HomeMy WebLinkAbout1860 SANTUIT-NEWTOWN ROAD - Health 1860 Santuit-NewtQ�vn_Ro?d
Cotuit
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TOWN OF B STABLE
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LOCATION le4 SEWAGE # 'S f.S—YSP
VILLAGE ASSESSOR'S MAP & LOT 45112 3
INSTALLER'S NAME&PHONE NO. 7�®�
SEPTIC TANK CAPACITY �/ U
LEACHING FACILITY: (type) T (size) fy��V 3
NO.OF BEDROOMS
BUILDER OR OWNER
i
m, PERMITDATE: � COMPLIANCE DATE:' J sJ
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
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{ TOWN OF BARNSTA BLE BUILDING PERMIT APPLICATION'
Map QZ _ Parcel Q Z Permit#
Health Division f Date Issued
Conservation Division Fee
Tax Collector
Treasurer SEPTIC SYSTEM MUST BE \L
INSTALLED IN COMPLIANCE
Planning Dept. WITH TITLE 6
Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND
Historic-OKH Preservation/Hyannis TOWN REGULATIONS
Project Street Address ��tl7WI/ —zfe�,( —a J
Village c��ui / to
Owner ZeA q Y r-AOL/i j Z— Address
Telephone -50,5 -- o/Z0•-00.3 Z
Permit Request •-y erg' l'
2,y"rz y- lelaoot FiZlp�e Qo-f-9 e u li-A Z,�ra(��eo✓ �0� ��2
r3�� kr �.�q•e
Square feet: 1st floor: existing le k 0 proposed 2nd floor:existing'�J�� proposed 13 F Z Total new-! W
Valuation 11,36,D0o Zoning District Flood Plain Groundwater Overlay
Construction Type W00
Lot Size Grandfathered: O Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family � Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes YNo On Old King's Highway: ❑Yes ,k"No
Basement Type: )('F'ull 0 Crawl .O Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing new Half:existing / new
Number of Bedrooms: existing new 3
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ZGas ❑Oil O Electric ❑Other
Central Air: t6es O No Fireplaces: Existing $ New —a— Existing wood/coal stove: ❑Yes N-No
Detached garage:Cl existing O new size Pool:O existing ❑new size Barn:O existing ❑new size
Attached garage:❑existing Mn"ew size 2 XZ Shed: Clexisting ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded O
Commercial 0 Yes o If yes,site plan review#
Current Use Ke�i� ,q-� Proposed Used
//��DQ ,, BUILDER INFORMATION p
Name �l./,�4 w Telephone Number
Address SLILY o-,/ License# CS p DSO
Home Improvement Contractor# fl(yl 7
Worker's Compensation#
ALL CONSTRUCTION DEBRIS ESULTING FROM THIS PROJECT WILL BE TAKEN TO
04` ^rQ,Lllj �/
SIGNATURE 1 DATE
48'-1 5/8"
23'-10 5/8" 24'-0"
12'-0" 12'-1" 11' 7 1/8" o
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I I T I JBtlt CD
GARAGE
!Nl11000 , 1t�'•2TP I I I � .
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eeevoem � N
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II PORCH III OI
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2T•P�7�6• � I�
32'-3" —I - - - - -
LIVING AREA St floor
1729 sq ft
24'-3 5/8"
/ 23'-1111/16"
11'-11 5/1 — — — —
N 11'-9 7/16"
bedroom L0
.bedroom / I .
mom above garage —I� / (D.
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00
,oft o
open I
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scale
2nd floor 1/8 - 1'
owner Elovltz NewtownRd. Cotult 11 -8-2001
Densmore Building & Remodeling P.O. Box 659 S. Yarmouth
phone 394-7249 fax 394-2226
jV62 32'55'
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5823255
ASS.
.LOT .25
ZONE- "RB" This MORTGAGE INSPECTION plan is For FLOOD ZONE "C"
N: _HAX ST Bank Use Only
--��----------_-- REGISTRY OWNER: ��.�_�'_1��PL'R
D REF: .��1,5���.3__ N ----------------
BUYER: �L'86LL3 P�_EL�dY --_'
'E: _9,�2OIA5 ---------- f-------------
------ PLAN REF: _73 5J--__ -----SCALE:1:'-- 40----FT
REBY CERTIFY TO ENp — -----
i77A(A nS 777W_JWS CCO_k_JE_FFR_Ei.�_TERNTHAT THE BUILDING , SHOr,1��
/N ON THIS PLAN IS LOCATED ON THE GROUND AS YANKEE SURVEY
rN' AND THAT ITS' POSITION DOES ____ CONFORM Mfairs CONSULTANTS
HE ZONING LAW SETBACK REQUIREMENTS OF THE c No.J2098
OF ___jL9AL?LVt2'rA& __---____ _—_AND THAT ,, y 40B INDUSTRY ROAD
)ES_ NOT_ LIE WITHIN THE SPECIAL' FLOOD HAZARD MARSTONS MULLS, MA 02648
AS SHpWN ON THE H.U.D. MAP DATED_2,'/_O-W2 _ <,�,a���, TEL: 428-0055
t — ane 250001 0021 D FAX 420-5553
��-
No. (�'.
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
ApV iratiott for DiBpwital Wurku Towitratrtion Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
......40, -D ---'--------------------------------'-----......---'-------•------...-------••--.............._...
Loca i n-Address
............... or Lot No.
tl Address
W
Installer Address
UType of Building ` Size Lot............................Sq. feet
..� Dwelling— No. of Bedrooms.......!_---------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons_--_.__._-_____-___-----.- Showers ( ) — Cafeteria ( )
Otherfixtures . - -------------------------------------------- ---••-----------------------------•-----•--------------------
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 ( )
0-1 Percolation Test Results Performed by.........----............................................................. Date........................................
Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water_-.-_.-..-----___-. --_.
GX Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water._.-__.---_.____--_.--.
a ....-........................................................................................................................................................
0 Description of Soil........................................................................................................................................................................
U --•------------•-------------'-----------------•----•-------------------.--'-•-'•----------------------'•----------•-----------'--'---•----...--•--------------------------------.....-----•-'-••••...
W --•-••-•--••- .......... --------------------------------------------------------------••---......' ------- ..... ------
-- B
U Nature of Repairs or Alterations—A wer hen applicable.._ � Q d..... . ......., 4c�4___..,j.l .
G
a
Agreement: :Ip �
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmen Code—The undersigned further agrees not to place the
system in operation until a Certificate of Complian e has een issued y t e boa f health.
Signed ........ ... ... .. .. -- �--gS�
-;;6 Dare
Application.Approved By - . ....... ........... . ..... ...--------- -------------_........._.. -
Dare
Application Disapproved for the following reasons- ------------ -------- ---------------------...---------------_---------------------------....._---------- ----
.................................................................................................._....----------------------------------....................------------------------------------------- ----------------------
..7 _ Issued �`... �".L� -Dace
Permit No. .... -----
.-
Dace
Ai
FEjc
THE COMMONWEALTH OF MASSAC,HUSETTS
BOARD OF HEALTH -
y �
TOWN OF BARNSTABLE
Appliratin,ii for Ditiip l ial Wnrkw C ontitrurtion thrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( n Individual Sewage Disposal
System at
a 6� 02
p
L1 ..... •.... ...................................................... ..----•-.
--•Loca i n Lot .
.Address .
!L.f 22B N l................................. .................................•....•.....
O vnCr ------•------ S
Address
# ! Idstalhi
V Add
Type of BuildingSize
L5
r Size ot............................Sq. feet
P••� o Bedroos. __Dwelling—No. m ________________ _ _____ _Expansion Attic ( ) Garbage Grinder ( )
pal Other—Type ouildiugl /¢ r No. of persons____________________________ Showers ( ) — Cafeteria ( )
PL4 Other x'tures t 11` ta•- cr l °------- - -- - --
- ---- -
W Design Flow.. ` .... g311ons1 per person per day. Total daily flow-..-------------------------------.---------gallons.
WSeptic Tank—Liquid capacity gallons Length---------------- Width---------------- Diameter---------------- Depth................
x Disposal Trench—No ,/��:�`�______- Width------------- f: . 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........................................
W
Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
40 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
xa ----•---•-••-----------•----....--•-•---•-••....-•------•-•••------••-••-•--••............•--••••••.....................................................
Description of Soil---...----•-------------•----•--•---•-•-------•--•-------•---•-•------------------------------------------.....----•-•--------------------------------.................
W ...
U Nature of Re airs or Alterations—A r wer he applicable._. __ ___ s �_____� _--U-•_-C,�
Agreement: -uir 'A, 'e-z*
'The undersigned agrees to install the aforedescribed.Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmen;tal��Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance"h s/leen issued fy tL4 boapd of health.
Signed -..--.- — '--- ,��.. 0,7a-%'
------
'A -
-J / Date
Application.Approved By - j... ....i .... Wit.. - �r..
jDate
Application.Disapproved for the following reasons: --------------------------------/..----------------------------------------------------------------------------------------
..._.._......................... .......:...._-----------...--.....-...-----------------------._...------ --- .---..__-..--------------------------.----....---------------.-_------------- ----------------------------------------
Date
Permit No. ......_-...` .. ��'� Issued ------- ` °t''' 7
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
l
Vfifi Qrtifi ate of Coraplia"nCP
TI<IIS'IS TO CE; TI Y, 1`iat the.Indi"idual Sewage Disposal System constructed ( ) or,Repaired
by ----- =
Insr.J icr at ............... ------ ...... - -_......... .:........... -
..--_.--._--_......-.--._..-----_--_--------------------
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Cod assscribed in
the application for Disposal,Works Construction Permit No, __-. dated .. '""" r�
....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. %
DATE . ..--... .--..... ..5� ..------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE .�
No , " _!'.. ?✓ � FEE...1;�Opr-.P.Z.-,
Biquval Workii Tomitrudi.vrt "rrmit
Permission is hereby granted.f---------------------------•------------ ----.-.------
to Construct � or Re air / an Individual Sewav Disposal System
atNo...... �/. .--•• . ( .. ( .....................................................
----------•••-............--
as shown stree
on the application for Disposal Works Construction Permit0�7 �"�` ed.._._�.^`.
......... _..� -:_ T
s> _
�^
Board of Health
DATE............. .................................
FORM 385O8 HOBBS rf WARREN,INC..PUBLISHERS
.,r
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
I, hereby certify that the application for disposal works '
construction permit signed by me dated (Q-- (R S� , concerning the
property located at O meets all of the
j
following criteria: '
}
• There are no wetlands within 300 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is-14 feet or greater below the bottom of the leaching facility
ti
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
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P
13
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SIGNED : DATE:
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
[Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted].
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