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Home My WebLink About0101 OCEAN AVENUE - Health 101. Ocean Ave Centerville. A _ 326- 046 UPC 1= an ad mn • Us&In use► ZD' { I � i 'sag � ovs( I rFj i i a :. BUILDING&RENOVATIONS d (508)428-9929 rt rR i r � r -� C- ONr'o0 BUILDING 8+:RENOUATIGNS (508),428-9929 TOWN OF BARNSTABLE llss LOCATION v Z/ SEWAGE# 91- VILLAGE4Z VrSSESSOR'S MAP & LOT . INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY A)o Q /-onl O LEACHING FACILITY:(type) / �(size) NO. OF BEDROOMS c. PRIVATE WELL O UBLI WATER BUILDER OR OWNER Arzo e DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED VARIANCE GRANTED: Yes No 32 Dy a. C ��qq FrRs.... .Q....J.. THE COMMONWEALTH OF MASSACHUSEAIS, - . BOAR® OF HEAL_ TOWN OF BARNSTABL `''�,.A�'o !-Z yr V lr Appliratiun for Diapaiial Works Application is hereby made for a Permit to Construct ( ) or Repair (I/ an Individual—,:be age''Dis�osal System at: -• _...Ca ., a �` .....----•---- .....c�.P��.�> .........................................�@�� ----- Location-Address or Lot No. -- CA -- -•- Owner Address Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms___-_-3..................................Expansion Attic ( ,) Garbage Grinder ( ) 04 Other—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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest 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........................ ---------------------------------------------------•-----..........----------......---------..................................--------•-----------•--........ 0 Description of Soil----------------------------------------------------------------------------------------------------------------------------------------------------------------------- x U ----------------•-------------------------------------------------------------------------------------------=-------------------------------------.... x ------------------------------------------------ -- ----- ......Alterations ----- ......�A ---------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with <t the provisions of TITLE 5 of the State Envit Code— e un ersigned further agrees not to place the system in operation until a Certificate of Comen issue by e board of health. Signed .. . 1 9'`'' - V .......-... Application Approved By ........ ...� J........................................ .................... �1� -.1..-.p�....... .... . . Dare Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------- -------------------------------------- ---------------------------------------------------------------- ---------------------------------------------------------------- ------- --- ---- --- ---- ---- -- -- . . --- ------------- - --------------.... Permit No. ....------1 -"----�. - ..... ........ Issued - Dare Dare THE COMMONWEALTH OF NiASSACHUSETTS BOAR® OF HEALTH�,K TOWN OF BARNSTABLE�j-� Applirttfiuu for Dis�ruuul Worse Tuuitrurt 1r- erMit Application is hereby made for a Permit to Construct ( ) or Repair (Lan Individual Sewage Disposal System at: pQ .....�1.Q Q..0 ..........1�v.�----------------------- ------C... _P ..V..!._� � ............ ---. -------- ..3.._ Location-Address or Lot No. .T... ........ - ............. Owner Address f�.N �...c3o K....9a.a • � ....... a .............•-•------ Installer - Address UType of Building Size Lot..........:..... Sq. feet Dwelling—No. of Bedrooms......3..................................Expansion Attic ( ) Garbage Grinder ( ) a a Other—T e of Building g ____________________________ 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.......................... f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0 a -•---------------------------•-----...._....-••-----.....---------...------••--------•-•----•................................................................ Description of Soil........................................................................................................................................................................ x U ---------------------------------------------------------------------------------------------------------------------------------------------------��.�.� ---------------------------------- w ------------ x . .-•-•------ U Nature of Repairs or Alterations—Answer when a cable.... ......... .. a0--4-0 �tr__ _ _._____.__. ...._PP �` -------..--------------•• -------••---........ ....•---•- Agreement: /_ The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Envi,onm1 tal Code— he u c ersigned further agrees not to place the system in operation until a Certificate of Com 'a ice h . b en issue by the board of health. _.---_ - ' Signed :. - - =................. 9- ---... - - _ � -4 Date Application Approved By ........ , - ...------. -----<... .(- � r. J Lns��'"��`^�} r t� ante.. ..,.. Application Disapproved for the following reasons- --------------------------------........................................................------------- --------------- ------ ----------------- ------------...........................-------------------...........................................--- ----------------------- ---------------.................................. ------------ -------- ------------ Permit No. q .-...... - - ..................... Issued --_................ Date---... Date ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cfer#iftctt#e of Qlantlaltttnce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( L--r by......----19-�...--1 --------- A. e-C ............................... .. ......................... ....... .............................................. .................................... Installer at ........1--D-f--- .... t._L ---------------- -------- - ------------------------------------------ ---- 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. ...... U._ . dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE a SYSTEM WILL FUNCTION SAT�SFAGT.ORY. d � ,r DATE............................................... .............. Inspector ----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... /. .hz�s� - FEE.....3�............ �iu�ru��tl urn$ Cnua��#r�.t#iun rrttti� Permission is hereby granted...... ._...._.. _P�.0 to Construct ( ) or Repair (L)-an Individual Sewage Disposal System at No.......1 .....•. .......Zq V•c Street q/ as shown on the application for Disposal Works Construction Permit No./-/^_6?'6' �_Dated.......................................... -------------------------•-----��j----7--........................................................ J! Board of Health DATE = _ _2:. -------•-•-- FORM 38508 HOBBS 6 WARREN,INC.,PUBLISHERS y