HomeMy WebLinkAbout0074 KNOTTY PINE LANE - Health 74 KNOTTY PINE LANE a
CENTERVILLE
A = 191 - 101
IY
No.---81-.Sod ...............................00
THE 1" THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...............:........T own---.....O F......�r ns -table--.-..
------------------------------•-•-•-•••••-•...----
App iration for Dispaii al Warks Tiumtrar tiun rrutit
Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal
System at:
.I L.K otty Pine..L??.:.,...Centerville_,.. ..._026 2 ..----------------------------------------------------------------•-
•Location.Address or Lot No.
.Patrick Cullinan 74 Knottr Pine Ln., Centerville , MA 02632
------------------ ....---..... ..._..._......-------••••---•--------•----•------ ----------------................
Owner Add ess
A & B Cess�ool Service, 128 Bishops Terrace, hyanniq NA 02601
.......---••••....................
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling No. of Bedr .........................................................Ex ansion Attic� g— � p � ( ) - Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
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........................................
a
,.a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_.___-.--_-.-__.: ---
fr4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-._-..-._-----.._-_----
Q+' ..-•-•••-•-•••-••-•-••---••-•-•-------------••••--••-------•--------.....---••-••...--------.....•-•.........................................................
0 Description of Soil.....S a-A......................................
x
U '
W
x ••---•-•-•--••--•----•----•---••--•-•---•-------------------------------•---•---••---•--•--•------•--------•--------------------------•---•---•-------. -=--------....-----....
U Nature of Repairs or Alterations—Answer when applicable...iis tallat o.u_.of__
stogy P eked.. � ..pit...(.over.oW) ........................... ....................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIIL LZ 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 boardroflth.Signed... .-•...................�.. ...:x .. . . 9� 1�81
.•.
Date
Application Approved By............. :..� ...................... .. ...............
9/ ate
Date
Application Disapproved for the following reasons:------•-------------------------------------------------------•-----------------•-..............-----.......----
............
.........
.----------------•-------------------------- ........._.......... ------------ ...
/ Date
Permit No----------81- ....... Issued-_... 1l gl-----•--•--•-----•----•---•--•----
Date
No.----81...50 7 Fx$.......$...5..00..._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOW op.- Larnstable
..............
Appfira#inn for Disposal Works Tonstrnr#inn rumit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
,'j? Knotty-Pine,-L .t Centerville MA -02632
..................................................................................................
.•.
Patrick CullinanLocatim-Address �4 Knotty Pine Ln. en
or t N
�ery_.__________ , .....
• )"A 02632
A & E Ces.�pool Serve; 128 Bishops Terraced` yannie NA 02601
...............••---•-------•----•-----..............................---
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.......... ...............................Expansion Attic ( ) Garbage Grinder. ( )
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............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........................................
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 --••----...•--•----•--------•••••---•••----------------------•------•-•--•-----------•-•-•••................................................................
O Description of Soil....Sat$........
W
UNature of Repairs or Alterations—Answer when applicable..AZP:t 7.la.tion of-_a_1_,000 e��lon__pre-Cast,
stone hacked leach pit (over low)_______________________________
--------------------•---------------•---------------------------------............---
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIE 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 hea lth.
Signed... c, yc 9 1/Sl
-u:l�— � -------------------I 1....1.'....---------
P, D to
Application Approved By----------- 1! ........................ ............... / -�1`7-�1•-•------
Date
Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------------
..............•------------•--------------------......-•-------•-•--.....-•------•-------•--------••---•.--.._......•-•-••-•-•--•-•-••-•----••-•-----------...•-•••••-----..._....----------•••---------
•.......................Date
Permit No..........81 Issued. 9� 1�91
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T own.............oF..............I3arnstable
...................................................................
Trdif irtt#.r of Tomplianu
THIS&I'S 1N_Qgjr aye4j&1hel '` or Repaired (X)
by...............••---•-----•-•-•----........_.........-•----------................----
74 Knotty Pine Ln., Centerville, MA D2632 - Cullinan
at......................•-----•--•----•••-••-----........--••-•------------------.
has been installed in accordance with the provisions o TITLE 5 of The State Sanitary C�jde s described in the
application for Disposal Works Construction Permit �-._..SQ ....................... dated__.. /__.1 8.1...........................
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.... ,..11g1........................................................... Inspector....------------. /'..............................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town PArastable
81- So ..OF..............................................:...................................... 00
No.....................7 FEE.......$$.....5............
Disposal Works TUnnu#rnr#io�n rrnti�.
Permission is hereby granted..._.._A & B Cesspool Service, 12 Bishops Ter.,........................................Hyannis , 02601
to Construct ( ) or Repair (X ) an Individual Sewage Disposal System
at No....7.4.-Kziotty.-Pine... n..x..CeYtteryillel_.Y1A....02632..-_.-0ull naxi----------------------------•----------•----...-•----
Street
as shown on the application for Disposal Works Construction .eet 81�...........:. Dated.._g-- 1 81
.............................
9 1�81 B of Health
DATE.-_-�.... ...-•-•------•--......••--------•.............................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS r
ti
LOCATION / SEWAGE PERMIT NO.
VILLAGE
Opt-4e co 1 I Ls
IMS A LLE�S NAME i, ADD.RE4S
�- ass�og6 1 servl f
GUILS R OR OWNER
DATE PERMIT ISSUED
9
DATE COMPLIANCE ISSUED
all ) ri re. \
1
o`
• Affidavit of Residency
Craig R.Johnson
74 Knotty Pine Lane
Centerville Ma.
10/12/2017
Craig R.Johnson
74 Knotty Pine Lane
Centerville, Ma.02632
I Craig R.Johnson had purchased this residency in March 1995. It has 4 bedrooms. I have never added
on this structure. Parcel# 191-101
Thank you Craig R.Johnson
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AI prices are in USU CP 2017 Mineral Tiles.Siternap
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