HomeMy WebLinkAbout0082 NYE ROAD - Health 82 Nye Rd., Centerville Lg rl
A=170.001-001,
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No.••• ......... ...... Fxs..:�..11................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
A '�-��ltrtttt,au for �t�pl ,t�
3tti Wnrkw mitrurttnn Prruttt
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
t �' - -----------------------------
........... ............ / v ��-
_-ocau or Lot No.
' !T
Owner Address
W
Installer Address
d Type of Building Size Lot------
...Sq. feet
U Dwelling—No. of Bedrooms______________-------------_----_--._.--.-.-Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building _------------------ ...... No. of persons-_--_-.-_--_--______-..---- Showers ( ) — Cafeteria ( )
d Other fixtures
---------- - -
W Design Flow.................... ........... gallons per person per day. Total daily flow_.___-_-___---__----..._-_�i��......gallons.
WSeptic Tank—Liquid capa6tv.1400_galIons Length---------------- Width---------------- Diameter---.------------ Depth................
x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area_--__-___---------sq. ft.
3 Seepage Pit No.---__-_.-l..._ tameter----------10.... Depth below inlet........6........ Total leaching area....?6..sq. ft.
Z Other Distribution box ( e Dosing tank ( )14 !/ /
Percolation Test Results Performed by.._____.-cWl.'X7i-�..__ ..P-Y6•____--`AW . Date--------3.^3 _`p
Test Pit No. I---.-.7 _minutes per inch Depth of Test Pit-------/_2--.... Depth to ground water_._' ----------
(1 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
a ...--•---•-•-----•-----•----•--••-•--•• • --••---•-•-•-{
0 Description of Soil................................ J!/n
x
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 TITLE 5 of the State Environment 1 ode—The undersigned further agr not to place the
system in operation until a Certificate of Compliant as been issued-by the. 'd of he h.
Signed .....V. ....... i G
I � ton...
Application Approved By .... ......... --:-!17.. - ........................... .. .... .. ......... .
Date
Application Disapproved for the following reason : ............... .............. ._.............. .. ........ ..... ................................................
------------------ ---........--------- -----..... �.........-------------------
? ® ) �� Dace
Permit No. ...--�„/� ��'�/........................ Issued ...... 0 ... . ..........�..
--------------
a
No.. _.. Fiz$
THE COMMONWEALTH OF MASSACHUSETTS
BOARD. OF HEALTH 21
n TOWN OF BARNSTABLE J
Appliration for Disposal arks vustrnr#inrn- Pr-rnnit e"
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an-Individual"Sewage Disposal
System at: Q `
.............. ....- -------•----•--•---•-•-----------------•• ---�----------------------..--------------•
Locati lddress 't
*' or Lot No
Owner Address /
a _
� Installer Address .-
d Type of Building Size Lot..___.e(F_�5. ...Sq. feet
Dwelling—No. of Bedrooms________________________________'J__-_P_ Expansior Attic .(' )fr. Garbage Grinder ( )
aOther—Type of Building __________________--.--____ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
dOther fixtures --------------------------------------------------- -----------------•------------
W Design Flow....................�r?. ---------------- per person per day. Total daily flow..__._._._........._....._���._._..gallons.
WSeptic Tank—Liquid capacity_l040_gallons Length---------------- Width___...-_-__-__-- Diameter-----.---------- Depth................
x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area....................sq. ft.
Seepage Pit NO........... ........ iameter----------/ .... Depth below inlet........6........ Total leaching area.... &.sq. ft.
Z Other Distribution box ( Dosing tank ( ) `/ // _ p
~' Percolation Test Results Performed by....__....�1�A! f __. ..�1/1� .------L��-........ Date........ J..�/.- ___._..
Test Pit No. I.......Z__minutes per inch Depth of Test Pit........ .Z_... Depth to ground water- -'__----
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
o p �_ `
Descri tion of Soil . . ••-•-•----- _ .....1.-/ - `�v! ----.-
----------
S.
U .................................................... ..... D �. ...-•---•M..-r-_-•----...---•---•---•-----•-•--.....----•---.......--------------
W •-•-------------------------------------•--•----•-------------- .........- -. -
U Nature of Repairs or Alterations—fnswer when applicable......_.........................................................................................
•-•-•-••--•. ..............................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmenta4Code—The undersigned further agr s not to place the
system in operation until a Certificate of ComplianceAhas been issued by the beard of heXh
� - � .Slgn-d . .. ....- - ............ - -j :.. ,� Dare
Application Approved BY . . ..:.....--✓' -- '.. J./...t.'. ::.. � :-. �__n±a /:/-
-�
� �•Dace
Application Disapproved for the following reason�------------------------_...._-------------------------........ - -.............................................
------------------------------------------
/ - L, Dace
Permit No. .....•�....... ... �� Issued /v -=<:/.. ...
.r
! �` Dare
--------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Tier#ifirate of Cfomplittnre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( `_ ) or Repaired ( )
by ----------------------------------------------------------- --------------------------------------- --------...---------------------------------------------*--.----------- ---------------------------------*.......
at .................. 1"...`�... - Fes" 0. .......----------------------------------------------------------------------------------------------
has been installed in accordance with the provisions of TITLE-5 of The State nvironmental 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.
DATE 2, - .� -/ `..q( ...... -.... Inspector � )
--
THE COMMONWEALTH OF MASSACHUSETTS
(� BOARD OF HEALTH
TOWN OF BARNSTABLE -owl'
No -............-- FEE)�.............
Disposal Works Tontrndinn "rrmif
Permissionis hereby granted..............................................--•--•--------------------------------------------------------•--•............•--•-•......_..•.
to Construct ( ) or Repair ( ) an/ Individual Sewage Disposal System
atNo............ ........................ �/• ^` /�................................................... ll l
Street
as shown on the application for Disposal Works Construction Permit No.-,"'-,". ated�.......................................
------•-•---•-••-`r---�. ..................•---- Board of Health
DATE. --• ---------
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
------------------------
51u6L.- FAMILY 3 $EVZot,M 1
i40 6A25AC.E G1zIrJU '
ETC .
( FLOW S'4Uo=330
SEYTI c TANV. 3.30 5C 15c�7o=a4� D
io 00 �nL.
DlSPQSQI Di,- j-l000 COAL H S`D'i
51DEw4IL a2C-A = 106 sF s
1
106 SF X 2 : 410 G,P'U,
BOTTOM A 8 sp I
'l!3 A l .o
ILP
`rOrAL DAILY
Q�
T-S2e-7LA`MoN QA•TE = I" iN ?_MwAIW16
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SAXTER
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oc:.E-
suc�sOIL. P.V C
MG--D SAUD �n (0ou IN
Som S ►I VAST iuo INV 6AL, IN✓ 45 0
6 ltx� ICJ ae�z Box .cap} edb seprrc 'g
T..1... 4 �L A4 TtiNr`
1,6m: ALL-5mt ruzF) stT — -—--- — ---a
Sa.up STONE ftM TuaN a!vr-ZF
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(�o Pu. 1-j
lo----+�- -- (ZC 110 j10
-VCRNELcp
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a.`f �4fit-. 3119.CIS
5�lowN NE�2t=r,N�co ( "i�IAT T4{E�wM-1- kr, PLAN pc-�RFaJC.E
M'P�YS "TA "ME SIVEUtJE LOT
A+� 15 flrL ocA witul rNE 7140D PL Bv. &Z3 Pam. '1S
NYE (
01 FLIIl 15 NOT- . Y3A,� oN eN 146 _.._. p SSro�4r_ LAQD Sue.� �5
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Sv2v�=y AiJv. rNE OFFSETS ��vti4EUt" � /
USC-1� T'p EST ��I�ri EtZ UT_ aE o STEfzv�C E�J61 N EELS
QPpLIcaNT; �C.Ar� � SMa_L_
SlN6LE FAMILY 3 13EVwx.7Mj, �
iAo 6,AZ3AGE G1ziNDpZ
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...'>?A I L ( ��>(110=�30 6�
$
EPi l C T �� w
A
U�G ioco 6AC__
DISPoSAI pl j-to0o 6A1- /2! sThj M ? '
51 D E W4 L APEA = 106 SF s i
1013 dl o
.p`p, o ��
BOTTOM VeA — 1 ij sF I
T�L •pc�16N = 5�E:3 '�d��o�
3.
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.. ��aC.AT1oN QA-fE z �•' rN Zv��u fr.� •a � ' �/
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BAXTER Ile
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R 1 � Is3.03
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rn s itx L ru) gox ,� 4 a�b sepric
4' ��{ 44 TANZ
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I CEZTiF'r T�AT TRS-bwLll.L4Q::, PLAN
SKow HezEoN (::OM'P� S ,,IT,, TNT
'=&� Rahn , 51�EU+JE
AO Is °� �� �w� of �AeN�
�--o�T� u,/ltul THE I�XOD tf olu P� Big �z3 ��. •�s
DA`(�
XrF
V4K FUij IS NOT- rjQ/l) oN AN rE o p�%tOf44r_ LAQD Sueve,/C>Z5
6L)W-y AND. 1�STL'�ti4E111
CSC-1� T'p E51',ti��LlSr'i F�SE�'SEpvLI) u QT' �3E o 5'('Erzv t� r_ E�1G�N EEt.s
SOP T Y L,u�5 MAC
APPLICANT; ALAtA E SMaLL_
i
I TOWN OF BARNSTABLE ,
i 4'1 SEWAGE# ' �� I `
LOCATION.':..
VII.LAGE . .
=HONENO.
` ASSESSOR'S MAP &LOT /7'S.NAME
INSTALLER.
}. SEPTIC TANK CAPACITY _
LEACHING FACILITY: (type)
, (size)
NO.OF BgDROOMS
ell
BUILDER.
�✓ 6 $ COMPLIANCR ATE .ni _'� ..��
PERMIT DATE,:.
Separation Distance Between the:
Feet
Maximuiii Mu.sted Groundwater Table to the Bottom of Leaching acility
•• • an wells exist
Private Wat0::SupplY Well and Leaching Facility (If y `Feet
on siEC::or`within 200 feet of leaching facility) t
Edge of,,...
and Leaching Facility(If any wetlands exist; Feet
withi'tt:300`feet of leaching facility)
Ftun'ihe
ni
No........ ...................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HE TH
f '. ._---------OF.......� ��...-------.............................
Appliration -for Disposal Works Tonfitrurtion Vrrniit
4�
Application is hereby made for a Permit to Construct ( r Repair ( ) an Individual Sewage Disposal
System at:
....................09:30 -
' .......................................................
..••aLaooc�cat�o -Address or Lot No:
Li�Lc ..... .........-••••-••-•...-•••-
ig Addr
----------------------------------------
W f
I I � Address �
Type of Building Size Lot...... /. Sq. feet
.-, Dwelling—No. of Bedrooms..............................:.............Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons.........------------------- Showers ( ) — Cafeteria ( )
a Other fixttt es ----- ------------------------------------------------
W Design Flow................ ....•.-..................gallons per person per day. Total daily flow........5 .........................gallons.
WSeptic Tank—Liquid cahaci�Q-V--_.gallons Length------ Width...J')......... Diameter................ De ------------
x Disposal Trench—No. LfS .__. Width.... . Z----- Total Length--_.,,3 f,X._....... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet. ..... .... Total leaching area--___-..-___-__-__sq. ft.
z 'Other Distribution box ( ) Dosing tank ( ) ��" L — ;?— 2 C --70,
aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------
,a Test Pit No. I----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water...._.__._____.__._.....
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...._....__..__---_-....
9 .._..-•----------------•----........_....---•-----------........----•-••-------------••--•--•--•-•--...................................................
0 Description 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 Article XI of the State Sanitar ode—The undersigned further agree not to place the system in
operation until a Certificate of Compliance ha e issued by the rd of hpajth.Sig //74
n . .. ------•----•-- �J
Dat
:1 Application Approved BY ..... / - ----------- --
'- :�e�le�-• ' e
Application Disapproved for the following reasons:.. -- ---�-----�-.�....f.
-----------------------------•----�•------•---•----•---------•�-•---•--•------•••----•••----••-•----•••--------•--•--•-•• -••-----•--•----•----------...---•--•---------•-•-----------....
C Date
Permit No.--•••--- ••----......•----••_.. Issued........................................................
-----------------
Date
(7j
No........ �--•.. .................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HIEa�.TH
v "
l6CcJ-!^ oF.......1....Ol...0 ....... ..rz.
Appliratiun -fur M,ipu ial Works Tomitrurtion Vrrntit
Application is hereby made for a Permit to Construct (i-10"or Repair ( ) an Individual Sewage Disposal
System at: 9_7 14
Locatio Address or Lot No.
01
!/ �' r ���f� •- Add r s
Installer ddress .+..,--
UType of Building 3 Size Lot......��.t G ......Sq. feet
«-� Dwelling—No. of Bedrooms--------------------------------------___-Expansion Attic ( ) Garbage Grinder ( )
P-4 Other—Type of Building ---------------------------- No. of persons.--------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtt S ------------------------------------------------------
W Design Flow................ ----------------.---------gallons per person per day. Total daily flow.......-? _-_-_--__--__--_.-.-------gallons.
WSeptic Tank—Liquid ca,p1aci/(7YO---gallons Length---�......... Width---(....... Diameter................ Depth.--.._-.--.-----
x Disposal Trench—No.
A. _l___ Width_.._.2-_-__ 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 ( ) d.40 -2 — Z
aPercolation Test Results Performed bY......................................................................_... Date-------------------------------•-------
a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
f� Test Pit No. 2................minutes per inch Depth of Test Pit.----_---..______--- Depth to ground water--. ---._-----.-___-.-.
P4 ----------------_-- ---------•---•----•••----------------••---••••••......---------•-••-•-•----•--................................................._........
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 Article \I of the State Sanitar ode—The undersigned further agree. not to place the system in
operation until a Certificate of Compliance ha issued b the rd of
Sin
Da
Application Approved BY-------
------------
Dete `� G•
Application Disapproved for the following reasons:---• -------------- ----'-'---"-I---•-------•---.........-•----------••.......-----------...._.........•--•--
•-•-•----•••-••-•-•••------------•----------•--------------------------------•---•--•------••••••••-•----•--•-•---------•••..............--•-------•--•--•-•---•---------•••-•--------•-•----•----•--•--
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOAR OF HEALTH
..............O 1 ......../ II�N�/.• r•I .....................................
�rdif iratr of fIuntphattre
THIS IS TO CERTIFY That�the Ind duaI Sewage Disposal stem cp structed (�or Repaired ( )
.a. e
.'
by....
................`....................---••• . ......•... ----- -----------
Instal]
at.................... _Aw ----------------_?,_T_.Z....-- '........... .......
has been installed in accordance with the provisions of : i I of The State Sanitary de as described in the
application for Disposal Works Construction Permit No.� -`-7•-•---------------- dated . �------4.y-..7_l.
.•�•-
THE ISSUANCE OF THIS CERT9FICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE--------------;' Inspector
....... --.
-------------------�J THE COMMONWEALTH OF MASSACHUSETTS
-.-/ BOAR• OF HEA;kTQH,,
y /Oiay.qOF/�� -] ls- -C Cr.....................................
No......................... FEE-10
uu.6trnrtiu$t Jr it
Permission is erebY granted ....._. __ ___ ______ ___ �
-.......................................
to Construct ( 'r R air ( ) a Individual S.wa e Dispos .DSyste
t. _� _
Street
as shown on the application for Disposal Works Construction rmit oDated.. .:Y�.;---�)--Lf..74
/ ;-• 1- G� -----------------------------
DATE---------------".../...-------------•���--.......--------•----------------------
_
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
4
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fa n. .�°bt1.S✓�D A� .�'NOWN HEd�GOM /ci�t,/.Z� TNgT /-T ` y en. `,�.r •.
T<-✓E �sV/v of .30 c/sTFJc3�� ���Zt1 OF
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ARNE,'
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LIQ�/O SUBV6YOB5 ` ^�
MRSS. D TE .eElr. Oe �
°✓'CiO,EtA/�/�e
TOWN OF BARNSTABLE `.
LOCATION �'— ® 9 bC /t o SEWAGE #
VILLAGE_C;e4i4ed CZ ZZ-A e 's= ASSESSOR'S MAP & LOT /ZO ao
INSTALLER'S NAME&PHONE NO. I/®®0 /Va
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) � (size)
NO. OF BEDROOMS
BUILDER OR OWNER
PERMIT DATE: 47ZQg 6,- 7 6 COMPLIANCEtD'ATE: 1 >3__a 7_7&
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of LeachinpFacility' 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