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Home My WebLink About0086 HOLLY HILL ROAD - Health 86 HOLLY HILL RD, CENTERVILLE A= 188-093 J No. 42101/3 ORA ESSELTE 10% 0 O O O No. Fas...$....3.Q...Q.Q.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiun for Divi-pn!3al Mirk,i Tunitrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair hXX) an Individual Sewage Disposal System at: ....................... 6-,Holly--Ri-1.1...Road,--Centerville Location-Address or Lot No. MarX.._ Trace caner Address W J.P.Macom er Jr Installer Address Type of Building Size Lot............................Sq. feet Dwelling{ No, of Bedrooms----------- -------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ----------------_---.----_- No. of persons------------1-------------- 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. Z Other Distribution box ( ) Dosing tank ( ) 14 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........................ •--••---•----••-------------••-•------------._..-.......-.-..._.------•-••------•-•••----•-•--------•--------------------------------------------- •-----_--•-- ODescription of Soil........................... •------------------------------------------------------------•-•----•--------------•-•-------............------•------•---•---------------• x WSand & Grave-—..................--------------------------------------------------------------------------- UNature of Repairs or Alterations—Answer when applicable._-OM-J t..-ce.s.spools.....Ixl tall----l..-.I.O Q.Q........ ,,,,,,,,,,,,,,,,,,,,,gallon...tank,.1 distribution„box,,,and1_-1_Q_Q0__.gall_pnleaelli_ _g,__�1t,,,,,,. 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 nn * sued by the b and f health. Signed .------- G<.... '/..�A-- . ....I--------------------------- -------3./..2.5.L.9.5.:...... Dare Application,Approved B ..................................... - ... -' r�.-------------------- Dare1� ._...... .......-------------------- --------------........-'--------'-- Application Disapproved for the following reasons: ..... .... ------------------------------------------------------------------------- ...................................................................................... .. _ Permit No. . �..... ..... Issued .r...�` ....... Dare No. FEB THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / G9� TOWN OF BARNSTABLE Appliration for Diopw3a Wor1w Tomitrur#ion jinmit F Application is hereby made for a Permit to Construct ( ) or Repair }CRY) an Individual Sewage Disposal A` System at: 06 Holly Bill Road Centerville .................................................. ....................... ............................................................. Location-Address or Lot No. Mary Grace ................ ----......._••--......---•--••-------------•-•-------••-••__..._ ._._....----•------•--.........._..........--•---•••••-••---•-•--•..............................-- weer Address W J.P.rlaco r Jr. ..... ..................•-----••--•-•--••--•--•-•-•--••--•---•--•--•---•-•--.......--•-----•... ................................................................................................. Installer Address UType of Building Size Lot............................Sq. feet Dwelling;;', No. of Bedrooms-----------?-------------------------.-----Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons------------1-------------- Showers Cafeteria ( ) Q Other fixtures ------------------------- -------------------------------------- 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 ( ) aPercolation Test Results Performed by---------- --------------------------------------------------------------- Date........................................ Test Pit Nlo. 1________________minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ LT. Test Pit No. 2................minutes per inch Depth of Test Pit__._._......_....__. Depth to ground water........................ .."...................... . -O Description of-Soil.......................................................................... -- -"-.......----••---••...._._.---.-.•x . 1 V ...........................•--•...•-- _____ W Sand & Gravel x ----------------------- -------------------------------------------------------------------------- -----------------------------------------------------------------------------------------•-------- U Nature of Repairs or Alterations—Answer when applicable._.Omit---c2S-SAOOls.____Install_._-1_-1-000"•"""--- .................. gallon tank, l -distribution "box""and. 1 1000 "gallonleachin"q oit. Agreement: r 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 ben issued by tie beard f health. Signed ......... . t Da e Application.Approved B ------------------------------------- -- ---- ------------------- ............ :._ ��--- -:.r- Dace Application Disapproved for the following reasons: ................. ................I ---------------------------------............----......--------------------------- ---- Permit N ...- v..'/ ........... Issued '`...--.............- - ..... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ILPrtifirate of (gomplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX ) J.P.Macomber Jr. ...----------------------... ller - - _._... -------- by - ...._..... _.. ns------ at ......... 8.6 Hol l-y--.H.i l.l_--Road----Ce.n.t.e-rvi.11-e------------------ -------------------___------------------------------------ ---------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in 17 the application for Disposal Works Construction Permit No. ��-�...�_ ..- dated .-_. U- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR E AS A GUARANTEE THAT THE" SYSTEM WILL FUNCTION SATISF TO Y. DATE --! r�-.V...� --- . Inspect tom- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH g 6 TOWN OF BARNSTABLE No,./ FEE."$...�0..0 0... �i��oo�tl ork� �oa��tr��rtiori �rrtttit Permission is hereby granted_J.P-.Macomber- Jr.___________________________________________ ----- -- -- ---•-- to Construct ) or Repair 111) an Individual Sewage Disposal System at No...._._.__8�.._Holly Hill Road Centerville........................................................................................... .._ � stre �J as shown on the application for Disposal Works Construction Permi �_ _._ --Dated__-a- r L --� ....................... ...._.._ _ Board of Health DATE "-""------- --•--•.-• FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS