HomeMy WebLinkAbout0041 BAXTERS NECK ROAD - Health 41 BAXTERS NECK RD.
MARSTONS MILLS
A - 056 078
E
TOWN OF BARNSTABLE '?7
LOCATION ` ' + / ;i�L V� t SEWAGE # '
VILLAGE �`�la�lS s" �� _ // 0�
1, � ASSESSOR'S MAP,&SLOT fO� I
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) / ,�`� (size)
L2 G/J�1� �.
140. OF BEDROOMS e
BUILDER OR OWNER Ci l�
PERMITDATE: COMPLIANCE DATE: Do
C
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
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
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lk ONW Lffl ®F MASSACHUSETTS
0 Board of Health, Barnstable , MA.
APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for a Permit to ConstructK) Repair( ) Upgrade( ) Abandon( ) - X)Complete System ❑Individual Components
Location Owner's Name
..1 41 Bax D. Scott Horgan
Map�areel# 56/78 Address 30 Cit Ave. Hyannis
Lat :1 Telephone# 7 7 8—6 9 41
Installer's Name Designer's Name The BSC Group, Inc.
Address Address 657 Route 28 , West Yarmouth
Telephone# Telephone# (5 0 8) 7 7 8—8 919
Type of Building Residential Lot Size 4 3 ., 5 61 sq.ft.
Dwelling-No.of Bedrooms 4 Garbage grinder ( )no
Other-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
Design Flow (min.required) 440 gpd Calculated design flow 4 4 9 Design flow provided 4 4 9 gpd
Plan: Date 11/19/9 9 Number of sheets 1 Revision Date
Title Sewage disposal system design
Description of Soil(s) See Ulan
Soil Evaluator Form No. 11 Name of Soil Evaluator M. Pe tr i n Date of Evaluation 11/17/9 9
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to ie- e
a abo cribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a ees to not tost %operation until a Certificate of Compliance has been issued by the Board of Health.
Signed Date
TOWN OF BARNSTABLE
LOCATION Z/7�'� to � i let:L\ SEWAGE #
VILLAGE !zo/
` _ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. J _2-ri "'it�s
SEPTIC TANK CAPACITY
LEACHING FACILITY. (type) r' .'L1 c1 i�t��'.:� (size) ! X S S
NO.OF BEDROOMS t
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
j r
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
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
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or
No. { ! 'Far FEE ( c
COMMONWEA
p� Board of Health, Barn stable MA!
1 APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERM, IT
Application for a Permit to ConstructX) Repair( ) Upgrade( ) Abandon( ) - 11 Complete System ❑Individual Components
Location 41 Baxters Neck Road Owner's Name D. Scott Horgan
Map/Parcel# 5-6%7 8 Y
Address 30 Cit Ave. Hyannis '
Lot# 1 Telephone# 7 7 8—6 9 41
--Installer's Name Q C Designer's Name The BSC Group, Inc.
Address t ;_ Address 657 Route 28, West Yarmouth
j Telepho e# Telephone# (5 0 8) 7 7 8-8 919
—Type of Building Residential Lot Size 43,561 sq.ft.
Dwelliriig-No.of Bedrooms 4 Garbage grinder ( )no
Other'-Type of Building No.of persons Showers ( ),Cafeteria ( )
Other Fixtures
Design Flow (min.required) 440 gpd Calculated design flow 4 4 9 Design flow provided 4 4 9 gpd
Plan: Date '11/19/9 9 Number of sheets 1 Revision Date
Title Sewage disposal system design
Description of Soil(s) See plan
Soil Evaluator Form No. 11 Name of Soil Evaluator M. Petrin Date of Evaluation 11/17 9 9
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to installe abov'es�bed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a e to not to eat" cyst operation-:until a Certificate of Compliance has been issued by the Board of Health.
further aVe to not to e,
Signed C:-..' Date
d
No. COMMONWEALTH OF MASSACHUSETTS � FEE �o_
`
Board of Health, Barnstable MA
CERTIFICATE OF COMPLIANCE
' Description of Work: ❑Individual Components) Complete System
The undersigned liereby cert h t the,Sewagge/I Sposall System; Constructed ( epaired ( ),Upgraded ( ),Abandonedat
( )
k
has been installed in accordance with the provisionsyf 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
application No.���r �_:-dated /— d" !\ . Approved Design Flow% I (gpd)
Installer /f
Designer: Inspector: /1 &at,�:
The issuance of this permit shall not be Iconstrued as a guarantee that the syst funcfion as designed.
No. / J FEE
COMMONWEALTH OF MASSACHUSETTS
ge
Barnstable J �r/
Board of Health, MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
l 41
Permission is hereby granted two; Construct(�Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system
at �/ lswk 4"1 /'l/< i&911 1141t- as described in the application for .
Disposal System Construction Permit No. / / `* , dated
Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA+ Date Board of Health
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•______J_____________J____-__—J_________-__L_________J � fN[FT NUMM@
11/16/1999 17.00 15067786966 BSC YARMOUTH GE 01
Ir
t 'Town of'Ifsu-nstable IIa
Deportment of I ICU III h,Safely,1111111 Envir0um0ulal Services
�a{(( l'llblic Hehllh Division Dale j
9' 767 Main Snect,I lyamis MA 02601
1 ■�nNKAblx i � /!t ����
re,s
o,A1d` Unlc Schedule) 'Time U/ Fee I'd.
Soil Suitability)Assessmeat.far Sewage Disposal
I'erfannedlly: N►i1F1AEL PF-ref�4 Wimessedlly! 0614t 1A �-A �-pJOKA V 1
4/�1 OCATION&(;I.NI;t L INPORj UN
IocalionAddras I 8AXTEIz1C Owncr'sNenle a L UELOPMi;I,ET
MAfmws ml Address 2 AVTUMtn LANE
Assessor's Mals/1'arcei: 4p linginter't Nnmc
KIS?AN R:A`Y
NIiWCONS'f1111CTION� nrPAIR TelephnneA SO ttsl
(.and Ilse yjo o V F� Slopes(°!.) Surface Shines / h E
Dislances Guol: Open Water Body 11 Passible Wei Arco 0 Drinking Water Well f1
Drainage WAY II Pmpcwy Llnc 11 Other 11
SKI:I CI I:(Select same,dimensions or inn,exact locatiuna orlest hales&pert tests,locate wellnuds in poximily to holes)
DUTWA5(i >
I'arsta wntcrini(gcolagic) DtpIU to Bedrock
Depth 11)Gruwldwalm Standing Water In Ilnlet Hope 1Vecping from 191 Pace H b N E
Estimated Seasonal I ligh OrOunJwpler 1
DETERMINATION FO12 Si ASONAL IIIGIi:WATER.7'AI),LE
NklhoJ used: . ...
Depth Observed standing In ail.1101t: in. Depth to soil mottles, In.
I)cplh to weeping from Ilde of oils.hole: In. Gioundwarer Adjustment R,
In.1cx 1VA 11,• 11rading Date: _-•_ Index Wcll level. _ Ad,l.factor._Adl•Otoundwaler Level_
PE-11COLATION TCS'I' llJ Illa9rlm°II%`45
1 lbscrvalion
Ilule B �p — 1'Ime at 2g GA-- 1f4 15 14 1
Depth of Perc 6 1 Time a[6"
Slod Ilse-suak'fime @1 .4 Tine(9"-6")
rod)•rc.snak
little Mill./Inch L 2 K%,4 H `1
Site Si ilability Assessment: She fanned_� Silt hailed: Addhiunnl'1'estiug NeedcJ(YIN)
original: Public Ilenuh Divisioln ohsel-VAIJoll Ilole DUN 7'a Be Compielyd oil Pack j
Copy: Applicant
11/16/1999 17:00 15087788966 BSC YARMOUTH PAGE 04
b1�L1'01351.1tVA,'1'tON 1�0(,1 :LOG.Ucpl6lirml Snit IIorIUm Sull'rcxlum IIo1C#
Sudhee(in.) Snal Color Soil hUler
(l1SbA) (Muusell) Moulln
..�__ 6 (Slnlcoue,tilouex,Ihndderea.
ei
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0;t�,i6 --5SA t� d 5 Nogg
26-�Z - -8 LOAytAy �.5 r 676 -t4-01-5
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DEEP OBSERVATION HOLE LOG Ilolc#5�-2
1)gdh linen Soil llmixun Snil'I'esurrc
tilfl l'14C(in.) Sail('olor Sbl1 Other
(1151)A) (frlunsdb AtoIlI61
_ 8 (Slrucuoe,Slimes,tlauldcrcy.
_-7 _ '
toy 3��
— - LOAK
GtAtx
DIN P.O13SERVATION II0I,1;LO(+ Ilnlc#
Depth renal Soil Ilorizon Soil'Ittauc Sull Vofor Snll Ulba smplcc(ia•) (I1.SI)A) I�IunsMq Mg11Hn
__`__ 6 (SIrUUmc,Slnocs,Ilunldcres.
DE MP OUSEWVATION HOLE IOC 1-I011:#
I)cplh holm Soil Ilorimn Soi1'I'exmre Sull color Soil Usher
Sor(nce fill.) (IISUA) (A4unsclll A9ollling (Slruchim„Blanes,Bold-lams.
- s:wttistclls.Y.11.SilaYsll—_,
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Ir oll ,>SurAnee Rnle Mn1z Z S OOC>( 00
Mime 500 yew Mond bnunrinry No- — Ycs )1
Willlln 500 yenr Immulary No Ycs
WOhin 100 year flood buundary No Ycs�-
1slllkaLINIJItt ' y OcClICUIl -Y' ILUaLultll
Does at least four feet of nnturally Occurring pervi ws materiel exist in all nrcas observed throughout the
area proposed for the soil absorption system? Ra_
If out,-lint is Illc depth of nalurally o6ca ing pervious Inalcrinl')
�srl'll'fl&fll-tI 1
I cu lify flint On 10 L 12I OIL wnlc)I hnve passed flit soil evalllalor exnntanalion approved by IIIc
I)eparinietit of l;uvirotlmcnaei PrOlecH011 anti Ihnf(tic above nunlysis Was performed by me conskicil(Willi
16c required training,expertise land c pu�ic Ice described in 310 CM It 15.017.
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