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Home My WebLink About0036 DONNA AVENUE - Health 36 Donna AvenL(,e Osterville A= 142-123 TOWN OF BARNSTABLE r C- LOCATION SEWAGE # �`� VILLAG ASSESSOR'S MAP& LOT / . INSTALLER'S NAME&PHONE NO.,64ell?C 1 SEPTIC TANK CAPACITY ao C i LEACHING FACILITY: (type) SWGd 1-w „fit A k.s (W(size) iG,x yd X,� NO.OF BEDROOMS Y BUILDER ODD.`::' ER PERMTTDATE: le-JI—M COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility t 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 � �:z ,� _ � � �� o �, � �_ ,L u �� o - - - o �= � � . y ; . 0 , � 0 No. 76_ - Fee s�— --�� THE COMMONWEALTH OF MASSACHUSETTS ! Entered in computer: _ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Migpogar *pgtem Congtruction permit Application for a Permit to Construct( )Repair Upgrade(' )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. 36 Agwp t qI Owner's Name,Address and Tel.No. Assessor's Map/Pazcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 7 Lot Size sq. ft. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1119 gallons per day. Calculated daily flow 4e zle9 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Ans er when applicable) 6 �' d0 �® Aa wj)"4 "itro e e 'e? l Ae-,251 ayew Date last inspected: Agreement: The undersigned agrees to ensure the construction c$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 issue y t o -.._ Signed Date 1 < 11 Application Approved by Date �� Application Disapproved for the fo owing Aasons Permit No. �%_�� Date Issued `— lqZ-lz� No. s Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(pprication for Mie;pogar *patent Construct on Permit Application for a Permit to Construct( )Repair(►/)Upgrade(' )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 36 Aare' Owner's Name,Address and Tel.No. L/ , Assessor's Map/Parcel � Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. i Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder(,vim a Other Type of Building. / gyp No.of-Persons Showers( Cafeteria( ) Other Fixtures j Design Flow L/(9 gallons per day. Calculated daily flow Lf V-22 gallons. Plan Date Number of sheets Revision Date . Title Size of Septic Tank Type of S.A.S. Description"of Soil Nature of Repairs or Alterations(Answer then applicable) ��►937�d/� —✓�1�4vf�c�/�f.�/� 1&Df"h ).4l%Y"4 .5 tm P .5,y//lt e&, 110^1h j /D�e#z2 'X� 4 - Date last inspected: Agreement: The undersigned agrees to ensure the construction ,ie tooWf 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 issue y t s oa-d o He th Signed Date Application Approved by Date�/0_2.4 Application Disapproved for the fo wing asons Permit No. � li Ll Date Issued THE COMMONWEALTH OF MASSACHUSETTS L BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (✓')Upgraded( ) Abandoned( )by AD/-7`/4elll ��/15�`/r,�'�/G��'I ,Ul /',0&,1 at 3� 2!&� has been constructed in accordance with the provisionsr`fi of Title 5 and the for Disposal System Construction Permit No. dated /Installer "- Z10 I,A_ldfl � Designer - The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector ------------------------------------------ No. — Gr Q 1 (- `/Z3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION':—BARNSTABLE, MASSACHUSETTS li!gpoar *pztem Con!5truction Permit Permission is hereby granted to Construct( )Repair(Upgrade( )Abandon( ) System located at 3Z z[ 'T'mw, 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 must be completed within three years of the date of this permit. Date: Approved by I i 1 1 o � � �o CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION TION I'I;It51fI' (WITHOUT DESIGNED PLANS) hereby certify that the application for.disposal works construction permit signed b me dated �a/Zf<e� concerning the p g Y property located at 30 wew a O� > ll meets ail of the following criteria: `.1cre arc no wctlands within vo rcc! of!he'proposed septic system acre arc no privitc«veils within 1M ica ,f the proposed septic system 'ic obscry ed errundnnler '^bie s i 3 fc -r ;rater:xlow the hoflom of the ie fchin¢ farlity ilue is no increase.in 'low ;and/cr c7an2e :n -use proposed Nere are no vnrianc`s rcanested or needed. 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 certined plot pinn, this plan should be submittedl. t.�_�.._Its•• m.. _ , .,.i L _ .:,f..'.i. a. ..-.*Now�ya-wti-_' .s. _-• zvc LOCATIO SEWAGE PERMIT NO. col is 5 VILLAGE IN A LLER'S N ME ADDRESS B U 11 D E 0 OR OWNER DATE PERMIT. ISSUED DAT E COMPLIANCE ISSUED 4 J L� O �` �� ,� h I �r J CY No.. .......... F$s.../t��................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........-.OF............. .... .... .......... ......_........... ......_.................. App iratintt -fur 4%ipoiiat Workii Totifitrurtiou Vrruift Application is hereby'made for a Permit to Construct ( 44"'or Repair ( ) an Individual Sewage Disposal S stein at: . .Qllg oocikv .............. -•...•-•--•..................•••••.qS--•--•-•••--...-•--•--•••--•-•-••-----••---..._..-- ation-Address or Lot No. — -_.__...... ila.--- � .4-1�- --------- ------- -----------------------------------------•--------------------------------......---------------- W t (Zo -Address ••-• ---•--.........c G •--•..-•-•• -•.._..•-•--...-•--••-------•-••••••••-•••-•••-•----•---•--•--•.........................••.•-•--- jwn�.r staller Address Q Type of Building Stze Lot----A-'S.��....Sq. feet U Dwelling�No. of Bedrooms--._----- --_.Expansion Attic ( ) Garbage Grinder ( ) Other—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 7 7 '~ Percolation Test Results Performed bY------- ---------------•---•-•--.....----...--•-••---•--••----------•---- Date--------------------------------------- W ,a Test Pit No. 1----------------minutes per inch Depth of Test Pit_._-----_-_..____-- Depth to ground water-.-__.------.-----. -. LT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--.-----._----_--_-_---. P4i ...................... ---....-------•----••- Description of Soiv '� � ... L .- W;_ i� ` s._ _ % O jAt V - ." ..(Ii1 .._.L ,�AL` :t�-sctE.._,�.� .... --�f .. ��r .... W .V Nature of Repairs or Alterations—Answer when applicab ----- --------------------------------------_-.............------------------------------------- ----------------------------------------- -- ---- ---------------- Agreement: The undersigned agrees to install the afored ribed ndividual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary ode The undersigthealth. further agrees not to place the system in operation until a Certificate of Compliance has - n ' tied by t e boar Signe - ----- -------- -1 Date Application Approved By. . .. _.. •-- .... -- ------------- •--• b Da --------- te Application Disapproved for the follow' g reasons----------------------------------------------------------------------------------------------------------------- ...............................................-.......................................................................................................--------------------...--------------------------- Date Permit No........................................................ Issued... - - --•--_ /—� ----••- Date r No. e Faa "`........... 'I�T COMMONWEALTH OF MASSACHUSETTS OARD OF HEALTH 1�Otir4t r wpolial Iaark� C� �i�#r r lQYt frr��i# Application:is hereby`made for a Permit to Construct,,( or Repair ( ) an Individual Sewage Disposal System at iL•- -� --0L C --------------- -- --•----•-•-------------•---•--. .�s•----- . Lgeation.Address -, or Lot No. i Owner Address ................... ......... Ynstaller Address Type of Building Size Size Lot_._.'_.__._j_____________----Sq. feet U Dwelling�No. of Bedroom -------------------------------------------__________ _______--.-_.Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building --________________________ No. of persons---------------------------- Showers Cafeteria ( ) Other fixtures --•------------------------------•-------------- W Design Flow--------------------------------------------gallons per person per day. Total daily flow......................__---------_----_-.-....gallons. USeptic Tank'Liquid capacity- gallons 'Length---------------- Width.........-._... Diameter.........:------ Depth---.-.__-.----- xDisposal Trench—No..................... Width____________________ Total Length.._--__-__-___-__-_ Total leaching area.........___.....sq. ft. Seepage Pit No........:............ Diameter.__._.•___ -__---_-De Depth b ow inlet_______pI ,�! _. Total leaching area __---__--sq. ft. z Other Distribution box ( ) Dosing tank Percolation Test Results Performed bY------- ..................................................... Date.........--•------------------•------- ,� Test 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-------------.---------- .r. • `_ Description of So _... 40.__ _ .... - ----2. «► .. U -------- w UNature of Repairs or Alterations—Answer when applicab, ............................................................__.--_._. ----.-..-__.-. -- - - -•------------ - ---------- ---------------------- Agreement: " The undersigned agrees to install the afored¢ cribed rid vidual Se age-Disposal 'System in accordance with the provisions of Article XI of the State Sanitary "ode The u ders. d':further agrees not to place the system_ in operation until a Certificate of Compliance has ued by t e boar of health Signet ... w• X 1 "TOusc^• __ ..... ....... - te Application Approved BY -- - --•-- ---- l��a� --------- > Date Application Disapproved for the following-reasons: ---- - --------------------/ -------•---------------.---------------------------------------------- ----------------------------------------------------------------------------------------=--------=------'----------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued...............----•.............••--•--...........-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH " err#i�ir�#r of fit�rut��i�nrle TH I ' TOIRTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) .1 1 e7o - , ii - .1 , �, ". 1 has been installed in accordance with the provisions of A i I of The State Sanitary de as described in the application for Disposal Works Construction Permit No._ .f"dated -- -•--•• THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ; DATE �/. qq 7---- - Inspector -------E--�--�-------- ..................................... THE COMMONWEALTH OF"MASSACHUSETTS BOARD .OF HEALTH . / .. . ...�. I ..F...... ..O F..........: FEET! _.._........ .. ��#r�r#i�it _ : Permissions eby granted--- ............ to Con t• 2t i ) an Ifidi al Se is osal S stem at No.- t ` �� t .. " . .---. -----•---•------••--- * � � Street .�r as shown on the application for Disposal Works Construction it No Dated.... ."`1�t` ........... ATE �' s Boa Health �-- Board of t ts •FQRFNzt 1255 Hoees & WA.RREN,:INC.: PUBLISHERS - a � T p� M t k a kit 43 Dt tt.d� t c , ,J- CEtZTIF 1t"?z) p L c>-r ' ca N Y L � • _ No. 13 A � 0C ATI O Wix !(Z �- SC-AL r* ! 3 SAT ,•- -- G6rz-t'1 F�{ TNAT TNG— GcsUW Pb—,M ,, 50,0,0 Q -A�.1 RIr cR 4.3G� t-�t�Zt=a►..� �G�VI '1-�15 WIT" TNT Stt7E_l_t►•�� A1.la 5+ �'13ACtG T�EAc�i�Z�{Vt ;-i 'ems bF T"e To W LJ 0P �aTt= S REGtSrx: t=t> LA-wo ,U��•'�Yoc2S TNtS Dt_AW IS LJOT 8,4,Ser> O'S oSTEIZVkLLr-- o A►�ASS, tW5tMUAn.E.NT tzv � T►tG co S t'S ,�towtz� APPt-t.GA"'r 'RM}.4Z3,.K) Kt.;: .LEIAEV- hbT B USCQ To Derr-vM+N& Lo Ll WE;S ASSESSORS MAP 110: R-. v, PARCEL NO. - --/ No...... 2.0....QQ.... THE COMMONWEALTH OF MASSACHUSETTS � BOAR® OF HEALTH T.a_Wn.....................OF....... arrnstable Aliptiratilan for Uispaoal Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (XX) an Individual Sewage Disposal System at iV&.- 36 Donna Street 0sterville .............. __.... _................. .............. ...............................................•-•------.......................................... Location-Address or Lot No. .............Md Clad I ....------.. ......------------..................•-•--•----_ ......................................................... Owner - Address Wd...P...Ma.Q Qmbe x-•-------------•------••----•--•---•-----------•- Installer Address Type of Building Size Lot............................Sq. feet Dwelling�No. of Bedrooms.........�-�.�................................Expansion Attic ( ) Garbage Grinder ( ) `•4 Other—Type T e of Building No. of persons............................ Showers a YP g ---------------•-----------• P ( ) — Cafeteria ( ) 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 ( ) aPercolation Test Results Performed by.......................................................................... Date................... ----------- Test Pit No. 1................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........................ a •----•-----•------------•-•-----------•--•------•••--••------•-....-•-------•--•-•--------•-•--••---......................................................... ODescription of Soil.................................Sand---L__..Gr.ax.e_.................................................................................................... x V W x ••---•-•-•-•------------•-----------••----------------•----------•------•--------••---------••••-•••-•----•-••--------------••------•-•-•-----------••--••-•--•--••--•-•-•-••-----------........._...... U Nature of Repairs or Alterations—Answer when applicable................... �_a_l 1p —_p_ _-_______-.___..-._-_._____._. -----------------------------------•--•------•-•----•-•---••-•---•-----•••-•••••-••.._..........•••-•-----------••-••-------•--------•---•----------•••--•••--•--=-----•---•---•-•------............••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i T T;l'•p of the State Sanitary Code—The undersigned further agrees not to place the.system in operation until a Certificate of Compliance has b n issue by h rd of h h. Signe ° • . • ...............•••--- ---2/ 7Application D t Approved BY--------- -- ------------ - -----------•- �•----•---._._..�..---•-- ------ - - - �---- Date Application Disapproved for the following reasons:_..---------•---------•-----•--•-----------------------•-------------------------------------------------------. -•----•--•----------•------••----•-------•-------•-•-......--........-•-----------•••--........•---••-••-•--•-------•------- ----------------••-••-•-••-------•-•-----•----•-. ...................... Date Permit No........5 ( .................... Issued--........---•-----Date............................... e' .n 1 9-hq No....d Fmm 2.0 -O0,..... 1� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......Town-....................0 F.....Bd Y'.rri S t;ab 12 App iratiou for Disposal Works Toustrurtiou 11trutit Application is hereby made for a Permit to Construct ( ) or Repair '.XX ) an Individual Sewage Disposal System at: ............3 6 Donna S t r e e t---0 s t e ry i 11�...._._..... ------------------•------._.............. --- ........... -•---. Location-Address or Lot No. ............mike.". e..mill................................... ..........-•...................................................................................... Owner Address ............ _e_ °.� �"O1�IIJ C --------------------"-----------•--................ Insta;ier Address d Type of Building Size Lot............................Sq. feet 72 Dwellings{—No. of Bedrooms........ ..............................Expansion Attic ( ) Garbage Grinder ( } aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Pi Other fixtures ----------------------------•-•. . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ 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........................................ a Test 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........................ •-•••-•-•.....................•---------•---------••---...........-•---.._.....------••-----._............................................................... O Description of Soil...............................$nnd--- ...Grave.1 U •--•-•••----------••--•-----------•-•-•---•••--•-------•---•---•-----••---------••-•---------•-••••--•----•----••--••--•.....-••-----•••-----•-•••---••---------------------------------••-•-----••--••- W UNature of Repairs or Alterations—Answer when applicable._..............Lt1.0.0.0_-ct ___.:__.__..___......_._.__.___. --------•--------------------------"•------•-----------•--"----------------------------•----.......-••-......-•--••-----••••-•-••••----•----•-•----•••---•--••-•--•-•••--............--•------......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i-,T1 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b'en issu b,' t e oard of h 'lth. Sign ( '. ..... .• . .....-••--------------- Application Approved By---- - - t../� -•_._. .__� .._. .. ate n Date--Z•-�---- •--• Application Disapproved for the following reasons:_...---••-----------------------------------------------------"•----------------------------------------------•- ..............................................................-••--•"--•--------------•---"---•---•----.._..................-----"--------"-----...---------------------•--------------------.......... Date * Permit No......0--Q........ � ... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town...............OF.........Barnstable......................................._.... Trrtif iratr of Tompliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or RepairedNXX) by...-•-...J_s..F.JO QQM!a�X...-•----------•................................. at...........36 Donna Street Osterville Installer •---•----•-----------------------------•----... .... has been installed in accordance with the provisions of 2 i" �r' i)of e State Sanitar:�o c}� dg din the application for Disposal «'orks Construction Permit No.__. -25- --(�// -------_--- d ed_ / L/,?iQ_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------- �.12` .............................. Inspector Inspector.................------ -•---------------"----------•----•--""-•-- 09- j THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH U 6 Town Barnstable ............................OF..................................................................................... 00 1V 0................ ..... FEE�....2.:_.0.............. Disposal Works Tuustrwtiaau prrufit J Macomber Permission is hereby granted ------- --------------------"--- " to Con t uct (( )) or Re air XX� %n Indbv' al Sewage Disposal System 1 D�sn�ia SEt�'ee ClsLervil-Te atNo...........:..............•---.......-•---••----•----............._...------._.....----•-......-------•--...---•- street �. as shown on the application for Disposal Works Construction Pe it N .. ted--- _ (/... ... ............ .....•--...---- " ------- r�/ --" ........ B oard of e DATE--------.:�_t�.:U--- ---------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS