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Home My WebLink About0028 PLEASANT PINES AVE - Health 28 Pleasant Pines Centerville A=234-013 I SMF.Adj No.2-153LOR UPC 12534 amead.com • Made In USA mmqi� i i No... q.► THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphration for Diopo ial Workii Tonitrnrtion Famit Application is hereby made for a Permit to Construct ( ) or Repair (< an Individual Sewage Disposal System at: Location- ress or Lot ..�i4'a .......................................1I ----- ------t-••--......---•-•-•--'-•-�'✓. A...t�.........--------- Owner Address a �-� C✓�- ou1 y, C �.t 7(�� l,tl,4-1�.'$"f f...............................................` .................................. .....•--------------------------•-----------•- Installer Address Q Type of Building Size Lot............................Sq. feet U 113 Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pi Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a Other fixtures --------------------------..--..._..--------------------------------------------------- -------------------------------------------------...--------- W Design Flow................v��.J..........____gallons per person per day. Total daily flow............ 9.....................gallons. WSeptic Tank—Liquid capacitylQPP-.gallons Length._............. Width---------------- Diameter-___._-_---.-- Depth................ x Disposal Trench—No. .................... Width........t........... Total Length.................... Total leaching area....................sq. ft. � Seepage Pit No---------- ------- 40....... Depth below inlet___.�v............. 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..................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.-____-_.__________- Depth to ground water........................ 9 --------------------------------------------------------------- ---------------- •------------------ ••----••...... •------------------------- •-•--.............. ODescription of Soil....................................................................................................................................................................... x U ....••-••-•-••-•-••-----•--•••••••----••-•••-•--•••••••••••-•---••-----•---•-••--•-•••••••••••••---•••••••••-•-----------•-•-----••--••-•---------•••...••-••••-----••••••............•-••••••••••••••••. UW --------------------------------------------------------------------------------------------------------------------------------------------------------------------• ---- --------- ------••-- Nature of Repairs or Alterations—Answer when applicable._.. iJ:S' 4-1 .. .. --_____�.U00 (' . ...nZ --' 1........ - �,�� / LOB!¢ 1 "` Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h�bened tlye9board of health. iSigned ................. - .................. . .... Dace ApplicationApproved By ----------- _j................. ............................... -------1 Application Disapproved for the following reasons: .....__.........................................---------------------------------...-----......--------------------------_--- .......... .................. .......... ............................... . ..........._....................... C, Dace PermitNo. ------------------- Issued ------------------------ --------------------------- ------- Dare r, TOWN OF BARNSTABLE LOCATIONc:)oa �/ �'pn9G ;%vRS' SEWAGE # YV 66 VIL LAG E� ASSESSOR'S MAP & LOT D/3 INSTALLER'S NAME & PHONE SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ll'� 'D� C /) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER O 00��NER"__ ,6 f�% DATE PERMIT ISSUED: Z2 41-9v DATE COMPLIANCE ISSUED: m` 57 `-7 VARIANCE GRANTED: Yes No -�� < ,��'% 9 ,ti � � .. � a �k THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Tontyliance THIS IS TO CERTIFY, That_ti Individual Sewage Disposal System constructed ( ) or Repaired by ................................................................... U/U� -40—'7T'1..------- ----- l/�vs'?L..�'it...:J ..................................... ..... Z:lc at ------------- ---------------- ---- -- ------------- ------/----------- --------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .... ... —r --6--4-7----- dated ---- b^ --9._c.�/'y-------- PP P Y THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR NTEE THAT THE SYSTEM WILL FUNCTIONSATISFACTORY. DATE------- .. !. '...../f.... - .........} `-------------------- Inspect - -------------------------------------------------------------------- ----- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH q TOWN OF BARNSTABLE No....(. ..-. .7 FEE............. ......... Disposal Workii Tun.o#rWivu Vamit Permission is hereby granted.............. .... Ui _�J [tl 7T7NS'. to Construct ( ) or Repair an Individual Sewage Disposal System at No.... s—> '. 4!� .......:`._..... ..rv�r. --------C.......`�./�-u�c �.� Street as shown on the application for Disposal Works Construction Permit No.?V_.667_ Dated_____(_- •............................•-i_j• f ............................................... `/ Board of Health DATE.......... ....-- -�=f............. FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS ' 14 ' r No....(.. - ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE AvOratiuii for Diirivnutt1 Workii Toutitrurt"inn remit Application`is hereby made for a Permit to Construct ( ) or Repair (--*'-) an Individual Sewage Disposal System at --c� F ;'-1. &4-.:S'A,-rT"_ �)N L Eire/ t ...........................................................•------•--•--.......------..... --------------------------•-•••-•-•-•--f.................................................. Location•Ad�res or Lot No. s w(�......................�. ..�� --•�•r-.•3--_---"-"------•--;- t , --••�......�......•.......... .................. v Owner i LL Address . C6,vs ' M , /Y l -------------•-•-•••---:•.••-•••-••---•-•- -•....•--••••••-•••............................. -•-•--•--•--------.....•. •---------- _.. Installer Address UType of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms.__---_.--__•___•--•________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons_--_-_____.______---_-_-_. Showers ( ) — Cafeteria ( ) QOther fixturrees.------------------------------------------------------------------------------------- W Design Flow..............._................____gallons per person per day. Total daily flow.......... G---------------------gallons. Septic Tank—Liquid capacity/-UP!�._galIons Length________________ Width__.._-_____--___ Diameter---------------_ Depth---------------- W Disposal Trench—No. .................... Width-------------------- Total Length.._____-.-.�_______ Total leaching area....................sq. ft. Seepage Pit No.___-___-/........ Diameter.......410------- Depth below inlet----�............ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..............................................--------------------------- Date........................................ Test Pit No. I___.___--_-___minutes per inch Depth of Test Pit____________________ Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-_-___-_-__.___----_ Depth to ground water........................ W •--•------------------------•••••-••••--••-•----•-•••--•••••-----••--•-••-••••......---.....---••---......................................................... O Description of Soil........................................................................................................................................................................ W V .....•-••••--•---•--••---••••••••---•-•-•---•-._...------•-••••••--•...--•-•-•••-•••--•••••--------••--•-••-----•--••----••••------•••---•-•--•-•-••----•------------•-•••------••-....-•••••............ W - ------•-------- ---•------------•- --------------------------------------------------------------------------•----------------- ............................................. - Nature of Repairs or Alterations—Answer when applicable.__.- sT \ -A- ...................../ UOU�v.� ryL 5 ............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n i ued 'y t e7board of health. Signed ..... ............ ..... �/ ..� . Dace Application Approved By .............� - .t �.,�.,,�..........------ . ------..//�.. ._- 1 .....-'—'--'-------.........-'-----.................. Dace Application Disapproved for the following reasons- --------------_-----------------------------------......._........--------------..........------......---------------------------- .... ..... . ........................... ....................................... . .................... . . ............-------------------------------------- ........................................ Date Permit No. ......J� -^....... -6_72................ Issued ........... Date