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HomeMy WebLinkAbout0066 JOYCE ANNE ROAD - Health 66 JOYCE ANN RD, CENTERVILLE A= cX O� 03- o o 6 rd. N0. 1521/3 ORA dm� 10% I TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME Riverside--.ns t ADDRESS 66 Joyce Ann Rd VILLAGE Cent LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: 6/22/87[YPE:Sjteel. Rear of Building 500 OR CHEMICAL #2 Fuel oil (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 6122181 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: __ 6/22/81 TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS APPROVED Barnstable Omorvation Commi-ssiod Gfi cc^ fit"/ Signed fbate ' TOWN OF BARNSTABLE ' UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME ADDRESS ze2, i VILLAGE LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS A P P R O V E D 8arnsta�Ie Conservation Commission Signed Date Fss.............................. THE COMMONWEALTH OF MASSACHUSE4Tr,,., BOARD F HEALTH //,,,, ...........................................OF..... `1-------1' ......................... Applira#ion for UiupuoFal Vorkg Tonotrnrtiun Permit Application is hereby made for a Permit to Construct (16, ) or Repair ( ) an Individual Sewage Disposal Sy tem at ..-`_`-' - - .......... O?,,�tion.. .. • --..__... .. .......................................�L - ................................. �•_---......�.j _..—. ^ -•--..�---°------..... _ r= t .........../ . ............. ��t! o.......--•---............................. Own ddress ! '� Installer Address UType of Building Size Lot...__.. ....�_______.._._Sq. feet Dwelling—No. of Bedrooms... .:....................................Expansion Attic ( ) Garbage Grinder ( Q a44 Other—T e of Building No. of persons................ YP g ------•-•-•---------.-•..--- P ------.-.-.- Showers ( ) — Cafeteria ( ) dOther fixtures .........................................•--•-------•-----•--•-•-------••----------------- --------•---•-••••...----•--•-•-•--......------•--•------ Design Flow.......... �.....................gallons per person per day. Total daily flow-............. ................. Ions. W // WSeptic Tank—Liquid'capacity!- ..gallons Length................ Width................ Diameter-_._-i__..... Del th_. ............ 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 k Percolation Test Results Performed by..... L_ � ..?--................. Date...�l.%.f W Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.....................__. r4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -- , - h -- ----------- ------------- - O Description of Soil.....O 7 -- -! �. r`Q l - - -- -- --- - V --------------------------------------------------------------- ------------ -.................................................................................................................... W UNature of Repairs or Alterations—Answer when applicable- -----------------------------------------------------------•------••-----------..........---....... ---------...--------------------......---------------------•----•--.........••••---•-.......---•---- 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 is by the b of Signed........ ....................----- ............. .......9.07 Day,��� Application Approved By................ =- =••-•-•-�--/ .. ... .........•-•--•-•--•. 5. .............. Date Application Disapproved for the following reasons:---------•--•............................•-------•-•---•------------•----------------------••---•----•-•-------- -----------------------------•-------•---•---•-------•------...-------•--•-----------------•-----...-•---........-----------------••---•------------•--•--------•------------•-------•--••--------------- Date PermitNo......................................................... Issued....................................................... Date FimB THE COMMONWEALTH OF MASSACHUSETTS r; BOA RDr OF HEALTH Appliratinn for Disposal Works Tonstnutinn Prrutit Application is hereby made for a Permit to Construct (!�) or Repair ( ) an Individual Sewage Disposal System at G� catioA�re s� / Lot N . Y Cel"li Own ddress Installer Address Type of Building Size Lot..l feet 1—, Dwelling—No. of Bedrooms.. J........................ .....Expansion Attic ( ) Garbage Grinder (dip. p.1 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures ................................................. Design Flow.......... .. ......................•..gallons per person per day. Total daily flow.............�U co . ........................gallons. W 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.._//•/f"_ i••• .•._•_••.---. aTest 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........................ R+ = = = =':.....--...-•--� -----....... A o Description of Soil © .............................`/--n-j -',I /I �� � �=/� 61el .. . ................••••••-•-•---...........•- U --••--•------------------------------------------------------------------------•-•-•......-----•-•-•- W ----------•.....•-••••---•--•-----•-•----••-••-•......•-•••--•---•••...-•-•-•--•----•••.....••••--•---••--•••-••-------------•-----•---•••-•......•--•------•••----.................................... U Nature of Repairs or Alterations—Answer when applicable.....................................................................................•-..•.___- ---•-•-•.....-•---•-••••--••-••--....•-•••••-••......................••------------•.....-••---•-----•-•--•--•••-------------••--------••--•-••-•••••-----------------••--•-••--•-----•--•-•--•-----•••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of-TIT11 5 of the State Sanitary Code The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss ed/by the b• —d of , Signed--------- . ` ---•-------------------------------•-•-- Application Approved By......-•••-...• ........ J/ _� . .................•.... ......� ................ / / Date Application Disapproved for the following reasons--------------------------------------------•------------------------------------••-•--••-••-•..._.....-•--••-- ..................••--••-••---•------••••••--•-•--•----•-----•---•••.....-•••-•-•------------•-•••••----•-••-•••----••---••••-•-••-••--••--•--•--••-------•...•-•--•••---•----•-•---•--••...••---------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................O F..................................................................................... Tatifiratr of Tomplianrr THIS ISTO CERTIFY.,That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ¢ t r c b r� by----------------------------------� ••-•.._.._........ -•--•----••-----•---••---;•••••--•---•-------••-----•----- .....-----....---•-------•--•----•-•-•. has been installed in accordance with the provisions of TILE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.r ....J.Y_5.............. dated........................................._....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................. —...5 d Z Inspector.....- ��`. ................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH�� No_ ✓.................. FEE........................ Disposat Works. Tn 19trnrt' it it r.r � �..."._.__.... Gv'i Permission i hereby granted . ...-••--••---------------•-•---•-••--•-.........................•---- to Construct L ) or Repair, ( ) an Individual ewageaDisposal Syst, atNo..� .... .......... (f?t/1 ..............••. ✓!/L/_.. ................................................................ Street as shown on the application for Disposal Works Construction Permit No..................... ............. Dated.......................................... -I r............ � a �-Weaith-- ---•--••--••-------------- B. of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS S1+. aLEra��.A�Mtt.mil! r 3 8meoa�K UO L>.t W FLAW = t Ib x 3 3�b G.t�'•D. .Cl t=r-t IG T4"V- 3 O,r F5C % • 495 6.f?D. U Ste- t o00 c-,A L... ..,UG ALL AV-EA - 1So s.t;. 1�w SF -c 2.S • S715 so S.PD. M Z3 � ¢ 4ND, TOTAL -C>S6l6w Pr--rlGDLDTIOLj C2laTE [ t�.l !4t tJ OQ LAY,. o 1,81 f�P � Ir 96. � ,t 1 �, p4Stt n y�, �r Alt9 f f L-w-L ` ,reef "�� ay ,5 it.tEms. VV !!X? 4. • Q °P.o� iuv.• 97p / 1Oa0 IUV. ,A p -Pox9G•G Sc-+�nc ...: wv -I a►1k ' P t000 9�.0 (WV. 944 Irw LAN Spy PIT Whit c. 40 WAS+-lE'D CEQTt1=tEt7 pLbT- PL./�� L OCA Tl o t-! ''�!•Z:'G /2� ►..t o S.c A,�.�- �G.A L - �1�� �C.� t�•AT� '„$��� � fJo LUaT('z lI { CMIZ'rIPIq T1-4AT T14r-- �nv��"fvrx� 5wc> w PLAt.I REG'c�'ct.tt:E ti••lF:l.L-OW CC>,rV%PL`!S W t'T I > `i'1-lam �j1 Dt`.1.1►-3E- A1.t� 5C't"�,�CIG {'GQUl�EMtGi.tTS oG Tt-�C;. ju. - 9M-6 5t''c_iZa•� LAWD 5UZVayc)Q- = TI-415 PLAW 1 l�- EJOT ZAScv 0�4 pN OS?E2V1Li.G o tiCAsS, IIJSt'L:1.'�lC,t.iT ;ut_vt 4 Yuc: i3Ft=�, t'�, 15440WLD n�c?l l GAt�.!"T' tr.k:v CM.1 U'r,Gi- r�) t�C'1 LC'.MI�lL LDT t_twaS i I LOCATION .� I, SEWAGE PER 0• VILLAGE r t/ I N S T A LLER'S NAME i ADDRESS YC I U I L D E R OR OWN o /z: / _ DATE PERMIT ISSUED DATE COMPLIANCE ISSUED i jp / 3 k