HomeMy WebLinkAbout0151 WHITE OAK TRAIL - Health 151 White-ite-Oa�tcT*1 =
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No.....0.l.-.YR.... Fis.....r
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
IMP-N.................oF� �t 4�....----
Appliration for Uispaa al Works Tonotrurtion Pumit
Application is hereby made for a Permit to Construct ( ) or Repair ( � Individual Sewage Disposal
System at:
....L1.__.�c, .N..1 ...... --------••--------•............. -----------
Location-Address or Lot No:
._._..&S. .9.AAtIl a ----------------------•---•-------•-- .......... Y"Z.f... .........................................
Owner Address
a l k-�d1--------1l(� '� t..A. ....................................
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................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 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--___._--_______--___---
�14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--______________----__--
Ixr-----------------------.....................................................................................................................................
0 Description of Soil------�`_--............ - •-•--......----•------------•--------------------------------------------------------------------•--•----------------
x
U --------------------------------------------•--•----•---------------------._......------------------------•-----•--------------------------•-----------------------------------•--••-•-•---------------
w
. p
Nature of Repairs or Alterations—Answer when applicable__ _ t.�£- � ���
U P PP - ------------------4r--------------------------•---•---------
�`°-iryt ----------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
!`1i:IET rl�^
the provisions of : 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha een issued by the board of health.
Signed._
Date
Application Approved By................ ) -------•---- --�-
Date
Application Disapproved for the following reasons-------------------------------------------------------------------------------------------------------------
--------------------------------------•-•--------•------------•-•----------------•-•••------------.....•.---------------------------------•-------------------------------------------------------------
Date
Permit No.---------- rj Issued.....................................
TOWN OF-BAlI VSTABLE I
LOf:AT1oIV 6,4 7W Alle- SEWAGE #
i
VILLAGE (��` �i/L L.� ASSESSOR'S MAP & LOT
r
INSTALLER'S NAME 6r PHONE NO.
SEPTIC TANK CAPACITY GNU
LEACHING FACILITY:(type)_ (size) U
NO. OF BEDROOMS PRIVATE WELL REPUBLIC WATER`
BUILDER O OW 7R_
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No �' '
�1 3q�
No..... Fss.....� ..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Ajivlirafion for Uiovoii al Works Tomitrnrtion Pjamit
Application is hereby made for a Permit to Construct ( ) or Repair ( Loy'a_n Individual Sewage Disposal
System at:
................s
. .w N t..::...--o -'..`-------..-`-z. `•l� ........ .................... �.c,171.E.IZA...........................................
2 Location-Address _ _
Lot No.� . rz
.......-............... �._.._..... . ------........------------------....------...---
Owner Address
a /�`t�//�t/- �t{CK-fir - ! =S"4,Z_r JW 4 l�
...........................•-----•-----• --•------...---------
M Installer Address
Q7i Type of Building Size Lot............................Sq. feet
U Dwelling No. of Bedrooms.._.�......._._ _..._Ex Expansion Attic�-•+ g— ----------------- p ( ) Garbage Grinder ( )
aOther—Type
of Building ............................ No. of persons............................ Showers ( ) —,Cafeteria ( )
dOther fixtures .-•-•---------•--•---------•-----------•----•--------•-•--•-•-•-•--------••••-----•...........................•-•-.
w Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
W Septic 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.........------------------------------.
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-___-.________•-___--.
Gr, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--------------------____
f� { ----------------------•-Z---•-•--------------•-•-------- ---------------------••------•....................................................
DDescription of Soil------Q" .............. -----•--•--•-----------•-••-----------------------------------------..................................................
x
U ............................_......................................••-••-----•---•------.....••---•---••----••---•--••----•......--- -•-------••-••••------•----•---•-•-••--•----•--•-••••............
w
VNature of Repairs or Alterations—Answer when applicable..........4.��_-__-_-___ N£ 1.4.16...............................
G...._t,......!t/...---_.A.f c`//-----..je Tr-------�.......
..................................` 1 -S_ r�J
....... .►------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T':IS 5 of the State Sanitary Code—The undersigned further agrees rot:to place the system in
operation until a Certificate of Compliance h een issued by he board of health.- ,
Signed. !. '5. = ,...... ------•---•- .....t �, --�.....
Date
Application Approved By............... � ..:..,,..�.=s ----•------I= �� --�t-
.--... ----•--------------•- Date
Application Disapproved for the following reasons:-------•-----------------------------------------------•---------....._...-----•--------------------------....._
..............•--------------•--•-----•-----•------•---------•-----•-•-----------....---------------------•-----------•------•-.....--------•---•••-•••-•••----•--••--••---•-•-••-•-......•-••------....
Date
PermitNo...........Sl---- -- ....................... Issued_...................................................i
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................o ,......................................
�rrtif iratr of Tontpliattrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by-----A.L Zv eS....... ----------------------•---------....------•---------...-•-----•--•----------------•------•---•---.......-----.....--•--•--•-------------------
Installer
at------13.- ......••w}.� ` ......Q�'- S� .....D`0,0�.--------------- e k w Tz rr V A.- _L
.•. .........................................
has been installed in accordance with the provisions of TIT Z 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No....... ,. ......... dated------------------------------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE........................... ..-. ......................... Inspector................ -----.----------------•------------------.----
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
`` r
..................0F... 3 ��- �Z. ----..........................
�L..... �..8_. FEE..
Disposal�Works 0ontr ion amit
Permission is hereby granted........•-• )...... .... -------- --•------------------------------•-------..............-•...............------
to Construct ( ) or Repair ( an Individual Sewage Disposal System
atNo.......!..'--J.......... ....------•--.-------•-•---------------------------------•-•-----•--•------------•----..............--•--....
Street
as shown on the application for Disposal Works Construction Permit No.. ........ L.. Dated................................•.........
••--------------•--•..... ,,,=.1......................................................._
'DATE.................... "" ti` '-- I.........................•---
Board of Health
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
Fits............................
THE COMMONWEALTH OF MASSACHUSETTS
E®ARD F HEALTH
�i
�/ ... .. .... .... .......OF....... . GiLiY------ -----------------..._..........................
App iratiuu -fur illhipoiial Works Tote trurtiuu Punift
Application is hereby made for a Permit to Construct Repair ( ) an Individual Sewage Disposal
System at:
..�r ..... - ........................�� ----- R ,` ---.-----------------------------------••-------------------.........------
Lo ation•Address or Lot No.
4. --------------------------------------------------- 1.....ems..................................
Owner A dress
Installer Address a/
Type of Buildin Size Lot--.- ��074'Sq. feet
Dwelling—No. of Bedrooms______________..____.__.._.__.._Expansion Attic (N� Garbage Grinder ( )
Other—Type of Building ------------------•-_-_-____ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ------------------------------- - -
W Design Flow........... ..........................gallons per person per day. Total daily flow-----_._5-(!__v.-_-__-______...._._._.gallons.
Septic Tank iquid capacityR--gallons Length________________ Width---------------- Diameter_..____..__----. Depth___.---__.-----
xDisposal Trench—No_ ____________________ Width-------------------- Total Length-------------------. Total leaching area_---.-.-__--...___-_sq. ft.
Seepage Pit No..................... Diameter.................... Depth belo inlet,,4c�_�Total leaching area.--------------_.sq. it.
z Other Distribution box ( ) Dosing tang ( —1�6 ,/'�
a Percolation Test Results Performed bY------------/_ .( ........................................ Date-__'-----------------------------
._..
Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water....-_-..-._-.._-..-___.
�14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--..-.-..-_--_--__-_.__.
��
--..... .. ------------ ------------------ - ------=----------
O Description of Soil----------- a - ;-------
x
a = - - - /_ --------------- ,
W ------ -
U Nature of Repairs or Alterations—Answer hen applicable.-.------------------------------------------------------------------------------------------_
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article NI 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.
4 igne •--.._ .. r^ -----------------------------
Date
Application Approved By----------- 'Zd.----7-- `--
G !L_71W----------------------
-•-------------Date-•------------
Application Disapproved for the following reasons:............................................................................I- "
-------------------------------------------------------------------------------------------------------------------------------------------------------------------=------------------------------------
Date
Permit No. - Issued. -�-'�-------`�-- .
Date
.. 1s -� 7 A-
No. /•_. Fig$.... .................
THE COMMONWEALTH OF MASSACHUSETTS +
BOARD OF HEALTH
-.. ......... _... - ---.OF.....................................--------........-.............:-.-....-.....
, ppliration -for DioVoottl Workii Tutui#rortiou Veroii#
Application is hereby made for a Permit to Construct (4-r—or Repair ( ) an Individual Sewage Disposal
System at: _
LLoo ation.Address -- or Lot No.
.. .' ..c�:_'. ................................................. p .v�S ------------------.
!� ^- Owner Address
Installer Address ,rc.t�
U Type of Build in �� Size Lot----- feet
Dwelling—No. of Bedrooms______________ :_--..__-__.________EYpansion Attic Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Other fixtures ---
W Desi n Flow._...._.. . _ Mons per person per day. Total daily flow............. -_----____.--.-__--_gallons.
g g P P P Y Y
P4 Septic TatikV***L,iquid capacity_I _.gallons Length................ Width-----------..... Diameter------.--------- Depth.............
xDisposal Trench—No____________________• Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No--------------------- Diameter-------------------- Depth below inlet C;/x.�Total leaching aren-_......----------sq. ft.
z Other Distribution box ( ) Dosing tanl (J-) -, 6" I
~' Percolation Test Results Performed b -(. ----------------------------------------- Date---- -__
Test Pit No. I................mintytes per inch Depth of Test Pit_.______________.__- Depth to ground water._.:__.___-_.__--__.
1:14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------
----------D Description of Soil Q a.. 'v d-ZOA ' v / - - ...... - -
U - ---- • ------ ---
-=----------- ---------- -- - --
_V W ----------------------------• -�- ' ------------------
Nature of Repairs or Alterations—Answer hen applicable..---------_-----------------------%_t __- -------------------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------I--------•--•--•-•--••------------------------- -------------------------
Agreement: -��-•—�- •
The undersigned agrees to install the aforedescrilbed'Individtal Se-Wage Disposal System in accordance with
the provisions of Article XI 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.
Sign
...........A-� ------ - ------ ----------------------
Date
Application Approved BY =- --- - --1�- --7--S`---
`� Date
Application Disapproved for the following reasons-------------------------------------------------- ---------------------------------------------------------•----
--• .....-------•••-•--------•---......---•-•--•--•------
------------------
Date
PermitNo..---� . = --------------•--•-----------• Issued...................-----................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
I..� :Y.'L.........OF................c ...........................................
01.1edif irate of Tompiiatta
THI ,4 TO CERTIF That the Individual Sewage Disposal System constructed (4-Kor Repaired ( )
--••---••------ - ---- ------ ---------------------- ----------------------------••---------------
st IleT.
at--- TX"'v`�-------
has been installed in accordance with the provisions of Ar s XI of The State Sanitary //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................................................................................ Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALTH
.............OF.......... ......._.._.......-------•----•--............ -ram
No.--•----�-7!------. FEE--/ ............
Binvolia orkq Ql#witrurthm Vermit
Permission is hereby granted- ---- -- -- ✓•---- .....................................................................•----•••--_-----
to Constr t or Repair ( ) an I div•dual ewap%Z' 5sal•S stem
al
Street
as shown on the application for Disposal Works Construction Pe No--- _'UG__ Dated_. '�� 7J. ........
f
DATE----- -•---..l. -- .....-------•----...............................
Board of Health
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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June 25th, 1987
Board of Health
Town of Barnstable
Main Street
Hyannis, MA 02601
•
Gentlemen: , T ,
This letter is to verify the fact that I , Robert W. Kershaw,
am applying for a Building Permit for the construction of un -
attached two car garage with an overhead playroom, located on
my property at 151 White Oak Trail, Centerville, MA. The garage
will be 22' x 22' in size with the room above used. for storage
and a Childs' playroom. This room will not be used as a bedroom,
nor will the size of thetbccupancy (4) be increased.
R ctfu11y,
Robert W. Kershaw
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