HomeMy WebLinkAbout0050 LAKEVIEW AVENUE - Health 5 0 Lakeview Avenue
Centerville-
A = 252 - 119 `
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, TOWN OF BARNSTABLE
LOCATIO (,,SEWAGE
VILLAGE e/j��` ASSESSOR'S MAP & LOT
t�INSTALLER'S NAME & PHONE NO. �UZ1 A(3 ��/fib
`SEPTIC TANk CAPACITY Z o
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LEACHING FACILITY:(type) � , / (size)
NO. OF BEDROOMS_/ PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER ZItI4 2
DATE PERMIT ISSUED: 9'- ® Oil
DATE .COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No (/
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No...�..'._..`.. `` Fss........7.
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH `` -- �P
q �
�
_.._�p!!111 ...............0F...., n1s g ...............................
Appliration for Disposal Works Tonstrnrtion Prrutit
Application is hereby made for a Permit to Coar�st.u t (.4 or Repair ( ) an Individual Sewage Disposal
System at: 2i1 A-4ilfYecl
........_ —L�8 ................. .............. � .. ......................................c ..-- ..............................••- Location-Addres or t
_.1�! —.Y.. -----. ^� .................... ............9 �lvlGl� .
. - ---
W Address
Installer Address a /
Type of Building Size Lot...
1.1,15 ....Sq. feet
aDwelling—No. of Bedrooms.............. ....................Expansion Attic ( ) Garbage Grinder-(--a—
pa Other—Type of Building ..............:............. No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures -----------------------------------
wprzm --------.--•- ------•-------••----------------------------
Desi n Flow....................11-Q....._...._.gallons er er day. Total daily flow.._..._..__ gallons.
W g g P �gex�soH"p Y Y '�s�-�°�---- ---------------•----
9 Septic Tank—Liquid capacity.1(90jq.gallons Length&' Width.'$-'J0".. Diameter.. ........... Depth._45.'�
Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft.
Seepage Pit No-----------l........ Diameter....... Depth below inlet.._........... Total leaching area..3Z�*.sq. ft.
Z Other Distribution box (>10) Dosing tank ( )
aPercolation Test Results Performed by..... 1.------ ............. Date...... .'. .�8.6.._.....
a Test Pit No. 1__L1.......minutes per inch Depth of Test Pit-----I. ro.��._ Depth to ground water.W077-R!J/-�.
Test Pit No. 2.4. ......minutes per inch Depth of Test Pit.....144r.._. Depth to ground water.ND-F_M>_.
V............................................ -�.V'. Gt-...
O Description of Soil.................. ./20n SE,�/?�!�.!r✓�ll�k✓�` HL------A" i?.OQ/ SWL.....
--
U .................................................17.. VM---5-1I:�LQ---••----•-----�---------•---------24"71M..'if._44w.
�/ ,. L
UNature of Repairs or Alterations—Answer when aj�icable..............................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITi-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 jAsued by the board alth. ._
Signed ............. .-- ........................ _P6
......................................e
Application Approved B ••�-• ------------------------•
r Date
Application Disapproved for the following reasons:----.---M`_ .... .. . .........................:................................................
.................................=....................................................................
Date
Permit No..... ..�........q........7
�-�......................... Issued.......................................................
Date
No........................ ..............................
THE COMMONWEALTH OF MASSACHUSETTS
/BOARD OF HEALTH }
7`(_ ......'........OF..... ' r:�... /'�'`krLrL lr'1
........................ ---•---.-...._..-----
Appliration for Disposal Marks Toutitrartian Prrmit.
ApplicatiRn, is hereby mad for a Permit to Construct ( ))r or Repair ( ) an Individual Sewage Disposal
System at: �2 �'�'t-2 Y�SE /� f�2f11 jL
Cam_ �3 /�-.;r�,r ✓ECG` �n �E,vTE/� ���,� �5
................--••-------..._...... •-•--------•-•-••-.......•-_.._.. .. .......................................................... -
L7ation-Addres or Lot No.
-'/
--•-• - ............................................. --._...-------------------.._..._......----...._......•-•-•-•-•...---...._._...._...........•••---
Owner Address
W
Installer Address
Q Type of Building Size Lot.___119, 13
__ .._Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder
Pk Other,—Type of Building ____________________________ No. of persons_________:_______-__-_______ Showers ( ) — Cafeteria ( )
a
Other fixtures _.. r ..� i.
W Design Flow------------------ -------(----------------gallons per on per day. Total daily flow...........�_2--...-....)..................gallons.
R: Septic Tank—Liquid capacityJO�"�gallons Length_ '.._J.__._ Width.:' __. Diameter____ __________ Depth___5___`'�__-
Disposal Trench—No. .................... Width............ Total Length.................... Total leaching area-------------------- ft.
Seepage Pit No------------`_______ Diameter--------1 __..__ Depth below inlet.___A._______.__. Total leaching area_..._.>.G>....sq. ft.
Z Other Distribution box (`-7 Dosing tank ( )
Percolation Test Results Performed b �N�_____ __
Y------=--=---=--•--------•-•--•-•-----------••-•-------. ________ Date._.____ .
-
aa TJt Pit No. 1 minutes per inch Depth of Test Pit...... ( ,___ Depth to ground water_._NC)r_
(i Test Pit No. 2...........
__,..minutes per inch Depth of Test Pit...... ...... Depth to ground water__Nil___--_--
? ./ a-36 Sv�sc� - 0-1z --IL•--• ----------------------- ..................................
O �6•-/7c) •e ey1/�Sr Sjl,.v of �;r ✓.�Ca,5gU- /Z"- 24 6 . -5ue�cl,c.
Description of Soil................... . .........................................
170- 1576' N/E�.
�- ✓
e - o N- � < .B6t
W NU_..wl O -- „-- .:�. -14,4" MC l? S f) .�p' ==
t.. .---------------------•----------------------------------------------------------------
U Nature of Repairs or Alterations—Answer whenapp Icable.________ ______________________________-..._....._.__._...._._..._...__._.__._._.__________..
Xy. t
Agreement: '
The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with
the provisions of 1 i: of the State Sanitar Code' The undersigned further agrees not to lace the system in
P Y,., s g g P Y
operation until a Certificate of Compliance has been issued by the board of health.
Signed-------------------------------------------•-•-•-----------------------------------•-
Date
Application Approved B
Date
Application Disapproved for the following reasons________ ______________�,_____._✓/
-•-------------•----••-•-------------_._.___..--.-.•---•-------------------•_..__._...--------------•••-....--------------------- ----------..---_-------------•--•-•-•------_•----------...-------------
�00b -
q-76 Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......................•--................OF.....................................I................... ....................
�rtifiratr of Toutpliattrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ,( }
bY..................................................... +�----------------qFj.t-ate . ......_---•- Y
Insta
atf:X3-= �-•--------tj u� •----------�s •-------------------------------------------------
has been installed in accordance with the provisions of TI i EE} j oY he State Sanitary Code as described in the
application for Disposal Works Construction Permit No... 6 - ____.____ dated-.... .........
THE ISSUANCE OF THIS CERTIFICATE Sh1Al.I. 07 BE COBdSTRUED AS A GVRANT E� THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...................... ................................ Inspector..... ................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No....... ........................................OF............-....--...--...._....-........_........_._..-..-....................:-. FEE_.......................J
Permissionis hereby granted............................................................................................_.................................................
to Construct . ,) or Repair an an Ind' *dual Sewr'q V i�vs�;yst� ( Je � I
atNo.--------•----ll--''--------•----•-------------------•----------------Y'----c.•------....--•-•----- �-- -----•------------------------ -
' Street 6 �/ � �•}�
,IK
as shown on the application for Disposal Works Construction Permit No.___._S J:_:________ at _____ ____ _ .................
-•- --•0 ----=--------------------------
Board of a th
DATE ----- ----------•-------------------------------
FORM 1255`..HOBBS & WARREN, INC., PUBLISHERS