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Home My WebLink About0285 STRAWBERRY HILL ROAD - Health 285 Strawberry Hill Road A= 247-217 Centerville 4 S M EA 0 No.2-153LOR UPC 12534 smead.cam • Made in USA lii��!iF�FaODUCT l6J@ CERTIFIED SOURCWG Y..:o"LSRr�0"1a;.1.1GiG D . ASSESSOR'S MAP NO. PARCEL I. DCATION i SEWAGE PERMIT�NO. VILLAGE STA LLER'S NA E i A 0 D R E S t`na-'O „_, S _ M&A D e if_ Wla s S, S U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED r \\. '� �k7 / 1+��'�` o1JJ� T� OMMONWEALTH OF MASSACHUSETTS ' pate BOARD OF HEALTH TOWN OF BARNSTABLE Alip iratiuu for Diupnuttl Workii Toutitrnrtiun rrrmit Application is hereby made for a Permit to Construct ( ) or RepairV-�.an Individual Sewage Disposal System at: Q I ( 1 ...........- • ....Q-S^. � Y s�._ --1-1 , ------•---------�------•-�.(�. --- ------•-------------•-----•---...----•---- Location Add res or Lot No. l v'11er r««�ss a C�..�'rl_.�.L.✓.._..�....._�_.��.1. \�� `�''" 3..Ast Y.�.' jQ.ti.:\:11:'.��►4 Installer Address UType of Building Size Lot............................Sq. feet .-� Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a Other fixtures . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacitv............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 ( ) .4 Percolation Test Results Performed by.......................................................................... Date....................................... a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water_.__--.______-__---____ LT, Test Pit No. 2................minutes per inch Depth of Test Pit-----:............. Depth to ground water........................ ......-----•................•--•-•--•----------..._-----...-•---..........__...... 0 Description of Soil--------------------•• . ----- .... ............. -- ---------- ---j •-----•-------- V -----------•------------------------------•-- ..W ------------------------------------------ ----------------------------------------- -- Nature of Repairs or Alterations—An wer wh a he ble___ �� U P PP -----.. --.•. c� . . �- - -- ................-•-•--------•-- ........................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State EnviroqmNtal Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp ance as en issue y the oard of health. Signed ---------- '7'..°�7 �'5.......y.:...... } •-� Date Application Approved By ................ J V... .°-c;4s Q. ... Date Application Disapproved for the following reasons: ..... ........... .... . .................. ........... .......... ... .. . ... . .................. .................... ......... .. ............. . .......... ........ . ....... . ............. --°7 '= Date Permit No. .... ...- ... (---V------------------ Issued ........... ..�.. ..'�1.e f. Dace HE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uinpoottl Nork.6 Tiltuitrnrtion rumit Application is hereby made for a Permit to Construct ( ) or Repair �,Pp< an Individual Sewage Disposal System at ......... x... : --------------------- \ Location i\ddrrss fit ckS or Lot No. ..........-•.............................fl.S•---- ..........•--------------• Y---\=••_' ............................................................•......._......._........^........... iv er ----^. kdr�ss ( Installer Address VType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms_________ _-------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------------------------------------------------------------------- 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 ( ) Pereolation Test Results Performed by........ ---------------••-•---•--•----•---------•----•--•-------•--•••--- Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit-_.__-_---__.•-____- Depth to ground water........................ P4 --------------------------------•_.......----------•-----•••----...----------------••--•---.._...........---•-•--••••---••••-•--•---.......-----....---•-••-- D Description of Soil----------------------- ........-••-..._......---•• -- W -------------------------- ------•-----••--------••.._..............._......------.--• •---••----------•---�, x •• .......................... Nature of Repairs or Alterations—An wer when applicable._.- .__ -- _ �w ..�--- 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 Comp iance�has been issued y the oard of health. Signed - I /) l 1 s(� c' ....9 -- 4. . . . '="...�^R..................... . .......... Dace Application Approved By ................ ` V ..cam, ,.....- .----------------------------------------------------------------- Application Disapproved for the following reasons- ----------------------------------------------------------------------- . .................. ...,._........ ..... ..........._................................... . . ................Q.............._... . ------ Da te Permit No. ----- L/...-.... .......... ...................... Issued ......... °� =c7 f.................. Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cler#ifirate of Compliance THIS IS T0)"C5NURTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaire ) at ............. . . �r .0-�... .r - . ..............�- �.---------------------..._......-------------------------- has been installed in accordance with the provisions of TILE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ---- .. —........ ------ dated ...... ---------------- ------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ......... --c _ff.—J �---- ---------- --- ------- - ----- ---- -- Inspect>,r,*...r / 4 ? �4-7 THE COMMONWEALTH OF MASSACHUSETTS atTCr` ( ( BOARD OF HEALTH TOWN OF BARNSTABLE 0-6No......................... FEE- -�---•---.----- �io�roo � orv(9jan1mdiqn rrrmit...�k�Permission is hereby granted - / ----- ---- . --- ------ to Construct ( ) or Repair( ,—an Indivi ual Sewage Disposal Sys eV I at No- --------------- � Street as shown on the application for Disposal Works Construction Permit No. .__ .: �t�_ Dated... �_�S• -!.T_.___. ................................... w..----------•--- ............................................. Board of Health DATE ------------------------------ -- FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS