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HomeMy WebLinkAbout0082 BOSUN'S WAY - Health 82 BOSUN'S WAY, PIARS70NS HILLS � 46-115 it TOWN OF BARNSTABLE 'LOCATION�" I is k)aq S � I VILLAGE ASSESSOR'S MAP & LOT l INSTALLER'S NAME PHONE NO. _ SEPTIC TANK CAPACITY�_� LEACHING FACILITY:(type) dO(D Pl`'1 _(size) �D NO. OF BEDROOMS RIVATE WEL OR � BUILDER Of OWN' ER^ y �lc� lk � DATE PERMIT ISSUED: DATE COEIPLIANCE ISSUED_ VARIANCE GRA14TED: Yes No .S n. I J .J J TOWN OF BAMSTABLE O.CY—W—N �� a���SlE�9S rl�u� SEWAGE# �d'dc3 '%ILLAGE 65 AA13 �/ � ASSESSOR'S MAP&LOT 2,11STALLER'S NAME&PHONE NO. 4690�Z 11' ��l`�� 7J f3l 7 SEPTIC TANK CAPACITY LEACHING FACIIL=: (type) xa size) to`X 40 NO.OF BEDROOMS .3 BUII.DER OR OWNER PERMTTDATE:3 71�1 COMP CE DATE ;: s Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility S74— Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) ®G Feet Edge of Wetland and Leaching Facility(If any wetlands exist y� within 300 feet of leaching facility) rI Feet Furnished by �3 40i 1 Y 3 - A 0 5' o � No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Apprtcatton for Mtgpool *pgtem Com5truction i3ermit Application is hereby made for a Permit to Construct( )or Repair(V)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. BBSU,y.y wa� Ge rr 0®5 ver ✓Aellwvl' Afl' (9Z dye Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ;go�^�-oGo3C4�sf 7'Gv Type of Building: Dwelling No. of Bedrooms 3 Garbage Grinder Other. ', Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures' } Design Flow a.' ' gallons per day. Calculated daily flow ?J 3 gallons. Plan Date 5- 8 .7$ Number of sheets ! Revision Date `Title Description of Soil A*Qn 6 T' 4�1�9 //Z Q�"SJ�B�I✓ �1���5 Nature of Repairs or Alterations(Answer when applicable) D v s � Date last inspected: Agreement: ✓,��_ The undersigned agrees to ensure the construction of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the nvironmen Co and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo4 f �J Signed G ``Date Application Approved by - Application Disapproved for the following reasons Permit No. Date Issued 777 No. Fee THE COMMONWEALTH OF MASSACHUSETTS �' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE MASSACHUSETTS 01ppttcatton for M gpool *pgterrt Congtructton Vermtt Application is hereby made fora Permit to Construct( )or Repair(✓)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 8Z �65U�+5 wOy Garr �rsyvv�►y',�i//s dz dig �z �su�s cdQy �.��//5 ��dyg Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ,go/ ,a GD sfst 7 j1c', 7GS'GVQ�B�y /'� .L10,�'s>"-v,►�s,�i%/S i Type of Building: r 1 Dwelling -No.of Bedrooms 3 Garbage Grinder(/�d Other Type of Building No.of Persons Showers( ) Cafeteria( ) i Other Fixtures_ Design Flow 710 gallons per day. Calculated daily flow gallons. 'rrr � n Date S"/8 176 Number of sheets ! Revision Date j Title Description of Soil 10/4?17 6 \'t Nature of Repairs or Alterations(Answer when a plicable) /� � ���j©/� O>< ,U.f'I Sl/f r Date last inspected: Agreement: The undersigned agrees to ensure the construction of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of�,'Tie nvironmen Co and not to place the system in operation until a Certifi- cate of Compliance has been,issued by this Bo f y Signed ----. Date Application Approved by y Application Disapproved for the following reasons r Permit No. -Date;Issued i THE COMMONWEALTH OF MASSACHUSETTS 0 1-M l� PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certtftcate of Compitance - - y THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(✓)on b /gD4 )'DlD I �/y r/5}�/Yic /O`l for 6e,.' ADYeHr a s" Z S has b constructed in accordance with the provisions of Title 5 and the for Di posal System Construction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: -- No. �W VJ 0 6/i — J✓ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -.BARNSTABLE.s MASSACHUSETTS wtgpont *pqum Comaructton Vermtt Permission is hereby granted�to l70!14—alt� to construct( )repair( ✓)an On-site Sewage System located at $ BDSG/f/S 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. All construction must X17 " eted within two years of the date below. / Date: Approved by CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL W0111 S CONS'F UGHON I'ERMI'l' (NVI'1'11OU'I'DESIGNED PLANS) i 1, Rp���Tf� le/)'4 p4 i reby certify that the application for disposal works construction permit signed by me dated ��� �q°� , concerning the property located at Z b's all meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED: DATE: . 3 `7'l C LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF 13ARNSTABLE NUMBER (Attach a sketch plan of the proposed system. Also irthe licensed Installer posesses a certified plot plan, this plan should be submitted]. `_ No........... Fws...2:.✓.�.............. TH2 COMMONWEALTH OF MASSACHUSETTS ,, BOARD OF HEALTH ( Z0.t0..77..........OF........ 1��'► .j f$ A. ------------------ Appliration for Disposal Works Tonstrurtiun Prratit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal stem at: ...1,5.....W..... ....................................0JA........................................ ...... Lo; i -Add ess or Lot o. Owner Addr s WC",..., a.� _..... � -...................... a Installer � EA' Address V Type of Building Size Lot0?,:.Pr.P U....Sq. fee �-, Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—T e of Building No. of persons............................ Showers W Other—Type g --------•------•------------ P ( ) — Cafeteria ( ) dOther fixtures ..---•------------------•------•-•----------•---------.•-•••-••••-•-------••--••-•••--------••--•-•-•- W Design Flow........... ...............••__gallons per person per day. Total daily flow......7....._........ ............gallons. WSeptic Tank—Liquid capactit� �Q.gallons Length_Z��...... Width-_6.......... Diameter................ Depth..6.. x Disposal Trench—No. ------!�._�..... Width.................. Total Length..................... Total leaching area....................sq. ft. Seepage Pit No...... .,........... Diameter... ___.._..... Depth below inlet.....6........_... Total leaching area.R.R.�.....sq. ft. Z Other Distribution box (/�) Dosingtanks _ r a ................Test Results Performed by,`17{-1-------l_.R ._ � -_�.•................. Date... , ..__........_.. Test Pit No. 1. _:........minutes per inch Depth of Test Pit-------6._...._.. Depth to ground water.*a... ... __- (i Test Pit No. 2................minutes per.inch Depth of Test Pit.................... Depth to ground water........................ 0 Description of Soil-------------------- ---. ..... ..` ' ...................... ....... .......................................................- x ......................................................................................Y................... .......................................................................................... U 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 be n issued b rd of health. Sied .. ... .............X. .. ...:... g `Z'-............ ------ _ Date Application Approved By......... - -----�- - - ... 7 ---- Date Application Disapproved for the following reasons:................................................................................................................ ---••-•----•--•-•-•••....-----•••..........•----••--•--•-•-•-----••••-•---••-•-•-•--•-------•-----•------•----••----••--••••-•--•-•----•-•------•-•---•------•--•••••-•-----------••.................. PermitNo......................................................... Issued_...... .......................a Date' � THE COMMONWEALTH OF MASSACHUSETTS-: BOAR® OF HEa TH OF APpliration for Ubiposal Works Tonstrnrtinn thrmit Application`is hereby made for a Permit to Construct or Repair ( . ) an Individual Sewage Disposal S st t ....._.. _... .. al r/�E s ✓". - p - ---- ..... o . :��4 ..... Owner Address W Installer Address � 0V S UType of Building f Size Lot____ . .___ ____ q. f�e� �., Dwelling—No. of Bedrooms............................................Expansion Attic �i Garbage Grinder 4(jo Other—T e of Building No. of persons____________________________ Showers — Cafeteria PaOther fixtur s ---••---•-•----•----------•••••-•---•-------•-------...--•-•-••••----------------------------- W Design Flow.......... _________gallons per perso er4-4 Total c aily flow______.__________._______________._._..___eons. G.' Septic Tank—Liquid capactbQ_gallons Length___ __________ Width______Cl__________ Diameter________________ llepth______________-- Disposal Trench—�jo._______//_1N_t___�_____ Width__r_______________ Total Length..._�__ ....... Total leaching area____.. .__.__sq. ft. Seepage Pit No......./_____________ Diameter.._ .__._....__.... Dep li below inlet___._._ Total leaching area_ .....sq. ft. Z Other Distribution box ( ) Dosin an `4 Percolation Test Results Performed by- �_ !4! � ---- Date- --------- a Test Pit No. 1____ ..........minutes per inch Depth of Test Pit.................... Depth to ground water......�___:_________. (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ • ....f ® Description of Soil-------------•---- ....!._........'--•�--- --•, '�-�-��-�="-"---------------------------------------- -------------.....------ V .........................................-............................................................................................................................................................... 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 TITi:4 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. S• ne _.. ._....--•.............•------•--•--•-----•-•--•• .......................... Date Application Approved BY-------- ---- ------- --- ------� ��'�:.....---•---------------....---•-- ....... � ---- Date Application Disapproved for the following reasons-............................-................................................................................... ta Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... .......OF............Z'o .............................................. Trrfifiratr of fSrrmpl ana T I IS CERTIFY, That the ividual Sewage, Disposal System constructed ( or Repaired ( ) by . ..... . ... ..... r.. ..... ... .............!�/'...- •--•---..._.. ... -•-•--•-•------•--•---•-----------....._ s ler has been installed in accordance with the provisions of Tf P75 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. ...........- _______________ dated_`-1;t_4-----------____7. ...._____.____... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AAA GUARANTEE THAT THE SYStE DATE.N1 ..... FUNCTION,�SA�ISFACTORY---•---. Inspector. •----....�.. �! - :,. THE COMMONWEALTH OF MASSACHUSETTS BOARD OA. HEALTH + :...7--#---ten......OF...._. ...46 44 ................................................. N ....._. .... FEE __.......... .. ........ ��an�#� uan �ermi� Permission s�l`iereby granted. -------- ------ -- ---- -------- --•----- ---.......-•--••--••-..._.....•----------.._.......---...._.........._.... to Cons t ct�A or.Rep >r n Individ Sew 'al Syst atNo. < f i ` � _...�t -- ....... .........................................................."' --- -- -•-•-- .. fo- Zac- . as shown on the application for Disposal Vl orks onstruction Permit No Dated _._ ............. AZI Board o lth DATE...... .--� ... ........= = FORM 1255"HOBBS & WARREN, INC.. PUBLISHERS - - ' ` - ;_q � �• ., J .'x ..A '' 'l � '` 4 • - _„ _ .. �' 4" - rs 6`i~ •� .. V.,: .y •- �A <s' �y - .. __„ �. i9s .S1i,asar On /�2Zti 77 ize Th Z 7j / . .�'• ' - j�� �v.� {(�/.//MI/[�Q - .sA.dle 1,4 D)o �/� lot fg ®/ tea. a cfl w JE-5V C4 H 4e &1 -5 rle UC 7-1,0A1 Q_ c o , / - .� • .sue u 1� u`rt o ,�c 7- 7-1 r^/ '; -9<� / - L Le4 r ef11 2� Y No ? /9c 0//5,00 -T� L , a. �'' TN OF FRANK f Rare a CONFRY L` o CONERY ¢ No. 623Z O v No. 6573 Q Y ,f. PLAN ©F .AND L` ` t / OWN15 ear 7� - /4-4 •` S��, d I FRANK CC'M ERY 5 TRENTON ST. HYANNIS. MPM. 02601 FlO S4 Z¢ D e9 5 / 3� ( • l "W LAND a uo SUSNEVOP va7le `cs.s t�i r, ?ry i za )e r f 7 r C 16 SCALE t IN ZV FT. c:!%/ 78 /JR Ooo /D ✓Q �e v /4r- 0/a _ o uC .7 to �Q S5. L�n V/`O)7 lr7C )7 �st L �a ° 77, l e &--- . of4 = IS J. F re9 /000 � � /e-6C4 �, f = .zo/ l L 1 c o , Co - /s T /P v c .7-/c L d .3 ,5e-d0-0077-7 � o /^��/ / -/ . / YG� Q4✓b4gC G� /S/0p .SG R_ .90 a 80, a/ tiN Of � �r���'7o OF Af4 FRANK A Vy yam) O 3 G✓ N .5 !�/Q [// 1 a COKERY . a F FRAM 1 CERTffY THAT THIS PLAN SHOW V CONERY No. 62Jtcm Mo. 6573 O THE ACTUAL LOCATION OF THE TE °� 4 STRUCTURE ON THE LAND AND '�� sU, +° THAT IT CONFORMS WITS-! THE BY-LAWS OF THE "r'OWN t t o 4 J'n � 0,1 L: , PLAN OF LAND 1, l 7IN 10 0� ri g _ .�, _ �vc.vr1 v� cs•'� ; _ 1 f4k, s TAN �li- S MASS. t 4 OWN W BY J Ije N FRANK CONERY 5'TRENTON Sf NYANNIS. MASS. 02541 .2O- .2 / 1 / .�¢ ¢ /D �5 /O 3�% (, � ' �� fMaeta�e 0+w�aw & w.o sustvEvnw �-r C f j / SCALE 1 1 N -,ZD Ft. .5-1817 B Z' ' / � � • ' �f.S f D! 5/��7� �/�f'tc� D� P�ulrre�