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Home My WebLink About0336 BUCKSKIN PATH - Health CENTERVILLE A = 191 128 J� a � 2 UPC 12534 N . 2� 15w 3LOR gaGSr.00u5Jp� WASTING$, MN No. U Feed510 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Migooar *potem Construction Permit Application for a Permit to Construct( )Repair(X<Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address 94.ot No. Owner's N Address an l �TO,No. oP/� 33C� Assessor's Map/Parcel / I i �� jl� Installer's Name,Address,and Tel.No.-725—� �� Designer's Name,Address and Tel.No. �o Yl1 E� 'p"O U 1 la^ W/Yi se'-v1C'-d- Type of Building: Dwelling No.of Bedrooms I Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures ' Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil S Nature of Repairs or Alterations(Answer when applicable) r - I/-%Y_ 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 Bo d of Health. Sign . GP Date/)`,1Zf—d-C- Application Approved by Date Application Disapproved for the following reasons 6Z Permit No. o Date Issued J Q' ~ U 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLX HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Migpool &pgtem (Congtruction Permit Application for a Permit to Construct( )Repair(X<Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address gyj��L.ot No. Owner's Nam Address an Tel No. 14,4r k Y,4 and az 3 3 /j;? i Assessor's Map/Parcel , I I Cf�rv, /-t Installer's Name,Address,and T 1.No. 77 s' Designer's Name,Address and Tel.No. �✓m R'. Type of Building: f. r , Dwelling No.of Bedrooms y 4 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow, gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank T Description of Soil 5,d4 9 f Nature of Repairs or Alterations(Answer when applicable) /o.f Date last inspected: 4 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 Bo d of Health. Sign Date/)`'wZf��-y Application Approved"by Date Application Disapproved or the following reasons( f -- Permit __W xf) 4:n No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS VAm° BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that tb e On-site Sewage Disposal SS tern Constructed( )Repaired (Upgraded( ) Abandoned( by kzm C k,0 0/y�Sn� e. Jtry�e at ? T& u @.4 ��ki✓J, IO 42 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer 1 The issuance of this permi s a tl notbelponstrued as a guarantee that the sys �Will nction as desig d, c Date Inspector _ -------- ✓1�� 7-- No. � � r / ✓ter-*-- /f� Fee �g yyiU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpogar *pgtem Con1truction Permit Permission is hereby granted to gopstruct( )Repair 4'�U grade( )Abandon( ) System located at 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., l' Provided:Constructio must be ompleted within three years of the date ofPt. Date: Approved by r 116l99 -. NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMn(WITHOUT DESIGNED PLANS) I, William E. Robinson,S�eby certify that the application for disposal works construction permit signed by me dated ��"'l � , concerning the property located at )/ (S�fC tt�t ��l h meets all of the following criteria: a , • The fail system is connected to a residential dwelling only. There are no commercial or business uses assoc ted with the dwelling. The soil is classified as CLASS I and the percolation rate is less than or equal to S minutes per inch. There are o wetlands within 100 feet of the proposed septic stis�en► • There ar no private wells within 150 feet of the proposed septic system There* no increase in flow and/or change in use proposed • The are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the ma dmurn adjusted groundwater table elevation.[Adjust the groundwater table using the Frimptor method when applicable[ • If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation _ +the MAX. High G.W. Adjustment DIFFERENCE BETWEEN A and B SIGNED : % � DATE: ,� � [Sketch proposed plan of system on back). y:health folder:cen .. z :.. .,-.. a �� y y - 1 4l �� '� TOWN Ot,BArRNSTABLE ' C. LOCATION 23 SEWAGE 10 VILLAGE t ASSESSOR'S MAP& LOT �' INSTALLER'S NAME&PHONE NO. -7 77 Z SEPTIC TANK CAPACITY AF z,--e LEACHING FACILITY: (type) <_ (size) /�L-3 4 e--r> NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE:, COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table t/theBottom 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 Leachin I/ acility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i" �. .. �e`� I .. �,, 9 ��` �� ^'�� c '� .� 1 k �._ .„ —-- i TOWN O ,BA.RNSTABLE '' II f LOCATION 3� � � cr c�� •;�. ��N SEWAGE. -� VILLAGE c.'-y l ASSESSOR'S MAP & LOTfl - INSTALLER'S NAME&PHONE NO. %t 6 . -i. .f� /L., SEPTIC TANK CAPACITY 1EC,--fi LEACHING FACILITY: (type) L (size) /�2-—3 e,; NO. OF BEDROOMS t/ BT,TTT nr:D nD numm D PERMITDATE:�/ems' '�"� COMPLIANCE DATE: %/—Z,< Separation Distance Between the: Maximum Adjusted Groundwater Table,t6 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 c M 7 $ 5.00 Fms..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ."."T own...I......OF.........Barnstable Appliratiun for UiupuuFal Works Towitrnrtiun "trutit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 36..Buckskin Paths..Centerv_ille, MA -026 ----------------•--......--------•---------•-----•- Location•Address or No MarkVamo. .....................•------•------•-------......-----............--------•-----.................. Owner Addre W A & B Cesspol Service 128 Bishops Terrace, Hyannis, YA 02601 - - 1.4 1.4 Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................3..........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons....___..__....3.......... Showers ( ) — Cafeteria ( ) Pa 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........................................ aTest 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........................ P1 •-------•----•------•------------------------------•-------•------------................••-•-.---••-......................................................... Descriptionof Soil........Sancl---------•...............•...:---•-••--.........-•-------------•-------•---------------------••-----------...--------------•---------...........------ U W ----------•----------•-----•--------------------------------------•---............---------•----•----------•----------------------------------•-------------.......................................... U Nature of Repairs or Alterations—Answer when applicable._.ixl�t.�71&f _S?I�__of--a--1.,-000_-gallon--pre-9ast, storLe..packed._.leach..Tait---(faverflow)-A-------•-••-•---------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI,= 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complianc issYed-by t o r health.- .., . Sign . -•_C ---- _--------.' .�` '' •1--2 .....28,81............ Application Approved By------. ------------------------------------ ---------•12M81-_....... Date Application Disapproved for the following reasons:.............................................................................................................. --••-•-•-•--•-••-•--•------•-•----•-•----......--•--------------------•----------•-------------•---------------•--•-----•-----•---------------•----•--•-••--•------------------------------------....... Permit No...........81- - Issued......12,28/81 -•-------------Date...... Date ^� rr 8 - $ 5.00 . . FEim............._............ _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................... own-..--..--.OF.........Barnstable... ApplirFation for Dispas af- Works Tonstrurtion 1hrutit t Application is hereby made for a Permit to Construct ( )` or Repair ( X) an Individual Sewage Disposal System at: .. +-- A .026j2. .................. Location-Address or t N Mark Yamos 336 Buckskin Path, enterAle, KA 02$2 ---------------------------....._.........__.---- r---•-- ------•-••-•----... -__.._____..___------- -_-.___ ------_---_..__...-------•----•............... A_do B Cessool Service 128 Bishops Terrace,eHyannis, MA 02601 - ------------------------••••-•--•-----••• - ••----.....•--••............•-•••--•--••-••--•-----_..... Installer Address UType of Building Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms_______________ __________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons__-.____._-____3.......... Showers ( ) — Cafeteria ( ) dOther fixtures -----------------------••----------------------•-•---.-••••-••-•-----•---••••••-•-•-------•--•---•••--•••••••••-•-....--•-•••.....•--•._...._•-_-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............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..................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........................ GL, Test Pit No. 2.........._.....minutes per inch Depth of Test Pit.................... Depth to ground water......................... ...................................................•.........................................................................................................O Description of Soil........Sand................. ......•......................................................................................................................... x U .........................................-.............................................................................................................................................................. W UNature of Repairs or Alterations—Answer when applicable_.iz�sta�lation-_Of__a l,000 �allOn pr9—Cast, shone--packed._1each.-pit---(.aYsrflox)-a...................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of.ITT:;. 5 of the State Sanitary Code—The undersigned urther agrees not to place the system in operation until a Certificate of Complianc as eeik'ssued by the bo th. , Sig �......-------------•-------- -----------._.....------ ---f1c ......................... ' Application Approved By....... •--• •-' .�X.-....::-'�� /�`r81 ........................................ Date Application Disapproved for the following reasons:-----•--------•-•---------------------------------------------•-----------------•-----•-•-••••••---•-•..._._.... ......--•-•---•-----------------------••-----------•-----•-----------•--....---------•-•---•---.....-----•--•-••-••-••-•••••-••••-••---•-•-•--•••••-----------•-•-••-----------•-----•-•-•••---•------- Permit No............81....................................... Issued 12/28/81--•-------------- Hate...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1t .......................TQXn........0F.............Baxnets.b],e....-...-....-...........-.......'........-. Tntifiratr of Gout fi nre THIS IS TO CERTIFY, That the Individual Sewage Dispos l_Syri�n c$Stru�t g0( ) or Repaired ( X) �tr a Yan 1 A & B Ces ool Service 12 r�isho s Te ac by.......---•-•-•••-••-•._......................•---.....-'•---•--.........----••--p•••---------•------....-•-._.._.._......---•---•••••-..._.._..__._..._.....-------•-..............._......._ Buckskin Path Centerville, MA Ins�y]�ey32 _ Mark Vamos ` at --------•--------------------'-------------------------------------------------- ------ has been installed in accordance with the provisions of TIT — 5 of The State Sanitary C�d� � fribed in the application for Disposal Works Construction Permit No______________81 ____� `�--........... dated.......----/----�----.-_._.____._.______- ' THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................................�_-�`��sf 1 .................... Inspector...........................................4ZZ:_k..._ � � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town OF.......Banstable................•-------.......•-----•---•-........ No.__81.-._ b`;l FEE..$ 5-00....... Disposal Iffiarb C�onstrnrtion ranfit Permission is hereby granted...............A & B Cesspool Service ----• ............................................................... Construct �) or Repair (X ) an Individual Sewage ;pk,� sal guest at No____ __________ckskin Path, Centerville, MA 02b - Ma c�Vamos r Street as shown on the application for Disposal Works Construction Permit No 81 ._._____ gated.......................................... / Z �B ar�ealth DATE................. � �-------------------------•••••- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS " LOCATION SEWAGE PERMIT NO. - 33 b �uc��-,►� 1��I-lam VILLAGE i fig INSTALLER'S NAME i ADDRESS fit- 00--;6 o 6UILDEIt OR OwNE DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED�a_ �_�j r JC, _ y Ys -09 to C'�ss��j o