HomeMy WebLinkAbout0098 DUNASKIN ROAD - Health q B bVAOjskjf4 R a
CPln�'ervsI1t
Z zq - o4z-7
TOWN OF BARNSTABLE
VvAlkS �A
LOCATION V5 i5u�,v A Cry S lcf) SEWAGE #
VILLAGE ��,,���. x� ASSESSOR'S MAP LOT
INSTALLER'S NAME & PHONE NO.�
SEPTIC TANK CAPACITY / jam MA
LEACHING FACILITY:(type) � (size)
NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED: cj ,, X 7
DATE COMPLIANCE ISSUED: D '"
VARIANCE GRANTED: Yes
I
DvNRSK IJ
LOCATION " SEWAGE PERMIT NO.
f? d Vr
VILLAGE
INSTALLER'S NAME i AD RESS
BUILDER OR OWNEIT
YtiZ- :5 c A&,(o A/
DA-TE PERMIT ISSU- E D
DATE COMPLIANCE ISSUED
O
Qo4
F 30 00
No — ps............................
THE COMMONWEALTH OF MASSACHUSETTS
DcPa'u"qgOARD OF HEALTH
Z7),cyt2 TOWN OF BARNSTABLE
Signed Date
Appliration for Di ipwi al Work,i C owitrnrtion Vantit
Application is hereby made for a Permit to Cortstruct ( ) or Repair (X) an Individual Sewage Disposal
System at:
98 Dunaskin Ave Centerville
...............................................--- --....-•---------•-- •--•-------..........--- ------------...----...............-------•---•---------------------... .... -
Location-Address or Lot No. ( f
__.___.Scanlon
Owner Address
W J_.P.Macomber Jr.
Type of Building Installer Address'
V YP am` p ( ) Size Lot-Garbage Sq. feet
t-, DwellingNo. of Bedrooms...-.--.-.--3-------------------------- Ex ansion Attic r ( )
aOther—Type of Building ---------------------------- No. of persons-.-..---------_-----.------ Showers ( ) — Cafeteria ( )
QOther 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 ( )
W
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
0.4
Grr Test Pit No. 2................minutes per inch Depth of Test Pit..............--.... Depth to ground water........................
1:4 .....................•-----------••-•...............................--•---------•-••--------._..........---------...--•-•-.....................••-•-•••-•----
0 Description of Soil........................................................................................................................................................................
W Sand & Gravel
V ---------------•--•-•------•-•--------....---------•••---•----....-•---•---.......------•••-•-----•-•--•----•---------------•----•-•---•---•------------•-•--------------...................---•--..----
W
---••------------------------- -------------------------------------•-------•-
U Nature of Repairs or Alterations—Answer when applicable-------------Omit...cessl00o1........Install...................
1-1000 gallon tan'. 3—infiltrators
--------•--------------------------------------------------•----------------------------------.............------...-----------------------------...---------------............---•-----•....-••.....---
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 be n iVuedy the bo d health.
Signed . ..- G.�i�'� � .... ............91.2./..9.3......
Date
Application Approved BY ...... .... , .. . �` .�,.�..-.
............................. ...........................
Dace
Application Disapproved for the followsng reasonr: .................................................... ... ........................ ...........................................
........................... . ........................ . ... ..... . ............
Permit No. ..... .�J... T.p� .................... Issued ..................
Dare
30.00
No.. -.... Fa$..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Diripw3al Workii T ontitrurtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
98 Dunaskin Ave Centerville 1
..-----...-•-----------------------------------------------------------------------•---...-•_----- -•---••••--------•-•-•-•••-•----•---•------.....---=--•-------•••--•----•------•............------
Location-Address or Lot No.
.......5 c a n 1 on ----------------•-••-------•- -•-._...._....._-----•----...............--
Owner Address
W J.P.Macomber Jr .
Installer Address
UType of Building Size Lot----_--.•_-__-_--_•-_______-Sq. feet
DwellingX- No, of Bedrooms.--_______-_3-----------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—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 areae._.................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..:t....................................
Test Pit No. 1................rninutes 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........................
C4 ..............•-•-----------•------•-------•-------------•---------•••-•-------••-•-.....-------•--•.........................................................
0 Description of Soil.........................................................................................................................................................................
V •--••---••---•----------•-------------------------------------------•-•--.Sand---& _Gravel t
W G -
. -•----------------------------------------------------------------•--------•-------•---•------------•----------------•------...---••------------•••••-----•------------........---•-•-----------•---
U Nature of Repairs or Alterations—Answer when applicable............Omit...Cesspool-.__Install.....................
1-1000 gallon tank 3-infiltrators
•---------------------------•---•---•--------------------------•--------------------...........--•------••------_._...-----------------•---••--•-----------------•-•-•------•---•----•-•----............
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 be n is'ued by the bo rd f7health.
Signed - /%% � y� 2
Date
Application Approved By ........` xA. ............. T....,�s-�.-.--, -�
........................... .............. ........q.. .) ..-..,.....
Date
Application Disapproved for the following reasons: ...................... . ........................................ ................._...................................
.......................... ................................................................. .......................................................................................................... ........................................
Permit No. ....... ..----- Issued
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
C ertifirate of (fomplianre
THIS IS TO C�RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XX )
.P.Maco. .. . .. e .....by ......J--
r Jr.. .
....._........... .....m .. ....... . ---------------.---'---...sr,Jicr _ _----......... ...------- ------------------------------------
Ia
98 Dunaskin Ave Centerville
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. ...---- .. ..._,. . .. .. dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY,. Z
DATE........ ..........1.6....... J._-...13.................._.... .._..........._.._. Inspector ..��L.. ----- --...........------
...............----
- THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE $ 30.00
Disposal Workii Tuntrurtion "Vrrntit
J.P.Macomber Jr.
Permissionis hereby granted..............................................................................................................................................
to Construct ) or Repair 7M an Individual Sewage Disposal System
at No...
98 unaskin Ave Centerville
---------------
•-------------------------------------------
---------------
•......
---
Street [ � -..(q
as shown on the application for Disposal Works Construction Permit No---�3.-;� Dated.._._�'_,�:a .3............
.............................. ...
C� .................................... Board of Health
DATE............ -'"�==�"•-f--
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS