HomeMy WebLinkAbout0057 CURLEW WAY - Health 4
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH s
.....OF........... 4..........
Applirathfu for Bi-qVviiFai Works Tomitrurtinn ramit
Application is hereby made for a Permit to Co truct ( ) or Repair ( ) an Individual Sewage D' 0)osal'
System 4Ad
......... ........, m . ------------------------------------------
-Locatio - or Lot No.
Owner n Address
JA
Installer Address
d Type of Buildi/n Size Lot____ �_l ..5q. feet
U Dwelling No. of Bedrooms..............._...._.......___.....________Expansion Attic ( V)� Garbage Grinder Vr}—
Other—Type of Building ........ No. of persons.....__.__.2............. Showers ( I ) — Cafeteria ( )
Q' Other fixtures .._..s........................
Design Flow.___ a. _.__ o j gallons per person per day. Total daily flow......,._.
W ------�----------------g P P P Y• Y -----�-----------------------gallons:
WSeptic Tank Liquid capacity1M6_.__gallons Length................ Width................ Diameter................ Depth.'.............
x Disposal Trench—No. .................... Width.................... 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 —_.2
Percolation Test .
Results Performed bY._....___ .__AS........................................... Date.... 1..'7�".._._..
Test Pit No. l ____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........................
••-/........... ....... -- -------------
O Descri n of oil. ._._.. _ �
x .... . _. ...... --•••-
.. - - ------------------------------•----------------.-•-----•-•------..--
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 iIT 1E 5 of the State Sanitary 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.
Sig d .......
------•--------------------•--•-•-._......----------------•-----------•. ...•-•--------.---._.............
Date
Application Approved By... =�F, - '.:....
7Date
Application Disapproved for the following reasons-----------------•-• ----------------------------------- ---------•---------
...............................•--•----•-----•-------••-•-•-----••••---••...•-•--•------•--•---•-••••••---••-----•••--••-••--••-•-•••••-•-•-•-••-•----•--------••-------•------••-•-----•---••-•........
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:.
Permit No....................... -----•............. Issued...yT
/ •.....ate•.....
Date
i
(� TOWN OF BARNSTABLE
J �
LOCATION t��C �S SEWAGE #
VILLAGE C�XUff- ASSESSOR'S MAP & LOT Oa`/ 0 G
INSTALLER'S.NAME & PHONE NO. jl,� p
SEPTIC TANK CAPACITY 1 —
or
LEACHING FACILITY:(type)�(-,•T.(&T p\T (size) M0 GA-C ,
ti
NO. OF BEDROOMS.PRIVATE WELL PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED: , 9
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No 1�
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THE COMMONWEALTH OF MASSACHUSETTS
BOAS R® O F HEALTH
�4
1,/ �' ... 3......0 F..........� ..Q' �1'P .
Aji iration for Dispaii al Works TanDtrnrfion ramit
Application is hereby made for a Permit to Collstruct or Repair ( ) an Individual Sewage Disposal`
System ............
..........
........... �,-:......
p f{
Lo atio -Address fi or Lot No.
.. _Y {r. Y' ` J •................ _ ..___...
O ner * * • "Address
a
,.
Installer Address
d Type of Buildingo.. .........................
Size Lot.:__ _ �--Sq. feet
U Dwelling No. of Bedrooms ._ ....__.__.Expansion Attic (6 Gar age Grinder ( ° }
. a. Other—Type of Building w f _....___._.. No. of persons......... .......... Showers ( ) — Cafeteria ,( )
Other fixtures .._. .. ...
---- -•--
W Design Flow.';I
. ..2` gallons p3 rjp rson,per day eTotal"ally,flow .; � `_.:._ ..-_:gallons
Sepric Tank—Liquld capac>ty� .gallons"« pLei�gth "`� .__._ Width . Diameter_______________ Depth..._ .._...__.
W Disposal T'rech No. Width_... Total Len .th^ ,z Total leaching area..................sq. ft.
p ...---. Daainet,�'
Seepage Pit No. ..�; ,.._. Depth 'below" lets:.`_.._ �._.___. Total leaching area."... ...:.....sq. ft.
Z Other Distribution box(` ) Dosing to '( ) ��� '• a x 3
Percolation Test Resul s Performed'bY._......: _.__ .:.................. ........ ......... Date... ".°�� ...�. ...
,aa Test Pit No. I x._..minutes per inch Depth of Test Pit................... Depth to ground water ._::,....
# F
ri, Test Prt I�To 2 3,_*. nunui6,0en inch Depth of Test Pit Depth toagtound water
'Lr S.
AR of R6 i{ L f wi. t } `R' f
Descrip 3 n of oil _. a�
.�: ..a'"r--..--•-��-:•-•--"-aka.--- ` --- r......................................� ^..- ---- ....................................... - -----
as
---------------------
t --
U Nature,of Repairs or Alterations—Answer ,When4pplieable�' �.____ ._-__- _______ _________ ___ ___ _---_
............................Xs -rs -- ..# :'"_.. f,5?r fca?:1"` `ne..w .- .....................................................�� �.
Agreement 1 f , Y
The'undersigned `agrees to. install the`afor`edescribed Individual Sewage DisposalSysfem in accordance witli'
iahe provisions.of iITI:%{ �5 of the State Sanitary'Code�The> ndersl ried fui il�er a r.es of to place the system in
operatiom`untll'a Certahcate 6f Ccm�iiance has'been issued by,;the board f .re lth M
Sig".c'd _ ________µ.M.._______ _.c .p __.___. _._.`.'_. ' - ___.. .. ___. _.__
a+ Date
Application Approved gY---• -: � , .'� ' 'ct
�. ,;.•„ , ..u. Date i °.,r
Applieation;Disapprgved for the_'following.reasons:---------------•......-•----•--•----------------------------- -•••----------•••.. . _-----
................................................------------------------------------•----.....--•----------------------------------------------•••------------•-- ----- •-- •.....
Date';
Permit No..-.-----•-•------ ------ -- -------. Issued__... . . ........... .
_ -
Datd
{° THE COMMONWEALTH OF MASSACHUSETTS
kf . BOARD OF ff ALTH
# . �'
Yl/l
ay T�rrfifir atr of (to otpliFan �e
T y IS TO CE hFY, TK6 the Individual'Sewage Disposal System constructed ( or Repaired
Ins`ller . � M
4.4
& - - a.
has,rbeen,installed in accordance with the provisi s of T of The State Sanitary Cade as described in the
appllcation.for Disposal Works Construction Permit No............_._* _ _ .........
-dated. :. .." .........' :.............
THE,ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
,SYSTEM WILL FUNCTION SATISFACTORY. +,
DATE........-•-•--••.............................................................. Inspector................................,; •------- :------•- .--.... .•••...
`+�
'THE COMMONWEMTH OF MASSACHUSETTS #
BOARD, ®F EALTH
........... . a .oF.. .. � t-° ........................................ c -
No .....C-A ¢ .. FEE.........".............
i oaa - o nr ' n rani }
Permission i �r=eby granted•-•` � _,::...... E'............................. ...........
to Cons r ft or epair (/) an In ivl ual Sewa * sal y
.,
` Street�.r
as shown on the application for. Disposal Works Construction. mit o _..__. Dated.___.
, "�
Board of alto Y R
r
DATE................................................ --•-•-•--•---------------- °
FORM'1255_ Hoeas,,& WARREN. INC., PUBLISHERS -
� TOWN OF BARNSTABLE
LOCATION (,/r 7 l./�tn /J
c 4l 6e/C4!( SEWAGE #
VILLAGE
�'a&/ ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.`), /� // ��i�'f)�r/i' •< �'cYY) �`
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type� r),)) (size)
NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER
i
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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nTHE COMMONWEALTH OF MASSACHUSETTS
LL BOARD OF HEALTH
'''OWN OF BARNSTABLE
pro Oste
Appliration for Uiapwial Workii Tontrnrtion Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
5.7...Curlev Way Cotuit...
. --- - o......... -.....---•----------------•-•---•...............--
Cotuit John ao� aress °r I°t N°•
......................--.......................................................................... ........----------...------•-•-•-.....----•------••-••••--•----------•---•.......................
Owner Address
W J.P.Macomber Jr.
Installer Address
dType of Building Size Lot............................Sq. feet
V g .__..Expansion Attic ( ) Garbage Grinder ( )Dwelling No. of Bedrooms..............�..._._._..____._..___. —
aOther—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( )
Q' Other fixtures ............................... . .
W Design Flow............................................gallons per person per day. Total daily flow............................................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.................... Depth below inlet.................... 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........................
pG, --------------------------------------------------------------------------------•-------------------.........................................................
0 Description of Soil----------------------------------------------------------------------------------------------------------------------------------------------------------•------------
v ................Sand.............................................................................................................................................................................
W
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•----
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
............................i-1Q_QQ---gall-an...leash,... j-t-•------------•-------------------------------------------------------•-------------------------....------
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 Complian has be is ed b the board of h lth.
Signed ---- 12/27/91
.g .. .. .. .... .... .... 4�...... Y
dare
Application Approved By .....................C' V. .... �� -------------------------------------------
Uace
Application Disapproved for the following rearons: ......-- . . ............................................................. ...... ........ --- ............
........................................................................................................................................................................ .......
Dare 7 /
Permit No. l ------------------------------------- Issued ................
Dare
6 L/ "7
VX
��.;�No.... :.-51__7 Fes$.... ....3 ...�C
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for DWpoaa1 3Vnrks Tnntfurtiun Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
7 Curley Way Cotuit
.........._...._.... ....... . •..................................... ..................•------......•--••-•-•--.. .........-•----.........................
I- ti'b Address
&.t.�r v or Lot No.
Cotuit John ,
.._.. _.......... - .......................................... ...................•........................•- ..................................................
Owner Address
a J.P.Mac omb e r Jr ---.... ........ ..................................
Installer Address
UType of Building Size Lot............................Sq. feet
I—t Dwelling-X No. of Bedrooms..............3...........................Expansion Attic ( ) Garbage Grinder ( )
�_l Other—T e of Buildin
a yp g ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures
W Design Flow............................................gallons per person per day. Total daily flow............................................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.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date----.....------.............-----------
,.� Test Pit No. 1................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........................
P4 ...-.........................................................................................................................................................
0 Description of Soil........................................................................................................................................................................
W .................. and------------------------------------------------------•----------•----------••---------------------------.
---•------------------------------------ ----------------------------------------------•------------------------------------------------------------------------------'---....---•--•---......_..._.....
U Nature of Repairs or Alterations—Answer when applicable._..............................................................................................
---------------------------In 100.9 ga.11-na... e r.h...p l t-a...--------
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 iss ed b the board of h Alth.
r 12/27/91
Signed ..-- . .. .... ........ . � � ........ '.............. -------I......-- --...---....... --
Dare
Application Approved By -------------------- �-�{.......�c�<a��tti.��_�,^ ........ ............ t!�' Da?
Application Disapproved for the following reasons: .........................................................................................................................................
- - - --------- --------------- ---- --- ------------------------------- ------------- .....................--........................................................ ...........................-----------
Dare
PermitNo. `.... 7. ....................... Issued ---------.............................................
-
Date
THE COMMONWEALTH OF MASSACHUSETTS
r
BOARD OF HEALTH
TOWN OF BARNSTABLE
Trr#tfirate of C�umplian e
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X'1 )
by.....J.P.Macomber Jr.
-- ------------- ---------------------------------- ---- -----------------------------------------------------.................................. ---------------------------
at
57 Curlew Way Cotuit Installer
.. ............... ........................................................................................ ........................................................... ...........................................................
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. .----�/.--.. .79............. dated ................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
� �1�J
DATE........ !. - Inspector ........ ........................................... ........... ..---
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No......gl:..5. �
F FEE......�0-.-�0..
Disposal lVorkv Tonotrnrtion amit
J.P Macomber Jr.
Permission is hereby granted . .. ' ...-•-----. .......
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
at No.....57-..Lurlew Way otuit
. ---•----•-----•-•......-•-----•-.-----••-------------------------••----•---•---------••......-------•---------••---.........----
Street fir S� Cj
as shown on the application for Disposal Works Construction Permit No._l------------------ Dated..........................................
................................., ............................................................
Cf DATE............... ��---[,�------------- ..... Board of Health
FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS
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CODE TITLE �� ,o.EoF>oSE� L�ACN C�P.gG/T
77
T.A_j
/ _/��C�� / �.�` B(fry/'•'II'4,��J/...w'
. SITE PLAN SHOWING PROPOSED CONSTRUCTION
FOR = '�0�a ~'�`''f°y APPROVED 197
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SIC A L E D A T E: �� �''r %, � BOARD OF HEALTH
R E F E R E N C E
I ,, a-.,' �,� DATE A G E N T
c� OF s,
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•� H. �Y �` �3fPti 4i'mmcrtsy
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p 13230a C M S ASSOCIATES, IN-C . ► r , ,a • m
1 f$TFaL tic S(3
_ REGISTERED ENGINEERS 6 LAND SURVEYORS q
�SsroNAL '\ MID-CAPE OFFICE BUILDING - I'Z65 ROUTE 28 4 fsT o�
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SOUTH YARM OUTH, MASS. 02664 ,� -
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