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Home My WebLink About0052 ASA MEIGS ROAD - Health 52 ASA MEIGS R MARSTONS MILLS A=031.001.009 I ` ��-Z 3 , No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _� Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppricatiou for Mi.5pont *p5tem Conearuction Permit Application for a Pernut to Construct(pair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ,5"4 Owner's Nam ,Addre s and Tel.No. 6j-f�y t, YIile'Jew/aey Assessor's Map/Parcel � � ��! �®� / •4 le� e ii Installer's Name,Address,and Tel.No. q 77 L95 q 9 Designer's Name,Address and Tel.No. As.e P4 0., (jar-r®S 1 tr /V W01's ra,05601i//S .Sid Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures • Design Flow gallons per day. Calculated daily flow 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 hen applicable) _C11ST�! P,rea � Date last inspected: Agreement: The.undersigned agrees to ensure the construction and maintenance of 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 isj by this &arVeh. Signed Date Application Approved by - Date Application Disapproved for the following reasons Permit No. �3 Date Issued TOWN OF BARNSTABLE LOCATION ,Sg IVs14 SEWAGE # Z9 - 2�3 VILLAGE fyl�tnS1'a`i S /2!,L'�s ASSESSOR'S MAP & LOT Q �•aal-t�9 INSTALLER'S NAME&PHONE NO. l;=0414/ ✓or efp4 1, 1?0.11ha.3' SEPTIC TANK CAPACITY 1200 LEACHING FACILITY: (type) ' -SOa GAL. �i�y W1:5 14ize) NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: P-0 /9- COMPLIANCE DATE: r _ 19 -%� 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 leachi g�facc*lity) `Feet Furnished by lbw �Lfv�� w ' 19A b �h TOWN OF BARNSTABLE LOCATION ,SZ /VJ9 Wcio,5' SEWAGE # % - D-3 VILLAGE ASSESSOR'S MAP & LOT 4-1-bcl- c`r INSTALLER'S NAME&PHONE NO. y0 7=04 S"/ SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 00ly wli 5, ize) NO.OF BEDROOMS 3 f BUILDER OR OWNER l rl�d� PERMTTDATE: -f 9— �" COMPLIANCE DATE: ! _ ! 9 - 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 leachi g fa: 'ty) Feet Furnished by v !� I Dr I 0 �•,,Ij1L % ..ti .. >:.., .- -....: ... `y +4 .a .. +.sue. .--..+�-,. --., - .- . ......-r..� ..yWr _. No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for Mizpogar *p.5tem Construction Permit. Application for a Permit to Construct(4,�"�epair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. sZ /9S14 /A/Q/G s /Zc/ Owner's Namf,Address and Tel.No. Assessor'sMap/Pazcel DJA/ (90/ 090? i f ! Installer's Name,Address,and Tel.No. C,I rJ=O:�41 Designer's Name,Address and Tel.No. Jas,e_A 0t Boor os - 9 �-s rah Type of Building: Dwelling No.of Bedrooms ' Lot Size . sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil t! r Nature of Repairs or Alterations(Answerwhen applicable) �yJSA* / 2- s A0 G►,"X L/r� G(//;11 G /�T y ' f—ro a e IW A�oll Z " A2/t o 5"I-ew r• Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of 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 is by this oard HPeh. Signed .� Date Date /"1�%9g 9 Application Approved by _ 9 Application Disapproved for the following reasons Permit No. ��'— 2 3 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ertificate of (Compliance THIS IS TO CERTIFY, that the;On-site Sewage Disposal System Constructed(--") Repaired ( )Upgraded( ) Abandoned( )by at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer L��eo� � d14ed aJ Designer Jo e_,W4 U-e d'r"O S The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Cl q Inspector ^�� e r- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS x1i6po.5al *pgtem Co6truction Permit Permission is hereby granted to Construct(4tepair( )Upgrade( )Abandon( ) System located at S2 '4s"I 41-t 4;r /2c� 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 ee}completed within three years of the date of this ermit. Date: �'" "// Approved by C t a4�zz,I'a 10/9197 NOTICE: 'Phis Form Is To Be Used For the Repair Of Failed .Septic Systems Only: CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) hereby certify that the application for disposal works construction permit signed by me dated / — /8- 717 ,concerning the property located at S"? /V.g ill,-- I ors lls meets all of the following criteria.:, ere are no wetlands located within t00 feet of the proposed leaching facility There are no private wells within ISO feet of the proposed septic system There is no increase in flow and/or change in use proposed There are no variiances requested or needed: • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will LLgl be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) B)Observed Groundwater Table Elevation(according to Health Division well map)_ 5-__ SIGNED: DATE: LICENSED SEIE'TIC SYSTEM MSTALLER CN THE TOWN OF BARNSTABLE NUMBER _ (Attach a sketch plat of the proposed system.Also If the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder.ceft Asir 1000 lv�l �h 90 1 LO CAT ION �'r SEWAGE PERMIT NO. V I l l%G,E INST LLE 'S NAME i ADDRESS d 4 w IF 3ER o OWNER �.� DATE PERMIT ISSUED _ s . � "�7. E�3 ®DATE COMPLIANCE ISSUED � �_ � - . ., �r . . . ,� �� C� _ ' ' � , . . � � I ..- _.� .. _ � -- � .� r Q ,� "„�� : � 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD O H EA ..A.-UN/V.................OF......... ... ............................... Applustinn for Disposal Works Tonstrurtion Vrrmit Application is hereby made fora Per ' to Construct ( ) or Repa- ( ) an Individual Sew Disposal ..... � �H61- Gcat a � - ✓ ..........nen 14 ...... .... q. 2� ........... Installer Address T ng Size Lot............................Sq. feet Dwelling—No. of Bedrooms........................................Expansion Attic (44 Garbage. Grinder ( ) Other—Type e of Building .............. No. of ersons..........Ze.-.:......... Showers — Cafeteria fir . YP g. .............• P. ( ) ( ) p' Other fixtures a .......................•..•.•.--•-••--•--......................-••._...•---•••.............••--.....-- W Design Flow........... .........................gallons per person er y. Total daily ow...,.)S;._................._............gallons. WSeptic Tank—L quid capaac,I �64e..gallons . Length :... . Width•.-�. Diameter...._=...... Depth....' x Disposal Trench— ........ Width.................... Total Length.........-.• ......Total leaching area......... ...sq. ft. 3 Seepage Pit No.......f.......... Diameter........1Z.... Depth below inlet...... ....... Total leaching area....,33-1k.sq. ft. Z Other Distribution box ( ) Dosirig tank ( ) . // 1.4 Percolation Test Results Performed by................. ..... Date........................................ ,.a Test Pit No. 1.. ....minutes per inch Depth of Test Pit.....,11....... Depth to ground water........................ Test Pit No. 2................minutes per inch. Depth of Test Pit.................... Depth-to ground water............... O Description of Soil.....-�J �=-- ..........�17� :,7................................................................��.... ......�� /'�........................................ ....... .. . V1--: -4°2R............... .----' ..................................-.....................-. . 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issued///�/�tf�h�e board of // J l.W. • .109f ............ . __•......•._ •q_. _ .___ •'� Application-Approved. ......... --- .. .... . ........................•--•-•----•----•-----._........-----. -- �� 7..... .......... Date Application Di sap .owed or the following reasons:................................................................................................. ......................................................•--------.--........._........0......................•••...-•••--••••--•--••••.....................••..---------.........D�............ PermitNo............................. Issued......_....................----......_._..........:.. r _ )THE COMMONWEALTH OF MASSACHUSETTS ABOARD O H-EA1 .._ _.... v n.'....'�..--...OF........ .0 *.A LE"_.._.........................• _ ` t Apphratiun for Dispnsttl Works Tonstrudion 1rrmit Application is hereby made for a Permit to Construct ( ) or.-eRepa Sy a (r) an'Individual Sewage Disposal o� i. . '/� i Loeahon ress �/� , C...•_ .• `1��/t/» /oz Lot .o» .� ••••» /` � /Owner, �........... •--+ Address fJ Gt r, / /� r /!' /7 l�s /J / l�s/ l/ a �..........» --•-----•-•-----••-•-----.....�...../...:...._... - -- ...1....----- .. . ....................�..... .•-•- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.....o...................................Expansion Attic (//f Garbage Grinder ( ) `4 Other—T e of Building No. of persons . QI Other—Type g --------•------•--•--------. Pe ------------- Showers ( ) Cafeteria ( ) a' d Other fixtures .....-•-•-•-•-------•-------------•---.......-•------........------............--"--...._..--•----•---------=........................................ Design Flow....... W ........................gallons per person per day. Total daily ow ,-.y�...........................gallons Septic Tank—Liquid ca acit _ti. .gallons Len8 l� Width._ �- Diameter.. .._.__. DeP —Disposal Trench—No..... .. 9........ Width................... Total Length . Total leaching area...................sq. ft. 3 Seepage Pit No.....:./.......... Diameter........ZZ.... Depth below inlet...:..:............. Total leaching area._..13..5..sq. ft. Z Other Distribution`box ( ) Dosing tank ( ) Percolation Test Results Performed by................. ...... Date........................................Depth to ground water........................ ok Test Pit No. 2................minutes per inch. Depth of Test Pit.................... Depth to ground water........................ a .......................I................................................................ - O Description of Soil.....1 2- ••••-- {�� .. :!�!� --•J! �i .................................................. ..- ...� �-. <'l'�!-fit r` ' •��' ........................................................... W - . x ._.........-••••-------••-._.....••-•-•-•-•-._......••-••-•••••-•••----•-•..............••--•-•••------.......-••-••--•••-••-•---.......-•---•---•--...._._.....__._....-----•-••-•-----•-.............. 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issued bbayl'the board of%ealth ig f/„ ,lf W/ram /J..G`'�__••...__..-. ... Application Approv :. .:-_ ............................................................... - --�'� � ...... Date Application Disa roved;0r the following reasons:.............................................................................................. ____..»_»» •- .....`... :......... ...................................._...............•--•--••••......._•-•--•-_..........._.••-••---•••--•.......•••-•._..... - ............ Date - PermitNo............................._....._.-....»......._ Issued-.................................................. _ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH _..........OF........... .!! ! .......................................... .t,. Trr#if irate`ivf`Toutplinnrr HIS IS TO CERTIFY That the Individual Sewage Disposal System constructed or'Repaired Installer has-been installed in accordance with the pro`sions of T P . 5 of The State Sanitary/UANTEE s de_ ibed•in the application for Disposal Works Constructi Permit No______________ ......._....... dated.. _...:.t .____.___........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A THAT THE SYSTEM WILL FUNCTI N SATISFACTORY. DATE..... '....�.. ......................... .......... i Inspector. �..... ---•-•----- ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD) OF HEALTH No171 ...... � .........................OF.... ..�.. ........................................... F d................ 0isXann nrks Tonstrurtinn rrrmit Permissioni hereby grante ..............•---•-----.•-••--•--••••-•--•-•-••---•-----...•--.._.....-••-•-••••.....•--...__...........-••.....»_.. to Construct ep�air ( ual e is oral System atNo...._ ......_....le..._..--• ... `... .----•......•-•-._...••--••-•-•-----••-••-•••••-_•---- -• ••......... Street as shown on the application for Disposal Works Constr ion Permit No............ .... ated.. _........ ..... .��........ -------•-----••-••----...•......... .... ........................................................... Board of Health DATE....................0 Ap ............................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS �-d1` f k 4 Q l L�-r I <1 \o a 1 �• Am Wa .. �Q p L1-.JE. LL.f '� .Y /000 P7/G 7f1NK. - N ` 43, SCco S,F OF ' 3o F. S, 6, Pf,kseD 3 .} ��,SN Mgssq f t. M Dww' i s S e,. �� _ FuDfu loi:o I. ASsLjMtrti PPnr� go cr*n �8874 ti t } AP_nccE ZIL . c,iaD�C� ul, �+ 'i u I �p� gR�'Q► k 3q � , EL=CO, - r r: LEGEND.� f EXISTINO SPOT ELEVATION 0�4 : .4 CERTIFIED PLOT, PLAN 1 EXiSTLNO CONTOUR --,- 0 --�— ��NoFM' Lv7 9 Asr) rVInF 47 s FINISHED SPOT ELEVATION ' : . . o�� A_ ' y� /yA k'S7wrIS /l') i. . FINISHED CONTOUR. . 0 g N - ' I N C ORSE y } ; AI0ROVED 14OARD., OF,' HEALTH No io9si o t �� t . xaDA E. AOENT>. `t �`� a Fssioy . � 3CALE� //_ �o DATE ` L,:DREDGE, ENGINEERING COt %N n1G CLIENT , I CERTIFY .THAT THE PROPOSED EGISTERE REGISTERED `- JOB NOf'y 'BUILDING SHOWN ON THIS PLAN ' 'J '- CIVIL ' .. LAND CONFORMS TO;THE ZONING -'LAW$ ` ;• ;; .I "IENGINE R Y DR,BY+ '` OF BARIVSTASL ASS. �cc a� K 712 MAIN STREET CH.'SY, J : ' 6.V3 tr3 _ .. 4 . HYANN I S, MASS. 2_ SHEET.Z. 'OF DATE R LAND SURVEYOR _ . 1 n.�.`��.;:t�a+wl�.:�n^,y w, ,at. w.. „ ,.„ 4-.��"1..w4..+,e.. .a r ,.J�4 �,y. .,h.o-yai..+,+{.MCr•n .. - 'W "ri'....'�,.«w.w°`w W.Y. ..kt .w r• ...,.... ....- ...-,........._ ..... -'»r .....t.w... ...aw.+a.: .w..acu.w✓.u.x .. ,y..N.;,r„ t N 0TF /F E/THR TsIE SEPTIC TANK OR , +w PS p*- T ARG'' MORE 77NA"l /2"8EL01V' ,, s4 �T_ ri>r . _girt BRA OE,A 24'!//it M E T.FR C'ONCR E T� CO vEA SNAGL ®E ®.Q000iN7* TO GRADE.`,-+,t/ + w 'PYC J'IPL 14E,4VY CAST /RO/Y C o CONGRl'r'R ,y/N- P17Ct1: 1F//V OR/✓—=WA Y' L l:0 3 COYERS is ,W FT .r +•.. 2 sus n/iA/. CONCRETE _ G .�Dd CO iiER CL EAw SAN L7 �� ,v—, 4• 4. eAC:fF/LL f - _ �S p GsAL..; - . , •. t • • . s • •• • s 40 WA S YeO'STGNE /dll1V.O1T141f Q/ST. • • • • • • • • O s a PER fT. Sl=PT/E rAM • • • a. DX � • • • � • • • • se .•• �, +'`�* r F ,. •o ' • • •EFFECT/Yff •� • • 3 4 • • •• • DPPT19t • • • • • ' : WASXFO STONE ~ _ F D s i • • • ! • • 1 1 o e • PREG45T a0 `..t p c;.. ;t ly, rl,p F •S: f O i♦ . • • • �at' f SEA-9 G Gr -.77 C x, - r/6''»cF� JAY s . • • • • o • i • i a • o P/7 OR ZVU/V, &A4f, C.-may a• /0 ®/A1M- CCad TADUL.ATION, lIS►LfT .S�pT�"Ti4X�t' 9 9:&�' �: ®LtT��T .SE �'lC Ti4�NEf • - �- •` �r-� - GROt�NO= �tTER Ti�3LE ` ,o - lJ4t/�DI$TR/6ElT! EGTlt3� - 11lLET L8''�9 IJ1K �tT ,F7Czi T TA&ZALArAC 1� LEACH1 .�ary�.•.joy f NS DIES- GARl�AG.�'OISPOSr4L UX/T 114SO�L' TOTAL JN 336. G.4t/a4-e SO/L TEST,*/ `: Sa/L.TFSTO . 14lUM8f�P L,fAC1V/NG.P/T3_ tr1L"Y. /" A �EL&Y. Q4 r OF' .SOl,L TEST SIDE LEACHING PER P/T .Mi AT. p _ Z RESULTS Jvl-r"gSSgD BY 3oTTOM LE,ACH1NPs PLsR P/T._Z .SO FT. Lea.M PER COLA r,10M AATg At/ LESS IyIAS/!lVCM sug.so 1L FfERCOt.•1T1DN R.�TF 1�2 TE-!R� l+jl/v, lNCN TOTAL LEACHING AREA s4- FT �ESERtiE t EA[WIN6 ARE.!► SQ. FT. ca• �Il... TEST K�•� :" A - 3Q�o is P\'(NOFM{ u / ,��vi�J /-or A�of �� ac S N f� /v1/� A 57 T-0 nos /�1 /�_L S Al tip, aORSE y 0 No.0951 0 EL.DRE®GE ENGINEERING CO,J/1/ 24874 'Po �G/S Y 6P �� CL. 71 Z "A 11Y Sr. 1r/YRNN/S• MAS1, �Q�sTgo� �F� /DNA\-ca� NO Cv T0VWo kV,4TE14` lrNCOGINTL�Rgo LL/ENT: N� SURD •„� ® r•r�4 v�:✓c' DRTE : j, Q Gm UND yv-.4 AT Ez-- J08 NO.• $3�3 SHtET �- Oi� z