Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0143 NICKERSON ROAD - Health
143 Nickerson Road Cotuit A TOWN OF BARNSTABLE ' c It 6W-') SEWAGE# VILLAGE ©017-U r 7— ASSESSOR'S MAP& LOT v INSTALLER'S-NAME&PHONE NO. C kfA;CC —7 7<'r SEPTIC TANK'CAPACITYA `� ° l� t_ LEACH NG FACII.ITY: (type) v� (size) NO.OF,BEDROOMS 3 BUILDER OR OWNER '),K'e A PERMIT DATE: L COMPLIANCE DATE: OF-O'- C, 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-Leach ng.Facility(If any wetlands exist within 300 feet of=leaching`facility) Feet Furcushed.by P \' - W 7Z W � cr, i r ' �i�/ti / •�� Fee J V Entered in computer: "_tzv THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for Migpogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(L,-)<Jpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./y`j /C e rSvYl 2 Owner's Name,Address and Tel.No. Cafvt+- CAM Mdne--a _ Assessor's Map/Parcel aR c aTRh'1 e— Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 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 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /dc>0 Type of S.A.S. Description of Soil Ind Art Nature of Repairs or Alterations(Answer when applicable) ___L),j i4jI 0 8 d x o oL r•vc✓r,(Is czJ/ 41 ' 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 C_ de and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Hfal . Signed 1 Date 3a 0-1 Application Approved by .-._ Date Application Disapproved for the following reasons Permit No. ZO U 1 -91 11 Date Issued 1 LVto• - .r Fee l..� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes `Y 01pprication for �Digaaf *paem Construction Permit Application for a Permit to Construct( )Repair(L,,�Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No/2/3 %C (SoY1 2 Owner's Name,Address and Tel.No. V ro I /1/1 )r'e a �.t , r Assessor's Map/Parcel O t 8 ©q S Installer's Name,Address,and Tel.No.' Designer's Name,Address and Tel.No. C19 rl_C O ✓�/Iq . 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 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /oo0 Type of S.A.S. Description of Soil i Nature of Repairs or Alterations(Answer when applicable) -Zhj f 4/1 C' d X •�-O pt Soo gq yc✓r,ds w/ 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 HealfV. Signed 1 Date 3Q 4� Application Approved byof Date 6 Application Disapproved for the following reasons Permit No. U ' S! t Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Cornpriance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired (''.Upgraded( ) Abandoned( )by "gAiC O IN at %G ker,sa /,)&, C'0 411, has been constructed in�ayccordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Zw_S_ dated Installer Designer The issuance ot thij permit shall not be construed as a guarantee that the syste 1 fun tion as des' ne Date U a Inspector A No. CNCJ /yam Fee r- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ° Migool *P!5tem Construction Permit 1 Permission is hereby graanrted to Constrtyt(/- )Repair( J pgradee( )Abandon) System located at �7 3 /CG(p✓'S O.✓ �d�. C o 714,11°7 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:Construction st be c mpleted within three years of the date of this e t. Date: Ci 9 �Z Approved by �~ TOWN OF BARNSTABLE F C 'T LOCATION SEWAGE # VILLAGE CcEb ASSESSOR'S MAP&LOT y 1 L 0 01 INSTALLER'S NAME&PHONE NO. � �� C/*A;C d Cr% . SEPTIC TANK CAPACITY..' t.,Yr .3 y. %D y 9"04t l LEACHING FACILITY: (ty"Pe) MZ /12 NO.OF BEDROOMS 3 BUILDER R M gee PERMTTDATE: COMPLIANCE DATE: ' Separation Distance Between the. M: imum Adjusted Groundwater Table.to the Bottom of Leaching Facility Feet Nvate 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 d(leaching facility) Feet Furnished by 3S' 12 ' 1 + -� ' 3 ' I n r 1/6/99 1^` t NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND.APPLICATION FOR A-DISPOSAL V WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, 1� �,'� w�, hereby certify that the application for disposal works construction permit signed by.me dated (4 -�kA ® � , concerning the property located at /(4 c-jk qZ Qa meets all of the following criteria: • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. O • 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, �' f Please complete the following: A) Top of Ground Surface Elevation(using GIS information) �. O B) G.W. Elevation S" +the MAX. High G.W.Adjustment _ DIFFERENCE BETWEEN A and B 3 SIGNED : 12-01 DATE: � �n) O [Please Sketch proposed plan of system on back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert _r J )�) y �i 0 Q : .1-113 LO C,A T ION SEWAGE PERMIT NO. Ldt- YIIL LAG E A ` 1 N1STA. LPLER'SF NiAME & A-DDRESS R:' I'L DE R OR: OWN ER: " 4 DATE PERMIT I-SSUED A DA,T' E C0 P1IANCE ISSUED 7 L wv�'" � 4t 4�. LO>---C AT ION S. E PERMIT NO. & vILLACE INSTALLER'S NAME ADDRESS j BUILDER OR OWNER w a G fiu DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED ��3 � �► O"e14 0-00 k \ V V �JS7r�4�Dd i �. e� i ;: No .....Y'.7 FEB..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 1 Town.................OF..............Barnstable .. . . --- Appliration fur Eliip.agal orkii Towitrnrtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Nickerson Rd. , Cotuit Lot_ 1 :_ ________________ --•-•-•---.............................••--•........--•••--•-....---......-•--•-•-----------•.... .... .•--- •-- Location-Address or Lot No. . .MeS. �x1�...Const�u�tiQ -----•----•-•----•-------•-•-•--••-- 14 Neck Pond Rd. Osterville . .......................d._�....---- r ----................- Owner Address W Francisco Tavares,...Inc. 69 Old Meetin House Rd Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms..............3............................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria a 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........................................ aTest 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.................................................................................----------------------•----------------------------•----------------------*------.----- U -----------•------------------------------------------------------------------------------------------------•---------------•-------•------------ W -------------------------------------------------------------------------------------------------------------- -- ------------. •---- i� UNature of Rep ' or Alterations—Answer wh n applicable.______: -:f DJ C� S ,.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL L 5 of the State Sanitary Code e undersigned further a rees not to place th sys m in operation until a Certificate of Compliance has been i u y the boa of � =- � ----------------- ----- - ate ApplicationApproved By.................-- �•......--=•--•---------.............. --•-•-•-•------------ ------� -Z-/�............... Date Application Disapproved for the following reasons------------=------------•-••-•----•---•-----------------------•-------------------•----•--••----••-------.----- •----•.............•------...-•---------...-----•------•------------•---•......-----.........----...•-•-•---•-•-•----------•-•-----•--•----•----•--------•-----......----•------------------------------ 1 j Date PermitNo......... J ------------------ Issued....................................................... Date Nod,r � � ._........J.. FRs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town......... ....OF...........-.Barnstable ......... ... ... . . Appliratiou for Disposal Works Tomtrurtiou truti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: - Nickerson Rd. ,. Cotuit Lot #1 ................__.__......................................................................... .........................-------•--•---•------------------................._______._...........-- Location-Address o Lot No 19 Neck Pond . Ile ---------------- .. •...eS Me...� structiG ..................... Owner Address a Francisco Tavares Inc. 69 Old Me t.in House Rd ........................................••-•-....... .._.....-••-•••-•--._...----- --.....• •--- ............ ... ---•-------.._.....-------------• Installer Address d 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 A4 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........................................ aTest Pit No. 1................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........................ -.................................................................................................................................................... 0 Description of Soil.....................................................................-•--•------------------------------------------------------...---------••-•---••-----•-------•--- x V ---------------------------------- ------- ----------------- --------------------------------------- ------------------------------------------------ •--------------- _-•.................. ----------- W •---_• • --•------------------------------------------------------------------=-------------------------------------•- U ...�swer , n applicable.------�:?N� (c�J c� >t�� �c�= .�............ Nature of Repairs or Alterations—_Answer when /c� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1E 5 of the State Sanitary Code e undersigned furt�her--agrees not to place/thn `sys em in operation until a Certificate of Compliance has been sue ' y the boa�"d�of 1 � _ 6- ------ --. ..{..�� �-....... ---- ••----------•- •--•-----• -----•-- Date ----- G_s a Application Approved By....... ----------'----............................................................... -•--._� .2 . . ..�---.......-•--- Date Application Disapproved for the following reasons--------------------------------•-------------------------------------------------------------------------------- ---••-.......-••-•-•-•----•••--•-•-•-•-••-•-----••--•••••------•--•••-•••-...---••--....:-•••••--•-•---------•-•-•-••-••-•-•-••--•-----............................................................... Date v PermitNo.......... ... ..1 .. Issued....................................................... _ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF......................................................................I............. (19wrrtifiratr of Toutpfiaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) =�?L( _1 i Installer) at--•--•••••--.L-�••t-------------'1� 1U�c ILIn�_`_�x� I . C_ has been installed in accordance with the provisions of TITIZ 5 of The State Sanitary Code as escribed in the application for Disposal Works Construction Permit No-------c? 7 i dated_--..__._���� ?______________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F N TIO SATISFACTORY. DATE...................... ...�&.......-•--------...•---•--•---- Inspector................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF....-...-..-......................................................................... . Non..__..I_ / FEE........................ 00�tl arko Touo#rudiou andt Permissionis hereby granted.................. yr/I C ----------------------------------------------------._......---------------...._•------_.... to Construct ( ) or Repair (\_�an I Ividt{al Sewage Disposal, System Street as shown on the application for Disposal Works Construction Permit No. _�__---__!_ Dated____1____1/�__/?�':_._.___.:_. C.iy>..c U� ---------------------------=--------------------------------- _... J Board of Health DATE---------•-•.--, ._�... [. ��--•••-•••---••--_---- FORM 1255 MOBBS & WARREN, INC.. PUBLISHERS N, - i ? No -•-••••........... ........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f Application -for Di-qVoiittl Wore C� tinn Vrrniit Application is hereby made for a Permit.to Construct ( ) or Repair ) n Individual Sewage Disposal System at: - -- ........._ --- . cation_Address or. No. --� -------------------------- + '._ err O ner ddress Installer Address d Type of Building Size Lot...........................Sq. feet U „ H-I DIvelltng—No: of'-uildinBedrooms..'` ___________________________EYpansion Attic ( _)::._. Garbage Grinder ( ) Other T. ' e of B G4 ;,. YP g ------;:.. .....--•-•-•-•--- No. of persons Showers ( ) — Cafeteria ( ) W 4.t ••,. Other;fixtures . __________ ___ W Design 1710'w:_ ...................+- gallons per person per day. Total daily flow_______ .......... .gallons. USeptic T.-Ink—Liquid can tv _gallons Length................ NVIdth................ Diameter--::.------------- Deptli---------------- xDisposal Trench—'No. { VVtdth__. __. Total Length _________________ Total leaching area......�._._. ......sq. ft. Seepage Pit No. � :.Dtameter "° .__ Depth below inlet____________________ Total leaching -area..... _..__sq. ft. Z Other Distribution box ( ) hosing tank ( ). aPercolation Test Results Performed by----- ----- -------- Date...... .......................... Test•...Pit No. 1...._-----------mu7utes 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------------------------ Description of Soil ---------••----=----•--•------- ----•---•----=..............'--------------- - -- ---- ---------. . x = -- ----- --•••--•-------••= ----------------------------------------- ------------- ------------ -------------------- ------- ' W' , --- =- -------- -- VNature of P.e atrs or,Aiterations—Answer when applicable � .tra '� �r^�•"_----- dam! -------. Agreement The undersigned agrees o`install the aforedescribed Individual Sewage Disposal System in accordance with. the provisions of Article XI of, State Sanitary Code=The a dersigned,further agrees not to place the system in operation until a Certificate.of Compliance s bee ` s by oard of health. 1 th.___________________ ________ Date/ Application Approved BY---------- ----- k � rt M1 Date e Application Disapproved for the.f ollowang seasb'ts f --- e. 1 -----------•-------------------•--•--•---•-••- -----=--- �-- ----- ---------------------------- ------------ �+ k Date PermitNo.........................................................-----.-• •- ••-•-•- Issued--------------------------------------------------------- Date E COMMONWEALTH F MA,r�SACHUSETTS k• v: BOARD A`LTH 7L ., .................................OF........................... .......................................................... 015rrtif ratr of Tontplittnrr t. TH T CE T , tWhe Individual Swage Disposal System constructed ( ) or Repaired ( ') ----•• F'l ...-----by...... _ - -- ----- ---� :----- --' d . .....................................................................-.......-.............. has been installed in accordance with the provisg-ions of� T�he State Slmtary �,+,elcibtt the application for ............... ...Works.'Construction P, r' nit No............................... ,.......... dated ; -__--_..-_--_--___.-:--__________________ ,. THE ISSUANCE OF THlt CERTIFtC'ATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM VV;ILL FUNCTION SATISFACTORY. ' DATE........................................................... Inspector _ TFIE COMMONWEALTH OF MASSACHUSETTS BOARD O HEAL TH707 F._ ... . ..... ....OF................. '-- ...... .....--- NO......................... FEE-.... ......... Permissionh eby granted_::_.__-- --- ------------- --....... ---==---•-----•••-------------------------------•-------•------------___----------------------- to Construct r • .f� n v u r e Disposal System atNo:= ....._................................. ---- --- ----- ---------- as shown on the application for-Disosal Works Construct Dated___ .....___ •! / 1 -------`-------------- >" Board of Health DATE...........------=----- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS