HomeMy WebLinkAbout0754 SHOOTFLYING HILL RD - Health (2) 754 Shootflying Dill Rd., Centerville
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALTH
--® - � . O F......................... C� T�� ..---------
ApplirFatinn for %yal ial ? nrki Tnntrnrtion Famit
Application is hereby made for a Permit to Construct (() or Repair ( ) an Individual Sewage Disposal
System at
�.. '
•Location- ddress ., or Lot No. ,
3Qno-+ ti{q �.�.io' i +�,1iVCs� r t-A G _iV erV, Ile....._..._....�.. .... .... ....... .... _...__.........._............ .._......._._.. ......_...__.__._..........._....... ___......................
Qwner L, Addressy ig
............................ .....................9-J.--.......---•----.....-•---•-- ---------•-•-•----•--------•••---..........:....._.......�:........ ........•--
Installer Address ` � ........
d Type of Building Size Lot....__.__,�_ Sq. feet
Dwelling—No. of Bedrooms...._.._ Expansion Attic (�,� Garbage Grinder ��
P4 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
04 Other fixtures ............................
W Design Flow..... _...............................gallons per person per day. Total dail flow-_3 %�_ -®l. .....gallons.
R: Septic Tank—Liquid capacity` gallons Length*R'�.... Width_6?-.4 16..._ Diameter"'!'....... DeD .
ths.142
• Disposal Trench—No. .... ........... Width....12......... Total Length------- Total leaching area.A.______......sq. ft.
Seepage Pit No--_---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box `06 Dosing tank (146
Percolation Test Results Performed by.......................................................................... Date-------------------• ---�.�--//......
,tea Test Pit No. 1_.�7...__._minutes per inch Depth of Test Pit-----M....... Depth to ground water_. _�_4%1rr►L
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------.__-_--___--:..___
O Description of il..__.0."7...._.._K7f�SM �
v .....t®' --�2--...M-s _.5- -Q---------------
W ----------------------------------------------------------------------------------------------------------------•---•------•--•----------•--•---------•-----•--•----------------•--••••------•-•----...
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 i'Lli LE 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.
..................................... ........//
D� w ..............Application Approved BY =-- = ' /Lt
Date
Application Disapproved for the following reasons: - ------------------------------------
................•--••-•--------------•••...--•--....--------------------------•-•......--------------------------••--............•---------•-----•--------••---•-•-••... ------------------------------
Date
PermitNo..... `r- 3.,0 Issued-------------------------------.................... .......................................................
Date
0 ....... Fm3..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH,
............
...............OF............................. Kj
Appliratiou for Uhiposal Works Tonstrurtivit Vamit
Application is hereby made for a Permit to Construct (�,/
System at: I I or Repair an Individual Sewage Disposal
'5 -;-- t 1� Ct �_
.......................�.......61............. ....................... .................................................................................................
Location-Address or Lot No.
............................................... w One r.......................................... .............................................�r cs.s ..........................................
.................................................................................................. ..................................................................................................
Installer Address
Size Lot--'-
Type of Building ........ZrZ,—_t....Sq. feet
Dwelling—No. of Bedrooms........S................................Expansion Attic Garbage Grinder �3_
PLI Other—Type of Building ............................ No. of persons---------------------------- Showers Cafeteria
0.4 Other fixtures ....................................................................................................................................................
Design Flow..... ...............................gallons per person per day. Total daily flow..... ' ------gallons.
9 Septic Tank—Liquid capacity9_f O.gallons Length Width.5__'-_3, _". Diameter---n--- ----D_Vth.5_.-
Disposal Trench—No. ------=........... Width_._.:`__.e ......... Total Length.................... Total leaching area... ......sq. ft.
Seepage Pit No--------------------- Diameter__-__-__-_--.-._--__ Depth below inlet.-__......._........ Total leaching area..................sq. ft.
Z Other Distribution box (-"t4< Dosing tank (K�o
Percolation Test Results Performed by--------................................................................. Date____._..............._____._.__-
-------
Test Pit No. I... minutes per inch Depth of Test Pit___-_ ....... Depth to ground water.. 7.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...----_-__-___..____-_.
--------.........;;;,,.......................................................................................; ..............................
0 Description of Soil...........::Z......... JS .�J............
---- .. ... ............... ...
iv.
........................... .................................................
U .................... .............................................................................
........................................................................................................................................... ...........................................................
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 T II T IE 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.
.. ....................................... 6-gued.....................A..J.
0, 4U�
ApplicationApproved By........ .... ... --------------------------- ........................................
Date
Application Disapproved for the following reasons:................................................................................................................
.......................................................................................................................................................................................................
1r'j-- 3 0 7 Date
PermitNo....................................................... Issued..................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
61 ..........................OF...................................I..,..............................................
Trrtffira#r of ToutIffiaurr
THIS ,4;0 C-ERjT WI
h,,.TjV,,J�,t_he Individual Sewage Disposal System constructed or Repaired
by............................................... ...... .............. .................................................
JU4_
at.................................................................... n.,..........................................................................................................................
has been installed in accordance wie7l_�ti�provisions of T ';rhe State Sanitary Code. as described in the
. ' q "s ;'�J_ Rt
application for Disposal Woirl�§ Construction Permit \i*o.......................................... d-ated-.-------- .....................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNICTION SATISFACTORY.
DATE.................... -`?s.................................... Inspector...... ...................................................................
THE COMMONWEALTH OfF�'�-Jy1ASSACHUSETTS °`BOARD HEALTH
X/1(11rl1w C_
...........................................OF.....................................................................................
NO......................... FEE .........
"'isposal Ylgrkn %ft 0 "amit
Permissionis hereby granted..............................................................................................................................................
to Construct ( ) or Repair a _Individual Sewage Disposal System
a No..-). ........ .......... ..x, I
t -------- K_ _Qj-----------------------------------------------------------
-1 treet
as shown on the application 6'I)isposal Works Con4truction Permit 1\FqESn ...... Dated-4- 21 .....................
------------- --------------
Board of Health.......... ---------------- _ ealZ:�7 -
DATE..............q
..................
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LOCATION SEWAGE PERMIT NO.
VILLAGE
I N S T A LLER'S NAME a ADDRESS
729 /\,j A _ lsA6,�-lfc/-i� �
B U I L D E R OR OWN ER
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED il _z6 _�S
L7
:30
3�,
:November 80 `1985
r Hi D A:' an, Speakman
11 Speak.Way
North:Harwich, MA 02645 f
.'Re.- Notice of:suspension*of'Disposal Works,Construct ion:Installer's Permit
r, ,Dear 14r Speakman a_ r
Your.Disposal Works Construction Installer's. Perm.it has" been suspended'`-for
November'29, •1.985 because of•vio mmencing :;'November . 25, ';,19$5,' through , -
lations of Title 5,;ofFthe State Environmental
Cod'e, and the Town of.Barnstable Health:reguiations.
Mr: Lawrence A. Hadfield,'•owner of ttie, property; notified us November 8, t`
,1985,\; that` you had instated a, septic system on his . property ..at Lot 5,
Shootflying;Hill Road, Centerville::,You;did not obtain a permit'`fro'm-the'Board
t Of'- Health ':to install`::thin system as , required ,'by -Title 5 of the*..'State
�:
.,.Environrriental Code, r and the Town`'of Barnstable Health Regulations. In
:-
addition ,you ,did::not call for an inspection prior to,backfilling`and completely
covering the system These':are .violations, of Regulation 15 12(4);(7)`, and..•.(10)
` of 310'CMR 15.0,0, Title 5; Minimum"Requ'iren ents 4or'`the Subsurface Disposal "
of Sanitary''Sewage N f'
SYou, may Frequent$ a :hearing before the Board of, Health if .written petition_
requesting same is received',within seven (7)¢ays after the date,order.served :
You are reminded that any.. future violations could result in .the';permanent
revocation'of your Disposal Works Insta' ler's Permit.
PER'ORDER OP THE'BUARD'OF .HEALTH A
:John M Kelly r,,•, w ._
Director of Pub11c'Healthi f F`
r .P. .tip {r• ; J J, � - /-
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