HomeMy WebLinkAbout0032 DONEGAL CIRCLE - Health (2) 3a b6nV
No. l ` Fps.... 2,'0. ........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......Town......... -- .OF.........
.Barnstable
Appliratioo -for Biopootti Vorkg Tonotrurtion Prrotit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal
System at:
........a2. DorieFal---Circle
Location.Address o Lot No.
Gerald Dow inp; Centervilie
-------------------------- - ------••--------•-----------*---------------•- ..................................................................................................
Owner ddress
Joseph P. Macomber & Son, Inc : Centerville
--------
Installer Address
Q Type of Building Size Lot-_------------------------Sq. feet
U Dwelling—No. of Bedrooms-----.-......:............................Expansion Attic ( ) Garbage Grinder ( )
aOther
—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 ( )
Percolation Test Results Performed bY-------------•-----•----------------------------------------------------- Date----------------------------------------
�_4
Test Pit No. 1----------------minutes per inch Depth of "Pest Pit..............--.--. Depth to ground water................-----.-.
�14 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water------------------------
Ix •---•----------------------------••----•--••--•-•......--•------------.........................-•--.........................................................
O Description of Soil---------S_a.Tl-d----&----Gr-&ve 1----------------------------------------------------
U ------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------
-------------------------------
W
U Nature of Repairs or Alterations—Answer when applicable.'Removing... .-Re�lae-ink 1-1QJJ gallon
---Pit &...T)ac_k n ..pit in stone Exj..s_ti_ng...sy-stem...
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 ee i ued by the board f ealth.
7e
Sign -• ------------------ --------------------- ...... -- -..--•-•• -
ate
Application Approved BY et ----- - -��----- -- ------------------------ ----
Date
Application Disapproved for the following reasons---------------------------------••-----•---------------•-----.....-•-•-----------.............--•-----•---------
-----------•--------------------•---------•--•---•---• ------------••-----------------•-•-•--------------•---•--•-•------------•-••-------•------••---•-•-•---------------•-••-------------------------
Date
PermitNo......................................................... Issued........................................................
Date
Il '---------------------------- - - - e
,No......................... Fz�s.....��+...�.�.......
t THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town ... ... .....oF...........Barns.t. .. .a
... ble e.................... ....................
ApplirFation -fur UiBpov al Works Totwtrurtiou Vrruift
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
32 Donegal Circle
--------------------------------------------------------------------------------------- ------------•------------------------------•---•------.....-------•----•--------•----...------...
Location-Address or Lot No.
----•--Gerald---Dowlin ----------------------------•-----................ ---•------•-----Centeryil e-----........----------------••--......:........
O ner Address
w Joseph P. Maeom�e�r &_ Son, Inc . Cen e
,a -------•-----•----- tery _
Installer Address
UType of Building Size Lot............................Sq. feet ,
.-� Dwelling—No. of Bedrooms-------3..................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building -_-------------_-._.---- No. of persons............................ Showers ( ) — Cafeteria ( )
.el 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 ( )
Percolation Test Results Performed by------------------------------- ------------------------------------------ Date.---•----------------------------------
a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water..........--------------
CT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........._.._...-------.
Ri ...._..---••-------------------------------------------------•--•--•--------------•---•---•--------•-------------------------------------------------.......
O Description of Soil---.-._..15s' nd.-.&..Graven .___.......
x ----------------------------------------------------------•------------------ -------------- ----..-..----
V ------------------------------ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------
W
U Nature of Repairs or Alterations—Answer when applicable---RE."OQXi g--&--Rep.1a_c ng_l_,!1000..S-a-Ilon
P1t,---resetting---pit.-&--packingpi in stone..- . Exist��z�..>�y�te�._
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 ee issued by the board f ealth.
Sign d?. ------------
.. .. - ................ !
Date
rT �_�/�/1!11-U ....Application Approved BY
...l.'_
Date
Application Disapproved for the following reasons------------------------•-------••-----•--------.......-.-----•--•--------------..............--•.......---------
------------------------------------------------------ ----------------------------------•---------------...---...-------------------------------------- ------------------------------------------------
Date
PermitNo......................................................... Issued----------------_---- ................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........Town......._.........o F.......Darns:dab.1�..............................................
�rrtifirate of f.Tompliaaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X)
by Joseph P. Macomber. &- Son Inc .
----- - -----------------------------------...............................................................
Installer
at...------.32-.Donegal- -Circle F Centerville Dowling...........
has been installed in accordance with the provisions of Article YI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit N_17l'-.-r-------?._.��71_4F........... dated...... 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
7� BOARD OF HEALTH
S 3� Town.................OF......�3a1"T1$tab le
No.---- FEE---$ DO------
�i��u�ttl urk� �uaa�tratrtiuta rraaait
Permission is hereby granted-._Joseph P. Macomber & Son Inc.
-------------------------------------------------------------------------------------------------------------------------
to Construct ( ) or Repair (t ) an Individual Sewage Disposal System
at No...... one. l...... rc_le-� Ventervllle _.. Dowling
Street
as shown on the application for Disposal Works Construction P1 Dated------------------------------------------
-�f✓ y/ .,
// �^ / Board of Ieatffi
DATE---
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
ti,