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HomeMy WebLinkAbout0005 CHARLOTTE AVENUE - Health Z" -J, ....�a11-.. Fes$� ,�. .� .-. 15.06"No 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 w 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- J 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 ^�x:rt_._. ___ V � f . e `,�� ;,.� ' ` "�,. ��' � -,� ' � Y d ��/f /�/ ,- � ' •�J .r � .� ` j�' It' � ,` •i ' a. � s .i 1 *,� � ~ No..7... Fis... .Q....Q.Q.......... 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 V y 1 . 1 ,�