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HomeMy WebLinkAbout0202 PATRIOT WAY - Health —: 202 Patriots Way, Centerville L. A=1934 —) 9� No. 42101/3 ORA ESSELTE 10% (5 o O O Q r TOWN OF BARNSTABLE - LOCATIUN a 6 SEWAGE # 1 VILLAGE 6—r ASSESSOR'S MAP & LOT 3� R INSTALLER'S NAME&PHONE NO. 9Ar() e,,,.--0 SEPTIC TANK CAPACITY � c� LEACHING FACILITY: (type) - (size) NO. OF BEDROOMS BUILDER OR OWNER VV . �,PERMIT.DATE^ .a. p'�S COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 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 I 4 / / � ` 9c'00, No. 1./ Fee $ 50 .0 0 THE COMMONWEALTH OF MASSACHUSE UTTS � Entered in computer: y Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for ;W6pogar 6pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade JKX)Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 202 Patriots Way Owner's Name,Address and Tel.No. Bill Higgins Centerville,Mass. 02632 202 Patriots Way Assessor's Map/Parcel tell �410,Centerville,Mass. 02632 Installer's Name,Address,and Tel.No.5 0 8—7 7 5-3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8—7 7 5—3 3 3 8 Box 66 Centerville,Mass. J.P.Macomber & Son Inc. 02632 J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 Type of Building: Dwelling X No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building RES No. of Persons 3 Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 0 gallons per day. Calculated daily flow 3 x 1 1 0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 0()() eXistinn T1 —box Type of S.A.S. 1 —1000--pit existing Description of Soil Loamy sand to medium fine sand. Nature of Repairs or Alterations(Answer when applicable) 3—3 3 0 Cu 1 t e r r e r h a r cl e r s r a r k e rl in 3 ' of 1J5" stone with a 3/8" stone cap. Date last inspected:_ 2/2 8/9 8 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 Certifi- cate of Compliance has been issued y this B d He Signed Date 3/219 a Application Approved by Date 3 b'J, Application Disapproved for the lowin reasons Permit No. Date Issued — — — ——— TOWN OF BAPNSTABLE 'LOCATION )(� Prp� tr _U,.� _ SEWAGE li v i+ . _ .� =e_r, l �s ASSESSOR'S MAP &LOT 013-1 9 VILLAGE - — 'S NAME&PHONE NO. .INSTALLER ...:SEPTIC TANK CAPACITY s.��. a o 0 S (size) Z� LEACHING FACILITY: (type ))Q NO OF BEDROOMS 3 i ..BUII DER OR OWNER XAI i :a.;:: PERM)'fiJATE: COMPLIANCE DATE: .Separation Distance Between the: Feet I, Maximum Adjusted Groundwater Table and Bottom of Leaching Facility i ,Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) ::::,.:,.'-:-`.'Furnished by ; LIT Q f _ s No, - , - Fee 5 Q N Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '' Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Z(pprication for Migpool *pgtem Congtruction Vermit Application for a Permit to Construct( )Repair( )Upgrade(X)o Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 202 Patriots Way Owner's Name,Address and Tel.No. Bill. Higgins Cebterville,Mass. 02632 202 Patriots Way Assessor's Map/Parcel f Centerville,Mass. 02632 - Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 5 0 8-7 7 5—3 3 3 8 Box 66 Centerville,Mass. J:IP.Macomber & Son Inc. 02632 J.P.Macomber & Son Inc. Box 66 Centerville,Mass. 03632 Type of Building: Dwelling 'X No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of-Building RES �i No.of Persons 32 Showers( ) Cafeteria( ) } Other Fixtures "* Design Flow 3 310 gallons per day. Calculated daily flow U110, gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1000 existing 1 -box Type of S.A.S. 1 -1000 nit exi st i nq Description of Soil Loamy. �saq��,idto medium fine sand. - a Nature of Repairs or Alterations(Answer when applicable) 3-330 Cultec rechargers packed3 in ' b�f 11" stone with a 3/8" stone cap. Date last irispe�cted: 2/2 8/9 8 f Agreement] ,/� { 4, 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 Certifi- cate of Compliance has been issued y this.B d� el . Signed /' Date 3/2/9 R Application Approved by ` Date 3- C/1 Application Disapproved for the MlowinUgreasons 1 .t r • Permit No. Date Issued .? ——————————— ————— —— I--————————————— r THE COMMONWEALTH OF MASSACHUSETTS ,,,"BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(XXX Abandoned( )by J.P.Macomber & Son Inc. at 202 Patriots Way Centerville,Mass. has been constructed in accordance `` with the provisions of Title 5 and the for Disposal System Construction Permit No. e- 3 �L_ dated' Installer J-P.Macomber & Son Inc. Designer J.P.Macomber & Son flnc. of The issuance of this permit shall not beff construed as a guarantee that the system will function as designed. Date �i — — !, 5( Inspector No. �d � I3� --------------------- \ ----Fee $ 50.00 a --THE COMMONWEALTH OF MASSACHU'SETTS\ -- k PUBLIC HEALTH DIVISION - BARNSTABLE, MAkSSACHUSETTS lwigpaar *potent Congtruction Vermtt ; Permission is hereby granted to Construct( )Repair( )UpgradeYX�Abandon( ) System located at 202 Patriots Way Centerville,Mass. f and as described in the above Application for Disposal System Construction Permit.The applicant recognizes 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: — . Approved by , I 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I, Joseph P.Macomber Jr,hereby certify that the application for disposal works construction permit signed by me dated 3/2/98 , concerning the property located at 202 Patriots way Hyannis,Mass. meets all of the following criteria: /There are no wetlands located within 100 feet of the proposed leaching facility There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed 4/ ere are no variances requested or needed. If the proposed leaching facility will be located within 250 feet of any wetlands, the bottom of the proposed leaching facility will=be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. Please complete the following: r� A)Top of Ground Elevation (according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED :G`% DATE: LICE 6 ;SEPTIC SYSTEM INSTALLER IN TH OWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted], q:health folder:cert a O 7 - 7)444 14: i� - ; LOCH j ION SEWAGE PERMIT NO. VILLAGE II INSTA LLER S NA E i ADDRESS (� Dt�tti �ll�nLJU� 8UILDER OR OWNER f DATE PERMIT ISVUED A-/ DAT E COMPLIANCE ISSUED �o� �� � - � �� �� -� . � c �g � � - �' No................. .. FES.............. I....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town...............I.....OF.........Barnstable . . Appliration for Uiipnaal Works Tonstrnr#ion rnmit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: ......LQt. ..-75..2atLi ta... ay...................... Centerville MA 026 3 - .................................... ............ -...................... Location-Address or Lot No. :___Mark . ..-- ........... Owner Address W Kevin Hickey 72 Carriage..Lane•_•BarnstAb)_e................ ,-1 ...........................................••--- Installer Address . 637 d Type of Building Size Lot..-. '...... .........Sq. feet Dwelling—No. of Bedrooms..................... Wo_______________Expansion Attic ( ) Garbage Grinder (lo) Other—Type e of Buildin i cafe No. of persons ............... Showers 1 — Cafeteria o a YP g P ( ) ) a' Other fixtures .................................. W Design Flow.........110 gallons per person per day. Total daily flow.___-__-330 gallons. WSeptic Tank—Liquid capacit 000 .gallons Length................ Width................ Diameter._._.. ..... Depth................ x Disposal Trench—No ------_---_--- Width'.................... Total Length.......... Total leaching area....................sq. ft. Seepage Pit No........Y.......... Diameter........l�_ Depth below inlet............... Total 1e�ch' g ar ,26;.6.-...sq. ft. Other Distribution box ( ) Dosing tank ( ) I/- / 7 Lr" . . U>a� a� Z Percolation Test Results Performed by.........Ronald.Gifford________________________ Date..JzAl--.--..G�.............._. 77 aTest Pit No. 1................minutes per inch Depth of Test Pit___.__........_._._. Depth to ground water-___________--.----__. ri Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ ........................................................ ............... -----•-•---- O Description of Soil-----------------------------------0...i /...... ......... Y`--= . ----- ................. -............ ------------ V W -••-•-••-•------------•--•-•------------•----------•--•••-••--------•---•--•................•-••-...----•----.....--------------...-••-••-•-•••-•-•-•-•••-•---•-•••••••••••••............•-•------•--•-- UNature 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 iI E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss by the bo d of health. --Sign .--•----.. ��.�.... . -•... ............................••---- =f Date Application Approved ...........�-� ----- ........... ..................... ....... ._lam_---7 Date Application Disapproved for the following reasons-----------------------------•-------•-- ...............................................-......................................................................................................................................................... PermitNo......................................................... Issued_... Z-7 -.------Date------ Date No................z/... FE$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town . OF........Barnstable A .. .... .....----•............................................................ , ppliration for Disposal Works Tomitrnrtion Prrmit Application is hereby made for a Permit to Construct ( X) or Repair ( } an Individual Sewage Disposal System at: .....L4t..A...7..5...Patrlots...Kay.......................... Centerville. MA -02632- .............._.... Location-Address or Lot No. .....Mark Elaine Tolch risky,,,,,,, , „- �, y �,Qwer...Texxa0eL_.So, .Yarmouth Owner Address W Kevin Hicke 72 C.arriiae..Li5ine..BaM.5tilb1.et. Installer Address Type of Building Size Lot.29 637 Sq. feet �-, Dwelling—No. of Bedroo s._...._. .....tWO_______________Expansion Attic ( ) Garbage Grinder k1O) per, Other—Type of Building__cafe-.._._..... No. of persons..........2............... Showers (1 ) — Cafeteria PO) Q' Other fixtures ----------•---• -•---------------••-----•-----... W Design Flow.........110 gallons per person per day. Total daily flow........330 gallons. WSeptic Tank—Liquid capacit�000...gallons Length................ Width.............. Diameter..... _..... Depth................ x Disposal Trench—No. ................. Width.................... Total Length......... Total leaching area....................sq. ft. Seepage Pit No........ .....____.. Diameter.......14...... Depth below inlet......1� ......... Total le�c 'ng ar .Z G I�:..sq. ft. Z Other Distribution box ( ) Dosing tank ( )) // /3 / . � /.,�j�fir• '-' Percolation Test Results Performed by......__Kona d Gifford a Date ��l =' .. Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........_............... fps/, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W ..................... ..............................................................................'` D Description of Soil---------------•-----••-.........'� r! _22........r��w!s �r�'�------C?-n,...j.(......................................................... W ��' .7 < < V ....................................•---•.........._..----•----• •••. /// ..___. ?r/e?r W f/7/i�k1..:l...__... .. --- ......................................•...........................................................* .............................. V Nature of Repairs or Alterations—Answer when applicaOj ............................................................................................... i:. .............................................-.......................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d2thed of health. Signta -• 1-•-•............................ .y/217,9•------- - --- Date •�Application Approved By ..�� � ..:.....-•-•--•---•-. --•---��` l,".----7� Date Application Disapproved for the following reasons---------------------------------------------------------------•---...-----------•-----------------------•------- ............................•-......................................................................................................................................---•---...---...,Date-•----- ,.. __ PermitNo......................................................... Issued....................................................... Date 1 THE COMMONWEALTH OF MASSACHUSETTS Olt BOARD OF HEALTH ......... own Barnstable. OF......I......... .......... . . . .................................... (Intifiratr of Tomp1ianrr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( X) or Repaired ( ) b Kevin' Hickey y -- ••--•-•...................•••........--••--........••..........--•--......._.........--•...... at...............Lot # 75 Patriot Way- Centerville, MA.____...02632.................................................... has been installed in accordance with the provisions of T _ ''' 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No�9------ l ................ dated._...y' .'__7r/.._.. • THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM ILL FUNCTION SATISFACTORY. - DATE.............:2 T �.1�J. ...................................... Inspector--- ...--- $' --------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable -7<( � 2 ...........................................OF..........------......•-----•----••.................................................. Z NO ........... FEE................_....... Disposal Worko Tontrnrltion 00prrvAit Kevin Hickey Permission is hereby granted...................... ,l rid -u...............g----•........... to Construct (XLo�r l�e A (Pa�triI divi Way ea,aget evillest MA 02632 atNo................................................................................................................. Street as shown on the application for Disposal Works Construction Pe 't No..._ U_.__._ .._ Dated.'04/ 7,�1 - .............. F. .` l !l...._ DATE------------ -,�--�-7-C/- ........................................... Board of Health E FORM 1255 HOBBS & WARREN. INC.. 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