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0029 PHINNEY'S LANE - Health (2)
2 Da -bqq r,® S M EAD KF�PING 70U 9RGANIN No,10334 2-153L MADE IN USA GET ORGANIZED AT SMEAD.COM N0 � . 5••00 . •---_.... Finc $ • •-••-•-........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......Town _...............OF........Barnstable-----------....................................... Appliratiun -fear 'Mipwial Works Tomitrurtiun Vrrntit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 29__PYii-nneys.... ane-•--------------•------••------•---------_---- John Weston Location_Address or Lot No. Centerville Owner Address J .... a oseph P M �9m r_..$�._Sol?p._._I.Xl�.......... •--------Ce n avj.?.t. r -P Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons...._.`_:.___._.._..._....._ Showers ( ) — Cafeteria ( ) Otherfixtures ----------------------------------•--------------_----------------•---....------------•--...._......_...__._.-......-------••--- ----•--•------- W Design Flow............................................gallons per person per day. Total daily flow.........................................---gallons. W Septic 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-_-___---___--____-__--. �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__-__-______________-__. n+ --------• - G Sand---&---Gravel.........................................................-------------------------------------------------------- Description of Soil -- •••----•--•----- x VW --------------------------------------------------•--------------------------------------------------------------------------------------------------------------------- -------- Nature of Repairs or Alterations—Answer when applicable._..,-_0..Q��.__��__1, on..-P_Z_t_____� A-e r -------------------------------------------------------------------------------------------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place'the system in operation until a Certificate of Compliance has e iss d by the board of health. J Q Si ed ... vr( l a ✓✓�J � Date Application Approved By...... �_ �_ _-_ _._. _� Date Application Disapproved for the following reasons-----------------------------------------------•___________.____________._._.__._..---_---._ ------------ .......................................................... ---•------•--------•-•-----••••-•--•------•---------------•-•---_....--••---•--•-------••---------•--•-•--•-----------••----•-•-------••----- Date Permit No......................................................... Issued....I ---------�:� i Date L a E LOCATION SEW f� PERMIT U O. �,e Q/ IWSTQLLER 5 U&ME � ADDRESS BUILDER 5 Q I MF— ADDRESS D47E PERMIT 7e' DATE COMPLI &MCE ISSUED : 4 %z-G= So.� ���� G.�5��4- '� , a R v i w i � � �h�����s ���� Ji ......... Fnic 15_.2G.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town... ..._ ._....----OF.........Bs,rnstabl................................................... Appliratinn -fur Biiipuiitt1 Works Towitrurtion Vrrniit Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: Q Prt ,�nnevs--•T��. - John Weston Location-Address or Lot No. Centerville Owner Address a «T ser �_.:P=.._h c©m Qr_.. ...S n c--------- ........_Qentery _..�P....-----------•--------------------••------------------ Installer Address Type of Building Size Lot----------------------------Sq. feet �-+ Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) W aOther—Type of Building ---------------------------- No. of Persons_----_------._---.-..------ Showers ( ) — Cafeteria ( ) d 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 ( ) aPercolation Test Results Performed bY.......................................................................... Date------------------------------------- a Test Pit No. 1................minutes per inch Depth of "Pest Pit..........-_---.._-. Depth to ground water........-..-..-.-....._. rZ4 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........-..------------. P4 --------------- ----- --- ---------- -----......--------•-•----------------------•--------- O Description of Soil------------------SSand & GraveT x - ...-------•--••---•----•-•-•-----------•---••-- --------------------------------•-----------------•---•--------- ----------------------------- --- U w U Nature of Repairs or Alterations—Answer when applicable_--1_-lD 7G r a.l lon n i t ----••-------------••------.-----•-------...-----.... .....................................---.....--------•---------------•-••-•-----------•-------------••------------•----------•-----------.--..._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI 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. Sig ed-----i------------------------------------ , Y, r .f ), Date Application Approved BY �.. _ � z�-` 7 ------ ---- Date-------------- Application Disapproved for the following reasons:.................... ----------------------------------------------------------------------------------------------------•----------------------------------------------------------------------------- ---------- ---------- Date PermitNo......................................................... Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............T.own................OF.........Ens table . ............................................ UIrrifiratr of f�0MVIianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X) by......----J©sax�n--P-=.....`-acomber &-Scan.jent rv; e Installer at...-.2a••Phinnevs_--Lane ,-- Centerv� lle.Intaller Weston - - - ----------------------------------------------------------------------- has been installed in accordance with the provisions of ArtieNI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.--- -----.5��1.--.-_.------. dated-.---_l�..� ..^ �G THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............To.wn..........._..O F........earns.tab le........------...........---------------.... No.--•---...>...../•.... FEE...... r�•_nn.... Bispoiitti Vorkii TIuntitrurtiou Vrrutit Permission is hereby granted.....JOSeph P. Macomber &e' Son, IriC--------------------------------------------- ---------------------------- to Construct ( ) or Repair (X) an Individual Sewage Disposal System at No 2ajhinnevs Dkne.:.Centervillea. Weston Street as shown on the application for Disposal Works Construction Permit No... __. "-..-f_Dated-...`0..--_ ........... ------ ---------------- Board of Health DATE f "Z -�� FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS