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HomeMy WebLinkAbout0057 INDIAN TRAIL - Health (2) '57 Indian Trail Road it 'Centerville' _ 81- % 5 $ 5.00 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..................T.own.......-----.OF................Baz'x1.s. �ble..... .._.. � 5 c 5 Appliration for Big niial Works (9=31rurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: •Indian Trai 1 .Rd:_,_,•Centerville,,MA ,026.32 119E - .....................•-----------. --•-----------------------•--.•--••------•---- Location-Address or Lot No. Joseph-Casey-__,••_,•,•_,.,_ „ Indian Trail Rd , Centerville, n A 026 2-- .... Owner Address W A & B Cesspool-Service 128 Bishops Terrace- Hyannist 1A 02601 Installer Address PQ .< Type of Building Size Lot.... ...................Sq. feet V Dwelling—No. of Bedrooms.............................. .Expansion Attic ( ) Garbage Grinder ( )�+ '4 Other—T e of Building No. of persons...................5...... 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rli� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P+' Sar 0 Description of Soil.............................................................................................-.......................................................................... "W V --------•••-••----•••--••-•-----....-•••------•--------------••...........----------...•-•-••------•----•---••-•-•--------------•-•-----••--••------•---•-••••----••--••••-----------••................. W UNature of Repairs or Alterations—Answer when applicable---iraatallatiQ ..of--a._1.,000_-gallon__�re-cast, _o:Lme.:Fagked..lea.Qh--- it gV e fl°W),............................ 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 h b n.issued by th boa of he�ith. ._..... .- 111...E 81 -- ----------- Application Approved B Date Date Application Disapproved for h f ollowing reasons:------------•------------------------------------------•----------------------------•--.._...--•-----•••-....... ................•----------•-•-.---- ......•----------••----------•---••---•-------••-•••--------•••-•----------.......---•••-----•------------•---••-•---• ---------•---------•................... / / Date Permit No.---•81- 0 '5� .. Issued -11� 4/81 . Date LOCAT ON SEWAGE PERMIT NO. Xna� , > -7a VILLAGE p e � INS TA LL R'S NAME i ADDRESS GUILDER OR OWNER DA T E PERMIT ISSUED ' DATE COMPLIANCE ISSUED ��_ � ��y �14CK � � ,� is � � � y�;�i� �'4i � Q �� �,n �' �� n � � / � ` 4 i i � r p �����c�r L��tt`'� Y ��`?iv . „��,,; �1 � v 1 - LO,CR'TL SEWAGE PERMIT NO. , `� V 1 tVm E 011, I N S T A LLER'S NAME i ADDRESS BUILDER OR OWNER s6s- G�s';5-r,i GATE PERMIT ISSUED DATE COMPLIANCE ISSUED �� 41 y i i ;COO Y' No 11-..... : . FEs$...5.0©........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................T own..........._.OF.................Fa metable Appliration for Disposal Works Tonstrnrtion rrntit Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: _Indian Trail Rd..,...Centerville,--�?A....02632. .--•-----••-•----.-------•------•------•----------------------------------......... ------- Lo,ation-Address or Lot No. Joseph Case!.................... Indian Trail Rd . .Centervi._lle. v'A 02632 -- -------••-•--------•••-•............ Owner Address a A & P-Ce$sp•ool.Service 128 Pishops Terrace, Hyannis, lE� 02601 Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.......................4 ..................... Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of person ...................5_..__. Showers — a YP g ••---••-•••--------•-•-.--- P ( ).. Cafeteria ( ). Otherfixtures -•............................•----•--------------•----------•--••......----•-----•---- •-•••-••---------•_... 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........................................ 1.4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Sand ...............•.........---_.... xO Description of Soil--------------•----•---•---...-•----------...............-------•-•---•---•------------------------•-•---------------------•-----•----•-------------•••---•----....._.. W U Nature of Repairs or Alterations—Answer when applicable....installation•-of•_a,_•1,000 a11o21 re—Cast sto �. p ne packed_•leach pit_ (overflaa)............... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with .Xthe provisions of AITla: 5 of the State Sanitary Code— The undersigned-further agrees not to place the system in operation until a Certificate of ComplianceZhasfieen issued by the o lth. Date Application Approved B ••----------•....--•-•-----•- . ---•...... Date Application Disapproved for f ollowing reasons-----------------------------•----------------------------------------------•-------........................... \ ..-•------•-•-•-•---...---•--------•---...-----------•---•--....--•-•-----•--•---••------•-•-••••---------•----------•----•------•------•---•--------••----•----------••------•-•••---•--•-•---••-•-•--- Date Permit No............. 11 14 81 J-------------••--••-----•---- Issued_ .......................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH \. .................... .°T"m..........OF...............A.=Stable........................................... . Tertifiratr of Tnntplinnrr TH S I e CER F Tat th i u 1 Sew e Dis osa st co uc ) or Repaired I T �I h I�r1 d 1 S tr ( x • A by - Cesspool Service, ZU Bis lops rra�e, Hy�n s, A 6D1 ) Tndian Trail Rd., Cterville, MA 02 -= at Jos. Case �:. -•----•----•- ----------•- .....•. --en-•----_--•••-•--•-•- ----- ----------1Z has been installed in accordance with the provisions of 'I!L: 5 of The State Sanitary Cod d�sq iped in the application for Disposal Works Construction Permit o......................................... y /�� '1 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 11� 4/81 DATE..---•----•......:.............•-------------....._....----•--••-------.....---• Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 81- ........................Tarn Barnstable..............0 $ 5.00 . F.................................._........................_....._................... No......................... FEE........................ Disposal Works Tontrnrtion rranit A & B Cesspool Service Permission is hereby granted x� --• -- .... .................. ....•------•--• w to Construct LlnrTRra�ir Rd.', tenTevr'vYl e;�rl Ae D� Sysjos. Casey atNo............----•----------------•----•-•-•-•----•----............_..................---------....------Str-------...........................••----............................................... as shown on the application for Disposal Works Construction Permit tNo..81-._:"� D Dated 11:�__.`.':/81................. .....................................................t................................................... ll 4 81 Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS