HomeMy WebLinkAbout0040 WATERFIELD ROAD - Health aterfeld,Roa.d. '
Osterville
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YOU WISH TO OPEN A BUSINESS?
For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in
town (which you must do by M.G.L. it does not give you permission to operate.) Business Certificates are available at the Town
Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at. the Licensing counter.
- DATE: 1 ,�:�i- C)1 l7
Fill in please:
f APPLICANT'S YOUR NAME..-
BUSINESS YOUR HOME ADDRESS:
L
77
TELEPHONE # . Home Tele hone.Number: L
p - i - ,, q
NAME OF NEW BUSINESS i'Yt uJ j1 CA TYPE OF BUSINESS
IS THIS A HOME OCCUPATION? r/YES NO "
Have you been given approval from.the buildin divisio ? ES NO
ADDRESS OF BUSINESS ,. A r MAP/PARCEL NUMBER
When starting a new business there are several things you.must do in order to be in compliance with the rules and regulations of the Town of
Barnstable.. This form is intended to assist,you in obtaining the information you.may need. 'You MUST GO TO 200'Main St. (corner of
Yarmouth Rd. & Main Street) ,to make sure you have the appropriate permits and licenses required to legally operate your business
in this town.
1. BUILDING COMMISSIONER'S OFFICE
This individual has been informed of any permit requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
BOARD OF HEALTH
This individual has.been inf m11 of t e �rmit requirements that pertain to this type of business.
Authorize i a ure**
COMMENTS: MUST COMPLY WITH ALL
. TIMIt
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual hasikpen ' f r of the.licensing requirements that pertain to this type of business.
Authorize �Siigture** -
COMMENTS: O
� / U ) TOWN OF BARNSTABLE
LOCATION t 4,fl 01a��r T`d, R, SEWAGE # K_
VILLAGE 05116 /Ie- ASSESSOR'S MAP &LOT 1 Z 9 6
INSTALLER'S NAME&PHONE NO. ����► �4/�o
SEPTIC TANK CAPACITY /BOO y
LEACHING FACILITY: (type) (size)
NO. OF BEDROOMS 3
BUILDER OR OWNER 6-5 ;�rc, r� ✓ ites
PERMITDATE:' COMPLIANCE DATE:- — .-
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
f3
5 .
g-
3li113
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No. . ......It ( 6 Flcs.... ..
THE COMMONWEALTH OF MASSACHUSETTS
BOAR®. OF HEALTH
' TOWN OF BARNSTABLE
0
,gyp,plir i it for Diti-pwial Wor1w Towitrnrtion Vamit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at
-------------------- i .................................................................
lion-:\dd 5 or Lot No.
Owner Address
---------------------------------------------- ----------------------------------------- ..........-----------.
Installer Address
d Type of Building Size Lot_ /.`,.'Ae........Sq. feet
►.� Dwelling— No. of Bedrooms..__._____ _______________________________Expansion Attic ( ) Garbage Grinder ( )
04 Other—Type of Building __________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
04 Other fixtures ------------------------------- - -
W Design Flow33-�....._------------------gallons per person per day. Total daily flow--------------��_ l..................gallons.
WSeptic Tank Liquid capacity.,PAW.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 b C ...... t.. !,�'._._.________.___________________ � /K.ho_Y -_� --- Date----
Test 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.........................
04 ---•------------------------------------------•--------•-•-•---•-......_-------------•-•-•--.................................................................
0 Description of Soil....................................................................................................................................................................
x
--------------------------- --------------------------------------------------------------------------------------------- --- --- - ----- --•• -
U Nature of Repairs or Alterations—Answer when applicable.. �........ .. .. . . .. ............
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage D sposal System in accordance with y
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 bee s d by the board of health.
"following
-- -------- - .............//--- �..._......_................... ----
i.�' S..... .... ............. ......�.... Qyce
Application Approved BY --- ---- ---d . . . . ...
- .. ..........----Dace.-------..........
ApplicationDisapproved fo - -----------------------------------............................................................ ------------
- ......... ....... - ....... _. ...................
re
Permit No. 5 -----
�I----------------- Issued .............. -- - a�-�---
R rr�CJt1 No.. / - ��4. G .� , Fxs..400..
COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
v ,
Alip irtttion for Bi-nVasal orkB Towitrnrtinn omit
Application is hereby made for a Permit to Construct (�/ or Repair ( ) an Individual Sewage Disposal a
System at• -
. ,. - -- ---
Lo tion-t\ddr�ss •---or Lot No.
[
Owner Address
2V.................................................. --------------------------------------•-------•-------•---------------•-----------•-•-•-••-----
Installer Address
Type 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
Desi,gn Flow.=...... _5-4----------------_-------gallons per person per day. Total daily flow..-...........�'�_KI'J. .................gallons.
04 Septic Tank!L-iquid capacity.f,Vagallons 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-------- _._.__ '°E' ..................................... Date...._ ��.,� 7...__......
•--
,� Test Pit No. 1................minutes per Inch Depth of Test Pit-------------------- Depth to ground water........................
(r Test Pit=No..2................minutes per inch Depth of Test Pit.................... Depth to ground water.............-...........
--•---. . ............•----......--- ----------------
Description of Soil - - --------------•----=-•-- �
x
x ............................... ---------------------------------------------------------------------------------------------------------------:' „ & - ,I// :....
U Nature of Repairs or Alterations=Answer when applicable.-------------�71___A_._.__. •:..v.
-••• -----•••-••••••-•.......-•-----••••---•----•--•-••-••---•--•••••-•-••••-••....._..•--•-•--•--•----------••---- � ...... V
Agreement: U U
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 iss ed by the board of health.
Signed ..._..... f......._ f..\� .. � "-Z' �S
..------- ------------------
� � Dace
Application.Approved By .._'....... / 1!'t.._........ t� /�•
�., �. Dace
Application Disapproved for the following rearC...............................----------------------...---------------------------..........t-
-------------------------------------------- r j -...,. ---------....... ...... . ............. ..............._.......... .. . .. �.. : ................
Permit No. --- -- .J.----
.---------
11---------------- Issued ............. v---
i yne ! I
' F
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH 10
TOWN OF BARNSTABLE
V ertifirahh of TontylianrE
TICW.S TO CER�'IFY, Thai he Individual Sewage Disposal System constructed ( X) o Repaired ( )
by ��..►►: --------------------------------------------
at
---- -- - .... ... _1 ---------------------------
has been installed in accordance with the provisions of TITLE 5o f The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ..r .:a'�.'�. .`....... dated .......-_-------------_.._.................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION -SATISFACTORY.
RY.
DATE....... -'''.. .... - .. - ---------------- ---------- Inspector -----. ' '....... Y
THE COMMONWEALTH OF MASSACHUSETTS
r-/ BOARD OF HEALTH
TOWN OF BARNSTABLE ���
No........................
....•-•-•-..... FEE.......................
Rspwia1 urk T mdr-nti.oxn prrmit
Permission is hereby granted \ a ....... � =j -------------------------------------------•-----------------......-•---....
to Construct ( ) or Repair an Individual Sem, e Disposal System
at No. �!�= ; /�_)/, %.� ._ r �tl - ' -------------------------------- ---------------
Street s. I
as shown on the application for Disposal Works Construction Permit%�No�............. .. ! Dated_._._. ,+�___.r�........._........ .c
�,L
I � Board o�f I�ealth
DATE..................
v / (/
FORM 36508 HOBBS Q WARREN.INC.,PUBLISHERS
V
APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS
LOCATIONi 1-0 I 1 NO. I
VILLAGE Z_:e ZLf- DATE/,-1 4-97
APPLICANT FEE. 10.0
ADDRESS yS/,¢„ L— �h,,�,s f>eg/ TELEPHONE NO.'�75=y��/(Non-refundable
ENGINEER ��i j,`�,y OyL _TELEPHONE NO. §30 -ZS-3
DATE SCHEDULED
pp� po Q( QA}p en Applicant a signature
• A3hhi§69'30i �1I LbY AOC 0 0 0 0 0 0 0 C 0 0 0 a 0 0 0 0 a 0 0 0 0 0 0 a 0 0 0 C 0 6 0 6 0 0 0 6 0 0 0 0 0 0 a 0 0 6 0 6 • .
6-X SOIL LOG
SUB-DIVISION NAME
DATE l2-o l- q3� TIME 11',3
EXPANSION AREA: YES VINO _ _ s , 1)o L= RsSoC,, ENGINEER N
TOWN WATERY PRIVATE WELL �� -3r.►22`9 BOARD OF HEALTH
NA�LT y r--Y L, _ EXCAVATOR
SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and
percolation tests, locate wetlands in proximiky to test holes)
NOT
9
GED •
59,940
CIOo
k
(N
-��•zo
. PERCOLATION RATE: G 'L "gA' 1tac.tt
TEST HOLE NO: EELEVATION: TEST HOLE NO: ELEVATION:
Z -rdP � 5�.►8 so�� 1 .
_ 2
3 3
4 4
5 5
6 _ 6
7 7
8 sw4, 8
9 9
10 - 10
12 12
13 11° 4z o V.1M40utsTSM6' 13
14 .`. 14 .
15 15
16 16 /
SUITABLE FOR SUB—SURFACE SEWAGE: LEACHING FIELD LEACHING PITS y
LEACHING TRENCHES
UNSUITABLE FOR SUB—SURFACE SEWAGE. REASONS:
NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION
ORIGINAL: COMPLETED IN ENTIRETY PY P. 'E. AND RF'
rr?t�v• nr'rr. rtrrn nv nnrr rr•n��-� TURNED TO BOARD OF HEALTH
PROFILE OF PROPOSED SEWAGE SYSTEM
TOP FOUND. EL. 3Z•O NOT TO SCALE
IN DESIGN DATA:
MAX. 1' COVER
MIN. 1' COVER STRUCTURE 3 -Gi�DrZooNl bWrl��A4G
�Ge,
DESIGN FLOW
3 h 1ko 1>1S�os('fl.
d 1000 GALLON TANK 4 INV. EL. z3.0 ° F
INV. EL 6' x 4' o f
1 S� W/4' LIQUID LEVEL A c! ;
INV. EL. Z.3.5' DIST/BOX o LEACHING PIT
d W/6" SUMP W/ --3 STONE o �f.; SEPTIC TANK
ALL AROUND 1 330 k ► .S = 4qS Ci?D) - ys1` loot t L. 7%14L
INV. EL. z3,3 INV. EL. zz.S' '
c o a o S o os / 5 4' EFF/DEPTH
LEACHING FACILITY z 1r x x 1! k INV. EL. Z S = 3T(o CipD
i •a - d
— ` •" A 3z' 34 Tt- ([,') X 1 1 O = 113 Cs1?D (To hf�
•�-..,_,..moo'
�TRL wW 3-T� + \13 = �SR C.iP�
�4� AER.V�vuS Mi3� � � 1�96 . 489 -330 = ISR LIT?� 1N T C�ERVE
Co'l-►A, k 4' -TYER PIT W�3 ' STosf-
DESIGN STRUCTURES TO BE SET ON A LEVEL BASE
s � /
ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE
ALL PIPES SHALL BE SLOPED 1/4" PER FOOT EXCEPT FIRST TWO FEET OUT OF DIST/BOX / )
WHICH SHALL BE LEVEL
ALL MATERIALS AND CONSTRUCTION METHODS SHALL CONFORM WITH MASS. TITLE V
ENVIRONMENTAL CODE.
._
'LOT 1 -3A
34'- r s f i 56,960 sq.ft.
30 / PROPOSED
l' 3Z DWELLING
-30
�} 13
roLo
�
24' � � \ ,�/ � LOT
T it; 60,657 sq.ft.
SL-PF- L C
u z.'V/z.5I" x ESQ \Z TZ5- 01
Ul
f
SOIL OBSERVATION DATA:
10g k0
TEST DAIS
ENGINEER S Jam(L` _ A
B.O.H. AGENT
EXCAVATOR
PERC/RATE L z M1�1• i1JC1
TEST NO. 781 Sq
EST. GROUND WATER TAKEN FROM
BARNSTABLE - YARMOUTH MAP <10.0'
PROPOSED SITE PLAN
CL IN
OSTERVILLE - BARNSTABLE MASS.
DEPICTING
r. < < � . LOT _ ,, WATERFIELD ROAD
To
NV
SCALE: 1" = 40' DATE: 4/26/94
k1 4
S. DOYLE AND ASSOCIATES
�o IALO Fv'ANp 4 (2� �� �� Icy 42 URY LANE
HATCHVILLE - FALMOUTH TMA. 508 540-2534