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HomeMy WebLinkAbout0256 BOG ROAD - Health 256 Bog Road A Marstons Mills A,= 046 ' 006 L� 5 M EA r No.53LY UPC 12943 ameadcom • Made In USA {� v Ur r L Gf�I G ��j, °v G'�?-�j►�1 y'Q,t �b j AD d dr, r� t Ov No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE 01ppItration ifor Vern CousStruction i3ermit Application is hereby made for a permit to Construct(vY Alter( ), or Repair( ) an indi-iddual well at: 2;S& 606,id r4ots]oh,-3 /4t//e Location-Address Assessors Map and Parcel oI Fr- .2sC l,�mC g f 4c-PT7.w s tit://j Owner Address e.Un�l,g cS'Cg/.jIV `l Lei Q-cCraS'y lqd CIV.6 ee �tr� Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well Gl " z U Capacity Purpose of Well !t l C a a•i Gov l y Agreement: The undersigned agrees to install the afore described 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 Co liange has been issued by the Board of Health. / Signed Date Application Approved B '--5A ate Application Disapproved for the following reasons: Date Permit No. �-©z 0 — 013 Issued Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Commphartce THIS IS TO CERTIFY,that the individual well Constructed(11, Altered( ), or Repaired( ) by ,�eti�1S �cGL N n- e l/ I -� Innstaller at 2 5� 4o` �� /�1a�b/O wS /4 t 11r 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 NoW2—Q& --V 13 Dated 0 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector o. V''�7i 0 ' O N t 3 � pU Fee BOARD OF HEALTH TOWN OF BARNSTABLE 2ppricotiou jor Yell Cougtructiou Permit— Application is hereby made for a permit to Construct Alter( ), or Repair( ) an individual well at: Location-Address Assessors Map and Parcel Owner Address e•JIIJJ % .SCci/)tUe j� /d�' /�-rC�GSs /dc ;'X�,P� Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well L/ /'y C Capacity Purpose of Well /f i l G aTo' , 6IV Agreement: The undersigned agrees to install the afore described 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.Co/mpliance has been issued by the Board of Health. / Signed Date Application Approved B ,,..►�'' r .� G,D �C� Date Application Disapproved for the following reasons: - nn Date Permit No. 02-©2 O — v1 3 Issued Date _om_--o_e-_e_veems_e-o_o_o--------------------ss-a---- ®_vovememe_---__-- _____-_>-e------e_-_o---- . BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed("), Altered( ), or Repaired( ) by ,D e 4_) l S SCGI I-J ry C /_ Installer at 2 56 13o6 RJ /Ua/ Sla-�-,S ru l //C 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! 2-049 -V 13 Dated r THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Vern Conotruction Permit C� No. (A)Zo0 0 13 Fee Permission is hereby granted to ^' c G Installer to Construct("S Alter( ), or Repair( ) an individual well at: No. !>6� R� Macs j, ^S r't(A Street as shown on the application for a Well Construction Permit NoW2070 — 0 Dated Date �l ��ZD Approved By" �� TOWN OF BARNSTABLE LOCATION ZY& go& kc-x - SEWAGE# 2.o2O 0 S'S VILLAGE yK 1g� ASSESSOR'S MAP&PARCEL LI ()Q- INSTALLER'S NAME&PHONE NO. t-y-tC 5i'4--VF,pS Sc�q)-7 q0�y SEPTIC TANK CAPACITY IS®O LEACHING FACILITY.(type) �h e��n (size) NO.OF BEDROOMS raj f OWNER P PERMIT DATE: S Q COMPLIANCE DATE: 3 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 0 oNr c3' �;g aS6 Q = '74.1/2 r TOWN OF BARNSTABLE ��_ SEWAG 20 ZO LOCATION ��6 �OCr E# � VILLAGE YMr rots hit ,< ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. tL 51r—Vt — - O i SEPTIC TANK CAPACITY size LEACHING FACILITY:(type) ('h�►w ( ) NO.OF BEDROOMS f OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Facili Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching tY Private Water Supply Well and Leaching Facility(If any wells exist on Feet site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist within Feet 300 feet of leaching facility) FURNISHED BY Ci �71L A gZ YL C3 y : -7a1/2. No. �o f Z a b 15� Fee L, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for VspoSal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System E`Individual Components Location Address or Lot No. Z- RE1, Owner' Name,Address,and Tel.No. IM Get a 1 IZO I !'►�>rsF h.;1 Wv�A ©1�4�y 44 ��, Ik�s a►.S VhM& F't19, OZ4,'{b� Assessor's Map/Parcel t Installer's Name,Address,and el.No. �R1 r 5�'EVC4 S Designer's Name,Address,and Tel.No. N16 �`t�A-S P_a ox�`�, MrtQStols NILLS V►,h, qq f'a N/ 961 if. rh A. 0Z So -776-9 S-010-366-331) Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Ce S. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 666 gpd Design flow provided 6 gpd Plan Date 2 I ZZIzc� Number of sheets Z Revision Date kloo(: Title Size of Septic Tank /00 Type of S.A.S. C hL%g,6j,vS CQ L FA), $� Description of Soil Nature of Repairs or Alterations(Answer when applicable) trTj�a j Date last inspected: Agreement: i 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 Certificate of Compliance has been issued by this Boar ea th. Signed Date - Z Application Approved by Date Application Disapproved by Date for the following reasons Permit No. )L-v 9-o 0 5 Date Issued - S No. i'.2L-0 y 55 Fee tTV ;THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for Misposal,6pstrm Construction 3prfmit Application for a Permit to Construct(�') Repair( ) Upgrade( ) "Abandon( ) ❑Complete System ❑Individual Components + Location Address or Lot No. Zg{p R6 Owner's Name,Address,and Tel.No. m j C a o l go 1� _ l�ars��s S Yea Assessor's Ma /Par 1 y Y.S(o �s , nna+- }c . Vh���S M14, at ,Y ` dGf �' b P Ce � h. 1 lea ., �• Installer's Name,Address,and el.No. �Ri _ S'Yf4etj S Designer's Name,Ad ress,and Tel.No. po vox I rhft0loolls NI"s {?Q go/ 961 Lf, sar, WIC,, r%P. D Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) % Other Type of Building Itf%, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)(„(, gpd Design flow provided /' gpd Plant' Date Z 0? 1)�, Number of sheets ?_ Revision Date Title Size of Septic Tank 4cbo Type of S.A.S. , {, , 6 &S i Description of Soil Nature of Repairs or Alterations(Answer when applicable) r it 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 Certificate�of Compliance has been issued by this Boar ea_th. Signed Date Application Approved by —�i- f Date I- $- Application Disapproved by Date for the following reasons Permit No. 9-0-0 - 1 Date Issued s^~ s --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by p€ Sl C,911 14PVr-110h INC. s at / _ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.;aa&-653 dated - 5 ' 20 Installer r' Designer r #bedrooms a Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system w' l fun 'on design Date i v Inspector l� ------------------------------------------------------------------------ --------------------------------- - _- ------------ ------- No. d o;,o — 6 5 Fee Iry THE COMMONWEALTH OF MASSACHUSETTS t PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction J)ermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. �- f Date � ' Approved by i ,� Town of Barnstable Regulatory Services Richard V. Scali, Interim Director i S * Public Health Division 039.� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: I`'� ( Sewage Permit# Zozz ®T:��—Assessor's Map\Parcel 0 040 Designer: ►" t §ZAAS 1V1,C,, Installer: VNC, Address: Po 1�j�j�C (�� Address: eo_ r :A On 2 2S� Z© �Ql i L Sfi�JS_N� was issued a permit to install a (date) (installer) septic system at Z�(6 Q V"s V,I u., based on a design drawn by (address) C1y JZ131 -S �✓1 C- dated 2 -Z,ZI2-6 XI certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the Y pP distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify.that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of:theLI\Aapproval tters(if applicable) n e 's Signature ` MEYE coo No. I esigner's Signature) (AffixWON. ere) PLEASE RETURN TO B STABLE PUBLIC HEALTH ERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc I I l ti 9 Y OCUS DR -�" m SAD WAY) 0 ��ROPQ 'M'•11 -it ���r E)L MF PA710 TANK jB'X3 2'POOL CONC.BDUND C W/DLSK \ EX � 8 $M FUTU pWDlING 7� OjS 24 PROP. TIION _p_OLE BIDC. D�'CK FMEPS FD. _,""°o- �� �`r? `�� _ _. 0�3 Blk, CONC.BOUND W�"D�ND �/ �A J ,� W/DISK uei / `r 395.42 CONC.BDUND T W CONC.BOUND /DI9C W/DISK $ r r 'l TANK J- SCALE: 1"=40' Ex SHE 6� EX NkLUNG PROP. / GARAGE DECK i' EXHIBIT FOR NOTICE OF INTENT 00, •' MBLU 46-06 . T-12 7-17 1 CERTIFY THAT THE NPFOMOCS SHOWN 256 BOG ROAD HAVE BEEN LOfiVED BY A f1EID SURVEY. �t MARSf0115 MIS' T-13 aoee DATE 9-14-201. RBS T-10 sntES SCALE L�m40• am� CF BASTBOUND LAND SURVEYING, INC. SCALE: 1 =20� T �p P.D. BOX 442 ROBS SYKES. PIS DATE FORESTDAL& MA 02644 506-477-4511 all Ael / TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS 9 / o-0� NAME x COLONIAL CRANBERRY Cu berland Rhode Island 02864 ADDRESS 519 Mendon Rd. VILLAGE �' ��T � 1 LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL Marstons Mills on Bog Road 2000 Gasoline 11 yrs. Steel (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. Jan. 19 6 92. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: Permit issued August 28, 1969 TESTING CERTIFICATION SUBMITTED: PASSED X DID NOT PASS -� NAME LOCATTON MAKEPEACE„ A. D. Co, Bog Road P. Q. B oy. 1st Marstons Mills Wareham, Yass.02 5711, BOOK & PAGE - 0.ATE GRANTED AMOTTN'(' STORED 77/222 August 29, 1969 DATE PATD March ?(? 197� MAR 101975 wAAR - 41976 MAR 10 107M MAR 9 197 1 T G SENDER:Complete items 1,2,3,and 4. Add your address in the"RETURN TO"space r,:�,-i,reverse. '(CONSULT POSi9@s9ASTER FOR FEES) i.The following service is requested(check one). F IXM<Show to whom and date delivered.................... _Q ❑ Show to whom,date,and address of delivery.., 2.❑ RESTRICTED DELIVERY =¢ (The restricted delivery fee is charged in addition to the return receipt fee.) TOTAL S 3.ARTICLE ADDRESSED TO: M Manager, Colonial Cranberry c 519 Mendon Road 1 z CUMBERLAND RHODE ISLAND 02864 m 4. TYPE OF SERVICE: ARTICLE NUMBER WI A ❑REGISTERED ❑INSURED m x�ERTTFIED P517 442 184 � ❑coo ❑ExPRESs MAIL M (Always obtain signature of addressee or agent) I have received the article described above. M SIGN ; E ❑ Add ❑ Authorized agent m ",7 G S. DATE OF DELIVERY POSTMARK m 1�v Z 6.ADDRESSEE'S ADDRESS Oel i,mpest t7 n m A 7.UNABLE TO DELIVER BECAUSE: 7a.EMPLOYEE'S INITIALS v s P VNITEDSTATES POSTAL,�'EH1`IICI f OFFIGAL SUSINESS' r �ti� i �ussng PENALTX F,ppR PRIVATE' SENDER IN9TR '1FI5 USE TO AVO*'OAYMENT ..r Not your no% end8P�� 6spa&t1eIG.IN: OF'POSFIIOF,�300 s Colepk 4m II,26%v44.an revenge.,F,.,.a • Ailacb to hoMotmtlglpe 0ffWWI ditlobeett=��de. • EndOree ertlde"Roball t�ipt Requested" � adimt to number. i RETURN TO BOARD OF HEALTH (Name of Sender): TOWN OF BARNSTABLE 1^ P. O.Box 534 (Street or P.O. Box) i HYANNIS MA 02601 0534 (City, State,and ZIP Code) P 517 442 184 RECEIPT FAR ERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED— NOT FOR INTERNATIONAL MAIL (See Reverse) Sent to Mgr-Colonial Cranberr Street and No. P.O.,State and ZIP Code Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to whom and Date Delivered Return Receipt Showing to whom, N Date,and Address of Delivery 0 o,' TOTAL Postage and Fees $ 1.55 p Postmark or Date w o " 0 ao M E maile3d 11/5/,84 o a STIM POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS PaSTAGL.,11- Ior o wa IFF.E;'mm Ctinas FOR my SELECTED oPriom aq mas.(set fr 1.if you want this rpcaipt postmarked,stiokthe gummed stub on the left portion of the address side fifthoavt"sc:eloevringtheereceiptatLachedandpresentthearticleatapostofficeservicewindowor i ha-nV It to your rural harrier.(act extra charge) ' .Ifpu do notwant this receipt postmarked stick the,gummed stub on the left portion of thcr ddr aWs of the,article,dste,detach and rennin the'rem ipt,�aartd mail article. .It you want s return receipt wri(e.the.certifled-mail number and your name and address on a return receiptcard,Form 3811,.and attach itto the frontofthearticleby means of the gummed enda f if space permits+Otherwise,'affix to back of article.Endorse front of article RETURN RECEIPT' RE+QUIE D w.Pacant to the numbs.. 4.It you want defivery ro,%ricted to the addressee,or to an authorized;ageAt of the addressee. endorse RESTRICTED OEUVERY on the from of the article, .EF16 fees for thes'ervicep requested in the appropriate:&paces on the front of this receipt.If J return receipt is requested,check the applicable blocks in Item 1 of Form 3811. S.Save this receipt and'prkent it if,you make inquiry. �i CUMBERLAND FARMS, INC. 777 DEDHAM STREET, CANTON. MASSACHUSETTS 02021 617-828-4800 TWx: 710-348-0130 (CUMSFARMS-CTON) January 14, 1985 John M. Kelly Director of Public Health Town of Barnstable Office of the Board of Health 367 Main Street Hyannis, MA 02601 RE: COLONIAL CRANBERRY MAP NO. 45, LOT 17 BOG ROAD MARSTONS MILLS, MASSACHUSETTS Dear Mr. Kelly: In reference to the underground tank located on the above-mentioned parcel, further investigation has shown that this tank was once used for the stor- age of gasolines to ,service machinery used in various bogs in close prox- imity to its location; however, this tank has not been used for several years and will be removed from the earth and from the town within the next two weeks. If I could be of any further assistance in this matter, please contact us at your convenience. Very truly yours, CUMBEND FA M .L RicrL.d Long-ton ngrton Vice-President, Construction maw cc: John Peck I s S:.s ..f'` r _ 7 ` 1j :;X" r...x-�,. c ,p�x';�.,a.+,,r. s. t "Y�x '2 � r� #Y'`' n.+ ,y, ' �. \ :•r,•a, 'yam tr'�t 'r,r',•'y -.a" r " s- gi� d i {�r 4.}-�,- jq�'fis1 } "�'0 f i kx\ ,. "•w A_ 4,2, `+i a}rf w �. xr� ,-�.' !';, ,t i s ? s, t w i,�t .v L r. iy i-t x .} 'i S .h '_�,r�q n :i.�,i� �]�§ '` /' s M1 3.5r7- a ^'. y,:.�T4y ` r x�,'GC 1 - f .3 r's..' F. 2 s.�§ fir} ,t ..t ti'♦ 4 �" �Ls, :-..r a+'Y r�* 2 StSs. .`L rc'�'�,.Yt'�,�,�.yC'7}�.t M r'xp`"7+`� iI •a *rr,S '� s� sr,.ir rr,.:. ? S' r� _- � a tt' t66' ..•2cy .t'rf• L `"\•aa t». . •. 7 y,r3".u'�c" ..i .✓, YS �.Y vw• S -.i. Y C wf ,,. _{ �' �y,;r' y„st,'3.' 'r"t < w,fr ..< rr,.yAa� ^�4.. ,� ".Yy ,, aF ,� k'• i,r, r S { !E,7 4ty t'yk + to ? '�`r ,_-` r, ,�a r ".k. 1 +. . ," it.�' ss ter^ `E�'t,,.i� �§ _R'r . . \ b r s �4, z r .. v '• t'` a ,' s x .".' �,5 1. t a { .eo: "'.*'..� y E'#:, �` ,.s�»a ty -• t .. 't .,w. 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