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HomeMy WebLinkAbout0209 PATRIOT WAY - Health 209 Patriots Way Centerville A= 193 - 194 1 IN S M E A D No.H163OR UPC 10259 smead.com • Made in USA �J `Qf LOCATION SEWAGE PERMIT NO. 4.* VILLAGE M� . (2 93 INSTA �L/LER'S NAME i ADDRESS BUILDER 0 OWNER DATE .PERMIT ISSUED 3_ 2t -7g DATE COMPLIANCE ISSUED r �� �e t 8 t�'f Foo , i � 27 ` �, �'� �$ ,�y� o �7 No......................... �' ......:' w. THE COMMO WEALTH OF MASSACHUSETTS BOAR® OF HEALTH d/ ...........Town....... ....OF.........Barnstable 3 .................................................................... Appliration for Diipnstal Works Tnnitrurtiun Vanfit 0A Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: Lot # 28 Patriots Way Centerville, MA 02632 .............. - ......_. .............. -•-•--------.......--- ...... --------•---•--------..........•....--•----------•---•• - -•-............ o ation--Address or Lot No. Suffolk Rea _y Trust P.O. Box 308"Centerville ......................__. - ............................................... ...............-•-----•-----•-••••...............•---.•-••--•-•--.....................------•..... Owner Address W Kevin Hickey 72 Carriage Lane Barnstable ,.a ........• ........ Installer Address Type of Building Size Lot-----15_t_735------Sq. feet , Dwelling—No. of Bedrooms.........tbg.e.e....................Expansion Attic ( 0) Garbage Grinderno ) .4 Other=Type of Building No. of persons............................ Showers (10) a YP g ---��3Zeh...----... P ( � — Cafeteria Other fixtures ------------------------------- . W Design Flow...........10 .gallons per person per day. Total daily flow..............330 _ _ -- gallons. WSeptic Tank—Liquid capacity.1.0.0.0gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.__... ... _._..-_- Total leaching area....................sq. ft. Seepage Pit No......... 4...... Diameter......./d...... Depth below inle ... Total leaching area...��.�/.�.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) d �—/QG�y„L . aPercolation Test Results Performed by.........Ronal d._.Gifford........................ Date..June... 76 ,4 Test Pit No. l..less_.Anutes per inch Depth of Test Pit------1.3........ Depth to ground water.-_ M' ne......__. Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------------------------------------------------------------------•-•----------•------•......................................................... O Description of Soil...................................... -2......loam-&.._Subsoj aphaQil.......................................................................... U .--------------------------------------•---------------------------2--7.-......Jrayel...& s nd...------------------------------------------.....------.........------------ UW -------------------------------------------------------------------7 .-13!--•fine- white---sand-----------------------------------------••-----....----------•------ Nature 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 TTTLL 5 of the State Sanitary Code— The undersined,further agrees not to place the system in operation until a Certificate of Compliance has been iss d by the b#-oealth.igned.--------- ---------- - 3.- - Date Application Approved By... ,.< - - -- ------------------------------------•--- Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- -----•--------•---------------------------•-•---•--•-----•---------------........._......................._...............---- -------------------------------------------------------------------------- Date Permit No. .._.. Issued... 7 ............. - ............................ '� Date No. -...... �.` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............Town...................O F.........Barnstabl e --- - ---------------------------------------------•--- Appliration for DispasFal 1#orks (Inntructiun thrutit Application is hereby made for a Permit to Construct ( )Q or Repair ( ) an Individual Sewage Disposal System at: Lot # . 28 Patriots Way Centerville, MA 02632 ................__..................--•--••---.........................-------- .....-•---.... ......---....------••-------------._..........-•--•---------------• ...... adyn'� On�ervilleSuffolk Re rust P.O. Box 308 Ve ......................__ ........................ ................................................ ._ .... KOwner Address Kevin Hickey a y 72 Carriage Lane Barnstable •.................... Installer Address Type of Building Size Lot..... r. 3 ......Sq. feet U Dwelling—No. of Bedrooms......... ....................Expansion Attic (10) Garbage Grinderno ) aOther —Typee�of Building .....raneh........_. No. of persons............................ Showers ( — Cafeteria PO) d l fixtures --------------•--------------------._....-------------------•-------..._.._...-•--•------.....----.........-----....-----....-----... W Design Flow........ l....................................gallons per person per day. Total daily flow..............330......•..............gallons. WSeptic Tank—Liquid'capacity.l.OQQgallons 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._. l�-4.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `` AAh,�, '-' Percolation Test Results Performed by.......__ftnald...Gifford........................ Date... une... 9.,.___19740 Test Pit No. l..leS$..t4inutes per inch Depth of Test Pit......1.3._......... Depth to ground water....ZI-one......... pc., Test Pit No. 2_••••-•------_-minutes per inch Depth of Test Pit.......................Depth to ground water---;'*---------------------- R'+ ------------------------------------•...... ---------•-------------•------------•-•--------•---------•--------•----------•--•-•--•=-•-•------••••....._ D Description of Soil...;:............. + 2 t loam & ub-9Pil ; 0'- v `�7 ...grayer..&•__sand w 7'-13 1 fine white sand ----------•-----------------------------•--•••-------------•---------•----•---------•--•----•------------------••--------•--.....---•-----•-•---•-•------•--•••-••......••••-•----••-----.............. U Nature 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 TITLE, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in. operation until a Certificate of Compliance has beiiissed by the board ohealth. Signed---.... <.. � �, r.. c.r./�!. •................... 3-21-79 or Application Approved BY-- V Date Date Application Disapproved for the following reasons:.............................................................................................................. -•..........................•-----•---------------------.._.......--------.i................--------------•-••-•--••-•--•-•-•--•••••-•••-••••-•-•••------•---••--•-••--•-----------•••----•:......-•--- ,. ate Permit No......................................................... Issued.........-•-------- Date / THE COMMONWEALTH OF MASSACHUSETTS E' BOARD OF HEALTH Town.......................O F...........Bt'rnstable a ......... fP�rrtifirtttle of ftuutpItanrr - THIS IS TO CERRTIFY That the Individual Sewage Disposal System constructed X or. Repair.ed b Kevin' H].ckey g P y ( )<� y •. ••.........•-•................ Lot # 28 Patriots Way Centerviff4e MA 02632 at.............................................................................---------------------------------------------------------------------------------------................................ has been installed in accordance with the provisions of T' 5 of The"State Sanitary Code as described in the application for Disposal Works Construction Permit No.._ .._...... .._....... dated..-.".�-�,�±�i_ .'�......._... b THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL,FUNCTION SATISFACTORY. /J y r - DATE.......... 1.��.�....��.._.....----•----------------- Inspector..... ,��r�:.v. Gl�YL��............. - > THE COMMONWEALTH OF MASSACHUSETTS BOARD 'OF HEALTH Town ...........OF............Barnstable r� N ..........G?.... FEE......... nrk� �na��tr�ti�n rrutit Kevin Hickey Permissionis hereby granted......................................................................................................._...................................... to Construct'('X or Repair ( ) an Individual Sewage Disposal System or #__28 Patriots Way Centerville at No. . --•-------•-•-•-----•--•---...••--••••••---•----•-----•-------•................. Street d as shown on the application for Disposal Works Construction er it N .;f ........ ... _ Dated._"',, ..... 12 :7_f... `� .. -•--••.....•--...... or of ealth DATE....... +_..._...---•-•--•--------.._..._. 4M FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS k` r 20. o u 57(1 . 9©. o k : is, � �r t r G c�T . �3• � 9G, .. _ �x�'�a•�ss�,,,,,_ --%ono G .c'x,s7- � `� �" --- - N`• Al. E + � . ........... � .• � /!�''..�F.,w�G3 W 4 F ^'9 /'A// /1.U� 73t11�. l /IVG S TPH ?EC U/JET` E/`'1 n1T5 ?. 'I V" �/C �" L c' C' Z3. Q ' .0 ';5 � E.Z>R b L./I9!� 'T"�. „ " /`'7 U A�/4ASS Z 'E Sl n!' 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