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Home My WebLink About0296 BUCKSKIN PATH - Health (2) a� �e 4u�Ks��n P� , �-. � � No........Flo® FuE ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD -OF HEALTH ..............Town. -- --------OF.....Barnstable .................................................... ApVtiration -for Mgvsa1 Narks Towitrurtinn Prrutit ' Application is hereby'made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System-at: .96 Buckskin Path Location-Address or Lot No. Robert St. John- Centerville •--•-------------•----------------..-...------------._...---...-----•--••--•.......•----•--------- •••-••-•--•------•--•-••-•••••---•-•-•------••--•---•-....--•-•----•-••-••--•----•-------•-----•-- ` Ow er Address a Joseph P_. Maco'Z� r & Son Ine. Centerville Installer Address Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms....................................-_------Expansion Attic ( ) Garbage Grinder (. ) a, Other—Type of Building -.- ------------------------ No. of persons--...--.--...--..-.--------. Showers ( ) — Cafeteria ( ) fM 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........................ rXq Test Pit No. 2__----_--__-_-minutes per inch Depth of Test Pit-------------------- Depth`to ground water-_--------------------- P4 --•----------------- -----------------------------=-------------------•-------•---------•-••-----••-------------•----•-------•------•----------•---------- O Description of Soil-----------$.And...&-•Qr$Y_e1------------------------------------------------------------ ---------------------------------------------•-------------- x V --••------•---••................•....-•••••----•--••-=.-..-•-•--•--.-•-••-•---•-•-••-------•-••-••-------•----•••---•-•--•---•...-----------•----•-------•-•----•---••- ........................... W U . Nature of Repairs or Alterations—Answer when applicable"1-nIOO -.ga-llon-.-pit---_------(overflaw-)------_. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage 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 e iss ed y throar;oo health. e d►�'' UI d'10 d 9r Signed.. ' ---------••---•----- --------•------------------•-------- •--4/2--- Date Application Approved By---- :�1 ��1 -_..-...---•------•---••---•••-•-----------••--••••----•-----••-••-•••-•••-••••-- -----------�" ----------- Date Application Disapproved for the following reasons------------------------------------------------•----------------............................................... ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- w Date PermitNo. ............................................ Issued........................................................ Date No........ d 4 Fay.. . ..:.... .......... f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 L"�,JTI $3 nstd C le ........... ........ -_..OF...............'..................... .......... pphration -for 1:1riposcal Works Toustrurtiou Prrutit Application is hereby'made'for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal a . System at 2q6 Buc.-skln Path ---------------------------------------•--------...........-----•--------------..--•--••----....._ ......---••--------•---•-•---•----•-•--•-•--•••----•--.....------•-••------•--------••--•------- Location-Address or Lot No. Robert -t:_..John = Cent: ry° '1e --•---•--•-----V-- --••• •-••--•------•-•-•••--•------•-•----•-•---•-----•--•---•---••- W COwner Address P h ~ pmcer & son Inc . Center—.11r, _y _�c....._...._._7_ ...... .......................................... ,, * Installer Address hr "U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a d Other fixtures -------------------------------------------------------- ------------------------------------------- ------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic T.uik`=Liquid capacity------------gallons Length---------------- Width_............... Diameter__-__- --------- Depth.__-_._._..._-- xDisposal Trench—No-____________________ Width-------------------- Total Length_.________-._-____. Total leaching area.-------------------sq. ft. Seepage.Pit No--------------------- Diameter---------------------- Depth below inlet__--______________- Total leaching area------------------sq' ill. Z Other Distribution box ( ) Dosing tank ( ) `-. Percolation:Test Results Performed by----------------------------------------------........................... Date-------------------------------------- Test Pit No. L______________mmutes per inch Depth of "Pest Pit.................... Depth to ground water...___..._____-_______-- rX4 Test Pit No. 2................minutes per.inch Depth of Test Pit___________-__.__ Depth to ground water__.._-_______________._. ------------------------------ -•------------------------------............................................................................................ D Description of SoiL.------- !_nd__ �__Grnvel x ------------------------------------------------------------------------------------------------------------------------------ V ---------------------..........................................................I----------------------- ----------------------------------------- x -------------•-------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------- V Nature of Repairs or Alterations—Answer when applicable__ '..Z_ ^___:'. ---------------------- .. c.V >>..___... ----------------- ---------•--------------•-------------------------------------_-----------------------•------------------•-------------------••------------------------•----------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage 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 beee-n�-iis�s_ued by the board of,health. �` Signed-_,/ 1 �Cl 4/29/77. ----------•--•------- --•------- Date Application Approved By...... � ` ----------------------------------------------- Date Application Disapproved for the following reasons------------------------------------------------------------ ------------------------------------•---•----------- --_--•----•---•--------------- --------------------------------•-------••----•--•---------------------•---------------------------- ------------------------------------ --------..._-•------------- ' Date PermitNo.--.-......... ........ Issued......................------.......................... Date `, THE COMMONWEALTH OF.MASSACHUSETTS BOARD OF HEALTH _9TnOBp s ,.`1eJ"tf . ............. ..... ...... .................................................. Trrtif irate,of Tompiiaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by .Jane}I P. �: combe?^ Son s .-c x Installer at r'_:_ . fur s=r r Path,-- ..._C�n rtT 1 e.•... ` t . John has been installed in accordance with the,provisions of Arti�II XI of The State Sanitary Coc�as�dpscpVd•in the application for Disposal Works Construction Permit No....../_-__-•__________________________ dated.-_-____.__...._.__.._--------................ __ THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......----•--•----•---------•-••--••-•----•-----•------•-----•••--•-•-••-••--•. Inspector.................................................................................... Nif��.i, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF w'EALTH �6 .TaI-T ......OF.....L.-rus t:--b 1e ... t`.................. ............................................. .... NO------................... FEE............................ BinVosal Works TwOttstrurtion Vrrtgtit Permission is hereby granted-----j_0s_er�............................................. o TY b _ ---Lac . -••-----------------•---- ................................. to Construct ( ) or Repair (X) an Individual Sewage Disposal System at No.2^{____3ucus'si n Path. Centcrv,..2__e St . Jf*jn ---------------------------•------------------------------------------'----- . '-----------------•...------------------...-----•-•-----------•--- Street f as shown, n the application for Disposal Works Construction Permit No-__r_-_-G_-_____ Dated-------..' ---� ---------------- --- ,, 4�0/� I) DATE............. Beof Health ----- -- ---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS