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Home My WebLink About0053 KEARSARGE AVENUE - Health 53 KEARSARGE AVE Centerville A = 226 - 146- 003 t No�.......�..��.. 1 Fis.......... :.1s7� THE COMMONWEALTH OF MASSACHUSETTS ------E1eA R® OF HEALTH Z r - _ OF......... ..1......... ........:Il .� 1PLC App iratinn for Dispos t Works Tonotrnrtiun rumit Application is hereby made for a Permit to Construct or ( ) ar ndividual Sewage Disposal �Ysystem at J — j .................�1. h_ ..S�3.Q .6.4 ......... v ...... _ ..........................T.. ....................................................... ` ation•Address UCS� or Lot.No. LJ o`....�S L1 C.. --- W O Owne ` 7 1 .. 6'�- .VAs o-•J / !i(!`C l7- Installer Address Type of Building Size Lot.:20s.06.0......Sq. feet Dwelling—No. of Bedrooms.........................................................................Expansion Attic W&V Garbage Grinder f(/&A Other—Type e of Building - a YP g ------------------------- No. of persons............................ Showers (Z) — Cafeteria ( ) Q' Other fixtures ...................:. ....... .. �/� /� �� - ---•----•-- ----- ------ --------- -- --- - --------•----- ------ ---- •------•------- W Design Flow_..c.;, ...13L................gallons per person pe�day. Total dail flow..._ •__....._.....__.:_._.___gallons. WSeptic Tank—Liquid capacity-TO-gallons L.ength1�.__._.... Width,` �(- Diameter................ Depth.... ...... x Disposal Trench—No. .................... Width.....->............. Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No........ZZ..... Diameter../I.-------- Depth below inlet...4.........._.. Total leaching areaZZAI/2 . 45: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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ••••••••--•-------------•••-•••-•••-•••••-•--•••....••••-•--••-•----.................._..._.._...---......................................................... ODescription of Soil 5-7 s�.................---...........-•-•-----------•-----------------------------•-----------------------------------------•••......--•--•-- W UNature of Repairs-or Alterations—Answer when applicable..\�.P X 8_�_�--------------J��`S h1._____._____..__.___. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T T L:p 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 I th. Signs . . .................................. - I ........0y/ . -... Date - Application Approved By................ ................. tr .... ------- Date Application Disapproved for the following reasons:................................................................................................................ •----•-------------------------------------------------•----------------......-------------•---•----•-•--•-•--•••--•----••••---•--•---•••••---•-•--••-•-•-•--•--•--••-----•----••---•----_..._ L Date Permit No...... ....��`� Issued... Date TOWN OF BARNSTABLE LOCATION Qd SEWAGE # 53 VILLAGE .21( l LL C� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. Tuctz— q zS� ? z-z SEPTIC TANK CAPACITY 1600 (� LEACHING FACILITY:(type) b' (size) •6Z3z7 NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER_jLD 1 t y+fLIC � DATE PERMIT ISSUED: r �C_.,•.��I Cf ca VJ DATE .COaiPLIANCE ISSUED: 7 2 709(o VARIANCE GRANTED: Yes No �J z� i �Fy �E2/ ,�r �, 3g '�� J �� f j No: --�..... .7 FRics,'--...... ......... THE COMMONWEALTH OF MASSACHUSETTS +) ARD OF HEALTH ------.._....""�... 'n`.'...----------.._OF.......... � 1..1..�. ................................................ 1 � Appfiration for Biopos al Works Tons ratrtion ernti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at 14 Y rz.51..E ...._... .............. _ .............................•-------------------•----------------•-••---••-•-••--.....-•-•--•••-- Location-Address or Lot No. TZ•c.4--. ..... '.I.L-----•.................................. ..........--...................................................................................... Own _ ............... _f•d�ress � h 4 Installer Address Type of Building s Size Lot'loc!060.......S feet Dwelling—No. of Bedrooms..................................._.........Expansion Attic WO Garbage Grinders 9`k-1 Other—Type of Building _________ ........... No. of persons...= _________________ Showers (Z) — Cafeteria ( ) p" Other fixtures ...................--�••-•••---- - - W Design Flow__. ________________gallons per person per day. Total dail flow t____ x _ .....................____gallons. WSeptic Tank—Liquid capacity�a��•/�gallons Length}��7_..__..... Widtl�'�`Y"__./r_. Diameter________________ Depth__ " '_____. x Disposal Trench—No f;- ____ Width_c...>_............. Total Length.................... Total leaching area-----...............sq. ft. - Seepage Pit No........ .. Diameter_//_,......... Depth below inlet_._-_._____.____ Total leaching-area!✓ A-%;Z .15:PX 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_.___________________'_. fs. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to groundwater........................ D Description of Soil..........�^�A-Ai ..................................................................... W -•-•-•-••••-•-•----•••----•--------•-•-------------•••=••=••-••--------------•••••-----.......•---•••--------------•------------..._._••-------•-----•----•--•--•••••....•-------•-•••--•-•---••--.._.•- W ------------------------------- ------------------------------------------•---------------------------------------------------------------------------•--------- ...................................... U Nature of Repairs or Alterations—Answer when applicable:_._lop . : _ 4;-________________" ...................... ! , c> t, �= /pry;............. Agreement: The undersigned agrees to install the afor edescribed• Individual Sewage Disposal System in accordance with . the provisions of TTTL 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. F Date Application Approved BY t. ............................ i -• __. ..•----t -------- ""`-w--- Date Application Disapproved for the following reasons:--------•-•------------•----------------•-------•-••--------------•-------------•---------•--•••--•-------....._ ................•----•--......------•---••---------•-------------•-•--•--•------------...--•-------.._....---•-•---------------------------------...----------------------- ............................. Date PermitNo. .�---....---------•----•-------•--•--------._.. Issued............................................---------- Date r ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......../.a. .. U..............OF................... �� 'NS (9rdifirate of (fampliatnre THIS IDS TO CERTIFY, T�Iat the Individual Sewage Disposal System constructed ( ) or Repaired by �' J.r�-�_�. ��!< � )---- --------------•---•---•-------------•--•---------•-----....._•---•-•••--•--••••---•-- ^� Install �. at has been installed in accordance with the provisions of TiTIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.7�C�......��►__7 � d --_..__. dated-- ------ '------------•--•-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... �� t-71 9 Inspector .................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF__ HEALTH --- l ✓�U...............O F............................................................. ........... FEr .D- . Disposal Vothii W111ais#.r ion rrntit Permission is hereby granted • •-•=•••----.._..-=---------------------------------•-•--••-•----... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System r at i`To.......... IG=`� C!•s ��•b:. ................................... t PP p �;_ Street•.-��..r' I �i J lication for Disposal Works Constructio Permtt Io:. .....:.... .. Dated.... as shown on the a 1 ......................................................... fi .:f- "_... . .,. ------•---- Board of Health DATE. — - .'�FORiN 1255 HOBBS & WARREN. INC.. PUBLISHERS ' L �. � - l�. ��„ iL�� , �� 3 ��