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HomeMy WebLinkAbout0539 HUCKINS NECK ROAD - Health 539 Huckins Neck Road Marstons Mills A=234-038-T00 SMEAD No.2-153LOR UPC 12534 emeadcom • Made In USA y 0.91 � �YNAI1N.SiiROGRAly1.ORG No. O'©I " Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RppIitatiou for Disposal 6pstem Coustruttiou Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System [Individual Components Location Address or Lot No. 535 NUc :fAL6 N1r CL Owner's Name,Address,and Tel.No. C+1(lecC �8i�l J � PPA4( ZA L.-bl�4 Assessor's Map/Parceltic- P. Gt w Installer's Name,Address,and el.No. tS-4 -99?-7 Designer's Name,Address,and Tel.No. gel Type of Building: Dwelling No.of Bedrooms r Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixturesy- Design Flow(min.required) l� f� 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) 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 Board of Healt Signed Date to—30_A019 Application Approved by Date 10 `3,) f Application Disapproved by Date for the following reasons Permit No. quit 33/' Date Issued /P 'f b aMa �¢ fr" No. �C>� 0 1�� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpfication for Disposal 6pstetn Construction Vermit Application for a Permit to Construct.( ) Repair(Xi Upgrade( ) Abandon( ) ❑Complete System [X4ndividual Components r Location Address or Lot No. 531 HUO jk' NE UL Owner'Mamp,Address,and Tel.No. C'V14tc- -7pW&) 4& P*gazA i-a-b1,AW— Assessor's Map/Parcel t�. �� �" b;.,y 4!!�2 /L.L.A- Installer's Name,Address,and TEL No. V vZ-tf"-11 T17 Designer's Name,Address,and Tel.No. _ PIA, Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( . ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures y / ` Design Flow(min.required) Iy ft gpd Design flow provided I 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) _�/,� 7rZ)j j�U&P ruxaPC, 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 Board of Healt Signed Date fly-30-.1L 9 c- Application Approved by ,t Date �'/U - �a Application Disapproved by © { Date for the following reasons Permit No. oiot fs' 33�— Date Issued 'r� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )byy152"g b& �� at 534 14oct4 1US Niaj/-- Au�" gt V([1_,AC_has been constructed in accordance - f with the provisions of Title 5 and the for Disposal System Construction Permit No. o201 333. dated b 3 O-t �1 Installer ` z A -rr Designer /,rQ„ #bedrooms �/ f+ Approved design flow A,1,, Fes, gpd The issuance of this permit shall not be construed as a guarantee that the system functioegn dt Date ) ( (Z Inspector No. l k '- 3' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstrm Construction Vermit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) 'System located at 5 (�(„(/.,,(�� [V vie / 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 h- 30-1 Approved by 3L, L C o / Fimic.-30......... THE COMMONWEALTH OF MASSACHUSETTS H APPROVED C . BOARD OF HEALTH APPROVED Conservation Department TOWN OF BARNSTABLE —4 Appliration for Dispasal Works Tonstru114 fft to' Mt hP Application is hereby made for a Permit to Construct or Repair ( _1<1 Individual Sewage Disposal System at: ................-: C...... ............... .............. .................................................................. Location-Address or Lot No. .................................... .................... .--?......................................................... ... . ..... . Address Ow er ..................C.J� !{ ....5.1014C&I-2......................... ............... -2 ............. Installer Address < Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.....--------------------------------Expansion Attic Garbage Grinder a Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other fi ures ....................................................................................................................................................... Design Flow._._... --.75—) ' ------------------------------gallons per person per day. Total daily flow.....as? ........................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width._........_..__. Diameter......_......._. Depth................ Disposal Trench—No..................... Width............______.. Total Length.._................. Total leaching area....................sq.'ft. Seepage Pit No------ ------------- Diameter..__I-Ve........ Depth below inlet.....6.(......... Total leaching area..................sq. f t. 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..._.................... Test Pit No. 2................minutes per inch Depth of.Test Pit...__._............. Depth to ground water....._..............___. P4 ...................................................I------------*------------------------ 0 Description of Soil....................................................................................................................................................................... x U ........................................................................................................................................................................................................ W Z ...... -------- ....................................................................................................................... U Nature of Repairs or Alterations—Answer when I A-_-__e' &"--. "C", lrat --,a __/�.... ................................................................................................................... ................ v .....6y' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Dispos'al 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 heen issued by the board of health. Signe�d� ....... ----- Date Application Approved By -------------- Dare Application Disapproved for the following reaf onf: ....................................................................................................................................... .............................................................—--------.................................................................................................................... ........... ..................... ............... . ........ PermitNo- ------------7'�......./0a................ .. Issued .......................................... ........... .. .. .. .Dv Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 1t ti -�`�~ �:-a -3 -��_9� ,gyp rtt nn for Disposal Works Tonstrurtion �rbttt Application is hereby made for a Permit to Construct ( ) or Repair ( J,,t6i Individual Sewage Disposal System at: ................. .�. ... �� -- .�:...' t� ...-• - .� �. ..5. °:i�'�'t a C>. y. ..•..... ..... Lot No...........•.............................. ii —. w= •-----. .. Locatwn-Address � ` ................. ---------- _n...C�- %.v'',r: ......................... --------------------- .....__..............................................._. W Owner ddress .................. ::5.y? . ... .:..^ .:...� .................. .. ?...,*�.C_:::AII(/ 1::.....!fn � PI I.0 M �'' `'"—V'`� -Installer` K t t� Address QQ7ii Type of Building Size Lot............................Sq. feet aU DwellingNo. of Bedrooms.......�7.................................Ex anion Attic — p ( ) Garbage Grinder aOther—Type of Building ............................ No, of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ..---•-----------------•----•------------......------.----•-•----------•......--•--•---------------------•....--•...•-••--•--.......---........---•-- W Design Flow........ .........................gallons per person per day. Total daily flow......"?.3r?.......................gallons. WSeptic Tank—Liq d capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........I............ Diameter......0..Cir....... 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......................... 44 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......_.; _..._,. o ......v_ ....tL.Y.. ...a!' .�._. 1.�.... ._. _ . .L , r i _. ..................... t .--`.... v '� = ', .........--•----------------------------------------------------------------------------------------------•-------.... Agreement: 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 � place the system in operation.until a Certificate of Compliance has been,issued by the board of health. Signed" ..... ..........1 .�.r...c c_..- \ ...�''' �) \ Dare .`.._. Application Approved By ....... 0 C ------..- J.>.- Dace Application Disapproved for the ollowing reasons- ---------------------------------------------------------------------------------------------------------------------- -------------- ------------------- --------------------------- ---- .................................................................---------..................---------------............---------- ....................................... Q� Date PermitNo. -----------{ v� ���� r. -------_--_-- Issued -------------------------------------------------------Da- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C�Plrtifi zt#e of Contylittxtu THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( 44 b ........................................... qn :ra. / 2 Z y. ..f.. .. ...�..y . ........................................................................................ nsta f�;.. ..... has been installed iri accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ...........9?:.,...,1/J. ...... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. - 1 , DATE................ ....................... ..... :............................................................ Inspector ........------ / / r, ............. t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No....g`� - L? FEE.--.21�...."�:. Disposal Works Uontrttrtion. rrntit Permission is hereby granted............. nA + �" ivl - ----------------------------------------------•.....................--- to Construct ( ) or Repair ( ) osa an,Individual Sewage Disp System Street as shown on the application for Disposal Works Construction Permit No_/- r -Z..�--Dated........ ............................... ............................... - -----------.. ........................................ DATE...... Board of Health ? 1,7.:.`'..._.. FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE a LOCATION ��� 1�y��tal.S �,eG�j[, SEWAGE # 2 VILLAGE- ,ASSESSOR'S MAP & LOT I INSTALLER'S NAME & PHONE NO. APa Sef:(k� SEPTIC TANK CAPACITY i LEACHING FACILITY:(type) (size) NO. OF BEDROOMS ^ PRIVATE WELL OR R C'�- BUILDER QR OWNER 1 •''�� ��t'TZ��4- ,(�Q - " DATE PERMIT ISSUED: ylATE COMPLIANCE ISSUED: .3 VARIANCE GRANTED: Yes No V, FVvv