Loading...
HomeMy WebLinkAbout0022 JOYCE ANNE ROAD - Health 22 JOYCE ANNE ROAD CENTERMLLE A=209- 109 I z UPC 12543 N0.53LORa.,. y��° Mw¢rowam YM T jjW No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for 30isposal bpstem Construction Permit Application for a Permit to Construct( ) Repair( Ixul'pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address arlCo. 4 a01—r b 1 Owner's Name,Address,and Tel.No. n Assessor's Map/Parce GG�J"�f✓ ��� Installer's Name,Address,and Tel.Noy0j__ J6` 9 S' 9 Desi er's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.8. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 > gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank /� dO-D Type of S.A.S. L Description of Soil Nature of Repairs or Alterations(Answer when applicable) �a ,is •� /j r(i t(d✓l d/<— 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 Heal Signed Date Application Approved by Date C ~� Application Disapproved by d Date for the following reasons Permit No. y Date Issued No. Fee r 'THE COMMONWEALTITOF`MASSACHUSETTS Entered incomputer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes F ZippIication for Disposal Opstrm Construction permit t Application for a Permit to Construct( ) Repair( )/,upgrade( ) Abandon( ) ❑Complete System ❑Individual Components jLocation Address orLot No. -2 0 9-j 6�f Owner's Name,Address,and Tel.No. or's Map/Parcel C. G�•i ✓ r's Name,Address,and Tel.Nos©� !' PDessii'g`ner'sName,Address,and Tel.Not� J CAI / Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grander( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures f Design Flow(min.required) > gpd Design flow provided gpd Plan Date Number of sheets Revision Date f y 4M.,r; • Title , " Size of Septic Tank 4 Lw 4 Type of S.A.S. - Description of Soil Nature of Repairs or Alterations(Answer when applicable)- ' 1®�G �' / ,�S��•t r( 1.,A Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in J 'accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation1 til i Certificate of Compliance has been issued by this Board of HeaULI Signed Date Application Approved by Date Application Disappryived by Dat ` for the following reasons Permit No. V ® Date Issued t( " { 7 - 0-0 _ THE COMMONWEALTH OF MASSACHUSETTS `BARNSTABLE,MASSACHUSETTS -- Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( "Upgraded( ) Abandoned( )by 66 1 . e a "C-)GGy ef �P-J D re,k•� at G?, ::To n f e /Yo-q !Z 0 has been constructed in accordance If with the provisions of Title 5 a d the forPsposal System Construction Permit No. a 0;0-30 dated /1 _ Installer �� t .(' 1 ,; G( 0 A A Designer #bedrooms f y Approved design flow r, g d A The issuance of this permit shall not be construed as'a guarantee that the system will functionSas designedd. i Date �/ �� / Inspector 1 �__�,•......!,?� - - -- - - --- ------- ------------------ - _ - --- -----.-•-.-.- - ------ -- - -- - S .,- No. a 2'0-- 361 Fee / THE COMMONWEALTH OF MASSACHUSETTS J PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pste `onstrurtion Permit Permission is hereby granted to Construct( . ) Repair(� Upgrade( ) Abandon( ) System located at Z o y t Aq I and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Tittle 5 and the following local provisions or special conditions. Provided:Construction musta be completed within three years of the date of this permit. Date roved Y - L � A b PP No....... F,�x,.. .............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HE L .............. ...j�Ir1�. ......0F........ � . . . . . . . ......-----.._............... ?f App iration for Disposal Works Tnnitrurtion Frrmit Application is hereby made for a Permit to Construct (ie'5�or Repair ( ) an Individual Sewage Disposal System at: e � U � L-.oca. --------------------------------- --- .3 �..5 ----------.........------. �]. Owner Address.......................•......._ Installer Address Type of Building Size Lot...l ...D.:Z �,�....Sq. feet U Dwelling—No. of Bedrooms.....................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4Other fixtures ------------------------- ........................................................................ . .... ........... Design Flow.......s.1�..J_0........... ........ . ......gallons per person per day. Total dailyflow............. Ions. WSeptic Tank—Liquid capacityldi'lot.gallons Length................ Width................ Diameter................ Depth................. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq-.ft. Seepage Pit No....../_____________ Diameter.................... Depth below ' et....._..___.---_--- Total leaching area..................sq. ft. Other Distribution box (il) Dosing to ( /y/71�. Percolation Test Results Performed by.......-- ................. Date__...................................... Test Pit No. 1................minutes per inch Dep of Test P .... Depth to ground water........................ AT Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W •-------•------.....-•---•----- Description of Soil.........Q-- a-••••-• ...............------------------ -------------- --....... --•----•-----------------•---------------••-----------------•---------------------------•-•------------- 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'I'M 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' ued by the board of health. Sig --------------------------•-•---•-. ............•------------Da...•............. Date Application Approved By.....:. .. .. . . . . . : Application Disapproved for the following reasons:.............7........... ............. •............. Date .................................•----------•----------•---.......------------------------....-----------....------------------------------------------•-------------------•-----...••--------••-------•- �s �Date PermitNo......................................................... Issued.... ............................................. Date No........................ F .......1►...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD FHE t ✓�►, r, . .................. ...... .................OF......................................... Appliratiun for UWpotiFal Works Tomitrurtiun rrutit Application is hereby made--for a Permit to Construct (0<,or.Repair ( ) an Individual Sewage Disposal Sykem at ,4 ................ .............L..caAd�r s o N_ n ._............................ Lo ......• ....... o ......_ O ner Address a ................ ...................................... -••-•----•--•-••------••-------- Installer Address PQ Ir d VType of Building Size Lot........r.................Sq. feet ►, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building No. of persons............................ Showers YP g ---•------------------------ P ( ) — Cafeteria ( ) Othfixtures ----------- ..................... allons per person per day. Total daily flow..........."'er' __._.................._gallons. ----------------- W Design Flow........ :.. ..� // g P P P Y• Y � WSeptic Tank—Liquid capacityf_d49_gallons Length................ Width................. Diameter................ Depth.......... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.....)............. Diameter.................... Depth belnl »t� �dotal leaching area..... sq. ft. Z Other Distribution box (e) Dosing ~' Percolation Test Results Performed by.._- ........................................................ Date.... ................................... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gr, Test Pit No. 2................minutes per ch Depth of Test`Pit_ .................. Depth ro water.--_- ----------------- ®z" C 1 . Jtl6 " f— ��� lF . Descriptionof Soil.............................'.......................--....::-=-•--•...••---•-•---•---••----•--------------••--•--•---•------••_•--•-•-•-•-----......•--•--._........---_.. 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 TIT?.;. 5 of the State Sanitary Code— The undersigned further.agrees not to place the system in operation until a Certificate of Compliance has beensued b the board of health. 01 Sig -s� -------------------•----•-•-••-------•-•-•--_. Application Approved By...... ? • at ........................................ Date Application Disapproved for the following reasons:................................................................................................................ -------------------------------------------------•------------•-•----------•-------------•---------....-'--------------------------•------•---------------------------------------------------- M1. Date PermitNo......................................................... Issued............................... �--------... Date "A + THE"COMMONWEALTH OF MASSACHUSETTS BOARD Z EALTEAL.T���2 ..........................................OF.................................................I.................................. Trrtifiratr of Tompliaurr T CE Y eividual Sewage Dis osal System constructed ( ) or epair ) by . ..-_.... ---- e: .............. -- - /T1J• Gf Li� suer at has been installed in accor ance with the provisions of 7;lae C State Sanitary e Aesc .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 FtfflCTION SATISFACTORY. DATE................ ".._..... .... Inspector::.. . ......../.. `-------•-----------•-----.---------•-------- THE COMMONWEALTH OF MASSACHUSETTS 70pd BOARD OF HEAL.TH ....................OF..................................................... No......................... FEE........................ t* Permissioroqereby granted............... ------••..... to Cons�r ,t ..................................... r,Remaix ap I ual S . s al ®'� ► at No........ -- -•••-•••-•--•---._...-•••--•--••-•...:.............. ....--•---.........-------•......... ------ --------------- ------------------- ;� Y Street � as.shown on the application for Disposal Works Constru ermit Dat d... .................................... Board of'H h DATE ............................................................... FORM 1255 HOBBS & WARREN. INC.. 'PUBLISHERS C.���tG►..l Z'j,d,TA �•b. 11C? C�At�AG�� R1�to'�-1Z t to .4 3 - SSo G PD• E�!/? ��EPT'1G T tIC = 330,e (SG % * 4�r'a 6•PD. t)S� l000 C=A L-. Saw/ALL A¢.EA = lSD 5.1=. lc>p sF )c 2.S • S 75 '$c7T'iZ AA AQEA t F.;O ST-. 1 CE:o S►r-7. t .o = Sd (E>.RR TAC.. '�ESIGI,I � •42S G.RD. �� �.�'� ; 14 7'.404ai.. TO �� G�fZGOl.�T10t,1 SZI�TE "��•! 2�t�u OR 1�55 Q t C •'"'-~. •'; � � o � -��`(�LLB L ac J Top 1"uo L�oo.o r.6 4' LoA� � Poe I o00 ��•�! '"' . + 4'PP� n�sr iw. 6AL. 931 5a�,�„t, f -$ox q34 S�r+C to Z INV. TANK 1000 q �Nv, iwv. GAL• ,A LAN . Pi T a WvrW •i was IED STOWF-- I • � L>✓.eT1Ft>rc� Ptro�r >✓~�-.a.ti Pep�"t L-E: t 0 GA 1'l O) l C G►J'T iZ 4` l.} l GG6.ZTI p Ti4AT TtAE PovF,1DaTtOO 5"a�v►J PLA ! RL �.cZG Gfr t4F{2 t;.ot-I cc &APLI-(s W Irl 1 TWC- i v Awr--> SE'1't-:5ACIG Vc-QUiQeM&WTS oG T►+ ` -Tow►.r aV,,.t c 0 PATE L P�-^ B/S.7CTCVZ t- u t"G- tZEGlStttZ�D LAWO SUZVE'(Oc:.S OSTEiZ�/1�-�.G v /1�tA55. TWI5 M-A" 14, uoT 1C>A�,EC� v�� SA�ww 1t•/r,r-etjAAr--k-JT ��Uc:r/ °{ T�aC- . ApPt_I CA,"-r r ac Usc ro c��rcetit�u� t-oc' t_►W��� ���J ZSru, LOtCATION SEWAGE PERMIT NO. VILLAGE a69"- G 9 INSTALLER'S NAME & ADDRESS / rc (� B U I,L D E R OR OWNER R � e -�r �� Cdv, DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED • Y • /2- i