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Home My WebLink About0035 LONGFELLOW DRIVE - Health (4) 35 l,000Fe(,Cw N( FE$....$ ...04....... THE COMMONWEALTH OF MASSACHUSETTS e BOARD OF HEALTH Town Barnstable 1 ��•� ........... 0 F.......................................................................................... 1. Appliration for Disposal Work.5 Tonstrnr#inn ramit = Application:,is.Hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at ...... .... arxg e. 2Qht.._P..xaave. ----•-----.... ..... ................ Location-Address r or Lot No. --------------------------•----•----•--------------- ......Center�rille-----................-•-----•----------------.............-- wner Address a Joseph P Macomber & Son inc . Centerville _ � Installer Address � Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (' ) Garbage Grinder ( ) Other—T e of Building .. No. of persons............................ Showers — Cafeteria a' Other fixtures ----------------------------•--. . Q ------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity.....--.....gallons Length................ Width................ Diameter----.-.-..--.--- Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. FZ Seepage Pit No--------------------- Diameter..--.....--..--..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ►-' Percolation Test Results Performed by.......................................................................... Date........................................ W a Test Pit No. 1................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.-----..............-. P+ -----------------------------------•------•--.....:.---•---•--------.....•---------------•-----..............----------••--------------•.........--••-•.--_.. O Description of Soil..... .a n.d--&...GraylQ2................................................. x W ---•----------- -----------------------•-----------------••---------••-•----•---•-•--•-•-----------. -----•--•----------------•----•-------------------------------------------------•--................ U Nature of Repairs or Alterations—Answer when applicable...1--10Q-Q---ga11On--0.V_er !Q.W____________________________ ---------------------------------------------------••---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi 1E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be s d by the board of iealth. Signed._ - - --- ...... �'� L '�.................. AApplication Date PPlication Approved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:----•----------------------••----------••---------------------•--------------------------------------- •...._ .........................:.•---.....----...•••-•....-------------------•--...----------•••-•---------•-•------•----•---•----------------•---------------------------•---------•-------•--••------------ -------------•-------•-------------•--. Issued...... -7 - Date Permit No......................................................... ---. ------ Date N . ..... .G Fims..... ....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ?'ovrn Barnst�.ble . firation for B44pooa1 Vorkfi Toaaoirur#ion umi# Application,is hereby made for a Permit to Construct ( ) or Repair ( .;) an, Individual Sewage Disposal System at: .............. - ..._�._._............:. = ::::_...__.._......--......••-••--•--•-- --._...--••--•-...--•-•-•-----••---•-----•-------•••--.......••---------•••----•---........_•••_.. Location-Address or Lot No. F. 'a r6. .�ervlz. Cent <<- I - = -- •-- •- --------•••--------------•--- ----...-------------::.:...-••-••-._............................................................. Owner Address W Joseph P Macottuwer & `ion Inc ",:�riterv"i 1 ..........................•------------------•-•--..._..._........----------------------•-•-•---•• ---•._...:-----•-•---...._._......... ........................................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms______________________________ __ _Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of ersons____________________________ Showers W YP g ---------------------------• P ( ) — Cafeteria QI Other fixtures __________________________________ W Design Flow............................................gallons per person per day. Total daily flow..............................._............gallons. x Septic 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........................................ Test Pit No. i................minutes per inch Depth of Test Pit...__.__-__._______1 Depth to ground water_________._____________. G4 Test Pit No. 2................minutes per inch Depth of Test Pit................. Depth to ground water........................ a ------------------------------------------------------•---------------••-------•-•--------------- .......... .. ------------------ ---------- O Sand L;, Gra-vel / Description of Soil ---------------•-•------........---•----•--•--•--•-•-----------•----------------------------------------------------------------•-•••-••-•-------------- x V ----------•--•--------------------------------------•----••••---- W U Nature of Repairs or Alterations—Answer when applicable..............� __." 1-1 n�� irpr :l nr.r -------------------------------- ------------------------------------------•--------••••-•-••-•--•---•••-•-_.._..•--••-•--------•--•---•-----•••••--------------•••-----•----•-----••---•-------•---•-----•-•--•--••••-••-----•....•---•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signedr.....................•....................... ................................. ---C-..................... Date ApplicationApproved By................................................................................................. -------••••-•--•-------.......... ... Date Application Disapproved for the following reasons_________________________________________________________________________________________________________________ ,4 Date ' Permit No......................................................... Issued.......� . Date:` THE COMMONWEAL' OF MASSACHUSETTS BOARD OF HEALTH Town OF..Bt:rnstabl:('..... (9rdif irab.of TompliFaurr THIS IS TO CERTIFY, That the Individual Sewage..,Disposal System constructed ( ) or Repaired ( X) by Joseph r' r � � �Ut y', �, �n Inc ............................................................. ---••-•••----•----•---- 1 Installer at �7 ', x:all ter T)r?�r _C`an fi -r`n 1,n --•----------------------- ............................................. has been installed in accordance witli`'the provisions of F 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N „ ._'�______________ d'Ited_. "._/.%Tr_ _-______.__.____ THE ISSUANCE OF THIS CERTIFICATE SHALiL,NOT BE CONSTRUE® AS A GUARANTEE THAT THE ^ .... ........ _ aJ 3 .i Tnn 4 f SYSTEM WILL FUNCTION SATISFACTORY DATE. �.........7� ti �' °r` �i�, Ot6k- _ ;• wu�uryom'�.�'iti2�j3s��, �L��R+�'E�:.•M'cs"':?..x;.... �.d. '"s'-' .t' •i v>.�.,<,c�.§�v�s`=.�} �cM1d'{:��n, a�•csE✓,f�,t�: THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f No......................... _ FEE.. :_ Ellopoottl orko �oaao#rr#imrn rraatii Permission is hereby granted---- '` ^ to Construct ( ) or Repair (X an Individual Sewage Disposal System at No,_<_._-.! r i nsr �Y'�s'e> ( A-rli:�,t_�ri• l c?._.....--------"--- •----•-----• .................... Street as shown on the application for isposal Works Construction Per o..______ :._________ ted_. '' r ......?. __._._.... l� ----•---•----- DATE..... I oar o ealth ' - ---------,�------�-*-------.,.-•---------•....................................... , FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 4