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HomeMy WebLinkAbout0086 ABBEY GATE - Health 861ABBEYf GATE ; .COTUIT A = 021 052 _ 4{ 'I c Cotuit Fire Department pT Ul *; Fire, Rescue & Emergency Services G 'PIP CRW `• 64 High St. P.O. Box 1632 u 1926 Cotuit, MA 02635 �'•RE$ Paul A. Frazier Phone (508) 428-2210 Chief of Department FAX (508) 428-0202 TO: Tom McKean, Director of Public Health �v, a Town of.Barnstable, Board of HealthP. 0annXMA. 02601 BAR 1 3 2002 Hy FROM: Chief Frazier, Cotuit Fire Department ..; SUBJECT: Tank Removals, et al DATE: March 6, 2002 The following tanks have been removed/abandoned since my letter dated December 6, 2000. If you should have any questions or require additional information, please feel free to call Thank you. NAME ADDRESS DATE NOTES Lanza 86 Abbey Gate 12/07/00 1000 gal. tank removed, Cotuit, MA 02635 No contamination or odor present . i' No. FeeJ �OTHE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for �Digo$ar *pztem Con.5truction Permit Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Y � Owner's Name,Address eand Tel.No. Assessor's Map/Parcel (op,/', (f t0A_-1'ss[n/) Ins�t�)ts=a-Pit�ne, f /dress,and Tel Designer's Name,Address and Tel.No. �✓—r� per-" L e�5- (S OvrS 5 Type of Building: Dwelling No.of Bedrooms :3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures G Design Flow gallons per day. Calculated daily flow % gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank VUZYD-t 60'r" Type of S.A.S. rc:1 Description of Soil id _ S&end Nature of Repairs or Alterations(Answe 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 Environme tal Code and not to place the system in operation uptil a Certifi- cate of Compliance has and ealt . Signed DatelL) Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued i TOWN OF BARNSTABLE LOCATION SEWAGE # v(�V VILLAGE _ ASSESSOR'S.MAP & LOT � INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /rOd LEACHING FACILITY: Tpe) .(size) NO. OF BEDROOMS BUILDER OR OWNER - PERMTTDATE: d� .COMPLIANCE DATE: Separation Distance Between the: . Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private:Water Su 1 Well and Leaching Facility PP Y, g ty (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 �. t e —. ;T �'d- ,f No. 1 /fJ 10 Fee d cal/ %H'� E COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS �2pplication for Migpaar *pztem Construction Permit Application for a Permit to Construct( )Repair((/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (� Y E�- Owner's Name,Address and Tel.No. Assessor's Map/Parcel M,V _Q \ (f F OA-4 Installer=s-Name,A-,ddrree,,and Tela �r Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) ` Other Fixtures !' Design Flow &-?d gallons per day. Calculated!daly.flow 3��� gallons. Plan'Date Number of sheets 1 Revision Date Title Size of Septic Tank Ln r'L,I -k0Z-0 1 0'--gc-/ Type of S.A.S. Wir Description of Soil 1/�,t- � �G✓!17 S I�r/1� Nature of Repairs or Alterations(Answer when applicable) .1"i l..-S% (1 FU 0 t2 /( Date last inspected: F 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+y­this B. and o ealt _ -- Signed f Date Application Approved by . ' Date Application Disapproved for the following reasons Permit No. Date Issued f ----------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certif i•cate of Compliance THIS IS TO�CERTIFY—p h t the O.n_site S wage Disposal System Constructed( )Repaired( )Upgraded(V ) Abandoned( )by e - at D A7 Ui—I has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Perm�1­3 0 — '_ 4'ked /'0,-f r' Installer Designer // �y o The issuance of this pie shall not be construed as a guarantee that the system/will functioln�as designed: � Date �^�( / . � / � Inspector ir� �A ��P� t'�f , �iL , �! f t -----------------------------—--------- il 11 �/ •� Fee JF' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ligpo.016potetn Construction Permit Permission is hereby granted to Construct( )R pair(1..►rupgrade( )Abandon( ) System located at _ G ti*_,C 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 e it. Date: / / C�' Approved b �, 1/6/99 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 DESIGNED PLANS) hereby certify that the application for disposal works —�— P construction permit signed by me dated Id M concerning the property located at meets all of the following criteria: The failed system is connected to a residential dwelling only.. There are no commercial or business / uses associated with the dwelling. IC The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system ✓ 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 There are no variances requested or needed. ,Iyl�e bottom of the proposed leaching facility will not be located less than five feet above the mammum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] e' i the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: ' A) Top of Ground Surface Elevation(using GIS information) 41 � r f B) G.W. Elevation V0 +the MAX. High G.W. Adjustment ./i V = t DIFFERENCE BETWEEN A and B 3� SIGNED : DATE.- [Sketch proposed plan of system on back]. q:health folder.cent U ,,, ::. ,r. 5rn 1 �s j THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiuu -fur Ui,ipuuttt urku Cnuuutrurtiuu Vrruift Application is hereby made for a Permit to Construct (/--r or Repair ( ) an Individual Sewage Disposal System at: fr �-913LY....C1_l a_ ��........................•---- -- � � _._.l�_f_/�.. �c .on Address or Lot No. O ner Address Installer Address Q © _ •y S feet Type of Building Size Lot_.A..f_________________ q. U -, Dwelling,�No. of Bedrooms._____________________________________Expansion Attic ( ) Garbage Grinder ( ) PL4 Other—Type of Building ---------------------------- No. of persons ___.- ----------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures --------------- ------------- - q. W Design Flow...IM..�... ....................gallons per person per day. Total daily flow.......33jO.........................gallons. 9 Septic Tank—Liquid capacity%ZOV__gallons Length---------------- Width ----- ........ Diameter_-_-.. Depth J -_s Disposal Trench—No_____________________ Width_______..___....__.. Total Length_._._._.____._.___.. Total leaching 1re1___4 ._._._ q. 3 Seepage Pit No--------I----------- Diameter. �•�___-_-_-. Depth below inlet_--_______='_._..._.,Total leaching area.: -_ ---__-.sq..tt._4 Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by--------------------- ------------------- ground w�er _%1'222�__-- Test Pit No. 1....._°sr________minutes per inch Depth of "lest Pit_:._:��_-------------------=--- Date..._..__... Depth to G14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water--..-.--._--_---__...... 1:4 ---------------------------------------•--•------------------ -------•-------------------.--------------------------------•---•------------•-•-------•-.- - 0 D g 6 i escription�ofSryo�--�-�'°�-�---.�1�1.c/.3M.r��_..5_�!���?�f�.-j'---�--._s'_�..,����lst!__0=/N�---�}.i✓,�`--------------------- xe5d-._•----------••----•-----••--•---•--------------------------------------------- - 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 Article \I of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the bo health. igned - - ----------------------------------- ate 50� Application Approved By- '°n---- ---- •.-- . .--`%��. .. ------------------- � ..' Date Application Disapproved for the following reasons------------------------------------------------------------•------------------------------------------------•••. ----- =------------------------------------------------------------------------------------------------------------------ ---------------------------------------------------------------- Date �-1 1 Permit No. Issued. ----------------------------------- Date No.- v Fug....��.,y...'"'"..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH GtJ --oF: AVVIiratiuu -fur Uiopottl Workii Tuttotrurtion Permit Application.is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: - hJ?46 Ar44, tar'--------------------------- -----,--U fa/ "►'-------.1f 1WW9f_1FR ------ � Fs !!�!; •... o f._ No Y_.dress ,•.............................. Xl�'-iFrllrl"1 ; or Lot �!iM......-•----------------•---- wner Address ac 'M -- -------------------------- tN. , �?l1�1 1° Installer Address d Type of Building Size Lot.p U .......Sq. feet ,. Dwelling To. of Bedrooms_.__- ------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons.--------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ...................................................... W Design Flow.-JI& ( •...................gallons per person per day. Total daily flow.....330--__-.-_-----.--.-..-__-..gallons, WSeptic Tank—Liquid capacity1400-__-gallons Length.................Width------ ......... Diameter---------------- Depth-_---.-_-.----- x Disposal Trench—No- ____________________ Width-------------------- Total Length------------_----- Total leaching area--------------.-----sq. ft. Seepage Pit No.......f---__-_--__ Diameter..-SO_f---------- Depth below inlet____________________ Total leaching area....._.__. ------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by---------------------------------------------------- r_-__-___-_.--____-__- Date__ Y /t _ .._....... �f a Test Pit No. L____AL-----minutes per inch Depth of Test Pit.... --------- Depth to grounder./1raIG"E".... (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------_..--_-.._ Ix . ----- ----- ....... ...... .•. ......-- --...---- -------------------------- D Description of Soil , �"` ! 1alM Y .,S�J$a � a �«" � , a�Qi� 1G`j _c"�/4'& �--•--------------- x ------------ I > "I #. $4M)..... •-•--- -------- -------- -------- --------------------- -- ----------- --------------- --- W --------------- ----------------------------------------- -------------------------------•--•-•--------------------------.....---------•----•---------------••-•------ --------------------------------- U Nature of Repairs or Alterations—Answer when applicable--------------_...-------------------------------------------------------_--------------.----_ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Dispo"sal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b issued by the bo f health Igne - '.',. ------ 'ate ------ �Application Approved By.w_... ---------------- � Date Application Disapproved for the following reasons----------------------i:...-----•--------------------------------------------------------- .------....-------- ----•----••••---•----••••-••-----•----------------------------•••--.......•---------.._..--•-----•---•---.. Date PermitNo......................................................... Issued---------------------------------------•--•--••--••--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD- OF HEALTH .......... ...............OF...., 1? 7XAIS 4.4.......................... �rrtif iratr of Tompliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) by.. ,H_IV-----h-A-4,'- --------------:...-----=--------- ................... ----------------------...............------.....-!-'--------------------.................... .} has f:s••- _.. /.. : " --- °' ?"l1.1 :--••--- Ins - --- --1_,e V-6 ----{ ............................... as been Ins aped m accordance with the provisions of _ c XI of The State Sanitary Code as described in the ,�+ dated ' '` ' application for Disposal Works Construction Permit No.:..�. ep----:. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C014STRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---------------------- .-- 9 J Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y ''��r ��^^►►�10 ... .............OF.,�74.RNS5"7X..8.4�............................... N i7: ----••--•-- FEE."'..? "'^'.'. Biopopttl Workii Lllouotrurtion Permit Perrhission is hereby granted.__0-OD&AI......10 M-A/.,- ------------- -- ------------------------------------ ------ to Construct- I or Repairs(may)-an Individual Sewage Disposal S stem w h at Noj�077— •,5 3F..z!�= t - � �l �t'�� .__ ...................................... treet as shown on the application for Disposal Works Construction r it N _ _____ __ _____ Dated_':__f = '�7P' 'r ---------------- -----•--- �f Boa.rd of Healt DATE = ... ...`-�-/-----------------........................... •.� . .,Y FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS •s { 24 iadlL�( Flaw 1i� 3 ' 30 �,•.Ptv -; AM14 ;,5�'Ic T'A�t�_ - 3>0� l50 % • •�i5 G.Pt�.' ; �. � Per'P . /;11 r�cQ ` , . . ;. , � USA l o0o saw. ' ' For s �1'SPOSAL PIT - USE (o0a GAL S;MPWAL.L AV-EA =.iso S-P. JS • S.FF.�r�>g /�2z.5 • G�IS G.P.o. .. ;... , w ..-..... f 'w, ,OAA Iu OP-A 4 : 0 ST-7. ^•wn:vs:: w,+u,•.a,.{ s :1 L IG R . - TA � D To ES ►.1 G 2 .5 ►1 }•, Irr PMC-OL T1O1.) BZAT�`:. l w 2M I w'oIz U-16 . t t 4 `;�+t i�.,r , ,F e 1 � A f ,' r}. 5 4 L. ,• 1 - 1� ' _ .._.• i 1 ,i 5 1. { 4 � Fc IQ s. J i6r!v�' g' /`O``�L ,<�•q f } r.+_ Jry A} ®AVER 7n l` s ` } ',o r!� i , ~' ' �25 , - ,A.,;+ -ST 10 Tor Fdo%few o : EL=9'1 cvs 7Ttc z 7ITJCccTi"� ' °: 4N�� .1 r, LoA}y Rv' e loan lw- Ll+ , i� SL3011r a t 4 ROl ... DISC Iw• �}}Q t+ �•,, r .ma x w 1`� e Pncr ,J6 16. y��L1.aw� INV ( it "--i AW1L �� r c� Fug , IOoo , qb'g wv I1fV , 101,4 L sAcEi 9�I '/i�lr; Iai�L�l°lt }k "; SAND ; sroNE g 4 < , • C E t ,; t AZT 1 F 1 ED p l.bT' P1._.,4�� o ScAL�- r} 0 4�A7 `ate ( : .Ll p *2A T l_ 10 �$ _. - r G��ZTi T�IA'r T&4r-- rou DA'I'1ot� SNow�.! a ' 4�LAw RE.rERE` ceG /• f if C }'%4WMo J COAAPLVS W ITIA TWG '�jiIIe_Li�- E t t . • i 1 + AND Ls ITS -rowU oT 7A-R-Q/Vr g � � L _ aZE G l S tt.tZ�D t..au 5 vc ocZ� c7 u e Y TMIS; C»Ai-1 IDS WOT BA-Sep C)"; t>�.J OSTE2VAL.LC� , o` Ma51. ANPL.icA.l..i-r 5 = ' ' Tt7WN OF BARNSTABL'E - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION DOWNER AND INSTALLER INFORMATION f` t 86 ABBEY G�;E ADDRESS. MAR NO. PARCEL NO. 1 _ OWNER NAME: VILLAGE: INSTALLATION `DATE: BY: J©,-N ALTO CONS`. co ADDRESS: CERT. NO. l - TANK INFORMATION RTG T FRCINT COMER OF HOUSE LOCATION OF TANK: k r; CAPACITY 10,00' TYPE ' -Steel AGE 9 VrS-FUEL/CHEMICAL Fuel Oil TESTING CERTIFICATION C J PASS C J FAIL DATE . LEAK DETECTION C J CHECK IF N/A /3-1N0 TYPE/BRAND ' 'ZONE OF CONTRIB UTION C J YES DATE TO BE REMOVED FIRE DEPT. ..PERMIT ISSUED C J YES C J NO DATE CONSERVATION - C J CHECK . IF N/A DATE ^' BOARD. OF, HEALTH TAG, NO. [ I[ J C 11 J 'DATE PLEASE PROV I DE.':A SKETCH` SHOWING THE TANK,'LOCATION ON. THE BACK OF .THIS CARD v Ti 4 ....g..>ri.,r I TOWN OF BARNSTABLE 2 08 9 8 l sAUVrA, i Builduig Inspector Permit No. ___---- .... 1e70 . Cash OCCUPANCY PERMIT Bond X No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Raymond Cronin • Wellesley, MA Address .lot 5 84 Abbey Gate Cotuit Wiring Inspector Plumbin Inspection date g r Inspection date Gas Inspector Inspection date VEhgineering Departme Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. uilding Inspector r. � f �a ,; r �� �� C'� �� � � �" � �� �' i i y 3 }� 7 t 3] 5 { :J i G i q. I ,q 7 Y WI � ^a � ® z m 0 1 TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGEASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. r- SEPTIC TANK CAPACITY 11dC) LEACHING FACILITY: ( pe)/AZV'1'f2.(�/r��/)sS (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: 22 COMPLIANCE DATE: 4�Lla,Lo Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 A �L� g o 1. a3 L.O CAT ION SIE:WAGE PERMIT NO. VILLAGE _ = I N S T A LLER'S NAME i ADDRESS BUILDER -O-R OWNER e w f*. Ro.0 " 'to In r 017 DATE PERMIT I S S U E.D., `"'' DAT E COMPLIANCE ISSUED -� p_ � ' i o � ` l/