Loading...
HomeMy WebLinkAbout0077 BRIDLE PATH - Health 77 Bridle Path, Marstons Mills — A = 149 147 1 0 No.-i � ' FEE'COMMONWEALTH OF MASSACHUSETTS Board of Health, ,` xm540'sle_ MA. APPLICATION FOR DISPOSAL SYSTLM CONSTRUCTION PERMIT Application fora Permit to Construct( ) Repair Upgrade( ) Abandon( ). ❑Complete System O Individual Components Location 1 *'a CI l¢, �O -h maCS Dt►S A,,q Owner's Name Map/Parcel# I Address -In L a� ' i 15 Lot# Telephone# Installer's Name E XcCLUCLA 1, Designer's Name Address G S G L �o G Address Telephone# L1 _ Telephone# Type of Building RCS 1ItcnA;at. 1 Lot Size sq.ft. Dwelling-No.:of Bedrooms U I A Garbage grinder ( ) Other-'Typeof Building No.of persons Showers.( ),Cafeteria.( ): Other Fixtures Design Flow (min,required) gpd Calculated design flow Design flow provided gpd Plan: Date Number of sheets Revision Date Title Description of Soils), Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF-REPAIRS ORALTERATIONS Gc Lmq c- -4 O CSC S C A-I 1 C- SuS-Ic� The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5-and further agrees to not to.placentphe system in operation until a Certificate of.Compliance has been issued by the Board of Health. Signed 4� Date Inspections. ------------------------------------ ya 'l..®l�llMO WEALTIJ OF MASSA'l.lrJt'L SETTS Board of health, MA. APPLICATION .FOR DISPOSAL. SYSTEM CONSTRUCTION PERMIT Application for a:Permit to Construct( Repair(-I'Upgrade( ). Abandon( ). - ❑Complete System ❑Individual Components _... .. .�. Location Y',d I Q. Als Owner's Name Map/Parcel# 4 4 Address `7`� t^ �C. y r __ Lot,# Telephone# x� Installer's Name F xca i Jesigner's Name i D Address IL4 Address Telephone# y`)', 0% -i Telephone# Type of Building pCS An'-\A�,-: Lot Size. sq.ft, Dwelling-No.of Bedrooms Garbage grinder( ) Other-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow (min.required) gpd Calculated design flow t Design.flow provided gpd Plan: Date Number of sheets Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of.SoilEvaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS l�r f"1e 1 P�^_� C-,i s C" `a c- -A '-:Z!a S The undersigned agrees to nstall,the above described Individual.Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place-the,system in operation until.a Certificate.of Compliance has been issued.by'the Board of Health.. Signed _J't l. ' Date 1�- 1. •1 y Inspections No 1 3 �/ p� FEE COMMONWEALTH. OF MASSACHUSETTS Board of Health; MA. CERTIFICATE OF COMPLIANCE L✓► >, j Description of Work: @'Individual Component(s). U Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed g y fy g p y @,.Repaired (.'*,*Upgraded.( ),Abandoned ( )' at *1"1 � A� �� �C{'�l� Y-A 1tle�F .�'a has been installed in accordance with the provisions of 31.0 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application N.o.. dated Approved Design Flow (gpd) Installer .R � .3 A xC,,l J _4 1 ca Designer: Inspect ��. ..1�+. Dat d: e; 1 i - The issuance of this permit shall not be construed as a guarantee that the system-will function as designed. No. 3 V FEE: �OMMONWPALTH Of MASSACHUS FTTS. k Board of Healtic, r�"i� �� C_- MA. DISPOSAL. SYSTEM CONSTRUCTION PERMIT Permission is herebygranted to;:Construct(#) Repair(,-If Upgrade( ) Abandon( ) an.indixidualsewage disposal.system as described in.the application for Disposal System Construction Permit No. dated Provided: Construction shall becompleted within three years of the date of this permit. All.local conditions must be met. Form 1255 Rev.5/96 AN.SAO co(Westown,MA Date I t / /�1S Board of Health in4, 6 h y ' '�'°�� C�oFfM,+lf�•crw,Tlvn �Aiwwwe,mow�,a',ow.�+r v o C7CJ f 9:c, ct-t off, CIL- P L PIY f4rV.%t Calz..,..w... , _..`. L N l� W W I NNW . � t KA N6-y T ev C- I J CT ,�--�-�--{---T • rwnaw[MlYr rlN+r-Mt/��'.+�-heMn\ -rlurw•er^ .�,a i .....��' ti U P 1"A B i FV141VJA � vrN icrn.r:ur-r•r..v;�wTKµ�tlMtwrMlrlPMr..r�hr+•-..rw-c•rr�WrG�mrvrw�wuw\f! PV Y•✓NSTA 6 LAN 6,rIf_'1 ' .w�emm•a�z�wJw�rinr•110!InY!�YPwwne.+nn�rwrl�M+r • 5('EI° �b�= ���k��,- ram.,•�r-��R>~�� I C I+ TO BARNSTABLE LOCATION SEWAGE # . f VILLAGE AS ESS 'S MAP & OTp/f�9. ZNS�C-CTt�(�� NAME&PHONE N ✓, Q SEPTIC TANK CAPACITY CC U- LEACHING FACILITY: (type) / 7 (size) 0 NO. OF BEDROOMS BUILDER O OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 f of lea 'n aci Feet Furnished by d's 0 3eA -. �. -- - OWN OF BARNSTABLE Li°�:a�i'ION ,77 �J"% �e , Q'��'I SEWAGE # ASSESSOR;S MAP & LOT/y?-/?7 INSTALLER'S NAME&PHONE NO. /�D/' OLO � �iPIS Y7/-9✓?�I� SEPTIC TANK CAPACITY 1i o00 4�w L LEACHING FACILITY: (type) , / �/T (size) X �� NO.OF BEDROOMS BUILDER O OWNE_10G7 PER�iIIDATE: /� �J��"� —�COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Gr(ur water Table and 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 ro vZ , 4/77 ag 33� 9� ti '�Gw /L/ No. •G 'L Fee c:l THE COMMONWEALTH OF MASSACHUSETTS t' Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,, MASSACHUSETTS 2pprication for Migozal *pgtem Construction Permit Application for a Permit to Construct( )Repair(a/ )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. -77 A-Mlle �e�- ����rl�y Assessor'sMap/Parcel: /.ldl"5�0113 .YI/A� y7 Installer's Name,Address,and Tel.No. Desi ner's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ® Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow .?D gallons. Plan Date //—9— 77 Number of sheets / Revision Date Title Size of Septic Tank /d®Opp Type of S.A.S. Description of Soil Nature of Yepairs or Alteration (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 is e d Signed Date Application Approved by yn Date _Jy I 94:�- Application Disapproved for the fo owing reasons Permit No. Date Issued No. 1 a Fee ``5 THE COMMONWEALTH OF MASSACHUSETTS V Entered in computer: _� Yes t PUBLIC EALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS RpPlication fo Rio-px r', gtemc Coi�gtructiori Permit . Application for a Permit to Construct( )Repair(/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/PMap/Parcel77 49r)'elle �°¢r� Be 4 We 5�Ple y `, /)s, w4pl �,5 J Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �artol�o�/ Goasr. �ocry-cam� �vy� 77/—�'3 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(dip Other Type of Building 06144110 No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1/0 gallons per day. Calculated daily flow G�- /� gallons. Plan Date //- 9— 7 7 Number of sheets / Revision Date Title Size of Septic Tank D oe"IType of S.A.S. /D 1J01A Description of Soil Nature of Repairs or Alterations(Answer when applicable)- d ,7 04: Z 7"A"11 ?'' .s�`a7� S girl©uH.a�:ra 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 tide Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss t ' o d of . alth. Signed Date Application Approved by Date—.41,0�1=91 Application Disapproved for the f owing asons ?:< Permit No. � Date Issued i -------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS /y �_I / BARNSTABLE, MASSACHUSETTS / (Eertificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( el"Upgraded( ) Abandoned( )by { l 04 at 111r. has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer�1Dry'� � /'��`s� Designer 04K fic y.f/y11 The issuance of this permit shall not beconstrued as a guarantee that the system will function as designed. Date Inspector - --------------------------------------- No. I`7 f-A/7 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Miopogar *pgtem on5tructiou Permit Permission is hereby granted to Construf t( )Repair( Upgrade( )Abandon( ) System located at_ ZZ r °Gt �)Z ,ei1S/� �ti1 C6,af/0 y ®r'�/ .' Cam'h S�✓'�G��.*�.7 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: Construction must be completed within three years of the date of this permit. Date: Approved by Uo CaA.R8AG6 [�RI♦.JL�� rad1L�{ FLAW z Ilb � 3 • ��O G•P•D. SEPT1 C lSC % • A-9 97 6.P 0. uSr-- tOoo CMAL. bI�5PO5AL PIT USE loco �941 . t UPAOA LL AV-GA = 150 S•F. tso 13crr l(A S0 SJ5=. A 1 .o z Sb S-P D. TOTAL G.PLD. 4 0 ToTQ L 1Z:;)al L.:-( FL.OkA./ z 3W 6.PD. T•llt N. t�dGDLQTIOLJ O&TE C ILi SM I U' O2 Lam. 14 J. Awv, .d$ O% 1 /015 r Y Tdf �Md a lbO.e �"`l � .. o y , i �Tl7C•i,• � '�jAlr •' 4'pP� T IW. &AL -Box . Q67 •r oX 4L• SepncWV. T�hkK i GAL. t I I LL;gcN - N-I'li W.4S41<D' 3TO%jf- ! ".. CA 110 t-4 C e L4TER,I1 L_t..ts ►Jo Sco,Ltr- SCAL {J Ct7-rLT11=-r TOA'T- T14r-- 1--^vLJ-baT,cJ S WOW u Pt..4►J. R�FEQ��.1GE ti-�;: ►��c-._�'I,, c�_.�-lt����� �,v 1,-1� -rj-�:_ 5l o� �1►-tE � �„l„ �3 �MCWT-, OP THE L&Qm Coin- Sze; Y-1��r.1''-a. _-,�L C�. t� � -•-•" BQXT��Z �`. 1.!•(E it,.1G. : t2EGtSttiZ�D 1..,�►.Itp SueVi�`foL'S. - ,(t t lam_ {7(_A.►-1 I t-1 UT i�A.Seo V1-4 A.a.1 OSTEQ ViL,.LC-t< o /IitAS�s• �LJ ,:{(?J.t11_l.l i �cJl_•/l:y' TIaC' cUFt=�F`�, i1�GlalLD APPLI CAW'!` vl... A� , s; lA� C c� $�a �U YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: IQ"I4 IA Fill in please: Ha t f i APPLICANT'S YOUR NAME/S: h et h kLZ BUSINESS YOUR HOME ADDRESS: IYM �'� aa� ,12$ `' 4 `�u�,afa:, � TELEPHONE # Home Telephone Number U 7 .� eittP'�rd.Y�1.4'�f z VIP NAME OF CORPORATION. 1 l NAME OF NEW BUSINESS.f. °-TYPE OF BUSINESS S��-Q -��da-l_ CMG tauC IS THIS A HOME OCCUPATION? YE NO cm�5 ADDRESS OF BUSINESS rf f t 1 �5 <<�S MAP/PARCEL NUMBER [AssessirigJ . When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ISSIO ER'S OF ICE This individu a `t'nf r f y p r 't re ui ements that pertain to this type of busiOMOST COMPLY WITH HOME OCCUPATION -41 RULES AND REGULATIONS. FAILURE TO Aubqori Si r ------ COMPLY MAY RESULT IN FINES. MENT 0 - 2. BOARD OF JALTH kjUS COMPt y `NIT'' This individual hasibefgr eTf.tkte�i mit requirements that pertain to this type of business. z JGGt� ttT�illYV v��I HA,' .. _ . `.!S MA R1ALS RED vS Authorized S nature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of'business. Authorized Signature* COMMENTS: `r Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITENINVENTORY NAME OF BUSINESS: tUUYI R 01 lb k) BUSINESS LOCATION: 11 INVENTORY MAILING ADDRESS: M( ((.S ma cz&L(� TOTAL AMOUNT: TELEPHONE NUMBER: �6 AMOUNT- -2 CONTACT PERSON: e-( EMERGENCY CONTACT TELEPHONE NUMBER: _ SA 332-�0 93 MSDS ON SITE? TYPE OF BUSINESS: a fan(*vG INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze 9 Y gasoline or coolant stems) Miscellaneous Corrosive ( ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids i (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash &Z I'KA � F' WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS A plicant's Signature Staff's Initials f YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates COST $30.00 for (WHICH YOU MUST DO SY at 200 Main St., M.G.L. - it does not give `� years. A Business Certificate ONLY Hyannis. Take the completed form to Town permission too erate . REGISTERS YOUR the Business Certificate that is required b p You must first obtain the necessar NAME in the Town q y law. Clerk's Office, 1'' Fl., 357 Main obtain y signatures on this form yannis , MA 02601(Town Hall) and get Fill in .<_ Please: t` APPLICANT'S DATE: BUSINESS YOUR NAME: `" YOUR HOME ADDRESS- NAME OF N TELEP ONE# E EW BUSINESS Home Telephone Number: IS THIS A HOME OCCUPATION?/O s y�S P Have you been given a ES NO_ TYPE OF BUSINESS ADDRESS OF approval from bui ng division? YES BUSINESS NO c 7- VVhen starting a new business there are several things MAP/PARCEL NUMBER I Barnstable. This form is intended to assist you in / g you must in in order to be in compliance with the rules and re ul Yarmouth Rd. & Main Street) to make sure obtaining the information you in need. t0''vn you have the a y You MUST g ations t- the Town of appropriate permits and licenses required to Go TO 200 Main St. — 7- BUILDING Bally operate our (corner of COMMISSIONER'S OFFICE y business in this This individual has been informed of any permit requirements that pertain Authorized Signature** p n to this type of business. COMMENTS: 2• BOARD OF HEALTH This individual has beep '^r- rmed of ther uirements that pertain to this type of business. Authorized (/('COMMENTS: nature** MUST COMPLY WITH ALL HAZARDOUS MATERIALS REGULAT! 3- CONSUMER AFFAIRS (LICEa This individual has been v nlformed oHhORITY) e Incensing requirements that pertain to this type of business. COMMENTS: Authorized Signature** ( - y TOWN OF BARNSTABLE Date / 1'7 / TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: BUSINESS LOCATION: /pz INVENTORY MAILING ADDRESS: /e7,O ZZ< g e ®a6yS TOTAL AMOUNT- TELEPHONE NUMBER: r:22_30�0_ 7"T/07 CONTACT PERSON: �i//y ��sys 20 ye EMERGENCY CONTACT TELEPHONE NUMBER: .5O63bo :Z/VQ MSDS ON SITE? TYPE OF BUSINESS: _�,�/1✓?>Sl��/�/� INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) soline Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood:preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints,,varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials I L 7�. (2j) LO•CATION SEWAGE PERMIT NO. VILLAGE �,q�S7�rs' �rGG S INST//A LLE,R'S NAME & ' ADDRESS , BUIL�DjEIt OR OWNER DA T E PERMIT ISSU-E-D , s DATE COMPLIANCE ISSUED z Cl `` .r w • a• r e 1 • Z L� 'r .r. 17 No..........AY4/1......... Fss....� ................ THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH _...... ......OF.......... ..... ---------------------------Gz!���1�2. Y y Apphrution -fur Di,spuuttl Worku Towitrurtion Viermit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System t:es 7-- .................................... r' ... ................................ ................................................................................................. Location-Addres or Lot No. .— ,-�'-- . � - /A{///) Owner Address a ----•----------------------�.± -! -X,/'l' .r�a.Cf��!.._....._.. - Installer r Address Type of Building / Size Lotrr+ :__°r�..Sq. feet U Dwelling—No. of Bedrooms..................�"- -----------Expansion Attic (-7)1 Garbage Grinder _ aOther—Type of Building ............................ No. of persons-...____-_______._-_-_._---- Showers ( ) — Cafeteria ( ) Pa Other fixtures ------------ - d W Design Flow...................... _ __.-gallons per person per day. Total daily flow................ . ..........gallons. WSeptic Tank—Liquid capacity_e Z�allons Length---------------- Width................ Diameter__-__..._.--__- Depth.--_-__------- x Disposal Trench—No. ....... �Iidtl--------------------- Total Length--------............ Total leaching area..___._-.___...____-sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet_------- _......... Total leaching area------------------sq. ft. z Other Distribution box ( ) Dosing tank--(4—) Percolation Test Results Performed by....- !�f _ --____� -:_� -- f�-«-•--. Date........................................ aTest Pit No. 1................minutes per inch Depth of 'Pest Pit.._.__..f`___.__. Depth to ground water._.__-._____-___-__... Li., Test Pit No. 2................minutes per inch Depfh of Test Pit-------------------- Depth to ground water__.__._..__.__--_--.---. Q+' ------------------- je�........................... .. = . -----••-------•----- O Description of Soil �.................t -- ��, /--__~ .-- -3� (i �........- -----------a------------ v .................................' -................................�/> c-%--'----=�- - ---�Z h......��r - --------------------------- --- �/ ------------------ - W ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------- VNature 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 Article \I of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the board of health. _ Signed:r---- -- 6--�� ------------------•-•- Date Application Approved BY ...-. : /�-2 C,-'7`7 . _.. -._..._._I !�--Gi !� -------------------- - - Date i Application Disapproved for the following reasons--------------------------------------------------------------------------------------------------------------.. --------------------------------------------------------------------------------------------------------- ''�f� Date Permit Nb ....................................................... Issued Issued------. ----1!`.fJ.----•--------•---- Date a� � L77 ......... Fnic . ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 14t;:�Om . HEALTH ..........OF......... , .................... % Application -for f3hipwial Works Tanstrurtion Prruid Application is hereby,made _for a Permit to Construct or Repair an Individual Sewage Disposal System it: 542 'J PA Vic ............ ... ... ............................................ ............................................... . ......................................... _ :_ 0 �. Locatijr,-Add,es., 0.or A ------ . . ....... ............ ................................................................................................. Address 6wne .. ......................................... 47$�............................ .................................................................................................. 4 a Building nstaller Address Type of 9 Size Lot0._jP!n_.Sq. feet Dwelling—No. of Bedrooms---------------------------------------------Expansion Attic (o**PZp Garbage Grinder:o$'f#d PL4 Other—Type of Building ............................ No. of persons-.--___---_--_____--_____--- Showers Cafeteria Otherfixtures ------------------------------------------------------------------------------------------------------------------ W Design Flow.....................J.'."r7-..___.grallons per person per day. Total daily flow.............. ----0........_gallons. V4 Septic Tank--Liquid cal)acitv,/,M, allons Length________________ Width..___..--....... Diameter_........- ----- Depth._-_--._-_--. Disposal Trench—No- ------ Vidth--------- ..........Total Length.................... Total leaching are- -------------------sq. ft. Seepage Pit No..................... Diameter_________-_____--_-- Depth belo%y inlej...... . ....... Total leachitlg area.- ......-----sq. tt. Other Distribution box Dosin nk,' Performed by--- e.. Date---------------------------------------- Percolation Test Results ___tll oi,_ Test Pit No. 1................minutes per inch De Test Pit..__.....:_._....__. Depth to ground water------------------------ Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water--------------------- .................... . - ------------------I 0 Des I ztton of Soil 7. --------- ---- ---------------------- L) ... .....*'r 144A4.No---------- . ........... .. ... . ------------------------------------ -------------- -------------------------------------------------------------------------------------------------------------------------------------- -------- ----------------------------------------- U Nature of Repairs or Alterations—Answer when applicable.-.------__----- ---------- ........m---------------------------------------------------------- ------------------------------------------ ---------- -------------------------------------------------------------------------------------------- --------------------------------------------------- Agreement: The undersigned.agrees to install the afo.redescribed Individual Sewage Disposal System in accordance with 9 the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be9ej*Xued1bv_jhe bo�Lrd of 4 as h. -------- ............. D to ................... -------- Application Approved By._ :-/------------- Date Application Disapproved for the following reasons:------------ .......... ................................................................................1-... ........................------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date Permit-No........................................................... Issued......................................I................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD Z HEALTH .......... .TO.... .. ....0 F............ ... ....... . ............. w.rdifirate of 1.1.10mVIt'aurr. That the Individual Sewage Disposal System constru cted ucted ..TELL IS TOG TI WT or Repaired X by....... .. .......................... A --------- - -------------- ------ ----------- r ................. In ..........a --- -- -- ----- has been installed in accordance with the provisions of The: State Sanitary Code as described,in the p ................. applicationjor Disposal Works Construction Permit No................ ...................... dated. ... THE ISSUANCE `OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. x. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA T ...OF....... ............ ................................... o-d ............ FEE._!' ...... No.............----------- s . %sVo INorkii no rurtion errant P&missionj I ........... hereby granted---- 4,4., ........... ....�Z------- ------!------------------------- '7- 1 ------------------------ to ons"uct .or it I I�,Diipc,4 A yKeni4 A C an 9 _3� ..... .........No*4144 91 P42; _0 . .......................... Street a as:shown on the application for Disposal-Works Construction it AN ... ........ ..... Dated-if'-;4...-7;� ...... ......................... V. --- ---.............................. 51 Board of Healt DATE... ...................... ............ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS or_-- ►J Ut�T A St4bGLf-:- 1.10 GArzaG.--F-- C�RI+JL� 1L - r>/StZam{ r-LOW = 1 tO -4 3 = G.P.V. G TA+-ttG = 33Oy ISO % = 4-9cj 6.PL7. U Ste- l 00� 6ls.l_. i 15Po5,�. PIT - ' uSE !ocao GAS.. • Bt1TTO,(A AIZEEA= CEO Sr. TOTA L ESIGI.I = 425 -t-oTA L t»St t_�( Ft�•� = 33p 6.P.'D. r4;jx lV � e , PErZC.DL&TIOLJ O&TE � IQ 'LMIIJ 02 L.ESS. .. eA tvel ( -�,• •' /1.1%E }�A Tom/ i TEST EL.-�S Top P-N V _l co o.o ..Y d"Afg loco iuv 2 4' DIS-r IW GaL. 1,7. r -Sox io' ,. Wv. I Do0 �5� liuv. IW. .� Pic LsAr,y A W I Tt-•1 :i WASHED Ao /Me�LoCATIO" C 1L E►jT IZ'4 .LF- ASS. iJp VJATr.,t.1 CI;ILT1F=-{ TWA7 T14G trr `oUaDATtoQ 5t{orv►J Sit--A.1J R F tZc�.iC W I-rl-A TIa 5 r v �1►�� �..oT' 3 AkJ > ISE::TU'IACl/ V:r-QUID' -ME NTS Ol; TW1 C>!�'i'G• _.�� R �,�.�.�^-�-�--t'�.' C+� ►�.�i =' C3/�XT C ZZ �. 1..1 Y'E 1�1 G. VC -rc 5u2vEYo�y T1,AI5 t7t_A." 1!, c_!OT I-!b G.ID 064 AN 05TEIZVII_I-.G o 1+J�.r�'Jt✓lL"_w i %c�c,,�r-_� � YI�>~ c:;�rr�r=C'�, �t�O>w►� Ap4�t...I C_A.►�1�T" PAUL LZOWAeD I.Iat C t:: U'�Ci: -1c, � �. Al 7 WINDOW SCHEDULE Lo z n N L.JTYPE MANUFACTURER'S UNIT ROUGH OPENING REMARKS ' L � A MARVIN INTEGRITY!TDH 305G 2'-6 112"x W-8 1/4" DOUBLEHUNG TYPICAL A5PHALT W B ITDH 3052 2'-6 112"x 4'-4 1/4" DOUBLEHUNG RooF SHINGLES Z o < C MARVIN ULTIMATE WUCAFCIR 2750 2'-1 112"x 2'-I 112- CIRCLE w [_ g D MARVIN INTEGRITY ITDH 3040 2'-6 I/2"x 3'-4 I/4" DOUBLEHUNG of N _j LJ NOTE#I:CONTRACTOR TO VERIFY ALL QUANTITIES AND SIZES OF NEW WINDOWS WITH OWNER AND TYPICAL I x 8 FASCIA V Z ROUGH OPENINGS WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS a FRIEZE BOARDS - TOP OF PLATE �D L17 3 I 1 III II1111 I 11 I!I 111 11 it II i I I 1 1 I III! III II II - CV . 1C [fill I i I1 llI I 11 1 I II I II I 1 V 28'-O (5HEDDORMER) LJ I I 1 lilt 11 11! I ! IIIIJI 11II I LLI III li I I I I I I II i l III III I II I I II 0 1 IiS III I 111 1A - 1'I lill 1 II II II 1 !1 1 I1111 it if 1111. -N A4 A4 1t II 11 II 11 1 I 11 T1! 1 Il !1 111111 I!I I °�_ z M 6'-I I° 6'-6' T-8° - 6'-I I" "O I! I II I III: 1 1 ! I IIII 11 I i t`� "' t A D 612 A _lii I ! i II 1 it I I I I II ! nlll�I IlJ !nl,ill iJ 1 1! a (jt I L _ JJ1 1_tl. I !I ll I --Ibw SECOND FLOOR '^ SUBFL JO co 0 00 lit L OP OF PLATE z Lv? -I m ''�I111�1I1�1 11 HI Will If IIII 1 I' I I I I I 1 I I 11 I II III I I ! IIII I II Q' 1...I II I I111 I IIII 111 O ¢ ! BAT 1 1 1I ill II II I IIIII 11 I n I I! 11 1 t 1 ll u I lu ! 1 1 fl 11 1 a 1u Q cc 11 1 II I I II it I II ! I 111 I I 1 1 III 1{I IIII 1 1 I it 1 I I I I II I I (� G �. I IIIIINIfI 1t 111llial it 11 !t 111111111 i I III III f! iil III II I I!i+ Iltlll Q N - t s r-s 11 I !I11�7-LII IU III II 111 I I II-I II II I I I I I I I I III III i p AUG 212 J 6 'A`,11°�y I p o LJJu � I I I I I_I��I I III I I I I I II 1 1 I II 111 I 11 1 { III o LIN. 2O x _ tl I uII''i�t�1 L I I 1 11 lilt JJ LLI l ___JpppllLlLll 1 IL !Jll Ll 11LllJllL111 n C/1 I HOMEM 68° 6� / \ _ II�T I11 I ! 1 I I !II IIII 1 IIJI _tL� I�l.1,I�jL!J,I�IL,1,.�1JI I IL, w X L' 11 ,+ _ {I 1 It 111 II11 11 nU1iNU11 I 1 f ifI ! I L!1fLIll! N 1 tl IJ 1 fill I ip 2, Q (n El_ OFFICE v BEDROOM u-�1i11L��[ JlulJJllu ll iliiL4tull�ullilil 1iiiI� IIII Ji[uti1 ityu1u1�1911� i4�1a� 1Iu �1i1'tliul.ltiJu°ui v CQ � 5'-0" 2'6°x 'a I!U 11.14 U_Il_II_tL y uI"bJI 11 Il tl it _II Li .II[ ll ILU 11t1 U II Il U-LI[T U It U 11 u U lI LI .II U_ c� O J J Bt-FOL�i LO 5TAc nil aI[_LL I-JLIIILLLUJLIi_U_llJ 1l lLI !t_Ull�11_[1 lllt_LLIIIIIII�_ILt_U LIE! IJJ_ LL�1L[�.li q-11 I LLJ Q w/D U..1111 U 1 L1 1l-I T II II JT�I li 11 II I I L Ii Lt it_I1111 IL[l !1 t111 U.U 1 Il ILLI IIT Ifl I L1� I[i�11 IJ U IL( V I T Il All TOP OF M IAU N. cn 7'-6° q Il U-U_1l1L-..II l LU IJ 1 1!LI Ii 11 l l i_[I( i 111(I I It IJ 1.1 U t1 I tl l- 1-I1 LI J.I L 11 L II Il I j- II IT 11 III FOUNDATION '^ v `>/ 5b Ox 6 8' 6 N 612 DN 12 REAR ZLEVATI ON a 15R@ REF. v L A LIVING n D HEJ ill 11 11 I i 1 I III.1 1 2 O KITCHEN f p L 6 (VERIFY CABINET r TYPICAL I x 8 RAKE BD5. !IL!UI�tl Iljl .U11I i I'I_ LAYOUT W/OWNER) W/ I x3 DRIP BD. - I IfJ I J lUJ I I!I� IIII fITU!1iLU 1If IJ li 11 it t I II I i�L�JJI f I ILJtj�1 II ILLJ I II (I J in - .il III I _ � ! III l i I I 1 Il.l iL 11 11 IJ' L1I n I I 1 I III I I L I L��I J1J1 II IUI Lll I�I I UI jTil O l T L LI111 LLI I II-1 II TI1111J.U I I U Il I1 U� U 11 1 - RA GE � �o I Lt 11J„1P t LI I Ll !1L J L L'_. IIII_ UJ U1Tl t1 Li�[1 U-IIl1U-W�i1Jl.: 12 cl:� 00 p II I 11/ I1pJll`f1J1(1 J it I b - i — ! iJ ]�.1TU 111!~I Il� ,^ TYPICAL I x 5/1 x 6 r J L 1 2 I 0 V) CORNER BOARDS I I II {I ill I II 111 ' I I I I I I II 11 11!1 I1_iJ- O - 'IIII '111 11 1 Il lil;l! 16'1 1 11 I i 111 t i l 111 ® IIII I IIIII I I I IIII I , 1]�_(I - FL7 I I 11 it 11 1I I I I TYPICAL I x 8"FLYING RAKE" 1 it fill I-1-TI I I I I! 11 I -- 11 I�I I 1�I) _I L11 jU :111_ I - - - m`NBOA.RD5W/Ix3DRIP I I 11Nu UIt I IIlll'U_11.1LlJJIIi 3K N 2 3K 3K 2 2J N 3K (, 4 I x65U8-RAKE .! L�—III :1 LI .I11I'I111 IIj1-1 11 JI�II�t�11J)I-IL(�J-U.~` 1_ J Ll I U_II1T U 11.1- tl ~f_ NOTE: B B e G B B B l 1l I U Ullili_ JI' J U u I'n l 3 SECOND FLOOR n [ li L'1.1t f"1 1" THE PLANS 5HOWN ARE I 21 THE 50L F PROPERTY OF 711E DESIGNER AND CAN TOP OF PLATE - NOT BE COPIED, : '1T REPRODUCED AND/OR 2'-ID" -10" 3'-6" 2'-1O" 2'-10" 2'-1 O" ALTERED WITHOUT THEI[ I I 1 11 EXPPE55 WRITTEN I t I I i 'il1, L I I I! II corlsENT of THE ; A4 A4 I I I I I I'I I I I I 1 I I DESIGNER 24'-O' 2•_p° = p I I I I I 11 II I I I I 1 1 I 1 ' t`v it I II11! I I !11 ! II it 11 11 , I 11 1 I If lullIfII-I SCALE.: (SHED DORMER) - f TYPICAL WHITE CEDAR - II III I II li it I 1 I_J I!If lilt II II I 1 II I I I I I ,t In SHINGLE 51DING !II 1 II I f l l I I I 111 1 1 1 t I I I I III 1 II_1J 1� .I-Ill L IJ.I.t 1/Y = I-0" io 5't TO WEATHER I I I I I I I 1 1 i I I L L ll U-Ifl t 28'-O° _ 1 I I t ! - 11 1 I I I I I I IL I �L!!, )! I U I I i 11 1 I 111 II I , I III I I I 11 11 I IIII i I I i l u DATE LJ,�1 JI 11 A! 'L1. LILJ.LJ n 11 1 ltll - 1L 1 tll[ 11 L_J L: J UJ I I I I I I 1f I I TOP OF 11J!LL'J. �1�-ll U 11 I. J-ll.l �,�I 1 I 1 ! 1 1 I i-f II IIII U F l//� F P L1ULI1 5/23/2018 SECOND 1 LOOK LAN FOUNDATION ' 1 III Ill it l 1 1 I III ; 1 I f 1 11 L_ LIJ PROJ. NO. 2018-113 HABITABLE LIVING AREA = 775 S.F. LE 1� ✓1 D E ELEVATION DWG. NO- f \ QS SIv10KPlCARBON MONOXIDE DETECTORS ! ` CML O 5 10 15 20 e �. ©COPYRIGHT 2018 BY THOMAS A. MOORE DE51GN CO. OWNER OF RECORD I CERTIFY THAT THE EXISTING DWELLING ELIO PAS505 LOPES �- 13RITTANY KEITH LOPES LEGEND SHOWN HEREON IS LOCATED AS IT IR(FND) LCB LAND COURT BOUND CERT. #208G43 °� EXISTS ON THE GROUND. . LAND COURT PLAN 38325-8, LOT 33 ! IR IRON ROD LCB(FND).. FND FOUND Assessors Map 149, Parcel 147 1 1 7.5± PROPOSED DIST. DATE EXISTING DI5T. RX DENCHMARK TOP OF L.C. BOUND EL=51.2 O'REiLCY -� G -±- ;ter rn � (ASSUMED D Approx. Location of a NO.GS733 ATUM) LOT 33 g,- \ Existing sewage Card 11 S 8s .Per 80 As-Built C Card AREA = 25.537 5F± sLn Q 03 IR(FND) \ �� �4 // \ •}7\ Q\ Qo� I.O \x �O AN-OUT col / rZ o; a / co IR(FND) / ;+ a �d ? _ ��oQ Shed ; . . ... _ :-:; _ �} 'TO BE REMOVED Step,\ AS-BUILT PLOT. PLAN SHOWING DWELLING WITH PROPOSED GARAGE AT Q1 /' 77 BRIDLE PATH, f\%IAR5TON5 MILLS, MA NOTE: PRIOR TO SETTING THE FOUNDATION FOR THE PROPOSED GARAGE, Q `� / FREFARrU FOR THE INVERT ELEVATION OF THE TANK SHALL BE UNCOVERED AND rr''->� \� ���� ;� ELI O LOPES _ '- VERIFIED. ANY CHANGES TO THE INVERT ELEVATION SHALL BE :':;:, ;;: '= /.. AND - REVIEWED WITH THE DESIGN ENGINEER. ',.' `''' / / 1 ' DRITTANY LOPES 0 30 GO �0� / SCALE 1 " = 30' JANUARY 25, .20 I'i ` r G:\AAJob5\8518LOPE5\DWG\8518.PROP05ED PLOT PLAN.dwg Drawn by: JMO. JMO-8518 J.M. O'REiLLY & ASSOCIATES, INC. 1573 Main Street, P.O. Box 1773 / ' Professiodal Engineering & Surveying Services Brewster, MA 02631 (508)896-6601 1 �