HomeMy WebLinkAbout0005 CHARLOTTE AVENUE - Health Z"
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THE COMMONWEALTH OF MASSACHUSETTS
x BOARD OF HEALTH
Town of nstable
............... ........................
App iration for Disposal Works Tonstrnrtinn famit
Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal
System at:
5 CYarlotte Ave ., Cotuit, n 02635_--••-___--•---
Gar O'Neil Location Address or Lot No.
----•-y ....----- ?..C haxl otte Ave.:.,...C of uit x 026 .5.............
Owner Address
w A & B Cesspool Service, Inc. 128 BishopsTerrace,__.Hjannis,�•_MA 02601
a .....------•--••--•------•----•-•---•--------- ------------•-•----•-•-•-•-•---•.....-•----•--•-- ---
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms........._.................................Expansion Attic( ) Garbage Grinder ( )
p4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures .........................................
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 ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
fT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
----------------------
-----------------
•.......
--.--••-•----.-..........---------
•-------
---
-............
-......
-.--------
•----------
••......
0 Description of Soil...........Sand.......................•---•---.......----•--•-----•--•---•----------------------------------•----......•------•••---•-----------•-•---------------
x
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UNature of Repairs or Alterations—Answer when applicable____inst 11a i.Qa._Qf.-a-..I.,000..gal1Qn_,...pre..Cast,
stonepack_ed_-leach_.Pit---overflow,)'-----------------------------•-••------------------------------------•------------------------------•----------•---......
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLL 5 of the State Sanitary Code—The undersign4h .
ees not to ace the system in
operation until a Certificate of Compliance has been issued by the board o
Signed ?%�' --.---•-----���2 84..
Dats /
Application Approved BY ---------------------�
Date
Application Disapproved for the following reasons:---•-•---------•----••-•-------------------------------•-----------------------------••------•-••------•.••--•-
------------------------------••-----....-•----•------•-------.....•------•----..........------..._....-•-----•-------------------•-•--------•---•••----••---------------------•------------•-•---------
Date
Permit No.---� -•--•-----•----•---••--••-...----•...•---•--. Issued_..........7/12�84
Date
e -
No...... a
.,t�...�Q. FEs...�..1500.._.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.....................Town--.of cxnstyble.................................................. ..........
, pphration for Disposal Works Tonstrnrtiun Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
Charlotte v Co
Location-Address or Lot No.
Gary 0-'Neil........................................................ •• ._ hsxlotta.-9 �, CDtuit,. �--...Dz6.5.......----
Owner Address
A.. & .. Cessp ool__Service, Inc. .2 _Rg-sy� Te aae.,.._N nnist--?`lg_.__Q2fiQ1._..
Installer Address
Type of Building Size Lot-------------------------...Sq. feet
., Dwelling—No. of Bedrooms.............. ...........................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building .....................__..... No. of persons....__.._.___._..... Showers ( ) — Cafeteria ( )
Otherfixtures ---............---.......................-..................-...............
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 ( )
1.4 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--------------_.........
04 ...............-............................................-................................................................•---••......-------•-•..........
DDescription of Soil.............Smid................................-.........-...............-......................................................................................
x
V ------------------•--•------------- .................................................-.....................................................................................................
W
------------------•-••-----•••-•••--------••••••••••-••••-•-•••---••-----------••••......--•••••••• ................................-........---•-••••••••---.....................................
U Nature of Repairs or Alterations—Answer when applicable.__----Anstallati on...of
stone � ec a�ka__�#.t 1,oxerf1.ow)......................................................................--------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIS 5 of the State Sanitary Code—The undersigned further rees not to lace the system in
operation until a Certificate of Compliance has been issued by the board of he
----------7/12/84
Date
Application Approved By------•--•--•-••-----...........................................-................................ 7.12f
84
Date
Application Disapproved for the following-reasons:---•---------------------•--•----•--------------....----------•---------------------------.........-•-•••.....
........................-..................................................................--...... --------------------------------------------------------------- ----------••--------
Date
84-
Permit No.... .............. - Issued.......... 7�12 . -
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........................TPM.......OF............B. StAbUe...l................................--•--...
Trrtifiratr tit Tuntlifianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X}
by......... ,....IM -1-•12,8-- 3i-slZops---T'err"ei...iz3sBey.m;------w6fo1--•-•---•-------------
Installer
at................5-.C1=1-ott.e--due-•T---0,atult7---VA......0263,J------Cam•-G-'!-hie-U----------•------•-------------------•-----------•--•--------
has been installed in accordance with the provisions of TIZLE 5 of The State Sanitary Code as d c ibed in the
application for Disposal Works Construction Permit No._..__.__.^............................ dated-----------741276 __._...............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU AS A GUARANTEE THAT THE
SYSTEM WILL FUN TI N SATISFACTORY.
7/12/84
DATE..............................................................•--•••••....M.•-- Inspector---• --- •----•---•-•.....------.........-------------•••••--------•-••......•.
THE COMMONWEALTH OF MASSACHUSETTS
i
BOARD OF HEALTH
T mrn.......®F..............Farnstable
No...:`xm ..e FEE.....----.-..1.L90
Dispos t Vorkii TwOntrnrtuan Upfrutit
Permission is hereby granted....... & Cesspool, Se. e.,..�z1e_r-------------•••-•-•--•--•••......----...-••---....••.......---_....
to Construct (( ) or=,Repair ( X) an Individual Sewage Disposal System
at No. Ghaxlotte_.Ave... ...Cotuit,_.. A-._.0263.5-•.n..Qa ..Q':1e�.1.
Street
as shown on the application for Disposal Works Construction Permit No ._: Dated....................7/1,218.:.....
7/iz/8(� ! Board of Health
DATE..............------------•----...........................-•-................7-
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FORM 1255 A. M. SULKIN, INC., BOSTON
O CATION S E W A G E PERMIT NO.
VILLAGE
I N S T A LLER'S NAME ADDRESS
r{
R U I L D.E R OR OWN Ek
DATE PERMIT ISSUED
D A T E C0MPLI'ANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Dhaipoottl Wark.6 Tomitrnr#inn ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
5 Charlett Ave Cotuit
................................................................................................. -------------•-------------------------------...------------------....--------.........-----------
Location-Address or Lot No.
Sandy Dannhauser
......................_...........................••-•-•-•---------------------...---------.----- --.....----------------------•----------------------------------•----...----------------------•-.
w W.E. Robinson Septic Service P.O. Box 1089 Genferville MA 02632
IustalIer Address'
Type of Building Size Lot...........................Sq. feet
Dwelling—No. of Bedrooms..........3...............................Expansion Attic ( ) Garbage
( )a Other—Type of Building ---------------------------- No. of persons............--.... Showers ( ) Cafeteria ( )
0.' 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 ( )
Percolation Test Results Performed by.................................................•........................ Date........................................
�-4
,_� Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water..-.-..-----------------
(i Test Pit No. 2................minutes per inch Depth of Test Pit--..........--...... Depth to ground water........................
------------------------------------------------------------------------------------------------------------------------------------------------------------
Descriptionof Soil sand---------------------------------------------------------------------------------------------------------------------------------------------
x
U ----•-------•-----------------------------•----•---••------------------------------------.....------------------------------------------•---...........................................................
w
UNature of Repairs or Alterations—Answer when applicable.....n s t a 11 a. 1 . 000 gal tank (septic)
-••-------------------------•-------------------------------------------------------•--.............----------------------------------•---------•------------------------.....--•-..............--------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syst in accordance with
the provisions of TITLE 5 of the State Environmental Code—Th undersign urt tagrees not to place the
system in operation until a Certificate of Compliance has been ' s d b�b alth. tq� (�
Signed ......��t.... .. ..................... ------------------------------------ ...................
-...........-- ------=------
Date
Application Approved By .......... .: ,,..,,, .................................................................................. .....2..-..(_ l'
Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------------
...... ................................................... . ..........................-
E)a
Permit No. ------ ... �......—. g ..... ......................................... .. to
Issued ------
Date
ti
qq �
..........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratinn for Di_nVv!3a1 Workii Tinuitrnr#inn 11rrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
5 Charlett Ave Cotuit
................................................................................................. ....................-•--•---------------...-----------•----•------------------•......----....----
/ Sandy Dannhauser -`aare55 or Lot No.
......................_.....---•-----------------•--------•-------------------------------------. --------------------------------••-------••--------......--•-•----.....-------------•-------_....
w W.E. Robinson Septic Service P.O. Box 1089 C�'enterville MA 02632
Installer Address
UType of Building 3 Size Lot............................Sq. feet
�.� Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Otherfixtures --------------------------------------------------------------------------------------- -------------------------------------------------------------
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........................................
14
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........................
----------------------------------------------------------•--------------------•-•-----------...•--........................................................
0 Description of Soil...............sand..............................................................................................................................................
x
w
x install a 1 , 000 gal tank (septic)
U Nature of Repairs or Alterations—Answer when applicable---------------.................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syst m in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersign urt `grees not to place the
system in operation until a Certificate of Compliance has been i > by�>h^e b a alth. j� ` 1/
Signed ------:Z ..... ......................................
Date
q
Application Approved By .......... ......... .�_== �.�e..-......�./
Date
Application Disapproved for the following reasons: .... .. ............................................................ ...................
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ........................................
Date
Permit No. L'{ - ... .... .............. Issued ........................ .--------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
C'IEr#ifirate of C�omyliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x )
W E Robinson Septic Service -
h Charlette Ave . Cotut Installer
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. ....C?.y--....... g„c :. dated .___...._.................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.............. - _%... ........ - Inspector-------�--� '� f......
00
------------------------------------------ ------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
qq TOWN OF BARNSTABLE FEE.-30•'-00.
No.....L.!�-.....�.d.3 -• •..............
%yopal Works Tnmitrurtinn Wrmit
Robinson Septic Service
Permission is hereby granted-Y.E.----- -p---------------------------------------------------------------
to Construct e liarftairt&rive Ind id
I Sewage
e age Disposal System
atNo................................................................... ----------....-----------------------------------------------------------------------------------------------------•.-.---
Street �1
as shown on the application for Disposal Works Construction Permit Nof!-_�_..y��Dated......9_-._!7-:Q V..............
L ,-o
DATE...................... •-----...,---------f-� ( ard of Healt h--......----------------•- Lf
FORM 36508 HOBBS h WARREN.INC..PUBLISHERS
TOWN OF BARNSTABLE �.
LOCATION 7 !/`,�P SEWAGE #
VILLAGE )L j ASSESSOR'S MAP 6 LOT
y
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY /0 b 0
LEACHING FACILITY:(type) !b 6 4) T (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER ,q
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: i, •"�����
- a
VARIANCE GRANTED: Yes No
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