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Home My WebLink About0070 ELLIOTT ROAD - Health (2) 70 rig itr Rd e ntervtlle zq8 5 M E A D No.2-153LY UPC 12934 smead.com • Made In USA SUSTANAUF FORESTRY wftAm cr"Mw 8maing wwru�ipta�p��+Ms �i f TOWN OF BARNSTABLE LOCATION 20 //07 R SEWAGE VILLAGE `° 'S 6��.G ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR UBLIC ATER BUILDER OR OWNER DATE PERMIT ISSUED: ! yL DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No s :N g r � f / ' � � r � � �, � � � .. �, � � �� . ,• � �� - s. :-_ � . . J L0CATIO SEWAGE PERMIT NO. VILLAGE INSTALLER'S NAME i ADDRESS S U I L D E R OR OWN y1� �� mac'. / DATE -PERMIr ISSUED DAT E COMPLIANCE ISSUED /o r �79I t.. a.. �/O W.e• t=r.wT �j r-� f� I ASSESSORS MAP NO: - y PARCEL NO: 30-00 V .......................... THE COMMONWEALTH OF MASSACHUSETTS QPPROVfD BOAR® OF HEALTH O rnstaaie Gunservation Depet TOWN OF BARNSTABLE L__4 =—TVPP d4 j. �ato 1 Dispuiia1 Works Tonotrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 70 Elliot Road Centerville ........................................................•--•---------------•--------•-•........... -•---•-----------------....----...----....--------••--.....----------........•-----....--•-------- Holland Location-Address or Lot No. --•• -----•-••------......................� ......----.........__........------•----._._... - .._......... W J.P.Ma e omb e r Jr.Owner Address Installer Address UType of Building Size Lot............................Sq. feet t-, Dwelling 7 No. of Bedrooms...........3..............................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Buildin a yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d 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........................................ a Test Pit No. I................minutes per inch Depth of Test Pit..----.........---.. Depth to ground water........................ rs. Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water....................---. 9 •---------••-•••........-•--•--•--•--•---------•••--•-•----•---------•...................•-•-...............................................................O Description of Soil................................................................................-----------------------•----------------•-----------------............................. W Sand.__&.._Gravel U W -----------------------------•------------------------------------------------------...--------------•-------------------------------------•-----------------------------------....................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... 1-1000 gallon tan: 1-1000 gallon leaching 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 Complia ce has be hued y the bo d health. Signe .-- �/1��92 ---........ �.. Dace Application Approved By -------------------- . ...-- --- � D Date Application Disapproved for the following reasons- - ------- - --------- ----------- - --------- ................................ -- ----------------- ------------- ------------------------------------------- ----------- ----------------------------------- --------- ------------- ----------------- --------------- ----------------------- ------------- ---------------- ------------- ---- Date PermitNo. ...- -oZ..-..- -- J�--- ........... --- Issued ------............................. Date No. -1 VQ Fps. 30.00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 70 Elliot Road Centerville ................_................................................................................ ----..._._..............._..........-------••---••-----•-••-•....•----......_._...._..........•--- Holland Location-Address or Lot No. .................................................................................................. ..........--...................................................................................... J.P.Macomber Jr Owner Address W _ Installer Address Type of Building Size Lot............................Sq. feet aDwelling X No. of Bedrooms...........3..............................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building __________________________•- No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W 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. 1----------------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........................ a ............................................................................................................................................................ 0 Description of Soil............................................................................................. ----------------------------------------------------------.....-----...... W ...Sand...&-_Gravel. =.......................................................... UNature of Repairs or Alterations—Answer when applicable________________________________________________________________________________________-- 1-1JJU..Fallon_ tank---1-1�OJ.._� allon...leachin�; 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 Complia ce has been issued by the board 4health. g G¢ ..............------- 6/18/92 Signed --. i Date Alication Approved B -----------------------------------------=- p ... pp pP Y .... � -�-� ' Dace Application Disapproved for the following reasons- ------ ------------ -- --------------------------------------- ----------- -------------- ------------------------ ---- ----------------------------------------------------- ----------------- -- --- ------ ------- ----------- --------------------------- ---- ----------------------- ---------------- - ------......................----------- q PermitNo. ......... -.-. ..2;,%...................... Issued ............................ Date Date .r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C erti rate of C ontyliaxn e, THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) by J.P.Macomber-..�Jt. - - --------------------.................................................................................................................................................................. Installer at ----70....Elliot....Road---Centerville....... .................................................... ............................ 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. ....... - a..g a------- dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. G DATE................... 1.- ----------............ - ... Inspector .---------.�-J .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... - FEE... ...30.00 Disposal Works Tono#rt iott rrutit J._P.-Macomber Jr. Permission is hereby granted - ....-••.....-•--•--•-••-• -- to Construct ( or Repair (X ) an Individual Semrage Disposal System at No......7a-.Eliot Road Centerville -- •-•-----•-••-------------------------•--- .....--•--------•-•----..----- -----------------...-----------•------------•---------------------------.•-•--==---.....- Street as shown on the application for Disposal Works Construction Permit No.-�R- 6 Dated........................................ DATE Board of Health ------------------------•-•-------...-----•-•-----•--------•--------- FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS