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HomeMy WebLinkAbout0039 VINE AVENUE - Health -39 Vine Ave Centerville A= 226- 029 TOWN OF BARNSTABLE LOCA' ION _s� (1/AJE SEWAGE VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. OG0777 (f-0AJ_V__ SEPTIC TANK CAPACITY v LEACHING FACILITY:(type) CSC_ (size) /DDl9 ' NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER_---> BUILDER OR OWNER .(,(1LAIO,/ . —'1 DATE PERMIT ISSUED: � z/fx � DATE COLIPLIANCE ISSUED: ��� VARIANCE GRANTED: Yes No i 1 �K a.+ � I s �� �. � �'D� � '! �,'� ��� �.,, .� �.t9 ��� y�f�� � TOWN OF BARNSTABLE LOCATION d1laV8 SEWAGE # � y VILLAGE ASSESSOR'S MAP & LOT,'06 4a,9 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) n 0yeZ-:F Y-5 (size) r4eA NO. OF'BEDROOMS PRIVATE WELL OR LIC WATE� BUILDER OR OWNER ZVe~� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �, �: � - �� � �� ��° r f TOWN OF BARNSTABLE LOCATION && L �� Qe SEWAGE VILLAGE � � �^ / SSE SOR'S MAP Sk LOT�"&--D�9 j INSTALLER'S NAME & PHONE NO. W727Z6W 4f?,V&9S7t 7;�1-9J-W SEPTIC TANK CAPACITY ,1Z;?404l LEACHING FACILITY:(type) jam/7— —(size). NO. OF BEDROOMS v PRIVATE WELL O;�PUBLIC WATE BUILDER OR OWNER ,Lit11/lJ'/G � � DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No .......... I C No...�q'. Fps. ....:.... THE COMMONWEALTH OF MASSACHUSETTS aa� BOAR OF HEALTH Appliration for BhipogFal Works Tongtrnrtion Vamit Application is hereby made for a •Permit to Construct ( or Repair (XI"an Individual Sewage Disposal System at: .... . ............. W/14-4. --......-----------•----------------------------...---------------•--------------......----------- Location-Address or Lot No. ... 1 ...aVA T... %/mE.....fie-----.-.- .......... Owner �y. A �:.i!ti- s............... �'l�.l. /� dres« ....................... -- ._.....�...... ................. Installer Address g Size Lot.. �.0-00- --..Sq. feet U Type of Buildin �-, Dwelling=No. of Bedrooms................._........._....__....Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building a yp g ............................ No. of persons..._..........___.__.____... Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow..................... 55 ......_..____gallons per person per day. Total daily flow..........', Q_.__--------------_--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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (3� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 -•-------•-------------------------•--------•-------------•---------•-----------•-•• --------•-•-••......................................................... 0 Description of Soil----------..-./---------G.0A S..F.---. 41�------•--/-------/� f -5 ------------------------------- x W ------------------------------------------- U Nature of Repairs or Alterations— e,Anser when a licable._.. _ __.. ! � ........ ------------- ------- ----•--•- l ...... -----------------------------•------------------------------------------------........._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT4 LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee su d by the oar of health. 1 Sign --- --- ....... ---------------- ..... oA ate Application Approved BY JIIf . ----- --------------- ---•-----•• ----------- �' Date Application Disapproved for the following reasons----------------•-------------------------------------------------------------------------------------------•-•-• ....................•-----------------------•------.....-----•-•-•------------------•------•--•------------------••-•---•----••---•-...•---•----------•--------•--------............................... j/ d Date Permit No._ _(..—� .!-_...... Issued. ---- ----- e r r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF...."444 _-------------------------- .----- Appliration for Disposal Works Tonstrnrtinn Prrmit Application is hereby made for a Permit to Construct (Y) or Repair ( ) an Individual Sewage Disposal System at: !!J.. --....C%;at ticc ... ..........•-•------------.....------....--- ---------------.......------.........--•- Location-Address or Lot No. . ..............................•----- 3�i /�/!�%. U . c< ........... Owner / Address !- v'7�Ji _Q,.1�T /�1/.. • �� �Q...__.t ? i c�...:.....J l ----------- `' Installer Address UType of Building Size Lot_-._Z.,.(�? ..-..Sq. feet Dwelling—No. of Bedrooms.............._..........._..........Expansion Attic ( ) Garbage Grinder ( ) aOther —Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures WDesign Flow..................... .............gallons per person per day. Total daily flow__...__--_1./�-Y .....................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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f%4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •-•••-••--•-----------------••-------••--•---•----••--••--•-•---....•-•---.......-•---------..------......................................................... D Description of Soil.......... ----Z......../6.4-4-f t_-X.......S_Oyl_3.........Z--------- /_1....... ----- lvb------------------------------. x U ••••----•-•----•----•-----•-•---•---••------•-•--•-•--•----------•-•-•----........•---•-----•-•••••-•-•-----•-••----•-•---•-----•--••-----•-•--••-----•------•••••••-•-•---•-•----•..................... W ---------------------------------------------------•---- ----•---•--•-•-••-•-----•-•-•--•••••---•-------•--------------------•-------------------------••••-••--------------------------------- U Nature of Repairs or Alterations—Ans er when a plicable___✓� © :� �c.- ..S•�f'r{C; . ........................ �n+� G t CLc l •. mac ------. _? •... • -•----•••-------••-•••------••••--•-------•••-••-••••...................••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT�� 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is�y the o/ar of health. Sign d.- --••----• / ,� �" :�- . ..... '!.�.. - -- /! Date Application Approved By...l.._ -�- -"��--� jj ----••----------------------------•--•------------------.------- ----.--••-�.3!/- Y..... Date Application Disapproved for the following reasons----------------------------•--------------------------••-----------------------------------••---•-----........-- ....................................................---------------•-•-....--•--•-•------•--•------....-'-•---••-••----•••----•••---•--•---•-----•-••-•-••---------------•----•---•-----•-•-------•••-•. ���� Date PermitNo._&. 1/1.f._-•-•----•-----•--••------------ Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /3�.►T"L�.:..............OF...6. 011'-��l.G !".�,„.,,....................................... . ........... (Irrtifiratr of Tlantplinnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired �.% ,,� "D//�1S iN by.............................. ...._.._..------roc.G---.AT-- --------•... .......------------.................................................................................. r Installer at..............................•.- ...............0 c - t i4�C�_.c)r� has been installed in accordance with the provisions of -I'_"IZ' 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. �_/_3_y............... dated_._-3.` . ' __.____ .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. y _ c DATE...................... ^..fl 1......••......................... Inspector...----------.------ L ................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD, OF HEALTH � ......7` ................OF.----....1 �t t -^ No ............... FEE.._ ---- Disposal Works TUnn#r ion Prrutit Permission is hereby granted---------- P' / .C&'777.......CA71JV5T......... _...---......•-••----•........................ to Construct ( or Repair ) an Individual Sewage Disposal System f ----------------------••--•----------......................................... "-- Streetj(31 ` as shown on the application for Disposal Works Construction Permit __ Dated... � s%y9.............. ` ..................... aryl of Health DATE- l�----------------•----....-----.._._......---•-•----....._.. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS FRic THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............OF..... /-, ...--... Appliratiun for Disposal Works Tunitrur#iun Vantit Application is hereby made for a Permit to Construct ( ) or Repair K) an Individual Sewage Disposal System at: `�� �"-_-` ... .... '��, ...- :C. --•--•-----•--•------ ---- ----•---...------•------------------- �..Loc do Address 4 or Lot - �i w ner Address W .------Installerii� Address Type of Buildirig Size Lo -�de.......... q. 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 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 ( ) aPercolation Test Results Performed by------------------ ....................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f=, Test Pit No. 2................minutes per inch r Depth of Test Pit.................... Depth to ground water........................ .......................•--•---•---•-•-•=............................................._....................................................................... 0 Description of Soil--------•-------------••-------•----....-----.--------....•------------•-•------•--••---••-------••----•---------------•••-•--•---•--•---••-------------•......--------- x U ............................................----•--------------------------------•--------------••--------•-------------•--•-•------•---------------••----•-----------------•--•-••--•---•------------- W ---------•••-----------------•--•--•---•--•---•----•----------------••---•••---••-••---...-----••------------ U Nature of a airs or Alterations—Answer when applicable._-. -_____. ------- --------------- ------- ------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITU� 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been s e y th bo rd health. Signed....... ------------- --•• Da e Application Approved By.......... -- - Date Application Disapproved for the following reasons:......................................................................................------------------- .....................................•--••---------•-•-------_....._....•--------•--•-----------•-•--------•---------•-------•-----------------•••-•-----•-----•----------•--------••••-------••------- Date PermitNo....... -01-tn. ® . -•-------------------• Issued---------------•--------------------------------••---- Date i No.. Fzes..... r -� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH ........... -........... ;....... Applirution for Disposal Works Tonstrurtion JIrrutit Application is hereby made for a Permit to Construct ( ) or Repair k/ ) an Individual Sewage Disposal System at: `' (, Loc do -Address _ or �Qwner Addr ss w ,! r, > �;,_ �"� _ • . ..:........... �7._7. ....--6---�-.��------- %�����c`�7�� ��'--- -� W�.....--•-- ..».... Installer� Address d Type of Building c Size Lots,- dad- Sq. feet Dwelling No. of Bedrooms_.........z�..........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures .---•-----•-•-•--•-------------------------•--•-...........--------------------------•---------------------------•---••--••-•...-•-••-•-••••---•-•.... w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid cap4city............gallons Length................ Width....-........... Diameter---------------- Depth................ x Disposal Trench—No..,.....I............ 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------0............. Depth to ground water........................ 44 Test Pit No. 2..........0.....minutes per inch Depth of Test Pit.................... Depth to ground water.___----__----_--______- 9 ....•••-••.....................••....•••--•-••••----•.........••----.......0.---•--------._................................................................. ODescription of Soil.........................................................................-..........................................................-................................ .. x U -•••-•••••-•---•-•••--•--••••.............................................................•••-•---•-•.......•--••••••••---••---••••••----•-----••-••---•••-•---•----•-•--•-•----•••--•••••-•-••---•--••. ------------------------------------------------------------------------------------------------ ••--- '= �, ------ ----------------------------------------------- - U Nature of R , airs or Alterations—Answer when applicable._. �a 'Cam[. S /�' ..... - ......-- -••••--•----•---•--••-••••••-••'Z�................................................................----••--•--•--•-•--•---••--••••••••.......................••- -•-•----•-•-•-•-----•---------•-•-•••---•-•----•-••-•-.......--•-•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TiTIIl 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been 'ssu by t e b rd 9f health. } Signed..... -------•----•- ........... w�r-------....... .....-.......... Date Application Approved By.......... ........ ..�"�--- --------------------------•-------- r =:.Ir..... Date Application Disapproved for the following reasons------------------------------------------------------------------------------------------------------------ ...............................................................................•.......................................•......................................................... .................. Date PermitNo. 6'.ly_ .�C-�--•------•----•-----.._ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD U;F HEALTH �T OF... !..-...................................... (Intifirate of Toutpliunrr THIS IS7_ Q, F. _. That the Indivi ual Sewage Disposal System constructed ( ) or Repaired ) by.................. 2._..... ...._.: �. - mskaller at.............. ------- - � -• ................ - -------------I------------------------------------------------------------------------ has been installed in accordance with the provisions of TTT'j 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....._. �'.... ..5 ..... dated_-..._--_-_____________________________________ THE ISSUANCE (?F THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION. SATISFACTORY. DATE....................a.:'.t '�I.............................. Inspector..................... •---------.-------•------.-----.--. THE COMMONWEALTH OF MASSACHUSETTS BOARD) OF HEALT l .......................................OF......................:.............. ..................... FEE. eae ="--•, Disposal qVk notnul' UP r uti# Permission is hereby granted..........--P:.....................•-=�.:.....�/C?--------�--- -----------------------•-•------------........................ to Construct ( Repaid <;) an Individual Sewage Disposal Sys _ treet as shown on the application for Disposal Works Construction Permit off:��~ .r Dated.......................................... -�-- -------- ---------------............--------------•--- DATE. 4 Board of Health �. . ....... ........................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS