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0032 HEATHER LANE - Health
32 Heather 7t,);Marstons Mills A= 0 3 �77 t'}{ 'n 4,.. Six r f -COMMOWMOWofi Massochusetts John Grac><. Executive Offtce o=-Errilconnientotdi� D.E.P. Trt1e V SepticInspector @ sit partm' ent of '. _ P.O: Box 2112 • - Teaticket MA 0253 e� sE6 - EnviMal Polo oft (508)564-6813 77 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM'' / PART A :;, ! � CERTIFICATION Pro arty Address. 32HeatherLanereAtewHk�ti, Address of Owner P Date of lnspection:1o/0219e t (If different) 7. . Name of Inspector John-Gracl Sllvan ' t,� Company Name,Address and Telephone Number 4 t. CERTIFICATION STATEMENT I certify that•have personally Inspected the sewage disposal system at this address and that the information reported below is true, accurate " and co7fipiete a's of the``time of�inspection'..``Th'inspection was performed b.ased:.on:my-training::and experience in theproper function and maintenance of on-site sewage disposal systems. The system: : . X Passes .Conditionally Passes - Needs Further Eval tion By the Local Approving.Authority Fails Inspector's Signature: [ Date: 100" The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this _inspections. If the system is a shared system or has.a design flow of.10,000 gpd or greater,the inspector and the system owner:shall submit- the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent;to the buyer,.if applicable and the approving authority. INSPECTION SUMMARY:.` Check A, 8,C, or D: Al SYSTEM PASSES: . X I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.803. Any failure criteria not evaluated are indicated below, B] SYSTEM CONDITIONALLY PASSES One or more system.components need to be replaced or.repaired;-.The system, upon completion of the replacement orrepair„passes,inspection. Indicate yes,no,or not determined(Y, N,or ND): Describe basis of determination in-ail instances. If "not determined",explain why not.) The septic tank is metal, cracked,structurally unsound,shows.substantial infiltration or exfiltation,or.tank failure is imminent. The system will pass inspection.if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. . - (revised 11115/95j One Winter Street • Boston,Massachusetts 02108 • .FAX(617j 956-1049 9 Telephone(617)292=5500 ` ,. „ yn jg s ,. 'a' :. -may f'f J x x = SUBSILACESElNAGE©IPOSAL'SYSTEM INSPECTION FORM u: operfjr gdtl,rssS: +�tLea11>erLane Centerville Owlier tolou9a Dateof.irtspection rs ,.. f "•- _D]_SYSTEM,FAILS(continued] '; Static liquid level in the distribution box above outlet invert due-to an overloaded or clogged SAS or cesspool { _ Liquid depth in cesspool is less than-6”below invert or available volume is less than 1/2 day flow Required purriping more than 4, times in the last year NOT due to clogged or obstructed pipes) N umbers.of times pumped: _ -Anyportion of the Soil Absorp4on System, cesspool.or privy is below the high groundwater elevation Any portion of a cesspool or privy is:within 100 feet of,a surface water supply.or tributary to a surface water supply Any portion of a cesspool or privy is within a'Zone 1 of a public well Any portion of a cesspoofor'privy is within 50 feet of a private water supply well _ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private.water.supply well with no acceptable water quality analysis..If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria;.volatile organic compounds;:ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS:: IJ apply fo lar a stems in addition to the criteria: ' following win criteria9 sY T he oPP Y 9 .. facility with a design flow of 10,000 gpd or greater.(Large,System)and the system is.a significant threat to ewes a fac g The systems tY environment because one or more of the following conditions exist: public health and,safety:and the a the system is within 4t)0 feet of a surface drinking water,supply the system is within 200 feet of a tributary to a surface drinking water,supply the system is located in a nitrogen sensitive area(Interim.Wellhead Protection Area(IWPA)or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall bring the system and facility into full:conipilance with the groundwater treatment program ;. requirements of`314 CMR 5.00 and 6.00. Please consult the local regional office;of the Department for further information.. ' (revised 1 Ill 5195) .3' Nk g � 'Y q�r4 h�#z {t•T�j f!-•.ero4c _f�+" 4 �1�nie3 "`4 fiY�h F L- S . i �.'S `2- } f j r !f'S, .w ^'��lnyT..�_ :.yam •i"+- _ y£ _ SUBSURFACE SEVJAGEDISPOSAL_SYSTEM INSPECTION FORM "- - CERTIFICATION(contlnuedd - — Y 'Property Address: 32 Heather Lane Centerville - - _ter Qafe ofilns action f0101198 Sewage backup or.breakout or high static water level observed m the distnbufon box is due to a broken k _ settled or uneven distribution-box .The system will pass inspection if(with_approval of_the Board of Health) broken pipes)are replaced _ obstruction is-removed " distribution box is I.eveled or replaced'. - The system required.pumping more than four times a year due to broken onob�tructed pipe(s) The I system Will'pass inspection ii(with approval of the Board of Health) brokenYpipe(s)are replaced obstruction is removed.. 4' C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH Conditions exist which require further evaluation by the:Board of Health m orde-to-determine if the system is failing.to protect the public health,-safety and the environment: 1) 'SYSTEM WILL PASS UNLESS BOARD OF'HEALTH DETERMINES THAT THE SYSTEM 15 s. NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: .-. Cesspool or privy is within 50 feet of'a surface water - Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 71 2) SYSTEM WILL FAIL UNLESS THE BOARD Of HEALTH(AND PUBLIC WATER SUPPLIER,iF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A.MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within.a Zone 1.of a public water supply well. ` The system has a septic tank and soil absorption system.and is within 50 feet of a private water, r suPPIY well. and soil absorption system and less than 100 feet but 50 feet or more from a private The system has a septic tank a P compounds indicates that the well is for coliform bacteria volatile organic comp .water anal sis _ well,unless a well Y e M. watersupply free from pollution for that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 pp c, 3) OTHER D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine-what be necessary to correct the failure. ` Backup of sewage in facility'or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of-the ground or surface waters due to an overloaded or clogged cesspool. :., SAS is in hydraulic failure. (revised 11115195). _ 2 4.s "I, _ ``1 h .•} < Sy_ s , -} `2 �4'i �, tS+ ccx- `' t y"�„'e'tCS" rf ua aJ-r, ,} fi:'� �. �+ ,s s °x,Y,ss s. s fat- ....a-- - S`�. ' ` �� 3s� 0" .+�.,.. *•, ' ''. {` , e 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR M ;b PARTB fir � `-� _X--�- -r ``` �- ->.^ 1 CH.ECL[S� �- � � � - { _wit--.•=--- "� i '-"--`�" =� � ""_'"�s�_.......c-. _�" E t«�•k,++'eck r"' .n ;w--- r-.z �.�-s.�.Y�y �r ^'-�nc� ', e,+. ..� Property,Addiess 32:HeatherLaneCentecvlUe _ Owner•:; _ -lsnvan - _ Date of Inspecti n 1010219B o a d k. `Check if the foliowinghave been done - X Pumping information was requested of the_owner occupant,and Board of Health X 'None of the system components have been pumped for at least two weeks and the and the system has been receiving normal flow rates Burin that;peiiod., Large;volumes of water have not been introduced into the'system recently or as part of this g g t inspection. - X As'built plans have'been obtained and examined. .Note if they are not available with.N/A X The facility or dwelling was inspected for signs ofrsewage back-up: x The system does not receive non-sanitary..or industrial waste flow. - ' °x The site was-inspected for signs of breakout t, x' All,system components'exclud'ing,this$oil Absorption System,have been located on the site., x The septic tank'manholes were uncovered,opened, and the interior of the septic tank was Inspected for condition of baffles;or tees,material of construction,"dimensions, depth,of'liquid, depth of sludge., depth of scum: X The size and location of the Boil Absorption System on the site has been'determined based on existing,information or approximated by non-intrusive methods.. x The facility owner(and occupants;.if different from owner)were provided with information on the proper maintenance of r Sub Surface Oisposal System:. - , s : mj ...i. r.r. ... r . (revised 11115195) - • AWW 4V ri, 101 7v 0 tS 0;R F.A C E�S EWA0 E D I$P-0zA 'sYST E MJNSPtZ JQ K FOR fSTE Property Address 32 Heather Lane.centervIn e..- % -IV 4 Own-er:-M. T .............. Mri V6 t to IT 7 Z77' FLOWCON RESIDE NTIAL' 7 Design-flow:-330- -gallons Number of bedrooms: 3 Number of current residents: 4 ,:-Garbage grinder(yes or no): No Laundry connected to system(Yes oe no)- Yes 'Seasonal use(yes or no): NO r readings.if available- Water mete Last date of:occupancy: 'COMMERCIALIINDUSTRIAL.- : Type of establishment Na Designflow: gallons/day- Grease trap present: or no) No : No industrial Waste Holding Tank present: (yes'pr no) No har 16 5 system::(y6s or no) NO Non-sanitary waste disc ged to the Tit Water meter readings,if available: nlaLast date of occupancy:-rda OTHER: (Describe) Na Last date of occupancy: GENERAL INFORMATION. PUMPING RECORDS and source of informaticIr', c System has been pumped every two years since 1990 for ritaintenance-Last numed In Feb.1996 by MacComber System pumped as part of inspection: (yes or no)No If yes,volume pumped: 0 gallons Reason for pumping: n/a TYPE OF SYSTEM X Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) if yes,attach previous inspection records,if any) Other(explain) APPROXIMATE AGE of alircomponents,date installed(if known)and source 1985 New it installed in Jan 1990 990 Sewage odors detected etected when arriving at the site: (yes or no) No (revised-11115195)- a a"P{ :t� f ,4 i1* •d xy .ymY.'}'a S"r r s-+..gfi�Fi _..: -—N, .,,ti a. " Ln ;x •4r r< r'.�,+ 3 r t '�^ �+ z� i A"r5v'p'^d`.: -" , . `�'e '°E{''#�.�j c1z 9 ,. H;Y .. •k .� a.:." ;; 'G'4 z" 1srh1 'i'._ h. �,+...�• > � � .. a ., i.. _ 3 SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION1FORM `PART C SYSTEM INFORMATION(contloued)`, 3 f Property Address: _32HeatherLaneCenterville - Owner: S.EPTtC I AN K:"' r — 4 x �. - - (locate on site plan) 3 F.Depth-below grade 2- Material of construction:x concreate •metal FRP other(explain) Dimensions:' 8'B'H 5'7"W 4'W Sludge depth:2' Distance from top of sludge to bottom of tee or baffle 25 ` _ :r 'Scum.thickness::4' , Distance from top of scum to top of outlet tee or baffle:r Distance form bottom of SCUM to bottom of outlet tee oF.baffle. 17' ; : ., 1• { s `r 7. Comments. = ; (recommendation for pumping, condition of inlet.and outlet tees or baffles,depth.of liquid) in relation to outlet invert,structural integrity;`. .evidence of leakage, etc.) Septic tank and all components are structurallysound.Recommend pumping system every one to two years far malntenanoe. GREASE TRAP. (locate on site plan) Depth below grade: nla Material.of construction: _concrete metal : FRP other(explain) Dimensions: Na Scum thickness:n1a . . DTstance from top of scum to top of outlet tee orbaffle:n1a Distance from bottom:of.scum to bottom of outlet tee.or baffle:n/a ; Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles:depth of liquid level in relation to outlet invert,structural integrity;:' evidence of leakage,etc.) Na (revised 11115195), �v` r r a i� > t kr, a buy £ { '' - � ; ''x�' er -r. 3° ��• ��..r.- ""s`^^2''W'- Off} ��� x {.E�r?�• rF - -faS 3� cC;. - �`'fmrt'K Y-- - R"' - e� ia�J�� 1 � ;� �" � v�r - • _ r Y, 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION;FORM . PART.0 , SYSfiEM INFORMATION(continued) - i - - :PropertyAddteSS:'r 32HeatherLaneCenterville Owner: silvan: - Date of tnspectfon 9# --- -_ - _ TIGHT OR HOLDING TANK:. s .. - -(locate on..site plan) - s _ Depth below grade: nNa Material of construction:_concrete_metal_FRP_other(expiain) Dimensions: Ma Capacity. nla gallons Design flow: n1a gallons/day Alarm level: Na Comments: (condition of inlet tee condition of alarm and float switches etc.),' DISTRIBUTION BOX:X (locate:on site plan) Depth of liquid leve(`above outlet invert: Liquid ievelwith:bottom ofpipE comments: (note if level and distribution is'equal, evidence of solids carryover, evidence of leakage into or.out of box eta) D-box is structurally sound PUMP CHAMBER: (locate on site plan): . Pumps in working oeder:(yes or no)' Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) Na (revised 11115195) ` 7 j5� ' «2!}w h e3 -.' .5: `,•� t t . ,.• F air v� r'::.: P #4 .•Fr"'FYI i,, - �"T. r.�, . ". � "k �+,✓`.+ ..... 2 A'l r"''t; is r 'tyyb s i'i •-�,. WrY e, , i ,zar r�=* J rs' ,-r_ :," e. x r r` S ,a.. 'S .tr,+^ s �xz k.,ti-s»„a a.. �' -.,r spa• h.sr�; �zssj P"' k,:3. �+. s e � > '- i� ra ✓,":S - k t�f u p f r�. y ,�,� 3' ,C �Yt6 s,:��''?u n� f �` a Y"�c�.` ' 1' — r, aURFACE SEWA DISPOSAL^SYSTEM INSPECTION FORM ""-z-'..���^-^-- ,r�. _r"-`r'"'a�s'a' '�-----`t-=�-•---�+-•_ci ���*�-�Y�'-.,�.�._� _ � r -�-'.,+���.,. � � .Yc ��3,',.,,� .�- r -t�. �_ �. i, -� ��3•YS�ENFt1V�41�M1�'LIfl,NL(�ontlnt�ed), �F- W� �,�•-.-, �..��--�����—��..--,-�3.•��+,-�.. � Property Add[ess 3 H adierLan--centeivfUe �^ y .".:_ �.. - 3 - -ace 3•* -i ' r— Dateof=Inspection �_-._� -:;.�' ._•__:. ., ;,, - _ SOIL ABSORPTION SYSTEM.(SAS):x` `M (locate on.site plan,if possible; excavation not required but may be approximated by non.intrusive methods) - --- Lf not determined to be present; explain: nla Type: , leaching pits, number, z 1,00o gaiian leach pits leaching chambers:,number:n!a leaching galleries.number: n/a { Teaching trenches,number, length: Na leaching fields, number,dimensions:n1a oyerflow'cesspool;number:n!a ' { r' Comments (note contlifion of soil, signs offiydraulic failure level of ponding,:condition of.,vegetation Sas is functioning properly,Recommend pumping system every one to two years for ma,ntenartce. CESSPOOLS: (locate on site plan) ge Number and configuration: n!a Depth-top of liquid to inlet invert::n1a Depth of-solids layer: n!a J. Depth of scum layer: n1a Dimensions of cesspool n1a Materials of construction: n!a Indication of.groundwater: n1a inflow(cesspool must be pumped as part of inspection) ' n1a Comments:(note condition of soil;signs of hydraulic failure,.level of ponding,condition of vegetation;etc.) nla . PRIVY: (locate on site plan) Materials of construction: n1aV Dimensions: n!a ' De pth P th of sol ids: n1a etc. lion of vegetation,- and t ) e level o f ondin c ' failure 9,ulic a dra P of h , Comments.(note condition of soil, signs y Privycomments (revised 11115195) $ ;, SUBSURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION- ,PART C SYSTENt,INFORMATION(continued) Property Address 32 Heather Lane Centerville t 9wner:. slIvan ate of Inspection 10102196 Date - SKETCH OF SEWAGE.DISPOSAL SYSTEM include`ties to at,least-two permanent references landmarks or benchmarks locate all wells within.100 ' - ! - f : 3 , m t i.y.: , DEPTH TO GROUNDWATER'" Depth to groundwater:12 feet. method of determination or approximation: USGS Maps and charts. (revised.11115195) ., , L 0 CAT ION 3Z SEWAGE PERMIT NO. ,"PILLAGE INSTA LLER'S NAME A ADDRESS p M ® 2iyu s S& I:L R 6 n-k- Od ,e y d U I L D E R OR OWNER e A] fv. DATE PERMIT ISSUED DATE COMPLIANCE ISSUED4° �a_ �� 0 !, fv � ' �� � �C ,� c�v L tI J F�$.. 10 No.. .��®-3. t ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . '................oF....,��ft i �% ----------------------------- ,� lirtttiu,t fur Diupuual Works Towitrnrtiun ramit Application is hereby made for a Permit to Construct (A<`or Repair ( ) an Individual Sewage Disposal System at: --..... ... Locatioe Add res / Gvs�l l Ufl' .. l.�.c�CJ,�t. ..,%L-�.(. ---•.-.-------- -•--...--•-•-�• ./.�i..RolL......f�^.-1 l . ............. --.....' j Address Owner / W G •-- .........., Q.a ., I LDS.--•-- .... Installer Address Size Lot. r--J...Sq. feet Type of Building U U Dwelling��1Qo. of Bedrooms... ...•............................Expansion Attic ( ) Garbage Grinder ( ) �., Other—T e of Building No. of persons............................ Showers ( ) — Cafeteria ( ) Other�-�xtures ....---------------------•------•-------...----•------•••••-•--•••••---------•••---.....---.....-----••--••••••••.....--•--•--•--•......-••••-...... Design Flow. � - - W � - -.-_------.gallons per person per day. Total daily flow_.:KSG)..........................gallons. W Septic Tank(--<iquid capaclt/ gallons Length................ Width................ Diameter.....--......... Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. xSeepage Pit No...../.-.._..---_ Diameter../,c,.>. Depth below inlet.................... Total leaching area 2g�:4..sq. ft. Z Other Distribution box (�� Dosing tank ( ) i '—' Percolation Test Results Performed by-.�WXC=�-4—W� •-•-�--•••--------••-----• Date.... ..._/...'. `` ------ Percolation P g A���_-- ,� Test Pit No. 1......:........minutes per inch Depth of Test Pit.- ...._.._...._ Depth to round water_ Gz, Test Pit No. 2................minutes per inch Depth.of Test Pit.................... Depth to ground water.....................--.. -------------------------------•-•• ......------.............- -------------f...---•-•-•----.....?..----..................-. O Description of Soil......G ....= .....---•--. -. A.t 1�rS'G7�' ..,--------•- ............................. �4 � � ..5- ...._.{��1_.. ;r.�✓c.d.. c� 2, i-- ------------------ U -- ---------------------------------------------------- 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu t e bo of health. f - g ye a Ap cation Approv ...........--.•-• .......................:.............•-..._........._..............._......- Date Application Disapproved f o he ollowing reasons:----•-••........................••--•---••------•-----••----------------•---•-------••--••...------..........--- Date PermitNo--------------------------------------------------------- Issued....................................................... Date No..��.41:.!-7, ,V. FES.....r ...... ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD 10F HEALTH ... ............OF.. �' ,� � - ?G ---------........------------- Appliration for Biiipoittl Works Tonstrnr#'ton ramit Application is hereby made for a Permit to Construct (k ror Repair ( ) an Individual Sewage Disposal System at: ....................•'"'--"-"'-'-- . . ---...__..._......_..__-'' -_..... .....--'--....---•--'--•- 6=' - ..._.. Location-Addr No /esj5 / /} ,J _ /y :..... ..... - - ---•Lot- ... Owner / �n Address a ••-- .............. = •.................. Installer Address d Type of Building Size Lot__ ^`` !tC?_..Sq. feet U Dwelling L--'Iqo. of Bedrooms.__. Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures -----------------------------------------------------•---•---•----•--•----•---•--•------•--______-•-----_________-----••-••----------__------------- W Design Flow.... O��_ __________________________gallons per person per day. Total daily flow.,3_.4;� .........................gallons. WSeptic Tank-Liquid capacity/55, gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No_____________________ Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_____ ____ _______ Diameter._'-°'.. ....... Depth below inlet.................... Total leaching area.4_5�!55i __sq. ft. Z Other Distribution box (�/` Dosing tank ( ) `- Percolation Test Results Performed by-_ - - .�:.t:=: 1 ----•-..-•----•-••••••- --------------------------------- Test d a ---_ Date---• --- Pit No. 1...... _.._minutes per inch Depth of Test Pit._�.�.,�________. Depth to ground water_,41/e__1Z/1 Lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1•y _______________________________________________________i____-___....__._____......_____........_._.._..... .................. O Description of Soil...... ram' "=- -- �-----��yc t S�mc' �f�y'��-� �`=--.•.... - I/� _ _ V ..f...:,J/' , ,_—•-'=r r. --•----r... ✓�::�;!_' '`......•--' _Y: "Y.%_�.0�.!5 -- -r�"�.�'. ��..c;,/.ff f. 15... a.'.�"�_�••_--_----_••----- W 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 TIT1Z- 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. grit--_ - ------------------------------------------•---------•-------------- --• ......................... Ap •cation Approv _ r,� r7 ';;,/ --------------------------------------------------------------- 6 Date Application Disapproved fo,'thelllowing reasons:--- ----•-•---•-•-••---------------------•-------•----...._._..••-••----•••-•-•..._....... •-•------_.... -•-----•-•--------•--•--------•-------•---•-•-•-•---------•-•----••------------•---•-•........................_..----------•-----•----•-•---•----••--•-•-•••••••-•-•-•••-•••-_---•-••--•._...•----'•-''" Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r`..........................................OF......................................I.............................................. Trdif iratr of Tomptittnrr r'73.?" TO 4ERTIFY, That the IUdividual Sewage Disposal System constructed ( �r Repaired by.... --------- 1-- ---------------------------•----•--•----•-...--------...-------•-•-••-••---•----....-----........._. nstaller at. a-•-•-••. ------- _./ has been installed in accordance.with the provisions of T _ F� 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._ -__zn_✓F............ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A qUARANTEE THAT THE SYSTEM WILL FUNCTION ,SATISFACTORY. (- DATE..............................f -`----------------••--•....------•_. Inspector....................---...... ..._... . THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH ..........................................OF..................................................................................... No......................... FEE.).�.............. W5111011 rko Tonstrnr#ion rrmit Permission is granted............- -•-----•••• _-`_-------.._-._-------------------------------------- ....------------- .....--------- ............. ........... to Construct ) o pair- �nn Indi dal ' e,A isposaall,Syleni at No... = - ---'--- .......... Street as shown on the application for Disposal Works Construction Permit No________ __________ Dated......11-7 __I d..I.� 1_ ._.... .•: Board of Health DATE..................--------.._._.._..--------- r FORM 1255 A. M. SULKIN, INC., BOSTON :.5"•li(/c�L E F.4Ml�- Y- 38Eo�L�I . .. ���. 10.4/.G,YF�ah/=//O X3 =,33U G.�� t / �. o..� / ,, ,♦',i. '��: //_SE /10420 JI I ;MR I BOTTGuj.4. 7,0 YN. S. 'i roT,4L- �6-s/6�f� a l.�l c.// 6..�?.O. � � N ��,1' s � ��✓D. .� N �:' 7OT.4L. 1.34/G.YF.C4�j/ =33G G•.o,o. � o .. oE.ec�ori�r•</ .ears' _ / " /,v ��(� '� ,` ,; I WILLIAMP` a C. p DAVID.N Y E pdULIN ,p No, 19334 u Nc. 2991.E c+ F, W� �ND SUOL Do`s isY��`� r 1 � a�orlal • i a IR �--. /d//, aA .o " 44 ,A AV o I�-- cEoZ-A Al .�dT�2 T,�A7 Tf�G ,c0GaT%o.c/ cE.e X- syOH/j�,r /Thy - �9 i 7"N� ,$'/OE.0/�/E ANC SETBA CfC i��L:•Ail/ .eEF"�.eENC� I , . .0 ocA 7-,E.o 1.siiTy/�c/ TyE F.Loar�PG4/�! 0G.dq/; OA TE= ,BA XTE,2 6 NYE /NC. TN/S P,CA.v/s ,t/oT BASED AV ,26G/S7ie.2E0 O�FSET.S.Sh.Oi✓�V S�,dv�� Na7- AP.�,L U.SE� TO vETE.2�(/�vE /-.o7- TOWN OF B�A/RNSTABLE f LOCATION 2 �� � ,/�Cf .SEWAGE # VILLAGE /Opl`�i� ASSESSOR'S MAP & LOT -130�-D03 INSTALLER'S NAME & PHONE NO. J/0- A / - �� Gy,� SEPTIC TANK CAPACITY LEACHING FACILITYz(type) 7- (size) I J-0 aC v� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: { VARIANCE GRANTED: Yes No r .. • �. i` � � � h � iG '��T� � � � :�� /7 � � f � � \ �� � � •• �� t �,I Z b✓ . x `1.q o� �o �y.����� ,�� No..-. � Fss... ....2Q.JO THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town OF Barnstable ..................... ....................--.....-_..........--------------------...._.._..__...--------------•- Appliration for Diqpooa1 Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair .4XX an Individual Sewage Disposal System at: 32 Heather Lane Centerville ................_................................................................................ .......------------...............-------------------..-.......--••------•-------------------•---• Location-Address or Lot No. Richard Silvan ......................-.......................................................................... _..-......---------...-------------...--------•--•--------.-...---•--•---•--..........-:...-----.. w J.P.Macomber Jr.Owner Address Installer Address UType of Buildy" Size Lot............................Sq. feet Dwelling—No. of Bedrooms...................3......................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 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........................................ P-1 Test Pit No. 1................minutes per inch Depth of Test Pit...............,---- Depth to ground water........................ Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 ._..---•--•-•----------------------------•-•--•-•----------------....---------------•--•-•--.....---......................................................... 0 Description of Soil...................................... x3arid...&---Gra-ve-1---------------------------------------------------------•----------------------- v ..............................................----------------------------------------------------------•----------------------------•------------------•----------------------------.....-------------- W U + Nature of Re airy or terations—Answer when applicable................................................................................................ -------------------- :---------------------------------•-------------------------------1--1J�0._.�allon---leaching pit. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI..i 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issu I byithe board of iealth. Signed ... ......... Date Application Approved B r �,-,�. ---, !'�.,, PP PP Y "' -------------•------•--•---•-- /- Date Application Disapproved for the following reasons-- --------------•---------------...----•-------....------••--•-----------------------•---------•-------------•- -----------------------------------------------------------------------------------------------------------------------------------------------------------------•--------------....-------•------------ Date PermitNo.......7 '�.).�1----------------------------- Issued_..................- te................................ Date No..- ` Fmc !>S'1 ..... ........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town oF.... .'rns.table� ......... .. ................. .................. Appliration for Uhipaii al Works Tomitrurtioo rumit Application is hereby made for a Permit to Construct ( ) or Repair (yY) an Individual Sewage Disposal S stem at 2 Heather Lane Center-.r_ille .........-•-----...................................•---...-----•--•---•--------....---------..... --•-••-•---•-•-•-•••--------•-----••-----•-----•------------------•-----------•-•......------•--•- Location.Address or Lot No. R5 � 'h,ar,l S ' . �..1 ......................-.......................................................................... .._.......•••---•-••-------••---..._..----....-•-••-•----•--•--•-•-------•---•---•------....-•---- Owner Address W J.P.^.q�„o-:1 >er or. 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 ( ) d 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........................................ 1.7 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........................ a .------•------------------------•--••-•-••••--•-•••--•--••••-•--•-•••••••--••---•--•---..._...--•---......................................................... 0 Description of Soil-------------------------------------••-•-•.....---•_•-•-----•_... ............. x _ e -------------------------------------------------------------------•--•---------- ��r�l+a :�, �.�rave1 U ••--•-•-•----•-•-••-•--•-•-•-----•-•-•---------••••-••-••------...-•-••••------•--•--••••••-••-•--•--•--•••-•--•------•----•--------------•••---•--•----------••-•------•••-••......----••-•-----•------ W ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--•. V� Nature of R�pairs or Alterations—Answer when applicable------------------------------------------------------------------ ......... _....._.___. ---------------------- •-------- � 1--1'Y") "."l l.a., l e a c h i n , pit. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1E 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. S /' ,elf �✓ '�! �igned_:l�.?c4 !!----Z-- Z��2 � � --------------------------- f ).......... Date Application Approved By--•-------•-- 1 - r J Date Application Disapproved for the f o ow�%ng reasons:--------------------------------------------------------------------------------- -----------------....... ..........-•••-•---•................•-•---••-•--....-•-•••-•-----•-•••--•-----•---•..._..••••••--•-••••---••-•--•--••--••--------••------••------------••-----------•------------------•-------•----•--- Date PermitNo....... t}'r ... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. Qk'D OF......... a�a.rl, table .................................................................. murrtifiraie of Tootph aurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired i( hj by :T.F. ��, •. - r= ----•---•------••-•------•---•-•-•--••-•----••-•-•-•-••.............••--....--•-•-•....-••--...-••---•-- 32 1I^:£1 ;her Lane C enter-i lle Installer has been installed in accordance with the provisions'of TI:"IZ 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------17-,OL__--I.�/________________ dated-.---------..................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO -_TRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 1 .� Inspector `� i � DATE--..-----. fy L....`� .---.--:!:..��.............•---•---....... f .ram�!-----•-------- -------------------�;.......... r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH of _ . No.../�2.-.� _..... FEE `.................... �i��ros�tl ork� �oa���rion rroti# - - Permission is hereby granted......_.:`�'�...��. '` �"..��....._.`T�'.. . ' to Construct ( ) or RepairX) an Individual Sewage Disposal System t at No. ............................................................ 1 Street as shown on the application for Disposal Works Construction Permit No.. /_. _____ Dated.......................................... ............................... -------- ____ -------------------------------------------------- Boar, of Health DATE.............. u 1�} = �( r FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ' 'f-" 1 No._ :�t2.--•• Fxs.... ....30 00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for lliopooal Marks Tonitrn.rtion famit Application is hereby made for a Permit to Construct ( ) or Repair �X) an Individual Sewage Disposal System at: ... ........ Stake__Road.._Centerville ••-•-•-----•------•-•--•---------•--•....---••••................................................. Bruce Cochrane cation-Address or Lot No. _.......--••----------------------------•---•-•----•----•-------•-•------•- --•-•-•------------•--------------•............------•---••-•-•--•---•------..............._...--- owner Address W J.P.Macomber Jr. Installer Address d Type of Building Size Lot............................Sq. feet v Dwelling X No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........................---- Showers ( ) — Cafeteria ( ) 04 Other fixtures ----------------------------------------------d .... -------- ------------- ---------•---------- 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G%, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-----------.-•_-----___- a ---•-------------------------------------------•-----------•----........-•------•--------•----------......................................................... 0 Description of Soil------------------------------------G-------------------------------------------------------- x � Sand & rave 1 --------------------------------------------------•---------•------...._.. c.� ---•------------------•---------••-----•----------------------•--------------------••-..._....-----------•-------------•--•----•--..-- --------------------------------------------------------------------------------------------------------------------- ---------------•----•---•---------------------------------------•--•---••------- U Natu of Re$pirs or Alterations—Answer when applicable----_-___ 1_4 1 � !' ---I=...S�Q..:�aTTori---tank-------•--•----------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli ce has bee is ed by the bo d o health. � � - Signed - - - -- --" ----- -- --- -t----------------- --lll.���.r�..----------- Date Application Approved By -- -------------------------------- -------------------------- ��M� Date Application Disapproved for the following reasons- ..........................................................--------......--------------------...------------------------------.....----- ............. ----------------------------- -- -....-----.-. .....-------------------------------------------------. ........................................ at - ----------------------------------------- ---------------------------...-------- D --------- e Permit No. ,�f . �6----------------------------------- Issued .----------� . -----T....---- ................... Date Fs$.....$....30.00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE �.-- Appliration for 14spuaial Works Tonstrnr#uan ramit Application is hereby made for a Permit to Construct ( ) or Repair j X) an Individual Sewage Disposal System at: __.51� Old Stage Road,..Centerville_......._... ranecation-Address or Lot No. Bruce Cochrane --------------------------------------------.. ..........--..................................................................................... Owner Address W J.P.Macomber Jr. d Type of Building installer - Size Address ............................Sq. feet oa C Dwelling X No. of Bedrooms.......:....................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............ ._.....__.__.. Showers ( ) — Cafeteria ( ) P4 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 areal............___.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........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •------------------------------------------------------••----------------........-•----------------.......................................................... 0 Description of Soil......................................................................................................................................................................... x Sand & 'Gra.vel U ................................................•••------•••••-•-••------------•----••--••--•-•-••----•-------•---------•--•---•...-•---•----•-•-----•----------•-•-----•---•-----•---------------•--... W -----------------------------------------------------------•------------------------------- -••-------•••-••---------•-•-----•••......-•--•......................................................... U Nature of Repairs or Alterations—Answer when applicable____-_-_-- ._ 5 �...-.a:16 t8 ilk - ---------------------------------•-----• ------------------------------------.....�--••-••••••-••--••-••-••.......•-••••......--•--•--•-......•... 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 bee issued by the board of health. Signed . ,., ° ,................... ...l IR/9C----------- Date A Application Approved B �y/ Grn2�=^—'\..................... ...................... ..�..- ire/ -ff ....... Application Disapproved for the following reasons- -------------------------------------------------------------------------- ---... ....................................................... ------------ -------..............................................------ ---------------------............................................ . -------------------------........------ Dare !r Permit No. ...... -- ..-.-.1�---------------------------------- Issued ....------. "' �1`.`..... .........--------.. Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�er#ifirate of Contylinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired�KXX ) J.,P..Macomber Jr. 55 Old Stage Road Centervillselle, 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. .....,cl(1...... ................. dated ..........---................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTICIN SATISFACTORY. DATE............ Y .0 ........ . �..? Inspector . ... ............ � � �.� -.. . - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��..... TOWN OF BARNSTABLE FEE...... �O...00 No../.!`J..."..A . ........-•--- Disposal Works Taan#rnrxian trrntit Permission is hereby granted.......J.P-._Macomber Jr. ------ _ to Construct ( ) or Repair ZX) an Individual Sewage Disposal System atNo.......595... 3AL--9t.&9ea...R_oA...Ge tem .J.lA........---•---•-------------------•-••-----............---.....------........_....-----•-•---......... Street as shown on the application for Disposal Works Construction Permit No...7,:�.�n-...... Dated.......................................... \� BoardofHealth-------------------------------------------- / DATE........j-�-...L�..�... ...�................................•--,. - FORM 36506 HOBBS 6 WARREN,INC..PUBLISHERS