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HomeMy WebLinkAbout0347 GREAT MARSH ROAD - Health 347 Great Marsh Road Centerville A = 210 006 F r i i NO. 1521/3 ORA 100/0 No. ✓o Fee `= THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Migool 6potem Conttructton Permit 10 Application for a Permit to Construct( )Repair( grade( )Abandon( ) ❑Complete System L9Vtdividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel 3 V 7 9,le£,4 y- e j'A-r A t O oo� Installer's Name,Address,and Tel.No. S-0 r• 7 7 S-J'L�b w Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 9 / �- 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 i ed by this Board of Health. Signed Date Application Approved by .S Date Application Disapproved for the following reasons Permit No. 200 J— 2 6 _3 Date Issued r No ZUo 3—2 J Fee 15 ' `4 THE COMMON Ye WEALTH OF MASSACHUSETTS Entered in-computer: s ; s � PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS Zipprication for Miopooa.r *pztem Construction Permit Application for a Permit to Construct( )Repair(epgrade( )Abandon( ) ❑Complete System 1AI dividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel C r 4of Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Ao, 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 iss ed by this Board of Health. Signed Date Application Approved by s' Date 9 G Application Disapproved for the following reasons i Permit No. Zoo 3— 2 SP3 Date Issued 614 —————————————— —————— ———— —————————— y �r THE COMMONWEALTH OF MASSACHUSETTS MA IN � BARNSTABLE, MASSACHUSETTS ` e Pth CE �-'" , Certificate of Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed Repaired g p y ( ) p d( LoTIJpgraded( ) Abandoned( )by A Ad C *C O IFO AVA0,161 If— 4— �,%Wre_ at Cri r o T r!l'Vend 013 c r �" has been constructed'n accordance with the provisions of Title 5 and the for Disposal System Construction Permit No..74`)3—Z S3 dated Installer Designer i The issuaCe of this ett shall not be construed as a guarantee that the syste n n� st ed. Date to�� 0 3 Inspector I i -------------------------------------{-- No. Z o0 3--2 Fee J THE COMMONWEALTH OF MASSACHUSETTS LIAR � PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS GAG c�� .11=i ogar otem Conotruction Permit �e P � p Permission is hereby granted to Construct( )Repair( 9�1iTpgrade( )Abandon( ) System located at 3 V ? c e r,4? .►or.l a rh, ora c- 1 •fr �" 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. Provided: Construc `on ust be completed within three years of the date of this permit. Date: i r Approved by / TOWN OF BARNSTABLE i LOCATION 3 / 1 P�'�/ /lI/��S SEWAGE # '� VILLAGE C L NT ASSESSOR'S MAP & LOT /0 DG d eo INSTALLER'S NAME&PHONE NO. j SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS E A£ BUILDER OR OWNER d3 PERMITDATE: o COMPLIANCE DATE: i ` 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 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by I a � � � ---,> � s - i n [a TOWN OF BARNSTABLE LOCATION 3 /7/7 CR£47 AVI�"P-h' SEWAGE # loo3.2S3 VILLAGE C £tiT ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE N0. ty J SEPTIC TANK CAPACITY X- A" LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER �'o 2 In o C— Z�£ PERMITDATE: o COMPLLANCE DATE: D3 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 Ede of Wetland and Leaching Facility(If an wetlands exist g g tY Y within 300 feet of leaching facility) Feet Furnished by c7la Ih�RS /�l - a 3 LOCATION SENT GE PERMIT NO, VILLAGE INSTALLER'S NAME i ADDRESS 8 U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED • 1 f3NC� _ h � CPss�a�� b k)PLO 'lab �� ! go 2 00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH T own Barnstab. le...O F................................... Appliration for Disposal Works, Toustrnrtinrt rrntit Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: 347 Great March Rd. , Centerville, 02632 ..... _.._.. _......... ••- ............................................. ----.....•••----•---••-•--•-•----••••---------•--••--.............._........_.._..............--•- Emo ene Lope Location-Address r Lot o. g ...................................................................... ••••••••••--••.._.__._.....•-•----•-••-----•......•••------••••--••-.... -•-- _-- W A'-& B Cesspool SerVT1S 128 Bishops Terrace, Tyannis 1# MX 02601 •- •••-•••••--------------------------- ----.....-----------------___---__...-----.........___--_-_------__-_-_-------------------_..._... � r Installer Address d Type of Building 3 Size Lot.................... .....Sq. feet Dwlling—No.'-of Bedrooms__________________ _____.Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ______________ 14 'of persons.............. .__._______ Showers — Cafeteria YP g •. P 3 ( ) ( ) Otherfixtures .....................•=---•=•••-••_. . -• ----------•-... -•-•--•-••••--•--..........•-•----••••-••-•...............•-•--•-• Design V16W.............................................gallons per person per day. Total daily.,flow............................................gallons. W WSeptic Tank—Liquid capacity............gallons Length______ Width_._ _'_ Diameter________________ Depth................ Disposal Trench—No_____________________ Width.................... Total--L-ength........_...........-Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.............._..... Total leaching area..................sq. ft. z Other Distribution box (.' ) Dosing tank ( ) a' Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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................... ----------------------=-----------------------------------------------------•••••-•--•--•--••-•......................................................... 0 Description of Soil........Salld------------------------------------------------------------------------------------------------------------------------------------------------------ W -•---•--••----------••--• •---•--------•--•--•••-------••---------•---•••--•--•••••••••-•--•-••••-•---•--------••---•-----------•-•••-•-•-••--•--•-•-•---•••-•-••••-• ............................ V Nature of Repairs or Alterations—Answer when applicable:....... Wtallati.m..of._a... 1.,001J_.gallan,_._pxe-cast, stonepacked leach fit...foyerflow.................._.................................................................................................... Agreement: The undersigned agrees to install the aforedescribed -Individual Sewage Disposal System in accordance with the provisions of JITTIL 5 of the State Sanitary Code The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by_,the bo d ofa Si e '1 - Lsy ._... ate Application Approve = y/t = = ----------------7/14/ .--•--- Date Application Di pprov or a following reasons---- --------------------------------------------------------------------------------•••- --....•-••••-•--•-•-•--••_••• ••-••--- --•-----•-----•-------------------------------•--•-••---•_---------- Date 7 14 Permit No.82-...................................................... Issued..........• -••• ---••82 •-------------------•-•------ Date w Na$2-...�� d.... FEz$....51G............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH own rarnstable ..... ...............OF..........':......................... Appliration for Disposal Works T11mitrurtion "anti# Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: 34.7 Great-T,arch Rd., Centerville, 02632 .................•------..................... • ......... ..-------------- ..................... ----.-------••---•-•-------_-.----•--•-•--•---------------------------------..--------.-----•----- Location-Address or Lot No. Emoene Lopez. .............................347 Great P�ars h d-. c... enterville •02F2 w A & B Cesspool Servvlcne 'Bishops 128 Terrace, Hyannis 222NX 02601 ,•a -•••........----•-•-•••••-•-••-•--•--•-•--....••--•...............•-•............_••-•-••--------- ......_......---••--•- •--•::...---------_._+..._. ............ =.........._........ Installer Address d Type of Building 3 Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons...._........3............ Showers ( ) — Cafeteria ( ) dOther 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P+ --•-••--•-•-•------------•----••-•-•-••---••--••........••••--••••--•-•----------------•-----.---•-•--•.... ------------------------- •--------------------- ••- O Description of Soil........ and x U .........-•-•-•-•••••--•••--•••---••--••-••--•--••-•.....-•-•-•-•-•-•••-••••••--•...--•••••...........•.............•-•-•-•••----••••••--•••••---•-•-•---•-••.....--••-••••---•-•-•----••-....._._...... w x U . Nature of Repairs or Alterations—Answer when applicable......installA.ti4n--- f--a-:1,, .00__Fall n.__•p==cast, stone P acked leach It ov -•----•--•••-•-- •-•-=-----••.....-•••--•---P erfiow� '-•--••--•-----------------------------------------------------------•--•-----------------...----•----------.......... 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.een issued by,the bo, Ord of li�lth. Signed/!_ -rAe--� -/. '� .... ........ Application APProved,BY.... 1toPzLr .._...._ Application Disapprove for the following reasons--------------------------------------------------------•----••------•••-----•--•--•----•-..D d ate .----.....-•-- --•••••••--•••••----•---..-4--r..�_- .......................................................... Date Permit No.82.-....---•-••--•----•-----•-----••••-•-•--------_ Issued-........_7/14-,�82 ----•-- ----------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................ .own........OF...........Barnstable.......... •••••••••....................•••.... �rrtifirtttp of TontlrliFanrr THI IS T , CERTIFY That the v d al Sewa e Disposal Sy stem constructed C ) or Repaired ) Isi & 13 �esspooi Service, 1Z1 J shops errace, Hyannis, YA 0?'�OS by-•---........�....................•••••--..._.....----•---------•--................--••--------......-----•---•--..--�..----------- ------------......_....----...-•-------..._.....-----.... 347 Greet ;'larsh Rd. , Centerville, TEA Lmeo ene Lo--..ez at. .........---••---•-••--•••--•-----•••••••••------•-•---•••••--••••-•-•••--------•-•--•--••. has been installed in accordance with the provisions of T��'LE 5 of The State Sanitary Code pscribed in the application for Disposal Works Construction Permit No._:: . _, .. `'................... dated.........7 . ��� -.............._...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FU TION SATISFACTORY. DATE.................... ..........82..... Inspector..... i�---------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 82- /o Town .OF..___.barnst.able 00 ......................... ............. ................... $ 5 No....................... FEE.........'.........••.. ' Disposal Works Tonotratrtion ramit Permission is hereby granted.....-A & B Cesspool Se ...., 12$ Bishops Terrace, Hyannis to Co ((ea o Re d )en 1 Se r Disposal System ' r �i ..d�, Ca t ��e, � j2 - Emogene Lopez----------------- atNo. ----- ---------- ---- Street ® `" as shown on the application for Disposal Works Construction Permit No` u._. Dated....7./1�" r2 7/14/82 Board of Health DATE--------------------•---••-----------........................0...........•..... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS