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HomeMy WebLinkAbout0040 HIGHLAND DRIVE - Health lfo �-h 4i Lax-td Z)P� -cep /// S M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR �NMAM 1 M ONM certfiae� POST�CONSUMER® maim M IN USA GET ORGANIZED AT SMEAMCOM A G E PERMIT 0 O. LOCATION SE W E VIrLLAGE INSTA LLER'S NAME i ADDRESS /9 *,8 Cites ©o S� iicr 11U1LDER OR OWNER DA. T E PERMIT 1-SSU E D DATE CO-MPLIANCE IS-SUED w rl �� No.......... 3 Sao FEB 04...._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................Town......0F..........Barnstable.. Appliratiou for DWpooal Works Tottotrurfivtt Frrutit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: Highland-DrY.e,..CentervilleA.. .....4z632 _.. ----------- .... - Location-Address or Lot No. Patricia Donelan _._72 Highlarnl__Drive_,___Centerville, _MA .02632 _.._.. - ....._.... .... ------- ----- gwner Address a A & B Cesspool Service 128._Bishops..Terrace_,_Hyannis,-MA 02601 Installer Address Type of Building Size Lot-._.__ -_-- Sq. feet U Dwelling—No. of Bedrooms.............3.................._.........Expansion Attic ( ) Garbage Grinder ( )ko aOther—Type of Building ............................ No. of persons........3................. Showers ( ) — Cafeteria ( ) Otherfixtures ------•-------------------------------------------•---.............--••-•••............................. 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water--_----______-___-_____. fs, Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ C4 •-•.---- ••-•-•••-••--•-••-•-•--•---•••-------•......•......................•--•-••----•--------•---...--•--•----------------•-......---•-------.........._. 0 Description of Soil......................Sand........................................................................................................................................ W UNature of Reppairs or Alterations—Answer hen applicable....installation-. •,0 of a •100gallon,-_•ire.-cast stone hacked leach Pitoverflow . ----------------------•----•------------------------•-----------------------•-........_. 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 further agrees not to place the system in operation until a Certificate of Compliance en issued'by,the boar o Signe r � - -C -•----....111183. Application Approved By.... . v� � Dat / A....-•••--•------•-••- .... ...-•-•----•----•---- (-11/83 •-------------------------•---...---•--•---- Date Application Disapproved for the following reasons-----------------------------•-------------------------------------------------...---------------------....•----- ------------------------------••----------...._..-••--•-•----------......••----••--..._......•-----••---------•---•----------•------------...---•-•-••------------•••-•-------•-•-••---•--•••----------- Date Permit No..........8...............d�----------•---------- Issued.-----------5/11/83------------ Date .m No. ---83-•,?0 U FPS... ...1Q.00...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................TsW.......OF..........�'- .=.St:able------------------------------------------------------ Appliration for Dispaii al Works Tonotratrtion rrmi# Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: --•---•-----------------•-----•------------------..............--•-------•-----------.......------ Location-Address or Lot No. Patricia_ onelan 70 Highland.Drive+_Centerville, ,A o2632 .... ................... .. Owner Address a A &_F Cesspool Service - 128 Bishops Te1^xace, H�rannia, MA. .02.601 Installer� Address Type of.Building Size Lot...... ..................Sq. feet Dwelling—No. of Bedrooms.............3 .............................Expansion Attic ( ) Garbage Grinder ( )�U aOther—Type of Building ............................ No. of persons........3.................. Showers ( ) — Cafeteria ( ) QIOther 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........................................ 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......................SBnd..........................................................................................................--............................ x w (, Nature of Repairs or Alterations—Answer hen applicable....installation of a 1,000 gallon, pre-cast stone packed leach pit (overflow . ----------------------------------------------------------------------------------------------- Agreement: .The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TILL LEj 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance-hTs--geen issued by the boar o , . � ,�� 11 $ Signed - ` 5/ / 3 Application Approved By..... .:.f`.._ Da�e/11/83 Vi Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- ......•••-----•-----•---........-•-•------•-•----------------------------•----•-......----------....•-•--'---------------------•------••---------------•--------••---•---•-----•---------------•......... Date 83 '_ r 5/ 1/ 3 1 8 PermitNo......................................................... Issued_....................................................... Date t. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T own.........O F.........Barnstable ................................................................. Cardifiratr of ToutpliFanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired b .A.&.°..Cesspool Service, 128 Bishop.............................ece, 4rannis�- 1"� 02601 a Highland Drive,__Centerville, 14A � 2 - Patricia Donelan . ---•--•. -----------------------------------------------------------•-•-••••-- has been installed in accordance with the provisions of T T I E 5 of The State Sanitary Code as dg•cribed in the application for Disposal Works Construction Permit No.83--..3 5/a11 3 ----- dated-. ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST E S A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........................V11/$3 Inspector_..._ . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF,<HEALTH 3 ......Town OF...............Darnstable ........ No.......-----•--------.-- FEE.._.......10.00.. Roposal Workv %'Pono#r ion rrmi# Permission is hereby granted..........A Pw° B CeSsI?ool SQrviee to Construct ( ) or Repair ( an Individual Sewage Dispgosal System . at No.......20.Iii bland Drivel Centerviller.._n?A..._.026 2 -Fat Patricia Do2�®lan 5/11f 83 Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... 3..----...----- ................•••••.........-------------------•------------------------••---------•••--..........--- DATE----------5/11/ - �83...................................................... Board of Health - ------- - FORM 1255 A. M. SULKIN. INC.. BOSTON