HomeMy WebLinkAbout0151 BUCKSKIN PATH - Health 151 611<krk iA
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17-0- 0 6S
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KEEPING YOU ORGANIZED
No. 12534
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FOPZW MIN.RECYCLED
1 INITIATNE CONTENT10%
CerdSed Fiber Sourolne POST-CONSUMER
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MADE IN USA
GET ORGANIZED AT SMEAD.GOM
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LOCATI01V
SEWAGE PERMIT NO.
VILLAGE
A &. B CESSPOOL SERVICE
128 BISHOPS TERRACE, HYANNIS, MA 02601
BUILDER OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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LOT NO. : ADDRESS: - -
014NERS NAMEk)lmsil�L� d�L� d
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SEWAGE PERMIT NO. : NEW: REPAIR:
DATE ISSUED: :3)tjht DATE INSTALLED:
INSTALLERS NAME:
INSTALLATION OF:
WATER TABLE: FINAL INSPECTION BY:
\DRAWING OF INSTALLATION ON REVERSE SIDE:
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disposal Works Toustrnrtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( fanIndividual Sewage Disposal
System a . - b F� 69l dLl�lj-e
..
Locatio - ddr t
... .................................
..... ..
W (� I�10 �+t.S..l ............ � ._ _N"AEes.
` k— V
aAte.\ ._.. ^................. Ju
Installer
d Type of Building 1-3
Size Lot---------------------.......Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
~ Other—Type T e of Building ............................ No. of ersons...._....................... Showers —
p`�,,, yp g p ( ) Cafeteria ( )
G4 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 ( )
a, Percolation Test Results Performed by.......................................................................... Date........................................
W
W Test Pit No. 1----------------minutes per inch Depth of Test Pit..........---....... Depth to ground water-.---.----.--.----------
f4 Test Pit No. 2................minutes per inch Depth of Test Pit.--................. Depth to ground water..--....................
P4 ------------•--•••--•••-•--•----------------------------•-•--------•.--------------••-------•----...........................................................
0 Description of Soil.....................-.........................................................--------------------------------------------------------•-........--....................
V .-----------------------•------•------•---------•----•----------------------------•--•-------•-•---.......------------------------------------------....................................................
0 Nature of Repairs or Alterations—Answer when applicable.....trt i� ...�"0..... ._ .......
l rc................ Y
..................................................
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 plat the
system in operation until a Certificate of Compli ee ,ssu\e e board of health.
Signed --- ...... .. `JV` ------ ........
` Dare
Application Approved By ......
------ .-------- ---- ------_--------------------------------------- ......3 // --I�/.....
M Dace
Application Disapproved for the following reafons- ......................... .......... . .-----....-----------------------------------...------------........--------
---------------------------............................. ------------------------------------------------- ---------------------------------......................................................... ----------------------------------------
(� Dace
PermitNo. .....--- / ` -'3---------------------_---- Issued --------------------------------------------------------- ------
Dace
THE COMMONWEALTH OF MASSACHUSE17S
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of C outplianre
THIS INTO, CERTAFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
b ............
at151! . .......-----Ce-OZ--------------------------------------------------.........-----------------------------------------------------------.----------
has been installed in accordance with the provisions of TITLE 5 of The State Environment��I Code as described in
the application for Disposal Works Construction Permit No. -- ../..--... �� .....�...... datedl................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE A A GUARANTEE THAT THE
'SYSTEM WILL FU�NCTIAN SATISFACTORY.
4
DATE----.......................--- ---- =... " ----- ..............---...---.....- Inspector =.-.-...
�- ! ?
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
OtoposaL Workii Tnni#rnc##ion "rrmit
Permissionis hereby granted...----- -----• .......... .................................................................................
to Construct ( Repair ) an Individual SewP
e.D�spsSaleSystem ....
atNo----------------- S-- ---- -.- . .. w- C�.�/ -_---------------. r__.��2:.-�.---•-•-----•---..............----•-
as shown on the application for Disposal Works Construction Permit No�c fit.-�-----. Dated..........................................
::y ., .........................................................
Board of Health
DATE............ -••-----------:................................................ v
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
I
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Fxs...... �xvp No................. }
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Uiiposal Iforks Tonstrnr#'ton Fermi#
Application is hereby made for a Permit to Construct ( ) jor/RCepair ( Individual Sewage Disposal
System a - 6 Ff 01 G'( ✓' /�' �`
-..�------ ........----•-----.. . .....�----... - ---.........
----
Locatio - ddre �--
p�`'`µ a Address
Installer Address
dType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms................�....................Expansion Attic ( ) Garbage Grinder ( )
Other—T e 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.
P z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date-------•--------------------------------
a 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........................
0 Description of Soil........................................................................................................................................................................
V .....-•--•----••--•••-------•-•.................•----•--•-•••---...•••------.._........-------••-----•........•-••--•-•--•...••------•••-•-••••••--------•------...--•--....------......................
W ---------••--------•-•-----------•-•--•---•••--- -•----------------••-••-•-------•-•-•-•-•------•••--•------•----------------•---.....................................................................
UNature of Repairs or Alterations—Answer when applicable......L pry �N ....mo--.-- •- •-•---•
------------` 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 Compli .ee-h ee\n 'ssue a board of health.
Signed .. �J�� r
Application Approved By ........ /co
Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------------------...............--
-------------------------
-------------------------------- ------------------------------------------------- ----------------------------------------
Permit No. / 3.. ......... ............ Issued ........................ ----------------------..Dace------
.......----------------------'-- Dace
s
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.................T.own-----.OF............Barnstable...
AVV irFatilan for Disposal Works Tonstrurtinn ".truth �
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
151 Buckskin Path,.__Centeryille, P _0262_______________________________
- ...............................
Location-Address r Lot N
James Sabo .................................................. 1j1___Buckskin Pa Eh G_enterville= .M 02632
Owner Address
a .. & B -C_e_s_ spool Service , Inc. 128 Bishos-p Terrace , Hyannis ,....�ZA.......
02601
Installer PQ Address
Type of Builing Expansion
Size Lot----------------------------Sq. feet
DwellingNo. of Bedrooms..................... ansion Attic ( ) Garbage Grinder ( )
a`4 Other—T e of Building No. of ersons............................ Showers
YP g --•-----------------•------- P_.....----------------------------------••----•----------(----)--- Cafeteria ( )
d Other fixtures -------------------------------•-•••......---.•---
it W
Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
W Septic 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........................
4_1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 •-••--••-•••••-••------------••.._....•••-•-•--•-•-------•---••-••-•--•---......•---•-........--•••-...................................
0 Description of Soil...........aaY]d.............•-••••-••-•-••-•--•-••--•--•--••----•-----•-•---------------------------•-••........................•....
x
U -------------------------------•----------••---...--•----------•--...........................-----------...-------- -----------------------•----------...-----------------••----•-•--•-•--------••..-•--
W
U Nature of Repairs or Alterations—Answer when applicable.ins.tollat-l-on...Qf'...a...1.,..000...ga1.........pre—
UNas.t...__E tQne.pa_ckad...leach--•pit----4•Q.varflawj-..........................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The undersigned fu her agrees not to place the system in
operation until a Certificate of Compliance ha i sued by tb r th.
Sign��� . ..----...................
------------•.....
ate
Application Approved By......................... ---••• .....C./�. ----••-----;u/26/•a
. .......................•------ Date
Application Disapproved for the following reasons----- ---------------•---------------•-------------------------•------------....................................
--------•.......••------••--•-•--•-••-•-••....--•--•-•-•---------••---••....-•----•--•--------•-----•••-•-•---------------•••••--•-•---•-.............................................................
I / Date
Permit No. 8..--...----•----•---•--•-•--•---••---• Issued--_-11,2 6 .............................
Date
----------------------------------
ate
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............................Town.0F....Barns ft:MP14.ble.................................................
00. rr#if iratr of Tautphaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired 1 )
by .A .& B _Cesspool Service, Inc. 12yQ Bishops_Terrace,___Hy_ann st.__ � 02_-01
t Inst uer
at-..... Pucxsin Phx Centeryllet ..043.2---______James___Sabo...........................................
has been installed in accordance with the provisions of TITLEE j of T State Sanitary Code s de cribed in the
application for Disposal Works Construction Permit No--- ".._ U _......... dated-....---126gI1
----- ------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTIO//N/SATISFA�iCTORY.
DATE................................11 -t.2-�/9. .................. Inspector-------- -----------------•-••---........--------.....--•----•----•--•--.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town Earntable .,
No....................` 5 � ...........................................OF...............................................--••-•••....-----..._...........-----. FA..15.-00......
A & B Cesspool. Service , nc,
Permission is hereby granted --- ......_.. -------. ---------••.•--•-
to Co ct��-�,' 1 0 �Re a ) at,Individual,SS wage D> posal S t
at No.�s��...-L�t A- ska.r� �* -h,- pert-ervil�.e, PVlk oZbJfn- James Sabo
----------------------------------------•----------------------------..............
Street
as shown on the application for Disposal Works Construction Permit o.,_8 -_..._.___. Dated....11�26�84
.................. --•------ --------•----------•-------•--• .............................
Board of Health
DATE------------------------------ . ..................
FORM 1255 A. M. SULKIN, INC., BOSTON •,s„
r -
No...B�l-.,�.t.� "' " ,. Fps ....1.5,00....
THE COMMONWEALTH OF MASSACHUSETTS
' BOAR® OF HEALTH
I—........ ....T own.......OF...........Barnstable
. ..................................•••......_..
, pplira inn for Disposal Works Tnnstrnrtion frrmit
Application is hereby made for a Permit to Construct ( ) or Repair (g) an Individual Sewage Disposal
System at:
251 Buckskin Path,......Centerville........._ 026 2... ---------------------------------------------------
Location-Address
James Sabo _ 151 Buckskin PatchL t_�enterville�-_.MA 02632
•...................... ....__....... ---............ ........._. ---------
ss
B Cesspool._.. ._._... owner --- 128..B.ishos� Terrace ...Hyannis , IPA 02601
w A & B Servs ce, Inc,a ........ ....................... . -•---...---------
Installer Address
Q Type of Building Size Lot............................Sq. feet
aDwelling—No. of Bedrooms............................................E xpansi3n Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P Other fixtures
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................
xDisposal 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........................................
a
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........................
x .. Description of Soil..........�';aa;cd...------••----.......•--------------------••----•--•--------------------------•----------------•-------------------------•------.....----•------
=°•--•--------=•-•-•------••------••-----•-----•-----------------------------•-•----•---- ----------•---•----------------••------------------ -----------
U Nature of Repairs or Alterations—Answer when applicable ll.st.a_11Rt.19n...4f...._.1.,OQQ._.gal....,.._.pre.—
UaStj.... tme. t_trod...Ie h---pnt._.(.QVa flom.)a---------------- ------•. •--•-•-••--•-••-•-••• •---•-•• ---•-.... .........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TI'L U 5 of the State Sanitary Code—The undersigned fu .her agrees not to place the system in
operation until a Certificate of Compliance ha p ed by tlye cfard lth.
C °
Sign ...... - r 1/26f 84_
Dade
Application Approved By.. `" - .!.. _. ............................ 11�2t�fcS4
Date
Application Disapproved for the following reasons:...............................................................................
---••------. ...---------
......................................••----------....-•-----•••----•--------------------....•-••-••-------------•---•----•••---•-•---•----•---•-••---••••-••--•-------•-----•-••-•--••----•-----------
Date
h- 11 26 84 Permit No.-- Issued-- ..�-- �------•.................•--•---.....
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