HomeMy WebLinkAbout0297 BUCKSKIN PATH - Health 29 7 8vCkskl'A P°►�i
CffnttrrviIl0-
17i � o26
5 M E A D
KEEPING YOU ORGANIZED
No. 12534
2-153LOR
ARSUSTAINABLE
MIN.RECYCLED
WRIATIVE CONTENTio%
CertifiedRber Saaraing POST-CONSUMER
www.dpropra-rp
swim
MADE IN USA
GAT QRGAMM AT SMW OQRA
TOWN OF BARNSTABLE
pLOCATION Q017 Z0cA"5k'tn" SEWAGE # �3-7
J
VILLAGEMej`LA ( c, ASSESSOR'S MAP dz LOT '7�- .,
INSTALLER'S NAME & PHONE NO..( (�- VYIAreW fjjvj�>
SEPTIC TANK CAPACITY Icon p
LEACHING FACILITY:(type) - (Y�=�1rl��Rt�e�zS(size)
N.O. OF BEDROOMS_3 PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER _
DATE PERMIT ISSUED: 7 - 13 - tr
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No t�
340 j 3�
� a
Il 6�
t /
No....7... .... Finc.A....3 d'.0 0
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE 0
Appliration for Dhi-poottl Workii Tomitrnr#ion thrmi#
Application is hereby made for a Permit to Construct ( ) or Repair (X3 an Individual Sewage Disposal
System at:
297 Buckskinpath Centerville
----------------------•----•---•----•--•------------------------------•-----•-•----•---._....-••- -•--•••--•---••-•--•---••---•-----•--•...._...--------...........__.....•----•-.....-•-•..........
Richard Wolfe Location-Address or Lot No.
..........--•-• -••••--•--•-•--•--•--....._•-----------------•----••-•••------•-•----•---•-•-•-
W J .P.Macomber Jr . Owner Address
Installer Address
el Type of Building Size Lot............._..............Sq. feet
Dwelling—XNo. of Bedrooms----___-_-__3
------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type
of Building ____________________________ No. of persons---------------------------- 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................
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. I................minutes per inch Depth of Test Pit.------------------- Depth to ground water........................
rX1 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water_-____-________---_---_-
a --------•----------------- ---•------•-•-------•-••--••---•---•-••------ ...................................................................................
0 Description of Soil------------------------------------•••••--•-------
x -•---•---••••----•---------•-••---Sand--_&---�ravei----••-----•.---•-----••-••--•--••---•-•-•-••--------------------•--••-._..._----•-
U
W
U Nature of Repairs, or Alterations-Answer when applicable.___--Add an additional l e a eh p i t
to existi69._,- nk-_& pit .
..............................-..---=...- ---.._..-•-•-----------------------•--------•--------------._...---------------------•--._...-------.-._...------.._._...._..-••._.._...........--_..._.
Agreement: v
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 Complia ce has b n - sued by the boa o health.
Signed __ - =' .. /2 8/9 4
----------------- --..7.-..----Dace..-....-...:......
ApplicationApproved By ... .0.... ... ...................... . ....... .......................... -------I...................------------
Dare
Application Disapproved for the following rear ------_--------------
. . ................... ...... -- --- ----- ----
Dare
Permit No. Issued o� - ---------------- ----------.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(fez#ifi ate of Tomyliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX)
J P.Macomber Jr.
by ------------------------------------------...------------------.-------- ----__----------------------_.------------------------.----------------------------------------------------------------.------------------------------
297 Buckskinpath Centerville
at -----------------------------------------..................------------------------------------------------------------------------------------------------------------..............----------------------------------------
has been installed in accordance with the provisions of TITI.E f The-State Environmental Code as described in
the application for Disposal Works Construction Permit No. .. _-� �dated _..........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS 7A GUARANTEE THAT THE
SYSTEM WILL FUNCTION/SATISFACTORY.
DATE--------------------------- ; = {;�= _---------------------- --- Inspector ----------
----------------------------- --- Y- — ---.-----------------------
THE COMMONWEALTH OF MASSACHUSETTS 71 '`00
(70 BOARD OF HEALTH ////
L - TOWN OF BARNSTABLE $ 30.00
No....L.. ---...... FEE........................
Disposal Works Tunstr iron "amit
J.P.Macomber Jr.
Permission is hereby granted -- - -------- -------------•
to Construct LL ) or Re, a,ir `�X an Individual,SSe rage Disposal System
l97 33ucks in�a h Centervi3�le
atNo..................................................................- 4......
Street
///yyy yy �,�J.......................................................
as shown on the pplication for Disposal Works Construction Permit yNo..�.._:_r_�..:_,.�_ Ddat>ed______....................................
oard o Health � -----------••--------------
DATE P............./
.....-..............................................
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
No.... ........ Fmc..A....30.00
................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH (D
TOWN OF BARNSTABLE
Apphrativit for Di-nVatial Work.6 Tomitrurtiou Urrmit
Application is hereby made for a Permit to Construct or Repair (XX) an Individual Sewage Disposal
System at:
297 Buckskinpath Centerville
................................................................................................. ..................................................................................................
Richard Wolfe Location•Address or Lot No.
................................................................................................ ..................................................................................................
J .P.Macomber Jr. Owner Address
Installer Address
Type of Building Size Lot............................Sq. feet
U
Dwelling--y-No. of Bedrooms--------------3
------------------------------Expansion Attic Garbage Grinder
PL4 Other—Type of Building ............................ No. of persons.__........_.........__.___. Showers Cafeteria
Otherfixtures --------------------------- ..........................................................................................................................
Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
C4 Septic Tank—Liquid capacity------------gallons Length________________ Width__..--.________- Diameter._.--.__-___.__ Depth............__..
Disposal Trench—No. .................... Width_._.._-_....._._.__. 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........................................
a
,4 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..--................_...
1:4 .............................................................................................................................................................
0 Description of Soil...........................................S-Yiyd7---&...qfav-�il-----------------------------------------------------------------------------------------
X
U ................................................. .......................................................................................................................................................
............. ....... . --------------------------------------------------- 7 .........Xddan i TE
U Nature of Re airs jor Alterations f--t Answer when applicable.____-__--._........................................ ...........................................
to exist aqlhgnk p
........................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed ItidiVidual 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 b en issued by the board ok/health.
7/28/94 ,
Signed -- ------ ------ AA---------------
... .................D.a
.. ----------
. ..................
te
ApplicationApproved By .. ---------------- - -------V.:.............A........... --------------- ....................................... ----------------------------------------
- Dve
Application Disapproved for the following reason. : -----------------------------------------------------------------------------------------------------------------------------------
............................................................. -—-------------------------------------------------------------------------------
---
------..--..-.-.-.-...D..-a t.V � "
Permit No. --- Issued . .. n ........... ...........
.........
No.. .1�(� FEE..; ,....................
THE COMMOlglNWEALTH OF MASSACHUSETTS
BOAR® OF HE T
a� .. OF .... .� -------------------
11 Xpli iration for Roposal Works T. nstrurtion Pumit
Application is hereby made for a Permit to Construct (k, or Repair ( ) an Individual Sewage Disposal
Syst at:. ...... .... ......... 1�4------�!n.. .......(........... ..................................
o
cation-Addres or Lot No.
!.._.. -- ............................. .................... ...........................................................
Owner Address
..._t.....
nstaller Address
UType of Buildig�gl „� Size Lot----------------------------Sq. feet
Dwelling L-"No. of Bedrooms...............3--.----_.___._--_--_-Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building --------------- No. of persons............................ Showers
a YP g--- -----------------------------------------�--•- ( ) — Cafeteria ( )
Otherfixtures -- �\ •--------- ------ ------------•----._..._•..... ------- -
W sign Flow_____________________ (dt_.___._ga Ions per person per day. Total daily flow............. ._Z--.(-------._.-gallons.
fYi .Septic- lank Liquid capacity __ __ Ions Length................ Width---._.___-----_ Diameter................ Depth_--._-.-.._----
fisposal Trench— o_ ____________________ Width_.__._ Total Length-______-____-----.- Total leaching area_. -- _----sq. ft.
Seepage Pit N ........... Diameter _... epth 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-_".__-__________---.---
LXq Test Pit No. 2_---______-_-minutes per inch Depth of Test it.................... Depth to ground water--_--_.._-----_-____---.
a' . --
.e .....................................................................................
O Description of Soil------- ...._ _:..
V -----------•••-------------•-----------•--------------•----•----••--••-----------•--------••---•---------•-•--------•-•------•-------------------•--••----------------------------------------"---------
UW ----- ------------------------ -----------------------------------------------------------------------------------------------------------------------------------------------------------------------
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 Article XI of the State Sanitary Code—The undersigned fur er agrees not to place the system in
operation until a Certificate of Compliance has been issued by the boar of I-e .
Signed. _,........ -------------------------------- ----- ✓�`—/
- � y Date
Application Approved By ----- --- ----- - -------------- te
Application Disapproved for the following reasons_____________•---.__--_-__-__•_
---------------•----•---------•-------•--------------•-•--------------...-----------------------------------------------------------•-----------------------._......-------•----------•-----------------
Date
PermitNo......................................................... Issued........................................................
Date
s------------------------------------------- --- --------------------- ---------------------------------- ----
----------------------------------
..................................................................................................................................... --------------------
Date
PermitNo--------------------------------------------------------- Issued...................... .................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF, HEALTH
/7
.................OF......... ....................................
QTkertifiratt of Tullutphaurr
THI rS 'T , ERTIFX That the Individual Sewage Disposal System constructed (41,11or Repaired
.................---------------------------------------............ ... ......................................
by.. .11 -4
-- - -------- -------- .......
7
�ns alle' -1
---------- ---------
---- - --- ----- ---------------------------------------------
a .. ...
has bFen installed in accordanc with the provisions of Aicle tate Sanitary Code as described in.-the
— j At .
application for Disposal Works Construction Permit No______ ------ ----Svn--- -------- dated .1 f
---
THE ISSUANCE OF THIS CERTIFICATE SHALL TRUED AS A GUARANTEE THAT THE.
SYSTEM WILL FUNCTION SATISFACTORY. OL 716 16
DATE........ ........................... Inspector------ ... - -------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF............
A,/ FEE
No..... ...24.....
... . ....
E15 lhgvor� 6 Towitrurtion Permit
Permission is, hhereby, ranted...... ...... --------------------------------------------------------------------............
9 e�' . ,
to Constrtjgt or Repair an In4ividual,. Sewage 01s p 0sal's tem
at No. ---------- .. .......................................................
� -----/----- e,
Street
as shown on the application for Disposal Works Construction Permit .... Dated-___--7---/�),
oar
DATE........ ........... ...................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
No.................... ..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................. .......................OF............................. -
Apphratiaan for Rapviial Worho Taanat>rurtiou tirrutit -
Application is hereby made for a Permit to Construct ( r Repair ( ) an Individual Sewage Disposal
System at
m
_ le �. •-• -•- ...................................
J'�[////,?Y 2__-- - a „ - or Lot No.
LL// J a ion- dr
w e -- .............................................................
Address
sta le Address
d Type of Building Size Lot_.........................Sq. feet
U Dwelling `To. of Bedrooms------------------- ----------------------Expansion Attic ( ) Garbage Grinder ( )
Pk Other—Type of Building ____________________________ No. of persons.--------------------------- Showers ( ) — Cafeteria ( )
Otherfixtures --------- ----------------•------------------------------------•-----------•--------------------------------••--------------- ......................
Design Flow......................... ______ __ gallons per person per day. Total daily flow___.________
W �� ----- �"'°� ------gallons.
WSeptic Tank- Liquid capa`isity�+' ons Length................ Width---------------- Diameter__---_.-------- Depth.-._-__.___..---
x Disposal Trench--No_ ____________________ Width______________._._ Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No_____ ______________ Diameter�,,d '_� _C
3p ._..". pth 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._____-____-__:___-_-.-.
rZA Test Pit No. 2................minutes per inch Depth of Test Pit............_....... Depth to ground water-_-__-_____._.______--_-
Pa
x Description of Soil----- -
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 Article XI of the State Sanitary Code The undersigned furtaer agrees not to place the system in
operation until a Certificate of Compliance has been issued-by the board of health.
Signed . .... .....,.� ..
gn -------- a --
Date
Application Approved By.__._. _ !.- -- ° -_. f
-. -
Application Disapproved for the following reasons-------------------------- ------•••-•-----••...............