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HomeMy WebLinkAbout0015 OLD STAGE ROAD - Health (2) �dg �i55 No......7���.. . � * J Fims....5 00.--......... ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . -". .. .....OF.Centerville (Barnstable) p .................••... 4 15� App trafion for Da,gpna al nrk,i Tonstrurtion Vamit IApplication is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: 19 Old S t ge..Rd. A- G ....._.. ....... ...................................••--- Loc tion-Address or Lot No. Frank Jaklitsc.. 19 Old Stage-_Rd._, _Centervilie.--,ma. ------------- ----................._........ ---- -------- ... Cannons Inc�� Owner Address a ' --•-••--••-----•--•-•---------•--•--••-•-- ......................................... W!t...Y armou th,..Ma. Installer Address UType of Building 1 Size Lot.............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (NQI Garbage Grinder (NO) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria (No) WDesign Flow.Other fixtures.._--.....---._gallons per personpr day. Total daily flow...........................................Iallons. W Septic Tank—Llquld capacity If 1000 gallons Length._......0.... Width�+...10_.-. Diameter................ Depth4•-6_..._-. x Disposal Trench lOOO Width.................... -�............... Total Length......-�T........ Total leaching area--------------------sq. ft. Seepage Pit No.-__.__------------- Diameter....... Depth below inlet.................... Total leaching area...300�+_..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) � `1 Percolation Test Results Performed by.......................................................................... Date........................................ M] a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water....................... f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P ---------------------------•--------•--------------•-----•--------....---------.........--•------........---•---•-•--...........---------:.....---•-----•-- 0 Description of Soil..................................................................................---------------------------------------------•---------------•-•-•------•-•-----••--• I U ••-------------------•--------------•--------•----•---....---•-•-•--------------•-------------------•-••-•---------------•----------------------------•--------------------......--=--•--•--........ W U Nature of Repairs or Alterations—Answer when applicable... -----U��-�-1��----�'�/9.�r�1'----"---�=-�'=------��I��•-- " ----� cf-------- ----- --j-r--f-.�crxf`--------•-•-- ...............................................EoK/ - ey­... ig .-------------- ------• Agreement: f The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with " the provisions of TITL Z 5 of the State Sanitary Code—Thd further agrees not to place the system in - operation until a Certificate of Compliance has e E tW health. 11/7/77 Signe _ -----•------- --•----•-=•--•.•---_-...---_•- J. Robon Date ApPlication Approved BY (---/G•- °-------------•- -------•-•----------• ---•---•------- -------- Application = ' 1 7 r Date Disapproved for the following reasons-................................................------------•--•-----------•------------------•--•---•---•----- Date Permit No.......711....................................._ Issued....... .lc -- --Zy• =7 7--------- Date ';; .s r 5 `00 No.-----...... 'F...... a Fx$:.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .---....".".....................OFCenterville (Barnstable) _.__. ApplirFa#iort for Disposal Works Tontratrtion rrnti# Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: 19 Old S to a Rd. Loc tion-Address 'or Lot No. - Frank Jaklitsc i _19 Old Stae-e Rd. .., .Centerville..__Ma. __.... ..... .... ---------........_........_....----•---------- • ..................._................... Cannons Inc. Owner Address a ....................... '.: 350 Main St. R. Yarmouth Ma. Installer Address Pq Type of Building Size Lot.............................Sq. feet Dwelling—'No. of Bedrooms....:.....................................Expansion Attic (No) Garbage Grinder ((No) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( �) dOther fixtures ..----------------------------------•------•-----------------•----•---•------•----------------------------------------.....----------•...........---• w Design Flow.....:......................................gallons per person er day. Total daily flow............................................gal Ions. WSeptic Tank—Liquid capacityl.QQQ_gallons Length......... _.__. Width Y..10_... Diameter---------------- Depth4_.§?....... x Disposal Trench—No..................... Width..-f_............... Total Length...........,........ Total leaching area....................sq. ft. Seepage Pit No ----- Diameter....... __.._..... Depth below inlet.....7_........... Total leaching area...3004...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----_-_______-__---_-__. fL4 Test Pit No. 2..........:.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 . ....................................................•-•---..........-----..............-•---•.......----....--......--•-•-------................----•-•---- ODescription of Soil........................................................................................................................................................................ x w UNature of Repairs or Alterations—Answer when applicable......................................................:........................................ Agreement: i The undersigned agrees, to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI LlE 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. l l/7/7 7 Signed...............-•-----•--------._..........._...---------------- J. Robert Cannon Date ApplicationApproved By..........c.___!�______________________........._._.r........................................... ...........+---------------�___ .._.... bite/ Application Disapproved for the following reasons--------------------------------------------------------•-----------------------•--------------------------...... r_................................. Date Permit No..............! _,';. .._::. --. Issued . . ....... Date v r" / THE COMMONWEALTH OF MASSACHUSETTS °? BOARD"O" "HEALTrH ........................................_OF..................................................................................... ., TrrtifirFa#r of ToutpliFanrr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.....................................................---•----------••••......------...._.... ------------..........................•-----............_...---------......---•--•-••------•......_ Installer at.................................................................................................................•••---••---•----•-•------•---•--------....•-••--••-------•------............-------- has been installed in accordance with the provisions of TITIF 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated......._._...................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL1 FUNCTION SATISFACTORY. DATE.. .. ............................................. e.�............ nspcor...... °--- --------------•-----------------------------.------••-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /a y/,. f>�a.,., }:...'.....'........... ............OF.........::....................._._......._.................................. ...._... No : .. FEE ...: - Disposal Works QVIonotrudion Vrrmit Permission is hereby°granted...............==-----------............................................................................................ .:_.. to Construct ( ) or Repair'( ) an Individual Sewage Disposal System / ice., ;/—% , r/, , Street as shown on the application for Disposal Works Construction Permit No.'.':%.._....__ Dated...........I..__.... ..................... / ------ .----• -- --------------- - Board of Health DATE---- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - } � F , ' P V �1���( i- Y r ,,rn y B. M1� y� r,r i F _ x§ ^-y , "P •3 . ,y October 26, 1977 4{ , Mr. William =Eisler, :Foreman Robert' Br Our Cn.Inc. ` "Great,,Western Road ti . North, Harwich," Massachusetts: Re:^ 19~ Old `St _ age Road Centerville .. Dear Hr• F 9.A• e,6 •, ; r Y rE Y. b tt' FK'H. .` s{ d• a,., , You ar .• • '�.. r M= ,� �`� � ,.d , _ '` ®`:; granted Fa 'variance to i.nstall a .leaching p t 15 ,feet fram i the >house ix lieu°of the 'required •20 ,feet: It.,is mu uzideratanding> " that .the hou646 does "not` l ave:.:a cellar 1 In addit�o you are granted' - a variance to. l date the`.p3.t 9�feet `from,the Iot 1 ae in lieu{,of; the d. required 10--'f eet The 9 .fdbi measurement begins!,from..the outside c£ ` your:.stone surrounding fihe: pit.' `V The s stems m 4: y ust. consist •of a 100 ,.gallon :septic tank, :distribution r box and i©00 ge I an :6 x^,a. atone» acl ed aaleach3ng .pit All other provisions''o Ti,t1e V" of-the State 'Environmental .Code- and Town of".Barnstable healthyulatonapply ' ;This variance expires, November.,l,' 1978. " T. Very trulV your's' r be L C rt -,� Child �- s Chairman A `Jane hbaugM nn . aW .-Mafidelstam, BVARD ,OF L�FJL'ii.'1♦�,+'e ; R. y i rs Y «:ic - - . y Ye�c ccs MrFrank' Jakli.tsch. w, 5 r t.r Y '.t� ,✓ r { + r�. � r + .« r '.'! ! i z ,r .� ,, '` ,-a r « .r Y _i �R�Y .x4 as:j t• `- -+, 4` ! o-, urc ; •.-� � .. • _ , F y L: - Telepnone: 432-0530 ROBERT B. OUR CO. INC. CESSPOOL BUILDING — CLEANING ALL TYPES OF MACHINE DIGGING GREAT WESTERN RD. NO. HARWICH, MASS. October 13, 1977 Board of Health Barnstable, Mass 02660 Frank Jaklitsch 19 Old Stage Road Centerville, Massachusetts To Whom It May Concern: We request a variance to install a pit 15' from the house which will leave approximately 8 or 9' on the sideline Mr. Paul Murray of the Board of Health has seen the problem. Enclosed is a sketch of the work proposed. Respectfully submitted for your consideration. ROBERT B. .OUR CO:, INC. � J William Fisler Forman WFihfs �5 00, Jt 0 A')J ALL 0 ,;4 lip �-� d�S lid ".. . � ,� i o 6 G� VN nty 44 T'