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Home My WebLink About0035 LONGFELLOW DRIVE - Health (2) � � 0�� C�� TOWN OF BARNSTABLE ' -2�- 4 -a� 4 �s LnCATION � � � �4/ � +'� SEWAGE # VILLAGE ASSESSOR'S MAP & LOT e INSTALLER'S NAME&PHONE NO. � � SEPTIC TANK CAPACITY I� LEACHING FACILITY: (type) I11-f (size) 2—3 ,7—/$/ NO.OF BEDROOMS 3 tl BUILDER OR OWNER I 1 PERMI TDATE: 4 COMPLIANCE DATE: el- `7 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching F cility Feet Private Water Supply Well and Leaching Facility (If any wells xist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands e ' t within 300 feet of leaching facility) Feet Furnished by �.�- � , ' � � � „.....�- 4 � m '� i� ��' �T � � a � � � � „ � E TOWN OF BARNSTABLE LOCATION 0/7- SEWAGE # VILLAGE .� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ��, �- S �� `T SEPTIC TANK CAPACITY /( LEACHING FACILITY:(type) NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER____ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: f`�•� VARIANCE GRANTED: Yes No �/� .�4 •Y • �\1 -� \ ,Af �� Y� A � ' f Nolrl�...:. s F>s..$30.�00.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `- C=== TOWN OF BARNSTABLE • .• � 3_ Uispuiial 10orkg Toustrurtion Famit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: ...35__LOngfellgw,Dr:.....Centerville....................... ....•-----....•--•--..._._.._.....-----•--•-.....----•--------._...-------•---.......-----......._ Location-Address or Lot No. Mrs.. Prizzi Owner Address .W.E.•Robinson Septic--Service .P.O._Box•-1089 Centerville.,..MA............................. • •-- ............. Installer Address Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms........ __________________________________Expansion Attic ( ) Garbage Grinder ( ) 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....................................... �_7 Test Pit No. 1................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 ground water........................ Oa :...------•--••-•----_....-•-----••---•--•-•.....---•---•-....------••...----_•---=- Description of Soil__._sand__a-gravel................................................................................................................................ x U .............................................-------..:_...---•-------•------------•------...------•----------------------•-----------------------------------------................................. W . x •-----•••-•----------------------------••--------•------------------••-•---••----------••-•-••••-•-----••--•--------------•---------•---------•-----•--•-•----•----•---•••--------•-•••-••--------_-_••• V Nature of Repairs or Alterations—Answer when applicable----(1_)___1_,_000--:gal.-tanlc,__-D-bqx__-_________•___-__•••__••_•_-__- stone-packed leachpit,,---pump--and_-f ll.•old-cesspools--__ --_----•-_ ............................................................ -----------------•-----------._.._...._....----•-------• 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—Pe underst-g9ed fVehfth. er agrees not to place the system in operation until a Certificate of Compliance has bee th and Signed -------`- - f /--. Date Application Approved BY ................ . �.. ------ ---�.- -..3--r .._.........................—.-........--------........ Dare Application Disapproved for the following reasons- ------------ ----------------- - -- ------------------------ -- --- ----------------------- -------------- -------- .............................................------------------------------------------------------------------------------------ -----.......................................................... ---------------------- ------------- q Permit No. ------ -1.-- -..-.. ......................... Issued ........................................... Date -- Date l � _ $30.00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 7�Azoplirattiou_ 9u � r Disposal Works Tnnotrttrttnn rnmit . Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: a.....3P.-_xli:?XVijj�...................... Location-Address or Lot No. ................ --__.------•-----................--.........._ ---------------------.------------------------ ...........__...------•--................. p y, �+ Owner Address W �rda' Ync'Q ..s? �.0 ° '�n14 �' ? �a 1Q�� '.PX1t�71�"tTla... •... ....................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms........ ..................................Ex anion Attic I-+ g— p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.....2..................... Showers ( ) — Cafeteria ( ) Otherfixtures .----•-------------------•--------••------------....---------------------•------------- ., ------------------ ---------------- •---------.---------- 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. I................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 --------------------------------•--------------•--------------.....------..--------------•---------......................................................... 0 Description of Soil----eared---r '� - ------------------------------------•------------------------------- U -•---------------------•----•-------....-------•---•----------------------.....------•-•---•-•-------•--------------------•---------------•------------••------------------.._...--•------ W U Nature of Repairs or Alterations—Answer when applicable___ �_1_-1-�QQO--awl , -kx� ................................ 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 undersi, ed f er agrees not to place the system in operation until a Certificate of Compliance has bee th and eat . Gt/ — V Signed ...;.... r Application Approved By ....-------------- ................. - /._- .......�z t -- Date Application Disapproved for the following reasons: ........................ ................ --------------------......-------------------- --------...--------------- ------ - ---......................... p Dare Permit No. ....1....ro...--"-- .�` �------------- ------- Issued ................ ......... ---------- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Terttft.cate of TIImlatianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X ) by----W<EF ----Roba,x son..Sufic...S.ex tice--------------------------------------------------------------._..-......---...-------------------------------............................................ Installer at ....3.5.-_r ongfel low..Dr......Gent?r_viI le MA_--------- ------- ------- -----------...........------------------....-------- ------------------------------------------------ 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. --------"a--.. ............. dated -....---..--..----.............................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE. .... .. l. �+ ------...... Inspector ----------------------------- C THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE $30.00 No.---.G�.d.:_�.�. FEE........................ Disposal Works %I-Paan#ration Uprrutit fir Permission is hereby granted......W tKn_R?biM50n..SPxat C... e)2 e--------•---••----------------------------- to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at No.....35_Longfellow Dr Centerville,__ ..........................-------- --------•-------•---------------------•----•------------------•--•--•-......... „ Street qq as shown on the application for Disposal Works Construction Permit No.._la'_ _ ._ Dated.......................................... A ------------•--•---------------- ...................................................... DATE. — - ./. Board of Health FORM 36508 HOBBS h WARREN.INC..PUBLISHERS