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Home My WebLink About0214 ANNABLE POINT ROAD - Health (2) I�4 AnnAL� Point 0-, �4, No.. ,��' L/ FR$....�..... 0........... j IrHE COMMONWEALTH OF MASSACHUSETTS . ' BOARD `OF HEALTH ` TOWN OF BARNSTABLE Alip iration for Mit-Vatitt1 Work.5 Tomitrnrtiun rrrmit Application is hereby made for a Permit to Construct ( ) or Repair IkX) an Individual Sewage Disposal System at: jn.t...p,pad-_Centerville,Mass. -------•------------------•-••---------------•-•---•----......---------------------------------•- Location-Address or Lot No. t.......-...................................... ................................... ---------------------------------•----------------------------•-----------.....-----.....---...... Owner Address a �7.e.1?AaQmher Jr 4 ------------------------------•--............---------•--•--------•--------------........--------- Installer Address Type of Building Size Lot............................Sq. feet �-, DwellingX— No. of Bedrooms----------2-----------------------------_.Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons.------------.----..-.--.--- Showers ( ) — Cafeteria ( ) QOther 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 ( ) W Percolation Test Results Performed by---- -------------------•-•-----.......--•-------------------------------- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.......---------_-- Depth to ground water----.................... f14 Test Pit No. 2................minutes per inch Depth of Test Pit............----.... Depth to ground water............--.......... 9 -----------------------------------------------------------------------------------------•-••------......--•--------------•............................------ 0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------ W Sane & gravel U ----•------------------ -------------•------...-----•---.......---------------------------•-------•---........................................... W ............. ----------------------------- - - --------------------------------------------------- ------------ t x Omit c e s s poa l-e 1'ri s£a I-I----1--1-�0_0-------- U Nature of Repairs or Alterations—Answer when applicable.-------- ---- ---------- ------------------------------------------------------------------- r_ gallon tank, 1 -distribution box, nree infiYtratarso . . . . . ..............•-•----...-------------------------•-------------------------------------..........----- 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 Yee iss d by the_board of health. I , Signed .... .. .. ........ 12./29-/9-4 Date ApplicationApproved By --------------- ------------------------------------------------------------------------------ ------ ..-... Application Disapproved for the follow' reasons: -- ......... .......................:.......................................... - a.' -_ Date Permit No. .......... .." �. ..---� ---------------------------- Issued .....- - / Dace t 1 l � dig No....T., z FEs.... ....3 Q........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for UhnVa!3ttl Wor1w C owitrurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (KX) an Individual Sewage: Disposal System at: • ...t�rinahle...Rgint---Road-•Centerville Mass. ......................................................... ....•---------•--•--••---•----•-----•-•---._.........•............................................ ,,Location-Address or Lot No. .....;..y....y........»............... ..................•...--•---.._._....•......---.._...._...• .......----•-------.............•..........•...............•...--..--............................. Owner Address a .ti7....r::.............Macomber....................Macomber Jr. .......•................................. .................................................................................................. ..___... Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling.`-'.— No. of Bedrooms.......... ................................Expansion Attic ( ) Garbage Grinder ( ) `14 Other—Type e of Building No. of ersons-__________________________ Showers � YP g --------------------•------- P ( ) — Cafeteria ( ) dOther 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 ( ) ►." Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water....................... f74 Test Pit No. 2................minutes per inch Depth of Test Pit.____-__-•_______- Depth to ground water........................ R: -----.-•---•------------------------------•-•-••--•-•-•--•-------••---•---------•------------ --------------------------------.---.--- O Description of Soil---------- -------------------------------- = x Sand _-•gravel W x diiiil cesspool. i.risral i i-rDUU V Nature of Repairs or Alterations—Answer when applicable.-_,.___:.. _ ____________________________________________________________•_--..---__. gallon tanlc, 1 -distribution box, ca�tree in¢i1t-rators. -------------------------------------------------------------------------------------------------------------•-----.......................................... ......................................... 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 bee, issued by the oard of health. Signed . _.....-------------------------- --------1.2./..29../..9.4.... Due Application Approved By . ...................... ...... � -.fir..-.��.. Application Disapproved for the Yollowmig reasons: --------------------------------------------------------------------------------- ------------.------------------- _.... Date PermitNo. .j-.--------------------------------------------- Issued .......................................... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certiftrak of C�omplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (?U* ) by -- J P-..M_a_Polnkaor---Jr- ----- ------------------ ---------------------------------------------...----- - --------------------------- ---------------- 208 Annable Point Road Centervlftle,mass. at -------------------------------------------------------------- ------------------------ -------------- ------...--------------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the a lication for Dis osal Works Construction Permit No. ..._, .. ........._.___- dated ............ PP P �� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------- .---------/,i,'------ ---- ----- ------- Inspector ------- ` = -----------• ------------ ................. ...-------- < ------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.... FEE .. TOWN OF BARNSTABLE $ Ja. . 00 �1 ..':�.�I� .. ....`..--- . ., -- Displititt1 Workii Tomitrudi.on �rrmit Permission is hereby granted_..).P.M_a.comber Jr. ............. ----- to Construct ( ) or RepairX(?X) an Individual Sewage Disposal System 20$ Annable Point P.oad Cen ter ville,Mas-S-°---------------------------------------------------- •----........• at No... ••-------------•-• -------- - - - _ Street ( { _ as shown on the application for Disposal Works Construction Permit No, 2Cy_' C.\ .. Dated..___ `,?.............. i.,.4._',..i/ ..................................................... .- Board of Health DATE - 1/ ` .---- - ----•---------------•••-----------•- l/ FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS