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
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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