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HomeMy WebLinkAbout0190 CONNERS ROAD - Health r /qc) Connus lZ.unv I oot - 00 C.�.rN�.rvi�IPi l� N6------- -. �... FRic $.... 5.t00...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T own Barnstable .. .. ..........0 F..........................................------..----...._....------...............------ Appliration for U44puiittl Works Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: �... Location-Address 632•-•-..... -----••--•---•------•-------••----•----------•----------••----•---------------------------•------- ...(�'.QI7rl0��..$ad�. fwE't7.�P�.T'TF�•l�& .....©� or Lot No. Robert Freedman Connors .Road....Cent erville,.._M......026 2 Owner Address A & B Cess�ool._Service. 128..Bishops._.... e, Hyannis MA 02601 Installer Address d Type of Building Size Lot......: .................Sq. feet U Dwelling—No. of Bedrooms..................... ....................Expansion Attic ( ) Garbage Grinder ( )1-1 Other—Type of Building ............................ No. of persons...... .................... Showers ( ) — Cafeteria ( ) a Other fixtures ----------•-•-• -••----•-•--.......-•-•••-_... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid"capacity............gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) !Dosing tank( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •......................... ..•------•--..... .-•-------•••-•....••---•-•-•--•.......••-••........................................................ .... *.... Descriptionof Soil......Sand........................................................................................................................................................ U ---------------------------------------- ---------------------------------------------------------••----•----••--•--.......... ---------------------------- - ---- •--------- --------------•-----------•------------------...--•--•-••••-•-•-•--•••.....--------•----•-••-••--------•--------------•••---•-••----•-••----•••-••••--••••-••••---••••---.............. V Nature of Repairs or Alterations—Answer when applicable_-installat ion--of•-a•-1500 septic- tank.-and 600 gallon leach pit �overflow� stone packed-. ..--.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLU 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance has n issued by the b hrd of lih _n .. .. ..... ... .........11,11,...i. ..... ....... Application Approved By-- ........... ........ ........................................... 1/107.......... . Date Application Disapproved for t follow' g reasons:....---••--•-------•-----------•----......--••................•--•--------......---------------••-•--••......••- ............................................................... •-•---•-•---••••--•••-•••---•-...-•-•-••--•--•-•..................................................................................... Date Permit No....84--.••..........................•._..._.._ Issued...1110�84 ......................... .... .. Date N-6.......81—......... Fxs...:i...a.�r...QQ..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......Town..............oF...........BA.rnsuble..... Appliration for Uiipn,ittl Workri Tnntrnrtiun Permit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal', System at: eonnors••Road-i .P,e�rttgry t1 i-• 4-A....42632--------- -----------•------•- \ ocatIon• ress or Lot No. ...Robart..Freadmam .......................................................... ConnDxs-.Road.,...Camtarvi.Ue,..-Lv_A......Q2b32.......... Owner Address .. easpoo1..ae v_iae-•---------------------•--•-••--•--•--.... 12fl._pjshQps..Tsx2a��,..�Iyannis- 1 A......Q26Q1__. Installer Address PQ VType of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms......................3....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.......4.................. Showers ( ) — Cafeteria Otherfixtures ------------------------------•-....------•-•----------------------------------------- --------------............------------......---.............. 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ----- --•-----------------------------------------•-------------•--•------------•..............----•......................................................... ODescription of Soil.......Sand-----....--••----•---...----•--•---•---•---------••--------------•-------•------------------•-----------•---•---------------......------•-••---•--..._.. x w I VNature of Repairs or Alterations—Answer when applicable___installador.L..of__a_1500---a8I2tic... ..__6.00--gallon_.loaoh..pit...(ovel tone..packed............................................................................................ Agreement: I The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance haseen issued by the bo rd of th. ,✓ Signe =' ! ...... ----i11o18�r Da -Application Approved By.................................................................................................. 1110l ..._.... Date Application Disapproved for the following reasons-----------------------------•-------•------------------------•----------------....---------------•---.....----•- ---------------------•--------------•-------•------•---------------------••-----------.....---------•------------------------------------------------------------------------------------------••-•----- Date --------------------------------------- Issued..---1/10/84 Permit No...._......'..--- -----.................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................T.m. .....OF...........AA=.. tab],e............................................... Tnxtifiratr of Tamplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired bYA•-&--B--Cesapa©1--Se-r-v4ae•,...128... ----I`A.....02601............................................... Installer atConnors.Road,.__Centeryi let--MA-_ 026 2....-Robert._Freedman.................................................................... has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Code as described described in the application for Disposal Works Construction Permit No..84'-'............................... dated_...._•1IP/ ......................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................0`9/`84............................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........................T.Own.......'OF............B4=5.table.............................................. No.B------------------- FEE....$...15.00... Uhyaoal Workii Tontrnrtion ermit Permission is hereby granted.................A_3.-Cesspool_-$ervIne................_..........______._.......__________.___ to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at No.............. oad,... enterville.,._NA 02632 Hobert-Freedman--- --------- - - - Street as shown on the application for Disposal Works Construction Permit No._8G_-....._..... Dated........1/1M84 ••.......................•-----------....- o�, ------•--------- .............................................. 1/10/ , Board of Health DATE............................................................................... FORAM 1255 A. M. SULKIN, INC., BOSTON