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Home My WebLink About0005 WAKEBY ROAD - Health «� 1�old�-, Q Q r Cal`-�i p-000t Q- - Q14 _ Al r vas A 1 O 5 M E A D KEEPING YOU ORGANIZED No. 12134 2-153LGN /A\SUSTAINABLE MW.RECYCLED o iNR mE CONTENT 1096 CrufiedFhsrSourcing POST•CONSUMER® wwwAfipropramorp SP41290 MADE IN USA GET ORGANIZED AT SMEAD.CAM - .LOC&.T_IO.N_ �V__ _� _ ._____ _SE/WpC,E_PERMIT 1�10. VILLAGE —_IAIST_aLLER-5 -U&ME__�_AD_D.RESS _$UILDER S AD.DR.E SS MITE .PERtv1,1T ISSUED D ATE. COMPLI W-ACE ISSUED : °1 z^7 r rRD.v T" z Fwic .............. THE COMMONWEALTH OF MASSACHUSETTS X BOARD OF HEALTH _....... . .- _._......OF...........................I................................................ .._......_... Appliratinn -for Bi,ipuiitt1 Morkg Tottotrurtion Vrrutit Applica 'on tsRh boy m e for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal Se - Location-Address o Lot No. ��- -----------------------------------------• /1fr�....ST �S--••-••-•--••----••---•---•-••----- Owner Address JG,Wj <� f/I/C/� � � L• --------------------••-------- �y,,,�N. iS.-----------•-------.-.--------------------------------- Installer Address d Type of Building Size Lot._4�_Z)UZ-.Sq. feet Dwelling' o. of Bedrooms__.__— --.---______________________Expansion Attic Garbage Grinder ( ) aOther—Type of Building ___________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------•--------------•----------- ------------------ -------------------------••------------------------------------------ W Design Flow-----------;:`M.......................gallons per person per day. Total daily flow.........s_ao-____________...._....gallons. WSeptic Tank—Liquid capacity/00-gallons Length-------- Width................ Diameter____-_ -- _-__ Depth.__.___-__._.... x Disposal Trench—No_____________________ Width.............•------ Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No._f'A�___- Diameter__6_'�r-_S*"'_._ Depth below inlet.................... Total leaching area------- ----------sq. it. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date----------------_.._-------_-----------. a Test Pit No. 1................minutes per.inch Depth of Test Pit.................... Depth to ground water..__________.._.__.--_-- ;M4 Test Pit No. 2................minutes per inch Depth.of Test Pit.................... Depth to ground water__._.______________..__. W -------------------------- -------- ---------------...............................................••••••-----•••••--•••-------------------------•---•----- Description of Soil 0/�---�G��--�is✓�- S--- CcJ��'.Y.....`; l/-�------------------------------------------------------------- U -------------....36"--- ! -_o----------Ce..4.V...- /�a.16f ....I V.a---- --------- W x --------------------- -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------•---- U Nature 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 Article NI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu d y the board Zalt ,- %- 7s- Slgned.. ... Da e ---------- A lication Approved B 7� PPPP y .... ------------------•---------------------------------------------------- -----------7'-Dat.e.------------. Date Application Disapproved for t ie following reasons-........................:....................................................................................... ' ---------------------------------------------------------------------------------------------------------•---••-•-•--------------•-----•-------••-•--- ................................................ __Datg_. Permit No.... -1�--•------------------------•----------. Issued..._"_ ./ Date /r r, Pic,....... ......>-•-.-.... FEs............................ THE COMMONWEALTH OF MASSACHUSETTS . ', BOARD OF HEALTH . ....._ OF.................................................---..................... ......... Appliration -for R!iVoiittl Nurkii Towitrurtion Vrrotit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: may/ Location-Address z Lot No. r •-'•'--'•'e-�--'--�=---- 1' 'f)Cst � ----••.------•........_...•................ ... .. �_•____`°-- /viJ/�1_ Owner Address f....'! '•---•.............."•".......------.......'-'•'-"•--•- Installer ' " Address Q Type of Building ,Size Lot. �..�JU -.Sq. feet Dwelling °`'No. of Bedrooms._...3..................................Expansion Attic' Garbage Grinder ( ) Other—Type of Building ............................ No. of persons-----------------------------Showers ( ) — Cafeteria ( ) fixtures !... -------------- ..... ..--- W Design Flow•Otler-ife gallons per person per day. Total daily flow.._......- ................._..gallons. USeptic Tank—Liquid capacity2 P��.gallons Length._..-...��_. Width_.............�Di lmeter_...._......_--- Depth........._.._-- x Disposal Trench—No. .................... Width.................... Total Length----------------.y.•Total leaching area-------------.......sq. ft. Seepage Pit No..f .._. Diameter..6.*..�_..._ Depth below inlet................i..'Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank aPercolation Test Results Performed by----------- ------------ -------'--'••"'----•-•••••-•-"-•---•--•-----••• Date-----_-----------------------; Test Pit No. I................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........................ --------------------------------------------------------- -------------------- r D Description of Soil O- 3!�_ .../��.✓� y .�f7...••... S _----•--- ----------- ` ....�V ', ._....�.�(! /(/ `-c)/J`GS!?� JGl.v p lrf,.I f iu,s: 4C Q 0O /v V - "`-` ".................... .......•-•---------...------------•-----------------------------•------ W ---------------- ----...--------------------------------•-----------•------•----------------....------------•-••----------------•--..........._..--------------------------•-------- U Nature 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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d y the board of health! Signed---------------'--=:-•-'-'••-- 1' l C bate Application Approved By-----' ---`--...------'--•-•----------------•----•----------------------------•'••--•'- ---'------•-•---•--Date-------------- Application Disapproved for the following reasons-----------------------'----------'---'----------....----....------------•'•-•-•-----------.........••"......--- Date PermitNo.... -............................................. Issued.--..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................O F..................................................................................... (1111extifira#r of Toutphaurr THIS IS�TO CER EIEY That theFIndii vidua��Sewage Disposal System constructed ( ) or Repaired ( ) by........ =`�L& /--, r ._.--------•--. -,,.-----••---------------- 1 /= Installer ( f at..-•--------------•-----•--•-----•----------------------------.....-•------------------------------------------------------------------------------------------------ has been installed in accordance with the provisions of Article YYof The State Sanitary CodFas/described in the application for Disposal Works Construction Permit No----------------I._._.._.__-_•_-.-_-..._. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED .AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS ",BOARD 0,5`HEALrT,�ki�` ..........................................OF.................................................................................... ✓ No......................... FEE........................ Uinpotial rko- on fru # o t°-�rrotif Permission is hereby granted..........................................--•-------------••---..._....s............... to Construct ( )for Repair ( ) an Individual Sewage/DisposalPSystem atNo................ .....f-=-- ...-.-•-----`-...----------•-----------•----•-••----•---------.------..------ Street // / as shown on the application for Disposal Works Construction Permit N,6" :.f.�_...... Dated................ ......................... ,I Boare of ealth DATE......... --- ----- ---------------------------------------------•-- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �F Yyyy I GOT- � � ��F• :}+, a C OCA*A..4' : /" ,P r ��':./p8� CG EAnJ CO9.QS�;"•. � y �' kM:, .�7Nio 2 NeBESY� CF.E•T/FY T/-/F-iT THE BC//LD/�c./G� � �3m7"T•��/I�, ., � Jri''3 5.t/0H/.V O.1/ TN/S OL.F?.V /S LOCATED O.V_ ,,Q5 3N0 W.V 7`s,/q`T /T itJo pii5+ �2 `t y r o co.vFo�.ti To T.&-V— zo.v/.vc- o OF BY-/-IQWS ARNE J i p0 ALA•. '""„ �;. +,. csie� cam en9ine�rir�9o26348z` L<i.va suevm}-ors ��l �n'�.;-.. �~• ,� GOUTS 6A^- �MOcJTN, MA55. Tom- AEG. ILA wwo� BARNSTABLE COUNTY HEALTH DEPARTMENT SA$NSTAHLE, MASS. 02630 TiLVNOMss 362-2511 Z" 331 Date: July 3,. 1975 To: Per. Dan Forte lo43 Shoot Flying Hill Road Centerville, Mass. 02632 On the basis of a sanitary survey and a laboratory examination on the sample of water taken from a .. ...,well. . � .. .. ... . . ...located on the premises of ...,.. ..,Daxl.F�xte... . .. . ... . . .. . . .. ... ... ...located at . . Lot. 2.Audrey. Lane Mar stons.Mills......,. .,, on .. June .3 ,. ?9.75... . ... . (Place) (Date) this supply is approved for domestic purposes at the time the examination was made. If you wish, further information regarding this supply, please contact us .at the County Court House, Barnstable, Massachusetts (Tel: 362-2511 Ext. 331), and we will be glad to assist you in any way possible. Signed............. 1. . ...... ...... ..... Public Health.Sanitarian