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Home My WebLink About0878 SEA VIEW AVENUE - Health �q 0- THE COMMONWEALTH OF MASSACHUSETTS AaOM BOAR® OF HEALTH C�C='X:::!= ntTOWN OF BARNSTABL.E , l�ir�ttt�:` �-�i►�.��t�u1 �i �rk,� Cn�gt��r�r#inn �Ce�uti� Application is hereby made for a Permit to Construct ( ) or Repair (—I an Individual Sewage Disposal System at 4 .. --•---------------- ---------•---------------•----....-• ------•-•------------------.......-----•••.....----.--....----•-----•-••-••----........•-•...•---• Locat ion -:\d ryys or Lot No. Q. M owner Address a ........................................ l 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 ( ) 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. .................... Wialth.................... 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........................ L=, Test Pit No. 2................minutes per inch Iml epth of Test Pit.................... Depth to ground water........................ a ----•---•----------------------------•---- --•-------•-------------.._..............._....--------.:....:...--•------...................:..........•--.•---- 0 Description of Soil....-.....................................................I.............................................................................................................. W ----------------------------•-..........---=--......._...•-•---------------------......---- ...........................�...............------ ...... ............................................ txj Nature of Re airs or Alterations—Anse er when applicable---- .T. ....... ...._. Y.. ....................... ° '...S.f C/jr.. o..........----------------------- -------- ----------------------------------------------------------------------- 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 Compliange been issued by t oar ealt Signer........... .......................... ............................ .................................. Application Approved By ......... „a. •• .,c c.wr.... .......................... ............. .....yt&C .'' -,3;--g Application Disapproved for the following reasons: ................................................................... . ............ ........................................ ............. ......................... ........... . ...................... ......... . ............................. ................................. ............-....-------------------. qqDare Permit No. ------/-.-3..7 -7_0...................... Issued .............. --- . �e ,t O �Q • �d � a0 � s rVF _.w.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEALTH TOWN OF BARNSTABLE Xvvliratiuu for Db3pwml Wnrk,i Tomitrurtiun ramit Application is hereby made for a Per mit to Construct ( ) or RCpair ( an Individual Sewage Disposal ..System at: `- I •--------•------------------•----------- ------------- ••--•••-----•--•--••-••-••.....................---•-•-••-•••----••...-------••-•-......---•-•---•- W )// i Location or Lot No. / R. ..- �/ Owner Address •...........•••••---•••........ 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 ( ) dOther fixtures --- -----------------------------.................................................. --_._.......-••••••••-•-••••••••-•••-•••••......-••-••......--•-• W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length_.............. Width---------------- Diameter................ Depth................ W Disposal Trench--:.To. .................... Width.................... 'Total Length.................... Total leaching area....................sq. ft. .x 3 Seepage Pit No____________________ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ tT., Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water..............,-......... I ---------•-------------------------•-------------------•-•-----------•--..............-•--•-.........----...--•--••-••--------........--••-----------.•--••- Description of Soil.. .............................. ..................... W . V ....•-•••••••••••••••--•••••••••••••••••-•...........•••-••......••••••-••---••••••••--•••••--••--•••-•••-•••••••-•••••••-••••••••-•••••---•••••......................••-••••••.................._-•••_. _ W --•-------------------------------------------•--......-------------------------------•--------------........-------- . ... // � --................... Nature of Re airs or Alterations—Answer when applicable.___ -.z. .._____1�........ Y_ .T.._ ._'"'!._.._...•...:......... ~ 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 been issued bye ee>board ofhe�� Signed;-..�..... 7.~ ...�� Dare Application Approved By ........ ....../. I. Dare Application Disapproved for the following reasons: .................................................................................... ... . .......................... .... ....... . .......................... . ................ . ........................... . .............................................. ........................................ Dare PermitNo. ......�'3----...........7.)--------------------- Issued ...... ................ . ........ ---....................... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of (fomplian e � THIS IS TO CERTIFY Th t the Individual Sewage Disposal System constructed ( ) or Repaired ( ---)� by ........ ��.-- .. ............................... ..................... ..............:. at .......F.7---; .............S- A ..zr.�.. .... ----...---. --------------------------- -------------------------------------------------------------- has been installed in accordance with the provisions of TITI.E 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ------��?..-...$7_7Q------- dated --------._.............__.................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE s z. • SYSTEM WILL FUNCTION SATISFACTORY. 1 DATE...........:;:;7 .. -- ..............._........... .. ............. Inspector ............. -7r,' - = ........................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH fi. TOWN OF BARNSTABLE No......��.:.-1� FEE..3C�............ Dispaoul Vork,5 Tonotr ion ";Irru if Permission is hereby granted..................... --•---------••-'--•-----••-•---- to Construct ( ) or Repair (�" a_n Individual Sewage Disposal System at No.- 7t jO v C v� S i, ---------- street 7 as shown on the application for Disposal Works Construction Permit Noq-2 -----__ Dated.......................................... •-•--------------------• •�--:- .......................................................... qc� DATE............. - Board of Health FORM 36508 HOBBS R WARREN.INC..PUBLISHERS, TOWN OF BARNSTABLE 6� LO': ATION F/7 5� Ai//Zdlc) l SEWAGE # VILLAGE�s�c 2U1 Cf� ASSESSOR'S•MAP & LOT INSTALLER'S NAME & PHONE SEPTIC TANK CAPACITY Z vim® LEACHING FACILITY:(type)l2 F"5� �� (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER ' BUILDER OR OWNER DATE-PERMIT ISSUED: 2 15 DATE COMPLIANCE ISSUED: `" VARIANCE GRANTED: Yes No -!�! r _. �,s !> t; _�-_ --• �� I � ^ � � � � � � o �v 3�� ° � ':. � __ � � CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT 1875 ROUTE 28 CENTERVILLE, MA 02632 (508)790-2380/FAXO(5O8) 790-2385 OIL/HAZARDOUS MATERIAL RELEASE FORM F.A.# ju nrm LOCATION: ADDRESS OF RELEASE:. 070 SRAMIEW Ammm{ ! SMZRQTT T R GATE OF RELEASE:- wwwam PRODUCT RELEASED: mm oxi ESTIMATED QUANTITY >��SAlOtiN CORRECTIVE ACTION TAKEN BY RESPONSIBLE PARTY• PR®PFR NftTTFT['.ATTM'T-q NOTIFICATIONS: FIRE DEPARTMENT: YES(M1 NO( ) DATE- 0411106 TQ'•IE• ]nhn NATIONAL RESPONSE CENTER YES( ) NO(" DATE TIME: DEPT.OF ENVIRONMENTAL PROTECTION YES( ) WX( DATE TIME: ' • OIL SP ILL COORDINATOR: YES( } NO(a) DATE:-TIME: TOWN BOARD OF HEALTH: YES ) NO(� DATE' o/>> /ate TIME: l ni n TOWN HARBORMASTER: YES( } NO(o) DATE TIME: OTHER AGENCIES: COMMENTS ON LOCATION AT THE REMMAT, OF WHAT MEARS TO BE A 750 GAT. ,QX iT MERGEOTMD FIEU, OIL TANK_ TTPnN REM=- TT TEAS NOTED THAT TANK HAD WHAT APPEARS TO BE PRODUrT AND WATER 1,0CIATED ONI THE BOTT014 OF THE TANK. ALSO NOTE) WAS A 1g0l E APPRORTMATF.T.Y THE SIZE OF THE DIAMETER OF A PRKTCTT._ SnTT•AT.SQ APPEARS TO HAVE OONTA1rIIMIOM PRESENT TOWK ROART) OF HF.AT.TH NIOTTF ED. AND REMOVAL COI,ANY TO FAKE nTHER PROPFR NIOTTFECATTONTH, REPORTED BY' tom �t✓��Y1��J° i�C HATE: 9/1 I /Ati WHITE COPY-FIRE DEPARTMENT YELLOW COPY-D.E.P. PINK COPY-BOARD OF HEALTH Y C-O-MM FORM #58