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Home My WebLink About0063 KATHERINE ROAD - Health s a t adiafr;At D r C�N�rvtN� FiczA...L..CC... /VI THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t` ;I TOWN OF BARNSTABLE Appliration for UWpatiFai Works Tons rn.rtiun rantit Application is hereby made for a Permit to Construct ( ) or Repair (KX) an Individual Sewage Disposal System at: 3 Katherine Road Centerville -__ - - -- - - •--- .....................................=............................................................ John Shklerviclgcation-Address or Lot No. --------------•---..... ---•--------------•--------------------------------- ..........--...................................................................................... Owner Address W J.P.Macomber Jr. --------- -------- ... Installer Address UType of Buildkng 3 Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) per., Other—Type of Building ___________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 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........................................ W Test 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........................ Q+' •------•-•-•----------------------------•----•-•-•----•--...•-•-••••-•-----•.............------••--•........................................................ 0 Description of Soil...................................................................................................................................................................... W Sand & Gravel v ....•--•-•-••••--••---•--•-•-----••-•-•-••••--------------------•-•-•-•-•••---•-•••------.....-•------•••-••----•---------•-•-•--•-•------•----•--•-•---•-----•-•---.................---•••....---...... W ---------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------•-----••-•- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --•-•-1-1000---Gallon.--Tank .1-1000 gallon pit......••-------•--•---•-•-••••---•-------•----•--•---•---•--•.........................•••. 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�issued by th board of health. Signed /-"� 3/27/9� - --------------------------------- Date Application Approved By ........... .. �. � - .. ....J`...6..-- Date Application Disapproved for the following reasons- ------------------------------------------------------------------------------ -- ----------------------------------------------- -..............................................................------- --- p Date Permit No. ,l `J`r..7.. Issued ------------a--------------------------------------- Date TOWN OF BARNSTABLE LOCATION/�4j �,-j,.�G fit,'✓c- SEWAGE VILLAGE &462-::z.::t4a_ ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY_�l,�i(, 0 C LEACHING FACILITY:(type) '''" (size) —0041 NO. OF BEDROOMS , PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: 1c%'165 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No t� �� m �K� ` \ � � � �/ i � �6 a) , No..-? :. -n Fxs.. .... .: ? ... Nl THE COMMONWEALTH OF MASSACHUSETTS Gp#. l BOARD--OF HEALTH -- _ TOWN OF BARNSTABLE, Appliration for Disposal Works Tonstrurtinn Vrrutit Application is hereby made for a Permit to Construct ( ) or Repair (�X) an Individual Sewage Disposal System at: �,?y Ka hr�w�ivin Irjn�ri ('wni arm . . a ....k "` Location-Address or Lot No. johra Sb1 lervick Owner Address ..................................................... ....................•-----•----•••-•-•----•-•-•••---•-.....--••-••-•-••........................... Installer Address UType of Building 3 Size Lot............................S q. feet I—t Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Ca., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) p' 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fL Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ A4 1 .................................. -------------------------------------- ---•-•-•-•------•-................................................................... 0 Description of Soil........................................................................................................................................................................ U •••••••--••-......••..................... Ca nrl._Rc..f_lr'ta tra 1......................................................................................................................... W U Nature of Repairs or Alterations—Answer when applicable..............................•...--........................--.................................. ...... ... a:l_l•nn__Tank...1_:n 0.0D..cral on...init.-------------------------------------•------------•--•--...........••-•••....•••••.•••••• 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 boad of health. I Signed.,.. ' sl.�� d. ..'�.1......-•-•--------------------- �/27/90------------ Date Application Approved By ............ .. rz=-= =J .... J'.-.& Application Disapproved for the following reasons- ------------------------ ---------------------------------------------------------------------...................................... .............................................................------------------------------------------------------ ---------------------------------------------------------•------------------------------ ---------------------------------------- D PermitNo. .......��-..�.-- .5.. ................... Issued ------------------------------------------------........ ate------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `. , TOWN OF BARNSTABLE C9.er#tftrate of Q.1-outylia cre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (KX ) by.............T P Ma r+.(amb a•r Tr .............................................................. ...................................................................-------......--•---------------- Installer at ............hR...Xat;h. er ne_.Raad.....Cente:ry lle----------------•---...---........--------................'.......---------------------------...........-------- 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. ....... .'-../377............ dated .................................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. f�� • �. DATE..------ /...... .9./... .. Inspecto ` - '... .......... y :. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C;1 , TOWN OF BARNSTABLE No. FEE.. .. ?..-. .. ........................ Disposal Vorko Tuntrurtiun Prrutit Permission is hereby granted-••-••-•---••-• •••.......•-•-••-••••-•-••...........••••••-••.................................. to Construct ( ) or Repair .(TX) an Individual Sewage Disposal System No. ?._.Ka+h a r i as A .ri at ... nd C P n e rmll-le.......•--•-•............................................................................................. Street 9l� `�7 as shown on the application for Disposal Works Construction Permit No....._....:.......... Dated.......................................... .. .----•..•..................•.....•. Board of Health DATE..................�--�-�`1---" --� FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS