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HomeMy WebLinkAbout0070 FERNBROOK LANE - Health 70 Fernbrook.Lane, Centerville - \ A=208-085.016 No. 42101/3 ORA ESSELTE 10% 0 a a 0 ASSESSORSMAPHO, No. PARCEL NO° 0 M Old Fee THE COMMONWEALTH OF MASSACHUS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYtcatfon for 30igpo5al *pgtem Conotructfon 30ermit Z- Application is hereby made for a Permit to Construct( )or Repair Lo-ran On-site Sewage Disposal System at: �. Location Address of Lot No. .�© '� 61 Owner's Name,Address and Tel.No. Assessor's Map/Parcel c, 9,&-4 ® 1 0 �o 11 .0 a b,r,,-k. ��e Installer's Name,Address,and Tel.No. i."''I I em s+ Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 3 3® SD. gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs o Alteration \wer when applicable) '�.1 a to Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is rXCZ ard of Health. Signed Dates.—q� - Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued ��' ;L6 qb ile Zoe � No. Q ty +s,� old Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Oiopo.oal *pgtem Cougtructiott permit r Application is hereby made for a Permit to Construct( )or Repair Lol an On-site Sewage Disposal System at: Location Address or Lot No. 0 _Q® " j • t 6 m#((_ Owner's Name,Address and Tel.No. Assessor's Map/Parcel I' Si Installer's Name,Address,and Tel.No. It1-1-01 ul Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow -3 3 c) 1a gallons. Plan Date Number of sheets Revision Date ..� Title t � Description of Soil ` Nature of Repairs or,Alterations An wer when applicable) - w' Ste, \ NCt,,,i 10,00 CaCA,,.� . Lbw O^Cy � � . ��_-a tit Q c� 3 its•� G� r t�•►-►� +cz.�t,��: u.,,j 11,00 G.4\1 O e�; Qt..�►.�t O I t►e �t2 eau•.. U d0«i�... -krs nK tuck o l 4I 1,,., Date last inspected: w 4 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is d by`this Board of Health. Q k Signed �A-�.. ��-+ bate$�c r 9 Application Approved by ' Date ' �'"Or Application Disapproved for the following reasons Permit No. 74 Date Issued �' 16 ————————————————————————————— --f-� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of ComPhance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(f/)on by Installer at r n3 jo cao k- on, e-�enleP-j- s- Mc . has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construc ' Permit No. dated +St-.1L G-'-`�4 Date Inspector THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTfE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. a THE COMMONWEALTH OF MASSACHUSETTS 3A �vdk' "" PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS q o r VVCe 1 migozar *pgtem Cougtructton Peruttt Permission is hereby granted to to construct( )repair()('an On-site Sewage System located at No.# Smet and as described in the above Application for Disposal System Construction Permit. ''• '�b Jr No. Date _ The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. r All construction must be completed within three years of the date below. ' V / Date: Q C7 Approved by Board of Health'., t Q �-OT 2O v TK- SS -16 i�Be�k i ,rv�G H 1> /I I A T v 1�1 • �v 7 3,7,3OF 41 RICHARDNfr No. _aI(i t � A. BAXrl_R ern �rc�..�i,,�"/! 9No. 24 ta O No.... FRs..... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirativn for Divi-pasal Work,i Tnnitrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair P4) an Individual Sewage Disposal System at: _ ...................................................�z�'".7��eiri4L CI�G�. f GT'zi'L.e�l f to�>� -----•-•---- -------------.............................................................................. C-f� kS t� Location L..dares. ................................. Owner Addd sss a �.! - ! .....lLu e� fU l�1 �7L-� (nP,ortL ee Gl ,� ' `M 5 r-- •- ----- PQ Installer Address U Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms-----------�-------------------------Expansion Attic ( ) Garbage Grinder t- t A J. 3 aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtur --------------- - --- - - - ----------------------------------------------------------- -------- ---------------------------------------------------- W Design Flow.................. ........................gallons per person per day. Total daily flow...-_....._.�W3U...................gallons. WSeptic Tank—Liquid capacity/090 gallons Length-_-.--_-______ Width---------------- Diameter---------------- Depth__----_--__--._. x Disposal Trench—No- -------------------- Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No-------/........... Diameter......... ----- Depth below inlet.......6---------- Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ 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........................ 1:4 .............................................................................................................................. .............................. 0 Description of Soil........................................................................................................................................................................ x U •-••---•--••-•----•....•--••--•----•--------••--•--•------------------------•-•-•-•-------------------•-•-•-•-----------•-•-•---•-----------------------••••---------------•-----•.....-•••------------- W x ------- . ---- U Nature of Repairs or Alterations—Answer when applicable.-. �. i4:_.._... ¢a o ............................................. ` •- 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 as been i e y the board of health. Signed - -------------------------------- Date Application.Approved BY e Date Application Disapproved for the following reasonr- --------------------------------------------------------------------------------------------------------------------------------- -------------- -- -- ----------- -----------------....--------------- ----t - __ _ --/----------....-- ----------- -------------------------------------------------------------............------ ........................................ Permit No. - L.- -...� ...-...5 ..1....V .. . Issued ----- ---- ... .aZ.�. ..�------- Dat----------------- ------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�er#ifirak, of Compliance THIS IS TO CERTIFY, ThA the Individual Sewage Disposal System constructed .( ) or Repaired (C<') b .i —O U1, 7 C�4 -JS7LU---�r U tiJ Instauer ...at .. -- - --..------------- -------------------------------------------------------- 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. ------17 ......5..4_81------- dated -----w.-.a..a..-c'�. ..._... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT-THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ------................---------------------------------------- -------......------------------- Inspector .----------_...------------------------------------------------------------------------ ti �� {, �� yet� f( t'✓�.c..e..11 085, 0/6 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphratiou for Diti-Vutitt1 Vorkii Towitrurwitt Prrutit Application is hereby made for a Permit to Construct ( ) or Repair 04) an Individual Sewage Disposal System at: -76 / C �-&Q J I L&f . ............. .-•--•-----------------------------------•-----•---------•----•--•----------------•-•.....-••••••. Location-Address or Lot No. _ owner Add ss ,W �l /U LU 1 / U 1`1 —7Le s (�A� ----�------------------- -� . ---'----------------------------- -----------........----------•-••---• ' `iv► ► t.LS Installer Address Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms----------- --------------------_.._Expansion Attic ( ) Garbage Grinder (—) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ----------------------------------------------------------------------------------------------------------------------------- --------------------•-- W Design Flow............------------------gallons per person per day. Total daily flow........... 3o...................gallons. WSeptic Tank—Liquid capacity/NUd.galIons Length---------------- Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. ._-_-_____-_-_.___. Width___________________ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..------ _.. Diameter.__--._--�4....... 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-.___-.-----___----_.--- GX4 Test Pit NO. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 ......-•--••................................................•--..........-•-•---•---•-----------•----------------------------------------- -........ •--------- DDescription of Soil........................................................................................................................................................................ x W --- ---------------------------------------------------------------------------------------------------------------------------------------------------------- -----• ------------------•........... U Nature of Repairs or Alterations—Answer when applicable._._ 'd.�....._�_._____..�G�.Q.f,4�.___�- `�.._�_" ..��=.=%_----- =?'-.��------- -------------ram- -� --------�`�' .t S_-_i t - .-5V-5 ......................................... 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.,, as n bee is e y the board of health. Signed ........ - ............ ......../. ...... ........... Dare Application Approved B PP PP Y � ' V 3�� - D -a ue Application Disapproved for the following reasons- --------------------------------------------- -------------------------------------------------------`..---------------------------- L/ Date Permit No. 5......- 57 1 6---------------------- Issued ............ -. .... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�.ex#ifi a e of C�ontylianre THIS IS TO CERTIFY, Ilia the Individual Sewage Disposal System constructed ( ) or Repaired .t U �eJS'�LuG by -----------------------------------------..----- - -.... _... Ine alley at --------------------------------------------------- ------------- -------------_-------------------------------------------..... 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. _ 17_S-...S..—1.211....... dated .....?j a.-�..-��_'�" ... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAAH-E SYSTEM WILL FUNCTION SATISFACTORY. DATE.---------.._...._-------------------__--------------------------- -----------------...... Inspector ------------------------------------------•---------------------"......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH qq TOWN OF BARNSTABLE FEE........................ %postt1 Workv "amit Permission is hereby granted...................! _✓C._t._J��'_�.........�r_G'`..�' -� (� to Construct ( ) or Repair O an Individual Sewage Disposal System at No........................................-741---• r 'v/ t �---------- '---1L/._.__� /C�/)tt Street as shown on the application for Disposal Works Construction Permit N4. ::_��_&_ Dated__ .- 6........... -------- -------------------------------------------- c DATE............... ............................. Board of Health FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS LOCATION 70 SEWAGE PERMIT NO. . . �_6 ►` VILLAGE I N S T A LLER'S NAME i ADDRESS hk Ic 4 a U I L 0 E R OR OWNER a V-LL N 13 at DATE PERMIT ISSUED ?� 1 �� DATE COMPLIANCE ISSUED r �`l ' , '�.-)► � •� � �-� j, t`� 4 yr` ,� ,K:. .,� r no—C, No.. ....I....... Fps............._............... THEBOARD OF HEALTH . ...----.T ...............OF.......f>�`u --:-------------------------------•--•- Appliration for 11ispos al Morkii Tonotr trtiun Prrutit Application is here made for a Permit to Construct (?k� or Repair ( ) an Individual Sewage Disposal System at: .... ......... C ------------ -------------------------•-••-------a -----------........_...-----------....--- -L tion.. d ess or t No. .............S_R_ s.r�� - t ------ c ----------------------- a U ddress_..... :..�. Y�L... ......................... - ................................................... Installer Address Q Type of Building Size Lot___ ,_ l .......Sq.' feet Dwelling—No. of Bedrooms---_______ �____ ___ $_ 4 Other ________________Expansion Attic (/lidj Garbage Grinder` (�tJ�) ` —Type e p yp of Building __��'g Q_., __.__ No. of persons._.__, __________________ Showers (Z) — Cafeteria, dOther fixtures .-----P-074f ---------------------•------•-------------------................._.........---•-----•-•-•--...--•--•--•--------•--....--------- + Design Flow............. .....................gallons per person per day. Total daily flow................3.3_a................gallons. WSeptic Tank—Liquid capacity_-1.gallons Length_..,_Q....... Width.....(Q_........ Diameter.....L........ Depth_..6.......... . x Disposal Trench—No.JVW..0__._ Width.................... Total Length.................... Total leaching area_.2._(4._4c____sq. ft. 15 Seepage Pit No------------_------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. ` Z Other Distribution box ) Dosing tank Percolation Test Results Performed by----- -14--A.T? ..................... Date... -Y......._. al Test Pit No. 1_ _Z...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........................ ---------------------------------------------------•---•----------------._.........•--•-------------......................................................... 0 Description of Soil......................................................................................................................................................................... x U ................................. ...-- ----- W ----------• ----- . UNa i A t rations—Answer when applicable-----------------------------------------•--------•------------------------------------...._... Agreemen - The a ersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TH ME- 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 t board of health. -----------• Da Application Approved By..--------- ! --.. .. ...... . ....---•-- Dat e Application Disapproved for the flowing reasons:........................................................................---..................................... Date PermitNo......................................................... Issued-....................................................... Date No............+ ........ Fimic THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF..... --------------.A.VVIka. thin for' %wasal Varks Tonstrurtivit ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: I L 1' P CeV_* J .......... 4 . .......................................... ........................P.. .............................................................................. I Ltion-Address C or Pt No. �Apl (4...... k I t ..................................... ............................ ............�A.! .... .. ...... ddress 7 j ............... ......................................... ................................... ................................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms_________ --_____________________________Expansion ----------- ..........Expansion Attic WO) Garbage Grinder Pd) a Other—Type of Building A)q Q.J9W..... No. of persons____= ................... Showers Cafeteria Other fixtures ..... Design Flow............S.-S.........................gallons per person per day. Total daily flow_______________.S_AA.................gallons. 9 Septic Tank—Liquid capacityJb'ao..gallons Length.../P�....... Width....1�.......... Diameter----4........... Depth-.6........... Disposal Trench—No. Width____________________ Total Length_____.__.___._..___. Total leaching area-2-AA,-4 I .......sq. f t. Seepage Pit No_____________________ Diameter___._.._____..____.. Depth below inlet__________....__.._. Total leaching area..................sq. f t. Z Other Distribution box Dosing tank ( ) V...................... Date._._____;_;, .......................... Percolation Test Results Performed by____ --4-_-KIr K.................. Test Pit No. I�4..a.....minutes per inch Depth of Test Pit____________________ Depth to ground water---------------------_- 0�4 Test Pit No. 2................minutes per inch Depth of Test Pit____._..____.___._.. Depth to ground water...______..________.____ Ix ............................................................................................................................................................ 0 Description of Soil....................................................................................................................................................................... W U ......................................................�w.................................................................................................................................................. W ........................................................................................................................................................................................................ Z 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 T I TILj 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 Signed A &'_!:............. ......... ....... Ddte Application Approved By............ .............. ...... ........ . -—_ --- -- ----- ---- ------- - . t" I Date Application Disapproved for the f flowing reasons:............................ ....................I............................................................ ......................................................................................................................................................................................................... Date Permit No................................................... Issued_..—.-- ............................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ ...............OF..... . .& . ...................................(9rdifiratr of Tout liana THIS IS T@,CER t the Individual Sewage Disposal System constructed (,K) or Repaired 73 ...........e............ . 'TIFY by.......... ....�/ -------------*---------- ------ ---------------------------- -----------------------------*........*----------*------------*----------------at ................K�4�_�.............................................................. ....................................... k Installer 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 FUNCTION SATISFACTORY. DATE._...-••-.. C S Inspector_.. _ ------------------------ I------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.15— .....................OF... FEE5................ ....................... Permission is hereby granted.- • •.................................................................................................... to C6nstrilct or Repair an Individual Sewage Disposal System at No...J.&I.............. ....... Jr±�lT---------------­- ....................................................... Street as shown on the application for Disposal Works Construction Permit NAS-W,+... Dated._ :L— ....... ........... ......................................................... --------------------- DATE....... ....... .. Board of Hea "V------------------------------------- FORM 1255 A. M. SULKIN, INC., BOSTON 7`.d ►.�,��E���rat,► �1( � 3'�3��►�, �� �S , ��`� -1,--'A,l t-Y FL.,C v.Vj I l O x��5?OS/�.L�Y *r�waL� Ae-Er, ►13a c-, C) .j or PETER 9cyGtiC�+ U F SULLIVAN RlcHaRED y 29133 A. Nye '°- No. ;� � eAXTER N` 4� O 1`' ido."043 P. .r.;r II 1S• 0t FG 38� ao Ta�''F.s�o 3�•8 P Cb r. 3, ve //V SAL. � Z' I G E.2T/F/EO PG OT F»L.4it/ a ; I6•9 P 3� ,SGdL� �sto � Q,4TE `2q 67. 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