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Home My WebLink About0186 SHEAFFER ROAD - Health (2) l gfn seha-e�T-er M., Cent-, No... Fss.... =.:20:.00 W THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable .....................OF............................................................... Appiiratiun for UWpatial Works Tonotrurtiura ramit Application is hereby made for a Permit to Construct ( ) or Repair ]�X ) an Individual Sewage Disposal System at: 186 Schaeffer Road Centerville -- -------------•--_ .----•----.......---.........--_---......----------......__.......------...... .....................-................................................................. Location Address or Lot No. Lo . ..........--...................................................................................... Owner Address W J.P.Macomber Installer Address d Type of Building Size Lot............................Sq. feet Dwellings No. of Bedrooms...................._.......................Expansion Attic ( ) Garbage Grinder ( ) 'C14_l Other—T e of Building No. of persons............................ Showers — Cafeteria P-4 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-----..--.-------.---... f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ P4 -------•-----------------------------------------------------------•--------------------••-------•--......................................................... 0 Description of Soil........................................................................................................................................................................ xSand & Grave 1 ------------------------------------------------- U - W VNature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- ----------------------------------••------•-----------------------------------•----------------------------...---- 1--1.....0_-q a.....o n---p i t Agreement: V The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 1•1---� the provisions of TT.T t IL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b� n issuedaby and o h�eaA.,/ 1/4 . Date Application Approved By....... -•------------------------------------- Date Application Disapproved for the following reasons:.............................................------•---------•-----------------•-----------•--•----.......-•--- -----•--•••---•--------------------------------------------------------------------------------------------........_....•-----------------------------------•-------------=-----.... ------------. Date PermitNo.......... -------------------------- Issued......................................................Date FEB....� . .... ��. .�t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiou for Disposal Works Tomitrurtion Urrmi# Application is hereby made for a Permit to Construct ( ) or Repair T ) an Individual 'Sewage Disposal System at: 135 SciLae1.far R a a d Centerville ................__......-..................................................................-... ----...---..._..---------••-•----------......--•------•-•--••-----._........-•--------••-••--•---- Location-Address or Lot No. Lon i�4_t��r .......... .......... -• ............................................... .........-----------•--•-••-----------•-------•----..............----•-.._.._......--•---•--••---- Owner Address W J. :).MacUn1 Fez Installer Address Type of Building Size Lot............................Sq. feet DwellingYLY 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—'_\To..................... 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. 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-.--_______-____..___--- ------•--------------------------------••-----•---•-------......--------•---•---.........------......----........................................ ------- 0 Description of Soil.................................................................................................................. --------------------------------------------•---•--- r. _ -----------------------------S...�-� � ,... �<..1 W ---------------------- ----------------------------------------------------------- ------------------------------------------------------------------------•-------------------------------•---•...---- V Nature of Repairs or Alterations—Answer when applicable.---_-_---------------- -- -------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f'tT�-IzI^ the provisions of 'T: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n issued by e and o"heal . Signe •------•-------------------- / ^Date ApplicationApproved BY . ----;;:.. �--------------------•--•-•--......-•-- ........................................ Date Application Disapproved for the f ollowing reasons---------------------------------------------------------------•-----------------------..._......------.....----- ---------------------•-------------------------------------...------------•-------------....------------•---------------------•-------------------------•------------•----- ............................ Date PermitNo.--------- e kv =-------------------------- Issued....................................................... L THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Ti own '?itrtl.,i:ab1e ..........................................O F. .................................................................... Trrtif iratr of foot fi �crr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ^ by..............j..........:.f din e r 166 v tip` �: �ri'7L" \oc7c? C '1' nsta6ler at................................. 1-•-••-..............•..... 1 ......i i has been installed in accordance with the provisions of TI T E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.............. _�_�__.X:.r�-:_... dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................................................................•--------_._.. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ...........................................OF..................................................................................... $ 20 .00 NO.........��^. Disposal Works FEE........................ �uu��r ion �eroti� J.P.Macomber Permissionis hereby granted.........................................................................................------------......---------.................--.-•--- to Construct e ai>r J I d uidual_Sevs'a .e Disposal System s . 1 So L - r h �� t��.1L, r v19,1 P Y atNo............................................................................................................................................................................................... Street as shown on the application for Disposal Works Construction Permit No....�,/___XS_Dated.......................................... ---•------------------•--...............--- Bo of ,alth DATE-----•----------------f-----•f-3---•- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS r