HomeMy WebLinkAbout0068 CHINE WAY - Health 68 Chine Way j
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Marstons Mills
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LO CA T19N �� SEWAGE PERMIT NO.
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VILLAGE
I N S T ,LLER'S A A A DRESS
� R U I L D E R OR OWN EN
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DATE PERMIT ISS-UED
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DATE C0MPLIA,N..,C<;E.;_ ISSUED
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THE�Co ^ RDALT C FUA�S,SACH�U_SETTS
DP'1 Lj r H E41 �
_......... ... ....... ..........OF................... . <<-...
b Appliratiun -fur Uiipuutt1 Works Tomitrurtiun Prrntit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at
..411t�;. ......................... ...................A .......... ..i�5�AIA - -------4��c�-c
Location-Addre or Lot No. �i!
•. • ..................••-- -----------......
Ow rr
Address
00
Installer Address
UType of Building Size Lot------- ._____Sq. feet
Dwelling—No. of Bedrooms---------------------------------------------Expansion Attic ( ) Garbage Grinder (�
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
QOther fixtures --•----------------------------------------------------------
W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity/s�_---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 ( )
aPercolation Test Results Performed bY-------------------------------------------------------------------------- Date---------------'----------------------
Test Pit No. 1................minutes per inch Depth of "Pest Pit_................. Depth to ground water-:.-.--..-.----.--------
f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...--------.---.-_-_----
W •---•-•--------------------•------••----•------•---............--•••-------•---••-•---•---•---•..--•..........................................................
0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------
x
U ----------------------•----•-••-----------------_-------.--------.-----•--------•-•-•----------------•----•--------------------•----••--------------------•---------------.-----------------------------
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 XI of the State Sanitary Code— The undersigned further agrees not to place the system in
ntil a Certifica e of Compliance has been issued the boPf hea
' ned. ----------------------------------- ---- ���
�-
� � i/Da`/"``` .4 .--
?441) ve Y ------------------------ -----•---------Plication Disapproved for the following reasons:-----•.............................•----•-•-----------••---------.......-------•----....................-----...
•.............•-•--••-•-----•---•----••--•---------------•-••-•••------•...-•----•--•••---•--•--•---•-..................•-------------------------------....-•--•---------•--•--••- •-------------------
Date
Permit No.--•-•-...5... - --------------------- Issued------....... l 3 � to
Date
t
7 -• i
.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...... ...........OF.........���. � ... - f
- ..................................................
Appliratiun -fur 43iupuuttl Vork,6 Tunitrurtiun Vrrui t
Application is hereby made for a Permit to Construct ( ' ) or Repair ( ) an Individual Sewage Disposal
System at 61
� r
"�.»• Location Address r or Lot No. 1
........... ...................................................
Owner! Address l �
�• �5 } `............i
Installer Address
Type of Building �, Size Lot............... ' ___Sq. feet
Dwelling—No. of Bedrooms--------------'�-__--__---____--_--__-____Expansion Attic ( ) Garbage Grinder
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures --------------------------------------------------------------------------------------
W Design Flow............................................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-------...........sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed bY--------------------- .................................................... Date----•--------------------------------...
W Test Pit No. 1----------------minutes per inch Depth of "Pest Pit.................... Depth to ground water-..._--..-.---_------.
(X, Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water------------_--____---.
9 -----------------------------------------•----------------------------------- ...............................................................................
0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------
x
V ------------------------------------------------------------- --•--•-----•----•-••-------•-------------...•-•-•--•-•••--------------------------•--•-------•------------•----•------•-...--•-----------
W
U Nature of Repairs or Alterations—Answer when applicable.---------------------------------------------------------------------------...................
-
---- -----------------------------------------------------------------------------------•••--•--••------------.._...-----.....----•-•---------•---------•-•-----........-_.....------.................
Agreement: I
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
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 been issued the board of heal
ned.... •✓`'�'" "� -� ''f -------------------- py
------
Application Approved B " [ `
--------------
Datre
Application Disapproved for the following reasons:--••-•------•-•-•-•-•---....----"--•-----------•-"------------------------•--•-••---------.....•--...--------•--
......................•----......••••..................--------•----•--....-••---•-••-----•--•------•-•••...---------------------.---------------------------....-------------------------------------••-
Date
Permit No.--------�5's a ----•-------•------- Issued................................... --� ----....._
Date
J
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......................................OF..............................................................I......................
0.1rrtifirate of f'Untplittnre
THI IS Tp CERTIFY, That the Individual Sewage Disposal System constructed,,O or Repaired ( )
bY----------- ' '
t°` 1
1 Installer
atd�.� - -------- 1 - ------- -- . .. .... -------------•---------•---------------------
has been installed in accordance with the provisions of Article—NI�of The State Sanitary Code as de cribed in the
►""1.� ---v--------------
application for Disposal Works Construction Permit No..................... ...-�--'�----- dated------...1. _5�
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA AN EE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE ............................................... Inspector---------- ----- ---------- --------- .............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
45 ? j— , .................................. OF....................................................................................
No......................... FEE.-
.......................�i��u� ti,� C�un�trnrtiun �rrntit
Permissio 's hereby granted----------- .. ..
to Constric r ain.,,,,( n In v' " ;�e4' f(gisP osal Stt�m
at No------------------ ..................... ........ .
- �y ------ - ------ -....
Street G5 is
as,shown on the application for Disposal Works Constru ie�,.,�'er Ii_t No.... .`............___ Dated...
YRI
....--•-----------------•------------•-•---•.••-----------------••------.._...------........--.---•...._
Board of Health
DATE................................................................................
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FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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EXIST.EXMAU5T PIPE 5TEP5 C BRICK WALKWAY 'n
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REPLACE.EXI5T.DOOR
NEW 3059 CASEMENT
� 4 REPLACE SILL,PATCH
5MINGLF-5 A5 NEEDED
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Town of Barnstable Geographic Information System April 22,2008 t
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DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:098 Parcel:068 ® N
boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:GARVEY CAROLE M TR Total Assessed Valuer$644100 Selected Parcel
,
1'=100'may not meet established map accuracy standards.The parcel lines on this map .
are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner:GARVEY NOMINEE TRUST Acreage:0.96 acres Abutters W ` S
rogw
boundaries and do not represent accurate relationships to physical features on the map Location:68 CHINE WAY
such as building locations. Buffer