HomeMy WebLinkAbout0079 PINE LANE - Health i e
LO;C AT ION SEWAGE PERMIT ' NO.
77
VILLAGE
INSTA LLER''S NAME & .ADDRESS
17
42
BUILDER OR OWNER
DATE PERMIT. ISSUED 7 -77
DATE COMPLIANCE ISSUED
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LOCATION77:� EW&C,E-PERMIT UO.
Joseph P. Macomber & Son Inc. �44&:L,—
Cesspoolsumping-Building-Repairing
Trenching- Septic Tanks- Leachfields -- ------
P. 0. Box 66 Centerville �S
- _.51L 775-6412 - 775-333 ---- ----
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_ __.DLQTE-.-P_E- 17--1.55U
• pp 7
_ _ DATE COMPLI D.K10E_. SSUED _
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No...........J�.°2...... Fas.. 5...r���........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Town.. .-...... .OF..Barnstable
.... ..............................................................
Apphration -fear Riiposal Works Tomitrurtion Vantit VX
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
Pine Lane
Location.Address' or Lot.No.
'..Ilr.. -Ai_chard....Zeigler........................................ -Os tervi lle---...Maas.A------••--•-----•......-•.................
Owner 3
a ._Jos.epb_..P.,.._Mac.onber.. Son,....Iag--......... ........ enterville,.__mass'
Installer Address
d Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons-..._-______--_-__-_._--_.__ Showers ( ) — Cafeteria ( )
a' 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........................................
a Test Pit No. I................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 •-----...--•------------------------------------•-•---•----•-----•--•------•---•-•----•--•----•-•---.........................................................
C) Description of Soil------S.and--- _._Q aVe 1--------------------------------------------------
U --•---------------•-------•-----•--•- -•----.............._....._.......--•-----...-----••----•.._.......•-•-----••-•--•---....---------•--•----------------•-----------•--••----•--..--•--------------
W
U Nature of Repairs or Alterations—Answer when applicable.. 9_alion...p t-_...__(overflow-)_:-_-.....
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has en is ued by the board f health. JJ ,,�
Si ed. �--�-011h 444'------ --3/4/7-7-------------
i Date
Application Approved B
PP PP Y ✓ 7-7-----------
Date
Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------
----•--••------•--••---•--••-------•-•-•--•••--•---------------•••--•-•-•--------•----••----•----••••---------------------------------------------------------------------------------------------------
Date
PermitNo........................................................ Issued..................... ..................................
Date
t_.
No............5-2- Fizu............................._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
r;n . r � •., ;
Applirtttion -for BhiVoiial Workii Tonitrnrtion Vamit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
La-r,
•-----•.............•---••-•-------•----•--------------------•--------••••-•------•---............ -•-•--•••-•••••••--•••-•--••••••-•••--•---•••-••--•••----•••••••••......---••-••-•--••----••••...
Location-Address or Lot No.
:. 1^ A.Ss,.ec
Owner = Address
Installer Address
Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
pa, Other—Type of Building ---------------------------- No. or persons---------------------------- Showers ( ) — Cafeteria ( )
P4Other fixtures ......................................................
w Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons.
W. Septic 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 ( )
aPercolation Test Results Performed by------- -- ---------------------------•---•••••••..........--•-•••. --•- Date------------------------------------.-..
Test Pit No. 1--------------__minutes per inch Depth of Test Pit.................... Depth to ground water...._.--._-.._.._--.-.--
�14 Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water.-.____-_---_____._-----
P4 ---------------------------- ------------------•-----•----•----------------------------------•--•••............................. -------------
O Description of Soil.._-_- {}_ r,Y.�.r.�l
fib_"
x
---_....................
w
--------- --
x �17n , r�: : rC =r "ct�l
U Nature of Repairs or Alterations—Answer when applicable..- :-',"r". -.-__-_-_„________________________________-_..___--------
-------------------------------------------------------------------------------------------------------------------------------------------•-----------------------------------------------•-..........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the. State Sanitary Code—The undersi ned further agrees not to place the system in
operation until a Certificate of Compliance has a red, ,thoao,halth ,
------ ---1-Z?'-----------
Si ed- G!.•
nDate
Application Approved By-__2 Lfi ... . ............................. ------.T'7"
Date
Application Disapproved for the following reasons-----------------------------------------------------------------•---------•---------------- -------------------
----------------------------•-------....-----•----------•--------_•-------------------------------------•--------------------------------•---------..-.-.--•----_.--.__--_-----.--------.--------------
Date
Permit No. = ......--•..:.............•-•--... Issued •---==
Date
THE COMMO_1iW%;FkLTH OF MASSACHUSETTS
A-r— w
'A BOARD OF HEALTH
......... ..1.....................................................................
14frtifiratle of f.1'ontpliana
y THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (1'_)
by--•.S,-)" -)-^ P= "Af'nr'�^}� O'• Tn- . '.;Gent,n �-J.'
.•_____________________________n._------_-------------------___-..--...
Installer
at..---. P' -- -.'lc L2.� Os i.Pr- - 11(, ZP 1�r
----------------------------------------•---------..... .......................................... .....................................................
has been installed in accordance with the provisions of . 1� XI of The State Sanitary Code as described in the
application for Disposal Works Construction.Permit No __....._ ................ dated----- — "'?_ ,___._..........._....
" " -EA,S.SUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
.
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enau,.-s"4•_`i7a`.f.�"*;.�w��<_��_.I� .s�..w_x-w R � :.t hY.i�_."• a}. gyt'?t,d.�c..�je0:.-eu'kYs�,ly;.s n'k".3 i=f ww.tea,y. t'7'?rc S� ^.�.i�.
THE COMMONWEALTH OF MASSACHU TTS•
BOARD OF HEALTH
,Qr+� ..........................................OF....................-----------..............------'--..............................
No. ........... FEE. ...........
R_sVasal NorkiiC o �trnrtion rrmit
Permission is hereby granted_jp,__r�r_ P. rya(,o:,'�r ', SO _L 'r
------------------------•--------•-- ----Y---------------- .............................................................
to Construct .( ) or Repair (X ) an Individual Sewage Disposal System
,., 0 r 11 „ ZP r 1or
7 , �s-, L F:f- ^ ,r
at No ---------- ------- -- ---------------------------------.--......----------•----------------------..-._-.--------•------------------------------
Street
as shown
pwn on the application for Disposal Works Construction mit ............. Dated_--. '„7-77......_.__....
= Board o ealth, `
DATE.'".-�_t------------------------------------------------------
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FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS