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HomeMy WebLinkAbout0028 BLUFF POINT DRIVE - Health LI .B1uffP6'nt- Uri V�otuit- = 034 075 I+I No. 4210 1/3 ESSEL E 10% -'enlUWN OF B STABLEDr. LOC SEWAGE VILLAGE CO T-2 1 T ASSESSOR' MAP &/LOT �rOK2 i1 _ INSTALLER'S NAME & PHONE NO. � ��� ( � 1-112T- 3��.5 SEPTIC TANK CAPACITY /eZzly S q, �. LEACHING FACILITY:(type) 7-- (size) NO. OF BEDROOMS- PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes Not ._ a ,., �� � � ; �� � 1 • � �*_ Z �� ri No.-- ------- --- ----- Fee--- __6--------- q BOARD OF HEALTH TOWN OF BARNSTABLE t-"/ ag �� Application-for Well Congtructionpermit h Application is hereby made for a permit to Construct (V), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel CnyW -------- --------------------------------------- ----- —------ Owner Address A__Scw # - ------------------------- - - ._PdK66------ a� -il"k� - ------------- Installer — Driller Address Type of Building Dwelling--=-------------------------------------------------------- Other - Type of Building------------------------ No. of Persons-------------------- -------_ Type of Well y -C9v ---- -- ----—--- Capacity-------------------—- - - -- Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate .of ompliance has been issued by the Board of Health. Signed — --- ------ - - ,�9`1----- date Application Approved By --- date Application Disapproved for the following rea :--4�7 -----------------------------------_-----_--------_________ ---------- --- ------------------- fda date LV Permit No. ----- Issued --te BOARD OF HEALTH TOWN OF BARNSTABLE (tertif icate ®f (tompliance THIS IS TO CERTIFY, That the Individual Well Constructed (4,1, Altered ( ), or Repaired ( ) ---------------------------------------------------------- Installer — at-- -0 4! fr A i� T 17 ---- - --has been installed in accordance with the provisions of the Town of Barnstable Boa d o ealt Private Well Protection /� Regulation as described in the application for Well Construction Permit No.W -- -- -`� - Dated----- ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE ns--- I ector------------------ _ -- - P o .5' No.--.-- -qi -------- - Fee BOARD OF HEALTH TOW-4N OF. BARNISTABLE Ot" anon or e[[ �ootruction ermit v Application is hereby made for a permit'to Construct (✓), Alter ( ), or Repair (. )an individual Well at: - - ------ -- ---t— ?- - -- - --- - -= - - ----- Location - Address Assessors Map and Parcel Owner Address -=--------------- --------- — - n bx �6 - _z s �- - �'------------ ------- Installer — Driller- = Address �• Type of Building Dwelling , Other - Type of Building ---------- No. of Persons---- -- ---- ------------=--- " Type of Well U---�`>� - - ;------ --- Capacity-- I Purpose of Well isr�'Gor_�� - Agreement: I The undersigned agrees to install the aforedescribed individual well in accordance with the-provisions of The Town of Barnstable Board of Health-Private Well Protection Regulation The undersigned further agrees not to place the well in operation until a,'Certificaa .of ompliance has been issued by the Board of Health. Signed - —/_ _�— --- --- - -L----= '. . date t Application Approved By date Application Disapproved for the following reaso :----------- - -- -- ------ =-=— -- � ' r' date Permit No.• _— 'Issued --— - ----.-- -- ' .itMi!itif.�Fa1•i! !a!i!�lili�aSi!rla�aSi-iTo�'►YG!�S6sititali9aliSifiOvi!!}tl9if'�M:161i@afililiTaM:tBeWdi4ilil6•�a{flilitsL�ili9aSil6filiRFlSli1934i!1b!i9a14T;21i411r!d2�'-wle's`� , • BOARD OF HEALTH TOWN -OF BARNSTABLE Certifirate Of Compliance` . THIS IS TO CERTIFY; That the..Individual Well Constructed,(0, Altered.( ), or Repaired ( ) b =_ =�A SClxn�ue �� -- — — — — — — — — = — y Installer I , has been installed in.accordance with the provisions of the Town of Barnstable Boa�qre alt P 'vate.Well Protection Regulation as described in the application for Well Construction Permit NOW o Dated---- ----- THE ISSUANCE OF.THIS CERTIFICATESHALL NOT BE CONSTRUED AS A GUARANTEE-THAT THE WELL SYSTEM WILL FUNCTION'SATISFACTORY..' r DATE-------- Inspector---------- - --- -------- ;` r I�ia.:,ai+iDiu Ri},alylvivi+f@'sslita•�w?Yill4T.ffi@4liGRORsls4>i�0'^�iAiaa'!S'@i36'a!'iRi a�64a6Vti9i6i1aYf7lYFJl:Qi$t!f�e"-i 9s'1��4iLi'1:'v-L��• " .. _.: - _ � _ _ BOARD OF HEALTH TOWN OF BARNSTABLE Well Congtructionermit E N o. -K-=--- --- Fee_ - Permission is hereby granted b A to Construct (V), Alter ( ), or Repair ( ) an Individual Well at; Street as sho do ppli a i or a Well Construction Permit " No. _� Dated ---- --------------- -o y d Board of Health DATE _ ,y P004(r 0 c. TU�WN OF B STABME . ' LnCA �i ( SEWAGE # V 'LAGS -Z> l T ASSES OR' MAP & LOT _ ' INSTALLER'S NAME & PHONE NO. �� r� f SEPTIC TANK CAPACITY LEACHING FACILITY:(tVPe) i O-L777 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER r % DATE PERMIT ISSUED: i - .� "�� DATE .COMPLIANCE'-ISSUED: � e VARIANCE GRANTED: Yes Noy_ (A ` �yC No...�,. -... � ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ovEa (� Applir�atiun for Uhipvii al urk.5 Tonstrurtin ruts t# Application is hereby made for a Permit to Construct ( ) or Repair ( �n Individual Sewage Disposal System at ................______._.... �..P� - _ a'� .- ......................L.. T... A...•.......... L cation-Add re or Lot No. .......................... - -------•.---- ------------------------------- Ow�n -----------•------•.............Address Installer Address U Type of Building Size Lot........!OS_Sq. feet Dwelling—No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures . _.._.._.. W Design Flow....................... ._._ gallons per, person per day. Total daily flow_.._._................................. 0__.gallons. WSeptic Tank—Liquid capacityj,0allons Length---------------- Width................ Diameter_............. Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------- �qqAA--�•-sq. ft. Seepage Pit No------------ iameter--------/ ..... Depth below inlet_____-&:....._ Total leaching area......... sq. ft. Z Other Distribution box ( � Dosing tank ( ) '~ Percolation Test Results Performed by.- N.Y� t-___ _ .............. 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-_____-___•..__---_-___: ----- ------------ Descriptionof Soil3"� - ............. 1L------------------------------------......................................... -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Comph nce has e is e by the bo d of health. Signed - ------ -- ---- --- ----- - . ...............----- --..--..... Due Application Approved B .... ..-1-.3.......Z pp pP Y - J v Date Application Disapproved for the following reasons- ----------------------------...................................................-...................................................... ----------------------------------------------------------------- ---------------- ----------------------------------------------------------- ---- -- --------------------------------------------- -------------- -- ----------------- - QC� Date PermitNo. ...---../...... ..-. ,---------------------- Issued ---------- ...... .---- -------- -- --........---....... Date No................_....... Fim..........................._ THE COMMONWEALTH OF MASSACHUSETTS .� BOARD OF HEALTH .............. u�.I ..........OF......P-,i A r?:! �`r� �'..�a La ..............................-•-- Appliratiun for Biupuual lVarkii Tunutrnrtiun Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( I,,)an Individual Sewage Disposal System at: ................_........_.......... , 1 --...........------•---•--•-•-• Location-Address or Lot No. ......................__........................................................................ ..........--...................................................................................... Owner Address W Installer Address Q Type of Building Size Lot..............¢-s.'�. .....Sq. feet U Dwelling—No. of Bedrooms................ Garbage Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures...--------------------------- . W Design Flow......................�:S..............gallons per person per day. Total daily flow.............---------------- 1 D....gallons. WSeptic Tank—Liquid capacity) �� gallons . Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.....................sq. ft. Seepage Pit No............ ------ Diameter--------- e..... Depth below inlet......1!�........ Total leaching area........;;� '°sq. ft. Z Other Distribution box ( y' Dosing tank ( ) ~' Percolation Test Results Performed by "� j1,...•.::E.Q'vl' 1P:a.............. Date-------:..-��.: ............ raj Test Pit No. 1........?,:: _minutes per inch Depth of Test Pit......j.;.......... Depth to ground water..._...- ......�--- Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil..........Q•---.................-- 9P W --------------�J- 1----I •-------- .--.> a ------------------------------------------------------------------------------------ --------------------------------------------------------------••------•----------------•------------------•---------------•----------------------------------------------------••----------------------- VNature 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp •ante has been iss the bo f health. Signed . fly C/fi --......�•.... ..� ---(.Date--- ----... Application Approved By -------------------------------------------- ------ ---....................... ------- ----- - ...---.................... ----- ------ -------- --------------------------------------- Date Application Disapproved for the following reasons- --------- --- -- ---- ---------------------------------------------------...............--------............................ ---------- ---------------------------------------------- -------------------------------------------------- ---- ---- ------------------------------------------- - ------------------- --------------------------------------- Date PermitNo- ------------------------------------------------------------------- Issued ...............................................-------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARR OF HEALTH -------------TO j ! .... of ........ r'-r _ �1 -----•- ---------------------------------------- Cex#ifi ate of C�omplinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( 1. by -------------------------------------------------- --- ----........................-.--------............................... Installer at _------------------- ------------ -- ----------------- --------------------- -- -------- ----------------------- ----- -------------------------------------------- -- ------------.............................. 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. ................................................ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------- ---------- ---------------------- -- -- --- --------------------- Inspector -----------------------------------------___................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD PF HEALTH �� ��01......OF........... .... -� =f' 2�•1tS`�-'�r No......................... FEE........................ iu�ruu1 Turku Trunufrnr#iun firrutit Permissionis hereby granted.............................................................................................................................................. to Construct ( ) or Repair ( kan Individual Sewage Disposal System atNo............................................................................................................. Street as shown on the application for Disposal Works Construction Permit No--------_---------- Dated.......................................... -----------------•-------•--•-----•----------•-•---•------------------------.......................... Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No._R 0/J Y/ LI Fee�,10 0- o THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE,MASSACHUSETTS Opplicatioll for Miq;Pol;tit �&Pmelll Cow6trllction 10ernlit Application fora Perntil to Construct( )Repair( )Upgrade( )Abandon( ) ❑Con7plcle System IXIndividual Components I_ncaiiun Address or Lot Nn.ul� 61A( </' dif)/'. q�C Owner's Name.Addye�ss and Tel.No. L(�7tzi.� J—d/tn yuta._ C�gai� Assessor's Map/Parcel /774 P Incualler's Nnme,Address,and Tel.No. Dcs�'�r ner's Name,Address and Tel.No. .vQ I `—�l� _r)) C7 sfCrr,'u� rn yl o�lnSS �'c� vas 3jyy Type of Building: Dwelling No.of Bedrooms Lot size--770 sq.ft. Garbage Cirindci(1�Q Other Type of Building 0A&ANA No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow uo CHAUG c gallons per day. Calculateddailyflow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) / 1j Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal sysicm in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certil1- cite of Compliance has been issued by this Board of Health. Signe f5i Date Application Approved byeff, Date Application Disapproved fnr the following rca. 7 Permit No. Date Issued 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 at}O / LL.6- - ;n / 74,'t Itas be consn-ucted in accordance with the provisions of Title 5 and the for Disposal System Construction PermitNo. atcd Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date_ Inspector ---------- ---------------------------- No.- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS �1�f10ga� �pk�tellT �011l�ti'netl0ll �ei'lliit Permission is hereby granted to Construct )Repair )Upgrad ("`*)Abandon( ) System located at :7cf Q 1G ff �a i i.�f CltW /z ci f and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duly 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 - e . .. "Z,I�. . - -,�- .... -- . .,-, '� ' i.--,r�,i . �I�.' - 7*..;,---� ..�- �:-. �- .- .*.i, 1. .,-..,;. � 1 q k A , �4 ,- -- l , ,o X , 1 Z e . r" ' ' E" Zi .'.1 S r -. '...-. .'., �. - �.'. ...-.� -:�'- W t ,11e1 f,? - �,- t .. 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Ge ed Larn \ Lem 1 �\ Polo Block 1 �I le 9-6 a e PgRtill Ic % l ,ay. it T No 6T�M / Poflo Black 14 co \``` ` C ISTCg rryC B•Akr,� /.! ��' '7 � \� it \`` /\ y— 40¢� EDICT // \\�\ " ✓✓ Slp4`C.,_1 .�y I /. / / 32— � �'`.. „ena // PLAN VIEW 31---- ///ry1 Scale;l°=10, 29 Underground Utilities to be Relocated, '- if unted in The Field.Contractor _ /-- \ / _ ti to Notify DIG SAFEDays Prior to } ` \ \\ �r4.s' // // / // Excavation(a71 7233 -888- 1 \ / V / �. ,, / .,•••�,� by ✓'• PR ti / Ttle: Cal" I � 1 I 1-112 Sty V IF ;i ♦♦\ ' i / Garo9e �j / I pod / jll III °d Ston' 11 / G° / t I 93.2j�AM�*G Y6,4 M � // t r t \ t ��• / }i Poue 9100k / �_ ♦ I . / / 9No�ao / ri �� ,' ♦��� Fro�/ Sk C ISTC LrN 4@AN i // ' ^'7 �' ~\� 11 I D_ i Y 1 O// `TANK—�// tttt ��, S�og'4 P 30 cP h 1�� o` 6Ht o 15.6 / s 32 — ___ �«`•, / / PLAN VIE W 31 ———— _ G��tO ;' / // tip Scale;I"=10' 30 29 /,. / //// Underground Utilities to be Relocated, �.2s' \ E Days for to \ \ Excavatlo 1-8 - . �`�. / tib if Encounted,in The Field Contractor _ \ / / i to Notify DIG SAFE 3 Doys Pr' 7�.6' // / / / n 27 y 26i ✓ T.....—.-..... .....—. .......... � 1 10 A / Title: PRl 1-112 Sty W1F Garage III Pool Pavers I I I / 111 Fence W/Iron III one Wall Coped st Lawn Lawn I \ \ \ 11 1\ 3 Q Patio Block. \ i Gorden i /age /e'lo 1 Sty 'g ga Lawn =t� �v: = shedi = 1z m { _ 15.6' \ !\ j aOyo,�� 20.8' �\ Generator � I 0 5 10 20 FEET /' 44.6' Sullivan En ineeI[`in Inc. C a, r)(a9 �JU V Sheet Title: �y V Proposed 349 Changes PO Box 659 7 Parker Road at 24 Muff Point Goad .Osterville, MA 02655 Osterville MA 02655 (508)428-3344 (508)428-3115 fox (508)420-3994 (508)420-3995 fox "��������@ ��o��0��9 ���� PSullPE@ool.com copesurv@copecod.nef Date 221SEP/00 Dwg # C323_2gI __ _. „.. � Si � ;;. �� �Jcl+�',�i�—:.•- '�'•^-..c .+'-�7 1.a.�?"�'- .�- t�w.+6.�/M.ar.,,�.-y�y ---- L. — — _ ._ — tNy e� "F tN✓ � 4o PSG +�� i� � ` \�� � �,o •� �.0 looms Z� iW� Dtsr' tN✓ S�sSotc.. 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