HomeMy WebLinkAbout0043 CATS PAW WAY - Health 43 CAT'S PAW
CENTERVILLE
A = 192 115
(Irford, NO. 1521/3 ORA
10%
a •
i s
No.a00 1-03`-� Fee 'SO
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer,
es
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,, MASSACHUSETTS
Zipplication for Mi5po5al *p5tem Con5tructiun Permit
Application for a Permit to Construct( )Repair(t/U pgrade( )Abandon( ) ❑Complete System individual Components
Location Address or Lot No. CIWL VpLf
Owner's Name,Address and Tel.No.
Assessor's Map/Parcel 1 01 �.,_ -�d-Mzo
ss,Instal 's N e,Addre an el No.t Designer's Name,Address and Tel.No.
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 gallons per day. Calculated daily flow ���� gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank i Type of S.A.S. 0 r�f,64 G. "t"s—Al.-t�� %�4Trt�
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Iti.` \ c-�a� Gt1 0 -
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 is d of Heal .
Signed Date 1'.17el—O
Application Approved by Date
:Application Disapproved for the following reasons
I ' i
Permit No. .4n b �� Date Issued
No. (goo Fee ��-C�33 Ves
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:PUBLIC-HEALTH DIVISION._TOWN OF BARNSTABLE, MASSACHUSETTS
2pprication for Diopool *pgtem Construction Permit
Application for a Permit to Construct( )Repair(%,4 Upgrade( )Abandon( ) D Complete System Individual Components
Location Address or Lot No. q�C�s Ppuj
r Owner's Name,Address and Tel.No.
Assessor's Map/Parcel I OVD—ql�� 1"_jKo mx)
Install s Name,Address,and el.No. Designer's Name,Address and Tel.No.
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 7J� gallons per day. Calculated daily flow ��1 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank G,� (ivy.) r,,A c. Type of S.A.S. c{ <-c, 4 c,-t c.,__: r l 1✓�,�ce�'�
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) ik.,�; \� y}G 6 A .�
t ( UnG 1 umor✓_,lYucc'1cIDC C '5Te;L-r" F'rJA e,
a / in�(J
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 iss-ued-by_this-Board of tb.
Signed r± -'' Date
Application Approved by Date01
Application Disapproved for the following reasons
Permit No. 7h()I - 6 33 Date Issued U b
——————— ——————————————————————————————
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFYIhat the-On-site Sewage D' p9sal Sys
Abandoned by
Constructed( )Repaired(� )Upgraded
( )
at ? G has been constructed in accordance
with the provisions of Title 5 and the for isposal System Construction Permit No. .-X__�Q 1~03?> dated 1 / I g JCS 1
Installer I Designer
/zr>
The issuance of s pe t shall not be construed as a guarantee that the system--iill �unctionas de ign�C� ��f��1�
j Date Inspector d? I H - -
---------------------------------------
No. �oo1 Fee 'So
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Mi5pog;ar *pgtem Construction Permit
Permission is hereby granted to Construct( )Repair Upgrade( )Abandon( )
System located at Z2 M_,U
�.� r
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 this permit.
Date: I/ F O Approved by )CJQA_k,v, Sc
1/6/99
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 PJF..RMIT (WITHOUT DESIGNED PLANSI
hereby certify that the application for disposal works
construction permit signed by me dated —��—G� , concerning the
property located at L� CJ ���t/ C -� meets all of the
following criteria:
`,- This failed system is connected to a residential Y
dwelling g only. There are no commercial or business
.
uses associated with the dwelling.
61-/The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
,There are no wetlands within 100 feet of the proposed septic system
'There are no private wells within 150 feet of the proposed septic system
-.114here is no increase in flow and/or change in use proposed
/Chere are no variances requested or needed.
"/The bottom of the proposed leaching facility will not be located less than five feet above the maximum
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) r
B) G.W. Elevation 350+the MAX. High G.W. Adjustment.11
DIFFERENCE BETWEEN A and B
SIGNED : DATE:
[Please Sketch p opo p not system on back].
NOTICE
Based upon the above information, a repair permit will be issued for bedrooms maximum. No
additional bedrooms are authorized in the future without engineered septic system plans.
q:health folder:cert
-� '
�, � ,
Gtt�,D�
G"
W-L-�
O.
TOWN OF BARNSTABLE
LOCATION -C�{j''.S ,�NI l[1 SEWAGE # D J✓
VILLAGE �°e.,/ %�✓ !//l�C� ASSESSOR'S MAP & LOTjQ
•'
11
INSTALLER'S NAME&PHONE NO. Cam/
i SEPTIC TANK CAPACITY /o o
I LEACHING FACILITY: (ty ) i r/{l TiC/-/ /OfZ S (size)
I
NO. OF BEDROOMS
BUILDER OR 0 '
PERMITDATE: 7 Q COMPLIANCE DATE:
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
O
i
TOWN OF BARNSTABLE C"'
LC3'ATION `- , °.S l��l(CI SEWAGE #
VILLAGE fey der di��C� ASSESSOR'S MAP & LOTn�—1/5
• INSTALLER'S NAME&PHONE NO. '</Yf//�Chi 42•e se 62 7�. C
SEPTIC TANK CAPACITY ZOO 0'.
LEACHING FACEL=: (ty, URS (size)
NO.`OF BEDROOMS
BUILDER OR 0
00�-- 1.11 q 10
PERMITDATE: 7 OMPLIANCE DATE:
_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) i �? Feet
Furnished by
4 1
• '' a o
Y �/'L !.:
143 133
No......f.L-.�i.�� a_ FIMs.... .�..
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
...................OF...........................---.........---- ..........................................
Allp irativat for Elhipos al Works Tonstrurtivat Orrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
.......... ;Q+....b �...............C'-=.Vt't&............................................................
Lo�aiion-Ad ess or Lot No.
--------------- - E . --•---�✓ ................. ..... ---------.......................... ....-•-•-------•-•--------........---.........
Owner Address
a ...................... .2.�S.c .4. ................. --•------...........----......................-•--•-----•-•...........---•----•-•----.....----....
�
Installer Address
U Type of Building Size Lot...LSt.49!!�...Sq. feet
�-, Dwelling—No. of Bedrooms..�:..?......................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures .........................------------------------•------------•-----------
W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons.
Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter----......--.... Depth................
W 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. 1................minutes per inch Depth of Test Pit..----.............. Depth to ground water.......----..........--.
GX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
M --••----•-----------------•------------•------•-••---------•-•-•--------•-------•--•------....................................................................
0 Description of Soil.....................................................................................................................................................:...................
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 TITi,s4. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance hasabissued by t board of health.
Si ned. . . .........
/� Date
Application Approved BY '..... ! - -- --- --------•--------- > --------
ate
Application Disapproved for the following reasons--------------------------------------------------------------------------------------------------------------_
...--•---------------------•----------------•----------------....----------••--------•--------------------••...-----------•--•--•------------------•---••-----••-•--•-------------------•--------•-•---
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...._.. "...............................OF.....................-.-...._--._..__.....--•----------•---..._.....__....._............_.
Apphratilan for Dispniital Workii Tunutrurtinn tirrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: ,
I,-ooe,tion Ad ress or Lot No.
................. -----......//=---•• °f~'° ......................
Owner Address
.------ •......•-•-•--••-•••--•-••-_.._.
Installer Address
Type of Building Size Lot_ . t_4_.0A.....Sq. feet
U -Dwelling—No. of Bedrooms,__________________ .____Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons____________________________ Showers — Cafeteria
QI 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........................
fs Test-Pit No. 2.........._.....minutes per inch Depth of Test Pit.................... Depth to ground water........................
a •--•------•------••--••••-••---------•-•-._............... .. -•------•------•--.........................................................................
oDescription of Soil...............................................................................................................................-----•••-----------------._.._..---•--••-
x
U
W ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --•------•••--
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
-------------------------------------------•-----•-•----•--•-------•-------------•------•-----------•---•••---•-•-••••---••-••-•---•••-•--•-._....._•••-•••-•••--•--•--•-•--------------•......•••••----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TiTI:;=. 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 thheboard of health.
Date
Application Approved By-- J .......r-•. ._ ----- •-------•------ 42
at��D
e
Application Disapproved for the following reasons:-----••------------------- --...............................................................................
------------------••..._......----------..._..--•-••---•-•---.._...._..._......__.._.....•-------•-------•--••••---------------••••------•-•••---------•-----•--•.......................................
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Trrtif irttt� of fwiantpliFanrr
T IS TO CERTI Y, That the Individual Sewage Disposal System constructed ) or Repaired ( )
by. .... -.......... .................... -•-------•-•-...........•----••. -...••-•-.........•••••••...-••••-•••••-•--------•••-••-••----
y- Ta Installer w
at------------------- ------.-d-----• ... '_..
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 CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
' � i /- -•-�l-•-••-••-------••-----•-•---•..._...._•-••----•-•-_--•---DATE.-•-•---.......••--------------------•-- --..__..._. ector_._.._..-----
THE COMWONWEALTH OF,,MASSACHUSETTS
BOARD HEALTH
;;lrrr ..................OF w• `'
N(YF - ��--•---•-:_V..... FEr�h..............
;Individual
I nrk� �an�#ruan prmi� }
Permissio is hereby granted...... . _ _ ........ -v ________________
to Construc ( ) or Re air ( ) Sewage Disposal System
at No..... .G�f_..... �7~__1...
........� •---�..e ------------------------------------------- =
Street
as shown on the application for Disposal Works Construction t No..................... Dated..........................................
Boif'Health
DATE..............-•-•_._._..._. .......... ------•-•--
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
3
9.
3 - .
\ 4
pu� e 9 s
4 0
_ �I
O90 .
9 b 7 4w3
f�
9 r� , %n �sr
<
a
MORSE
No. 10951
^I
,4i
S/ON E! Y C
/Goo cr^4 ,
7,1 N!K/o/.7 6 x 1 v
/!�O ,► p/s7: SAG f..
XP.�rvonl�� .• . I3vX !�
12
o
_. r"P,.AA.��.YA fY7N1 I Q6.co �--'�•.--.-»...... -.a.-+e......,.,.,,e„
LEGEND aF
EXISTING SPOT ELEVATION\ 0%0 0�� - CERTIFIED PLOT PLAN
EXISTING CONTOUR --- 0 — " ERiI Lv r (mod V C,47s P^-4✓ WA
FINISHED SPOT ELEVATION `° C�C J T 57/z V/ te.. .-..-
FINISHED CONTOUR 0-^---- — -
IN
APPROVED BOARD OF NEALT 4�0su
Rv�yo� g N
,
DATE AGENT SCALE$ -='30 DATE : /t) /f R/
EDRDRED6E ENGINEERING aQ INC. CLIENT NA6A). I CERTIFY THAT THE PROPOSED
REGISTERE EGISTERE JOB Na. .� . BUILDING SHOWN ON THIS PLAN
CIVIL LANDENGINEER GURNEY R �,RY� �4, CONFORMS TO THE ZONING LAWS
OF l3 M A S`i
712 MAIN ST. CH.BYS
HYANNIS�MASS. SHE OF -2— O TA E R G. LAND SURVEYOR
err c�- � ',i•� � �. ? Z'�` � � � n � � .� '� C� n � y by 4Ab-4 3
cj
ZZ
k oA � n� i � o •y � a y � � � ,.
9F.i �a v► Zt It 'h P fm y O
.14
p� y `I I Y
1bh
M y
� � � Spy `" a � • • , .�� : . . � y '0 ^'
. . . . .� . . . a� � 0yy
.. , . ,
. . �o ° r
. o �� oyT3y
° � !� � 0 ►� Of�
N
R.�
o r nln
ONZ
m
% �y by orR
11
•
AT ION SEWAGE PERMIT NO.
mow,
i I LAGS
INS V l ER'S N E i -ADDRESS
5UILDER OR OWNER >
r - i
Z io4&/1A1 eT
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED
I
1
f r �•
r
` �rr-7�