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Home My WebLink About0315 BLACKTHORN ROAD - Health 315 BLACKTHORN ROAD , MARSTONS MILLS -' A= 032-012 4v o.... THE COMMONWEALTH OF MASSACHUSETTS +� BOAR® OF HEALTH ....... O F..... ....................................................... Applirathin for Disposal Works Tonstrnrtiun Frrutit Application is hereby made for a Permit to Construct ( ✓f or Repair ( ) an Individual Sewage Disposal System at.: . ............... •- Lo tion-Address or Lot N ,/ � Owner Afldress ,W1 ..................6C. ........�I:L_-�___4� ..................................... ---..._^__._._...---------•-----•---^-----............----------•------...-----^---......------ Installer Address UType of Building Size Lot__�_9?�R..........Sq. feet Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No, of ersons____________________________ Showers a Other—Type g •--------------------------- P (--->._— Cafeteria (---->- Otherfixtures ------------------------------------•---•------------.._..--------------- W Design Flow.............. _......................gallons per person per day. Total daily flow_______.`3___3O._.____...____.__._.__.gallons. WSeptic Tank iL Liquid capacity_ P. _gallons Length................ Width................ Diameter Depth................ x Disposal Trench—No _______ Width.................... Total Length...... ........... Total leaching area....................sq. ft. Seepage Pit No.......... Diameter._J_0........... Depth below inlet..... ........... Total leaching area..................sq. ft. Z Other Distribution box ( / ) Dosing tank ( ) ~' Percolation Test Results Performed by........ Date........................................ 1.4 Test Pit No. 1................minutes per inch Depth of Test Pit_______._____.____._ Depth to ground water......................... 04 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ---------------------------------- •....... -•------------------- •-------- •-••--------------- --------- ------------------------------- ••------------------------ 0 Description of Soil........................................................................................................................................................................ V ...............•-•-•-•--...._.....--=---•--...__......---------------------•--......---------•••----•----...-----------•.._..--------------•-------------•--------•-•------.....•--...----•-------------. W UNature 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 TIME4 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 the board of health. %*f/ Signed---•••---__ �r2. l ''�''�L �� 1 -_. ..._ Application Approved By.....: cY .... D/�D�at�----•-•- a Application Disapproved for the following reasons----------------------------•----•----------------------------------------------------------------••-••------_-- •------•-•............................•--------------------------------....-•----._......._..--••_...__...---•-•---------_----------•---------------•--------------•------------•-.--------•------_-_•••- Date Permit No......................................................... Issued f' -J Date ........ ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF flEALTH ...........................................OF......................................................................................... Appliration for Uhipaiial Works Tonstrurtion JIrrmit Applicaiibn is hereby made for a Permit to Construct ( �or Repair an Individual Sewage Disposal System at ................. . ......................A L ti 'Add 't ............................................. ................. I....................................... 4t� U .1Z Ik 7 4--t C-I(- /) X 61,077 &r ............................t........... 0 ner j ---------------------------------------------A-1dress .......................... ................................................ .................................................................................................. Installer Address Type of Building Size Lot__� ----------Sq. feet U Dwelling—No. of Bedrooms_______________.P........................Expansion Attic Garbage Grinder 9k Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow..................W......................gallons per person per day. Total daily flow._____._3aQ ..........gallons. -----------*.....1:4 Septic Tank LLiquid capacity.1 04-gallons Length________________ Width___._.__.__.____ Diameter___.___.________ Depth__.____.._____.. Disposal Trench—No -------------------- Width_____..___._.___.___ Total Length_______ ... Total leaching area....................sq. ft. > Seepage Pit No-_________ ---------- Diameter...1.0.......... Depth below inlet___. .... Total leaching area.................sq. f t. I Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date____....______.____________.__.._...__.. Test Pit No. 1................minutesperinch Depth of Test Pit_____________..__.._ Depth to ground water________________________. G%, Test Pit No. 2................minutes per inch Depth of Test Pit._-__._._._________. Depth to ground water.______..._._________... P4 ............................................................................................................................................................. 0 Description of Soil..............................................................................I........................................................................................... x U ......................................................................................................................................................................................................... ....................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable........................................ ...................................................... ...........................................................................I........................................................................................................................... Agreement: The undersigned agreer, to install the afored6cribed Individual Sewage Disposal System in accordance with the provisions of T I T IIE 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 the board of health Signed.. . ....... .. ........... K1�0_Yj Da ........ . . .... ............................. .........Application Approved By.._._- --------------- Ka Application Disapproved for the following reasons:................................................................................................................ ....................................................I................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . —& P_ ...... N....:.........OF.......:........!.... ........N.S r.......A:q!��............................... (IrrfifiraV jaf 09-nutpliattrr THIS IS TO CERTIF--I, That the Individual Sewage Disposal S'3_l jstem constructed or Repaired .Ir e-A/ by.........." ....... ...................................................4� ....................................................................... Installer R. at................SfC.�..................73u/vz- .................!Il..................I.................................................... ................................................................... has been installed in accordance with the provisions of TITj;E 5 of The Sta4e Sanitary Code as described in the application for Disposal Works Construction Permit No-------a..F--0---------5...e----S............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS UED As A�GUARANTEE THAT THE SYSTEM WIL�L FUNCTION SAT SF.ACTORY. DATE............ ................................. Inspector........................................ ......................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ;P'O J A AAN�7-1 Re S85OF...... ...B ............................................... No...... .............. FEE........................ Ubposal orko Permission is ereby granted.........A i�C.A.............&VIV.ZIA.................................................................................. .,h to Construct or Repair an Individual Sewage Disposal System ....................................................................................................... at No.............. ..........�!2Prr,4AJr---------- /L4 P4 Street as shown on the application for Disposal Works Construction.Termit No..................... Dated.......................................... ----------1-1/tol-W------------------------------------------------- BKrd of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 41 * � y ,, A.Z .r ,,' r... ,�.. - ,♦ �,.tom i sF� - � s�wbSA a yW 4' r f � yw 70 C 4- 2— y ,1 L !ter �t 42t tv 1t� e ti =,4� r� r� �F•7/ �: r � �\ tit. "j,� k�� t� ,x . ND �' •�. i£'G "�#��4 M � 1\ `�� RV s r �n ��¢ �N'.�1F'fh M J r , o at is SG 7� 4�tr t Vf 13 $'r f U^,, f•PI,S T, QO� 'J s ,.: ml F2 t t,> + '.q�yy:•$ ` 4 L./ 7 c�/ !' r _ M -•�'+, b5t� ta'rL° ,:r ake a r axpiys u s ffoL� •. t a �a 're., w 6 -4vY - XP � `x�. r Sl0/y f .`! /o'. c� ]ROBF_RT ' m , . - _ _ �` I .?iT U SUNIKIS to Al—� 3 /5z; 3 7 A No-zzis2��o � 1 9ocF�,GISTEP �a�� SJOMAIL . }> i LEGEND r XfTtN.Q ,SPOT ELEVATION Ox0 CERTIFIED PLQT= =�nfLA .N 55 '~ : 2 A 4 Y tX),$TJ CONTOUR - - 0 l-vT Il 7-h�7-7-E-le s � 3� x tN r`S i E°D ,g PO T ELEVATION 10 0] 17� 7-0/✓S' '/'I 14-:Lr 7 . IN',SHE CONTOUR : IN p - �. . ROVED , BOARD OF HEALTH � DAXE; ..,� AGENT ' _ SCALE ! �ir_ 40 DATE` R6r � .� f. 1REDGE ENGINEERING CD. CLIENTJ .._ I CERTIFY THAT . THE PR"bt03EQ�, �£L {'3EG STEREt�'. REGISTERE'D1 JOB N0. ADD /Z_ BUILDING SHOWN ON THIS P. AN LAND CONFORMS TO THE ZONING "LAWS F £J.Y I L a I. .A eft_ 4 SURVEYORS) DR. BY .= �/F BARNST BL S.jE'NGINEER � . rAN S 712 MAIN STCH. BY,ti, MASIS. HYANN1S MA�� r SHEETL OF A E REG LAND SURVEY4fl . 4 ��a p 0 W Q r7C'7 GO CR r VIA AlF 74re FM' -)P-,eA A41. BE aJV0&adYT,7-0 4RA' Z;,,=. VC, P� CJRC'. F V Y,,CA 5 7-/A 0,1V 0 �i Z- DE U S A/rc AVA j-;R1 VA--4 dr, CC) &A CA-,,C*l Z-L- C 'LlQuID LEJ�'.I- 11L *L6 ! R 4" CAST LAYER IRON )=PlpZ t C) OF /00 GAL. 2 11 C, D157. - o a •f 0 WA 5 HeO 5710NZ- !4 SEPTIC TANK Q�i �i :.., o � o e 1 1 •EFFECT/VE •'!�' •� 3�4. - � �I2„ '� D STONEWA 5) h:.l. 5 1 r p , --py4;�,,EcA5 r 5,E--RA 6 f- P 92-.0 ,1Al;1E,RT AT ff411LAQ1,V& /00. r 6 j=7. P1,4M. 7 hVY-ET SEPTIC TANK _99,,5,-27 -7- 014 M, OlJTL ET SEPTIC 7-,4,V.I< --9�F7- if /,vz rV/57W1,04710v Box 99.0 =7 GROUND W T- ? TABLE 04IrLETD15TR1bs UT/UN BOX 96.9 FT. SH711OC FT. 5ENVAG,=- A915,400-SAL SK57747^1 i-EACH11V6 *10/ r TABULATION TCAL-E olmElv-519At A--,�--,=-T. DE.5161V CHITFRIA 0/M,-jv5 t4 J3 4-T, A141maER OF&Ecwooms _3 D114-7EIV51 I O/V T. SOIL 2-0 C7 z3TAL Fjr11%jA-r=D 7:65 L0 Av 3 0 Y SOIL TEST A/ SOIL 7--5T#,E NUMBER CF -04c-qI,V6; A-1177-5 v-,LO—0.0 -e o.= so.,L.7-Es7- -7 7 ,r za z>A 7 3 UV/1</S RESULTS AV17-IVZSS�FAD BYB- P,!FW C OL A wo" RATE */ -', /- /vl.,A,./.'N C H .TOTAL J-e,4CH11VCr AR&,A SQ. FT. $ PElCC0,LA7-10.lVRA7--jk2 Z:/-/-^-A"MIA1.11,VCH C) 1 40- 07 &1 4e �N1v 7 - r 7FFM ROBERT P' 5-TL tvs- A Lf l P. C.0 A 2-5 a, SO BUNIKIS No 22162 0 0-REDC1.0 ENC-1 IVIEWFINCT C49 INC.V, IJ e-v i, 3 /V.,., C;ST od" YA ;SYONAL ,q y,4,,A//V/,t 7, "K. bdAlb 7 ,A 7��',! o J, N. No. -------- --q--- Fee------- ------------- BOARD OF HEALTH TOWN OF BARNSTABLE ,App[icat ion_*rVeil Con5tructionA3ermit Application is hereby made for a permit to Construct ( JK'Alter ( ), or Repair (!fan individual Well at: —� — —/Ll.k iJ (---1 /ems /Z--- Location — Address Assessors Map and Parcel __/✓1/5---lv ee�r vt-�----------------- St /o �� ,w� /l.t G�S/o...$ it.t�l(C / Owner /� Address — D --------------------------------- ------------- ='D 4 �-- E O — � +`-------- G , —-------— x-------------- Installer — Driller Address Type of Building Dwelling---- --------------- Other - Type of Building------------------------------ No. of Persons--------------------------------------- n Type of Well�!�`� ;--= -- ----— --- Capacity-----------------------------------— - —--— — Purpose of Well--- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. Sign- L/ -�-- --- -- — -2 date ----- Application Approved By. --------- date Application Disapproved for the following reaso ---------------------------------------- --- -- —-- �- --- --------------------—-- ------- date Permit No. — ----- Issued---------------------------_ ___-- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Comphance THIS IS TO CERTIFY, That the Individual Well Constructed (Al, Altered ( ), or Repaired by----------go-A-sClt nny km r ff ------ ------------------------------------------- -------- Installer — !O C✓j /lAtU.g wS A, at--�S� -- o ----------------------------------- ---------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --------------___Dated---- ------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE—------- - — Inspector------------------ —----- No.-------- --- ----- Fee------- ----------- BOARD OF HEALTH TOWN OF BARNSTABLE Application forVell Congtruct ion Permit Application is hereby made for a permit to Construct ( may, Alter ( ), or Repair ( man individual Well at: . M� r , ---- - --------- ------ ---- ---- -- ----------- -------- ---- -------- — Location Address Assessors.Map and-Parcel SL /o e-/S 4 / +vAS / Owner Address --—---------- - -- �O-.�pX__- -----� ----'----------____---------- �aM, - - - '- - Installer — Driller Address l Type of Building Dwelling Other Type of Building------------------------------- No. of Persons--------------------- Type of Well �`�:�=-- - '- ----—--— Capacity--------- -------------- --- ------------------ — Purpose'of Well--D6�es — „ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well`P,rotection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed - vfu��j — — — 7 /�_9f------ date Application Approved By ---- date Application Disapproved for the following reaso ------------------------ -- ----------------------._—____-_—_ date q,q w� /� . Permit No. •��n..�) ---- Issued--- -- -- t date e�sa,ifY.4S:.'F�.=1sa3G'taAr�saots ti�rr:�.2ar:.'f.er.aif:la::rs?:ern@9:!c�xilrt+a:wee+r.4elfaea.r.?1:9r.br.rlrs:!Rbs.o+rlie►w*..7.�s..�8fnsrlF.»iefsasiar4rReslnsaa.i�r-e+��i•naw:�RiRa�RBArP:ili±r.!M..!: BOARD OF HEALTH ,y TOWN -OF . BARNSTABLE Certificate Of Compliance THIS IS TO.CERTIFY, That the Individual Well Constructed (A7, Altered ( . ), or Repaired ( y ------ ------------------------- by---- Installer at has been installed in accordance with the provisions of the.Town of Barnstable Board of Health Private Well Protection r Regulation as described in the application for Well Construction Permit No. ---------------Dated--- r 4 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE—___— —- Inspector------ —- ----- —----— OarsTK'Piss'IttxY.vY`�Qax aaia'a aarctr�t..a.su+...-�sz..w-..:-':rf�a-e-�-...._.::_..-.Y'....-.�'w�1`�.,-��.«y�,.i+sssa9c4alivrYa�lNfx.��oiawea4i.eL1�PiVs1YVY lieAlbei a.JiwL4iSa<12iei�iaY�i6.iaimi5�5 BOARD OF HEALTH TOWN OF BARNSTABLE Yell Conotruct ion Vermit No. � � Fee— - -------- Permission is hereby granted o A Sc a n.tie/� — ----to Construct ( ), Alter ( ), or Repair ( ''j an Individual Well at: No. — _ /S8 Tic(fP/f L•. �, ,�,/S�o« L' /L,"M Street -------------------------- as shown on the application for a Well Construction Permit No.- Date —d— -- BoardIeald DATE