HomeMy WebLinkAbout0055 BRIDGET'S PATH - Health 55 Bridgets Path
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HABTINGS.YN
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No.)0(b — d 1a (1
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Zipphtatlon for -Misposal *pstem Const union 3pPrmit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.6J'5 by s 4'(bm Owner's Name,Address,and Tel.No. 50Q,' Ll ag' "S5ol!;
C'�n-4c u i 1 l c p v+�A ,pa c{C a.'J(A-W n-De—j e. c
Assessor'sMap/Parcel Ilcq 64iCj G. h en0e T
Installer's Name,Address,and Tel. o. Saa WP—o f/!V Designer's Nalne,Address,and Tel.No. —Acr& a 1-11
- B R),f.J c�issLI.V a..1;d Yr A 5o*1
a.v.,i7 134bAd (.t) , 5 61a or -t in 6a rd w« W P Oa$3
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) N gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Ilk-
µ*tk, rdt4&,e.K*_aL kkA trap,,Yi in r
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Bo Ad of Health. a
Signed Date
Application Approved by t i. Date e
Application Disapproved by Date
for the following reasons
Permit No. �(5 Date Issued 3" `
-------------------------------------
No.;0 16 3 Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplication for MisposaY 6pstem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No 55 P)v r 4 0'1 r Owner's Name,Address,and Tel.No. �t><t �I C- aS
n r l i it C -yl ,A K` ! s ✓i�iP' +'e n G r C
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Assessor's Ma /Pazcel _
1 G /1 .f��} r /'�;.L. f
p { �-�" 1 1 �- C'c-� it�Ca`�' �1 �£'V'1 l F!L I L
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Installer's Name,Address,and Tel.tNo.Serp rJ�S'—py j!/!f Designer's Name,Address,and Tel.No. J.
8RJ,4,a C -:1(,-1l ck +�� �a mow►
a (m) On Rcf L"), r u-: trn a
Type of Building:
Dwelling No.of Bedrooms ( Lot Size sq.ft. Garbage Grinder( )
i
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) /V gpd Design flow provided /� gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil +
Nature of Repairs or Alterations(Answer when applicable)
�,, I iL ►n �ti r (_4G.c Inc r c c�vCa vYi r47 �.,f , 4 �r,r. J` CC
I � � tl
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions°of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Bo d of Health.
Signed _ Date
Application Approved by J Date 3- 7 `1
Application'Disapproved by Date
for the following reasons
Permit No. go Date Issued 3_ N
-----------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO ERTIFY,that the e,On-site�e Disposal system Constructed( ) Repaired( ) Upgraded( )
Abandoned( )by c
X at i��t a _ r . 4 h C' n{e -t� has been constructed
^in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 ojb-S9 t dated
Installer Designer
#bedrooms ' A) Approved design ow gpd
The issuance of this%permit shall not be construed as a guarantee that the system wil `nctio, a designed.
l j
Date �/�Z�( � 'ry Ins-
------------------------------ �
----- ------------------ - -- Fe -
No
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal *pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( )
X System located at 5 c, &t t(Q.V 4', n G`((n ('e-v� r y I t C 1'YI r't ( u
9
and as described in the above Application for Disposal System Construction Permit. The applicant recognized-his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date I� Approved b
PP Y
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r_ TOWN OF BARNSTABLE
' f3F • a���s
A11ON SEWAGE #oZ DD
VILLAGE C e/�t Pa. �t ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. f�9s?Dn,i^
SEPTIC TANK CAPACITY /ov® !.0 &
LEACHING FACILITY: (type) (size) I O
NO.OF BEDROOMS q
BUILDER OR OWNER 0C s T e ro,,,
PERMITDATE: q--Z - D 3 COMPLIANCE DATE: `f-93
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
,s
Q
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3
1 � I,
No. C�2cv 3 Fee
t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYication for ]h6pool 6potem Con!6truction Perron
Application for a Permit to Construct(Pr\)Repair( )Upgrade(. )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. } Owner's Name,Address and Tel.No.11�(DES
ru f`vt 0- pn—m ic-lei Dies—,
Assessor's Map/Parcel i q 65- AR-1066 i-5 1��11 C£� J=mot LLG
Installer's Name,Address,and Tel.No. 1 Designer's Name,Address and Tel.No.
f1 (Z€. cXC./:lt-14'7 (�c0;yZu-9i3oo DAjiD e,-tAS0r (503)M-2.177
3 ;8-6`giZ0 , 120 DLc-
Type of Building:
Dwelling No.of Bedrooms_� Lot Size sq.ft. Garbage Grinder( )
Other Type of Building ��It No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow /D gallons per day. Calculated daily flow gallons.
Plan Date 21-Z3 - y Number of sheets Revision Date
Title
Size of Septic Tank j o C» Type of S.A.S. .5� Ni CAS ��i=dfT/z,rti�'dZS
`✓/�/ F�' Si�' .s3/3c'�u�u�
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Pi.MP1,.)IC,/Ftla_ING Lc-e _1•1 Prf' L-/ FIG(-
Q�pi�'+r.J NG tr+ .17, N I GAP I N�iArs'2�'cfdt5 Lam/ �1�-f 5�[TN� A/govNfl S I L3C.�
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this B 5-of
Health.
Signed Date
Application Approved byZkF9Z Tc, `t Date -3
Application Disapproved for the following reasons
Permit No. 2003`l 29 Date Issued G3
No
Fee ---
? Entered in com uteri
' P
THE COMMONWEALTH OF MASSACHU'SETTS
t° >a. Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
2pprication for 0iopo.9;ar 6potem Congtruction Permit
Application for a Permit to Construct(pe\)Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
1 Location Address or Lot No. Owner's Name,Address and Tel.No.
5� g)21DGe-i5 }�
c�►.� a��mac . M- 2►C_-a REST 6F/?/V0
Assessor's Map/Parcel Q
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
PA51bQZ CXC4 41� 53o0 �1>vtO f�tASoN (50t)933'21�7
&3 t30)91ZO( V /ZD SA�vOW►[1! � L CN��Qa+�Cr� $q►.�Ow�tay
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building Siw[z P-4Mn t No.of Persons I 1 Showers( ) Cafeteria( )
Other Fixtures
Design Flow // gallons per day. Calculated daily flow yq o gallons.
Plan Date 3-Zi - z-:Y Number of sheets 3 Revision Date
Title
Size of Septic Tank /,to co 0 Type of S.A.S. S PO GAP /i r-Q/7 '70n5
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Pkom?l Ny�Ftl i j#JL cCc1.14 Ptr w/ PC(-
¢EPLAU Ne, w 6 H l CAP y-,r4 trt'2A7 c M S!'ONti A f20 V N>Q S I�C c
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the.system in operation until a Certifi-
cate of Compliance has been issued by this Board of Health.
Signed Date Z `
Application Approved by _ c `s Date -3
r
Application Disapproved for the following reasons
Permit No. 200 3 ` 12 g Date Issued 1-
-------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired()C )Upgraded( )
Abandoned( )by PfV!3 i rnz-C— Ex e tM_V41Vs rdVP_) 1►..)C
at F5 R R l dbr_--,7,5 P A i to has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 2003— 121 dated
Installer Po ,cswr_ �tLb vA 1ir�^ Designer %.„
The issuance of •s p t shall not be construed as a guarantee that the system f. a�n esgned.
Date 'c1 3 Inspector
---------------------------------------
No. 3 Fee d
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION — BARNSTABLES MASSACHUSETTS
lwigpozal *pztem Con6truction Permit
Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( )
System located at 5r; RR 106L- 1�AT31 e.Fki-m-fL V I VL� Nt ti4.
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of tW- e, tDate: aA 3 Approved b�.
tjo .0s& V
0t.4OCA1IO'N SEWAPERMIT NO.
l > r rl
VILLAGE
v!4.(_ 'I Q. q. 6
INSTaA LLER'S NAME i ADDRESS
I/E LO l f A-`0 gX 0-5
i U i L D E-R OR !WN ER
�1 S A4 /fH
DATE PERMIT ISSUED
DATE- C0-MPLIAKCE ISSUED
--Idol _
�EC-K
4
L-37
� `/'9.
s
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.1�?.. ................OF....... M. .
Appliration for Uiiipaa al Works Tonstrnrtiun ramit
Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage Disposal
System at: -
..... .. �, �. .......P ................................... .......... o_........--- .................--..--:-----.--------•---..................--
Lo'at7, -Address or Lot No.
`"`
Owner . Address-
.
.............:...........•LX0•�......•-------•-----•-• -•-•-••........ c ..:.V.. •- .
Installer Address
U Type of Building Size Lot.._�11 .....Sq. feet
Dwelling—No. of Bedrooms...........�.............................Expansion Attic ( ) Garbage Grinder (+)0
Other—T e of Building No. of persons............................ Showers ( ) — Cafeteria
0.' Other fixtures -------------------------------• .
W Design Flow.................110...................gallons per person per day. Total daily flow---------- 30._..................._gallons.
WSeptic Tank—Liquid capacitylO.00..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 t ( )
Percolation Test Results Performed by.__.... ._ ....... _._. _' _______________ Date ------•-••-•--
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
(s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a •---•-•-----•••---------•------•----••---••-•••••....----- •••...•---•-•--•-•-•••••--•-•-----••••-•.........................................................
O Description of Soil.....::..--I.........\ axyY .._...�__
x -•-------` _ ........ ............ -gm-f-------5.-V.0 r5(?.......................................................
W ...................................... � ' .......MP__...--------S --a................................................................................................
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 LITLL 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 cof_health.
Si ed•--•-� "\913..... ........ -------------------
Date
Application Approved By......... •• ✓ !//?— ✓.......
Date
Application Disapproved for the following reasons------------------------------------------------------------------------------------------------•--•-•........._
...................................•----...------------------------------------......---.....----------•---•••••••-•-•••-•-••---•--•------------•---•--••----------------•----••----•••---••----•--•_•--
Date
PermitNo......................................................... Issued.....................................
..................
_J
tr r THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.... .......--_---q._----------------------_-----.--.
Appliration for Uiopooal Works Tontrurtion rrnti#
Application is hereby made for a Permit to Construct (V or Repair ( ) an Individual Sewage Disposal
System at:
-• =—=, \t ,� c t ...................... ........ � 1,.�... ... ?__.._.. ..........................................
- •-
Location-Address- _ or Lot No.
r
. ` rTl o I
Owner -� dress
........ ..........................••-......... s............--.......--- .............. cs: ._.+.:_^... ....... - =_..................................
Installer Address
UType,of Building Size Lot.. �. '�. � .......Sq. feet
Dwelling—No. of Bedrooms..........3..............................Expansion Attic ( ) Garbage Grinder (0
`4 Other T e of Building No. of persons............................ Showers
a .yP g P ( ) — Cafeteria ( )
dOther fixtures ----------•-•-• •--•••••-•-••••••••-----•••-•---••-•---••••-•-•-----•-•-••--••••••-----••-•••••--•-••-•-.....••••---••-•••...-•---•.............••--
W Design Flow........................ 4Ah....................gallons per person per day. Total daily flow......... ..............gallons.
W Septic Tank—Liquid.capacitys.:)S?..gallons Length................ Width................ Diameter................ Depth................
xDisposal Trench—No. =.V................ Width.................... Total Length.................... Total leaching area....................sq. ft.
t.Y Diameter..........._.__..... Depth below inlet.._........_........ Total leaching area..................sq. ft.
Seepage Pit No.................*
Z Other Distribution box ( )'�.,s Dosing tank ( )
aPercolation Test Results Performed by........ -`;''- ---'._f.................. J- ................. Date.! .-1..__= .A..............----
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
40 Test Pit No. 2................minute's.per inch Depth of Test Pit.................... Depth to ground water........................
-------------------------- ------ --------------------------.-----------•---- ------•-•---------•------------------
O Description of Soil--•=---=---- --------- -•--••---r` :.: � = = -a
•- ••------ -' •••-•••••••-----•••••••...----••......---•--
--t\r_
W ••••••......-•--•--•••-•.........• 1. ................................ _...-•--•------------------------•---••------------•--------••----..........-•-------•--......--•--
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 TITI:;.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.
Signed:._...:. -z_C1•�Z:.: 1. : L--------------------- f_�?41... ...
--- - l •• _
� Date
Application Approved By ; _ ••-- Re
Application Disapproved for the following reasons: --- •-------
Date
PermitNo......................................................... Issued_.......................................................
Date
.W:
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............................OF...-_ .§.:L.r...:..: .. .+. ? :3n.................................
.
Tertif iratr of Tontpliatta
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( )
by... -�.......................................k== ---------......--•--•-----------•----------...--•---•---•-•--•--•--•-•---------------•-------------------•----•-------............--
Installer
at........................................�,s - b- �_ 1. - , - . — - -�
has been installed in accordance with the provisions of TITLE . 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.___ „_ �.............. dated.....__.._......................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............................. ._Lfl✓........._......._..... Inspector..... .............................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......-ram ..:.. --........ '..r ....j.- L..^.. .:...r�Eff V.... �...... .�\..............OF. §.._I.I':� j', v t- .............---.......... �f/
No.................... FE0.®...:1e..........
Disposal Works Taountrudion rrnti#
Permission is hereby granted......... _ _ �. )__�_____.__a 1� '?.:k_ _f._5•......._
-----------------------•-•••••-•.....---.......---•••--•
to Construct ( � or Repair ( ) an Individual .Sewage Disposal System
J Street
as shown on the application for Disposal Works Construction-.,Permit No..................... Dated.............. ........................
Board o th
DATE.............................. .............. ----------------------------
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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ASSESSORS MAP :- � �
_ _- - TEST HOLE LOGS
PARCEL :
FLOOD ZONE : l� _ �LIC��+?,�,,� SOIL EVALUATOR :_ ��UIC� NOTES:
WITNESS :
c P1LY��15 j REFERENCE: �� ram# �3SS 19 DATE : ! O
72 PERCOLATION I ON RATE: .L U�t I� installation shall com 1 with Title V and Town of Barnstable Board of
J 1) The comply
/ Z Health Regulations.
�i,, 11 Z g
� TH- ) TH- 2) The installer shall verify the location of utilities, sewer inverts and septic
rJ components prior to installation.
3) All septic piping to be 4 inch Sch 40 PVC at 1/8" per foot.
--_
4) Existing leach pit to be pumped and backfilled per Title V abandonment
w►�-+ ��
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` 5) This plan is not to be utilized for property line determination nor any other
LOCATION MAP = / �`5� /S '�' �'"' - - purpose other than the proposed system installation.
33 6) All septic components must meet Title V specifications.
7) Parking shall not be constructed over H10 septic components.
8) The property is bounded by property corners and property lines as depicted.
9) The property owner shall review design considerations to approve of total number
-N / << of bedrooms to be considered for design.
IN,� ,b41
1� SEPT I C:4 ..,.SYSTEM DES I GN
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FLOW ESTIMATE
7w��� BEDROOMS AT D. GAL/DAY/BEDROOM -
O GAL/DAY
i SEPTIC TANK
II 4LGAUDAY x 2 DAYS GAL
I
1 =.: USE i a GALLON SEPTIC TANK
.
SOIL ABSORPTION SYSTEM
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a SITE AND SEWAGE PLAN
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PREPARED FOR :
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SCALE:
w DAV I D B . MASON ZS DATE: 2743 0
DBC ENVIRONMENTAL DESIGNS
J
EAST SANDWICH . MA
W DATE HEALTH AGENT
W ( 508 ) 833- 2177
Z
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