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HomeMy WebLinkAbout0030 CAMMETT ROAD - Health 30 CAMME'T T FlOr. -j�o ct c ` NIA 8 .o1VS lv" fl,u J i r, i t a TOWN OF BARNSTABLE C "� --ATION 30 6,1044,11` Ab SEWAGE #1000- 7l� VILLAGE X.A Ar ASSESSOR'S MAP & LOT -D '00 INSTALLER'S NAME&PHONE NO. 6,v3 Awc/ -, SEPTIC TANK CAPACITY I oaa G#C LEACHING FACILITY: (type) JZ5t j:�a( ZrcLi 4trr2,J�J(size) 13 X 3� NO. OF BEDROOMS_ IV BUILDER 0 O , PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Sp¢ 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) l��Y� Feet FLunished by e3 7 �Sd r 37.5 ' f No. tdl�� �'C_ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 3pprication for Migogal bpgtem Congtruction Verntit Application for a Permit to Construct( )Repair(V )Upgrade( )Abandon( ) ❑Complete System adividual Components Location Address or Lot No. 30 Cal f Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. &f fps/ ) L 67` 37 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(/60 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /W gallons per day. Calculated daily flow 7 �d gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank la929 021 � �' Type of S.A.S. 0>e W e Description of Soil G mAezees /2- it 37•Sil'Z Nature of Repairs or Alterations(Answer when applicable) 7P--)>­/e J;r �' del/^ or 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 issued by is Boar f He h. / Signed Date I LI l�L% Application Approved by Date Z Application Disapproved for the following reasons Permit No. �� 7 Date Issued f v EL TOWN OF BARNSTABLE LOCATION o .a �� ,� - 3 C. lyle /{ SEWAGE #.2U40 7I -1 VILLAGE 1 A11r > ASSESSOR'S MAP & LOTaY4 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY Iftw e4G .1 LEACHING FACILITY: (type) 0,916,t L,,ts C �,(size) /3 X 37.1'•�> NO. OF BEDROOMS' y BUILDER ON OWNER) Ae PERMITDATE: COMPLIANCE DATE: D� 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 I .Edge of Wetliiiid and Leaching Facility.(If any.wetlands exist within 300 feet-of leaching facility)_ Feet Furnished by CY' - tw a. Ft for Q y � - - No. l��V Fee Sri THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppficatton for Zigpoml bpgtem Construction Permit Application for a Permit to Construct( )Repair(Y )Upgrade( )Abandon( ) D Complete System LLJ'Individual Components Location Address or Lot No. 30 C�/yJ/f9�' / Owner's Name,Addresss d Tel.No. Assessor's Map/Parcel �� Installer's Name,Address,and Tel.H No. 5�, Designer's Name,Address and Tel.No.of toG©//"> ©"f 7 7i 93�9 Type of Building: Dwelling No.of Bedrooms / Lot Size sq.ft. Garbage Grinder( C7 Other Type of Buildinge'Y?If No.of Persons Showers( Cafeteria( ) Other Fixtures Design Flow llI�j gallons per day. Calculated daily flow `� gallons. Plan Date Number of sheets Revision Date Title _ Size of Septic Tank /agep "907 Type of S.A.S3`` S/d , e,5�f Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: f \,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 issued by is B ard-of He .tli. Signed Date Application Approved by °'r�a+ Date Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS 0 7 l BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that thq On-sit Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by Ol r®7� / at �CJ CQ �/e /L� l S " �/ 5has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Perm o i a r'' /dated .Z" ' Installer Designer A -, The issuance of this p i s I°not be construed as a guarantee that the systemw�11 function as/designddi vG Date Ml�rr�C_l Inspector � s �� I L �� --------------------------------------- NoVA /�, © ®�O`�/ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS lwigpoga[ 6pgtem Congtructton Permit Permission is hereby anted to Construct( )"Repair-(✓)Wpgrade( )Abandon( ) System located at 31� C4;7W1W110 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 dopermit. `%%� i Date: �'� Approved y9 f NOTICE: This Form Is To Bets ' Used Fo r the Re pair Of Failed Sep-tic Systems. Only. _ CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRU ON PERMIT(WTTHOUT DESIGNED PLANS) here certify that the application y �' pp cation for disposal works construction permit signed by me dated !2- ///A� concerning the property located.at 30 GQl�I�1� j^� ��Q��, pq ��`�s meets all of the following criteria:. The failed system is connected to a residential dwelling only. Tner e are no commercial or business �les associated with the dwelling. .V is - e soil.is classified as CLASS I and the pe=oiation:ate is less than or equal :o f minutes oer inc2 V '-'fie:a are no wetlands within 100 fee;of he proposed septic system, here are no private wens within 140 fee:of the proposed septic l� ;here is no in=ease in flow and/o r change to use proposea ere are no variances requested or needed. The bottom of the proposed leaching Liclity will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater.able.using the rtimptor m od when applicable], If.the S.A.S. will be located with 250 feet of any vegetated wetlands. the bottom of the proposed leaching facility will not be Iocated less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface EIevation(using GIS information) -7 /. B) G.W.Elevation 3 t the MAX FFigh G.W.Adjm=ew(5 3_. 35 , 3 DIFFERENCE BETWEEN A and B 3 t j SIGNED : DATE: / Xvin [Slouch proper plan of system on Wd 1. �6eabm t+oider:oat i r s I 00 I 0 O d C� kv-9 fZ. 7.Sr X zea wRe 1 TOWN OF BARNSTABLE 1 �CATIONLor l SEWAGE #��—2 e' � VILLAGE � ASSESSOR'S MAP & LOT li INSTALLER'S NAME & PHONE NO. 2 7�/ SEPTIC TANK CAPACITY !sob Si LEACHING FACILITY:(type) ��,¢� e, ��s (size) /o o o Gg NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER G�G BUILDER OR OWNER 49zl l&� DATE P\RMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� S-7 IN, el TOWN OF BARNSTABLE LOCATION ( GAN\ i`� SEWAGE # �S m I — 2,C VILLAGE lbl5 �LkS ASSESSOR'S MAP Cz LOT INSTALLER'S NAME & PHONE NO. Ar--c R- Ct>3-5�, kasca, SEPTIC TANK CAPACITY IS DO , LEACHING FACILITY:(type) � (size) [000cya NO. OF BEDROOMS - PRIVATE WELL OR PU BL C WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: " VARIANCE GRANTED: Yes No K 1 Z-�?Ivzx M �vLT �� ASSESSORS MAP N0: � No..�l PARCEL NO: -- Fx$.. .7J............._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 1(75 .........OF....... y '� XPOratiun for Diupu,itt1 Workii Tuuitrurtiurt Vanfit Application is hereby made for a Permit to Construct (i/f or Repair ( ) an Individual Sewage Disposal System at: ..... --- .! .r►a.e.T1 ... ../�1:. +,�_l.!-- -- -------------------------- '---.. ---- 1 ......................... Location- ddress or No. Owner Address W ------ - --.. _ .. _.._...._.. Z✓i Installer Address Type of Building Size Lot l%.�!l--------Sq. feet Dwelling—No. of Bedrooms.........._3---------------•_---_--•__.•_-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures ........................................................................ Design Flow•.................................`��_..gallons per person per day. Total daily flow.13; ...............................gal W Septic Tank—Liquid capacity Z.4-A_gallons Length_«'4'. Width-. ;r7`" Diameter...__._.... Depth_.45�. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area................ ..sq. ft. Seepage Pit No.........../.------- Diameter......e��_..... Depth below inlet...4. ........... Total leaching area...Z•4e.7...sq. ft. Z Other Distribution box ( ✓) Dosing tank ( ) `-' Percolation Test Results Performed b .. � ._ it/ _�ei� ......... Date..._"Zh:. S � Y �i Test Pit No. 1-------Z.....minutes per inch Depth of Test Pit.....!. '....... Depth to ground water_____________•__-----__. r34 Test Pit No. 2._...__Z..._minutes per inch Depth of Test Pit-----45-....... Depth to ground water...................... 0 Description of Soil...4.s, ._ft„:,csfS�! 'c,.'� �o.l �a ,�S N"--------------------------•..................... x U --••----•--•--•--•-•---•--••••-----•-------•-----••-•-••-•------------------------------------------------------•--------•--•••---•--•------------•-•----•----------•-------•--------•----•---•-•----- 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 ;of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certifi e of Comp1. 'e - ued the boar f health. ` Igne •--------------- .... -' Application Approved BY-------- -------•-----•-. •------- Date Application Disapproved for the f ollowi e°sons: - -••-----.....--•.............•----••---•----------------•--••--------- ........................................................ Date PermitNo.......................................................-- Issued....................................................... Date No.. Fizz......... ............. THE COMMONWEALTH OF MASSACHUSETTS .BOARD OF HEALTH ...................OF.. ...... ............................................ Allpfiratilin for Uhipaoal Works Tonotrurtion 1hrutit Application is hereby made for a Permit to Construct ( V or Repair an Individual Sewage Disposal System at: ........................................ ...................... ................................... Locat*2n-.Addrips or Lot No. ------------------------------------- ....... Owner Address A— _- ---- --------------------------------- ...... .... ... ....... ................................... Installer Address-S Type of Building Size Lot`_.'� 9;---------Sq. feet U Dwelling—No. of Bedrooms___......_I..............................Expansion Attic Garbage Grinder PL4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ........................................................................................ ............................................................. Design Flow_________________________________`.. ...gallons per person per day. Total daily*flow._.3• ................................gallons. 04 Septic-Tank—Liquid capacity�!.-'Lgallons LengthZ, Width__j_-'.L__ Diameter__-_~—------- Depth- 5.,S..'. Disposal Trench—No. .................... Width........_._..__.._.. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._______../-------. Diameter_____ ....... Depth below inlet..,;.............. Total leaching area_.,"E1.,.7...sq. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed .......... Date....'�?- ......... Test Pit No. I......Z-.n-----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..................... -------------------------------------------------------------------------------*----­-------------------------------*---------------­------------------- 0 Description of SoiLiL2A_M.. .. ... e�-4 4�� < . .......................... ..................... .................................. ............................................................ U ........................................................................................................................................................................................................ ------------------------------------------------------------------------------------------------------------------------------------------------------ ----------------*---------------------------------- U Nature of Repairs or Alterations—Answer when applicable--------------------------------- .............................................................. ................................7....................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T'-LE 5 ol the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hasj4eq issued b he � a y the o a S-igne ... .... ....................... ..... .......................... ................................ Date Application Approved By.........PJI.I'Lal��V�............ I G L................................................. Date Application Disapproved for the iollowin,g easons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ............................OF.................. ................................................................... Trrftfiratr of Toutpliatta THI- IS TO CERTIFY, That the Ind -al Sewage Disposal System constructed or Repaired by........ ............. —T C ........................L. ........................................................................... at........2.�a.......C`.­..—­e-__1y7_....,e...... Installer /.4­,1.1__�............................................................... has been installed in accordance with the provisions of T�T;E 5 of The State Sanitary Code as Permit No.. ... c . ed in the (�s A application for Disposal Works Construction ................ dated-------- -—-------------- I............I .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTIr!RA" GUARANTEE THAT YHE SYSTEM WILL FU CTI N FACTORY. DATE................. .... .. ........................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Z• .. ....... .....................OF.. .... ...7.........�:........................................ No—,....................- FEE........................ I 'Diaposal 19orkii Tonidrmftott Virrutit Permission is hereby granted.............................................................................................................................................. to Construct Repair� an --­-­------------------ Individual� S4 ewage.Dyposal -S--y--s-;t.e..r.q at No.. _ 1 1/.1. .. ..................----------- ................................................. Street V ............. as shown on the application for Disposal Works Construction Permit No,. Dated.._.-.______:`_________ _ .................................................... ..........r ....... cl"/ -I i(��- q 'oa,d of Health DATE................... ......................................................... FORM 1255 HOBBS &'WARREN, INC., PUBLISHERS Note: Qt wv.>,u•i tab a W-e&i a t.i,& to be temoved 10 aaound pit and 4.eptaced with ctean J4-U. ; ' .4- ; . �a 41.o 41.1 \,L,y. _.R4- Xo t A4.ea 41.2 439579 S 9 road j` — - — — — — Za 40.E ' 40 1 wide �r2d D R V E N yA R. T-1 ++ �'` i 1 MI-6 1 6 Ir PRovosca !!- Saa Ge I Ll a cf11/2 atoHe -f3 ` jO 3 �.R. 4/./ hate 4-22-87 I kqd=�1087 ` ,217 a 1 { � rn 42.4 32f / RU Cape £n���k 00;? 49 Jdc✓cbot load \RganpaA, Ma.. 02601- _ k/^TER 44 i LI qo.S 4a•8 4/.3i /IO.G3M 42, �i No iite No Sca to No. bed-too" 3 4 Ga cba�e di/,. no C,i.t. to to t i tow 330 qpd v r• 1 S00 S Q M -l3 ckiAney .(•eachi jw. area 267 vo f� O ,y� YN t rr ,� M M M ^ ��II� 1-6 �G 6 p-1.t .,/r� f �es.eicue 267 a capaaiq 549 qpd PlN W/` %L vY� lulu' uM Sketch p.Can o f _'and in Aatd to►4 IV", //la. 90 c Diane IJe Uand lgeix,� a tot ati eJwwn on a ptan arced joy Diane We.itand bH Down Cape C �dated 4-27-85. . . Cteuat io" a.hown atc on an mussed datua. __{ geit Pit #489 z j rude 8-29-8 S Condon -------Rjerit---f Le go— No watvt encounte&.,-,d Pe&c gate 2 nPivi pet 1 37.5 - 37.5 - 3G• j CIAO coa4A.e 35.E 1 coax e Mks �q��N 0 ILNE ot i D 9 I Ol C► 9fSiER�� F�``�