... Dated.._7/26/83...................... ............................. ... ........•----------------------•-------•••......---••-•----•••.----- r DATE. -•--••--•-• 7/ a 133 Board of Health -•-- •-------•---------•--- FORM 1255 A. M. SULKIN. INC.. BOSTON f LOCATION � SEWAGE PERMIT NO. VILLAGE 40v ��v � A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER Ll DATE PERMIT ISSUED DATE COMPLIANCE ISSUED _ -� ��� I r a U ( � ,� 1 ti J, t f