HomeMy WebLinkAbout0476 OLD CRAIGVILLE ROAD - Health 476 Old Craigville Road
Centerville
A= 247-032
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S M E A D
No.2453LOR
UPC 12534
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E COMMONWEALTH OF MAS SETTS
�arnatob� APPROVED
6 BOARD OF HEALTH
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OWN OF BARNSTABLE
, lira i • - nr Di ipv! u! War1w Towitrnrtion Famit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
.. ---------- -• --•-- -••-----••----•••••-----•-•••••---•••-•---•-•---------------------•---...........---....•--.--....
,,//k�AA. -- eL_o\ca,tion-Address or Lot No.
................
Y� ,--` -F, ti ltiVVB
...............................
Owner A -ress
1.4 Listaller Address
M
UType of Building Size Lot............................Sq. feet
Dwelling— No. of Bedrooms.-._73__________________________________)✓�pansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons.-_-_--__--__-__--_-------_ Showers ( ) — Cafeteria.( )
a' Other fixtures ......................................................
W Design Flow.......��-....................gallons per person der day. Total daily flow. .r. .....................gallons.
WSeptic Tank-f--Liquid capacitvi gallons Length--- ------------ WidtlZ ------------ Diameter................ Depth................
x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------I........... Diameter.10.`_......... Depth below inlet...V........... 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........................
Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................
s�
0 Description of Soil---------•------------------------------------•-----................---.....-------------------------------------------------------------------••-••-••-......•---.--•--
x
V ----------------------------------------------------------------------------------------------------------------------------------------- --------------------------•-----------------
•----------------------••-•-•--------•-------------......----------------------........-----............. ----------------.............---....-•-----------------------------------•-•-• .....
U Nature of Repairs or Alterations—Answer when applicable__ .....� ?�-�`... Cry` _ 7�Z ......
............... ....... .m••••--••••••-----•-••-------------------••-••-•-•-••••--•--••-----•----••--••-••••••--••--............•-••--••-•
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 to place the
system in operation until a Certificate of Compliance has been issue by the board of health.AC
Signed .............. .._..�..... ����`
Application Approved By ............. ..�. .-e.R - -...........-...-.-...-........-... c1.'- -"
Application Disapproved for the following reasons: ....V..................... . ..........................--................................ ...........................
......................................... . .... ............................................................................. . .................... -- . ...................... ........................ ............
�e
PermitNo. ........73.. -.�----..-.. .f! �.... .............. Issued ..-..-.....-.--.-.-.-..................................... ......
Daze
THE COMMONWEALTH OF MASSACHUSETTS �.
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of Compliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by ....................................C-N---t\ �. .-:.�-.l .c. _ 5 .. `� - - --............................................................ ...............................................
[� 1 f� Insr I,
at ............................................................ O. ....... V......."-.--........ RQ...................
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. .._..._.c�. .�...��..1_/�....... dated ..............................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.............................. Inspector I`.... .. . ----------.............. ... ........ - .....----.--------.....------------------.-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No....J � ~� FEE---..��=•'•..
Permission is hereby granted.......
.��� Sf' —..............................................................
to Construct ( ) or Repair ( L-),-;rn Individual Sewage Disposal Sy ietry�
atNo---------------------------------------------------- ��.... ?.1 ./•�r ��f --.-i.-.------------.....----------------...--------------------------------------
Street G G
as shown on the application for Disposal Works Construction Permit No./�-�!-(_... Dated...................
%------------ --------------------------------...........................
DATE--------- r� .�..1. ------------------------------•---
Board of Health
FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS
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»"�-+=�'-=�-+� ] . / - ' - ' - ' ' - '-^=`�=----
` THE coMMomvvsxLr* or wAssAoHussrrs
����oJ� ���� K~��� HEALTH
���~^"" ~�� =~" " .~-" ^�- " " " ~, .
~ TOWN OF BARNSTABLE - ~ s
� � �°� ��~ ~� ��.°l � �� .
����������� ��� ��«������ ������ �o n 1hrutit
Application is hereby made for z Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
� System �� \�� �^�*_���\ ��'�
� '-------'-----�_���-_----=-'-----'_-�l��-���.......Locatioli-Address = Lot No.
'-------'-�����'-'�~�' -_------------------ -------------_�����'�'�' ...................................................
=n= /� [y A ��
_-----.--��''u���=�.�^r�c,��...=��.�^��_._.-_----' --_-----------_------------'------------------
I""mu,, ' A"u��
Type of Building Size Lot...........................Sq. feet
D�6}�o�--l�o� o� B�droon`y--_�.---_--------I�xpausiou Attic ( ) Garbage Grinder ( )
Other--Type of Building -----.-_-... No. of persons------_--- Sbo*cm ( ) -- Cafeteria ( ) �
Otherfixtures -----------_--.------------------------------------ ' -... . �
Design Flow.-.. _ -�a|000per person day. Totalda�vflow- _ � - .__-. ._
Septic TuokJ-Lu� �
Length-�:.---. '--- Diameter---------------- Depth................
Trench-- No -- Total Length.................... Total area.................... f t. �
Seepage Pit Nu-.-l---.. Diaoetcc. --- Depth below inlet...�p_L--_-' Total leaching area..................sq. {t.
Z Other Distribution box ( ) Dosing tank
^- Percolation Test Results Performed 6?.......................................................................... Date---------------^--.
Test Pit No. l................minutes per inch Depth of Test Pit.................... Depth to ground watec---.--_-
Test Pit No. per inch Depth of Test Pit'--'_---. Depth to cr0006 water........................
---._-'---_-'-............................................................
0 Description ofSoil- '-__.''--..._'.--'-_---'_.-___'__--
v ----------------------'--------------'-------'--'-----'--'-'---------''-----'
--'---------'-'---'-----------'-''----'--'' -----'' '
� [] Nature of Repairs or Alterations—Answer when applicable.- . ........
A&rccoeoz:
The undersigned agrees m install the aforedescribe6lndividual Sewage Disposal System iu 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 been issued-by the board of health./I
G�o�6 -���. c-` -~4^ ��� �'� .......... r \"�
/ ~ ' -�---.~~~~~-�-�~�----=---'�-� ' ���---
App1im6ou Approved 8v .............. c}_� / _� �
' �_~ ---------------------------. --+-'«��`-'+�+
Application Disapproved for the following reasons -----------------------_-------------------'
---'---___--_----__--__--_-----_-------------------'---- .......................-�_--
Permit No --'/L ^\-��-.��-l-Z------- Issued ..............
Date
_______________________---_______________________________
y7� TOWN OF BARNSTABLE
LOCATIO D Cy` v' p--O SEWAGE #
VI L L A G C of 1SESSOR'S MAP & LOT
INSTALLER'S NAME 6i PHONE NO. L SeL
SEPTIC TANK CAPACITY /tOOj g A kr j
LEACHING FACILITY:(type) Q'-c-C' A P T— (size) ct
NO. OF BEDROOMS 2-- PRIVATE WELL PUBLIC WATER
BUILDER OR OWNER jMr r- (rye �x
DATE PERMIT ISSUED: L/4 3
DATE COMPLIANCE ISSUED_
VARIANCE GRANTED: Yes No �/
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4
1
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6w
y 7
TOWN OF BARNSTABLE
I
LnCATIOSEWAGE # �
VILLADE ��Sll�
SESSOR'S MAP & LOT ,
INSTALLER'S NAME PHONE
L
SEPTIC TANK CAPACITY
LEACHING FACILITY:(t7pe) A-ST Pt V (size %
) �
NO. OF BEDROOMS 2— PRIVATE WELL BLIC 1VATE �CL_—
BUILDER OR OWNER
DATE PERMIT ISSUED: p -� L
DATE COMPLIANCE ISSUED: if
I
VARIANCE GRANTED: Yes
No L
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LOCUS Ra
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Croi Y1116 Beach Rd
L OCA TiON MAP
Jv Assessors Map` 247
Lot 4A
'� Area — 7,500 S.F.
Deed: Bk. 12777, Pg.89
Plan: Bk. 103, Pg.75
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Y RECORD .OWNER
m PATRICIA A. WKINNEY
�O 476 OLD CRAIGVILLE ROAD
n CENTERVILLE, MA 02632
ZONING DISTRICT
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LOT 5A
Off,
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5 PROPOSED 6
Addition
A SHED
PROPOSED Q�QQ�c LOT 4 CB
Rebuilt � ' 7,500 S.F.
Bldg. Section s' 0.11 Ac.+�—
LOT 2A 'j�.�°° h h
O
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OF M.gSS�C' of MA LOT 3A
NIEL
gb, ` STEBHEN tiN
o CROTEAU -_-A !�
CIVIL "''' MOORE
No. 46253 L No.39398 y
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Fss/ NAL
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(LORAN ENGINEERING ASSOC . , LLC
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508-432-2878 941 MAIN STREET RTE 28), HARWICH, MA
CERTIFIED PLOT PLAN IN CENTERVILLE
Prepared For: Poul Rufo
476 OLD CRAIGVILLE ROAD CENTERVILLE MA
PROJECT: 13-231 SCALE: 1 " =20 ' DATE: 9 2 L 13