HomeMy WebLinkAbout0102 BRIDLE PATH - Health 102 Bridle Path, M. Mills
A= 149-136
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TOWN OF BARNS.�-B..— -
LC'�;A',I'ION._f � � i cL�� SEWAGE # ��
-iLL/;GE =� � ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.—�—A
SEPTIC TANK CAPACITY / C b 0
LEACHING FACILITY: (type) `" d+- 1 (size) v
NO.OF BEDROOMS
BUILDER OR OWNER`CC X L
PERMIT DATE: c '7 COMPLIANCE DATE: 1 —
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 feet of leaching facility) Feet
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Furnished by
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No. �24 - Fee $5 0 . 0 0
' 6� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01 Yication for Migogaf gtem Cottgtruction Perron
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Application for a Permit to Construct( )Repair( 3')Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 1 0 2 Bridle Path Owner's Name,Address and Tel.No. 4 2 8—1 8 0 4
Marstons Mills Linda Corey
Assessor'sMap/Parcel 102 Bridle Path, Marstons Mills
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.
Wm E Robinson Sr Septic Sry
PO Box 1089 , Centerville, MA
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( nt)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil sand
Nature of Repairs or Alterations(Answer when applicable) Installation of Title5 leaching
system consisting of D-box, and 3 stonepaciced Cultex infiltrators .
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 su d by t ' Bo d of Heat .
Signed 6 ( Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. "` Date Issued
V,
No. �V l"? Fee $5 0,0 0
f 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pptication for ;Digpooar *p!5tem Conotruction Permit
Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) O Complete.System ❑Individual Components
• Location Address or Lot No. 102 Bridle Path Owner's Name,Address and Tel.No. Q 2 8—1 8 0 4
IV Marstons Mills Linda Corey
Assessor'sMap/Parcel• 102 Bridle Path, Marstons Mills
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.
ti
Wm E Robinson Sr Septic Sry
PO Box 1089, Centerville, MA
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( noo" 1'
Other Type of Building No. Pers<n g�r? Showers( ) Cafeteria( )
Other Fixtures
j . Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
I' Size of Septic Tank Type of S.A.S.
Description of Soil sand
Nature of Repairs or Alterations(Answer when applicable) Installation of Title5 leaching j
system consisting of D-box, and 3 stonepakked Cultex. infiltrators.
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 issu d by t ' Bo d of Health? ell
f Signed l' ✓ Date C
Application Approved by Date
Application Disapproved for the following reasons
t
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Permit No. '"' D ite.Issue�d"''r� ^"
A' THE COMMONWEALTH OF MASSACHUSETTS
Corey BARNSTABLE, MASSACHUSETTS
i
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( x )Upgraded( )
Abandoned( )by
at 102 Bridle Path, Marstons Mills has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 7 dated K� s✓�' 917
Installer Wm E Robinson Sr Sept SrV Designer '
The issuance of this t sha�}ot be co 1 ction as
g y g ued as a uarantee that the s stem designed.
{ Date P ! / Inspector
No. /^- Gr Fee $5 0.0 0
r THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Corey
lwi�poal *p!gtem Construction Permit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 102 Bridle Path
Marstons Mills
Installer• Wm F Robinson Sr SPnt+n Srv,
i and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
i
comply with Title 5 and the following local provisions or special conditions. /
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Provided:Construction must be completed within three years of the date of th' it.
Date: 1� " �•:7 '' / Approved
t '
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NOTICE: This form is-to be used for the repair of failed
septic systems only
I
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)
17 William=E. Robinson, Sr. ,hereby certify that the-application for disposal works
construction permit signed by me dated 4 s �—C I q .concerning the .
property located at 102 Bridle-Path,Marstons Mills,MA meets all
of the following criteria:
re are no wetlands within 300 feet of the-proposed septic system.
There are no private wells within 150 feet of the proposed septic system.
(
V The=obsevedgroundwater 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.
VThere-are no variances requested or needed.
SIGNEDZU _ DATE__6 S r�
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60
(Attach a sketch plan of the proposed system. Also if the licensed installer proposes a certification
plot plan,this plan should be submitted).
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t
r TOWN OF BARNSTABLE g 4l
LOCATION
►'� - , �,��(i' 4� SEWAGE #
`ASSESSOR'S MAP & LOT
VILLAGE
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY 6
FACILITY: (type)
_ ►�.� _(size) v 3
` LEACH
ING G
NO.OF BEDROOMS
BUILDER OR OWNER C
PERMIT DATE:
-- '7 COMPLIANCE DATE: /=
Separation Distance Between the. Feet
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility
private Water Supply Well and Leaching Facility (If any wells exist Feet
on site or within 200 feet of leaching facility)
exist
Edge of Wetland and Leaching Facility(If any Feet
within 300 feet of leaching facility)
Furnished by
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
...........oF...-. .....9 ....ZT..-a.t.1-67.........................
Allp iration fv� BiivuiiaI Works Tomitrnrtion Vanfit
Application is hereby made for-a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
...............iIIIA.IG.........RA, -- I.111i, .......................................... .0............._.............------------.........
. . cation-Address' ^ Lot No
Owner Address
Installer Address Q Type of Building Size Lot0A3,_7o.Z'_�/
.......Sq. feet
Dwelling—No. of Bedroom __.. .................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons.....3................... Showers — Cafeteria
a Other fixtures ---------------------------
W Design Flow...s-. --_-_-------_.•_..-------.-gallons per person per day. Total daily flow_........�.2-..0....................gallons.
WSeptic Tank—Liquid capacity_I Ao9gallons Length------4------- Width---- Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching areal b 6__....sq. ft.
Other Distribution box ( ) Dosin t k )
~' Percolation Test Results Performed by.....- _ ... _ _�.............................................. Date........................................
aTest Pit No. l.Q.,.ID......minutes per inch Depth of Test Pit__.__1.7-_____ Depth to ground water..'...............
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
---•----------------------------•-••-------------------------------•----------..._.---------------•-•--------
----------•-.....*-------------------------------
O Description of Soil... -�---•. v l �.Q?g..h... --....P C ly�---..G�U- J------------•-------------
U -------------..... ..o--- -cx-A A qval..---•---p---1-•Q=... S:1&_f-.2...........................................................
----•-------------------------------•-------------------------------------------------•--•-•----•-------•------•---------------------------------------------•-------------------------------------•----
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 TL I T1 11L 5 of the.State Sanitary de— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has qbissued by tV5_� /
Signed.. ••----•-------. �X
/ Date
Approved BY 1�----------------------------------------------------------------•--------•-. -----------
Application
Date
Application Disapproved for the following reasons---------------------•-----------------------------------------•-----------------------------------..........•---
.................•••..........-------•--. ...........---.....__......_......••--••--------------------...------------•------•---•------------•. ...' ---------�------------------------.•-•-•-•---
Date
PermitNo.._... ...:3 -.�............................•...... Issued .�.....,1�.._. ........................
Date
No......................... Flza...........Flx..e) U
THE COMMONWEALTH OF 4i4^'-,SA,�CHUSETTS
BOAR® Off• HEALTH
Allp iration for U44pooal Works Tonstrurtion Vrrmit
Application is hereby made for a Permit to Construct ( ) or.Repair ( ) an Individual Sewagt"D sposal
System at:
- t ..�. :.�.� . . ��,.�?�. �'V�6�,���:,� ��' 5 ....................................... �. .........................................
"
.....�'��c ati�on Address
.........
_ r-Lot N o
t + .
......... ..................
J
Owner Address
... E..... .......................................... _
Installer Address ^�
Type of Building Size Lot _,?_________ ..........Sq. feet
V Dwelling—No. of Bedrooms..... ....................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building ' No. of persons......I................... Showers — Cafeteria
a Other fixtures ---------------------------••-•. .
W Design Flow...y..........................r........gallons per person per day. Total daily flow.._..... __�-_.-)...................gallons.
WSeptic Tank—Liquid capacity _ ...gallons Length._._............. Width... :"�_..__ Diameter________________ Depth..__.__.._..._..
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area?.....6------sq. ft.
Z Other Distribution box ( ) Dosin tank F( )
Percolation Test Results Performed by., -:-L -"�=� ' ` a�` .................................... Date.......................................
aTest Pit No. 1_d.:_� ......minutes per inch Depth of Test Pit......L_l ...... Depth to ground water_._ ................
1� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__-___----___-_-----____
�+ ----•---------------- --- .... .......................................................................................................
0 Description of Soil..�.•q a...---- S YJ 6. O J.. L ... � �-' �... l�� .............................1 , I
t�i `� 1 -4_.I`t (A tj t��......... � !) 1 c�........�1 t13 s!J t �s_P/£=---- L ! __V............................................................
U .... f........_.. •
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 TIT LE 5 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 t 'boar f hea h.
�- f
Signed.. _. !_-.-.Date.�..�� ..._
Date
ApplicationApproved By.................................................................................................. ........................................
Date
Application Disapproved for the following reasons------------------•---•-'-•-----------------•--------------------------------------------------'--•--------'--'-
--------------------------------------------------------------------------------------------------------............................................................................-.................
3� � Date
PermitNo......................................................... Issued------- �®-.....7 ..................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.: .. .l.................OF... .. _i k... .. . r"../.C...........................
t u, w.krrtifirate of TompliFanrl?
TIZjS IS TO CERTIFY, That theme Individual Sewage Disposal System constructed ) or Repaired ( )
bY.........'-C-q.. - ' 1- . `.-----'----- --'---'----------- '------- '................................ ..............................................
p-
�^ P 1 _.f.. � ............7....Installer @ ...-.-d�°la` ----•---'•- _� t_�!_a----'...............................
has been installed in accordance with the provisions of TIZ F 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No------ ................................. dated------- - .!3"__��.-_--_--._-.........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. �..
/ .
DATE............. ....-.1. ............................. Inspector....
THE COMMONWEALTH OF MASSACHUSETT$,_
rh.'WtK r..{F^ �r�!k'
BOARD OF HEALTH
�2 �� ~j..........OF:... .. . ....�f .� -................... O
........... . ......
No................. FEE...........
Dwpos_,al Vorkg %"onlitrurtion rrmit
Permission is hereby granted.....K •. ----•-- l= ---------•------------•--.............................................................
to Construct ( ),fir Repair( ) an Individual Sewage Disposal ystem
at No..---... ........ -.-----P 6 T IN ;...... ✓'A r P; W(X'V 4
------ ------ ---- . -•-----•--•---'.--
Street �� )
as shown on the application for Disposal Works Construction Perm i ..... .... Dated.... ;<: wr..._..�.
}-_
... ..........
:
�................._
L _ Bard of Health
DATE )-- ---•--•---•---•..........................•---•'---
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
OR
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LEi4CN/IVG, P/.T A q,- MORE rH I N 1211 SELO 4V
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/FILET" SEPTIC' -r..41vK 9S EFT. !O f7 O/A!►�J. CC-� +BUL-ATION> _
®U-74ET sEpTle 7-A vx 9S. 3 Fr
INLET D/57R/A5117/01! BOX 9 5 0 )M7 GROUND LITER TAaLE -
OlITLETD/STRlallrloN BOX 94 9 -F7 AGe 0/e�4paSA L SP4,.S7,=M
LEaOC/•//NG /SIT- L. 94S FT, 7A4g4d.A'T/0N
- LEACHANG` J=/T
z SCALE %4
®ES/Ca/V CR/TER1A DIAFEJv5/i)N &
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NUM®ER OF®EDI�04A9S 3
G.4R®AGE®/,SPOSAL, UNIT
S®✓L .LAG : �:;
,05T
TOTAL R 7//r9.47-,6D F 6b J-0kV 3�U G. 4.1DAY , SSOIL.
MUM8ER OF LEACAIINZ; ,0/7S_./ �FLEY. 97 C ELA-V SO/L 'TEST
SIDE 4,-AC,4/A/6 PEI4 P/T ! .Sri -;r , RESULTS h�//TNZSSED By )Z•7>. 3 u V/1<1S
8B O —2- �A� CacA—r4/®N R-4.rO A
BOT'TO/l 40ACNIA/G PER P/T SQ,. FT. r
TOTAL LEAC/�/NG •4REA SQ,' PY. FWRCOLA�-r/GN RATE.*2 M//v.�INCN
RESERI�ELEAG'NJN6 AREA Z6b 59P.., FT.
i .r.. ! i+r �Ie A-✓EG. •rJ YE� � : rN •Y S R"_ -
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�N OF,� y /DLE
: �O ROBERT a
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LEGEND z
,CERTIFIED PLOT , PLAN,EXISTING :SPOT ` ELEVATIO,PI �®xOd �, , i ` / <� I ' .
fXISTO�A➢G: CONTOUR -� I ® — i LoT /0 Br< OL's, pA-r.H.
'14"6
FINISHED CONTOUR 0 � yC.$.S�
t 1 t 5 mD yi'4 �
APPR0VED,= B.O'ARD OF HEALTH * * ' R
DATE • AGENT SCALE: /n _4O� DATE=F`S��'�1�-`
L®f�E®GE' ENGINEERING CO. IAI�G I CERTIFY THAT THE PIS®IP® Eg
r_ _--. _. ._ .._. . CLIENT R K E
EGISTERE REGISTERED JOB N0. 7702 6 BUILDING SHOWN ON THIS PL�f�'.,. .r;CIViL LAND CONFORMS TO THE ZOIdiRIG LAWS
ENGINEER SURVEYOR DR. f}`/� ' OF BARIdST BLE 'ASS.,
CH. BY:/5� ,pi 0.
33 NO MAIN ST 712 MAIN ST. s x
S0, .Y�iRM0U1'H, MASS. HYANNIS, MASS. Z" �'
SHEET OF._ 'DATE
7777
w :R ':G :L.AND Sd1RVE�''�� ,�.�
L.0 A Tr10N SEWAGE PERMIT NO.
WIL AGE
,d�IAr�o� ��llr
INSTALLER"S NAIVE Si ADDRESS
po b c 2 1 o ulz C,' i
IjAg wicF4
BUILDER OR OWNER I
12vr-k-e �� f
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DATE PERMIT ISSU D &, l3 ?K
T � i
DAT E COIAPLIANCE ISSUED
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LOCATION SEWAGE PERMIT NO.
1-01 Iv p6z ►dk p"o-lil 79-~ 3a9
VILLAGE
PArc croli Af1*11r
INSTALLER'S NAME & ADDRESS
abelz T ourz cis
A AOT wici4
BUILDER OR OWNER
4 N N1 s
DATE PERMIT ISSU D 17 t�'
DATE COMPLIANCE ISSUED
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