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HomeMy WebLinkAbout0218 HUCKINS NECK ROAD - Health ($ v�k)'A_f NQC°k R� CbA Zvi S M E A D KEEPING YOU ORGANIZED No. 12534 2-153LOR FoR A,Em MIN.RECYCLED INITIATIVE CONTENT 10. 0. Certified Fiber Sourcing POST-CONSUMER wwwApmomurp W41290 MADE IN USA GET ORGANM AT SMEAn,coM No.... ...... THE COMMONWEALTH OF MASSACHUSETTS �sl c7G, BOARD OF HEALTH d 7 TOWN OF BARNSTABLE VVItratali t-n"r Dilipwiu1 Worlt,i Tomitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (D) an Individual Sewage Disposal System at: -----------------------------•---------..................-----------------------........-------... ------------------------------------------------------------------------------------------...----- Location- Address or � � C Lo 2v ct �£��! -=1...... < 4 --- - ....---- i --•---- Owner Address Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-----------------...------------------------Expansion Attic ( ) Garbage Grinder ( ) 0`4 Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) P4 Other fixtures ---------------- -------------- -- W Design Flow......................... — ...gallons per person per day. Total daily flow........... - o....................gallons. 1% Septic Tank—Liquid capacity............gallons Length................ Width.-..------ ..... Diameter.-.---------_-- Depth................ 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........................ GT4 Test Pit No. 2................minutes per inch Depth of Test Pit..............--.... Depth to ground water........................ 9 ------------------------------------------------------------------------------------------------------------------------------------------------------------- 0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------ x -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- W ---------------------------------------------------------------------------------------------------------------------------------------- -------- --_-------. ..........----..... U Nature of Repairs or Alterations—Answer when applicable...._. :.... -------- . 0�.. ..... �� ---------- --- ------------------sue 40,! TQ.------ _cam ie► ------------- '^Td 1.�- ------------------------------------------.............-------------........----- 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 Complianc�4� ssu by board of health. Signed ....... -.. .......................... .......... -- 92:...... Dare Application Approved By ..............CJ V....�.. .... ?'a^ Application Disapproved for the following reasons: .. . ........................... ............... .... . ................................... ............... .................................................................... ............................................ -- .........-- ........................._....... ... ................................ Dare Permit No. ..........9 Z------------- --- Issued ..-- -----. . . ._.................................. Date qq�� A •rt�` No....!_ _...��� ,. , Fas..... .._... THE COMMONWEALTH OF MASSACHUSETTS 35 BOARD OF HEALTH TOWN OF BARNSTABLE %phration for Ui►ipwial Worb; Tomitrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (<) an Individual Sewage Disposal System at: L I- -----------------------------------------------------------------------......-------- ----------------c----.. .......-...--------------------------............---- Location-Address or Lot No. ..........................n1 ac Gf i1 y'---.....--•---._ �------. ......................... 'U :, � T Ower Address ............................................... ..... / _G.�L�..... ........... � Installer Address UType of Building Size Lot............................Sq. feet I-. Dwelling— No. of Bedrooms................ ...................Expansion Attic ( ), Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons--_--__.-_-_-_-.--_------- Showers ( ) — Cafeteria ( ) 04 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 4 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--...................... i 0 Description of Soil..............................-----------------------------------------------•--------------------------------•---------------------------••••-••-......_...--•--•..... x w ------....--•--------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable-----f pP.-.----4 O_q_S ..... ..W...- +�!._._SlZ^'� .............. 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 r The undersigned further agrees not to place the system in operation until a Certificate of.ComplianceA&� .hias een,issued?by the bo�� � df health. , Signed ........ `.. .................... t --.................. -------- .. Application Approved By .............. .. ......................................... ......... Dme Application Disapproved for the following reasons: . ..... ................................................. ............................................... ... ............................. .................................................... ..... ... . ...............................................-- .. ........................................ Dare PermitNo. ..........7_3--- J.1 ------------------ Issued ........................................................._......... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' TOWN OF BARNSTABLE (ILertifirate of V IImpliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ----------.Cu hJ S.C:.. /uu�l ............... ................... ....X ) ;. " Insrdlcr - 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. r-1 el DATE ........................... ......... Ins ector ...° .. ......._..._....... _.. ... ..... THE COMMONWEALTH OF MASSACHUSETTS c BOARD OF HEALTH `! J TOWN OF BARNSTABLE No._. ... — FEE...` U...�.. Rapooal Works Toiiotruruon rrrmit Permission is hereby granted............... %GL %7Lr�//... ------------............_. to Construct ( ) or Repair ( an Individual Sewage Disposal System at No----------------------------------------- ..---� L_4 __&'__.-•-----•------G�nFi- ....._�J<��£ -- Street as shown on the application for Disposal Works Construction Permit NO.�... �:� Dated..._._._...�'.�•—.� ••---•.......--•-•••--••- ....................................................... Board of Health DATE .-. ,��------•-••-•--•••-•---...__.. FORM 36508 HOBBS&WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LCjCAT10Q)i? kinS t4rk:a ' J SEWAGE VILLAGE -�P-Z��` �� ASSESSOR'S MAP & LOTc;6'0— h INSTALLER'S NAME & PHONE NO t, SEPTIC TANK CAPACITY 1600 (201S. 20 S. LEACHING FACILITY:(type) p"'i (� -_/ (size) NO. OF BEDROOMS PRIVATE WELL OR (U:BL:IC:WAT�ER � BUILDER OWNEQ//�L DATE PERMIT ISSUED: �p L9 .3 DATE COMPLIANCE ISSUED: -7 -��. VARIANCE GRANTED: Yes Now; r a7 No..-- .... - .. Fps... ............._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALT�-i' T..-,,,..... .....................oF....... J .1 .1-. `......... - , ppUration for Disposal Workii Tomitrurtion rrmi# Application is hereby made for a Permit to Construct (J ) or Repair ( ) an Individual Sewage Disposal System at Lvr -2 f®1. I4/G-k14.5, iv�cK >�a� ................_----•---•------------•---•---------•------•-•---------------........_........... ---... .--••----..........-----•-----•---•-----•-•---•--------......--............---- Location-Address - or Lot No. - = _ ................................-------•---------- ......... aw.....a !° ............ Owner // _ Address ....................... ............................................�1 ^1 .................................... Installer Address Q Type of Building Size Lot_ _')4*------•Sq. feet Dwelling=No. of Bedrooms...... .....................................Expansion Attic (M) Garbage Grinder (ao) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------•. - W Design Flow...5.42'CG l--- -----------gallons per person per day. Total daily flow------- ........gallons. WSeptic Tank—Liquid capacity&P� ._..gallons Length----PI!------- Width...4.... ... Diameter....:........... Depth..4.1........ x Disposal Trench—No. .................... Width__A.._._._.. Total Length.................... Total leaching area-------------------- Seepage Pit No........I........... Diameter.................... Depth below inlet.................... Total leaching area..41& ___sq f.-.6!PD Z Other Distribution box (y[) Dosing tank (,AU) Percolation Test Results d' minutes inch f_ ."i,: "W----•----•----.-- Date Y ......A A/6.1- Faj Test Pit No to perDepth o Test it -- -....... Depth to ground water'- Test Pit No. 2_ __ r....minutes per inch Depth of Test Pit.A44"........ Depth to ground water.........I.... _. W ..................................••••---•-••••••-•---••......-•••-•-••.............- ------•---------•-•----.....................-••••-••---...•--..•••. O Description of Soil.......�.r_.__�___an..-Za...ea"a,' ...------ ----� .. 7✓.............................................................. "4 V ....•-••••••-••-••••--••-••-•-•-•••-•-----•--•----•-•-••••--•••-------••-•--•-••-••••••-•---•••-----•....-••-•-•---•-•---•-•-•-••................................-•-••-----•...............•-•-•••---- W x -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable----------------------------------.............................................................. Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL i; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been. s's'ue by t -boar h Ith. /N/ /Date Application Approved BY ..: = .�y�_ _ -------------- ------- if • Date Application Disapproved for the following reasons---------------••------------•--------------------------•--------------------•--•----------------...._......---- ........................................................ ............................................................................................................................................... Date PermitNo..................................................••..... Issued........................................................ Date &- r THE CCOMMQNWEALTH OF MASSACHUSETTS BOARD OF HEALTH'x ...-•......................................OF..........................---...........-•-- ........................................ Appliration fnx UhipwiFal Works Tomitrnrtinn 11nutit Application is hereby made fo�ai Xermit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ --•-•--•------._......----••-•---••---••••-•----•-•...-----••-••---•-•--•--------.............•... Location-Address or Lot No. .................................................................................................. ..........--................................. - ---------------- -......... .......-------- 9 Owner �j Address U> Installer ! y_ Address d Type of Building k Size Lot............................Sq. feet ...................Ex Expansion Attic Garbage Grinder No) U Dwelling—No. of Bedrooms______________________ _ p ( ) g aOther`—Type of Building ............................ 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-___-___-___-_--_____-. (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ K .----------------------------------------------------•-••----------...........-----------------------......................................................... Descriptionof Soil--------------------------- ...-....................................................................................................................................... x U w UNature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------------------------------------------•------------------•----.........-•----------•-----------------------------------......-----........._...........------------.............--• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ed-------------------------------------------------------------------•------------------ --------•---------------•------- �� ae Application Approved By.._. ._..... c^.% . � 0��'==' 1•� ' Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------. ---------------------------------------------------------------------•--.....----•------•--•---------------------------------•---•--•-----••-----------•----•------------------••---------•-----__------ Date PermitNo......................................................... Issued....................................................... Date yi THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..... ............................................................................... Tnrtifiratr of Tuntph atta THIS I O CF,�I�Tl� hat the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ��: by--------------- - - - .......... In Iler J at `� - -4 - c -��------------------------------------------------------------ has been installed in accordance with the provisions of TITIF 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit ............ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SFIALL NOT BE•CONSTRUE® S A GUARANTEE THAT THE SYSTEM WILL UN ION SATISFACTORY. DATE......... '.........`..:Y ................................................ Inspector--------. . ...........------------------------.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �?20�/�- ..........................................OF....................._...................._....._.................................... -.,,ram'' No. ................... FEE -r ......... 'Billps 7ki Towi#rudian unfit Permission is herebygranted ------------ ---------------------•-------..._...-----------------•---........------.........-•---•--- to Constru t ) or Repair ) an ndividual Sewa Disposal System �f at No...................";=� -X....--- -------- .------ -- ---.... �- '���1 Street as shown on/theapcati for Disposal Works Construction Permit No....................JDat d.._......._._................_..._........ � f- - --------------- -------- ------- oardofHealthDATE--------- ------•------•-._.....--•----•.......--••-...----_._... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS L 0 W & WELLER, INC. 477 Main Street - P.O. Box 119 Yarmouth Port, Massachusetts 02675 362-6868 - 362-8131 Registered: George Low, Jr., R.L.S. Land Surveyors Everett H. Hinckley, P.E., R.L.S Professional Engineers William G. Weller, Consultant July 25 , . 1983 BOARD OF HEALTH Town of Barnstable Town Hall Hyannis, MA 02601 RE: Lot 104 - HUckins Neck Road, Centerville Dear Mr. Kelly: Please be advised that we have supervised and in— spected the installation and construction of the new sew- age system for the above referenced location. We find that the system has been installed and completed in accordance with the approved plan. If you have any questions, please do not hesitate to contact us. Very truly yours, �v Everett H. Hiriokley, P.E. EHH;dlw i s `J LO AT ION SEWAGE PERMIT NO. 46� /,Oy /�t/c I�C��r YID ill z - "7 �3 VILLAGE C-e INSTALLER' NAME & ADDRESS Ych t U I L D E R OR/ OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED �pj " �AA 1° y Hocki �► s S.� _. 'Volt'. o F F o vn✓:�, Oo '� ST•. 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