The URL can be used to link to this page

Home My WebLink About0245 ASA MEIGS ROAD - Health 245 ASA MEIGS qV,� MARSTONS MILLS A = 030 088 I r - t TOWN OF BARNSTABLE LOCATION A se, Me.t 4 S Rd SEWAGE #-d®1 ' VJ VILLAGE ASSESSOR'S MAP & LOT OV g r INSTALLER'S NAME&PHONE NO. CCU �A \7 SEPTIC TANK CAPACITY L 6d 6 GC L k f S !�2 ac 7r LEACHING FACILITY: (type) 3 CU 1' (—C .?.76 J. (size), NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet'" Private Water Supply Well and Leaching Facility (If any wells exist n/I on site or within 200 feet of leaching facility) 4 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) /I/ Feet V Furnished by ++ 2` '� J v Ma SA 3 (36x a� LOCATION SEWAGE PERMIT NO. VILLAGE -T INSTALLER'S NAME i ADDRESS e U I L D E R OR OWNER DATE 'PERMIT ISSUED /ZZA DATE COMPLIANCE ISSUED +w a I _ _- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Miopogal Opotem Con6truction Permit Application for a Permit to Construct( )Repair( /Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot N /r Da(43Y �/n< Owner's Name,Address and Tel.No. i 1 ` " i 3 ��es C Assessor's Map/Parcel r � �q" L �l Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: J Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(�J 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 \ cs 0C C3 Type of S.A.S. Descripti n of Soil; 4 k Nature of Repairs or Alterations(Answer when applicable) 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 issue y this Board of Signed D 41 k Zo I Application Approved by 2M ✓ Date ci "�Z- 7-0— Application Disapproved for the following reasons Permit No. Date Issued (a — Z —d e* x !. Fee �. ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes • 01ppYication for Miopowfl *p-5tem Cou5truction Permit Application for a Permit to Construct( . )Repair(-/Upgrade( )Abandon( ) ❑Complete System' ❑Individual Components Location Address or Lot No. Owner's/� �^S �`j Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building:Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder J)o Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date '" E_ Number of sheets Revision Date Title Size of Septic Tank ff `` t 0�,'4 G G GGt Type of S.A.S. Description of Soil \CJ" C T3 U W Nature of Repairs or Alterations(Answer when applicable) 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 issued-by this Board of a�lth�— j Signed Dates/-� �6 Application Approved by Date tL Z 7-0 1 Application Disapproved for the following reasons Permit No. 7i0'V 1 I9 Date Issued o 0 ----------------__--_—------------------- THE COMMONWEALTK%,OF MASSACHUSETTS BAR NSTA;1i,rMA`SSjACHUSETTS Certif rate of Compliance THIS IS TO CERTIFY, that the On-site/Sewage Disposal System Constructed( )Repaired( 4.,upgraded( ) Abandoned )by `NJAP,�� at � A<, (� f"-NCnF-C�r� n^ Ahas been constructed in accordance with the prov tons of Title 5 and a for Disposal System Construction Pe t /- j dated z 7'1 t Installer �'� N Designer ~ s� The issuance f th s permit shall not be construed as a guarantee that the system will function as designed. Date Inspector Fee J# THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi.5pooat bpsStem onotruction permit Permission is hereby granted to Construct( )Repair U14grade( )Abandon( ) System located at �S �^ .CGi� 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:EConstruct�n ust be completed within three years of the date of this pe> `t. Gib Date: Z 7/ / Approved by 1i6i99 e e . NOTICE:,This Fo:;rm Is To Be Used For the Repair Of Failed Septic Systems Only. - CER=CATION OF SKETCH :-`TD .APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERNEIT (V�TFHOUT DESIGNEI}PLAYS) :ebv cc=—y that the application ` ". nor disposal worms construction petinit sinned by the dated �� C CD conce,ling the property located at meets all of the L/ following criteria: • The failed sysenl is conneV ed to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classined as CLASS I and the percolation race is less than or eaual co 5 minutes per inch. • There are no wetlands within 100 fe`t of the proposed secdc system- • There are no private wells within 1140 fe`t of the proposed septic syse:-n • There is no increase in flow and/or c.lmnge in use proposed • There are no varianc=s.repuested or needed_ • Tne bottom of the proposed leaching facility will not be located less.than five fe_, above the maximum adjured groundwater table ttlevranon. (Adjust the groundwater table rising the t imptor meshed when applicable] • if the S.A.S. will be located with 2-�0 fe`t of any vegetated wetlands,-Lhe bloom of the proposed leaching facility will net be lccated!ens than touneea(14) fee;above the ma.,(imum adius:ed s-oundwacer table elevation, Plea a complete the foilowin;: A) Too of Ground Surface =!evadon(using GIS information) ! y ' B) G.W. Elevation =the vLA_<. -igh G.W. AdjusLtnent DEFERENCE ?,and 3 � 6 SIGNED D A TE � V6 (S'setch proposed plan of s.se:n on back, a �� iS� 0 D WON,- FOW M IM . . ............ 7 LOCATION SEWAGE-# OO I vj`7 GE �ASSESSOR'S:MAP T INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY (=,C)c> og LEACHING FACILITY: (type) (size) -M;OF>BE D ROOMS BUILDER OR OWNER \t-,rA- e-,-s v�, r PERMITDATE:---6/�-17 jI� CE DA : Separation Distance,Betwee h the. ,y _4. Maximum Adjusted Groundwater Table to ifie"Boftom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wen s exist on.:.site or:'withifi-200 feet of leathing faciliy) i Fe et. Ed f Wetland:and Le Edge;of aching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished b y re X Q fib vo SEEMS SEES■■■ Ma ■ ■ ■ EEEEr.■�QEMM�r_M MEN■r■IM�IG_1,ERON ■r■■■EEE ■ ■■■ EEM■■E, M■r■E■■■■ MEMMML1I�l�lEOM■ mom SEES■ OOO■OM0�1 �!l�Hum ■■ MEN Sone ■■■■■M■■■ Mir■■_■i®EMS MMEM■■■MEMM■M■M■■ ■■■w man�►r��m�®0 airs no M■■■■mom MM■No NO mom SEE ME i■ MINE IN ■G�i IOM■MM■M■■■■■■E■■i5 ■■■■■■■■■■■■■■■■■ ITA No 14 ME 14 .14 oil ■■ ME No MO NONE E■,2■■1 IE■EMEMMSM®i� ' SENSE ONE mom IN 0 Epp" 0 SEEN a ■E►.■r�■■E■■ear■■■Errr�sMM■MEE■E■E■■M■■OEM ,ry IO■OOO �l�MiO■ Si�■E mom EEE■EMEMO ■■■OE■■ CrwiiMlM■■EJ■ MEMO■O■OM■■MOO■OOEE FFz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . f .............OF......................................................................................... OV ............... Appliration for Uhiposal Work,5 Tonstrurtion Vrrmft Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal S tern at, V.,j Wa.... '.. .. .........------ ------------------ .. .... .......... ......................... .... ........... Locaf. -'AM--r---- ------- ily , d or Lot f 1 .2 P,,( I ra Ct .............................. .................... ........................... ....... .... ...4.., Address ........................ ............. ........... ......................................... ........ ...................................................... Installer Address U Type of wilding Size Lot..?P:2.6'"4------Sq. f Dwelling—No. of Bedrooms..__...................................Expansion Attica) Garbage Grinder 0) Other—Type of Building ............................ No. of persons............................ Showers Cafeteria 04 Other fixtures ...................................................................................................................................................... < Design Flow.....___...X.d— W .............................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacitv_&!�P..gallons Length__?.'.(....... Width..,I/A...... Diameter................ Depth... 4 Disposal Trench—No. .................... Width................._.. Total Length..................._ Total leaching area....................sq. ft. Seepage Pit No....... ................... Diameter..._................ Depth below inlet.................... Total leaching area..................sq. f t. Other Distribution box Dosin Percolation Test Results Performed by...... ................. Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit......J'2........ Depth to ground water.._..._....._........... Test Pit No. 2................minutes per inch Depth of Test Pit................._.. Depth to ground water..._._...._.........____ .....................................................................................................................................................I........ 0 Description of Soil........................................................................................................................................................................ x U ........................................................................................................................................................................................................ ..............I........................................................................................................................................................................................ 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 TLITLU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in op ion until a Certificate of Compliance has beei.ssuedl..by t1fIC" of I iealth. j Signed-------- ....... . .-. U, — ................................ ................................ Date Apication Approved By................................................................................................. ........................................ Date Application Disapproved for the following reasons:............................................................................................................... Date ....Permit---, - -...N... -----------*----------- I-s-*s-,u--e--d-.-.-.-.-.---.-.-.-.-.-.-.-.-.-.-.--*-. .-,*-*.-.-.-.-.-,--.-.-.-.,.*.,.-.-.-.,--.*.-.*----------- Date THE COMMONWEALTH OF MASSACHUSETTS 7 BOARD OF HEALTH Application is hereby ooule for u Permit to Construct ( \ or Repair ( \ an Individual Sewage Disposal /_., r 4 a W 1!�.a%&t V_0.9---fL................ .......... L-, PW 4,tia .... ... ......... VL ... .. .------ ............. ........................................... s �� X . - Owner- Addres ............. . Installer Address � Type cfBuilding Size Lot.A%.�L�L�........Sq. feet Dwelling--No. of Bedrooms--��................................Expansion Atdcw, ) Garbage Grinder Other—Type of Building ............................ No. o6 persons............................ Sbmw,zu ( ) -- Cafeteria ( ) 04 Other fixtures Design Flow.--.. ........................gallons per person��`duv Totaldu�rflow-.--.---------. 04 Septic Tank—Liquid ��.�,ulooa Length-��.�.-' Width..--.-- Diameter................ Depth..`O .4-. Disposal Trench--No. ..................... Width.................... Total Length.................... Total leaching area....................ug 8. > Seepage Pb No-------/-'--. Diameter.................... Depth below inlet Total leaching—area,..................sq. fc. Other Distribution box ( ) .,�� ' ~~ Percolation �u� Results Performed by-.Test ------. Date------------------- Test Pit No. l................miootcuperiuc6 Dept 6 of Test Pit.....��......... Depth to ground water 44 � Test Pb No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wuter----..----. 1:4 ---_-.-------'___-_--_----__'__'--_'-_-'--_------'_------'----_-'---- �� o6 So Description _'''----'. � Z ----------------------------------------------------- ......................-------_--_--_-_-.--.----__--_-'-_-_---_-_'____- � �� Nature of orA1�zudooa--Answer when ' ......................................... --_--_'-_-.--_--_ ____-_---__-.—.-----_-_--__----.-----_-____._ � Agreement: � The undersigned agrees W install theufore6escribed. Individual Sewage Disposal System in accordance with the provisions of T I T LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in ope;;atkon until a Certificate health QPof Compliance hasjbeeissued....by of- "-' _ - ------oDate"' p,--- -' '""'-v-- -'-''-'----------' --- ---------'---------'- -�_--------------'---- Date Application Disapproved for the following reasons:.............................................................................................................. - ......................................................................................................................................................................................................... Date PermitNn........................................................ ....................................................... Date -� - THE COMMONWEALTH oFxxAesAo*ussTTs BOARD OF HEALTH | ................ -)� ...--0F....... ................................ | 9rdifiratr of atta . THIS IS TO ETIFY, Thatthe Individual Sewage Disposal Sys V. m constructed or Repairedhas been installed in accordance wi7th the�pnrvisions of TIME 5 of The State Sanitary Code ays de 'b d * the THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE S A GUARANTEE THAT THE SYSTEM WILY ION SATISFACTORY. THE COMMONWEALTH orwAssxc*ussrrs 130AR- F HEALTH | | °~=� --��"^��---X�F- _-------- Foz _.......... PermissionDthipim ~ �K� . �t '-_— _ -_ _ ----� to Con 0 Repair !an Iividual SpWage Disposal S stem Street as shown on the application for Disposal Works Construction Permit No. ated....... Ar ............. Boar DATE................ .................................. ronw 1255 A. w. ovLmw. /mc. oosruw 5►►�G LL- - ► � B I~D R o o M F A N1 Y /� Z±? ff ►,ID GARBL�G6 G�NDE2 / 3 Dia►Ly F P. p II rjEPT%d'TA►JK 33ox15o% -- A 9 6.P u5E- I000 GAL. o15Po5nL. PI"T' u5E Ivoo GAL.—, 9B 5►DcwAL� AeCA ►5�S.F 9a o •~ � 37 Jc 6,PQ �bP. BOTTOM AQF-A- 1`� 5F• f�r7. ! Sp S.F x 10 = 5o G,Pp. � 98 • y� � �9B.G II I •TOTA1.-. 06.51614 = 425 G.P. D. (U 'TOTAL DAIL. ? F\-C>W - 33oG.Po, IV• j PE2CoLAT►Or�FZATE : 1"IN 2MIN ot`1.V=55 AV 97 Ai NOFt„ Z 'v r� t WILLIAM ,,�;•- O ALAN C. c :N Y E ` '7. joNES hl Z9 Zlilr 151uo 'PF o. 19334�p4 AHD Su�v� i TOP FND=loo.o 9�.5 FG• �� 1►w• 9�.s i� .C�sA�►'1 s loon lNV• . . SvQ�o/L 66T. INS. SEPTIC z,/� IOpo INY. T.AMK PIT pIMV. INV. WIT14 9S / SAT 1�3/9 I Vi R 6,eAVE4 WASUGD 6Tv h16 ' CER.TIFIGD p1..oT Pt_AtJ /3 PRUFI �� L o c A•T►o N BS..S NO SCALE `jcALE c pLP.N REF trcZErt GE j CERTIFY -THAT 'TNEP�POSr-D �ISc.SNowN I NE2 EO N GOMC�L`(5 Y,I ITN Z HE S I DEL 111 �G T Aug SET�AGK R,6C�u►R.EME.N't'� oF -tµ� -to W N o'l= BAZNL1 -raT3LE---- A Nv I s Nor ,I3l�Z yy lc�5. 79 L.00P.T P -WITN, 1a oaD P N D A"T E I BAxTEQ.e tJ`(E INS• REGISTE.Q6U LANDSuIzv�Yoes Tu15YPLtar.l 15 NorT 4n5�U oW 06TGP-V1.L LF-- • �KASS• I W 5TR.0 M E N'r S u 9-V e y IF, 4 h F5 ET 5 NOT 5E 'v5EDTo C7ETER1^0,4 LoT LINES APPLI CA,►-J