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Home My WebLink About0033 JOYCE ANNE ROAD - Health 33 JOYCE ANN RD, CENTERVILLE Owrford, NO. 1521/3 ORA 10% • • No. ............. ....... FEim..J...o................. THE COMMONWEALTH OF MASSACHUSETTS 1.... 0WhBOARD/)F` HEAL H . ....................OF..... .�- :V.�!:J�.._. ..k . ------------------------------ Appliration for Uhgpagal Workti Tonitrurtion Vantit Application is hereby made for a Permit to Construct (v<or Repair ( } an Individual Sewage Disposal System at: e__ , ................ r J c....L .Q�....►:�- ��- ------�v��-s-�-!-�---------------------------------------------------- ... -- ... cation-Address or t No. ...... Owne Add ess Installer Address Q Type of Building Size Lot._. �?i.0Q®____.___Sq. feet U Dwelling—No. of Bedrooms.___.____3.............................Expansion Attic ( ) Garbage Grinder (IJO aOther—Type of Building ____________________________ No. of persons-__--_e.__....._...._..---- Showers ( ) — Cafeteria ( ) a'' Other fixtures -- ______________________ W Design Flow....... .... .5_.J..........gallons per person per day. Total daily flow-----_�'_--�✓_4...........................gallons. WSeptic Tank—Liquid capacity.�6op.gallons Length................ Width................ Diameter................ Depth.......... x Disposal Trench—No. __. .......__. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No............I'------- Diameter.....$............ Depth below inlet_..._.t.......... Total leaching area.._-Q_/....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) rn / / Percolation Test Results Performed by BA i1 e..¢'.... _.." a kt�$..... Date_.: .__��1.` Test Pit No. 1................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........................ •-- �---,-z------------------4.�.....`f'.�Le.`a_�So-�-�-------------••---•--•--------•-•-.................................... ...... .-------------- 0 Description of Soil----- --------------------------------------------------------------------------------- � L A, a��i P61 x 1 r� G! a U Nature of Repairs or AIt�rat>ons— n we en pp ica e.----------------------------------------------------------------------------------------------- -----------------------------------•-----------------------------------------------------------•---•---------------•----------------------------....------------------------------•--.................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of I i p 5 of-the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been I s ed by t e board of health. S' ned.... ---------------••-• ..................................... �/ 23 el . . .� . .- J ~ ' Date Application Approved BY--=----/ ._..__._'................"-• -__ /t >�. . ....._.......... Date Application Disapproved for the following reasons-----------------------------------------•----------------•----------------------- ....... ----------------- Date Permit No. - Issued....................................................... Date ny� NO........................ Fins.... .."..'........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - Q 4041 .... ... ........OF.... 9 f .......................... Alip iration for Btipoiia1 Workii Tnnitrurtinn Vantit Application is hereby made for a Permit to Construct (W<or Repair ( ) an Individual Sewage Disposal System at: _ .�V.G/"�1. ..yr...f.. O" �:1..z..... .7S '_... � oA Lddotr eNss. � ....._....r oco ati"AAddress ....................... ..........._ Wwne� -----------------------•--------•-••-- •------------------ -- •----------•------------.._............_... C -/ --&-, � Installer A re Q Type of Building Size Lot...-}1_e4go--------Sq. feet U DwellingNo. of Bedrooms._......_ _Ex anion Attic Garbage Grinder — P ( ) g ( b aOther—Type of Buildi g�---------------------- No. of persons.___.___-___-__.-__-____-__- Showers ( ) — Cafeteria ( ) a+ Otho� s Desi n Flow..._._.... gallons per person per day. Total daily flow-_____ W g ��-4-------------------- --g P P P Y• Y -'�3-- -------------------------.dons. WSeptic Tank—Liquid capacity.4010gallons Length................ Width................ Diameter-_._--_--__..._- Depth................ x Disposal Trench—No. ....ssp---------- Width.................... Total Length........ ,e....... Total leaching area..... ---sq. ft. Seepage Pit No.----_---.- ------ Diameter.....S........... Depth below inlet-------------------- Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0-4 Percolation Test Results Performed b --- - Date..__ a y�-�¢ , ate- -� ll7 8< ,� Test Pit ;\10. 1................minutes per inch `?eptr of "Pest i __._^..___..___::.'T�'ep�l'i to ground a e ....................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ --------••---•----- -- ----------••-••-•-......••-• -----=-----------......----.......................--•....----...------------...........---...--... O r Description of Soil......C'--=��'-----------6 -o.�-----�S m.,q.$0-f.4.......................................................................................... 17 ----------------------------------------- UNature of Repairs or AlMirianle—A4iiefqei L id ------------------- --------------------------------------------------------------------- -----------------------------------------------------•-----------------•--••-••--•...............•••--•--••...------------•----••-••••-•-••••••••-•-••-•-•------•••••••---------•--••••.....-•-•---•-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T 'E, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Com fiance has been i ued by the board of health. ------------------------------ � W-Anw-tt- ApplicationApproved By...............................................................•-.................................. ........................................ Date Application Disapproved for the following reasons:------•-------------------------------------------------------------------------------------------------------•- Date 4 - PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....tea. . .............OF.... iro a bpi✓.......................... TutifirMtpII nVilanIrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ,)06r Repaired ( ) _.. -- ,: ,( Installer at1'T" t C £�`;: t f' •{ - ; = ---•---------•-------••-- has been installed in accordance with the provisiol;A off he State Sanitary W .'xs,Si�El�e,(� in the application for Disposal Works Construction Permit No......................................... da.ted_-----_�_--__-_._--_-.-_-------.-----•--- THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................... �1-------•-----•----•------•-•------- Inspector--•. .......................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .(/J. .. O F.............. . 14 ................... Disposal sal nrkii Tnnitrnrtion anti#. Permissionis -hereby granted.............................................................................................................................................. to Cons �(�' ) or it ( )�}�n Indivi a Sewa �e Dis osal Sys tem at No....... -- ---- 4 _(- ----—•:.t.._ .Qe t_1- t� -- et as shown on the application for Disposal Works Construction' �.N��i�� -- ---•----- - ------ e Board of Health DATE----- 3j FORM 1255 HOBBS & WARREN. INC., PUBLISHERS �I � w � --...e ,►� ��: �:'y �..� VA 51 t.1G l.� 1;7- \t��f ^' 3�3t371zflo 14 - 1.10 GAtzg� A& b«�t� { t`Iow t�o � •3 = 33d G•Pv � w. } ��-Ic '!-,AF.!►C = 330,, ISc % • 4•�,5 6.PD. - qP.9 ! ��;' 44 z US f OOb 6A L.. i' 1 g s T M/N-� « 97'S . 6KP pI5Po5At_fjPIT - USE lOoo G .� O datA 77 7 t urewALL.. Av- A = !So t�j0 SF �lit '$v7TOiIV� ,C1,2t�. � ST=. �. •- :, r -- 'o '~f SO 9s=. ;k l •o - So Co.PD� ... f. �I O ToTAt�. 'flESIGN = 42S G.RD:` , �.,. s � 'r-oTA t_ t3a t t�f I�w - - �o4a.4T/o/J 330 6.F'.p- - t--- �, . Gt=.12GOl�Tti t l CZATI~ : C'10 ZMIQ clR e .+ C'HA'RD Y'\6\fir r ;I ALAN a b itA. � 2-1048t ANC �oq �R Job - t -rr-ST 11 �78 i ... 170 I rape A . Sv3S0/G- 4'p06 bfSG 1w. GAIT. 9G• p. 2 'Sox Q�'6 $t-.pnc !C r,: t IWK I{ TANK 1 i qL•Z g4'� G/2Ac LAN i PIT •; ; , .. . PCLO�-1 LE=- 1 otJI, �V'1C-t. t « LOCATI �., +.Jo /Jo II�A T@f- � ptA1J RL--� cLE►.Ic_�. �f C6tZTt1=�{ -r&4Ar TIdG' FouoT,,d-npt4 15"a4i WV t_a1J GaM�t_�!S W.ITK TN` �jiDE.Li►-�� I A1.1t� 5ETI GIC 1`CQUjCeAA&WTS. OF .Ti4r- �•••� `ro W w oT=`' 33 Ae 017TAC�L� r t' l�,�PLISV/oc�b vA-rc (2 c. �✓ f� B A ATM.tit. 4, u '"c. 9zc615rcrsD LA WG 5102vaYom< r TI-115 PLA" 1!, LICIT t�IA4,CG?; 064 AN 05TE�Vtt_lG- o MAsy. a. t 11JSf`:J!✓�l_tJ ��Ut_�/t_ { T14L: C�FG'S�T�, S1dG�vt� AF�Pl.1 C.t�.IJT t.1 � `,C_ U•::G iGG .l�r'1 C.C'Mt►�� 1.O (_1114ca TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS ' f��v2 F- P� �2 NAME ADDRESS /S �? � VILLAGE LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS doh-rl� �� t ^ � � y N � � �� a o ,d m `-b 5a o. w °� � � � ty 0 w �,�r m � m F+ LOCATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME i ADDRESS ,A-Y c h BUILDER OR OWNER CIO ki y _.DA T E PERMIT ISSUED _ 3 DATE COMPLIANCE ISSUED 5�2 ��-j .3"/ �z �-® - j I � � �f �° � � �- , �� f �- �� .