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Home My WebLink About0019 HORNBEAM LANE - Health 19 Hornbeam Lane Centerville A = 206 067 I i i a 0ffwl a�f�rf� VC OEM& 1521/3 ORA 100/9 P2 TOWN OF BARNSTABLE ` LOCATION /9 HdA V,6,cAM I-A SEWAGE # VILLAGE C em7e,C v/[G c ASSESSOR'S MAP & LOTt7a%.-!?_6'-7 INSTALLER'S NAME & PHONE NO. .T•� ,y A � o iY! /3 e A' SEPTIC TANK CAPACITY / ,,S-o o .LEACHING FACILITY:(type) f G ALG c)• (size) .NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER • D �f/,/ �G��ff!/ l DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No N\ Pr \ t 67-206 q ;File #94010 $ 30 00 No.---1-.af"43-- Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS AMOVED na"Cot�ro ►Department BOARD O F HEALTH h �o 8n S VTOWN OF BARNSTABLE Applutt# lT for Eli-npuiittl Works Tomitrurtlivin Application is hereby made for a Permit to Construct ( ) or Repair (Xy) an Individual Sewage Disposal System at: 1.9...11sarahLe am...L.a-ne_.. �.n t< xY .l_l e.r.Ma s s:. Location-Address or Lot No. / Jane N. Jackson Owner Address f�1 J .n .Macomber 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---------------------------- Showers ( ) — Cafeteria ( ) dOther 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................minutes 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------------------------ 9 ....--•--•---••-•-----......••-••-•-••••••--•-••--•-------•••••-•••-••......--•....................•.............................. •..... O Description of Soil........----•---...----•-•......................................••--•-•--Sa11d_&...Oiaval------.........----•-•-•-•-•--...............•--------._.. x t., W ............. ------------------------------------------------------------------------------------------------------------------------------------------•------------------•-••----.......-----•--• U Nature of Repairs or Alterations—Answer when applicable..--...Omit ee----Pool.. . Tn......11 1-1500 gallon tan' and four 4'3c4_' [all_ies , 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 CompliaEehas n 'ssued by the , a of health. Signed ----- 17 94...... .......... — ............-------------------- ---- �--------�----------------- DareApplication Approved BY - - �............... a;L-"(. -.�.. - Date Application Disapproved for the following rearonr: . -------------........ ........................................... - --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- Dare Permit No. ...... .Y.. .�t. ........... . .......... Issued ----------------------- .. ... Daze 67-206 < File #94010 a $ 30.\00 t FEs............. . ........... THE COMMONWEALTH OF MASSACHUSETTS� BOARD OF HEALTH c/TOWN OF BARNSTABLE D �� 4 XpV trtt#clan for Dtinpoml 10orkri Tono#rur#tun rrrutt# Application is hereby made for a Permit to Construct ( ) or Repair (gX) an Individual Sewage Disposal System at: L9...HnrA?.ea.m..j: ne...Can.t rvi_11e_rMass Location-Address or Lot No. Jane M. Jackson ..........._...................•-----...------........--------------•------•---•-----• --------------•-••••-------•-•-•----------------••--••-----•---••----............------------..... Owner Address a ...P_..Macomber Jr. Iustaller Address Ug Size Lot............................Type o Building Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................'`No. of persons---.---__-._..---.----.--.- Showers ( ) — Cafeteria ( ) Other fixtures ----------------------------- 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 ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.-...-.-.-._-----.-. Depth to ground water........................ Gz., Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................ P4 ........................................................•.._......-•-------•--•-••-•----------..........-----------------•----•-••-•-------•--...-----...... DDescription of Soil.......................................................................... and.- ..- ._.aye:l-----•-----------------------------------•--•-----••.•---• U ....................................... --•-----••-----•------•--•-•-••---•-----------•••-------------------------••••----------------------.....------•-•-----------------•----••----•--•-------. W UNature of Repairs or Alterations—Answer when applicable------Omit cesspools . Install 1-1....0 gallon tank and four 41x4I gallies. ----------------------- ................................................... 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 Complian e has b en issued by the oar,6 of health. Signed ........ .._ 2/17/94...:...... Date Application Approved By ............ `�.- ......--�- ..................... - .. ..... Dwe Application Disapproved for the following reasons- ------------------------- --------------------------------------------------------------------.................................... ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ........................................ Permit No. -----l. y.... ..................._......... Issued --------- .........................................Dare----- Due --————— ._.-------_.--_.—.-- ------_— _.--- ————— --------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TlO��WN OF BARNSTABLE zTertift.rate of ontylia ire, THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XX ) by J.P.Macomber Jr. -------------------------------- -----------------------------------------.----- ---------------------------------.. --------- Installer 19 Hornbeam Lane Cemterville 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. ------ ,Y,--.. dated _..._._..............._..---------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. /. /., DATE .........--- /. ...... Inspector-�.._ ------ �- _. --- C,/.-/ -- --- --------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE $ 30.00 �tu�ruottt Turku C�unu#rttr#tun �ertnt# J . to Construct ( ) or Repair (X� an Individual Sewage Disposal System 119riornbeam Lane Centerville, ass. atNo. --.............. -----•---- ---•------ ------------•------- -- Street as shown on the application for Disposal Works Construction Permit No.&-��-- ------ Dated.-- ........?.y......... ................•---••---.--.. V- J. --------- ` ' Cj` Board of Health DATE.......... ....... -- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS