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HomeMy WebLinkAbout0535 MAIN STREET (COTUIT) - Health 535 Main Street, Cotuit -- _ - - — - - - - -- A=021-005 V I �r• T&*N OF BARNSTABL. LOC�TION A "'I� J ..�Gy SEWAG3 F,+ VILLAGE .ASSESSOR'S MAP & LOT INSTALLER'S NAME : PHO,14 NO. SEPTIC TANK CAPACITY LEACHING FACILITY (type) NO. OF BEDROOMS PRIVATE WELL-OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: L "� DATE COMPLIANCE ISSUED. VARIANCE GRANTED:. Yes No �i IWN AWS TOWN OF BARNSTABLE [q/��J V Ce. LOCATION �.f /``I����j �` SEWAGE # 2O aJ � VILLAGE ASSESSOR'S. MAP & LOT b2 OD� INSTALLER'S NAME 6z PHONE NO. do,?it S SEPTIC TANK CAPACITY LEACHING FACILITY:(type) f.,2C $ (size) r NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER r/ BUILDER OR OWNER 1 • fr, .-t° DATE PERMIT ISSUED: DATE 'COMPLIANCE ISSUED: 1 JS VARIANCE GRANTED: Yes No_,,� 'V b ASSESSORS MAP N(k PANEL THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACH SETTS 0(ppItcatton for Mt000al *r5tem Com6tructton VCrmtt . Application is hereby made for a Permit to Construct(x)or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 635 M no W S-r 1=40SMEV- e-lo 'DILa:>EaL) Can)Srnvcr ion Cry elaru i`1-" 23-1 F;7_wCG= Avs M aft Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. _ a '5P-xTM_ ie. I►illf- Type of Building: Dwelling No.of Bedrooms _ Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3D gallons per day. Calculated daily flow 33d gallons. Plan Date QCj::: 14, 1 ciq'-7 Number of sheets Z. Revision Date Title C jEq-1 n en, Ror RX0 ~ COTY 17-- I r L 40' litre 9,_-rw_ 7,1 Lt7Dt5:AJ !T3V l LbtVZ— Description of Soil CSOAl <-A47 E r e Nature of Repairs or Alterations _when applicable) t 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' y thi ar 7" Signed Date �/� 1 Application Approved b Application Disapproved for the following reasons Permit No. <` Date Issued �`� ,..r� �.• ..tr �, t' .tirrr✓ .1 _.'�..r...•rs v. .�y �_Y �i- .. ,r .y,.t.�. �y,ti,1* a i No. THE.COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACH SETTS 2ppricatton for Mgonl *pgtem Congtruction Permit Application is hereby made for a Permit to Construct(K or Repair( )an On-site Sewage Disposal System at: Location Address or,Lot No. Owner's Name,Address and Tel.No. 53S M A►N S-r- I}os�FR. '::/o ';31 L, C Av CvN 5M UCr/old Co Goru r,t_-, 2 -� Pvvcs Aus- M M Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel:No. ?5 a x re5Z. �. 037- 1 taC.. �.17. MBA I Oqr 6G`7-yj nI 13 Type of Building: 1 Dwelling - ,No.of Bedrooms_� f arbage Grinder( ) f Other Type of Building o of Persons' " Itf. Showers( ) Cafeteria( ) ... Other Fixtures•' "' /Y �t� f lj' Design Flow g B 30 gallons per day.,C c lated daily flow `33d gallons. Plan Date OGC 14, 1 G"1"7 Number of sheets Z Revision Date Title Cb-r MTV Wr-> �LokN - C07V 1T"- ILL 46' Ft2 281e& " 1t•y����I ,73JtCTye"7L.r p Description of Soil C-A N7,!, / F ' Nature of Repairs or Alterations when applicable) Date last inspected: �j 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 i 66&5y his o dar off eaallfh? Signed /�/�`- --- Date/ (-7 s Applica ion Approved b Application Disapproved for the following reasons E P Permit No. ' Date Issued 0 6_47' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance _ THIS IS TO CERTIFY that the On-site Sewage Disposal System installed(I" )or repaired/r laced( )on by Af 4 41/,0 for •� j :- U k, ',.5. as a&twp constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N dated 1 ,6 Use of this system is conditioned on compliance with the provisions set forth below: No. `' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS M.5pont *pgtem Congtruction Permit Permission is hereby-granted to : /-F-je /� /1°� __-- to construct( repair( )an On-site Sewage.System located at -.�'i .,'`� +el J ?!J r 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. All construction must be completed ithin two years of the date below. Date: / Approved b _ �o PP �� b�Sll�-1 vATA �IIF�T I Of 2 FAMIL`( 3 QEDRcE Ply,I•L o1J BaGJC. uG�xzF� Na GA¢>=3ALG l�tl.t�� PAI Ly PLOW = 3 x ►►o =3�,�. GPp LoT 535 �c�t A i,.l ST , Cam, v>T S�P"T1G TAf4 - �No x ZOO% U IGCD 6AL-- . � v'Pvc. PIP>� 05-C 3 CuLTGG >Z � jOCi�AwtBE�S�d-STAUt(cc ao�) ATE c.A'1"1014 A>zf---A 260 D. ,iF,puGdTloN DrZil/o 1 Slt�wacl. A¢z=A= PLbN V1�1�(/ - L�AGI�It�Y, cNAM8Ee5 oTTOM AZeA = IZ' � -TaTAi. Am4 - If 40 ;.Oz- FlAlrsN 4zav� PE=Ol.&TV*4 MIS L �M,v�iN�t{ z' 3%tisax sort_ aka 5 I A p 5 -yZ ` '� e 0 G Ls .. ' sroNt: 1� o , a CuLrF� 2 a �, w 3 WA"O �t STEPHENQlaHARD �. .• ,� 330 o v sTofJ� ALLYN 4- WILSOfd a BAXTER , ai a �, IZ N°''4° "U�6z,6 �1?oss-SE��aN o F C► aM r� p�i 5�9 9 ts A,, 5AI,yj-'LOAM SG av A unc 53.o coAzSL 4- Ila IAN SaUb 1 C►-iA44BC-V5 52z SZ4 5z,6 I4Lv � 5Z.v 57 3�- EL=�o Col�>✓ T7►�, C saute GZ Co��?Sc �'VEI.OP�� �OFI� CE"RGD PLOT PLAN! p Rio 1- q ; £xr. ia,lain 5eAt_— I'z -6 �A 1�eoPas�r) .�. DcT 14,I<rg7 I GFZTII�Y T}WT TWE �w�xuAJl< 51 uN PLAI,I ZEI\1C1✓- 4aZWW ccM gc JS W 17U 1-ge 'SI DEl W e Alta S TB�tGIL >Z> U12E�N6dJT DF 'Tv16 jjGw4 OF MAP ZI PA=G-L �t J�`1"A�3t E A►,1� t S #Jvr I-ceATiD W l Tu l N A 5?6"J4L 'FLsO'D H.AZ1AZJ-;l 'ZON&. BAD A Hym Il\ic LA1,Jv SUQVV= • Will WGE94 faCT"• 14-,14G`� C�� �y� 05T�e`/ILLtr MdSS. OFF-- eT-- MOM BU I L )%hVv!5 -C90 XD NOT $6. QPpU G4N T: Lx�=D TU l�s'rnuu�y PRep�Ty LrlJerf. P� �iL_c�s�4J , 3v,wt2 • �� � �-Ir�T 2 oj= 2 vet ��'�'a�•�� , FAT V LD'DE:A O T:'e7E - G� oer 14,1497 i � ! t j woos E'_S��G I , MAP 24 f t LEWA PIED l!; t W . 1 � IV✓I • r z TA pns� Sk I STi al. s6prlG Hc,,a to48 Ott., sf � t. ,.,f. Ex AST. sEpnG f r + . MAP • ! _ PcL L _{ _" s� I�__I , r III WILSON �3 STEPHEN ALLYN No 3fP26 * 'j0Of i { j 8o�z7 . .•r �tH qICHJ1fiP A. M"ER Vo 240a@ { F f 1 f • Id • IS 9� TOWN OF BA.R.NSTABLE a` SEWAGE # VILLAGE �(i ASSESSOR'S MAP &LOT b? QD� IN"4LER'S NAME.,& PHONE NO. -���✓O!J�S. CyIS SEPTIC TANK,CAPACITY LEACHING FACILITY:(type) (size) NO.;'OP BEDROOMS .3 PRIVATE WELL OR•PUBLIC WATER BUILDER OR OWNER - DATE PERMIT ISSUED: DATE COMPLIANCE.ISSUED: VARIANCE GRANTED Yes' No Ll m, '�3 ` CCy� THE COMMONWEALTH OF MASSACHUSETTS /1 BOAR® OF HEALTH . 0 TOWN OF BARNSTABLE Applira#iun fur Diuputi al Works Tunitrn.rtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -*_ ae, •-- ..... - - - - -- - -.... Locartd -s orLotNo....... — - -------•-• --- ------------ ..__-_-•----•____---•---- ddr a '.................. ........._....----.._...._ �s_. -- ....................... Installer Address ' Ue of Building Size Lot______________________------Sq. feet Dwelling—No.-of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building ____..._____ No. of ersons____________________________ Showers — Cafeteria C4 YP g ---------------= P ( ) ( ) 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_____________________-_. fs, Test Pit No.,2................minutes per inch Depth of Test Pit____:_______________ Depth to ground water........................ •------------------------------------------•--••----------------...-------------•---•-•••-•-•----•--......................................................... 0 Description of Soil.............................-.......................................................................................................................................... W U ----------------------------------------------- •-•--------------------------------------- ___-------------------------------------------------------------------------------------------- ••-•------------ 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not.to place the system in operation until a Certificate of Complia ce has been issue by the board of health. Signed . ---- .......... ----------------------------------- ---------- --------- Date Application Approved BY -----�Y"�,�---- - ------------------------------------------- _-_ -- Dace Application Disapproved for the following reasons: ----------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------'--------------------------------...-----'-------------------....---------------------------------------------------------.........----......._ ........................................ v t�a Date Permit No- ............9,0------- ---- - ------------- ---- Issued .....-........... - ��.—.Date 'No '339 THE COMMONWEALTH'OF MASSACHUSETTS =' 00 BOARD HEALTH a l TOWN OFBARNSTABLE A ph anon for amit Application is hereby made for a Permit;to Construct ( ) or ;Repair ( ) an Individual Sewage Disposal System at: ....: - ------------ -------------------`..------- ..-----=-..._............._..------------ L�ocah Address or''Lot-No- . ) ............M, ,� ....... . � c� v ...................•--•-•*'#' 9.:.-•----•-----------------^•----------.. Addres ,. n ;. alter Address dof Building Size Lot............................Sq. feet " V Dwelling—No. of ----------__Bedrooms______________________________- _Expansion Attic ( ) Garbage Grinder ( ) aOther, Type of Building ____________________________ No. of persons____________________________ Showers ( ) — Cafeteria ( ) P4 Other fixtures ----------------------------•--- - el I W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. ` W SeptO Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ r W Disposal Trench—No_ ____________________ Width__________._________ Total Length.................... Total leaching area--------------------sq. ft. x ._ (Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `"' "' Eercolation Test Results Performed by______________________ W Date Test Pit Not=-y. -------minutes per inch Depth of Test Pit____________________ Depth to ground water........................ f% Test Pit No. 2.,________________minutes per inch . Depth of Test Pit.................... Depth to ground water........................ --------------=`=­..------------------------------------------•---•-•-•---•---•--.._...-----------.....................--••---------------------•-----•---- O l Description-of oi'1 -__---------•---•---•-•--------------------•-------•------ %- ---= •---•----•-•---------•-•••--•------------•---------••---•--••---•-•--•-•--.-...._•--•_.. W ` VNa turerof Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ X_ -•-------------------------------------••-•-•-••----•---•-----•------------------------...._.-......----------•----------------------------------------------------..--.---•-•••-•---••--.._._....------ A ree . +� g � - _ 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 Complia ce has been issued by the board of health. i ' Signed ...... . . ...................................... ------........----------------------`` Date Application Approved By ...--- ----7­ �? ! Application Disapproved for the following reasons: ----- ------------ ------------------------------------------------------ -------------------- ------------ ---- --------------------------- --- --------------------------- ...................-----------.-....... r+ Date PermitNo. f -=-_: .................. Issued ------------------------------------------........................ � Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF.BARNSTABLE 09rdiftctt#e of (fontylianre THIS TOLERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repairedby ........ ... ........---- ------------------------- --------------------------------------- .................... Installer at ................. .......... ?.... .............�C�.._-.........�' � ....-------------....-----------------------------------------------...--------------------------------------------- has been installed in accordance with the provisions of TITLE�S,o .��f The State Environmental Code as described in ' the application for Disposal Works Construction Permit No. %....... 3..{a......... dated ................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ------ ---------------- DATE ........... ..- j, ....^, '� .. Inspector 1� ......... ...... �1/�� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.. .. .". FEE. �'.C?�...�.. Mop 1 orkii onstr ion rrmi# Permission is herebyranted-------• --=• ---••••---•--------------------•--------------------•--•--------•----------.-..-----------------....._._.............._. g to Construct)(-,) or Repair ( ) an Individual Se rage I isposal System at No '`'cam' street as shown on the application for Disposal Works Construction Permit N :C!.' A.__.__ Dated...............____ ............. •----- - ------ - �^f' Board of Health ---- DATE----------- e7"_�J--•--n- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS Town of Barnstable 114 76 2, Department of Health,Safety,and Environmental Services Public Health Division Date 005r. 3 lgE7 � - 367 Main Street,I lyannis MA 02601 aABNRTABLX ' MAC Fee Pd. ) � Date Scheduled ) b 1a-/ - 9 Time Soil Suitability Assessment.for Sewage Disposal Witnessed By: J6—rw %/v1111J/'16 Performed By: LOCATION &°GENERAL INFORMATION Owner's Name 66m oc Location Address 53S M A/nl �7 Gfa 131t-M"tl Ce9 COT-t)T7— Address 23,1 P21AIC6 AV5 tMA2 STfl� vvt t"'S Assessor's Map/Parcel: AA AP �LI PGL.5 Engineer's Name:5A)(TW't_ �-­ N"t; /wc� NEW CONSTRUCTION 9C REPAIR Telephone# 1751 Land Use es % O= Surface Stones �2e'3�D�7"✓AL Slo p ( ) Distances from: Open Water Body It Possible Wet Area �� R Drinking Water Well n R Property Line 2� ft Other n Drainage Way p y SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) lvG-9e N I . PLO Ssn t Vo o ST, 14,441Dall 41✓0 A-'11 �i(/ST/NG CdSs�JaOGS � �Fr� n/bzu sysr�ni wo' ST- Parent material(geologic) ��/ AS69 �"��/" J Depth to Bedrock Depth to Groundwater: Standing Water in Hole: �+/6AIL� Weeping from Pit Face i Estimated Seasonal High Groundwater T3ETIJRIVIINATIONV FOR SEASONAL.H WATE IGH R TABLE Method Used: in. Depth to soil mottles: in. Depth Observed standing in obs.hole: in. Groundwater Adjustment n• Depth to weeping from side of obs.hole: Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ «: PEI2COLATTON'TEST Dateio ; Ttmc' o/�+y� Observation ,f�f 1f�/ Time at 9" Hole# !p,r Time at 6" Depth of Perc Start Pre-soak Time© Time(9"-6") End Pre-soak Rate Min./Inch 0NA&d�T LM4qS�ssa�� //� IJ X&V Site Suitability Assessment: Site Passed ✓ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back—� Copy: Applicant DEEP OBSERVATION HOLE LOG Mole # / il Color Soil other Depth from Soil I lorizon S(USDA)1f a ((Munsell) Mottling (Structure,Stones,Boulderes. Surface(in.) ° a sa l�a�t n 2 3�z 0 ley ' 7^ CD/ SvI Saib /O /L 7/& v DEEP OBSERVATION HOLE'LOG Holc # other Depth from Soil Florizon Soil Texture Soil Color Soi I Mottling I (Structure,Stones,Boulderes. Surface(in.) (USDA) I ( ) ° GraVch DEEP"OBSERVATION°HOLE LOG Hole# Depth from Soil Horizon S(il TextDA)1f a (Munsell) . Mottling (Structurree,IStones,Bouldcres. Surface(in) ° i DEEP.OBSERVATION HOLE LOG '' hole # Soil Texture Soil Color Soil Other Depth from Soil Horizon (USDA) (Munsell) Mottling (Structure,Stones,[3oulderes. Surface(in.) ° Gravch i I i 1 Flood Insurance Rate Man: / Above 500 year flood boundary No Yes Within 500 year boundary No Within 100 year flood boundary No ✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? —x4— If not,what is the depth of naturally occurring pervious material? Certification I certify that on tit (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required trainin exp ise experi a descri ed in 310 CM 15.017. q G Hate /� l�" / 7 Ci�nnture �✓___ ____ —_