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Home My WebLink About0556 SOUTH MAIN STREET - Health 556 SOUTH MAIN ST. CENTERVILLE A = 0)),rford, NO. 1521/3 ORA 10% SSESSORS MAR 0: b r s PARCEL NO.: 4 6 THE CO V ON YJ......................... WALTI�- �(fSAC SETTS BOAR® OF HEALTH 1 ........OF....... ................................... Appliratiun for Mapuua1 Works Tout3trurtiun Vanfit Application is hereby made for a Permit to Construct ( ) or Repair (L j an Individual Sewage Disposal System at: .fib .5&e,rf/ 'i.�.v -5'�� .......-•----------••........................................................C....�....v...T...d..•----v�-�---c•--e--�---v•-•---------...._...---•--------r--Lt N . - Locations.Address o o �y2~JUN� � . 4 ............ N L ...................................... Address �....... .: G r.......................................................................... � 340 Installer Address Q Type of Building Size Lot....__.,,...................Sq. feet -f Dwelling—No. of Bedrooms.............-3...................---....Expansion Attic.( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons..................---------. Showers ( ) — Cafeteria ( ) Q' Other fixtures .................•--------.......--------•-•--•-----------...-----•-••-------•-------------.......--••------•---•-----------------------•--....------ Q W Design Flow........................33..-.............gallons per person per day. Total daily flow.............3 30 .gallons. 9 Septic Tank—Liquid capacity.�se�.gallons Length.B K"�.-. Width.. .K,... Diameter................ Depth..s-'8'!__ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......../---------- Diameter-------/Z ---. Depth below inlet....... ........... Total leaching area...33f_--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........................ GT., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...---..---.---..-..---- a •-----------------------------------------•---•--•---•-•----•-----------•-------•-------..__..._.......-----------------........-•-•---•----•..._..--•------ 0 Description of Soil........................................................................................................................................................................ W ------------------------------------- -----------•---------------------........------...------....----------•---------.....------------------------------------•-------------•-----•--•------•----•--- UNature of Repairs or Alterations—Answer when applicable-.-...•---------------------------------------------------------------------------------------- --------•---------------------------•-----------------------------------------------••----------.....----•--•-•-•---•-----------•---------------------------•----------•--------------••-------......... Agreement: I The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with T,T^1'i the provisions of Tce- of the State Sanitary Code—The undersigned further agrees not to piace the system in operation until Cer ifi e of pliance has been issued by the board of health. • - ...�" s r C,.. . Sig. .Application Approved By�.# ' .. Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo.----- Issued-....................................................... Date I I .:"- I %* TOWN OF BARNSTABLE AV LOCATION S3- Sa �� i S t SEWAGE''# � P 0-3 VILLAGE /C,�rE2 v � ASSESSOR'S MAP & LOT/9-e-- X 4e' INSTALLER'S NAME & PHONE.NO.A!e G At /� f T 75—/ -Z SEPTIC TANK CAPACITY ld o LEACHING FACILITY:(type) ze v c (size) /000 64 NO.-OF BEDROOMS ,3 PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER, Fe i S DATE PERMIT ISSUED: DATE .-COZIPLIANCE ISSUED: � VARIANCE GRANTED: Yes �_ No 12,12 3;L 3a l lob r 46 THE CO O W L 1100L A TTS BOARD OF HEALTH ............. i.---. --.OF......4��T, .4. ................................. Appliration for Diopoii al Works Tonotrurtion rautit Application is hereby-made for a Permit to Construct ( ) or Repair ((.o*O) an Individual Sewage Disposal System at: . S34 .Svc,TV �1�r�.v s�7 T C,6- Lr�v�c. e •-----------------••---------------.....--------...---------._...........•-•-•--•-•-.........._.._ ..._...---------------........-••........_............._....._._..._..---------------•--....•••... Location-Address or Lot No. G--- 'S4'i'/MG G /G- CG...�/TG-:� E... Address Installer Address d Type of Building Size Lot_____.,,..._--•-.----------Sq. feet U Dwelling—No. of Bedrooms.........................................Expansion Attic ( ) Garbage Grinder ( ) aOther Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) al Other fixtures .................................. W Design Flow....................... - ..........____gallons per person per day. Total daily flow..........._:-TO .................. WSeptic Tank—Liquid capacity�_"5?�..gallons Length.0'..G._�.... Width_.I..4_....... Diameter__.____••___•... Depth_S__d...... x Disposal Trench—Nlo. .................... Width.................... Total Length.................... Total leaching area____-_-_.____. --__sq. ft. Seepage Pit No-------/_._________ Diameter.......14......... Depth below inlet......G_..._..... Total leaching area..3 ....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1__-_-_-_______-minutes per inch Depth of Test Pit.................... Depth to ground water--_________-_---------_. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •-----•---•-------------•••---......•--•-...__...---•------•-•.......------•..................--•---......................................................... 0 Description of Soil........................................................................................................................................................................ W 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 TTT1 E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until 4 Certifi 'e of mpiiance has been issued by the board of health. Sign d- Application Approved Bye..;: ..... ........................ a ............... Date Application Disapproved for the following reasons:----•----•----------------------------------------------------•----------------------------•••••......---------- ---------•---•-••••....••••-••••----•---•--•-••-••-•-••-----•.....•••••••------••-•••---••-••--•---•----.........................•-•--•-•-•--••------•••-••-----•--•--•----------•---••••-•--•-•---•----- Date Permit No....... .o �v' Issued....................................................... ;. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........I........... ........................................... TrrtifirFair of Tong hattrr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired kf ool by .................•-----•-...•---.......--•-•- _, Installer _..____... at•••••.............. =:.:—.6` ...._......•�-. a_.... -1- ..... --�-------------------------------------------------------------------------- has been instailed in accordance with the provisions of TITLE 5 of The State Sanitary Code Is described in the application for Disposal Works Construction Permit ........ dated-..--- � _ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspectors,�- ...................•-•--- THE COMMONWEALTH OF MASSACHUSETTS i� BOARD F HEALTH �7� T�, � f�' ��..sT�J 3cG- 7 5 o G No.._ 1-eu.... aO� .......................................... FE ........................ Disposal Works Tono#rudion "anti# Permission is hereby granted.-_::.� �� -_•_._ _ ____ t ..........------.................•----. to Construct ( ) epair Indivvlidual Sewage Dis S em ....... at Street as shown on the application for Disposal Works Construction ........�.....J... Dated•'_ !�.�? �!e. .............-�.,� .... m_..._.___..- . Board of Health DATE•• •• -M ----L/ )� �� .......•..•. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS r ` 1 or tr c / 24, 0 F \ o 11 �p � A>17- � `Y d 2- yl R 4 u OFF EJuVARD E. CD 2Z� lkry No. 26100 IST A/°7Z-- As-Bvic r PL,g,� �a CFE / q,,;5- %vc �� Su8h i7T&'D 7a 66,17 LOCATIONS??^!sT 4QG �_ SCALE . ..��.:. ��.... DATE -Ju6: �.i9c46 I PLAN REFERENCE , � 1 . S�wn! •one f?L�i.. ... ...... . . . . . oe-o / Tom/ I CERTIFY THAT THE ..... .. . . SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON, DATE . .. . 10477770.16'7Z REGISTERED LAND SURVEYOR