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HomeMy WebLinkAbout0056 FARM HILL ROAD - Health �f 56 Fa mHill`Road Centerville A= 247 - 091 d a *~&IN J�' O E"efie 1521/3 ORA 10% P2 Y '7 - 00 L/Fss.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE , VVftralinn for Bi-nipasal WorliB Tomitrnr#inn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 56 Farm Hill Rd W. Hyannisport .................•--------..............--------•--•---------•-----•------••-----•-----•• ----------------------•---•--------------••-------------------------.._..._..._...---•••-••••••. Location-Address J. Mel -..........................•-....---•-------------------------------------- -----------------------------------------------------...--•----•------•-•-------•---••......•... W W.E. Robinson SepFic Service P.O. Box 1089 Cd'Atgrville ,-� •---•-----••------------------•-•---•-•--...•-- •-•--•--•-•-----------•---•--•---------••------- Installer Address UType of Building 2 Size Lot------_--:_-----_-•-------Sq. feet �-, Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder a Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 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...................... fX4 Test Pit No. 2................minutes per inch Depth of Test Pit-----------------..-. Depth to ground water........................ Description of Soil..................... sand ........................................................ U -•--•-...--••----------------••••---••-••-•-----•--•---•--•-----•......•------••-------•--•---------•--•-•---•-•-----------•-------••-----•---••---- x •-- ----•---------------------------------------------------------------- ----------- --------- ------ _ install-----`--1--;-000•---gal---£aiiY-d-=box..- U Nature O00 gal r Alterations toneo aek ds p when applicable. ----• ---•---------------- ------- .................................................... -•-•----•---------------•g•--------•••-----•••-- P pit. 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. v Signed ...� ..--- -------------------------_---- 1b Date pa Application.Approved BY - ..L.. Date Application Disapproved for the following reafonf- ----------------------------------------------------------------------------------------------- ----------------------------------------------------------- (� Dale Permit No. .....r /', 7 ' ... Issued - p Date No....-.1.. f•-I �- x P F�s....30.0 0 ...... THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiott for Di 400dl Works Tonotrnrtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 56 Farm Hill Rd W. Hyannisport .............................•--........----•----...------...------•-----•--•---•.....---•--•----- -•----------•-•--•--•----•--•-••••------------••--•-----•-----•-•----••-••--•--•--.......•..--••-- J. Mele Location-Address 45 Audley Rd 5b?lftfield MA w W.E. Robinson S613T c Service P.O. Box 1089 dgWterville Installer 6 Address U- Type of Building 2 Size Lot............................Sq. feet Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) af Other—Type of Building ---------------------------- No. of persons-_.--__-.________-_---.-.-. Showers ( ) — Cafeteria ( ) 04 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........................................ 4 Test Pit No. I................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........................ 04 ............. . . ODescription of Soil--------------•------- -----•-••••-•-••-•-••••---••-•-•----•---•--••-•-•••--••-------------•------•-•-------••••------•....---••---------------•----••------------•-•. W U w x {{ install a T;O'OCI gal....tanit;'cl=box U NaAurj 0 aga1 stoations Answe ed iz:n applicable.............................................................=.................................. --------------------------------------------------------------------- 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 iss ed by the board of health. Signedt ........ -------------------------------------------------------- ..... r �� Dace p Application.Approved BY -- v... `. .". ............................................................... 3 =��...0------- Application Disapproved for the following reasons: -------------------------------------------------------------------..........------------...........---------------------------- ....................... _ y© -------------------------------------------------------------------------..._.-------- ......-------------------------------- Permit No. .� / 1 ..... Issued . ..............................................Da a------ Da�e 6 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE k"LlertifirMtr of (2110myltana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x) b W E. Robinson Septic Service y ... - - - _........... .... 56 Farm Hill Rd W. Hyannisport"s""' ------------------------------------ -------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. __....f --^_-� --jr..... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................. ..`...3..�...-..`��---__....---------------- - Inspector --------------G, .---------------------- ------------------------..._------ J.Mele THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` TOWN OF BARNSTABLE FEE........................ 1 Bioyoo W.E. oaks (gunotrudion "rrntit . Ro inson Septic Service Permission is hereby granted------------------ -- --------••---•----•---------••----------•----------•---•-•-••----••---------------•••---•---•-•-•••••............... to ConstruSt('Fxol RgaYrl(R) an.Inlxiadil�S�eaGgtDisposal System atNo.................•--' ---------------------------------------------------------------------------------------------------------••------------ Street ?4 ��t as shown on the application for Disposal Works Construction Permit No._ ,. . .._.___r Dated-------3._-_1.0- ........ -•-••--•--.....-•------•---... ----------------------------------------------------- �y_ O , j� Board of Health DATE................................................. `/--------..--._----- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE SEWAGE # LOCATION f�R� VILLA /�y��,U/ ASSESSOR'S MAP &LOT y G n.� INSTAUER'S NAME&PHONE NO.d.•�7� 03 0� SEPPItT.ANK CAPACITY LEACHING FACILITY: (type) �'`"''� °�£�c� l°/%(size) NO.:;OF BEDROOMS BUIID;E.R OR OWNER PERlul1`TDATE: 1 COMPLIANCE DATE:3 SeparationDistance Between the: Maz�i4m Adjusted Groundwater Table and Bottom of Leaching Facility Feet wells exist Pn'v te.Water SuPP1Y Well and Leaching Facility ( any Feet on:.site or within 200 feet of leaching facility) Edge::of.Wetiand and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Fundsh4d.by S C or, f � o a� a d