HomeMy WebLinkAbout0061 GOOSE POINT ROAD - Health (2) 6-oowot'o
t a o y j
No._ -Q-------._....
Ficim�...30.0o
THE COMMONWEALTH OF MASSACHUSE17S
BOARD OF HEALTH.
TOWN OF BARNSTABLE
Appliration* for Ui"aaal Works Tons rnr#ion Or"d
Application is hereby made for a Permit to Construct ( ) or Repair X(X ) an Individual Sewage Disposal
System at
61 Goosepoint Road Centerville
.......-•- _--_ __...---•--._...... ..- ......................... .............................................. ........__.._..........._.............-•---
ocation-Address or Lot No.
Fred Brown - L
....................--__........................................................................ -----------•---------------------------------------------------------------------:................
Owner Address
W ..... Macombe �x ------ -----•--•---- --------- -----------•----•-------------------------------------------------------
a .... .......s.••-• - ..... Installer
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwellings No. of Bedrooms............3_-------------._ _Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building . No. of persons............................ Showers — Cafeteria
Q' Other fixtures -------------------------------•. .
w Design Flow............................................gallons per person per day. Total daily flow:...........................................gallons.
WSeptic Tank—Liquid"capacity............gallons, Length................ Width................ Diameter---------------- Depth................
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----.....---•--•....------------------.
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
f1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
------------=------------------------------------------------------------------------------------------------------------------------------------------------
0 Description of Soil..........................................Sand & Gravel.
- - - ---------------------------------------------------------------•-----•-------------------------------------------
W .
U •-•-------------------•-----------•---...----------•----------•---•---•--•-------•---------••----------•-•-------------------------•-------------------...........-----------------•-------•-••-------.
w
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
VNaturelof p s or Alterations—Answer when applicable...............................................................................................
1-1500 gallon tank, l-1000 gallon leach pit. .::
----------------- -----
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 Compliance has beensued by the oa d of health.
Signed .. a --'- 0 -------------- °---------------. --- --- ....3/..2�....90-----------
71/�
Application Approved By _ ---- - -------- �-
--....................................................... ................. .................
Application Disapproved for the following reasons: ...................................................------------------------------------------------------------------------------
o- -- ----------------------------------- ----------------------------------------------------------- ------
Permit No. r ..-.--
. ........................................................Date---...
'� Issued
... ..�.... .......................... Date
� r
NoQ� , R ..........30....0...0.. .r -- ----•-- THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disposal Works Tonstrnr#inn jhrmit
Application is hereby made for a Permit to Construct ( ) or Repair XX ) an Individual Sewage Disposal
System at:
61 Goosepoint Road Centerville
-• ..... • ---...... ----•- ......................... -------------•---------.._........------------ .....................................
Fred Brown Location-Address or Lot No.
......................--........................................................................ ...... .._.....-----•---------------............----....•--•--.._...........................--
Owner Address
W J.P.Macomber Jr.
---------------- . .....-----------------.........---....------...............................-•-••-••----......---•
Installer Address
Type of Building Size Lot............................Sq. feet
DwellingX No. of Bedrooms............3.............................Expansion Attic ( ) Garbage Grinder ( )
p-, Other—Type of Building ............................ No. of persons............................ 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. ....... F
Z Other Distribution box ( ) Dosing tank
►-' Percolation Test Results Performed by----------------------- ---------------------------------------------- Date........................................
Tests Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
Test Pit No. 2................minutes per inch]Depth of Test Pit.................... Depth to ground water.........................
- •----------------------------------------------------------------------------
.---------
-----------------
•------•----.----
o ,,,, 'Sand: & Grave I
Description of Soil ------------------------------ .-----•---•••----------•-------------•---•-•-------•----------•--•---------...---•-•.....•---••--••--••-----•----
x
W ' fa' I
............................................................ --------------------•-----•-••-•----•--•-•-----••-•-----•---------••--•--•--------•-•--•-•-•---•-•--•--•......................-..........
U Nature of" &pairs or Alterations—Answer when applicable...................................................................................�........_.
1— �nvu 1-100 �a llontank, 1-1000 gallon_leach �•--------------------------------•--•-----------•-----.......................................................................................................... --- t- •-•---
Agreement: 1 � \S
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 Compliance has been issued by the oard of health.
Signed ..... A ----�' ��-----.... ..jt------------------------------- .... L22/9o--.........
Dace
- Application Approved By v ---------------- ---- ------......\� ....... :------------------------.............................. D,[e '•
'.
Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------------
t
Permit No. ..... �/.... . ------------------------ Issued -----------------------------------------------------...Dale------
� ...... C......f........ Dale
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Gertifira#e of TOM11 inure
T IS S TO CERTIFY, That the Individual Sewage Disposal System constructed( ) or Repaired ;(�XX )
J.P.Mlacomber Jr. �►
by-------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------
Installer
at -E-1....Goo.se po.in t....Road Centerville
........................................ .......... ----.......
has been installedin;accordance with the provisions of TITLE 5 of The State Environmental Cpde as described in
the application forEDisposal Works Construction Permit No. ....9��`7%-.1.1- ). dated .Ny. 1,Ptg0................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS,A=GUARANTEE-.THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE........ . .. .r�':3 �,7. .............................. Inspector ...... /�A.lxf,,.............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
o TOWN OF BARNSTABLE
Noq ,-- )
1
......................... FEE.$..30.-00..
Disposal lVorks Tunstrudion "prrmi#
J P Macomber Jr.
Permission is hereby granted.....'.....•.............. -.--•••••------•-•........----•-•.................................----...........................
to Con truct ( ) or Repair an Individual S .wage Disposal System t
at No....1..Goosepoint Ord Centerville � A�....
... ........ ... .........----• ------•-•----------•---------...
-Street
' as shown on the application for Disposal Works Construction Pe1E it No..r.(_./.....��.._. Dated.._.....�.•�....�d 1.................
Y. .1., .. ....................... 0
DATE. Boara oft Health
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS