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HomeMy WebLinkAbout0835 SOUTH MAIN STREET - Health 835 SOUTH MAION ST, CENTERVILLE A= 185-018 No. 42101/3 ORA ESSELTE 1Q% O O Q O { TOWN OF.BARNSTABLE p� •r L J LOCATION � u ►1 MAIN) SEWAGE # VILLAGE 0,F_ U z L ASSESSOR'S MAP&LOT 9. ' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY C�6 LEACHING FACILITY: (type) �11 ,� ''? k (size) 01 69 X 9 NO.OF BEDROOMS BUILDER OR OWNER Rl, k1Q(��� PERMITDATE: .S COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site,or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 13a, LJg r /e/v l Nof, �_1 � Fxs.............................. � THE�O�ON®ALTH� ���OF �� � � R Of HEALTH i &r® f TOWN OF BARNSTABLE Appliration for Bi-tipooul War1w Towitrurtiom Famit Application is hereby made fora Permit to Construct ( ) or Repair X) an Individual Sewage Disposal S at• 's . ..... of t---------- l-b` �� ti ' c� ° ---------------------------------- ------------------------------ ct ioc - dress - „s` p ------------------------------ .��or���'..s----- Owner his�S o r lc e ��'_._ Installer Address U Type of Building Size Lot____________________ rr ............................Sq. feet Dwelling—No: of Bedrooms---------- -------------------------------Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow_____________ ___________________^____..gallons per person per day. Total daily flow....................................... .....gallons. WSeptic Tank—Liquid capacityj606.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------------- _ ___----- --------------------------------------------- ------ ground water ,.a Test Pii No. I-_-_-_____-_--minutes per inch Depth of Test Pit-___ __________ _ Depth to round water.._.__._.__.._.._....... 44 Test Pit No. 2................minutes per inch epth of Test Pi _.r__.__________ Depth to ground water-.......................1 y_,s------- �2 �-------------------------- ........ ODescription of Soil--------------------------------------L.-------------------------------------_...-----------------------------------------------------------------------------•-_----. x U x U Nature of Repairs or Alteratio s—Answer when applicable.- _ jln.0-U.�_-_.-._-_5��._�.1`------ /6}`!t�____________________ -----------------���+------- -----------------------------------------------------------------------..--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance s been issued the board of health. Signed }' (� M fu�------------------------- � ----------:----- . � 4 Dace Application.Approved B .. :.....G .. .. .. -------- ........:. Date Application Disapproved for the following reasons- -------------------------- -------------------------------------------------------------------------------------------------------- --------------------------- --------- Dace --Permit No. �..._:-----:...� 4�9-------------- Issued , Dace 4, Noi, �►- 'I"/ � - � Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH MAP 19S TOWN OF BARNSTABLE i Application is hereby made for a P rmA'Kto Cortstruct ( ) or Repair X) an Individual SewageDisposal osal ` Sy e3n at, r� /� • 3 S ... _ l _ 11� catioc --•-dress ,_. � ........................ • ' .---- --•--•. -----. ................................. Owner Addr ,.a •-•---... _... --- -•--------•---•-- ------- ------------ ..----C /� � 0S � Installer Address YP g r ot............................ Q e o Building Size LSq. feet Dwelling—No. of Bedrooms----------5---------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ----------------------_.___ No. of persons----------------------------)�bowers ( ) — Cafeteria ( ) Q Other fixtures . ----- W Design Flow......................... ..................gallons per person per day. Total daily flow...............----------------------,------gallons. 1:4 Septic Tank—Liquid capa6ty1900-gallons Length---------------- Width---------------- Diameter.............--- Depth................ 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 ( ) W Percolation Test Results Performed by.......................................................................... Date------------------------------.......... Test Pil No. 1----------------minutes per inch Depth of Test Pit.-_-__-___.--_____ Depth to ground water........................ GT. Test Pit No. 2................minutes per inch g to th epth of Test Pi _-__._._...__ _ DeP round water------------------------ �t ------------- f Description of Soil..................................... _ _ -- ------ ••• -----•• ---------------•-•-----•------•••---••------------•-•---------• ---•-••----...........----- . -•----•-------- -�' t U Nature of Repairs or Alteratio s—Answer when applicable._.__ 9')Q V ____._..__ £ __>�_._____�/ ....-------•••------••.................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h s been issue1"uAkev the board of health. Signed .... �- 1J --------- • Dace Application.Approved B --- � -- ------ ................ ----------------------------------------- Application. . ...... ��...:.: _ '---GP%�`�-- _ Dace Disapproved for the following reasons: .. . ......... ............. - ..........:............- ..... - .... -- -------- - i` .................... ............................................................------------.......-----------...----- ---------------..._..---- -----------.._._-----------------..._...--- le Permit No. -� tS-�5t�.---------- Issued ....... .`" c.� A Daze .��.�..,�..���e.>�...��._.._..�....-...-...., �..�.».,.�..�...o....�.,_� ..�e.a o....�.. - �.._,c-�-:.,..�..-�.,,-.. ,.w.�.�.:_.__._.�.._._._,.�.c..,.��....a �. ..s..-+...a—�c.v<.,..r.-m—:e.s.ss.•®v+., THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Te r#ifiCM#P of QTumpliaare T IS IS TO CERUFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (J( ) by ----- e_�120(,Q ....................-........ .... -------------------------------------------------------------------- at ............. MA, 5.... -—---IUot'/4 G�. has been installed in accordance with the provisions of TITI. of The Spite Environmental Code as described in the application for Disposal Works Construction Permit No. _ -- dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B CONSTR El0 AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATES / P..... ..... ...._..---... - Inspect ------ �c'sa%c� THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH ' TOWN OF BARNSTABLE c No.- FEE.................... 4 �i��n 1 >ark�, u�,�#r�#uan rrttti# Permission is hereby ran d---_. __._ to Consir t, t ( ) or Repair (X) ad-Individual Se ;age Di osal System at No.. �..5iiTC.-!'Y1A.......--- ..... .... ���1►��p�� - ------ -----------------------------------------•-•----.... q as shown on the application for Disposal Works Construction Permit —IX fDated-__- .: ► ------••- ,�,. .� Board of Health j ! DATE.------ -- •------------------ / FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS - TOWN OF.BARNSTABLE LOCATIONP% S SO A I R1 SEWAGE# S VILLAGE U L ASSESSOR'S MAP & LOT 1 8S` INSTALLER'S NAME&PHONE NO. �.456"Y d SEPTIC TANK CAPACITY S 6 1 ✓ � LEACHING FACII.TfY: (type) �� k (size) p ' NO.OF BEDROOMS S. _ BUILDER OR OWNER R1. PERMTTDATE: COMPLIANCE DATE: �. Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any.wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within.300 feet of leaching facility) Feet Furnished by 4. 'N� --now" i TOWN OF BARNSTABLE LOCATION 833 ' S6(,1 h fqQI`►,) SEWAGE # 3'3 IO VILLAGE,CF-tyYlk U i//? ASSESSOR'S MAP & LOT::'/8S- O!� INSTALLER'S NAME 6r PHONE NO. Q• BUm: j011S SEPTIC TANK CAPACITY160o LA LEACHING FACILITY:(type) _L1 L (size) NO. OF BEDROOMS_y PRIVATE WELL OR P'UIC WATER i BUILDER OR OWNER DATE PERMIT ISSUED: 3/9 I93 DATE COMPLIANCE ISSUED:a_lq VARIANCE GRANTED:. Yes No 4 e TOWN OF BARNSTABLE LOB-ATION 83.E %oNA P74 I N SEWAGE # 33_ 1® VILLAGE Cr,_rjY try I/g ASSESSOR'S MAP & LOT %g?S- 0 INSTALLER'S NAME PHONE NO.q• BUMpQS SEPTIC TANK CAPACITY 00 J LEACHING FACILITYA ype) Lll y f (size) NO. OF BEDROOMS PRIVATE WELL OR PUXIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: %d, I0 1 VARIANCE GRANTED: Yes No ^�A t 5`, SM 1 , cel)s-y� o Ie No......1._J7-. ?7 FEs............0..p....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE®arnstable Conservation Uepartment Applirativtt for Diripwial Wurltl Cnngd erutit .� - 5 _sue Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage &!W&al System at: ........................................ .... -- ----•-........................... .............•.............. q�jnrt' '-Addrcssss or Lot J.5-f--------------------------------------------------- ---- ------...-..�......._ . SfZ........ .... --•-------------------------- Inst, er Address Type of Building yy Size Lot............................Sq. feet Dwelling— No. of Bedrooms-----------✓...........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 04 Other fixtures ------------------------------------------------------------------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. fy Septic Tank—Liquid capacitvW q....gallons Length________________ Width---------------- Diameter................ Depth................ Disposal Trench—No. .................... M idth.................... Total Length.................... Total leaching area........_...........sq. ft. 3 Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------- -------------•--•---...---•-•---•-----------•--•--•-••-•••----••- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------. Depth to ground water........................ GXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R; ---------------------------------- --.--./ } ..---............................................................. Description of Soil.....� ..............�/�---.. 1./1. 5 x x ----••-•-•-••---------------••-•-------------...-•••--••-•...._....----•-.....----•--••••-•• -•--••----•----•--•-----•---------------•-•----- U Nature of Repairs or Alterations—Answer when applicable...__-___--__��_�s hlU.��______io—..___r1 .s.' ....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the. State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian has been issued by the oard of health. Signed .. ... _-��......................-- ....... .................. .- ....................-....-.:...... Date ApplicationApproved By ............... ..........................................................------------------. ---------- ........3��.^....% Application Disapproved for the following reasons: .................................................................................... . .............................. .. . .............................. ... . ... . .................................................................................................................................. ........................................ Da,Permit No. ....... j........ .1-0_ 7 ----------------- Issued --- ................................................. Dare 93- l2 '. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 TOWN OF BARNSTABLE yy--,� Applirttiilltt for Uiripwiul Wurk,i C�oustruriin,r- rrmii Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .... . ! a.h.......17)AY ---•••-----•...............•---_--•--• ---- --•-•- -•--•_.... ._.._. .-••--•. -•--•-----•--•--......--•-•- Loq�' Address Oz Lot ............................ O - Address � a ..���r..: _...'! _... '---•-•-•----- Inst 'ler Address Type of Building Size Lot............................Sq. feet .., Dwelling— No. of Bedrooms------------------------------------------- Expansion Attic )Showers Garbage P" ( ( )per,, Other—Type Type of Building ----------------------_.--- No. of persons ( p Cafeteria f Q' Other fixtures ............................................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity;OOP.gallons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench--No. .................... Vidth.................... 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (? Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------------------------------- --• - 0 Description of Soil' ! -S-•-•----•••-•--------•----••---•-•••-•..............•---•-•............------•---.••--- x x -----------••---------------••--------------------•- --------------------------------------...-....------------------------------------------- _ •-- ----- U Nature of Repairs or Alterations—Answer when applicable....-..------ / -G?�P IG��.......r......�.�c ............ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia e has been issuey the of health. Signed -- 11 �l��------------------------------ n� Date.................. Application Approved BY ------------- A, ..� �, ..........................................................._......................... ....... .= ,1.:....,1c.'.37.� Application Disapproved for the following reasons: ..................... ............. ..... --...... . ........ ....................... ....--........--..... . ...................................... ....................................... .... -- . ........ ....... ........................................ p� Date PermitNo. ......./... ....-.----t..0..7............-----_- Issued .......--..................--............ ......................... / Date n.-•-»ems�. —ww-..c a.r i-------- ----- ems.—a.-a----...m»�..�y�ir� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CTErtiftcx#e�_f CZnmlttncP�� THIS I�TO CERTIFY, That,th di�idual Sewage'Dispo it:System constructed ( ) or Repaired ( ) by ............... .......1 C�. ..........--...+,- .�� �._rL� - ......... - ........---------------------.-------.......... lnsrdlcr at .. ..-...-... _.. --- V. - .............. l i .........- .-.....-..................... -1... ..........-.........-....--..... has been installed in 4acebrdance with the provisions of TITLE 5 of The State Environmental Code as described in the application for+Disposal Works Construction Permit No. . ----- ----- dated ..........................-------------- ...-- THE),ISSU'ANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ...-.-.-... ? `.. 1 . ................ ........... Inspector .. r� V THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No... _.���._. FEE.....1.ft r� �i��rn�tt/l �rk� ��a�,�,ir tmrn �rrntii Permission is hereby granted ( -!�`d_ .�CJ ", / L �`J`_..--•-----------------•------......--•--.....--•--•--- to Construct`( ) or Repair ( an Individual Sewage Disposal System at No.... '--------.,. '�s �< � /yL------ �` �, .. c --•-('--..- F Street as shown on the application for Disposal Works Construction Permit No;9�_I 7--- Dated........................................... 3 Board of Health DATE............. --- . .../ ............................................. FORM 36508 HOBBS&WARREN.INC..PUBLISHERS i-14,41AI Jr . Ily Jf Mtge, . lLffirr. Y � v i C9 i� -�a - �r�_- t.:.X' • '/: �'3 t' SF- i'i i C re -', nvo f`0V4:" IiEl U r -A!i l�A '� !;r*K 1J f)f=rF i�f'y� '.. /��tr" J-4 A,'d IV 4� Z= :�f�/t.f't 4..fi�1�Y ✓�".rf/�fd y r f- f- SUBDIVISION PLAN OF LAND IN BARNSTABLE 8884 Nelson Boarse — n1ohard 4awt Surveyors . Docombor 5r 1961 .:$ � .c.7\a� 3 p•. •E��o � t �9 L.0 .Plan AHA4L^N N41Ct8,L�f tl. U ��- •' _ � -..._. � N •�. ILSin p 8 ' 0 ;W0 o, ti'�AY• r11151 C. 140 _ r �.. . 17. j N J 1• V c 1 • �I - n II \1 tiJpv prl�►.W.�11 • P, jZ ��, Cb. I W • N 1,4 y�.az I � t-- t9 CD 1 180 . 1 . � � Rz� z•, �:r �j s ! ^! s Hot t s em ►s B U.MPS R E IV R 170 �rlck wall Subdivision of Lot Shown on Plan 8884A1 Sheet 4 / C.! � 1