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HomeMy WebLinkAbout0070 MAIN STREET (CENT.) - Health 70 MAIN STREET Centerville A = 208 — 061 /// S MEAD Na 2.153L,OR UPC IM4 .moad.mn • Waft in U" LOCATION SEWAGE PERMIT NO. VILLAGE c���-���l�i 4 IFS INSTALLER'S NAME i ADDRESS w ` e U rL 0�- OR OWNER )g - DA T E PERMIT ISSUED DAT E COMPLIANCE ISSUED ' - y __ _ -1 _.��-1�° 1 ��� �' ��� �� �b �_ ., - � E. �� _ . 13 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town.......OF....Barns-table... Appliration for Disposal Works Tontrnr#iun rumit - W"t Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 7� Main Street ....... ......_-....... ----.. ....- �l�t?�V �.�.... - --....- ....... ............ .. Location.Address or Lot No. William Bartlett Centerville -•-----•-----•---•---•.........................•--.................................--•-•-••.•.... ......._..-------------•------....._............_..........-••••••.............---............•••- Owner Address a .....Jaaeph---ID....Macamb-es_-&..Scn,...Irzc.......... ......C.enter_ville............................................................. Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a 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. 3 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......--................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---------•-----------------------------------------•----......_.....-----.._.........•-••--.._....._......................................................... O Description of Soil.......Sand...&...G a.1TE1-•-•--------•--------------•-•-•---•----------------•-------------.....------............-•-•--•-•---.............--•-•---- W U -------•---------------------------------------•---------------•......_............----------•----------....---------------•---------------•---------...•-----------........--------•--------------•---- �1 .......................................................................................................•------...--.............---........ d_-•-••------------------------------------------ ----- U Nature of Repairs or Alterations—Answer when applicable.--.a ml-9QQ..-gs�.�.�.o 1...tank...&. -10UQ-_-ga gallon Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT I.;,,. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ble issued by the b9qd� alth'! e ld/.!yu Sign e .__. ���'�+-�z....... ...........f�.. �- ........ Date Application Approved By.....--- yr 1 ..... ........................................ Date Application Disapproved for the following reasons: " ------------------••----•---------------------------------------•--•------------------.......--.--- ••------••------------------------------------------------------------------------------••-•--------•---•---------------------------------------...------------------•-----------------------------._... n n' Date Permit No.............. a Issued_ ....1-�--•----•----••-•-••-••-•---•----•-- L Date No................ .. Fnic $5._o.0......._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................Town--......OF....Barns tab.12..........----------------- ' Appliratiun for Disposal Works Clunutrurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: ..... O..Main•.S t, a t---•-•-•..................•-----------......-........ • Location-Address or Lot No. ....William Bartlett ____Centerville----------------.---•--------..............•--•_..__.••...... --a - ..t - Owner Address a .....JO.seph...P-.---Mannmber...&...saa ...lac........... ......Cen-ter-ui.11e............................................................. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g ---------------------------- P ( ) — Cafeteria ( ) dOther 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. 3 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. I..._....._.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........................ ---------------------------•--- .................... ................................................................... D Description of Soil......Band...&...Gr.&V_-e1-----------` = U ---•-----•-----•...............•----------•----•--•••--•--•-••-••--•-•...--•---------..........."_.....--------•--•----•••-•---------------.....----------.........._......------•------------------- UW ...........................................................------------------•--------••••--------- ...................... Nature of Repairs or Alterations—Answer when applicable__a.-19QQ___ga11Q ..tank..&-.1: 10.00_-gallon ---•-------------------------------------------------------------•-------........-•------------------------------•-------.--•-tit_...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of SITU E 5 of the State Sanitary_Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the board pf }ealth. (�' / J. Sign d.... ------ ,r�{l'd Yv�.(! v --.. .... ✓r Date Application Approved By............ _ . .. k "1 }��� •----•-------------- ........................- .............. / Date Application Disapproved for the following reasons------------------✓ -------------------------------------------------------•--------------------------•---- ••---•.....................••-----...------••--•-....•----------•-•----•-••••--------•••-••••----------•-•---------------------------•••------•-•--.................................................... Date PermitNo......................................................... Issued........t%....... ............... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................Town........O F.......Barnstab le.............................................. Trr#ifiratr of TompliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by...$oseph..P.._.Niacombe '..&..Son...I?ic .._.._. Installer at 7Q--Mai-n._Str-eet.,,...Center.YJ-Ue..-------•---------------------•-----------------------------•--------•--------------Bar-tl,'t-t...... has been installed in accordance with the provisions of of The State Sanitary Code as described in the application for Disposal Works Construction Permit No9— ................... dated___ ....... ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. C f ,,rr DATE........../. • _.... ... ............................. Inspector.........6:------------- �- --------------•----••---••------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................TOwn........OF....Rarnstable..........__.................................... �q. N t<. ......... FEE....$5.00...... Disposal Works Tonutrnr#ion rrntit Permission is hereby granted...;PA9_0...1�.... aC©Mbe -. im,r-- ..Son... .............................. to Construct ) r or Repair (X ) an Individual Sewage Disposal System at No...?o....... n..At a -C ntervzlle... 3art1 ... ----r----------------•-•----•----.---- Street / + as shown on the application for Disposal Works Construction Per it .._/°..__... .. __ Dated... .......... d of Health DATE......./= 1 -......................................... Boar FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - r � 4't z 4 ¢. /6 6¢ 0 41' J J dCl e} N � � 'E'►q!'J � v�J la i O �tr N o �'LE'v Tom of Ca.,.C, 17.3 j— ' 7)/ Z-Z4"yo}770 NS PA3 'T) Dam LJ.q - CERTIFIED PLOT PLA N ►�+<r�,!�i� L Ki'lify LOCATION G'�?✓r�7zVi�GE� /vl4ss,. . .. C,,NV., ,C4IJI0 MASS. 02675 7 SCALE 20 `. . . DATE PLAN REFERENCE . .�'�' . .!� . . . . .. . . . . . . �Z, rG �_ L�rrzE�/ zr� 67 uX o y _ . . . . . . . . . . . . . . . . . . . . { a I CERTIFY THAT THE 69157, ..vi.D/.c.r�. SHOWN ON THIS PLAID ED ON THE GROUND AS SHOWN HERE® J�—/ 'J�l/ •STi E'�`T DATE QCT9, /.I7rf�' . BtISEY PETITIONER: A�T�• I//LLC �l�}5 5 G�j-4� r REGISTERED LAND N59345 /¢,64 TOR OF FOUNDATION CONCRETE COVER CONCRETE COVERS 4"CAST IRON 12"MAX. • 12"MAX, • PIPE (OR 4"ORANGEBURG(OR EQUIV.) EQUIV.)— MIN. PIPE- MIN. LEACH PITCH 1/4"PER. PITCH 1/4 PER.FT. PIT PRECAST ° LEACHING o'� INVE�tj� a :..•. EL..!//. ... �INVER INVERT 'o . Q':' PIT OR SEPTIC TANK EL /o,y6 DI ST. EL iP, - _j= EQUIV. o INVERT BOX /eo o GAL. INVERT �' o; EL.//•.� ... 08 INVERT ww a: :i; 3/4"TO II .. v o a v.� ELJ.. ELl.dcS e% �� WASHED w STONE DIA PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE .. . . . . . . . .... TIME. . . . . . . . . . . BOARD OF HEALTH TEST HOLE I TEST HOLE 2 ENGINEER . . . . . . . . . . . . . . . . . . ELEV. . . . . . . . . . . ELEV. .. . . . . . . . . DESIGN DATA NUMBER OF BEDROOMS 3 TOTAL ESTIMATED FLOW . . . . GALLONS/DAY BOTTOM LEACHING AREA 7e ". . SQ.FT. /PIT SIDE LEACHING AREA . . l8 5, SQ.FT./ PIT GARBAGE DISPOSAL .N°'`� (50% AREA INCREASE) TOTAL LEACHING AREA SQ.FT PERCOLATION RATE 4'�S.?z--l'. ?WO MIN/INCH LEACHING AREA PER PERCOLATION RATE SQ.FT. .... . .WATER ENCOUNTERED NUMBER OF LEACHING PETS 1!�!T wi7�/ TY�/o APPROVED . . . . . . BOARD OF HEALTH r��yz ,aT DATE . . . . . . . . AGENT OR INSPECTOR N .SDI ` . . . . . . . . . . . . . . . . . . . . . PETITIONER