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HomeMy WebLinkAbout0094 BRIGANTINE AVENUE - Health 94 BRIGANTINE AVENUE MARSTONS MILLS A=098-029 TOWN OF BARNSTABLE ATIO SEWAGE#�©zAGEt ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) W14L (size) o�u��k ��•s�X o�� NO.OF BEDROOMS OWNER �G 1 ,o PERMIT DATE: `O-) COMPL CE DATE: y Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility > Q 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 t 300 feet of I hing facility)) Feet FURNISHED BY 'Q.0c 75 .4 VJ tA i"i'• A cy . B �S C. TOWN OF BARNSTABLE F, LOCATION �����-i� _ AjjE SEWAGE # f, VILLAGE- grams` aA 4r- ASSESSOR'S MAP & LOT (� INSTALLER'S NAME & PHONE NO. •�� ����® ��� SEPTIC TANK CAPACITY /000 G,4 EX�s��Jam, LEACHING FACILITY:(type)_RArcA:rr (size) /000 C41 Af`)� NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER �1$Ltc BUILDER OR OWNER j yAJI S Peaky DATE PERMIT ISSUED: � z�A/. T DATE COMPLIANCE ISSUED: Z— VARIANCE GRANTED: Yes No -=t/ o�y COO/ 0. v� " ��ltGRw T/NIE. Ar1t ---�V,,9401 9,0 Dom-Vl-c Q � n� © '�L � No._1.... ..... 7/ Fps............._............._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 8arnsta AF-s .,,; TOWN OF BARNSTABLE ,ie ConSer�atiun �� Uepartrttegt Apli ira#ion for Bisposal Works Toustrnrtiaa Application is hereby made for a Permit to Construct ( ) or Repair (L,-'an Individual Sewage DispftG� System at: ... ..�� � r%�t. v ........................................ ...A 7_&A4r....Ifd;Z!s- Location-Address or Lot No. ....p nz> .s �/............................................................. Owner A ddress . .....:.k.------••---•-----••--------------------------------------------------•-------.. .... *�.Ndo�bF/i Installer Address � feet Type of Building Size Lot...........................S q. U Dwelling—No. of Bedrooms.............................__. .__..Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria I� Other fixtures ------------•-- -•-----•---•..... . W Design Flow.............. !0......................._gallons per person per day. Total daily flow.............Mo.......................gallons. W Pa7i Septic Tank—Liquid capacity-./ o.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..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ ,4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •---•-•---•--------•--•-----•-•----•--------------••- ....................................................................................................... 0 Description of Soil...............................................................................------------------------------------------------------------------------................ x U .---------------------------•-------------•-•••--......---•-----•-•......---•••--...--------------•------------------••--•--••-••---------------........................................................ W -----------------------••----- --•---•---------••----------------•---•--•-----•--•-•------•-••---------••-----------------------•---••---------•---•-----•-----r------------------------- ------- U Nature of Repairs or Alterations—Answer when applicable.____ st':9llt...1 oQQ-.._G1lC.Ls h.�il•• ------------------------•--------------------------.--------------------------------•---------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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 ........... .....f. Dare A lication Approved B pP PP y ................ - ----- .. -. -. --------------------- ----------- �f--�Mte 9�� Dare \3 Application Disapproved for the following reasons: ...............................................................................................:....................................... ----------------------- --------------- -- -- -------------------------------------------------------- ---- ------------------------------------------------------------------------------------------- ---------------------------------------- Dare PermitNo. ....-- - r----t-7.7........................ Issued .- --------------------------------...........-- Daw 6q THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Bispmaal orki Tonotrurtua�n remit y _ s? Application is hereby made for a Permit to Construct ( ) or Repair ( t.iYan Individual Sewage Disposal System at: Ad ,'ate- 12 ....7- ...B. ' ......rts.......A...._ .......................................... ..../Y �cr�.1�.= r.J.l, ------.--------•----•--••-------•---•------------------- Location-Address or Lot No. ------------------•--------------------..................-- Owner f a ` Address !aJ_1�-•-�:�'__ .-•-------••-••----•.........................................•••••.............. --- -----........ < Installer Address d Type of Building Size Lot............................Sq. feet U g— ....Expansion Attic ( ) Garbage Grinder ( ) .-, Dwelling No. of Bedrooms................3_._..___._.......... Other—T e of Building No. of persons............................ Showers a YP g --------------------------•• P ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------••----•-•••--------•--•------••...--------••••••••••••--•-••••••-•-••-•-••.....-•••••-•-••••... W Design Flow.............�Lo........................gallons per person per day. Total daily flow.............? .......................gallons. WSeptic Tank—Liquid-capacity..AR;!o__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..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by ---------------------------•---------------•---------••--------------- Date Test Pit No. 1................minutes per inch Depth of Test Pit___..........._._... Depth to ground water......................... �T4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •----•-••----•--------------•-•-•--•-•-•••-•••--••••---•-••••••••-•--•-•............--•...•--................................................................ 0 Description of Soil........................................................................................................................................................................ x U ••••-•-•-•••--•-•---•--••••-••-••••-•-•••••-••--.....----•-•---•-•--•-=--••••-•••-••---•-•••••••---••-••...•---•-•--••-•••••-••••-•-----••••----••-•--••-•••••••••-•-••••......---•---•--••......-•----. w x •• -••--------------- -------------------••---•-----------------------------------•--•----•-••--••-----•-------•---•-----•----------•-----••-••---•-----•-••-••--•-•-•---............................ V Nature/of Repairs or Alterations—Answer when applicable_-__ ±sT1�__.-/ado.._ �.(.Lc�_`�ij--�:� �•actoai _- •--fit e. .!{....�.,"__.„�e,��_.�: ._,i-t�<l.,CG ----------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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 ----------- ! / z-- f--��3 . Date Application Approved By --------------t:? ------ ....----------- -- ----..�..- '-------Date Application Disapproved for the easons- ---------- --------------------------------------- ----------------------=------------------................................ ..........................------ -------------- ..........................--- -- ---.-- ---............--- -- ---.........................-------------------------------- -------------- --------.........---------------- ---- e PermitNo. c�. ........t.7-7------------------------ Issued .......................................................Dat---- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C er#ificaxte of V orayliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ✓) by------------------------------- """-------------........---------- . -- -- . .R .<. -------) ,-ssl,�.......... q Q Installe .1.. r / at ....................................................................... �.....l�k.I9-rQKlti c� ...........W��!�FTs2-�•t�'..F��1.�4�'................................................ has been installed in accordance with the provisions of TITLE 5 of TheThe State Environmental Code as described in the application for Disposal Works Construction Permit No. ........./....1 dated ------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNC� 10 SATISFACTORY. DATE..... / W ....-- ------ Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH qq _ TOWN OF BARNSTABLE , No...�. .....�. FEE.... p............. Disposal orkii Tonotrvdivic "permit Permission is hereby granted P. .J-.�*. .. .....-------------------------•-------------------...---------.....------............--- to Construct ( ) or Repair (p— an Individual Se�rage Disposal System at No........................A -•---•-- R�4 Ti AYE, ici PsrrA r'-�`'t' Street Cj��y as shown on the application for Disposal Works Construction Permit No..`.. .............. Dated.......................................... ............ •-••... -r•>---------------------•----------------------------------_ /�^ Board of Health -------------------------------------------------------- DATE................. FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS - No....pal.&�A.lJ ; " `F�s..........�....r-......... I THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH mod✓.. ................oF. f /� 1�_ ...................................... Applirativit for Uigpnaal Warkg Cnnmunrtiun Pumit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: T f i t+ J �g � �+ Locatil ress._ - Lot c�G`Ai�Ysy�S J 7� UG T/O/6��ci Cy���e--f�./�✓ © --- �® / Owner p Address a ✓�........ �� •............................•--•----.. ..... ]G.....-----•-•---•--•----••-•-•--••------••---.....................------ �Q Installer Address U Type of Building Size Lot_glc a:76...Sq. feet a Dwelling—No. of Bedrooms ....................... .............Expansion Attic ( ) Garbage Grinder ( ) # p, Other—Type of Building _ _ ............... No. of persons.......6................ Showers ( ) — Cafeteria ( ) a Other fixt res . -•-••---------------•--•--•--------•----..._.....-----••--------------------•-•-----------...--------- W Design Flow.........%5.S.........:................gallons per person per day. Total daily flow.......... _Q...__._......._.._.___gallon�. W P q P g -----_-- Depth---?--.3-- IxSe tic Tank—Liquid ca aclty�QP�_. allons Len h_�........_._ Width_./Q.._�_�.. Diameter._ _ $-Disposal Trench—No. .................... Width.................... Total Length...._............... Total leaching area__!VI.........sq. ft. ZI 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '"' Percolation Test-ResulIt Performed by...✓1��C!`� .._ .t?s !�'�Y ................. Date....4/ ............... a Test Pit No. 1...............minutes per inch Depth of Test Pit___-__/�.._.... Depth to ground water.._...../ �...- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•-----------------------------------------_......---•------------•-•-••------• -•----••------ -...... -------- .....----- O Description of Soil.Su Stir �'��1tx.S. ..s�'/�i✓ + 1✓b .�.�i� �?.�✓�----------•--•-•...............:.... W rJ ---------------•---••--••--------------------------••••-------------------••-......-------------•--------------•------------------------••---•----------••-------------•-----------.....------------.... s W j U Nature of Repairs or Alterations—Answer when applicable................................................................................................ s Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ued by the r of health. Dat Application Approved By------. '.... ­ ,� --. D.- D���...----- Date Application Disapproved for the following reasons---------------------------------•--------------------------•----------------•--•-----------------------•-•------ ................ ------ --•-------- .._...------------------------------ -------- --- Date PermitNo......................................................... Issued-....................................................... Date I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �/�t!!i✓- -------------------0F. 6�7�./ .G ...................................... Appliration for Disposal Works Tonstrn.rtion Prrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: boy` 7-,,le........... .......... %!' ` f c', ...._..._....._..................... . . .. ........ ............ .----------------------------•-- � ! Locatio-• dress /^ -• •---------- ----•-- o. -- -------- f/ d Owner Address - y�l�/r i 1,�l�l;/i�-�l `/i --.......---•-------------------------------------------•------------. Installer Address d Type of Building Size Lot_;��`�__�__h--..Sq. feet U Dwelling—No. of Bedroomsr ............... ........._Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ._ � yp g . . .. ............... No. of persons...... ................. Showers ( ) — Cafeteria ( ) ��_!`� dOther fixtures ..-•-•••....... ---•••-•-•••.......---•...............•----•--••••-•--•-----------•-------••--•-......-•------------.......•---•.....---•-----•------ W Design Flow..... .....5.....................••_.gallons per person per day. Total daily flow__._.._...�!_:_3 t?_.__..._._..._•......gallons. WSeptic Tank—Liquid capacity!'-'r%'-..gallons Length_S.•__......... Width../ L.6-..... Diameter.Z........... Depth. 7...._ -- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area.`'.:.2.........sq. ft. Seepage Pit No..................... Diameter...._............... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '—' Percolation Test Results Performed by--.���!''�r .. rt?%-`.-.��..:-�... . Date.... -----••...•...-. 1-1 ....-•••--••••.••-- 04 Test Pit No. I...E ........minutes per inch Depth of Test Pit......A«._..__. Depth to ground water.._..l�� P Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -••--------•-•----------•-----••---••-••....••••••••••••------....-•.................•---•-----•••••••••-• -----------------------•-----•-------------- O Description of Soil.:Sv! So i•L,......O�r�r.a•P `-`- )••' ' f��r a�6 .�./.•�5 ------------------------------------- x 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:IT1:2.. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been frssued by the boar of lipalth. A Si ned �......ii .. ...........u!1;r�!.F'{ .. Dat Application Approved BY ..---•--------•- � o�tf'�..------ Application Disapproved for the following reasons:_____________________ ---•--•------•-----•..............................................•- Date----........_ ...................................... .••-- ----------••......-•-•-•----•--•-••----.......•-•---•----•-----------------•------•-•------•-•--•--••--•-----•--••-----••-•----•-----• -•••----...•----- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � i!✓....................OF......, � />r5%/%G"iL Trrtif irttte of TontpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) Y ..................................................----•.--• -----•-•••••.....--•----•••-----...... Installer at..... .Y__......... ....... :?C_=!_.r r. ..,/ ..t..-•---_!=__!`"._ ..'--'••-•_/,/✓ ..'Y✓---',= '_---'---•- ....................•.......--......._............_..._.._... has been installed in accordance with the provisions of TITL=; 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit -..-_------- dated................................................ THE ISSUA CE OF THIS CERTIFICATE SHALL NOT BE CONSTR ® A GUARANTEE THAT THE SYSTEM WIL F TION SATISFACTORY. DATE......&... . ................................ .................•--. Inspector....-•-• -••.---- •••... .................................................... THE COMMONWEALTH OF MASSACHUSETTS _- BOARD OF HEALTH ..................O F............... ..�! ..r............................ FEE......... ....... Disposal Works Tongtrnr#ion rrntit Permission is hereby granted A_ ................i .' '_'_l.................... ---------................•-----...-•---••.............. to Construct O or Rep�/j�air ( an Individual Sewage Dispos�,ll� ystem / at NO...••9,?- sC r� /t i� i ifs-F ✓/C J .� /% i l�c';<-,.r�5 / ��C < --------------••••-�-•-•----•- -----....._..... .... -----------------•......-•----••-•-•...•-- ......................... Street as shown on the application for Disposal Works Construction No.__................... Dated,_....._.................................. ............................. Boar.d--'9, ealth DATE..........z ad �,�----••-••-••---••-••--- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS Fy CA 1 N SEWAGE PERMIT NO. 4 a � I A G E pVv 4 INSTAL R'S NAME i ADDRESS BUILDER OR OWNER /J p DATE PERMIT ISSUED DATE COMPLIANCE ISSUED .� �� � � c» � � --- f� � � �� I f � ,-:, , �n��Y� 1'- � .� �� � J -.y- am IN�4 t� co. AP•..� M EA.J SEA wv��lE� �J V 'S.,c G �� r ..�_ � P1TGLa fa�� �s�..1ES ,A, Mtr.1s►•^v� o¢ t/b f - y+ AL- P► J o t xj -T't•# SY sTE M s N A.�..k.. 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