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Home My WebLink About0140 STONEY CLIFF ROAD - Health 14o ITQ(\Ikv Off 0 c9nticvrcte /// 5 M E fDj No.2.153LY UPC 12934 amead.com • Made In USA SUSTAINABLE fORE51i�Y WITIATIVE CaNBodF�arSourcinp i I Now—T':.to3 F�$....$15.00... .`�: THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH * TOW 3..........OF....Zaxnstahle-............--------- Appliratiun for Bi-poiial Work,6 Tomitrur#iun ramit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: ....S.tQDey...C.Uf....R.®ad....Cen texuillz................ .....#?4.0------------------•--------------••-----...........---•--......................... Rudolph Russo Location Address 140 Stoney Cliffs Road _ ......................_.......................................................•-------------•-- ............................. Owner Address A..&... ._Canco................................................................. ........350.14a►i n...St._..W....Yaxmnu th-----......--•--------••--• Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..............3...........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 r Other fixtures ............................... .• _....-_ W. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W 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........................................ 1-1 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ----------------------•........ ........... .-------------------------------------------------------------------------................-------- 0 Description of Soil.........................................................-.............................................................................................................. W V .......-•-•---•--....-•-•--••--•-••--••--•-----••-•--------------------------•------------•-•---••-------•-----••----....--•----•------...-----•-•---•------•---•------............_........._...... •---•--•--•-------. -•.................•---•-----------•---..............__..._.............----...........•--.-•--......---••-•••--- ....•-••-••. , 1 --.--.-------- U Nature of Repairs or Alterations—Answer when applicable----Zoo... _��__�5 ?..... =7..bn.4' ... /U_d .... (�PcQc 1h ..1Q.4A...................................................................................................................................-........................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b sue by 'the board of health. Signed o ..•--- -. M. .-49�.------ pl--<2 e Application Approved By-- ..ci:.........`Q'.................................................... ........................................ Date Application Disapproved for the following reasons:....................•---•--•----•--•--------•----------------•--•----------...------•-•.._......-••-----...... --........--•-----------•.............................................•---......-----•---...---••--•--•-.---•--------••--------••-------•-----••-•••--••----••-•--•-•-----•---•-•-•--•--•••------....--- Date PermitNo. .....I 0......�......•-- Issued........................................................ Date ��—lei � LOCATION SEWAGE PERMIT NO. VILLAGE GZLA, / EP,Jr LL.5 I N S T A LLER'S NAME i ADDRESS c- 6 • U I L D E R pp0R OWNER ySS DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �_� a ! V k / � L i No.1-.........� Fss....$15.00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................:...TaM-----....O F....Bal»nat-able.......------....------.................--------......... Appliration for Disposal Works Tonstrurtion rrrntit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: ....:Ston 4.Cliff..Raad.....Gentemvi_ 7.e......-••••..... ......# 0....--••--•--•-••.........................•-•.....-----•--•--_......_.----..... Rudc%lp 1 Russo Location-Address 140 atone�T ClY4 Road ............................ ............ ................................................ . ............... ...r:......... ............_................................. Owner -Address a A & B Canto v ............. ..........• -----.................................._._...._.._ ......... S ..NI .n._-s:t Address .. s=011.th....................-•--•- Installer Address Type of Building Size Lot............................Sq feet U Dwelling—No. of Bedrooms..............3......:....................Expansion Attic ( ) Garbage Grinder ( ) `LI Other—Type T e of Building No. of persons............................ Showers L11 YP g ---------•-•---•-•--•------- P ( ) — Cafeteria ( ) G4 Other fixtures ....................................................... d ----------------------------------•---....................----....-••--•..........._.......-•-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --••..........................................................•-----•---......--•-------.............._.._.......-----•••-•----•-------•••---••.._.......---- 0 Description of Soil.............•-•--•------•-•----........................................................................................................................................ W V ......................... .........•-••---...•-----••--------...-•-•---•--------...-••••--•--........_........--•---•-----••--•---•---•---.• ....---..............------......-•--••......•-----. W _ ............... _ 1 � U N ture of Repairs or.Alterations—Answer when applicable...(9100........a.1L.(>n......._�� vc�----. a. ................................ '......_.__...... ..................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI T 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. Signed...................................................::. ............................... .........................._.... Application Approved 4 ^^ ........... ........... ..........ate . r... Date Application Disapproved for the following reasons:............................................................................•-..._.............---.---....___ ............................................................•--••-......... •. ................................---------.....------..... . .....----- Date — Permit No............... b -._.... Issued...................................................... ----�------��. '•---- Date _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town oF......82►xnstable ....... ................... Tatif irate of Tontplianr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by-•••••. & -B.Casco 3 :.Main..S ,...±�L._.Xa o eth..........::.............--•-•..............•-----....................._.__...._ 140,Stoney Cliff Rd. Centezviligaller at------------ ----------------------•-•----•--------------------------------•---•-------------------------------•---•----------------------------------..-..--------------.--.--•----.-.------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._......5....r.........!--- 4.... dated......1..('.., ..:.. ..!�.�.......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL NCTION SATISFACTOR,Y:-':,,,,r.,,- DATE......--•..... b ..........................................--••---_.. Inspector............ .............................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town.....OF.........Bar®stable ........................... ..................---...................................... Fay....6C......... Disposal Works Tonstrurtion rrrntit Permission is hereby granted... ................ to Construct ( ) or Re air ( ) an Individualewage Disposal System atNo......... ........... . .................(......................... �......... ................................................... Street _ as shown on the application for Disposal Works Construction Permit NoK �S..'.'??A9Dated..... _. ` '.` -.may............. .: ..1................................................... Board of Health DATE.........------04......�---.....L f, -......---............. FORM 1255 A. M. SULKIN, INC., BOSTON