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0028 DUNASKIN ROAD - Health (2)
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'"r v'..;�. ���' v.v �_./.;'._ _ .i,,, rv- +p ,p„�• ,fip,i. ,� .n � � • a9 h i, " " ,. „"'w ,. . ,. � � u ,, L .. n a n. a 't, k y , a, a. t I! az 4Tnq _M �f�0 Q:Q APPROVED THE COMMONWEALTH OF MASSACHUSETTS am tile Conserve 'on ;r7�lt BOARD OF HEALTH OWN OF BARNSTABLE Signed bate Appliratinn fur Di 5p iial Uludw Tvastrur#inn Frrutit Application is hereby made fora Permit to Construct ( ) or Repair (XX) an Individual Sewage Disposal System at RoY....Griffin .............................. ................ ... -....... - Location-Address or Lot No. 2.8.... -uaa.s-k -a---Au—Q-..Ce-n-ter— ---------------------- --------------------------•---•--•--------•-------.--------------.----.-•-----.-.---•-------.----- Owner Address WJ.P -Macomber Jr........................................................ •-••-----------------•••••----•-----.._...•-••----••--••--•-•••••.......-•••-•-••------•-----•---- Installer Address UType of Building Size Lot.:..........................Sq.. feet ►. Dwelling-X- No. of Bedrooms..............3----------------------.-----Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building Dvre 11_i ng------ No. of persons--------- _______-__-_---. Showers ( ) — Cafeteria ( ) Qp' Other fixtures .............gMons per person per day. Total daily flow..-__._.___._._.........._......_......_..gallons. __ _ _ __ _ ____ W Design Flow-------------------------- g� P P P Y• Y 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........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water......................_. G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .... ----------------------------------------------- -...... ---------.................... ----------------.----------•--•-•----•--------------- •------------•--- 0 Description of Soil........ ---•-Sand & Gravel....................•-----••---------•------.....--•----•-•----•--...---•-•--------•-----.........••................ --.. -•.... x W ••--••-•-•-•.....................•------•-------------•....•---------------------------••••--•••-•••----•--••-••-------....-----....•-------•--•--•••••••••••••---•••••••••••••-••••..........-----••... UNature of Repairs or Alterations—Answer when applicable_...Omit e e s s P o o l...................................................... 1��©fl13 ga-i-iort•••t-a-n 1--d-is_t-ri-but-i-vn•b-orl---}•-•i000---g-a-ilt7m---Ieach•.p-it............................ 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 y operation p system in o erauon until a Certificate o Com llarace a b n issued by tl-- b and of health. -e Signed . .. .... ,�•�- - -� Dace Application Approved BY --------(J' --------------- ---- ...............--........... . ......... ... ........ Application Disapproved for the following reasons: .......... . .... ..................................................................................... ................... .......................................... ...........p... . ....../........... . .... ... ............................... . .... ........................................... .................................... Permit No. .........1.....3----."....(.9.®. Issued ...-------- ........................................................Dace Dace vV - a�(a $0300 No..._... ..�L.... / F�$......................... ._ THE COMMONWEALTH OF MASSACHUSETTS 9 .-' BOARD OF HEALTH oil" y TOWN OF BARNSTABLE AVVIiration for Uiripwial Work.6 Tomitrurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair ((X) an Individual Sewage Disposal System at: RoY....Griffin........................................•--•--------•---•-•-----•-- ------• ... .......... Location-Address or Lot No. -8.... ---------------------- _•-----••----------------------------------------•------------------------------------------------ o«ner Address a ....P_.Macomber fir:...................................................... ••..................•--•-••----•-••••--------•••--•-•--•-••--•••----••-•...._.....--••-•-----•••. � Installer Address UType of Building Size Lot...........................Sq. feet r. Dwelling x No. of Bedrooms---------_____3___._.._•--_-__.___-_--- ---Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ...... No. of persons--------3................. Showers ( ) — Cafeteria ( ) d 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........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground-water........................ C4 ..............................................................•-•----••-•••--•-....--•-•-------•............................................................. 0 Description of Soil...............Sand & Gravel ------...Gr ••-.e.1.................................................................................................................... V W U Nature of Repairs or Alterations—Answer when applicable.....Omit......... Cesspool_. 00.0...9&1-11--Wi ---'- , -.�_-••.. --n __----I-----1 10 ,. 1_............................ iviY �.t�rtii ii-�I-s1•S"3i2>�LIt.3O.3 u�i�� i—i�v{}"ya'�:1:CYn•' l2a`Ia_"�.it, . 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 Complia ce has been issued by t e board of health. Signed --........ l... /fl ' ................................. ...........1.1.�8/..9 3.-... Dire Application Approved By ........... . ............Ze4eft..... �.> ......... ........f_r...-..%.�.%"..- � Date Application Disapproved for the following reasons: ......._........... ................... ..... ..............._................................... --.................... .................................................. ... . . ...... .... ...-,................ .............................................--- .. ........................................ ' Da w PermitNo. ...... 3.......... 2.ra ............ Issued ............................................_...................... Date THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH TOWN OF BARNSTABLE 'NLlErtifirate Df (11-ampliance TJS 1 TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( xx ) tl p.Macomber Jr. by ......... .......................... ................... - Inaallcr 28 Dunaskin Ave Centerville at ............... ................................_........ ........ .......... .... .... .. ............ .. .................--.............. .. ........................... .. --... has been installed in accordance with the provisions of TITLE 5of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .._7...3...-... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. -. DATE..................... _1...'_. ._.:._..h., ..--.---------...-.. __. Inspector ..... _� "L'� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF--,HEALTH Q TOWN OF BARNSTABLE No...../..'�•--'h©�� FEE.. ...30_.00-- ----Di�ipl�1�iFtIJ m akcomb��eiril���l�rttillt �rrtrttt Permissionis hereby granted(ed•-•-•--•-•-----•------•--•-------••-••-••••---- ........................--•-•----•-•----•--------•---- ...................................... to Constru t or LRp air Xx an Individtal Sewage Disposal System 2 unaskin Ave Centerville /- atNo...... -------- • -----...............=......................................................................................................... Street C� as shown on the application for Disposal Works Construction Permit No��>.��aJ• Dated.......................................... Board of Health DATE_ / ......................... FORM 36508 HOBBS&WARREN,INC..PUBLISHERS