HomeMy WebLinkAbout0302 ELLIOTT ROAD - Health 302 Elliott Road
A = 227—087
Centerville
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S M E A D
No.2-153LOR
UPC 12534
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Applira ilan for Uiipnsal Works Tonstrnr#iun Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
3 2...Ea.la.Q ...RQ .._C . t e r v 1..e------•------------• ..............................................
Robert L. P la t tLocation-Address or Lot No.
- ___._...... - .............................................. ---••••-----------......--•-----.....----•--•-•-••••-••--•--••---•....._........................--
D Trt y T Owner Address
� Installer Address
Type of Building 4 Size Lot............................Sq. feet
aDwelling X No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
p-, Other—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 ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water-.---.---_--.--.-_.-----
�14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
a ---•----------------------•--------•----------------------...---•-----•---------•---•••••.......----.........................................................
0 Description of Soil...............................................................................------------------------------------.....----•--------------•---•---•-----------•.------
v ..-•--------------------------------•----------------------------------- Viand-& Gravel---------------------------
W
. ----•--------------------------•---•--- ------------•------------------------------•-•--•-------------•-------.....-----------•----------------•----•-•------•---•-•-•-------------•------•----•---
Z. Nature of Repairs or Alterations—
Answh,when a icable................................................................................................
1-1000 gallon leacIng p
_ g
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has ben ' sued by the b and health.
Signed �� / 3/9
� 1 0
- '-- ----... .. ............ .....................-... '-----........--Dace .....---"-'--
ApplicationApproved By ----------- - ------_-. - -.-------- '---"---- -- '- --"- -"----- ------ -- - ................................. -- --.-.........................--'--'-
Application Disapproved for the following rea s: ..--'-""....---...--"'---"'-"'---'-'-"..."---'.....'--"--------'--'--.."--"..."'-""-'.........-'---- -''---''-'-'"--
.................... ............................. .- ..--....................................................-"---....'--- '.'--te...-- -- ----'
Dace
ZPermit No. �6)..7/7. Issued '' " ---------------'-""
t ,
as 9/0W/9
N .o-qo.-- Bs F .. .fin... ..
�J
..........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
. ppliration for Biopnsai Warkii Tonstrnrtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
Robert L. Plat t
fin? l i n t_,ROat . (`anl px��� _l,l t�_.......... ............................................... ..........................................
....-------__....
Location-Address or Lot No.
Owner Address
........................................................ --•---•.......••••--••--•-....•-•....----•--••-••...... ......-----•---
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling X No. of Bedrooms............... .........................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a - -- --------------------------•-•••-•-------••--...
Design Flow.Other fixtures - gallons per person per day. Total
W g g P P P Y 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P --------------------------------------•-------------------.........--------------------•----••-•-•-•.........................................................
0 Description of Soil........................................................................................................................................................................
WI........--•---•---•-••------••--•-----------•................................C l`�._. '�.._f`=rs tr¢�1----=---•-------------------......
W
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
---------------------].-�QQ�---�allon_..leac_h ... p3....
.............................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental 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.
Signed .t�... A'.e la ............................. ----....L 413/9rJ....
Date
Application Approved By -------------- --
v" Date
Application Disapproved for the following reas'ans: ....... ...............................................................................................................................
--------------------
-- ......................................................................... I
...... .. ........................................
Date
Permit No. .�/�. / �... ................ Issued .. ...q
. ........., �
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE r.
C e r#ifiratr of (1umplianrt/
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (t. - +,t ),or_Repaired (X ) .
by......3J?-..Elliot.t....Road....Centerv�:C.e.n.t.erville................................... ........................................---------
Installer
at -----J.-R.Ma e om1h.P_r ^T.,r.,........................................................................................................................................................_-----------_---------
has been installed in accordance with the provisions of TITLE 5 f The State Environmental Co es described in
the application for Disposal Works Construction Permit No. ... . ... ..__.. dated .-..... ...// q�
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B9 CONSTR�b AS A GUAR "I�TEE 4HATHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE........�roO Q17... .............................. Inspector ................�l�l r-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
� TOWN OF BARNSTABLE
No../.� .'..�� FEE:t..30.,.P ...-
Nispasal Works Tonstrnr#ilan f amit
Permission is hereby granted. y •a M_ M -� a-�..... .............••---•.....---
.,b.rrrx�.•c 3• �� .
to Construct ( ) or RepairX(X ) an Individual Sewage Disposal System
at No.............. �7... J a o t:..R ad, Cent.ryi le.....
Street q f�/ ..f` /,�_as shown on the application for Disposal Works Construction Peerr o
�mit N ........ Dated...._
.
DATE.�?"_ , _....... Board�of Health
.....----•.................... . ...........•
FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS
6/24/2020 ShowAsbuilt(1700x2800)
!-.G TOWN OPpBAANSTABLE .
JOY+ O
LOCATION 3C,Z F&,'I 7-1?r SEWAGE# 90-1 Ty
VILLAGE_rr,,irr ,'1/e ASSESSOR'S MAP 6 LOT. (9
INSTALLER'S NAME B PHONE NO. )./7 c•/Gr„Jw7�So� Lh c.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) 4,t— (size) G L
NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED; !-�•D-fin
VARIANCE GRANTED: Yes No ✓
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https://itsqldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=227087&sq=1 1/1
CC TOWN OF BARNSTABLE C7a
LOCATION C; 2 f/,'� /��� SEWAGE
VILLAGE ASSESSOR'S ASSESSOR'S MAP 6z LOTS'
INSTALLER'S NAME Cz PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACTL t . (size) k Ooo
I TY•.( ype) � fi`
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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