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Home My WebLink About0046 JACKSON AVENUE - Health 45 Jackson Avenue 226-126 Centerville No.._ .-._.l. Fim....../ ...... THE COMMONWEALTH OF MASSACHUSETTS 4 BOARD OF HEALTH 9fi � 0,�t TOWN OF BARNSTABLE eolf"111-5 Appliratiuit for Diripuuttl Wurk,i Towitrurtiurt ramit �2h5A41 Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......................'16 Z1'4-C �S d/V 4 V� deNCU •-• -----••---•----------•-------------• ----------------------------------•------------------.........-•------••-- Location-Address or Lot No. ... ...............Jrt!t_N,€ _ tom/- a ---•----- ----- I"/�oK._�i`:- S . f l�....._..----r--e-s-s-�•-- ------•-- .......---- d .......................................... -- .�.!`'l � ......----- . Z..!:•Y/'�` . Installer Address /7r,�0t U Type of Building Size Lot..r.�o�e ...........Sq. feet Dwelling— No. of Bedrooms.____ _____________________-__.__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - (4 Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacitv./_POgalIons Length---------------- Width---------------- Diameter...--.-._---_.-- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------)....... Diameter.-.--_4......... Depth below inlet____________________ Total leaching area..................sq. ft. Z Other Distribution box (3<) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I-_.---_-----__.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.................... a ----------------------------•-----•----•--------•--•---------•--•-------------•-••-------------••---......................................................... 0 Description of 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 TITLE 5 of the State Env'ronmenta ode—The undersigned further agrees not to place the system in operation until a Certificate of Complianc as en issuey t oard of health. Signed ----------- ------ ----- --------- ..... ..... f` - amr............. Date -APPllcation Approved BY ... �'In C' .... te Application Disapproved for the following reasons- ------------------------------------------------- --------------...---......----------------------------------- .......... ............... ............... .............. ... ............-------------------------------------------------------------------------------------- ---------------. ------------------- Date Permit No. E,,,,)�J�--------- ---- Issued................ ^.f��'. '�l......- .-.... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cfertifirate of Compliance THIS-�jS_T- CE IFY,•That the Individual Sewage Disposal System constructed ( ) or Repaired (e:_-) J �G EU -------- ------------------------------------------------------------------ by ......................................._.. /4 ----------- ----- - - - - - -; 7 Insrdler has been installed in accordance with the provisions of TITLE 5 f The State mental Code as described in the application for Disposal Works Construction Permit No. .__ ��f..-.-J?...�----._- dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..... I — ' Inspeao . : 7 . (----- - ----- --- -------- -=--- ----- ----------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -7 TOWN OF BARNSTABLE No... .y.-..l.1.3 FEE ...Q/........ Ropmat Workii Tuni#rudion "anti# Permission is hereby granted.....--. c�-"-.-.-1 '�G ,f'- ----------------------------------------- to Construct ) or Repair C:—)—an Individual Sewage Disposal System ................ .............................................--- ----------•-•-•---------••••---r-------------....---- .....---............. Street r qq [f as shown on the application for Disposal Works Construction Permit No.1.-y-._:----- Dated---.... ....... �._ .L...... ............................... r 7S---`--------------•-•--•--•-- 1G�................................. Board of Health DATE---------------..---------------•------------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS Fizz ez THE COMMONWEALTH OF MASSACHUSETTS jZ �--M BOARD OF HEALTH /_7,Na TOWN OF BARNSTABLE ��cs e Ilf��p Appliration for Diij-paiial Worlw Towitrnrtinn Il.erniit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 116 -j 4 C k 5o /✓ C tnyu Lv% 02 Lo7 ��6 /�/�,� f; 2 26 -------------------------------------------------------------------------------------------------- ---•••-----------------••-----•--•----•------...------•-•-----•---..........---•-•---------------• r Location-Address or Lot No. ! !i?/0/i l C_ '..---------•............. 7Owne — •• Address • ------- Installer Address 17101 U Type of Building Size Lot_,1017C..G.__..rSq. feet ►. Dwelling— No. of Bedrooms.......�....................---------Expansion Attic ( ) Garbage rinder ( ) 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./:?DUgallons Length................ Width.......-.------- Diameter.--------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...-.-.-. ------ Diameter------.6.....----- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution.box (X) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 4 ,.� Test Pit No. 1................minutes per inch Depth of Test Pit_----------------- Depth to ground water......................... (i Test Pit No. 2................minutes per inch Depth of Test Pit..............--.... Depth to ground water........................ I- 9 ----•••---•--•----------•---•••-•-•.......-----•--•--------------••••-•----•-•-----•---•------...----...........------•-----------•••--•........------...-•-- 0 Description of Soil........................................................................................................................................................................ Q-\ x c., w 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 TITLE 5 of the State Environmental-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. Signed ------------------------------------------- °" `. —.....- �.= .`.1 .`:- 1.. - f Dace Application Approved By -------------- .�' ................................,............................... /...... . . ..^.i.,.-.^• ,.... Application Disapproved for the following rearonf: .................... ......... ................................. . ................ ....................... .. ............................................................ .................................. . .... . ... ... . . ........ ---------------------------------------- Date Permit No. .....�....- . � —---------------- Issued ----------- �. .-./.5....-cry/ .......... Date 'P./ A4 I Vh O _ 7 -fir-- - M 17-1 � Uc/�j-�T`��. �-dal/dS• - - - - -v- - - -- ----- - ---- .- b , fs3iy� i'✓o,1,sn979 1StY� I �7//o/S . JI I 7r�dy� [� �y W/7& d I . Oh I O Z 37Ya'✓5 \ . �I ly o � ` ' Ned a'o07j P�/o�3 x S C`v x= _ /7�1,8' t•'d P-:fa'3i7 Oyd lit 1d Vol o r= des+'d O-c1cl I � '1dp®G -� ' -- — --- •o I � it o, sty 3-7-7/P ?j31N r� TOWN OF BARNSTABLE LOCAnoN j 0,r-y-C->6 F 0,U-'e- SEWAGE # VILLAGE s 'c` ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. C-4 r-Pr v) s1e SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS 73 PRIVATE WELL O LIC WATE V BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No � 4 / 3S S G 1 7-4� AL ` r Sv VE TOWN OF BARNSTABLE ,.. CATION , 'C.a -P SEWAGE # ,j L , VILLAGE_ �{� ` c1 ASSESSOR'S MAP & LOT296-, —f INSTALLER'S+NAME 6 PHONE NO. `tl mGew SEPTIC ~TANK CAPACITY f Gb C ! LEACHING FACILITY:(type) L` e r L& (size)41jod :4 Co y NO. OF BEDROOMS PRIVATE WELL /O�R PUBLIC WATER BUILDER OR OWNER Uj Z1 IS. DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: d'� VARIANCE GRANTED: Yes No a z,2 (45 . c - G = f. C= TE N2 ✓/Ct-E A ra as 9t- Q �z PRo•�os�v oF 7 - I� ppo .SEA foil �Q> Jf'tv,�Ki��Lb Ro�ivlr �y 30 . uMAP ti c0� ��` �h0�1 STOA��1£ �S p S6coNo FtooR PAN C$"YBSIS LDT (D p ;fir S is"O.c --•.-•—_— / n i — 20 �tv7 PtQ.•J t• \ �,-•�/N�Y ��1 Ho•eru $PACE I ^ EAST 4dF/ r•ow WEST ' SEc rioNAC —/7 I STiQ-/�W .....n(m • � � �� G,QS 2 v /�7c21NF N1 i tUK�-�'�� .• � VG T�f�'�3 on/A(/E FL 0.7R /�q�J o.n Yv /O s r G-E,2,e E�tE�✓/ELF �� _ TOWN OF BARNSTABLE LOCATION �b ) • SEWAGE # I V ILLAGE ASSESSORS MAP & LOT29 / INSTALLER S:-NAME PHONE NO. GP,!" SEPTIC TANK CAPACITY f as C Q V LEACHING FACILITYA ype)� t (sue) G® NO. OF BEDROOMS Z PRIVATE WELL`OR PUBLIC WATER BUILDER OR OWNER .y DATE PERMIT-ISSUED: _,4;7 DATE COMPLIANCE ISSUED: � VARIANCE GRANTED: Yes No !� Q � J - 3 r C - pdd P,t-' No.----�/=-.. Fim.....'3 ......� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for Digpniial Workii Towitrurtiou jJamit Application is hereby made for a Permit to Construct ( ) or Repair ('tX) an Individual Sewage Disposal Ys.. ... �i ..dw�� -t_� .. ate........................... .... .._. • .._. .......................................................... T,^cation-Address or Lot No. --------••-•---- .......s.�__A.-I S �I--- �lL�:.........• ................. � 14,"A-�.J- -•----- - --.............. Ow er Ad r ss Njl /..►� a ----•--•...._ :tl... S E flat_ Qk 1 . � ....... -- Installer Address Type of Building Size Lot............................Sq. feet U DwellingNo. of Bedrooms._�__________________________________Ex Expansion Attic a — p ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons____________________________ Showers ( ) — Cafeteria ( ) dOther fixtures .......................--------•--------•---•----------------------------------------- ---------•---•---•-------•------•--.....------••-....•--•---- W Design Flow......... ________________________gallons per person Mr day. Total daily flow____3c .O......................gallons. W Septic Tank �-Liquid capacityl.=..gallons Length---- 25........ Width... Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No......I............. Diameter.....f._L?_1..... 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------------------------ 44 Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water........................ a ----------- ................................. Description of Soil....................... r_�P_ n/...,�!l•- � •� '�' ............................ x _... W U �` ! Pp .o � �� ......am-..��--- -------- Nature of Re a rs or Alter tions—Answer when applicable _<__ ..... - -----------------------------------------------------•--•._........_. 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�hhas rd heSigned ......... A�issuued..,j . ................. Date Application_Approved By --- ----------------------- `�1 �r Date Application Disapproved for the fol owing reasons- ........................---------------------------.................................------------------------------------------------- ................................................. ...........---------------------------- G Date ....._/:�.-" ..3.�-6.................... ......... Issued .-----------.... Permit No. ------------ Date No.__ ` L...129 FEB ....`� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE - Appliration for Diopoottl Workii Tonotrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (`<) an Individual Sewage Disposal System at r� (-) d ► �T ................ v...... .....................'...--..�w c ---- L h..._.s_�Loccaation.Addre V.................................... _........ .... ; ! f�-(=C' `• ................ L� Owner �=_..L (r) .SF�I C_ /fi........................................................or U'-M 1 _/C( Installer Address Ga , Type of Building Size Lot............................Sq. feet I-, Dwelling—No. of Bedrooms..-----.:...................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building � yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ......................... Design Flow...... .. .........................gallons per person per day. Total daily flow.._.r�4 ......................gallons. WSeptic Tank 4L Liquid'capacityJ/YDgallons Length.---,?.......... Width---!5.------- Diameter..........--.... Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------I------------- Diameter.....LCD-1----- Depth below inlet...l........... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by----_--------------------............................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.......--........... Depth to ground water........................ f14 Test Pit No. 2................minutes per inch Depth of Test Pit...----............. Depth to ground water........................ a -------- ---- -----•-------------- ------------ D Description of Soil....................... a.. �_�/.....__._ � !.� W - ..I..� (=1 ►fit •---•-•-•----•--------- ----------••--•------..._._..--•-�---••------•-•--._...-- ----•-------•--•-------•------•----•--•-------------•--••--------•-------•----•------•---••-•---•------...------------ U Nature of Repairs or Alterations—Answer when applicable---�L .S( A[.(-.---�. -.S�" t }C / ........ `'- .' - / f 5 ----=`--- ---------- -------- --------------------- ••--------------------------- 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 Y p Si ned �been,issued by-the-board of health:-,— Signed system too operation until a Certificate ofCompliance hL �� `. '-.. / ................--- --....--------........----r------- Application Approved B -' Date - _. Application Disapproved for the following reasons; ! - --------------------------------------- ---------------------------------------- G PermitNo. ----- .------3--91.E�------------------------ Issued ............................----------------------------Dare -- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Contpliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( • ) or Repaired ( ) bY :.................................:.....�� t _.f�r..c t�N�1-..-c� " , < ...................................................... Installer at 14 t C ��c .......---------... . .------.4 (=--------------� ..- � �. u� 5 )61?.7 has been installed in accordance with the provisions of TITLE 5 pfThe State Environmental'Code as described in the application for Disposal Works Construction Permit No. .-------_. ......�J 19-6-_.... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. .4� n /--------------------------------- Inspector✓...................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ?l gQ TOWN OF BARNSTABLE No.. .(--.'_... l.fl.. FEE. .............. Eiopooal Workv Tonotrudian ` rrndt C 1 � L_ va C .. 0 � Permission is hereby granted------------------------------------------------------------------�------_------•---...---------•-•-----......-----..................---.... to Construct ( ) or Repair (\C) an Individual Sewage Disposal System atNo.........................................-................. ' PCK � �1 14N1 S POr/.......................................................... ••---•---••-•-•---••-•--......•..... •-•--••-•---•.....-- Street g�� as shown on the application for Disposal Works Construction Permit No.l_/ .. ...._ Dated.......................................... ----•-•----------------------------•------••---•-•--.....----/ a/ DATE.................7 ?1� __ Board of Health FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS •yam 4 _'�� • i p fir/ A rc) 23 32C p12oPv' r�. Na L45E 21l ap �A r �1 22. 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