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HomeMy WebLinkAbout0114 PARKER ROAD - Health 114 Parker Road Osterville n-:l.17-1:30: I TOWN OF BARNSTABLE o LOCATION C ,10.� �c.r �� SEWAGE # VILLAGE^�S �2,r J.� 4., ASSESSOR'S MAP & LOTS INSTALLER'S NAME & PHONE NOCC r(�o,,,, ,c��yiL1Gs • ` T2 ot9;5,5 SEPTIC TANK CAPACITY secs �. LEACHING FACILITY:(type)CAU� �. C;�' (size) /0" C,a•11f. • NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER m c �a-�- DATE PERMIT ISSUED: ® 10 DATE COMPLIANCE ISSUED: ® —cll VARIANCE GRANTED: Yes No rr . 0 P 17 `- No..?J,—_.YW Fps............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH P P ~�. a TOWN OF BARNSTABLEarnstab~: R e f "ration Ccmmis . SZpn Appliration for Uiiipin al Works (fulai � mi# ._ osa o ge�f Application is hereby made for a Permit to Construct ( or Repair ( an Individual Sewa System at: �� ..........�..�. ..._..... .. .... C............. ...................1. .--........_ ...............---.. 1... ..- - . ._. -Address � ��I or Lot No --------. ................ ^ (O ner a t (� t Ad ess f --....1' .^r..` .... k$ -- c. /Vl ----------• ............ ........ .. ( � Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................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 ( ) 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..--................--.. - ----•------•-------------------------------------------•------•--------------------------------------------------------------------- x Description of Soil............. V� U •--------------------•--•---------- ` U Nature of Repairs or Alteratio s—C9'Answer when ap licable�.. C — ...............�'�7t>-�................. Z92. d .........-----------................................. .........................._..............L........ .....................................................I........................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Envi mental Code—The undersigned further agrees not to place the system in operation until a Certificate of Co pllance has been issued y the b and of health. Signe ..--- �- l-- . ... . - Da[e ApplicationApproved By ........--- --- --------- --- - --- ------.. - .. . ........ ------------..............--- --- . ......... ...............---................... • Dace Application Disapproved for the following reasons: ................. ....................................... ........................ ---------- Permit No. -...... ......................... Issued ---- ................... Date Dace �No....,-.. •--- ----- a rc-c� FEs.3©:-�••••-.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEALTH TOWN OF BARNSTABLE Applirttfion for Uispuaal WorkgC��a� � i-n utit Application is hereby made for a Permit to Construct ( ), or Repair (pe3 an Individual Sewage Disposal System at: �.�V `M , [ocdti Address Vi 1 L/( 1> ^(�{Z!C�r L `O ner \ c t `ddfess CL.C.�..:\."C?w. 1 P �G�.., d �1 _�G_�L.3 A. rn� r. 7 l- 9^� c L k,tD__c ..... L ..............�-�.`........... Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms______________________________ ._.__Ex Expansion Attic a g— --------- p ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d 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........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P. Test Pit No. 2................minutes per inch Depth of Test Pit---:................ Depth to ground water________________________ ----- Description of Soil �� _. ------•--------------•----------------------------- V ----------------------•...--•-----------••---------..._----•-----•------ ----------•--------------..._-•----•---••••------------ --�-•---...•-----------------•----------------•-------•-------- -•-••--------- V Nature of Repairs or Alterations—Answer when ap licable�_-_ ..___- ` ______ _______________!:�2�__�<-„_.______....___. ._�. ` = ..................................� ------=---------------`-----------=------------------------------...-------.....---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Enviyental Code—The undersigned further agrees not to place the system in operation until a Certificate of Cor>;r►pli nce has been issued pp by the board of health. Signed'-_.�� -------------L `....-...... Date.............. Application Approved By -----..:__.-.-fC-a.� �-'l/1.....--/..Y� '/7Y--%/ �.� .......... ............... Date Application Disapproved for the following reasons- ---------------- --------------------------- ---- -------------------- --------------------------------- ---------------------- ..................................... =--------------------/------------------------------------------------------------------------------------------------------------------------------ ` Issued d a Permlt No. 1 ....... .... ............................... Date r Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C er#tf rats of Complianre )HIS IS T CERTIFY,That the Individual Sew' e Disposal System constructed ( ) or Repaired (��r .r � ` 11 L— y .-- Installer i 1 P at ------------------ ----- has been installed in accordance with the provisions of TITLE 5 ;f{The Sta„ tg Environmental Code as described in the application for Disposal Works Construction Permit No. -... --�- ... .............. dated --...-...--...-...----..--...-------..--.-..--.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WJLL FUNCTION SATISFACTORY. DATE -------------- ---- d "-----......�---�t---- -� '- Inspector --......---- ..--..-:!.:.... ....--.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE , No......... .... FEE........................ �i���a�tt�- nrk� �nn�#rimrn rrnti� Permission is hereby granted.......... _._______� .__-'�Y` e-�LS- to Construct ( ) or Repair ( n Indivi`o�1 Sewage Disposab-SS hem (r C at No.............. _ '.�._....�^---------.1_._..Q..:............ �y22� �! � 1`� .....----- ......................... Street (� �f�/ as shown on the application for Disposal Works Constructio Permit No..r___;_: ? Dated-----� ?__ �/ �- -._...... (� ( O Jr DATE---------------------------•----•----� B of Health -�---••------.....---•----------•----- u FORM 36508 HOBBS Q WARREN,INC.,PUBLISHERS AsBuilt Page 1 of 1 TOWN OFnBARNSTABLE LOCATION_I �_� P0.r ILc.� `\� SEWAGE # � VILLAGE �$�er�J �l� `�, ASSESSOWS MAP & LOTn7 INSTALLER'S NAME & PHONE NO.ar(-o,, ww�t,Ys . Y1'01935 SEPTIC TANK CAPACITY~ /0 b b LEACHING FACILITY:(type)c L Piz (size) /0&A NO. OF BEDROOMS- PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED; 0 7/D ~cl/ VARIANCE GRANTED: Yes No _. T 0 5 http://`issgl2/intranet/propdata/prebuilt.aspx?mappar=l 17130&seq=1 3/28/2011 LOCATION SEWAGE PERMIT NO. 2cZ VftLAGE INST.A LLER'S AME ADDRESS ' BUILDER OR OWNER161, r DATE P. ER III IT ISSUED �7 i I. ED • D E COMPLIANCE SSU .,. • ib \\\ --_ \ \\ II `� ,�� ill �� �i ��s� � � ��,� '� �.. �,, , . � _ , No........V�a ...... - F�s.. .S...Q.�....... THE COMMO`NWEALTH OF MASSACHUSETTS _BOARD OF -HEALTH :l T.o-wn.-.......O F.................Barns t-abl-e--------------......................... 'Alip ira#ion for Bi_qpuiiFal Marko Tnnitrnrtinn- umi# Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at 114 Parker_ rI. Rd - Osterville Ma. .. .......- ........................------... .------....----------•-•-•-••.....---•--._....-•--•-•----••------------.................... Location Address or Lot No. Jamea...A...AcCarthy-,....M.D_- ............................. 1-14-- ....Ma...... Owner Address \ w a., a •.A...&--•B-- ess�ool ery ce---------••-----------•-------• 1 8 B ,4�5...� ¢ 13ya I7,1r�_s\..- .... Installer Address d Type bf:`,Building Size Lot............................Sq. feet UDwelling—No. of Bedrooms................4.........................Expansion Attic ( ) Garbage Grinder ( ) of 1 Other—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. f Seepage Pit No--_-----_---_--- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank Percolation Test Results Performed by.-•:...................................................................... Date.........--.........-----•-•'••-•-••.. ,.� Test Pit No. ................minutes per inch Depth of Test Pit.................... Depth to ground water.....------- : 0 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water............... P4 .................................................... O ;.D` sc ption of Soil $ navel ••••--•--•-•...--••-•...............................••--- \� '�:,y'• 4 - yr�` w/ \ .._.._�_____............................................................................................................................................................................................_ Nature of Repairs or Alterations—Answer when applicable._I;-OOQ_...(.One__thous-and.) gallon. ..st.an.e... :...---------==----- f �. Agreement: -{� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accor6nice with the provisions of ilTIE 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 t board orhlae Si . — -----------------------------• ---- .......... .. f f. • Daa te Application Approved By---•-. = :" . ................•----•. �� `��` 7 s t Date t Application Disapproved for the following reasons:--------------- --•-----------•-•------•--•---------------...................................... f' .........................................................................................................._........__.-...---._._.............---...__..._ ..__....•...-- f Date Permit No.....................•...----••---••----•--------......... Issued---:1Q- Date A.. '--N..._....�r'AL_ FRB. S.:.0.0-.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .; .---......_......_T-bW ..........OF.................�Berrstable---------------------------------------- . ,�. , r�irttilan for Diatt1rk >anr#inn rrinit Application is hereby made for a Permit to Construct ( ) or Repair O an Individual Sewage Disposal System at 114,................_...- -er ..--•--------•------•-----•-------•-•---------------__---_---------------• Location-Address or Lot No. .: . �.. .... ar Y.0:_J ................................ ........ k Owner Address a Installer Address dType of Building Size Lot............................Sq. feet V Dwelling—No. of,'Bedrooms...............4.........._______________-Expansion Attic ( ) Garbage Grinder ( ) U 04 Other—Type of Building ....... ...... No. of ersons._..__.._4.______.__._.____ Showers — Cafeteria W YP g -----:-- - P ( ) ( ) p4 Other fixtures ........... W Design,, ____________________gallons per person per day Total daily flow........................-___.__._ .___gallons. ; WSeptic,.Tank.—Liquid''capacity.__.____:._.gallons Length_______________ Width..____.__:__.__. Diameter ti_____________ Depth................ xDisposal Trench—No_____________________'Width.................... Total Length.................... Total leaching area______..,.____._....sq. ft. Seepage Pit No .._.__ _.._.._. Diameter___________________ Depth below inlet.................... Total leaching area___ ______-___sq. ft. Z Other;Distribudon box ( ) .-. Dosing tank 1.,. aPercolation Test Results Performed.bY............................................................___.___.__._.__ Date�`{.__..___ 4 Test"Pit Na 1 ___.:-------minutes per inch Depth of Test Pit____________________ Depth to grou�� water . ii (i, Test Pit No. 2____:_______.___minutes per inch Depth of Test Pit____________________ Depth to groin,l *ater ______:_: . R: t l 1 .............. D Descripttori of Soil..------.. Gravel ! .j� U ...................... - -----------------------------------------••--•----......_____....--------•----...-------------------__--------•-•----•.= (i,................................ W 1j x VNature-of Repairs or Alterations—Answer when applicable._1+Qln'i(1_._(_one._.thaw sand- 9 1,1,0,t _____________ �3AC e °f 3. 1 ....................................................... Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions o£'IT p S 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 t board o 1 r Sig,> aQ-�. , �. , Date Application Approved By- { , �� '"� 1 " --•-_--_-•- a Date Application Disapproved for the following reasons_____________________....................................................-........-............................ ---------------------------------•-•------------------------•-•--•---.__...------•----._....--------••-•----•-•---------•••-----.._..-•-•---•---•-•--------------------------------------------••-•----- Date PermitNo....................................... Issued-..................---------------------•-=------------ *' Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........T-03M....................OF.................. arnatable........:......................... �r>�g�irtt�.e >afµf�nnt�li��rr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X) 3_... lea POPS.__. _eZ.-v ra.s...:i 28... haw...Tlarraae.,---11yin r ,a�..4�a............................... Installer atIaM-AIL__ 5 a --ka ' 5 ,_ __. k31 . : s _a................................................... has been installed in accordance with_the provisions of T F of The State Sanitary ode as described in the application for Disposal Works Construction Permit No._. _ ..•---•--------.- da.ted_... "'+�c1�_�` __ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS7Uf D AS A UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................. .. (�....._... Inspecto'r:.:..- ,,.., ..- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y' +� .........................Town....OF......B. rn.S.tahle..._........._.__.._.._..........._.._......_.. FEE. �J-.Q0 1�1 . ................ in ' Visposat Worko 01.1.ttntrnrtion pamit Permission is hereby granted.A.__ __.B...C_ennP.O.,01... Ze.r_e_.9...Ax@nnig to Construct ) or Repair ( X) an Individual Sewage Disposal System at No._a14- ..............................r •�...Osterville...-�,- James_.._A,.. t4P.Q r:tby ���e................................. 1 Street as shown on the application for Disposal Works Construction ernut __ Dated.......................................... --------•_•---• Board of�'Hcalth DATE. °',� ' � `------------•--------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Il