Loading...
HomeMy WebLinkAbout0090 HOPEWELL LANE - Health 90 Hopewell Lane Cotuit A = 040 064 TOWN OF BARNSTABLE LOCA1 'tvN .�4�9411:: ,- o /4 ° SEWAGE #4 -�J � VILLAGE (/ ASSESSOR'S MAP & LOTO ©'7.f�/ INSTALLER'S NAME&PHONE NO. M f1��1 �75` O? o _� SEPTIC TANK CAPACITY Imo' 441 la�. LEACHING FACILITY: (type)A 94 (size)015`xrll 'X 07 NO. OF BEDROOMS BUILDER 0 OWNE % fe Z i1-,me<1J?-1J . PERMUDATE: � COMPLIANCE DATE: 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 c. ;C,K- f r . 5a No. �J ..a t Fee �- THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ftpfication for &!6pozal *p5tem Construction Permit Application for a Permit to Construct( )Repair(,-f'upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No.9O p`4p? 6�G�� /f Owner's Name,Address and Tel.No. I _ l o+-, Sk►tky 2ivhct�trM�n Assessor's Map/Parcel cyy t) ^ O ifl qlet-30 wanqlay, GKc<, Installer's Name,Adi W'Tp Aco Designer's Name,Address and Tel.No. 350 Main Street A1l1* W. Yarmouth. MA 09673 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 gallons per day. Calculated daily flow 33 gallons. • •Plan,Date ' Number of sheets Revision Date Title Size of Septic Tank exiS4r-1Type of S.A.S. Description of Soil �y 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 Certifi- cate of Compliance has been issued by this Board ofjen.Signed Date G •r b Application Approved by - Date 7evo Application Disapproved for the following reasons Permit No. 00WO — 3 7 Date Issued TOWN OF BARNSTABLE LOCATION //0 WAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. Lkio--2 775-- SEPTIC TANK CAPACITY, LEACHING FACILITY: (type)A fag e4( ell4n4elel (size) NO.OF BEDROOMS BUILDER 0 0 1:0ele V 4J PERMITDATE: ?)OCein COMPLIANCE DATE: 17 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 Edgeof Wetland and Leaching Facility (It any wetlands exist within 300 feet of leaching facility) Feet Furnished shed by E63 ............. X-1 ZNE � �. P? t' No. Fee THE COMMO E TH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(p pricattou for Miopool 6pgtem Construction Permit Application for a Permit to Construct( )Repair(✓ Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.9 0 N o p e We, Owner's Name,Address and Tel.No. tit- r­++R�^; Assessor's Map/Parcel O t y. y pI �® GJ�Ilintl�vn , Gl't01, . Installer's Name,Adds"TCANCO Designer's Name,Address and Tel.No. 350 Main Street W. Yarmouth, MA 02673 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 Design Flow gallons per day. Calculated daily flow 33 a gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank q Type of S.A.S. D cription of Soil X y Nature of Repairs or Alterations(Answer when applicable) ! n 3 f A - / ey ' 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 Certifi- cate of Compliance has been issued by this Board of Ueallh. Signed + ( Date Application Approved by i Date 7rr Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance + THIS IS TO CERTIFY,that the On-site Sewage�Di_sposal System Constructed( )Repaired'( --rUpg laded by ( ) Abandoned( ) �'G-7�U�n at 9 ha . _ ee constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit Now r dated Installer Designer w The issuancof this •e t sial of be construed as a guarantee that thAs}�stert will f ncti adssined. Date Inspector �� g^ _ ____ '9 __ __ No. [.ivy v '3��/ ------------------ �e �----Fee J U ��! THE COMMONWEALTH OF MASSACH SETTS�Q PUBLIC HEALTH DIVISION - BARNSTABLE} AASSACHUSETTS Mgogai Opotem Construction Permit Permission is hereby granted to Construct( )Repair -TUpgrade( )Abandon( ) System located at 90 Ar I r L✓r// ��r� ��, i<u% �" 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:Consttrtact on must be completed within three years of the date of this ermit. Q Date: (� _ rn Approved by ,a- , �! 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) I, I hereby certify that the application for disposal works construction permit signed by me dated _ (e • �' O L , concerning the property located at '9U �d e 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. /• 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. / The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] �• If 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) 1P J B) G.W. Elevation b +the MAX.High G.W. Adjustment.3 a J DIFFERENCE BETWEEN A and B .� SIGNED : ' l J DATE: '/ • O O [Sketch proposed plan of system on back]. q:health folder:cen e l O ��- 30 � 70 L 0 C A .T ION E W A G E�4^ JE R M T N 0. 70, �Y I l L A G E �INSTALL.ER'S NAME j ADDRESS 4� (.O/,/ T � Nx B U I L D E R OR OWNER -- DATE PERMIT ISSUED `7/J:Z DATE COMPLIANCE ISSUED r; `y 1Lei 1 c;Go CIA t No... � 2— Fus.._.... q-O THE COMMONWEALTH OF MASSACHUSETTS SCE 06 `(_„ .BOAR® OF HEALTH Applirafion for Bisposal loorks nnstrnrtinn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at - J�r��A.Ive s_c ......... - -- ------ .......................----------- --------•-----.---------•--............---- ----•------------...-•------------._...--- Location-Address or Lot No. Cf1A L Lt/: / /zM .W..-•••••......•--•= 7 Gh' R L o>7E RD_ //sue{n >o 9•: ....... . ....._. w ,r Address a •..... O�m ........ -•- ---------- -------- --------------------------------------------•----•---------_-__ ... Installer Address dType of Building Size Lot.............................Sq. feet Dwelling—No. of Bedrooms._._.__�_______________________________Expansion Attic ( ) Garbage Grinder (-') Other—T e of Building wO�.._______________ No. of ersons._.rz.____.____.__._._._ Showers — Cafeteria a YP g P ( ) ( ) Otherfixtures ...............................................................__•--......--••••-•-•••-•--••--•-••--•-•--••-•••••--..._......•••- W Design Flow.........lxs.......................gallons per person per day. Total daily flow----- _3 ...........................gallons. WSeptic Tank—Liquid capacity_Z�Va_gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. ..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.__C! "�..___-._. Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (Ye4) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ ,-a Test Pit No. 1�F'!s_?n"�riutes per inch Depth of Test Pit_L#E._______.____ Depth to ground water________________________ Test Pit No. 2________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil.......4,f •C_ ou.rsF s... ..o... W V 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 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 i d by the board of ealth. igned_.__._ •---- ....... ................... Application Approved BY =• ... _-•-•-• ••-•--•..... nate,7) Date Application Disapproved for the following reasons________________________________________________________________________________________________________________ •------------------------------------•--••-•--•-•----•••--•......_..._..--•--•......-••-•...--•---•__... Date PermitNo.......................................................- Issued....................................................... Date f� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF.. HEALTH a OF ApplirFa#inn for 11is'pos al 19orksXonstrurtion V.rrutif ;d Application is hereby made for a Permit to Construct ( ) or Repair ( ) an IndividuM-°Sewage Disposal System at: ................ ._..................- ... .. to r oo Co relo r ........•••---...--_--•-- •-•----- -----•---•----...-•---------•--•----•••••••-------•--•.................... Location-Address or Lot No fib!R d 4 .!•A.." I..... �cw�.r�t.+tr a+ ,6•.p/. w Address Installer Address U Type of Building Size Lot...........................Sq. feet Dwelling—No. of Bedrooms...... ................................Expansion Attic ( ) Garbage Grinder ( ` ) a Other—Type of Building ir/odd . a yp g ........................... No. of persons.-A-&.................... Showers ( ) — Cafeteria ( ) dOther fixtures -----•----------•---------------------••------------------•-•-----------------------•---- W Design Flow......... 0 .........................gallons per person per day. Total daily flow .St ............................gallons. WSeptic Tank—Liquid capacity/ O..gallons Length .......... Width Diameter Depth................ x Disposal Trench—No.':................. Width................_.. Total'•Length `ff Total leaching area ._.........sq. ft. Seepage Pit No..0*�_6---------- Diameter.................... Depth below inlet .....::__ `Total leaching area..................sq. ft. Z Other Distribution box des) Dosing tank Percolation Test Results Performed by................ ............................................ .... Date................... Test Pit No. �t`sa � u e per inch Depth-of Test Pit!(f�............. Depth;to ground water_._ ........... Ps Test Pit No. 2................minutes per,inch Debt ;of-Test Pit..................... DepG'6 ground water........................ RI' ............. ----------------------- D Description of Soil.....A6r0 u w,................. ------•--••-----•---............. •-- --- --•••--•-------•-•-------------- --=---- ----------•-•..--:......... ::.............-------------•------•••---•-•-.........•---•.--- - nt 1 `J ................................................•-•----_ ------..._.......... ...... ---.• -•---..... , ..........._..... ........................ U Nature of Repairs or Alterations-Answer when applicable ............................................................ ` -------------------------------------------- -- -------------- -----=--- --------- ---••--- ----_--- ...=--- ------ ` •----------•---: .....`....................---- Agreement The undersigned agrees-:to install the aforedescribed Individual Sewage Disposal System m,accordance with the provisions of TITLL •5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certifieate.of Compliance has been issued-by the board of'health. f Signed < J:f � --� Application Appl oved By.� .. .. .....:::. 1 -- -.------ _..... -•---.. Date' Application Disapproved for the following reasons:.:.. ......... ..................... Y:-- ` _ z.: :Date.- PermitNo.------.. ................................................ Issued ry-----••-------•--•-----•----------•---------.......... ^I�. Date s l THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. ..............OF.... ..............................•................ (IntifirFa#r of TompliFanrr THIS I TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by............... '�/.. 1� xrrlil+?.. ! "-� .•• ...-- ----...._ .......•--......---•---•--•••. Install r at = „ 0..---------. -----------------------------------•------•----......---...---------------•--------------. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code s described in the application for Disposal Works Construction Permit No.__. !-�`.&` .......... dated_... .. ..' � 9 »�....... THt ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A UARANTEE THAT THE SYSTEM WILL FUNCTION ATISBACTORY. DATE - ----- --------- Inspector THE .COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF....................... WIR No ......... FEE .......... Dispool, 1. ion rnr ion lerani Permission is hereby granted............'.....:: ... ........ to Construct ( R4e ai*r .( ) an Individual Sewage Di posal System at No........ ...4n:s._....:�.c......... us_ -- -----------•--.....-------------------------------------------•------------ Stree as shown on the aPP P lication for Disposal Works Construction Permit tNo � ���,Dated�� ��1`P maw .. Board of Health. DATE =.... FORM 1255 A. M. SULKIN, INC...BOSTON - z0- 3-7 '-40"r— 14O . 00 1 � m OF M,gss WALTER 1 p�czcA N E. y - N � SMITH,JR.CIVIL eFT.EPP. EPT►1 /� 3 `']/ pl #15128 ri l Q� a' t 7 P •09 9FGIS-T " � DI ST• t�iUK oFFSS1ON AIL E�6 (Jpoe GAL—couc, SEPTIC Z-A"K 2 5 V ppo w sEfl 1 C N 3 8rDi2ooM ,Ae. N h �, Zq E t n L IN 0 s 37 ; 40 "E 00 g Di 5 Cosa L PLAtJ Z I M M e- KA VjILMIN lj 405 A 5-50cJrjc- 4-0' J a r,) E �— 4-2-1 -L- t � Io "P C olsT..�� P5 7 �T /WaShcd' Snr. A e�� �OFr• D(�iic. o0o Gal. conc. �5'4 A o ea CID"c. LEAcHjr.1C� ...P,r. ScP+tom Ton le _SS q 4G a GAQ A A Z-Fr 44 A 1 • ADO ��► � � v • 89.E � ► '1"i 3�4--���L tnln5�lc� S�nC • gor. PST E�.y o��GRovN n�� q4 T� \ ;i r o q8. SCT=�$0' 2Co L-P,T,I o 2 M/N'I>Jc o P TEST PC-R,FoRM E-C> M&t i'z, 14ej-� KAF-Drum QeDFZooMS K Ito C-lpD = 33o GFID LEACNIt,(C, o $o T 70^4 fV O C�A(��yE DISPO', L USE C15 48' . (oho CAPAcIry �R.oVlpep •; . . ,, . Sr oEs -4. X. 7a'5 G PD comes Trio u G oc z. s = 47 1- Z C-, P D TOTA,L- CAPA61Ty R7,0V! Piv . 5-49 .7 C, rn� SAtiD N oTE-- D ISPOSAL S�(s�� DEs1�NED I N A�LoRDP.NGE w t -N4 PR0vISIoNS o.F -Z-I T L-E S o c o . N o e6vMU ATE-c-r -4� Z, wt uAertv� .-. Loi- 3o t4Oe--weld Fss.........1.��... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF...... Appliration for Di-spniial Warks Towitrnr#iun ramit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: - I"ocation-Address or Lot No. . Al m-Z—... ......................................... caner n� j Address •..............• .........o. ...r.. ....A...---•--•---------•-. -----------------....--_..... ..---•----......-----.....---.....--------- a Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms......................................Expansion Attic ( ) Garbage Grinder ( �_ Other—T e of Building No. of persons............................ Showers — Cafeteria • . ------. ...................... � Other fixtures --------•------------ - - --- ------ � Design Flow..............D_'�k4D.................gallons per person per day. Total daily flow.............a,_-2h.0...........:.....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........................ �+ ---•------------------------------••------.._.__._..._....._.......------------------------ •-••---------- ••-------------- •----•----••----------------------- 0 Description of Soil.........................................................I................................. -•--------••---•-•----.....-•-•----•...-----•---•••......--•---•-----..•--•- U W ---•-•-----•------------•------•----••-------••---------••--------•------•-----•---•-•--•-----•--••---••------•---•-------------=- ----•-------••-•-••--•••••---••--•-----•---•---------•--•----------- UNature of Repairs or Alterations—Answer when applicable ....... L.. A..........................................................- rz_ c� ............................................--•-----------------------------------•............................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL% 5:thei Pgreasons: de—.The undersigned further agrees not to place the system in operation until a Certificate n ssued b th and of health. . 1 .... .._..._ - D to App7iDisap d By.............. V•-- C ..... ................. 22•�• Date 1 Appved` ---------------•-........--------------------•-------------........-------------•---------------•--•---•--....-....... ....... • ---••-------.......-••--•---•------------•------......----••---•-•---•--••-•----•-•-•---•.•-•-- Date PermitNo.........a_2-- (' 91...----•------..... Issued....................................................... Date -' No................_......._ Fxs...... • � THE COMMONWEALTH OF MASSACHUSETTS `BOAR® OF HEALTH ............ OF............................................................. .......... .......**"**'*---- .............................. Appliration fu i�� l WTrnrtion Permit Application is hereby made for a Permit to Construct ( ) or Repair O an Individual Sewage Disposal System at: L.................... ..... cation-Address .•••.. .......••.....•••.•••..•...•.••. .......................eh_4.... t^s�_.... .. .-- .�+�. 1k1 t.N�.......................................... ner (i_ . l Address a " h.... ............................ •------- ....---_..... Installer - - - Type of Building :- Size Lot............................Sq. feet U Dwelling—No. of Bedrooms ... ...........Expansion Attic ( ) Garbage Grinder aOther—Type of Building ....... ` :. _No.No. of persons............................ Showers ( ) ' Cafeteria ( ) d Other fixtures .. .......... ---- -------------------••--•-----------------------••---• ---- ............. •-•-•-------- Design Flow .. ;10.. .._,gallons ay. ow............4s. 00 : allons per person.per d Total daily flow ................gallons. W. _ x Septic Tank—Liquid*capacity...:........gallons .. Length................:_Width................ Diameter................. Depth................ Disposal Trench—No_____________________ Width............. Total Length.................... Total leaching area...................sq. ft. Seepage Pit No..................... Diameter...........___...... Depth below inlet.................... Total :eaching area..................sq. ft. Z Other Distribution box ( ) Dosing:tank..( ) ~' Percolation Test Results Performed by. .......................................... Date.....__..__...._.__.._ a ..............: . Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water...................... PN Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ AG --------------------- -........... ----------------------------------------------- .........::.....:: 0 Description of Soil..........................................................-----.....---...--------•--•-----------......._.........---...---............_...........--•-----•:............ W U Nature of Repairs or Alterations—Answer when applicable.... .....h::.... o.V. lOt t..tas, +---------------------------------•--------••---•-----...----••------•---•---------•---....---....._..........------................---------------...----•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of TITLE 5 of the State Sanitary de—.The undersigned.further agrees not to place the system in operation until a Certificate of Compliance has ben sued b th and of health te Ap7nisap d By... Date Apved`f the g reasons:..................................... -. - ..... Date ......... PermitNo....... ..---•----_.... Issued.....................................................- Date . THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH OF................... ......................... T tifirate of Tomphaurr THIS IS TO CERT Y, hat thepIndipdual Sewage Disp -st co gted ( ) or Repaired ( ) by.......................................... .... . ...= ......... ...... t .. .........__...._..---------. ._...._ y( Installer at.........................�: .�---•--•• f ..._...-- -----•---.. ....... -------•- ........ .. has been installed in accordance with the rovisions of TITLE of The State Sanitary Code:as de ri in the 5 Y application for Disposal Works Construction Permit No.._... _'�-.a"'. : ...... dated......._-�..i..3"�i..... . ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTE THAT THE SYSTEM WI L FUNCTION SATISFACTORY. / ' DATE.....L.T..j / ................................................... Inspector..-----• •-_----- -:............: ---.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................OF..........................................•--........................................ No...... ..... F ......�. ..' .^ 1hsVvsaQPvrks Tonotrnrtion r Permission is hereby granted..........-• •� �_ ......_. ... .................._„__ to Construct ( ) or Repair ( ) an Individual S;wa_ge Diis})osal. System at No...... I �----•------%# °"�`" E'""""'t-._.�-"� •' ( .� rgnt�►`t .. ............. Street as shown on the application for`Disposal Works Construction Permit No.......���l,Dated. .. U..95......... 4,1 _.....•-- K) DATE �„ .... .�. 1 soar FORM 1255 A. M. SULKIN, INC., BOSTON � k