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Home My WebLink About0045 PARTRIDGE WAY - Health 45 Partridge Way Centerville A = 208 - 068 - 002 No, 4210113 ORA r f� 10% 4k?No- �. GG1. g L_.ory C)6B -®O 2�- t THE COMMONWEALTH OF MASSACHUSET`rr�� BOAR® OF HEALTH ` avct :................oF...:#�45 ---....---------------------.----- Appliratiun for Bi-qVuuFal Works Tuaastrurtivaa Vamit 114/7P Application is hereby made for a Permit to Construct ( Yl� or Repair ( ) an Individual Sewage Disposal 17 ..-• ••-----------------------------•-••----•-•---- �j�p�,-�•�-� ocation-Address or Lot No. el_�...�.... .... � � ------•---••-----------------------------------------------•--.----••............................ we Address nstaller Address Type of Bu ng Size Lot-?w,��_....Sq feet Dwelling—No. of Bedrooms_...�--------------------------------•Expansion Attic ( (� Garbage Grinder �"i aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures .........---•--•-••-----•--••----. Design Flow.... -� ,a6......_._... gallons per person per day. Total it w................ W � •-- P P P� Y � Y �Q• �`�---�--................ga�llons.y WSeptic Tank—Liquid'capacity.) allons Length_1d.-.G.... Width'_S-."1... Diameter-----"-_---_- Depths-^8.. x Disposal Trench—No. ---•------------•--- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------- .. Diameter-------�,O...... Depth below inlet.....;...-....... Total leaching area.zG7..sq. ft. z Percolation Test Results Performed b - (�� --�. --------•.----• Other Distribution box Dosi nk �~ .....minutes per inch Depth of Test Pit..._ Test Pit No. 1_�� p p _.......... Depth to ground water��,0�� Test Pit No. 2_/_Z—....minutes per inch Depth of Test Pit.....10...._.... Depth to ground water________________________ Ga' --•---. ---- •-----------------•------- ...1. -------•--------------- O Description of Soi1... K'0. �....}- .... !tit -------------------- --- --- r--....... x W ------------------------------------------- '4411`,� �a--"--------------------------------------------------------------._.......------. UNature of Repairs or Alterations—Answer when applicable............................................................................................... -------------------------------------------•-------------------•-----------------------•--------•------•-••-•....---------------•-----------•--•----•--•-•-------••......----•-------•---•----•-••---••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with T P1 !. the provisions of(^i T L of the State Sanitary Code he undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d b the board 9fjiealth.. Signed...................• ............................................................... --------•--•Date-------•-••-•- Date Application Approved BY----...... - c�c" --••-------••--------------•----•- ------•--/-a-`Date---�-g-- Date Application Disapproved for the following reasons----------------------------••-----•-•--•---------------•-----------------------••-----------------•••-----••---- ....•---------•--•-•--••-•••-•-----•-••--•------••-------••.........................•----------•---••••....•-•-•-•....._.....-----•••------•-.......•--•--•-•--•----•-•-•-------_...-••.•------••••--•--- Date PermitNo....... :..: ...................... Issued_....................................................... Dsu r .. .7 ir' i 6B Fes$---..�,.��.......:..- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................................------------------------------- Appliration for Uiipos al Works Tonitratrtion Prrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: w —r lr`tFJk y?,6 Li.. ` � r' 't r:c/ .............._.....-_..---.....��:. ..� ---------- .............................................i ,—Location-Address or Lot o. W Owner Address Installer Address , Type of Building i i Size Lot_ " _...........S eet Dwelling—No. of Bedrooms...."'�---------------------------------Expansion Attic ( C) Garbage Grinder ��y Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixturesL W Design Flow.... :"9: i ................gallons per person per day. Total daily gow.............' 2-A.....__........_gallons.., WSeptic Tank—Liquid capacity i_)gallons Length.K, '�-... Width_ .-'_ �.._ Diameter----_-------- Depths ,._C__- x Disposal Trench—No..................... Width.................... Total Length............ Total leaching area.____---.....,......sq. ft. Seepage Pit No.__....._4_..____ .. Diameter.......1.0...... Depth below inlet..... ..._..... Total leaching area__-R........sq. ft. Z Other Distribution box�i Do ank (M 9p14 , t Percolation Test Results Performed by' �i�:;:b ` .f_ _ � (.. � � 7 77 W Date. +� '' £' -- Test Pit No. 1-� .....minutes per inch Depth of Test Pit.__-0......... Depth to ground water_4e,�-_i ns.` V w.-�. w Test Pit No. 2.._.G-_...minutes per inch Depth of Test Pit...... ......... Depth to ground water................... O Description of Soil-•---1 3� ) =f .�_kc' -.... r �`� "---•---•-•-------•--•---. .._--.- - -.... .-- �_._._ rv._:___ _.__. W --------------------------------------- - `-� 41!► _._.:.:�ri �C...- UNature of Repairs or Alterations—Answer when applicable................................................................................................ ..----•-••--•--•-------------------------------------------•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T 1E 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. Signed................................................................................. ---• -••••---------•-......---•------ • � Date Application Approved BY � _�c.er,�:t�. -------•--------------------- -•------- �'......... ---�g a._... Date Application Disapproved for the following reasons-------------•---•---------------------------•----------------------------------------......................... ....................................................--------•--••--------•-------------•--•--------•-•--.............................................................................................. _ Date PermitNo........ --.....S-5 .7.--------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT/H OF............ ear,., 1. ? ................................. 01rdifiratr of TOMptiFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed vtf or Repaired ( ) by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at................. 72----• cc, .� has been installed in accordance with the pro isions of TIT�y of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._____-._!.-�_.._.�.....�_. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.........................�.:...�...�._�..�j Inspector...... ------- --=- ------ -•--------- •--------•---------...-----...........--- THE COMMONWEALTH OF MASSACHUSETTS t z BOARD OF HEALTH g � � .......OF..NO. ............. . ..............._............ ........� FEE..... piltdual Permission is hereby granted -- ---•--•--•-•-••---..... to Construct ( <orr Repair ( ) an I Sewage Dispos/al� System /'/ /} at No.. �i l Y -------�._._.._.. .... ......_W C/..1'.f. ............ :..i:_.:G_cX.�...2?.r.�_�p._... ( Street �/ --r as shown on the application for Disposal Works Construction Per V�0� ___ob _: �lD p................ ..ra..._...__. Board of Health DATE--------_------------ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS a`� U T. .. l]]RZ •U 4 'N`��`� t`fe� �= 41 f''o. 2,0733 Av'nL IN r , 90 es oz LA, 9 7 ? 8 A asss, � 000.t� aeTe.► �� cr .�aUz /�P�L.1 CAA1�• : 'mac.,c�+,r,.,�.. cJC.ttO F l E C.. . � U L EC�cIST�2 1.�D -66 e�l�C25 MRCS i Y g E6-r I/Z WmA 1"�?�t��( c�ct: 110 x 3 x►sa90"s5 c- Usk �. E .l.�,.or•.t -6� i 1 c,i ► H b... OF Mass ^��6t��.�t'"iT ✓ti- t�3'E Ono �At�31�1.°�t'�' �,JZTEt ws°� PETER 9 SULLIVAN s Cm W4tLL r ci 9NO. 29733 1pemec - 108 • S�ONA E EN��'b RicHARD $, F t?l-0LA7I �� A 1 2 N�ct►� BARTER H 90 No.24048 oe ISTER�� N 0 ,..LAN S q0 SV¢saL 91.0 BOO �a,g ti►.�.v 1,waLK ✓O.0 ( i Ny SAL " ,�- Rev. 1 � � �� ZI INY t►1Y �� 902 F:.L aA o Lo,1 7 ?AW OG S k4va ` " . I lsx�`C�c7,ti-1 �i�tfl�cE�FIAY,CEU�"r�Ylll.E; 1Q Q-2 C 9'7 KoV,la tL CZ'M tY -MAT `(1't�.` "o v ti o�'t1 e1�1 g� .I f`„t � t►S`I -�'vUt � ,/ •c, kuemc�u c-0v4?ti5 `411`tK I-RE 6(DES��. C��lrt: r Tt)vJM 'OFL�Aet46 46LeA AV k5 qoT t�p.c,.f..� Sc T,- �C_FAOiZ'\ E.c__� ,0Mom. Vli M�4 AA TkC _FLD0T>FL AA LA• fit► =P°t ��v�A 1 �,.?a`�r. `I 2-Sg i ,� -� I? �. ��_� .. ��ev •{ ANv -iVkz CC'S 61A- wy Sl1oUt�� TOXIC AND HAZARDOUS MATER LS REGISTRATION FORM Mail To: NAME OF BUSINESS: t 4)1 SC 4 h e 5 Board of Health MAILING ADDRESS: VA' 10-tilei-dgP, Watt Town of Barnstable TELEPHONE NUMBER: P.O. Box 534 CONTACT PERSON: ll 'U Hyannis, MA 02601 .S�� ,-� S� � � e Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalli g, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO /--c Ss -t -V" a y!/a� y This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registered v9 ;u Please put a check beside each product that you store: ./Antifreeze (for gasoline or coolant systems) / Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners L/ Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Y Diesel fuel, kerosene, #2 heating oil }/ Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants —V— rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes —t,!!- Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers _ j/ Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM APF E 8E Mail To: NAME OF BUSINESS: C ��-��N��G ��yd�°� Board of Health MAILING ADDRESS: 8 Wood yp ke LQALR C(,-" Town of Barnstable TELEPHONE NUMBER: 509-• '7"71- 8 313 (p P.O. Box 534 CONTACT PERSON: _ (g,5 k4kd 4 E T T LE iQ i Hyannis, MA 02601 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalf g, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous characteristics and must be registeredwhenstoredi.nquat ,itlrr � f'® # fd .$ Wit. Please put a check beside each product that you store: Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business