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HomeMy WebLinkAbout0123 PLEASANT PINES AVE - Health R 123�P1easant,pines Ave: Centerville •A 233 — 05:7 S M EAD� ft Z40WR UPC In$4 smadmm • Mob In USA LOCATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER''SS�//� NAME i ADDRESS c BUILDER OR OWN_ERR//` Gr DATE PERMIT ISSUED DATE COMPLIANCE ISSUED )r:/Ro►�!' i rrAA� 7 Nd 80 j Fizs$...5..00............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ....................T own............O F................�S-Iable---------------------------------------------•- Appliration for Bi-4paa al Workii Tomitrnrthin Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: 123 Pleasant Pines Ave., Centerville, MA 02632 ................_ - ..........• ...........---•--....... .. --- ---... .....-- Location-Address or t No. Timothy Conley.-• _ 123 Pleasant Pines ve. , Centerville, MA 02632 •-•...... ..................... .................................................................................................. Owner Addr s W A & B Cesspool Service 128 Bishops Terrace, Hyannis, MA 02601 Installer Address Type of Building Size Lot----------------------------Sq. feet Dwelling.—No. of Bedrooms................. .... Attic ( ) Garbage Grinder ( ) ! P-1 Other—Type of Building ............................ No. of persons...... ................... Showers ( ) — Cafeteria ( ) PA 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 ( ) I . PercolationTest 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........................ R; ---------------------------------------.......... ................................ :.......... ODescription of Soil-----------S�---•-•----------------- ---------------------------------------•--_------ x ) U ••-••---•-•--••----•••------•--------••--•••------------ ---------- = j/ W ----- . --- .:. UNature of Repairs or Alterations—Answ when applicable.__installation.-of-a-_12000-._septic tanks 1 distrihutmQn_.box.. ns 3 l awsll us or ..p.aG ed with e =-..*:tq. .................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT LE!, y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the board of health. Sign , - -=Tdi� 4�k8 80 Application Approved By....... .__ _ �r .,.................... a ----- ----------------- Date Application Disapproved for the following reasons:.. ------------------ ------ --------•-•-----------------•-----------------------------------•--------•-------•----......----------•------------------------------------------------------------------------------------------------ Date Permit No.. 80- Issued...4/18�80.................................. Date { t T' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF................ .------.-- Aplilira#ion `fox UhnpwiFal Works Toustrurtann ramit Application is hereby made for a Permit to Construct ( ) or Repair O an Individual Sewage Disposal System at: 0, ftntet i ee---IA--- 0263?1... ......................................... ........ .................... Location Address or Lot No. ......................................... ................. 3_ L.. a .1#tT �.,... t`Qbi@ Y o.._ A 09632, Address OO�wner, g0� q�,{�/p,�p� ! �yy�p� [� rA,; W N_. $J -xs7�8 V-dSVw+.•..................................... 3. 3dCd t3..�a� }.. fi8sl ��... ..._.Q?hQl-. Installer Address Type of Building,( ; Size Lot............................Sq. feet U Dwelling-'No. of Bedrooms.......................3�....__.....___.___Expansion Attic ( ) Garbage Grinder ( ) g p _•__--______- Showers ( ) — Cafeteria ( )Other—Type of Building ............................ No. of ersons________�____ pa ._.... Other fixtures -•----------------------•---......---••-••••-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. R: 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 ;r z Other Distribution box ( ) Dosing tank ( ) a Percolation Pit Test Results sults minutes p Performed inch Depth Of ' Date. Test Pit.................... Depth to ground water........................ G%, Test Pit No. 2................minutes per inch Depth of Test Pit............_....... Depth to ground water........................ 1 Descriptionof Soil............•'ate w -•---- ----- ------- r ........................................................... ... : x Nature of Repairs or Alterations—Answ when a licable _ Agreement The undersigned agrees to 'install the aforedescribed Individual='Sewage Disposal System in accordance with the provisions of TTTLE, 5 of the"State Sanitary Code— The undersigned fuarti er agrees not to place the system in operation until a Certificate of Compliance has b en issued by the,, rd ealth. Sign .=� ----- -----_. .... .f ate Application Approved. BY ; .- Date Application Disapproved for the following reasons: •---------------------------------------------------------------------------------------- ......................................................................y........................ ........................................... Date - � � Permit No.......... ..... ......•--...................... -------...- -------.: Issued_- ------•-- -------...................-::_......__. ' Date THE COMMONWEALTH OF MASS CfiUSETTS BOARD OF HEALT .,......T.4.P.1%...OF....... ......... ................................. `j Trdifiratr of to 11 aaarr THIS IS TO CERTIFY, That the Individual Se"wage Disposal System constructed ( ) or Repaired by---- ...^7 �6?6 ______ Installer at.......12.3..�'1 31t.P11.0s..AY0. "4...QentleC:suls.9:'.19 _._.026 ...m!T 't'3:.tre y..G=Uy---------------------------------- +} has been installed in accordance with the provisions of 'I'I t LE yr� he State Sanitary Code as-,described in the application for Disposal Works Construction Permit No----__8.Q_m_t ._.__.._ dated---------- W-80_____________________ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT'EE CONSTRUED AS A GUARANTEEITHAT THE SYSTEHA 1AlILL FUN ION S ACTORY. Y le _.....DATI. ,/2 j :.......... Inspector ..--•-.. &^-_ --_................................ . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 80471.., wn...........OF..........P tab. ...------•-------•-•- . ...... 44.: .................... ... No........... ........... FEE.......... �Qfl .. Permission is hereby granted.. y---HyMnle,-._�Y�.,A....02601 to Constri (p1�or R a n Indi du 1 Se , e Dispos ,zf sax► ss eve.., 'exierv` ta�, T �ty Copy atNo........................................................................................................................................................... Street l� s as shown on the applicatio for Disposal Works Construction Per • Dated--_-_ � ® ................ 0 4 ..'? ............. .p �^' .... ...�......_... __••__.... ...4 �}� / Board of Health DATE................................................................................ 1 FORM 1255 HOBBS & WARREN; INC.; PUBLISHERS - -, P�auC No TES 1/2" I,P.� ---.. 4'O '`r ,%ts�pE�, 1. TlflS f'C;a,^i L,'A;� BEEN PREPARED (FD.) L = 150.22 - `+ TO SHO LV Ilf ONUA4EN TA TION FOUND R = 831.32 D.H. 'Alr CON('- = �4.69 -i � BU. (FD. ' AND SET ;iV THE SURVEY AND TO L R = 4. 03 ACCUR14 HL Y' SHOW THE DWELLING IN REL.f. T,,om TO THE L O 1' LINES. z CTR. DISK Z 5' off IN CONC. LINE 2. ALL OFFSETS SHOWN ARE MEASURED BD. (FD.) TO Co; Ir- 1130ARDS. b � rENr��s COURT 3. IVETLA/v'!), EXIST 01) THE PROPERTY, AREA FENCE BUT hl l t E NOT BEEN DELINEATED 1. 47 ACRES I OR LO 'AF D IN THIS SURVEY. 5.3' OF` LINE q • �z v 2 STORY W000—FRAME DWELLING -20.0 � C IRON ,4'ODS I a SE r �-72.4 i O lvDOO O m DL L.f Q of Q �t y O 4: O.H. IN CONC. moo, BD. (FD. PZA_i?,S'E'S P0)\/'lJ D.H. IN CON BD. (FO.) ROSE D.M IN O.NC. VANCURA BD. (IfP I CERTIFY TO ED WARD SPINDEL THAT THE DWELLING SHOWN HEREON IS LOCH TEO ON 1,VE GROUND AS SHOWN ,AND THAT IT CON- FORMS TO THE DIMENSIONAL REQUIREMENT.5 Of- THE ZONING BY-LAW OF THE TOY4'N OF BARNSTABLE WITH REGARD TO FRONTAGE,; PLOT Flu` j AREA .AND SETBACKS A T THE TIME of CONSTRUCTION. of LAND IN BARNSTAB14 . '...ASS:. 1 PREPAREI? FOR 5CA,'!E 1' = 80' A 116'E'S7' 12, 1991 �R RE OF I D SUR VEYO,R J'C,HN' GILBERT DICK P B.S.