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HomeMy WebLinkAbout0041 DOGWOOD LANE - Health (2) W 1 occl, d o cQ 7to i L 0 CAT10 SEWAGE PEITCAIT 930• VILLAGE I N S T A LLEA'S NAME AD0RESS 0UIL0ER OR 0013ER DA T E P ED0IIT I S S U E D V 6 .- O DAT_ E C 0 M P L I A N C E I S S U E V t,) 41 r �a ,pa Lot 9 sTRFET 2— ctk No. 2 O� Fee J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppYication for Disposal *pstem Construttion permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. y� o9u/o % Owner's Name,Address, Tel.No. Assessor's Map/Parcel + In tall er's N e,,��l1ddre s,and Tel.No.50 "775Y_ Designer's Name,Address,and Tel.No. �OS,Cpf !lam / G/^O Type of Building: Dwelling No.of Bedrooms �� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) . Other Fixtures ''qq Design Flow(min.required) gpd Design flow provided 11111gpd 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) 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 Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. S' ne Date Application Approved by PK 2S Date Application Disapproved by Date for the following reasons Permit No. `�(�' a —f� f Date Issued 3 / — 2 ' r Z� /u No. i C) t Fee. ?� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: v' PUBLIC HEALTH DIVISION - TOWN OF;BARNSTABLE, MASSACHUSETTS Yes M ftplication for Disposal 6pstrut Construction Permit {� Application for a Permit to Construct( ) Repair( Upgrade( )'Abandon( ) ❑Complete System '\❑Individual Components Location Address or Lot No. ZT/ Owner's Name,Address,.and Tel No. Assessors Map/Parcel Installer's Name,Address,and Tel.No. a —a 4�5 0" Designer's Name,Address,and Tel.No. _ A �r - Type of Building: v Dwelling No.of Bedrooms { Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons ' Showers( ') Cafeteria( F Other Fixtures Design Flow(min.required) N gpd Design flow provided iu�!(► gpd Plan Date Number of sheets Revision Date > Title t Size of Septic Tank Type of S.A.S. Description of Soil r Nature of Repairs or Alterations(Answer when applicable) ` f � /Vz`a,/ OX 1Y1 Y e Date last inspected: e t Agreement: The undersigned agrees to ensure the construction and maintenance of the afore'described on-site sewage disposal system in t .accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of y Compliance-has been issued by this Board of Health. Signed Cry. = a _ , 3r° �s� ,,,� Date' Application Approved by / t���`}�72 L Date Application Disapproved by Date for the following reasons. - Permit No. `Z 0.) Date Issued ---------------- THE COMMONWEALTH OF MASSACHUSETTS' BARNSTABLE MASSACHUSETTS f F Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed°( ) Repaired(" ) Upgraded( ) Abandoned( )by y at 3�1 7"�t�0 W;I r9 O r)6,7 has been constructed in accordance with the provisions of;Title 5 and the for Disposal System Construction Permit No. 0- 06rdated a�o� Installer ez fz/e® Designer #bedrooms k1j, ( Approved design flow �/� °� gpd ! The issuance of this perm_ itfshall not be construed as a guarantee that the system willfunctio as designed. Date err, 5/ �,.-- Inspector � _s-'1/ �„ r-- No. d Fee 2 3 ^ ��� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS J }) r �5 Disposal *pstem Construction Permit {{{ ✓ Perrmission is hereby granted to Construct( ) Repair( ) Upgrade( �) ,r Abandon -System located at CJ �/l/ ?C r:/' and'as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions."'"'`ro Provided:Construction must be completed within three years of the date of this permit. r. Date ,..a. :,,..., f APProved'by THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) m A- 7 1 L' DATA No.._.. :: Flcs... ......_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town......................OF.........Barnstable ................................................................... Appliration for Disposal Murks (funstrartion Vantit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal S stem a : yLot i Dogwood Lane, Cotuit, Ma. ................-................................................................................ ...............:.................................................................................. Location-Address or Lot No. - Cedar Acres Realty .Trust 24 Great Pond Dr. , S. Yarmouth, Ma. - -•----- ...... -------••--•-•-•-•••-• -•........-••-•-......_---•--•--•-••-••-•-••-•••...........-•-••-••-•-.........•-•................ Owner Address Cedar Acres Realty Trust 24 Great Pond Dr. , S. Yarmouth, Ma. Installer Address Type of Building Size Lot.. 3, 7 0 0 Sq. feet Dwelling—No. of Bedrooms.........3................................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T ype of Buildin g ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 0 Other fixtures ---------------------------------------------------------•-••- W Design Flow.......... .............................gallons per person per day. Total daily flow.......... ......_.......................gallons. WSeptic Tank—Liquid capacity.-©_©.pgallons 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 ( ) aPercolation Test Results Performed by.Npr_m&n...&r-o .&man-.g-,.E- Date9./1.b./$.2-------------------- Test Pit No. 1.........2.....minutes per inch Depth of Test Pit...1-2-!!_........ Depth to ground water-___-npne........ (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil.....0 -$:..a ndy:::�oam, $ -3 6 s ub s o i Y;"" 5 x • • . -•••••••--•--••-•••--•----•••---••---••----------•••--------••-•--•••••-••-------•--•.....-----•......------•••.•-•-- U •----------------------•--•---••-------•-•----------....-----.....--------....................----------•-------------------------.-•--- W --------------------------------------------------------------------------------------•--------------------------------------------------------------------------------....--•-•••...-••-........----•- 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 TITH,;,:. 5 of the State Sanitary Code— The undersigned further agrees not to place a system in operation until a Certificate of Compliance has b&iluedth °oa d o health. /�Signedy ' ..... •• ...---•..•-•-_..--•- Date Application Approved By---•-......•---••-•••••......-----• Application Disapproved for the following reasons:.......................................................... ...................................................•-------...-------•--...-----------.......---.....----•-•--•••-•••-•-----•••••------••--••-•--- PermitNo.......................................................... Ise, Fims. -0.'.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...------Town.............--.....OF..........Barnstabl e , ppfiration for Disposal Works C otutrnrtiun Vrrmit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal Sytoq aV Dogwood Lane, Cotuit, Ma. ................__.............................................................................. --•--......................._.................----•................••--•-------..........6.._...-- Locat' n Address or Lot No. ...Cedar Acres Reafty._Trust 24 Great Pond Dr.., .S. Yarmouth-.Ma. --_. ......................... .......• --- --•----•-_... Owner Address W Cedar Acres Realty Trust 24 Great Pond Dr. ,- S. Yarmouth., .Ma. a .... .•• -•---•-- -•....•--- Installer Address Type of Building Size Lot..21r.700_..._.Sq. feet Dwelling—No. of Bedrooms..........3...............................Expansion Attic ( ) Garbage Grinder ( ) Other-7—Type of Buildin No. of persons............................ Showers Gag ........................•-.- p ( ) — Cafeteria ( ) Q' Other fixtures ..............•.................. d .•-...--•------------------------------------------- W Design Flow........... ............................gallons per person per day. Total daily flow----.-*3�.............................gallons. WSeptic Tank—Liquid capacity..1.Q QZallons 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 ( ) aPercolation Test Results Performed by..N0r aga--GrGg.SMa--..P.,E................ Date.9-/ 6./a,2.-:----------.--_-. Test Pit No. I.........2....minutes per inch Depth of Test Pit.....1,2.f!........ Depth to ground water.....nOR6....... rl, Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water......................... D Description of Soil----..�.._-8:.saincTy::16 -.-- __T sukiscil1; 3� 14 sari x ---------------------------------------------------------------------------•------•......-••-•-•-- w 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'T'Ll, 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. Signed....................'. ----------- .. ..... ---•-- Application Approved BY ==- ...... �° .------- " Date Application Disapproved for the following reasons-----------------------------------•---------.......----•------•-----•.--_-----------------------._............_ --••-•--•-•---•-------•------•--------•-•-•--•-----------------------•--•-----------•----......._..---...............................---.....----...------------------•--•-------------------••....------ Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ...........I..............................OF..........I.......................................................................... (9rrtif irate of Tomplianrr .� THIS IS T �R��Tr��IFY, t the Individual Sewage Disposal System constructed ( ) or Repaired ( ) • 4 by........................ . ..............................................,,,Q . -r--------------------. ..........----------------------------....------------------.................... / sfis'�,�iv Installer at................ =--........-• ---.....----------•-------------------------------•----------•---......:..........••------ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary.Code as described in the application for Disposal Works Construction Permit No. +_.;>a f.................. dated_............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRW,6 AS A GUARANTEE THAT THE SYSTEM W F CTION SATISFACTORY. DATE_. /-� Inspector.. ---•............................... ••..--------------------•--•---........•••....................._........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable , ...........................................O F..................................................................................... Disposal Vorks T nstrnrtuan Vprrmit 1 Permissions hereby granted.-------�dar...Acres...Realty.- Txust....----•---•--•---....-•-•-•......................•-•----...... to Constru t or a air ) n Indivi a e gage Disposal System �0o �, Dotjwo6d bane, I0 e s` atNo................................................................................................................................................................................................ Street as shown on the application for Disposal Works Construction Permit N ............ ...... ]�a .......................................... ................................. --------•---.....----•--•--•............._ Board of Health DATE.................... .X.I.A................................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ` - �---_--- � � ---ALL EL EEO. �Now Af2� 6: t . �, M Aral SEA► l 1ieVEL_ —�- - r O-- PITcW ALL LWES A M1ijtMUtA of I/b/FoQT C+E CI►TQo►.1 [71��5C-*16D >`EY Ao P�j a 2d' l ALL SEPTIC 'rA►.IICS, Ot�rZtgkJrto,J gox, A"o LE!A-Cl,44"Ea PTF SHALL gE tDES%G,._►EV 1=02 MAI- - ---- ll � ® �-' QEN10 C AuL un1S�J TA3� MATE�IAt_ BE�.}Es>`TLI 7 O h� O 0000 0 0 T t�.,�/EeT ELEVA-no-iS of L-EAG1-4t,JEj PnS r-or— A P.-,6�uS oF' A tjo (AC-K Ft Li w Ih1 CL1aY ctE -�- -- ^r F O O C �J i Se.�O •►n.�D C�21a�1E� "�•1 - _ �, O Q. \ O—T�+E _ t I 0E t-+dTtFiED W"E-)J T4Z Sy1.TE►1 tS NEAr- I �'\ � CY�M�-ET1p,J A+.�O Pe�o� T� G.�C.aGFiLl..tw.�6w O O V o � ® O UkJL-ESA orliE2.�tSE �aoTEt7, ALi SyST�►� `+ G �crAGy Z�Mi• O G o c� O V COI..IPbplfEl�DTS •,SMAt� '1�iE Vr..1S'f-A.`�L7 NJ h A[CClZ DA.►.1C C t o IT\-1 T t T t_E -F T?i E STATE 7YPIG4L _ DI5TR-1bUTiO" eyox � 0 ® o C', �Q /� �.11Tp.�'y COCA- A-"D Ar F-Jy ►J OT T® SCALE �.1cYT>c D�STet�tlTr�.� BmK •.uv 1,100 c4.t_- T\fpic IcAW CV^L- SE?T/G Tr•..1� ?Y�PI C�9,L. 1` A►.CN 11.1Cra Q1T QaSetVA7/0A/ O/TJ ¢E,uF0Ofie-a Serr-tc sY svmEetc�..,1 PeE�.,sr IIoT � sc,e•�E mar-ro 5c.&> E FQUA L -rIWKS QW..JF.CGED Ti out;�lpvT wtn/ EwcrP-tc tAJEe_pED ` NOTt�:,d„CGEY•S l�tAhti101.00 TA 0638,t!VA7*1.ON5 day: -*- E."aso oED sTvaL. evt's "1 gaortc TA►1� AMP Li"KtN(Aib. r'rirtig AAev)� �:& Oo�t t o at- AW,4 L T y TAR ?>OTrc>N I. 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