HomeMy WebLinkAbout0155 BUMPS RIVER ROAD - Health 155 Bumps River RoD
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/$ u��if��� rTfJWN OF T'BARNSDAB,LE
LOCATION�(�t �34/� /Q"�i Vee — V. SEWAGE #%2�`307
VILLAGE �S p/�ylf�f ASSESSOR'S MAP & LOT /a0_`l;t-I0
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACiLITY:(type) �/ (size)
NO. OF BEDROOMS PRIVATE WELL O PU.BLIC WA�TER
BUILDER OR OWNER e V b hh Sbt
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes
1
http://issgl2/intranet/propdata/prebuilt.aspx?mappar=120042002&seq=1 5/28/2013
N A
E COMMONWEALTH
OF MASSACHUSETTS
�����& ���� K~��� HEALTH
BOARD- '' '--�L�-^ ^ ^�~^ ^~~ ^ " "
--.--K����f�&----��F-'���
`
Application is hereby made for u Permit to Construct or Il�oa� ( \ an Io6���u� 5��u�c
System at:
' Disposal
I ion or Lot K7.7
Owner �ress
Installer Address
Type of Building Size Lot....W,11_9_12---Sq. feet
-----------------------------------------------------------------------------------------
1:4 Septic Tank—Liquid
' Mallons Length ................ Diameter................. Depth................
Disposal Trench--No .................... Width.................... Total Length--------- Total area.
{:
Z Other uistooutmomx ( we Dosing tank ( )
~~ Percolation Test Results Po6orozcJ Date.. -------
Test Pit No. l--�L�-.minutes per��h Depth of Test Pit----------/.9-- Depth to ground water.-.����'_-
T�a Pit �u 3__���.��ontropor inch Depth of ���.--'�� - Depth to ground water--_..�........--
--- -__---.--'--'__.........................................................
0 Deucr�tinnofS�l-----
..............................................................
---------.-.--...------'_--__--.-__-_--.__._-_--_--_-'...---_--_--_--_-'------'--'
U Nature of Repairs or Alterations--Answer when applicable...............................................................................................
'----_------_'-------.'-----_---._-_--____-----_--------'_--'-_-'---'-_--.--'--_-'---'-_-
Agreeozcut:
The undersigned agrees m install the aforedescribed Individual Sewage Dis�sdS��miu �m��� ��
the provisions of TITLE 5 of the State �o6� �b� � ' '
�ummu���/ — u��o�ucd further agrees not m place the
system in operationuntil a Certificatebe issued by the board of health.
-.
No..........:::.._.�.. '. U "' (�. f f,
THE COMMONWEALTH OF MASSACHUSETTS
_17 `BOARD OF HEALTH
------------ --K .!: . )..1...........OF...... .1 f�c.l a T3"a (.:ti=......---------------...........-----
Aliptiration for Roposal Works Tonstrurtinn ramit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: RIO A
� /
llftzL................... ._ ................................................ ,.........._............_...._........._..... ._.....•_•....................._..........
Location.Address or Lot No.
.................................................Owner
. ..................................�W�res
..........__..._..._.__......................•---dd-ress--•._...._'____.............................._._
W
Installer Address Q Type of Building Size Lot.... 5---_S�«_-X_0...Sq. feet
Dwelling—No. of Bedrooms._.._...................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria
Q' Other fixtures ------------------•---------•--- --------•--------------- ----------------------- --•--------•-----------
W j Design Flow..................... ?_�____........gallons per person per day. Total daily flow..........__._....._._..`'..'..?:2.....__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........P..... Depth below inlet....~........... Total leaching area..... . . q. ft.
Z Other Distribution box ( G') Dosing tank ( )
Percolation Test Results Performed by.. _%. fir.....'.'....�`.................................. Date_.......................................l�
,Wa Test Pit No. 1...... -....minutes per inch Depth of Test Pit..........w.... Depth to ground water....................
fs, Test Pit No. 2.........--°"...minutes per inch Depth of Test Pit.......... »_.. Depth to ground water-----..._ .....__..
....................................................................................................
O Description of Soil.................-MF;�z2=------. �E _ -•----------------....--------•---------------------. --...-----------.----- ----------------
x � r �
V .---------------•--•----•---------------•-----------•-•---------------------.......------------------.......•---------------------------------------------------•----------- - .....
W
VNature 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 Compliance h'asibeen issued by the board of health.
Signed ----.._A.----------------'�-------------�/
Dare
ApplicationApproved By ....... ....................................... .. ....'---.......------------------------------- ........................................e
Application Disapproved for the following reasons: ................................................ '--.........------........ ------. --------. --------'-----............
.................... ........................ -----..-.....-------...----------•--— Da- -----------------------------------------------...........-------------'--........ ' --- -re------------------
_
Permit No. . ..r r..-��j''' )..f ...J...........- Issued ------------------ �� -----� -----...........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O,F HEALTH
f� ✓''... OF ------------"
C orti irate of C11pmylinure
THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed s�'' or Re aired
g P Y � ) p ( )
by ---------------------------------------------------------------------------.................-- ....---.............------. -------....-----..........-- --------------------------------------=
Installer
at .... .......................... ......................................................... "---'--------------.........--- ....-"--------------......-- --.............---...-- . -- -- -- ..'._...------.-------------
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ... .% .....L dated ..--._....................................._..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE �CONSTRUED;,A►S A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
G 1
DATE....... . ........ Inspector .... ------ I ...................................................
7... ..1.....-1..
THE COMMONWEALTH OF MASSACHUSETTS
Ttl.�
BOARD OF HEALTH
J ....................1. ....OF......... a ��1���..fir.-..:::...............
.........
---......1t.:. ' FEE.-....!........::....
Rapooal Works 0-Paanstr ion rrntit
Permission1 hereby granted------------•-------------•----•--•-----------.---------•----•----------"--...------------------------......i_.........-------:...............
to Construct (✓) or Repair., ( ) an,Individu,_ Sewage Diposalr Systems � t� ,r'
at No..__J.(�1" �_ o l) ��') /'`. �-�;� "....' t 1 i {� ;tea I f/� _y.
_f• Street '� )r}• �' .._
as shown on the application for Disposal Works Construction Permit No. _Y___,_ � ted........ ..................
........................................ -------------_--------------..-----......-----...
Board of Health
DATE = ,3_.�:._ ..
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
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LOCATIONC12-t A Vey- V SEWAGE #70� 7 30J7
VILLAGE_-Sf��I/�l�P ASSESSOR'S MAP & LOT /p?0 `y�-OQ
INSTALLER'S NAME & PHONE NO. j
SEPTIC TANK CAPACITY 1O00
LEACHING FACILITY:(type) pj -f (size)
NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC WATER
BUILDER OR OWNER /9Y4ne V b hh ^
DATE PERMIT ISSUED: -7-`- qo�
DATE COMPLIANCE ISSUED: -7 " 3f
VARIANCE GRANTED: Yes No ��
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALTHCZ
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Appliration -fur Diiivoiiat Workii Tutw1rurtiuu Vatuit
Application is hereby made for a Permit to Construct (4)"'or Repaid ( n) an Individual Sewage Disposal
System at: �,
yam.
...... .U�. ... ..................... ............
res—�--•--__.+ a
JiOwner Ad ----
Installer Address
Type of Building Size Lot.... feet -
U Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
Other Type of Building ____________________________ No. of p rs is _ Showers ( ) — Cafeteria ( )10
dOther fixtures -- - ....�"- - ---------- --- �'----�----------->-----......--------------------.._....---------------=-----------
W Design Flow............................................gallons per person per a Total daily flow............................................gallons.
9 Septic Tank—Liquid capacity------------gallons Length................ Width................ Diameter---------------- Depth.___.__-__-._..
W
x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inle _- Total leaching area-------.--------..sq. ft.,
z Other Distribution box ( ) Dosing tank ( ) �j o .
aPercolation�Test Results Performed by Date...........
Test Pit No. 1................minutes per inch Depth of "Pest Pit-------------------- Depth to ground water...--.__-._..__--__-.---
f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_--.-..--_.-._-..-.__.
----------------------------•---•-••----
0 Descri tion of Soil....................................................
x
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 Article \I of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been ' d by t o eal
Signe . ,.,.....-• .-- -•--- -- ��''�_........... ................................
.. ate
Application Approved BY----- . ----- • •. -- .............. _ V
-------
Date
Application Disapproved for the following reasons--------------------------------- ------------•----------------------------------------------------•-----------
---------•---------------------------------------------------------------------------•----------------------------•-----------------•--•---•....-• -----------------------------------------------------
Date
PermitNo......................................................... Issued...................... .................................
Date
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TOWN OF BAR.NSTABLE
i BABWSTABLE,
y MASS.
OpA 1639. \�+ Board of Health
Tf0 MA f At'
FROM THE OFFICE OF
rs
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No...�n_c `1......... Fus... .....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF.......... .'' fzy`tPa+°�L..t%�:.....:.....:. ................
Apli iration -for Bi-qpoiial 10ork.0 Towitrurtiott Vrruift
Application is hereby made for a Permit to Construct (41-or Repair ( ) an Indiidl Sewage Disposal
System at: 0 , f✓ L ,1;
-.e✓; :
� -----• � _-_
---------••-... -----
A � '�"Lion Lo No�
7v i
�.. - ,
Owner ------•--••------------•---•-----•--------.-Address
Installer Address 1
Q Type of Building Size Lot_._., r..� .----Sq. feet
V Dwelling—No. of Bedrooms_______________________________ __________Expansion Attic ( ) Garbage Grinder ( )
OtherType of Building __._.................... No. of p rs ,tis_ _______--________-.____.__ Showers ( ) — Cafeteria ( )
0.1 Other fixtures - "-1----fir .� �°°�" .� "� �°_:...r-----------------------------------------------------------------------------
Q
W Design Flow............................................gallons per person per'a Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter-----------.---- Depth----------------
x Disposal Trench—No- --------------------- Width-------------------- Total Length-------------------- Total leaching area--------------------sq. fI.
Seepage Pit No------------------ Diameter-------------------- Depth below inlet------- _ __ Total leaching area-------.----------Sq. It.
Z Other Distribution box ( ) Dosing tank
aPercolation Test Results Performed bY---------------------------------------------------------------------•••• Date---------------------------------------
a Test Pit No. 1...-------------minutes per inch Depth of Test Pit--------------------- Depth to ground water----------------- ......
(14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water.-.-.-__-_-_-.---_--.___
W --------•----------------------------•---• ....... ---------- .................................................................................
D Description of Soil---------------------------------------------------- . ...................
x
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 Article XI 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 boa(Tlf .�
healthy
Si ne �'�"- A- = a
g -•-•-------------- ---•------.-----
✓ � Date
Application Approved B zriw.j d_�_. .' f a--- ----•------- j '� -------
PP PP Y----4 ------ �..
Date
Application Disapproved for the following reasons:----••-------------•---•--------•-- --------•---•--•-•--------------•------_--.------------•----------------
-----------•-•-------------------------------------------------------------------------•----------------------------------------•--•------------------------•--•--- •------------------------------•----
Date
PermitNo........................................................ Issued........................................................
Date
r.
THE COMMONWEALTH OF MASSACHUSETTS
t BOARD OF HEALTH, _
/ .*' f�
`....�:....:............OF.... ...
fV .
i: ,. + .
�rrtifir�ttieE�f fP�uut�rlt�tttr�e
THI�IS TO CE 'TIFY, That tthe`Individual Sewage Disposal System constructed (4),Io r Repaired ( )
b o, . ---`
Y t .---•------- '-•-••......---•• ---- ---•--
1 , ff' Installer ( , � f
at....,T//f. � = ��..1f' ?' ?..f .e� ?Ara_'�* y � .. ," "r: �a���' / --------•-----------
has been instAA, -ed i ccordance with the provisions of AArticle XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No----------------------------------------- dated—.'f
- -- ----------------------•---...
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS �At,` ARA T.EE THAT THE
SYSTEM WI F CTI 34T1 CTORY. `
DATE__. ..-• --•---..( .._...._��-----------------•----------•--•-------- . Inspector------- --
THE 'COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
` OF...... __.... ��t....... ........................................ et
No------------------------- FEE--{-•---................
%ripo l grk,i Clawitrurtion "motif
Permission is hereby granted____. _.. -!o ___ p,,dy � _________________
•...
to Construct ( or epair ( ) an Individual Sewage Dis os 1 System '
✓ �'
at No.••-`..............•-•-.. _ ' + /
v --------------
'/ Street
-1
as shown on the application for Disposal Works Construction Pe-•mit NO.. __;_*_____f ated-------7,4__Pen _
..
Board of Health
DATE.......•. --- -----... . •-•-'....-•-•••......••. s E
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS -
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