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Home My WebLink About0121 STANLEY WAY - Health � 21 S?q�t�Y w�jt ('�n{ccv�ttt ZZg � ttq 5 M E A D No.2-153LY UPC 12934 smead.com • Made in USA WI11A71VE Cortl�d Fiber Soure4ip i �. i I I a V No... Fmil... :. ... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH aPmovEo TOWN OF BARNSTABLE 6vo>uo"amnmom AVVIlratiou for Dhiposal Works Tanigitr* 9+1 _SMV= 11,1 Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 121 Stanley Way Centerville ..................--.............................................................................. .....................:............................................................................ Location-Address or Lot No. Q--••-....-•................................................... •--•---•-•.....-•--•---...•---•-••-•-•---••-•••---•----........--•--.......-••••-•...--•--........ W J.P.Macomber J r, Owner Address Installer Address Q Type of Building Size Lot............................Sq. feet U I wellingx-No. of Bedrooms...............3..........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building a yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures --------------------------------------------------- •••--•-•... ------------ W Design Flow............................................gallons per person per day. Total daily flow............................................ 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 ( ) Percolation Test Results Performed by.................................................... --•------------------- Date........................................ 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........................ P4 ----------------------------------•- -----------------------....------- •------------ •------------ ------------------------ •------ •--------------- •......... 0 Description of Soil_____________________________________________ -gand--- '-----------------•------•----•---•----------•-•---•-•----•-------•---•-•••----------- U •••••--•----•-- =------------'...-------....-•--•-=-•-----------------•---•-----.......------••---------------------•--------------------------------------------•-----------...---•-•-•-•--•---- x ---•-•-------------------------------------•---------------------------------------------•-------------------------.------------:I ----•--------------•--------•------•--------•-•--•-----•-•----••--••--- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ 1-1000-•g p allon leachln� it. ................ 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 has been issued by the and of health. Signed 1/2/92 ----..s... ^ Date Application Approved By 7 c` ..... ..- �- -- ----------------------------------------------------------- f 3 D-. U Date Application Disapproved for the following reasons: .....----- -------- --- ---------------------------- -- ----- ----------........ ----------. .------..... --......... ----...................................... .................................... Dare PermitNo. a-------1.... ............................ Issued ---------------------------------------------------------- to Date ...... Fms..#...3C. �..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH j TOWN OF BARNSTABLE Allp tration for UWpatia1 Vork.5 Tomitrndtnn erntt# 14A Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 121 Stanley Way Centerville ................-................................................................................ --......._.....•-•-••...............-•---•--------••-.........•--••-------•--.........----.....--- Location-Address or Lot No. inl i l l i a.m A m r ra r n G -----•----•----- .................... .... _..... ...............•-•-----•--•------------••-----•---•---•-••.-•-•- J.P.Macomber J r. Owner Address W Installer Address Type of Building Size Lot............................Sq. feet Dwelling)No. of Bedrooms............... ._-------.--------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 114 Other fixtures -------"-'----------------------"--------•"---------••----------------'---•-•--••--.. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ �41W 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........................................ Test Pit No. I................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........................ P4 ---------------------------'----------•-------•••'---'------•-"------.........---...-••••••-_.._........................................................... ODescription of Soil......................................... TM M - '!--•-•-•-••---•-•-•-•------•--•-•-'----•--••-•----------'---------•---•--------..----- A� SLY tSC. iXY'�1 ti it.i. W U Nature of Repairs or Alterations—Answer when applicable...:......................---------............................................................. 1-1000 gallon leacninv pit. ---------•-••'--'-'---•---• - -------------------------'-'--'---------------'-.................................................... 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 has been /issued by the �board �of health. _ Signed 1Y, .s l-`Jj�%f! ./�.. f.--..--------------------- ..-1/--. .........---....-- ._.E....- _ 2/92 IYare Application Approved By - - M«-� -------------------------------------------------- Application .-..?.Da-`" ------------------ Date Disapproved for the following reasons- ..........................------------------------------------------------------------------------------------------ ------------ - ------------------------------------- ------- --------------------------- Dace Permit No. ...... -s �... ............. Issued .-.. -- --- --.......:---... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Clertiftrak rrf C�ontyliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( Z�X .v.iviacolau x by---------'------------------------------------------------------------------------------------------ ------------------------------------------------------_------------- -_----------------------------------------------- Installer at ....... 21...S t--a le v.-.Way.-...G e n t e x v11.1 e-------------------------- ------------------ ------- ------ ----------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 AThe State Environmental Code as described in the application for Disposal Works Construction Permit No. ------ : .- f-------------------- dated -----------------..--..-.--------.-........ .-... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-- " /,rr f r � ... -- Ir-------�� ..!......................... -------- Inspector ------ '' . --- .. t .. ...'.. ------f-----.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.----..__................ 3 FEE_ .... 0.'.00.. Disposal nrko Tnnr#nr trnn amit Permission is hereby granted.....J.T._MacOmber Jr________________ ___________________________________ to Construct ( ) or Repair ?(2Xi) an Individual Sewage Disposal System at No.._121---Stanley Way Centerville -- ...-----------------.-•••--------------"----------------'--"'------•--•--•-•-••-••--••'-----•-•------•••-''--••••- Street as shown on the application for Disposal Works Construction Permit No. _ __._._ Dated.......................................... ............................. = -----------------=.....................................- Board of Health DATE----'-...... .... ---------------------- FORM 36508 HOBBS&WARREN,INC..PUBLISHERS li TOWN OF BARNSTABLE LOCATION Z/, /�„/«, �/f;�; SEWAGE # VILLAGE Ceii ,. ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. J',��oL!� ��tl^�e,-¢S0y,.L4C: SEPTIC TANK CAPACITY LEACHING FACILITYAtype) / (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER o 0 BUILDER OR OWNER 09C DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ` VARIANCE GRANTED: Yes No. 0 � £� � 't h�► i.,�' �� , � � s �- 1 � � `�� ,y[L�. � \ \ / / ,• \ i � �,/ \ 'F. �� '�