The URL can be used to link to this page

Home My WebLink About0614 MAIN STREET (CENT.) - Health 61-4-Main Street Centerville A= 207-012 S M E A D No.53LOR UPC 12543 smead.com • Made In USA LO ATION SEWAGE PERMIT NO. wiguo VILLAGE INSTA LLER'S NAME i ADDRESS BUILDER OR OWNER I DATE PERMIT ISSUED DATE C0MPLI'kN-CE ISSUED �_/�'�, --` a 3 c_. � �, � f .f • No 0_3 $5..Q!2...... THE COMMONWEALTH OF MASSACHUSETTS BOARD {OF -HEALTH .................. own.............OF.....Barns tab 1�... Appliraatiun for Disposal Warks Tumitrnr#iun rrmft Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: ?�2 Main Street -=----•---------------------------------------------------•---..-..----....................------- ...... - _......... ............. ......... -............. Location-Address or Lot No. Anderson ..........................................................---•-.......-------••--•-----._......_.................................................... Owner Address ......JQ.3.eph-..FA....&_QQmbex_.&_..Son---Ina-•.......... ..........Centerville......................................................... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of C4 YP g ---------------------------- 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................ 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (z, Test Pit No, 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R.' ........................................... _..... --------------------- •------------- •-••.... -------- -------------------------------- •........ ---------- •..... O Description of Soil..............Saad...:t...Gralwel...............•------•-------------------••-•--•--•-•-••-----....--•-•--•--•-•--••--•--...-----•. •-------•---• x .........................................................--------.....-----...------------........-••----••-----••-----•••. w U Nature of Repairs or Alterations—Answer when applicable_._1-1QQQ___9a11Qn...Plf;______________•_•_•__•..___._•••._.____.__. --- --•---••----•-•••••---•----•-•-••-•••----•--•--•-----------•------------------•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issued by the board of health. Sign •-�ZrP.M ................ Date Application Approved By......... --- --• ....-•- - -__ t_/ ................. .� - •••-I 1......_ Date Application Disapproved for the following reasons:---•-•-•--------------•--.....--•---------------------••------•--.----------•-----•--•--..• ---...--•__--- ............................................•-------•----------------•-••-----------.........-------•-•----••-•--•---------------------------......------------------......---•--••---•--•--•-•••---•--- Permit No......................................................... Issued-...;•-_ -�-� -`�-------Date------------------ Date THEiCOMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TaWn......oF.....Baxneteb.le.,,-.... r :................................ (9rdifiratt of Tome' iiFau' a THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X) by.....Joseph._P_,_..Macomber.&:-_Son---Inc.................................................... .... Installer at_____592 Main Street, Centerville Anderson -------- -------------------------------------------------------------------------------------------- has been installed in accordance with the-p>iovisions of, j gf�T e, tate Sanitary Co as described in the application for Disposal Works Construction Permit No .-'.._ ...... _._ dated-..-:: "'-A....��j_____________ THE ISSUANCE OF THIS CERTIFICAE,,.SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. C7A ` DATE._....._...-•1d' .2_•�--.`_... . '_... t Inspector_:. L ---•-- -------_--•-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a Town of Barnstable ---------------------------------------------------------- No............. ... FEE....5._00........ 9Wpos ai 10orkv Tonotrurtiori Fa`lltt Permission is hereby granted....JO$ep$-P.---Macogber & Son c ------ --- ---•---- •............. to Construct.( or Repair (X ) an Individual Sewage Disposal System at No.592-_-----••--n Streets Centerville Anderson .. . .. ........•--•••--- Street as shown on the application for Disposal Works Construction P rn;i?N _ _______. _-_ Dated........................... .......... r ...------ :-�- Board of Health DATE...... ". ►•'........ ------•.........:.......... FORM 1258 HOBBS & WARREN, INC., PUBLISHERS THE COMMONWEALTH OF MASSACHUSETTS >:.,. BOARD OF HEALTH .................T.O.'IM.............O F.....R&rn.6tab le.. Ap,pliraatiou for Bispniiaal Works Tonstrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: .....5.42...Mill..%9l r0e l................................................. ................_................................................................................. -Location-Address or Lot No. ................Anderson..... - ....... enterville............................................................ ._ --- ................. Owner Address a ...._.J.oseph...P....MacombEr...&...&O l..Sna-....------ .......... enter-y-tup.... Installer Address Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........................---. Showers ( ) — 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. Seepage Pit No..................... Diameter.............--..... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit......--............ Depth to ground water........................ LZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.--..................... .............-;-•---••------•--•-•-••••-•--•-•--•-----•-••..................•-•---_..._..........---......................................................... O Description of Soil---••-----_Sand...A..Jrratrel..................................................................................................................... x U .---------------------•------•---•---------•--•--...-----•-•-•------•------------.......-•---•••••----•------•--•--------•......•--•---------•-•------••••••-----•--..............--••••--••-•......-_.. w �, x ---•--•--•---•--------------•--•---••-------•-•------------------•--...-•--•----•-••----------•---••------••••-------------•----•••-•••----•••---••-------•--•--------•-----------•-----._...._-••---... V Nature of Repairs or Alterations—Answer when applicable...I:n 10 0-0..94110n..Pit........................................... -------------------------•-----------••--------------------........................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TJITIZ 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. Sign .....`........ ti /.r . . ...... ._ � pate Application Approved By..... ,,� r_f••�°, �.5----71...... Date Application Disapproved for the following reasons: t� -----------------------------•--------------------------_---•-•--•••-•-•.....-•------- -••................•.......••--------•-.......---•••-•-•--.........••••--••----••--•-......•----.....•--•--••••••---_--••----••-••-••-•-•-------...---•-•••-•-_-----•----••-•---•---•--•-•--••..._....._ Date PermitNo. ......•--_...-•............. Issued--------------------------•-_.._......_....._---------- Date