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HomeMy WebLinkAbout0415 MAIN STREET (CENT.) - Health 415 Main Street (Cent.) Centerville A = 208 125 J111 �yj .F��kFo +JPC 12543 .53LOR :•ASTINGS, uN ASSESSOR'S MAP NO. ').o j PARCEL LOCATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME ADDRESS B U I L D E R OR OWNER «AA DATE PERMIT ISSUED 0ATE COMPLIANCE ISSUED 'yZ In �� � i THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........ ...T.ow.n................OF............Bar.ns.t.abl.e-------------------...............----------- Application is hereby made for a Permit to Construct ( ) or Repair (X� an Individual Sewage Disposal System at: 415 Main Street Centerville .................................................................................................. --•---••----....--------•----••--•••-••-•-•-•...•--------•-•••-•--••.....................•-••-•--- Location-Address or Lot No. Edward White Owner Address a J.P_Macomber Installer Address dType of Building Size Lot............................Sq. feet U DwellingX-X No. of Bedrooms--------------------------------- _Expansion Attic ( ) Garbage Grinder ( ) Other—T e 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. 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-----------------.___--- G% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------•----•----------•------••----•--•--------------------------------......................................................... 0 Description of Soil........................................................................................................................................................................ WI....--•----------------••-----------------•----•----•-----------............sar d-•-•--•-------.....-------------•--•---------...--------•---.----------------.....----------.....---..........-- W x ---•-•-----•-----------------•------•------------- ••--------------------------------••--------•-------••------------------......----•-•-----------•---------•------------------•-----•---•------------- U Nature of Repairs or Alterations—Answer when applicable............1_-_1.q_00...9a1.].Qxt___t_3nk................................. ...-................................................................................................................1-1.Q_Q_Q.-gal.l.wi...Ie cb.--Pit.....----......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL is 5 of the State Sanitary Code— The un ersigned further agrees not to place the system in operation until a Certificate of Compliance has b n issued th oard f health. Signed. . ' '' r ` -------------- .....51.3.�88....-•---- \� Date Application Approved By..............j� ------.�D. ----�.......................... Date Application Disapproved for the following reasons---------------------------------------------------------------------------------•--------------------.......•--- ' •-••-•--•------------------•-•---------------•-•-••------- •----------•----------------•-•----------•----•------------------------------•--------•-•-•----•--•---••---- ..................----------- Q'�/ Date PermitNo............Q..11.---J-92..................... Issued....................................................... No. • �• 7•--- FE$.... I$.....2 0.00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town................op............Bars tale e--------------------------------------------- Appliration for Disposal Works Toustrnrtinn Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair (XX an Individual Sewage Disposal System at: 415 Main Street; Centerville ..................-.............................................................................. ....................................................- .......................................... Edward j j rle Address or Lot No. -------------•-------------•----•---•--•---•-•---...................._•--------......._--------... ..........--........................................................................................ Owner Address W J.P.Macomber Installer Address PQ d Type of Building Size Lot............................Sq. feet U DwellingXIANo. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) al 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 ( ) 0-1 Percolation Test Results Performed by.......................................................................... Date........................................ Test 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........................ w •---------------------------------------•-------------•-•--•--•-•---•---------...........-•--•-•----....................................i................... ODescription of Soil......................................................................•---•--•---------------------------------------------------------------•-•---------••-•---------. x Sand V -----------------•------------ W -- •-----------------------------------•---------------...----------------...---------•-------------------•------. U Nature of Repairs or Alterations—Answer when applicable............ '- a �� an I-=1 Q fS0-ga ll ori...i-eacri'--p i-t-e--------------- ----------------------------•------------------------------------•-----------•-------------------•---...------------------------------------------------------------------------............----- 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 b the and o health. l 5 3 $U Signedr. .:. __... \� Date Application Approved By............... zcr^d• d�• `...... .---•-------------•------ -------------------- Date Application Disapproved for the following reasons-----------------------------•---------------------------------•-----------------------------••.................. .................•----•------•----•---------•--•--....-------•-•-•--------•------------•----•---------------------------•--•------•---------------------------•---------------------------------..__.._. Date PermitNo............ 4 = f -----------------•--- Issued....................................................... Date r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ..........................................OF..................................................................................... Trrtifiratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X* bJ.P.Macomber - -----------------•••---•-•---------------------•-•-•------------------------•-•----•------ Y -••-- -•- -•---•--•---... 415 Main Street Centerville Installer at............................. ------•-.-------•----------------------------------•----------------•------------- ------------------.------•------------------------------_--•-•-------------•-- has been installed in accordance with the provisions of TITLE 5.of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.......?.�__-___t_.9_._7---------- da.ted________________________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................9• J... —.51..................... Inspector...........-- ,�D..................................................... THE COMMONWEALTH OF MASSACHUSETTS 0 C57 BOARD OF HEALTH 7� J ........Town. . . able I ......................OF...........-Barns-�----------- t -- .---.................................................. $ 20.00 No.--- '+.j7... FEE....................... Disposal orkg Tonotrnrtinn rrntit J.P.Macom er Permissionis hereby granted.............................................................................................................................................. to Construct4(15)Ah&paAtr, n j�Z era e Disposal System atNo............................................................................................................................................................................................... Street aa II as shown on the application for Disposal Works Construction Permit No..�p__J.2—_ Dated...........................I............... •---------------------------------• .a-.................................................... I 1 C Board of FIealth DATE................... �-_�---------/- .................................. FORM 1255 HOSES & WARREN. INC., PUBLISHERS