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Home My WebLink About0044 CAP'N LIJAH'S ROAD - Health (2) Caf'n L�A IRoP.tai- I �. �. No_,...... .. ... •-F$$. .......�....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...... ........oF.........BARNS.TAB.LE................................................. Arptiration -fur Uhipuiitt1 Works Tonstrurtiutt Paula Application is hereby made for a Permit to Construct ( x) or Repair ( ) an Individual Sewage Disposal System at-:, .. Qat1.nL _1ah_ Road;._ Centerville Lot36 Capt'n, Li5ah Road ............. Location-,Address or Lot No ....I.e.11age.n-.E.e.r.rraaa..A=ss.or.......I.n-C.•..........:.... ..... C---C o_rp o ra t i an__ R o a__d Dennis.--...-•---• . Owner Address ...Rob er t_.-8,_.Our.... o C .____ , ad s -- -Inc---- ----------------------•------•--• ----Great---UI-e s t e t n....R o a d-.----�t'----H a r w i c h-•------ Installer Address Type of Building Size Lot15.t.Q00-20s_9�geet Dwelling—No. of Bedrooms................. ...............-__ ".Expansion Attic ( ) Garbage Grinder (No)- aOther—Type of Building ------------................ No. of persons----------- __--------_---- Showers ( ) — Cafeteria ( ) a4 Other fixtures ------------------------------- -- w Design Flow......_.....5-0...........................gallons per person per day. Total daily flow--------------3d0......_.._.......----gallons. WSeptic Tank—Liquid capacittlt.0.0-Ogallons Length---------------- Width------.......... Diameter-------.-------- Depth.....--_------. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.-------------......sq. ft. Seepage Pit No-------1".......... Diameter--------- ,I�e�th to et.................... Total le chits area......_.......-..sq. it. Z Other Distribution box (x ) Dosing tank ( �``��j�e L" �- Percolation Test Results Performed by------------------------------ --------------------*-------------------- Date---------------------------------------.. Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water......._....:..._....... tZ, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water--------------------- -- �.. ,� t�l ...fir _ I ....t --------------------- Description o oil ~�'G l!/�t'7� . Z .. V.." _' z. --' ------- -- ---------------------------------------------- w U Nature of Repairs or Alterations—Answer when applicable........................................................................... .................... ------------------- ------------------------------------------------ --------------------------•----------------------------------------------------------------=-------------------------------------- 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 been iss the board of e Signed-- ••••••ram" --=��L 2t�—T.....--- r Te e en-Perrone .assot I Date ApplicationApproved By---------------------------•-•-••••-••--------••.....-•---•-•----•---•-•---------------------•--- 3' ----------------------- ---------------- Date Application Disapproved for the following reasons----------------------------------- -------------•---------------•-----......................................... ..........................................-•.------••--------------•-------•---------------------------.........."...--•----=-------•-•-------------------....-..--------------------------------------- Date PermitNo......................................................... issued..................... .................................. Date No -Faa._Z ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN ._ ._........OF.........BARNS-TABLE................................................. ' Appliration -for 'Rapoottl Workii Towitrurtion Vrrni t Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: QApt!n-. _L jah Road, .Centerville lot 36 Capt'�••_- Li ah Road Location-Address or Lot No. Tellege_n-F-eszaae•-Assoc. Ins.• o Corpo_'@t Ian.... 0?d'9---- enn1A-------•--•-•••- Owne Address a •-Robert_-_8-..••Dur---Co.•••�nc. ---•Crea-t---l�eAte-rn___Road,__-�_!t___Harwi_ch•-••._- --- ---------------------------------------- Installer Address Type of Building Size Lot15sO00r20*_QQQeet Dwelling—No. of Bedrooms---------------__�........................Expansion Attic ( ) Garbage Grinder (Nj). aOther—Type of Building ---_____________________ __ No. of persons----------6_______________ Showers ( ) — Cafeteria ( ) P4 Other fixtures ...................................................... W Design Flow___________50___________________________gallons per person per day. Total daily flow...............300......................gallons. WSeptic Tank—Liquid capacitll.O.O.Ogallons Length................ Width---------------- Diameter---------------- Depth.---_.__-_--_. x Disposal Trench—No_ ____________________ Width.................... Total Length--------_........... Total leaching area-._-_-______---_-___sq. ft. ..Seepage Pit No------- ------------ Diameter--------6x0 t v inlet____________________ Total leaching area_-__---_-_-_--_•__sc ft. Z Other Distribution box (X ) Dosing twank� }� e 3' & 1 aPercolation Test Results Performed by_________________________________________________________________________ Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit_..________________- Depth to ground water..---.---_____--____---- (4 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water---------------.____---- a' JA----------------------- ,�;-•-_._. ...----•--•-- .a . t--- G Description o oil--- ' x '^�' `----•-,r ds.. ad. r✓F--_-�-'-----�-------_O � pec�4 / - ------ W VNature of Repairs or Alterations—Answer when applicable-----------------------------------------.---------------------------------_..----------------- -------------------------------------------------------------------------------------------------- ----------- --------------------------- ................................................ 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 been I the board of h 01 Signed ! �� - T` a en-Ferrorie -A-ss Application Approved By--------------------------- --------------------------------------------------------............. ---------------------------------------- I Application Disapproved"for the following reasons:--•--------------••-•--••-------•-•• ----------•--------------•-•-•-•---•------------•-----------••-••--•------- ----•--._.__._--•---------------•---•------------•--••---------------:•.---•--------••-•---•------------•_______--••----•--------------------------_-----••----------------------•-•---••••------------- Date PermitNo.......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT _ t...............OF...... .... .... �1 ✓.....- �ti ��........ ........ (9rrtifiratr of Tomlifiortre TT, S IS TO ERTIFY That the Individual Sewage Disposal System constructed (� or Repaired ( ) �� ............... '^ 'S t A. /IRst 1] / ... ` ' t a `�-r' ' - , has been installed in accordance with the pro lions of At XI-of,The State Sanitary Code as described in the application for Disposal Works Construction--Permit No._ ��______I_Q__�__-___-___. dated_? -t-2-1/. - 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 Of HEALTH :> No. --•--••-•--••• FEPv.......... ...... R-t Permission is hereby granted ar, S k oo trortto8t rrmit { to Construct (�4' ) or Repair ( )• an Individual Sewage Disposal System r ! t < (_ .it yr U Street I as shown on the application for Disposal Works Construction}Permit °No---------` _______ Dated___`-_ r_. --74;.......... Board of Walf4 DATE.............................................. --------------------------------- L FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Y 1 t - -- -- . r It l ,. . 37 AIV AL r�: I'.Al"EBY C Vr/ 'Y 714A7 T1-fi+ 4x157- r�• WA .. w /tVG FOUAla.'t7-10AI LOC-47%0M /,5`02PAL*Z W rq .,� •'