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HomeMy WebLinkAbout0065 WIANNO AVENUE - Health 65 Wianno Ave nuk., Osterville A= 117 - 118 0 &6) IO/`CATIfjON / SEWAGE PERMIT NO. VILLAGE h ,���Cc�/e'.�'✓"'�fO�, it I N S T AL1LER'S NAME 1D ADDRESS 0 UILDER OR OW ER � . R DATE PERMIT ISSUED '-/a � �'� DATE COMPLIANCE ISSUEDp v No................_....... _ Flms............................_ THE COMMONWEALTH OF MASSACHUSETTS 7BOARD F` FEE LT ........... .L......OF........ ....... ......................... Appliratilan for Dhipos al Workii Tonutrnrtinn ramit Application is herebymade fo a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at:, ................_. .-. . l r ........................................................... L tion- dress ' d Lt No. ...... V......................... .._...---...._ .± --........_ a Address ...." ��C_.. i ...................................... .... ........................................ Installer Address Type of Building Size Lot.......................�ZSq. feet..-__,/ ,,- Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ... `K........... No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtu es ............................ W Design ..............gallons per person per day. Total daily_ flow-------��®..............:............gallons. 4 Desi Flow--------------------- ----= - - WSeptic Tank—Liquid capac>tyldT.'6gallons Length--- ._.. Width.#.!,'v..:Diameter............... Depth.... .. x Disposal Trench-No..................... Width.................... Total Length............_....T otal leaching area....................sq. ft. Seepage Pit No.....$_l.�-�...... Diameter...(0.XS..... Depth below in-let...4 Qra Total leaching area .75.4,...sq. ft. Z Other Distribution box ( Dosing tank ( ) Percolation Test Results Performed by................................................... ....... .:...........................•-------•-•• . ... . Date........................................ Test Pit No. 1...... .-...minutes per inch Depth of Test Pit._ Z� : Depth to ground water...41%_ .:--- fX4 Test Pit No. 2......%!...minutes per inch Depth of Test Pit... --- Depth to ground water. DescriP --- ------ . ............. ....... = �' = _ ......... . x n o ems' -- -�- ,� Ut -- . , ..---•------•-----------------•-...----.---•--------. ........................................................ UNature of Repairs or Alterations—Answer when applicable............................................................................................... --------•-------------------•----------------------------------•--------------------......................-•-•---------------------------------•-----------------------------•---••-----•---............ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of L ITL 5 of the State Sanitary C e—The undersigned further agrees not to place the system in operation until a Certificate of,Compliance has b ssued by the board of health. igned. ... ........ ...................... . .. ..... ...................... .. �!-®L.. . .... Date 9 . Application Approved By.......... •-... . . .......... -•---- � -- ..... Date Application Disapproved for the following reasons---------------------------------------------------------------•-----------------------------------•---•---.._... -----------------------------•--------•-••------•-------•------------....------------..................------------•---•-----•-•------------...-------•----------------......----------------------- --•--Date Permit No......................................................... Issued..--- - .....--•- ........... Date Nt ns............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD F' HE .,LT Appliration for Disposal Works Tongtrn.rtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �a �ew-,................................. ................ ... .........`.'...... ..... Location Address or Lot No ......................A. ............. .....�ij� 1�� ri!.!............ '1 Ee4 t �. =_•:..... 1 ¢ Owner N-- _ yAddress �. 9 A!!L ' l ...... ?ryN+._., S F w ........ Installer Address ........ ... � UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .. p ( ) — Cafeteria ( ) a Other—Type g 4�i +�--------... No. of ersons...___.._...•----.-••------- Showers QOther fixtures ----------------••--------------------------•--........-------•-----•----------------------....-----------•---••---------.............-----.......-•-- w Design Flow...................' .1_5._...._....._..gallons per person per day. Total daily flow.......J.:7!q.._................._.......gallons. WSeptic Tank—Liquid*capacityl.!r .gallons Length._.,,t.._._ Width.4...,. ... Diameter................ Depth... =:����.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No.....I.............. Diameter..k A.3�_._... Depth below inlet_.+`_Z n/'Total leaching area-"*'_1i-=_-.<__._sq. ft. Z Other Distribution box (6,) Dosing tank ( ) Percolation Test Results Performed bY......................................................................... Date........................................ Test Pit No. 1......9.......minutes per inch Depth of Test Pit.. __ : ...... Depth to ground (si Test Pit No. 2..... minutes"per. lnch Depth of Test Pit. ':. (`_._. Depth to ground water_ < ?• :f� ... 04 --- -----•-- n of S it "' ' .tdye •-- f C2� :__C �_° 0 Description ` r = " , �a',r �- U �.,:_ i� r? :..r • ...............•-----•--•----..... ...-•-•-•-------•----.... w G' ---------------------------------••... --••-•--•-. ••••--•-•••-•-••••---•-----•••........_..... •-- U Nature of Repairs or Alterations—Answer when applicable ............................ .......•--•-------- •---•--------------•--------•------------••-1 ............•-�................................................................• — Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f:'IT �^ the provisions of Ti f77.i;.,. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed q �: ._..._j t$ Mgt............ } ' Date r Application Approved BY U ./,�- .�-: ----- -•-•-l �l ' Date Application Disapproved for the following reasons-----------------------------------------•----•----------------------......-----------...._......._.....---...._ --------•-•---•-•..............•---•----......_...-----------......----•--------•---------...-------•-•-------•------....••-------------------- .._----: ----------------- � _ Da't�j Permit No.....•----•.--- •- Issued......1 U D -{r•--�-?... ........ te THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALT T_ .. OF..... . . . . . ...... ......�................... fi�irtt#r nrf f�unt��i�anre THIS fER IFY Th tt vidual age Disposal System constructed (4. or Repaired ( ) by ... �.. .... :.....+..................................................... ' In tr e has been installed in accordance ith the provisions ofyrl..�F5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N � _................ dated..... ..`_. _ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST E® AS A GUARANTEE THAT THE SYSTEM WILL F NCT O SAT F CTORY. DATE..----•-...,(... ......./ Inspector.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF :HEAL H FEE. �t��trr�tt k �nnsM� i rrntit Permission is reby granted 'ff r to Cons ct ",ZepairA ) an,Indutidua Sewag Disposal System • ••--at No.. e�� • �-y-�'� :--•--`-=-£�--�- �� i�,�---� -•-� ----.'-..-•.............. Street as shown on the application for Disposal Works Construction•Perry-it No/,: ._.__._�._r. Dated•._". 1. ............. .... _ / 7 Board o f health DATE................ �!1`f 1� FORM 125 r 5 HOBBS & WARREN. INC.. PUBLISHERS #e WMAF/201:1VIEIl 13:43 C-0—MM FIAE DEPT FA'A No, 5087902385 P. 001l004 on GENTERVIL,L E—OSTERVILLE-MARSTONS MILLS FIRE DISTRICT.. DEPAR-MENT OF F:RE-RESCUE &EMERGENCY SERVICES 1875 Falmouth Road, Rte. 28 3 Emergency Number: ` Centerville, MA 02E32-3117 1 3usiness: (508)790-2375 John M. Farrington Facsimile: (508)790-2385 Fire Prevehtion/AdminietrGtion Chief of Department nsim le: (538)957-8239 D spEtch,Center FAX COMMUNICATION MESSAGE . DATE: JOA 1 / rax "--Igo FROM: r � WE.ARE SENDIN;, PAGES, INCLUDfN:3 THIS CDVER S.HEET. PLEASE 'CALL(508)790-2375'17 YOU DO NOT RACEIVE THE TOTAL NUMBER OF PAGES. CONEIRE~N-nAL1TY Nom:E: This fax transrriss;on may conta:n confi9ential inforrnmion belong;ng to the sender and such infcr-na:ion :s legally privileged and is Intended only for the use of the irdiv:dual-or entity named above. Anv copying disclos-Lre, tlistribufion or oissenination,of this informajon.or the taking o any action based or.the contents of this ommunication is strictly prohibited. if yo:� have received t;nis trans nission in error, please notify us :mmediately by t�ephone and retLrn the original transmission to us by mail or daive-f at our adores--above.- ve shall cover the,..ost of rsti n mail. Than-you! WMAF;2OL/wED 13:43 C-0—MM FIRE DEPT FAXA No. 5087902385 P, 002/004 A rug DO YYYY LDelate 01920 U L 05 1 10211 1 -0001246 I 1 000 ❑ Qa Basic PDID State* Incident Date * _ sta-ion Incident mroba= * g��e . ❑No activity 0ti.ck=hL bow:o 1"dA�t. tq-t th..dL—.£os tnp.1p-AA-nt}.prp+14 tl.w the Flldimd Pim 13 vocation* a4c1.in *'Altema:lve Y==.Ai sP--AA tlaa"• Uae only!cr mildland Sree. •. Census Trae= Nstxeet eddreBe 65 " Iwm wo av ❑13%ta—aCtion Number/Raspost P=efix Btreat of 8}C17way ❑In front of Stteet Type surAxx n L � OSTERVILLE I lJ 02655 LJ � Rear of Apt./.Suite!Room City - - State 2ir, Coda []Adjacent to Directions Crone street-er directione as a _ccoble 1 C Incident Type E1 Date tikes Midnighi is 0000 E2 Shift & Alarms 413 IOil or Other combustible Li quidl Check boxes if Month Day Year Hr Min Sac Incident = e lama as Alarm Local option datee aree the ilil�W ai-wa 1zeQ � 1 0� OM23 � ,+s reg4: - D Aid Given or Received* Date. Ala,.,* 05 Q2 2011 15:58:58 Shatter Shirt of AIar.As Dietti� i'❑Mutual aidseceiv¢d aRRrru, requ.irad, unless cancetaq or ai3 aot arrive I Ir I Arrival* 0$' 02 2011 1.6:0.5.31 E3 2 ❑Automatic, aid recv. Tlyeir AID Their 3 F—lbutual aid given State CoN=0=optional, Except far wildland fire: Special Studies 4 ©Automatic aid given I 1 ❑Controlled LJ L J Doca1 option 55 nOtler aid gig LAST Mr-7 CIFARED, required except for-wildland fires I �� LLJJ - Incident Number Last Xinit ' ' �� - Special 5gecial ©x9� ® Cleated 4 _L055J i --F 1 20111 16� Study IDI Stccy value F Actions Taken* GI Resources it G2 82t:imated Dollar Losses & value 'Shack this box ant skip tris- aectioa x= er.Apparatus or LOSSES Regnieed for all fi=ea it known_ option*} i f - �� 86 1lnvestigata -1 Personnel to=is 'iced. for man fires. Icon Primary?.ctioc Taken i1! Apparatus Personnel Property 000 , 000 ❑ - Suppression 1. Contents $I�_/ 000 . 000 El addition_Action Ta.ca. i2) PRZ-=CID= VAL'tIE._ Qgtioba= , other 0002 000a ❑ LJ I I � L:�J —1 Property 000 , 000 p Additional pctioa Taken (3) - Cha=k bon 12 raso=ce co=t5 1=11.1da aid zeceiveo reecurces. Contents 000, -f 000 ❑, Mixed Use Property vd� Cxsu �e fine 31—I�us" erl s R61ii38a - I Per Y ❑Fire-2 Deaths Injuries N ❑None NN X rot Mixed re 10 Assembly use ❑ Fi structure-3 Firri� 1 1 1 I 1 ❑tt-atural cBBe ,I,,,ok,„..,,tom„e.s .t a•a�as 20 Education use -]civil, L_� ❑Fine sexy. cas.=5 ; 1 1 3 ©Gasolipa: veli l•Eoma ft k er„:t.A. «-•-- 40 Pasidential use ❑EMS-6 4:❑Kerosene a :.i t... t-: 51 ROW of stores betector" - I�P� P-FteAte st rage 53 Enclosed mall ❑BaeMat-7 - .••. Diesel £�tel/fuel Oi. :whiaia M01 tMk trr PONt.W- P.e7uired for Coz£iaed fires. 5 ❑ l 58 BtiiS, $ Residential ❑Wiidland Fire-8 ❑Household solvents: h®!-t£Ya-P1i;ri.�may 59 Office use 1❑Datoetor ylaktea occypamte 6 . N8pparatus-9 7 ❑Motor oil: a•-��,.-n p•Rh.At•yataines 6o InduBtrial use QFereonne1-10 2❑3e=eator did not alert them 8 Paint: Vtmraiat seas tetetiap c£S"n-. 63 �litaxy use ©Arson-li ❑ fi5 Farm use U volciovn 0 Other: ea+.ei.?��t-yea--.�i=�--,��u>`•;;., 00 MOther mixed use Property Use* stsnctures 341❑C1,9,nia,elinic type infirmary 539 ❑Household tdoods,sales,rapairs 342 Doctor/dentist office." 579 ❑Notor vehicle/boat sales/repair 131❑Church, place of Worship 361❑Prison or jail, not 5=%n", 571 ❑Gas or service station 161❑Restaurant or cafeteria 419❑I-or 2-fam!IY.dwelling, 599 ❑Business office 162 ❑Bar/Tavern or A;L l tClvb 429 71Multi-family dwell imt3 615 ❑Electric.'generating plant 213 []Elementary school or kindergarten 439❑Rooming/boaxdisig house 629 ❑Laboratory/saionce lab 215 ❑High school or junior high 449,❑Commercial hotel or motel 700 ❑Manufacturing plant 241 ❑College, adult education . 459[]Residential, hoard. and.0=01 819.❑Livestock/poultry storage(earn) 311 ❑Caren facility for the aged 464❑normitor'y/b= a:cks 882 ❑Hon-resid*`!�04a ping garage 331 []Hospital 519'[]Food and beverage sales 8Q1 ❑WarohOuse outside 936❑vacant lot 981 ❑construction $i,ta 124 []Playground or park 9.38[]Graded care for plot of land 984 ❑ laduBtCial plant Yard 655 ❑Craps or ardtemd 946❑Lake, river, stxeam 669 FOreSt (timberland) Dookug and enter a property USQ code only if ❑ ) 951 ❑33ail.raad right of Way ycu have 902 checked a Property 75e box! 807 []Outdoor storage area 960 ❑other street P=Ferty Use 1592 919❑Dumpor sanitary landfill 961Highwa /divided highway 931 []Open lard nr field 962 ❑RAsidanUca street/driveway Bank i Coal Fire 0-920 05/0 /2011 11-0001246 N/MA/201"NED 13:43 C-0—MM FIAE DEPT FAX No, 508 r902385 P. 003/004 Rl 'Person/Entity Involved coca: Option Business nags {_f-appliea5ls; - 0-a Coco none Chao x Tnis Box if seSa address as XX••1%•, Mts. First Ims ba Last Name suffix in.lUeAt IcCatx4h• - d, aklp the C:1ree I - ' I I duplienta address pr� Street or Bi hxa• I �J lines. �� 4 /.. ,. � - 8,r6eL Type suffix Post Office Box Vt./suite/Roam city State UP Code, - ❑Mare people involvod? Chock thi3 box And attach Supplemental Dorms ( -1S) as necessary K2 owner Sens as pertat involved? Then check tiis.box and skip L.The rest of this section. Iocnl Option eu64ne66 name (it F1,7p11eaAle) Area coda Phone Byubaf• , ICI EJCheck this Sox if Kr.,XS., NLS-•Sestet RAG MI Last Naae - 1 Suffixn same address as Than skip the three �.J U street Type sttLtK to 8ddteba v'�es - arezix Stsaet ex �igbway lines. Post.Office Box - - Aft./sssita!Room i lty 1_I I I hl r. state 21D coda ..�.— Local Opt_oa - Responded in 3211"1; with 306(3) to West Bay Rd. and Wianno Ave., Cst for a hydraulic oil spill. Upon arrival, ' spoke to Bob Lcve_l of.TOB DPW who s_ates .cne of the sub-contractors for .the . town street sweeper broke'a hydraulic hose and spilled approx. 3 •,gal_ons of hydraul_c oil on the roadway, _hey have covered the arga writ),^ absorbant material and swept it up with 'another sweeper prior to my arrival. 3C6 cancel-led.- The leak is stopped and the contractor is making ._arrangenents to move the macaine -for....repair. The spill left..a. trail approx. 100' down the woad y �n of 1_011 �nv�aovc 'tp_, _�� 7- . +eye =oa r ace, no storm-drains are involved and the situation is -under control: Re_. to Qtrs. N -ifi r - � o� ed the TOB BOH and spoke tc Donna Miran^i �and advised her p o� the ..ituationanci th.. . . actions taken. _ , Responsible Party: Anerican Sweeping Co., N. Andover, iviA 1-800-933-1691, Brims McNeil. 05/02/201= 16.46:16 beldridge L Authorization . $I 200 ! I ELDRIDGE, BYRON L. ', I ICAPT I LS:iift -Comm � LOB 1 021 2011 Officer in,urge IF SSgnature ?esiticn or rank .Aasigraent Korth Day Year Box BoZ if 2] 182 60 I I ELDRI DGE, BYRQN L• I I CA I I 1 1 0 J U 1 2011 a¢ Officer Nex mslcing retiort ID Sigaat'ire _ Position or rank Asslgsuneat Month nay Year in cbar�g'e. .. - _ .. COMM Fire 01920. 05/02/2011 11-000_24b N/MAF;201 ''NEII 13: 45 C-0—MM FIRE DEPT FAX No. 5087902385 P. 004i004 CFNTERVii i,EZST ERWLLE-MARSTONS MILLS FIRE DISTRICT 1875 ROUTE 28 CENTERVILLE, MA 02832 (508)790-23801FAX#(5Ge)790-2385 OIL/HAZARDOUS MATERIAL RELF-ME FORM LOCA70N. ADDRESS OF RELEASE: ' CJa DATE OF RELEASE:��� PRODUCT RELEASE©; h ESTIMATED QUANTITY: ' --- -- -CORR5CTIVE-ACTION-tAKEF-INV . �4� - --- NDTIFICATIONS: FIRE DEPARTMENT- :ES(�:ul ? :DATE 2 — NAIIONAL RESFONSE CENTER YES( ) NOP(t nA rE` :..-_TIME EEPT.,OF EN'w1RONMENT.4.PRO,TLCT±ON 't`Est' } ?vi?QCe DitTE: Ti vSE_ OiL SPiLL COO PPINATOR, YES( ; ,PAC (&) DATE: TIME: ?_ OWN BOARD OF HF_kLFF..�.. TOWN HARBORMASTER: YES( ] NOK) GATE. TIME; OTHER AGE€vCIES:. REFOR T ED B f, DATE: AY'Hi T E I::+;PY--FIRE DEPAR I MEN7 .ELL'OW COPY-D.E.P. PINK COPY-BOARD OF 6! T H Ah• Aj IN v P15Y A�< 6! f Cog', w y 54. - 1444 t►.At C�q>� 3C�lC ; E Tn �cPn Of y� �ititl iAR! A L h f 193341 Q y 2. Sp� �� ICE `- \ �4�$T�a���i9• A �. ;r`�vlr f A,QK _ GP";= ?cam: c4bt..arn 2.z L = ICU G D -ZVI LL-=— . L e�:N C k4 !~c' - U5C 6, x q5F 75-76- &,�P- Q>C-TrTz)H cel .re;�. �.. L.. -«° t 7D G. '� t "t 4. .ipu�tiC�ru - ��'�.- ;�.../�-fir c�!� ��`t� ` L z �� t�� �t �..��-. �...���� �..�.,.�'", h�� ►.