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HomeMy WebLinkAbout0541 BUMPS RIVER ROAD - Health .541 BUMPS RIVER ROAD, OSTERVILLE A=144-042 FZ, VIA f IVAM)Yv� t A 4 I gog or VAW`� "RNA M-0 "1`4­'$ Mlll P, V Q If N hvgz�kr­r ag, tt OMEN zlik li V 3?, .-H CA "frMp�-M'Wj OWN um op� ',,%4" 41, J* 5 ENE IR MY, US MEN 5CR.Ti- Ida, 40 Mrs RNIM RN I 1'.ig;',I g lips I % 10 " pAp gm- ?�CNR 0 ,Rp f�14"'� "A $%w­",k aqluv yn- A n, TER' V"Offlflp 14"I'l If gin Ai mw WAI I- �- ?-1� , ;w-nit , . , ­ -,- - - "I , 'A' i I4� k I i ,I AM R4 Rf AA fil*"�IVTV wwp- - X "'cll, LA pg rx, 711-phr pi 1 M" V, 0 At 110 IN ik _U ognIg Vq `�T�l 4 M, X RAOS'N"7 FOAkIs %ji A;NE F�qz It 11, �T �! I N W"!, TA i BIMINI, 'W pf, A—' .41"1 VIP" .5 NN 0 '94il" , - ��i ,F4, 00 w UM 41; AURA � TOWN OF BARNSTABLE LOCATION't �iI 0,"Jg2C R, tz Tl? R 6 SEWAGE # VILLAGE 0`1pi—y 111 f— ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. r,J SEPTIC TANK CAPACITY o LEACHING FACILITY: (type) G o c7 {al /- P— (size) Na.OF BEDROOMS 3 BUILDER OR OWNER Z PERMIT DATE: COMPLIANCE DATE: 7 - 14 - Cl :2 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 w n o eaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist ' within 300 feet of leaching facility) ` 4 ✓/ .''' Feet Furnished by 64f "At"O"14 - - � l r � �� r `�� ���_ Z� I � P EI t� �! �� ,.� +� i �� � �°` = � �. � � � - No... U F�s....30.:�0.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for Uhnpw ttl lVarkii (nowitrttrtilatt Prrmit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: ------.J�....:ll........lurm. .s---- �.v ----------- ------O-s:f ADeaf' n-Address +\ 1%or Lot No. Owner Address w ..... Owner Lew :-5-------------------------------- ------d S°t•?�� r f 8' ' oZ 63 Installer Address UType of Building 3 Size Lot............................Sq. feet Dwelling— No. of Bedrooms.............................. .............Expansion Attic ( ) Garbage Grinder ( ) aOther—Type 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 ( ) aPercolation Test Results Performed by........................................................................... Date........................................ ,4 Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ (X4 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water......--................ .... •------------------------------ -----------•- Descriptionof Soil..................................................................................... -----------------....------------•-------------------------••---•----___-_--•---- W ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•. VNature of Repairs or Alterations=Answer when applicable...._L-Clo......`4-. .7 R----.-.T.-tl--------..................... 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 has�jbeen issued by the board of health. Signed ...... ���: . --- ........................ '... tS � Dace Application.Approved By ............. .----- '" ---------------------------------------------------------------------------- ---------t%=, Application Disapproved for the following reasons: ......... ............ . .. ............ .. ................. .. .. . ....................:... .. - - � Dare -. 0 . .. .........Permlt N Issued .......... "� Y1 ace 3000 No.---• -------�-----•- "�.' Fps............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEALTH TOWN OF BARNSTABLE 1 Appliratinii for Bi-aip3M1 nrkii C�nnitrnrt"inn amit Application is hereby made for a Permit to Construct ( ) or Repair (✓f an Individual Sewage Disposal System at: 2� e ......�`� .►'n. ..s e ocat}on:Address S i t i i or Lot No. Owner 1 !-e/- "_s-f e/-v r,I � e !y Address 'R a LV L Q w S v `- Installer Address Type of Building Size Lot----------------------------Sq. feet .� Dwelling—No. of Bedrooms________________3_______________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther 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 ( ) 9 aPercolation Test Results Performed by.......................................................................... Date----=- •--•••-•-•••---••-•--- ,� Test Pit No. I________________minutes per inch Depth of Test Pit-------------------- Depth to ground water ......................... 44 Test Pit No. 2.................minutes per inch Depth of Test Pit'__-_________________ Depth to ground water------:___-I............ "1 r tr - .' Descriptionof Soil.......................................................................................................................... W U Nature of Repairs or Alterations—Answer when applicable.----U_.D.:___ '�a-a{-_P.'------� t-------_--_--�Z_--:--::--_: 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 has been issued by the board of health. �} Signed ------ V ........ ------------------------------- -- - ------- ---- . Dare Application.Approved By ------------ E- ----------------------------------------------------------------------------- '' ..: rhte Application Disapproved for the following rearon : --------:__------._...._.. - � Date_ Permit No. ........ ` ...---5-9---------------------------- •,-, Jssued ---------------------a�e". .. .. .-" 5 THE COMMONWEALTH OF MASSACHUSETTS i BOARD OF HEALTH TOWN OF BARNSTABLE (111,Er#if rate of C�oznylianee THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by .......... G.�.t:.P--------Le� 5--------------------------------------------------------------------------------------------------------------------------------------------------------- RI nr.J ler at . 5. _L.....-6 ti '- -e-r--------------- ----- ------- S e_1----------- ( ----------------- ------------------ 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. .._. ..-_... .Q` -t z--------- dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY! DATE---------------------------------J- , ,_ - " cr)..I--------------------- Inspector ---------------------...C�...._ -- =--------------------_-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 1 ll R11polltt1 nrk.5 Tnnntru.dion Wrinit Permission is hereby granted......... ----- ------------- ...................................................... to Construct ( ) or Repair (-,4 an Individual Sewage Disposal System atNo.....S j'-•-•• _ta"np-)---•--. ----- --------- ------------------ Street /�- j' Cy as shown on the application for Disposal Works Construction Permit q gNo. ,,7�_:-C)9 ___ Dated..... ��_�1_ ........... Board of Health DATE........ 3 0� �L..-_ -------- FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS TOWN OF BARNSTABLEn� p � /yl S 7/ ' �N '`SEWAGE # L4C ATI,ON y r 2 VILLAGE," �� °� f ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 4 Ew Pt/ SEPTIC TANK CAPACITY e LEACHING FACILITY: (type) �/ (size) NO.OF BEDROOMS / BUILDER OR OWNER v t'01 w 5 PERMIT.DATE: COMPLIANCE DATE.--=-� Sepazation Distance B tween e: Maximum:Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water:Supply Well and Leaching Facility (If any wells exist Feet on site.or.within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) ) Furnished.by -------------- 0 F No......... ..rL ps.... +�................ lqql j� THE COMMONWEALTH OF MASSACHUSETTS BOARD SUBIECT TO APPROVAL or BARNSTABLE .'+1..............o F.........�r,h,...1"�...........................................---- CONSERVATION COMMISSION Appliration for Mqpnnal Worko Cnnnutrurtinn rantit Application is hereby made for a Permit to Construct ( <Repair ( an Individual Sewage Disposal Sys e� at• .................. ... ........... ......................................._._..... ..........._.....-_._I ._........._._._..--_-...-.---......__.._......_......._.............._ Loc ion-Address or Lot No. v/Gl v� 2 cv Owner Address ...__......X.....�__._.__.t ................................................................ .............................f....__........................_.__..._......._.........._.......... Installer Address Type of Building Size Lot............................Sq. fee Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (/VP aOther—Type of Building ............................ No. of persons...._.......I................ Showers ( ) — Cafeteria ( ) A. Other xtures .............................................................................gallons W - 9 Septic Tank-4 Liquid capacity®®�a__gallons Length................ Width---------------- Diameter................ Depth................ W x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth belloNy inlet... ___S-.f/otal�Ching area..................sq. ft. Z Other Distribution box ) Dosing _ Percolation Test Resul Performed by____;�� ....------ - �.._..---... Date.--- ---�� 'tZ.7 . 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........................ Q+' -------•--•- ---------- I. Wde4 ---.--- �t -O Description of Soil--------6,1_-.i.._-_ ..: _: ----. .-----/-�-------- �� ----�-- -�- -- x c., 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 TIT?.;... 5 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 board of health. Sign - • - ---------------•----- -•----------Da't'e-------•------ � ` -- � Date I Application Approved By..... -- % �-7� -----........................... Date Application Disapproved for the following reasons---------------•---------------------------------------......................................................... ...............•-•--....-•-•---------•--.............-----------..............------------------------------•-•---------------•-•---------------•--------------•--..................................... Date / 3O-Z�-- Permit No.... .. Issued....ll'_----------------------•--•--......._--•-•- Date FF THE COMMONWEALTH OF MASSACH'USETTS �&7.47- �A c BOARDG H A TH rptiratiou for UisVjaAa1,.JVvrkii Tonstrurtion amit ;, Ap. )yication is hereby made fora Permit to Construct ( or Repair ( an Individual Sewage Disposal em SVC _ �k e V tG! L. ion Address . LotNo. . ...... - ......................................... Own Address W1�.-_. . ...... ...................•-----•. .. . ----._......_.... .... -............................................• Installer X Address Type . uilding�r Size Lot_...........................Sq. fee U ,MAR Dwelling a� g—Y'No. of Bedrooms.__._ Expansion Attic ( ) Garbage Grinder VVP p.l Other—Type of Building ............................ No. of persons. --_:•.`4-_. __ _____ Showers ( ) — Cafeteria ( ) p•l '� Othe xtures -•------------ ----- '--- ------------------------- ----------- d j Design Flow... .................................gallons per person per day. Total daily flow........,J .... gallons. Septic Tank t Liquid'capacit)/jQ ..gallons Length................ Width------- _......... Diameter__---- -- Depth................ xDisposal Trench—No. ........ ......... Width........._.......... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter................ Depth belo inlet____ :_.. Total leaching area..................sq. ft. z Other Distribution box ) Dosing ®; L 5"•// 7' ~' Percolation Test Resul Performed by.__ _____._ _.�_. ._.t' ............ Date_. �` v !-'__-______-. aTest Pit No. 1 ............minutes per inch Depth of Test Pit.................... Depth to ground water _-_-_______..._....... (s; Test Pit No. 2................minutes per inch Depth of Test°Pit.................... Depth to ground water......................... _• . iZ O 'Description of --- .... . _Soil--•-- r � W •-----------------------------------------------•--------••-------.......•-----------•--------------------------------•-----------==------•---••-----•-•---.--=--•••-•-•-•-•--•-•--••--•-------•---- UNature of Repairs or Alteratiofts—Answer when applicable................................................................................_......._..._.. Agreement: ;:,< •, The undersigned agrees to install the`aforedescribed Individual Sewage Disposal System in accordance with 4 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 issued by the board of health. Sign ........... �;A Application Approved BY _...... . :............. �j' n � Date Application Disapproved for the following reasons:.................=.............................................................................................. ......................................................................................................................................................................................................... Date } zPermit No.................... --------•--...................... Issued-----•------------- -_-------•------ Da-- r THE COMMONWEALTH ,OF MASSACH SETTS" BOARD HEALT ?i I< ...........OF......... ..........`; ............. Tatifiratr ,af (9jam-4liattrr T IS S T ERTIF hat theeI dividual Sewage Disposal System constructed ( or Repaired ( ) by ---------------•----- • • -�Installe ' wrw... has been mst�lle fin;accordance with the provisions of ` of The State Sanitary de as described in the application for Deposal Works Construction Per N _ ______( .: ........... dafed. - �'" .�`'" ". x....... THE ISSUANCE OF THIS CERTIFICATE.SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION"SATISFACTORY. 4 DATE.. ----------------------------------- ..................... Inspector ------....__••="-' ....................................... THE COMMONWEALTH OF MASSACHUSETTS " BOARD HEALT meµ. 7 ... :...........OF....... . L1i � aa' FEE. ................. Y to CPer Repair ( ) an Indio :............ Permission s reby granted__: %__3emN.,ag, p al Systat No. r� �i * "� ----- -----•------_.......street — a as shown on the application for Disposal Works Construction Per it o.......... :. :.. ed... '" 2 ............ 1 G Board of Health i� / Z� DATE----- 1. -- •............................. .......•-•- . FORM 1255 HOBBS 3e WARREN,. INC:.' PUBLISHERS a ' shhn rye. ` D� rIrloe LIM LoAs 'PIP IkY Zg, ao ' 4 � lu�r '• SJ&SOtI. �� P �tsT. INV. GAL c 'd SEPTIG t'mKt f BoX t TAN N ' 1000 Z�jrO `CONY, 1 �• '� all LsA,CN f'i T x ,�. �rnrlT =tL 25 To Asa err t p R PE so -r AT .5L.oPe ?-aQL e4L rm I'L' No k� — - - -T - CF rm.F Aes coAA Pu so raft , W o \tI A7'EZ L o -r z .a. S. T y