HomeMy WebLinkAbout0041 BRAGG'S LANE - Health � s
A�\ a - S'7
LO-C=A T ION S E E PPRMlT NO.
7,72 04 VI t LAGS
INV A LL'Enos NAxM`E ADDRESS
S UILDER OR U 6WNER/I
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® F HEALTH
.. ?fJ_-l!!�_-}....OF........... �' J/.fir': - ..................................
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System
....... � -- ` .... -11--��' --•-•--�-----•................................
oca*o -Address or Lot No.
+^...---1�-=•---- -'�-•-- •--• - - -•=....... •--....------•-•-------- ---------------------•--------------•--•-•• Address
ress
a =----- ... •---------------•-------- ----•---------------------•---•-•----------•-------------•----._._..__._.._._..-------•----...---- -.
nstaller
----_-•--- Address
Q Type of Building,," Size Lot............................Sq. feet
U Dwelling 2 No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures ____________________________
Q ==---------••-•-•
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........................................
Test Pit No. 1................minutes per inch Depth of Test Pit____________________ Depth to ground water_______________________.
IZ4 Test Pit No. 2................minutes per inch Depth of Test Pit...............__. Depth to ground water........................
P4 ____ _ ____._..._____.___ ........
O Description of Soil ��1�� �'{ ------ ----
x
U ---••-------••--•-•-•-----•--• _ ----........ -----•••.............•-••••-•-------•--•---•-------•------•---•------•-------•---•• - --
W -------------------- ---- ----------------------- -- =
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U Nature of epa s r Alte ations—Answe hen ap icable____ __�-..............
W........ &--------2c�
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of I- .
p '" 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.
Si ned......
Date
Application Approved By ...... --- ._ � 7
Date
Application Disapproved for the following reasons:........................................- ------................................................................
.........................................................................................................................................................................................................
Date
PermitNo......................................................... Issued.--------Z---.f------ �-�---------------
No....(�U....... FEB......... .............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD qF HEALTH
........... ...................-OF....... IL944V...... .................................................
Appliratioular Dhipasal Works Tongtrurtion an it
Application is hereby made for a Permit to Construct or Repair an Individual Sewage'Disposal
System OV: 4*'�
.
Address
. .. ................. ..... ....... ............. ............................................................................
o a'0 Am-;/-"P . .........
C --------
. .. ... ..... ........................... ..........................................or....Lot No.
....................................................
. .. . . .......................... ..................................................................................................4
...................!i.. ..... ..
.staller Address
U
11 Type of Building Size Lot............................Sq. feet
T_
Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder
Other—Type of Building ............................ No. of persons......_..............._.___. Showers Cafeteria
Otherfixtures .......................................................................................................................................................
Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
1:4 Septic Tank—Liquid capacity.............gallons Length................ Width..____..___..... Diameter__-____-_______- Depth....__.._....__.
Disposal Trench—No_-----------........ Width.......i------------ Total Length___...._.._......... Total leaching area....................sq. f t.
Seepage Pit No..................... Diameter.._:_._..___........ Depth below inlet_.._................ Total leaching area..................sq. ft.
Z Other Distribution box.( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date-----------------------------------_....
Test Pit No. I................minutes per inch Depth of Test Pit__..__.._...._______ Depth to ground water.___..............._....
(Z4 Test Pit No. 2................minutes per inch Depth of Test Pit.........._.__A_'bepth to ground water........................
9 ................--------- ...................I r..............................................................
0 Description of Soil ....... ..... ------------ --- ......*......................................................
......................
....................................... ....... ..................................I......... .............
U ...... .........................
-------------------------- ------------------------------- ...........................................----------/—------
U Nature of e Al itions=Ans licable.
- ._'__•__
I.. %
-------A-------- ---------- ------ ----------
S r ... t .................................
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 undersign�d further agrees not to place the system in
operation until'a Certificate of Compliance has been issued by the board of health.
Siged...... ------------- ..................................................... .................................
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0.*'7 ,9
M44 &_01 ..... . .... ............f
Application Approved By.................. ....... ... ............................. ----- .
Date
Application Disapproved for Me following reasons:........................................T
..........................................................................
........................................................................................................................................................................................................
Date
PermitNo......................................................... Issued.......................................................
Date
THE,,.COMMONWEALTH OF MASSACHUSETTS
BOARD; .F` HEALTH
............... ...OF...... .... ..... .......................................
THI V' ...TO C RT Ividual Sewage Disposal System constructed or Repaired
by.....-_. Xei�. ............ .' . .. . . .. ............................... ................................ ..................... ------------------------------
I.rta
_-y
.................................
al .... ..... .................... .................f4__ .... ..........7_�*J............
has been installed accordance with the provisions of T of State Sanitary C de as described in the
application for Disposal Works Construction Permit No. ... ...... . ............. . dated-...7!;_--- ........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
I
DATE...............I
................................................................. Inspector.................................................1....................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OVFEALTH
C_ 01�
.........V-le .. .........OF........... .. ...................... ........
No................ . ... FEE.....�5................
Permission is ------
'�iereby granted_ . ... ...... ........... . .. .. ..........................................................
-'Re. r),?A 'r
to Constrgctj� Rep an, I idual S age isposal System
LAI SP' 10
a ....... . ......... ...... ...... ......... .......
griect
as shown on the application for Disposal Works Construction )ate .. ...............
Permit .... ...
................... .............. .... ...........
Board of calt
DATE.----- ...................................
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
M�- TOWN OF BARNSTABLE II�A�� v4 ' - t
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/UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS 'G
:ASSESSORS MAP NO. PARCEL NO.'® �9 �
ADDRESS; !�5(s 6 �/f G VILLAGE' N&KrAVE
11AME:._. 1A.1�. - Cr
CONTACT PERSON PHONE NUMBER 3 G
LOCATION OF TANKS:. CAPACITY: .TYPE- OF' FUEL GE::� T E: LEAK
OR CHEMICAL: DETECTION
o F� !0 '� Kti I�sa_ S . JEM=
WI
LLIAM P. SWIFT
ATTORNEY AND"COUNSELLOR'•AT LAW r C,®
49 ELM STREET
T." G} HYANNI6, MASS. 02601
t
DATE OF PURCHASE OF EACH: 1. 2. 3. 4. 5.
DATE OF FIRE DEPARTMENT PERMIT:
I'I TESTING CERTIFICATION SUBMITTED:, PASSED DID NOT PASS
PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD.
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WILLIAM P. SWIFT
46 Bow LAME
BARNSTABLE. MA 02630
TEL 508-362-3644
October 20 . 1 988
Board of Health
Town of Barnstable
367 Main Street
Hyannis , Ma 02601
Re : Underground fuel tank .Tag #470
Gentlemen :
Please be advised that the 1000 gallon fuel tans,
on the premises at 46 Bow Lane Barnstable , Mass
has been removed and was inspected by the Fire Chief
of the Barnstable Fire District .
I am _enc l.os i ng a cop,, of t-he Storage Tangy.: Removal
Receipt issued by LGR Tank Services., Inc .
Would you please update your records accordingaly. v
0
Very truly you
i t plar(ra�44 S i f t
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LCR
Tank Services, Inc.
P.O. Box 765 Marstons Mills, MA 02648
508-420-3365
Storage Tank Removal Receipt
Date: 10-18-88
TYPE: Oil #2
Gas
Other
Owner: Mr. William Swift
Address 46 Bow Lane
Barnstable, MA
Tank Size: 1 ,000 gallon U.S.T.
Date Removed: 10-18-88 FDID a: 01919
LCR Tank # 201-88 Dig Safe # 88405195
LCR Project a T2139
Tank Transported To: LCR Tank Services, Inc.
381 Old Falmouth Rd. , Unit.#5
Marstons Mills, MA 02648
Inspector:
Comments:
Approved Scrap yard:
James G. Grant Co., Inc.
28 Wolcott Street
Readville, MA
Yard # 03501
ank Services
`.WILLIAM P. SWIFT
1 ATTORNEY AND COUNSELLOR AT LAw
49 ELM STREET
HYANNIS. MASS. 02601
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