The URL can be used to link to this page

Home My WebLink About0066 JASPER ROAD - Health rA 61--=047.038 o h s L S vn a S f ¢ TOWN OF BARNSTABLE /v LOCATION Ao<ie SEWAGE # VILLAGE /" t hL I / Ls ASSESSOR'S MAC' &LOT INSTALLER'S NAME&PHONE NO. A! 16) SEPTIC TANK CAPACITY Z D LEACHING FACILITY: (type) z.) (size) _� x�- X 'NO.OF BEDROOMS '' p BOLDER OR OWNER PERMITDATE: '7 `- /� ' `� 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 feet of leaching facility) Feet Furnished by i t C• Ldt� a i�"' ✓ I CA _ q do G - No. �c 0 �y� ..._ ( -.$ Fee S� l THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Mi5pogal *pgtem Construction 30ermit Application for a Permit to Construct( )Repair( )Upgrade(Abandon( ) ❑Complete System ❑Individual Components Lo�atjon A�s�s r tg No. n/I �n ,7e �f/J Owner's Name,Address and Tel.No. Assessor's Map/ParcelX Inst'allleer''s Name,Address,and Tel.No. Designer's Name,Address and Tel.No. P2 .2� 3e�' Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3y 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 Nature f Repai or Alte �onsns er when applicable) L Y x �' X�- Date last inspected: Agreement: The undersigned agrees to ensure construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of TQthis the Environ tal Code and not to place the system in operation until a Certifi- cate of Compliance has been issued bar f He h Signed Date — F" Application Approved by a Date 7— 9 9 Application Disapproved for the following reasons Permit No. 9�l '�,/a Date Issued 7 —/.7 No. 77 % ... . .. & Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for �Digonl *proem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade X Abandon( ) El Complete System O Individual Components LoVatjon Addr�+s�_ tQ No. a M ,9) l Owner's Name,Address and Tel.No Assessor's Map/ParcelFiO.e"^�_ _ Q ��hcX-C'� Q Installer'sAame,Address,and Tel.No. Designer's Name,Address and Tel.No. 3� 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 3y 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 �� L Nature f Repai or A ations(AnWer when applicable) 1- i 3 X. 2�—X J Date last inspected: Agreement: The undersigned agrees to ensure 41 onstruction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of T tle 5 o the Environ al Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b this B ar of He _ Signed G"`� Date (3-_ F` Application Approved by �- Date 7-- T' 9 Application Disapproved for the following reasons Permit No. yyd Date Issued 7'" 9 ---------------------------------.------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS r�s `•,,�, Certificate of Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed( )Repaired (� )Upgraded( ) Abandoe�( ) at .J has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. - G v dated '7— Installer J ill CIA/ Designer The issuance of this ermit shall not a construed as a guarantee that the syste wili func ' esigaed. Q Date /y 9 Inspector --------------------------------------- No.— f ✓�7 d Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS %igooar 6potem Construction Permit Permission is hereby granted to Construct( )Repair Up r,aAde( bando ) System located at /Yc 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 It. Date: 7 _l�—9r Approved by -i ce- )�� K P 1 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) hereby certify that the application for disposal works corzuction permit signed by me dated 7-13 ` , concerning the property located at �4 �, �d�a L meets all of the following criteria: • There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system • There is no increase-in flow and/or change in use proposed • There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will two be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) B)Observed Groundwater Table Elevation(according to Health Division well map)/Q SIGNED : (/ .4 DATE: `l 1F LICENSED SEDeIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert r ' 4 y' y TOWN OF BARNSTABLE LOCATION -to J SEWAGE # VII.LAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. t5 �2J SEPTIC TANK CAPACITY D G LEACHING FACU Y: (type) 2. (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 1i 11 - ' O COMPLIANCE DATE: 7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 4- 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) —AZe Feet Furnished by -z C-f c ems- A -e= 6� FL ' Cl. (, r 1 LOCATION SEWAGE PERMIT NO. 2 A-S P2/L VFLLAGE ` IN.STALLER'S NAME $ ADDRESS B U ll D E R OR OWNER DATE PERMIT. ISSUED DAT E CO-MPLIANCE. ISSUED �� cv,� R n A No............:3 f�.... Fins..........'Z.S.....— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN........O F.........BARNS TABLE ......•••...............................................•--•- App ira#iou for 11ispostal Works Tutuarur#iuu truti# Application is hereby made for a Permit to. Construct (x ) or Repair ( ) an Individual Sewage Disposal System at: Jasper -Road Lot' 459 ..............................................•-....................•--.....••-•••••.........._ .....................-•••-•••-••••••••-•••--•--•--..............•••. Lo,ati, . r Iddrr,,s u No. ..... .`.. ............ �..[..C�.O`-- .�..5.. ....�^C ...---•--........1.P.. .`.��/ ................................................... Own r Address Installer Address t4 Type of Building Size Lot..2 0,8 0 0•_-----_.Sq. feet U Dwelling—No. of Bedrooms.__.........................................Expansion Attic ( ) Garbage Grinder ( ) ., Other—Type of Building ............................ No. •of persons........6.................. Showers ( ) — Cafeteria ( ) a Other fixtures ................................... W Design Flow.......... 5.............................gallons per person per day. Total daily flow...............3.3.0.....................gallons. W Septic Tank—Liquid capacity.l 9 Q.Qgallons Length8_-'-_-6"... Width4_'__-10."Diameter................ Depth...5.'..- x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........... Diameter.... 0_'_......... Depth below inlet.....6.'-.......... Total leaching area......2.6.7_----sq. ft. Z Other Distribution box (x) Dosing tank ( ) Percolation Test Results Performed by..CAP_e...Cnd...Buxvay...ConsultantDate......Jan_....L8.,•..:19.78 Test Pit No. I...112.....minutes per inch Depth of Test Pit...12........... Depth to ground water....iiOrie.....__. (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� ••••.......•---•••••••---••-••••-•---.......-•-•----••...........•---•----•-•--•••-••••••••-•-•••---......................................................... oDescriPtion of Soil....----Q-0 .5-..wood...jQu ..... .. .. a3..0_7_5.J_Med1 m-.................................................... v � � aUP� qS ✓ Jq W --•-••••••••-------•------------------•••••-----•--••-....---•••.................. -•.......•-•-••--••-•--•--••---•------------....••-••--••---......•--•-•............... �_ +ZEiµVdfEft oyG UNature of Repairs or Alterations—Answer when applicable.__...........................................:.................... _-............8........ CHAPMAN ..........................................•-----•-----------....-•----....................---•-- ..................... Agreement: A -p No. 27654 Q The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in the provisions of TITLZ 5 of the State Sanitary Code—The undersigned further agrees not to ply t operation until a Certificate of Compliance has been • sued b the board of health. Sign e . ---• ✓ ----------------------------------------------------- --------------------------- ' Date Application Approved By-•-• .. ... �A-- - r------------------------ _Z:: 2.�............. Date Application Disapproved for the following reasons:..............................................................................................................- ----------------------------•-------------------------------------------------------------.......----•---._.....--------...----------...-----------------------------------------------------------•-•-•- Date PermitNo..................................................._.... Issued...................................................... Date No.. Z'... Fx$............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................row.........OF.........BARNSTABLE------------------ --------------------------- Appliration for Disposal Works Tonstrudion rjernfit Application is hereby made fora Permit to Construct (X ) or Repair ( ) an Individual Sewage -Disposal System at: ................... Jasyae :. QAs .........................I............. .......-...................Lot...459---•--•----------------------------.-.------------- I:rcation-Address 4" or Lot No. 4t.L 4:_l ..... .. ,;. . '` •fit - > f �s .......... Ai�. ............................................ t.- ..... -•-•-- _ .-----... Own r Address a ..--- . ........................:........... .....................•----.. - Installer Address Q Type of Building Size Lot._Za.,.S.©.Q.........Sq. feet Dwelling—No. of Bedrooms.........3.................................Expansion Attic ( ) Garbage Grinder ( ) ' Other—T e of Building No. of persons....... Showers — Cafeteria QIOther fixtures ---------------------•-•-----•----•-•------•••--•••-•.••--••--•-••---•---•-•-•--•--•--•-•----••-••-•••---.....-------•-••••••-•...•--.......--•--•--- Q - W Design Flow.........55..............................gallons per person per day. Total daily flow..............310---_----_.__.-•----gallons. WSeptic Tank—Liquid'capacityj..00(�gallons Lengtl !-..A.n... Width4.i..„I0ss Diameter---------------- Depth..S.I. A.,, x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No.........1,--------- Diameter...1Q.l.......... Depth below inlet.....6.y.......... Total leaching area......267-----sq. ft. Z Other Distribution box (X ) Dosing tank ( ) '-' Percolation Test Results Performed.by, ape...Cod--•Sfit-rwey...O :3sult& -tDate...._j-an.�...2$�__..�9�g a Test Pit No. 1..1./'2.....minutes per inch Depth of Test Pit }.3.;.._....... Depth;. o'•ground water....none---.____. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �-----------=----------------------------•••-•-•-----........-•----...-----...+............---^�--..--•--._....---••-----•-••--•--•---- SN xDescription of Soil.......0---11�-5---ri:�:t�� r 4 5�� } St.#�s 3: �"u :�. 'J...ML 'it v Of Mgs�ge rJ ............sald...�,...c 3vR : 5 4» �4}...e I� t�---sand--•5-••medi wtr•g�ve_ . . ....-- .-• ti W ........................................--•-------••--------•.....--•------•----••---•--•••-••--•••-•--•--------•---•--•--'----•-•-••---•-••••-----•-----.........•--........••• RENWICK N VNature of Repairs or Alterations—Answer when applicable....................................... .... ti-•--C++A�Po1AN '' .yy.l�a.27B54 p Agreement: 0' /S The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accor F /pyc}�iENG� the provisions of LITT.;•. 5 of the State Sanitary Code— The undersigned further agrees not to place sy9 operation until a Certificate of Compliance has been issued by the board of health. Signed.............. ........................................................ .......................... < Date Application Approved By...... d4 ' = `", '^_ s ......... Date Application Disapproved for the following reasons:........................................................................... ............................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued............ ...................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ , .......OF.............4 ...................................... f9rdifiratr of ToutpliFanrr THIS IS TO CERTIFY, That the Indivit al Sewage Disposal System constructed ( or Repaired ( ) by.................................------------------•------------------------- •. ' ''� ! Installer at--- ---- _... --- .-A-WArl.------------A 0...........................A01....Ail.- 44-•-•--•. ............•-------------------•--------------- has been installed in accordance with the.provisions of T 5 of The State Sanitary Code as d%�Ped in the application for Disposal Works Construction Permit No...7�.___�1:.................... dated_..._/�Z.A. .....��.._....._._...._... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector............................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH "7 !` .............OF.... ......... ... .. ................!........................ No......_.. .. ,jr...... FEE. ....... ........... igsttl park wunofur#ion rrntit Permission,is hereby granted------- ....------------•----•----------------•---•------•--------..... ...... to Construct ( ,•}-or pair (' ) an Individual Sewage pos rS ym atNo.--•-4(--s �----- + ,,t- --•-----•J---------••-----•-•-- •• -- � L�e f .... ........................ ' 6' Street as shown on the application for Disposal Works Construction APeNo ........ ......... Dated...../................................. F. Board of H66 DATE................................................................................. ----------•--•----........._....---....----•-•-----------...-•---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS $OIL LOG .. .�>ti,�(u�c nw•Nti..�K•�.,,�..,�,J,,..�,�v,�,max � 3`7 2•;.PEAS TONE � LOAM B_FILL I?" fo n o 0 0 :.1 4I I C.I. DI ST. 1 �,°• ° °° t' 0 0 BOX I, ° °' o o0 2. MIN. ° 0 �u•�}•g /� ! 7f1• 'L7" /o'MIN. 1000 +� °, ° 1000- GAL. d 0 c I GAL. °° PRECAST OR ° o ° SEPTIC 6'�p o� BLOCK °° °o o l Aga CAI TANK 1�.• ° ° ° SEEPAGE PIT D iAm o4 4 13 4 Q 00 o � I ?9 20' MINIMUM +le°°°• °° Go 'I = Jt441 G+,�i� ` 'L'7. FOUNDATION t Lu r ! F Q Fj f C�cii t=y T elTx �C ki5 S{ a,� tl . I I %: I WASHED STONE emaA aj.os Zo-mTnt, Ac'Tea.9L. I 1 � Qro F,.ri.'rG 5ctataCy nN DAt • LO,F 177 4 Ato r to' ---j 'ERC. RATE co/.i3O a&AfS -2001 ' °",�r�v. . .Au3 U r C 6 tLOlt1 D (vr�L T� �r hh r° it r1 /!tS' 4Y I.Py TEST BY r . �espw� `N lg //0 c�/'�iE� l�r�/�1��':. TOWN INSPECTOR ; � ?� -ale BACKHOE OPERATOR �o DA A TEST MADE ON : W. 7 v MCKECIVIIIE N� - LOT- 4-rj- 6 s �y No- 17913 o -7 .r ® o Z67 - 1 I .S . k� -t-- -=a•* 3 �- :.- =meµ-- --•-i..._.�..�._.•--� ; 0 v to 7^pa,��,N 14r 3 '84" 5.1,,Y µ,pa r 130 7 E SIA OF q� ELEVATION SCHEDULEs PROPOSED SITE PLAN 9 0 R E N w,ICK B. � v 1. INV. AT FOUNDATION CHAPMAN - 'SEWAGE SYSTEM DESIGN No. 27654,0 2. I NV. INTO SEPTIC TANK = t3$'� I N 3. 1 NV. OUT OF SEPTIC TANK - /P'Ml�t'S7'c � ltrljS /MASS 4. INV, INTO DISTRIBUTION BOX = !3>?i'44 SCALE: I°=ZoekG 1917 y I 5. INV. OUT OF DISTRIBUTION BOX o I�$'Z C—:5(a7 6. INV INTO SEEPAGE PIT 7S7, 00 CAPE COD SURVEY CONS y�TANTS ROUTE 132 7:` .BOTTOM OF PIT = .00 HYANNIS,MASS. �• - A DIVISIbN BOSTON SURVEY CONSULTANTS, INC, 8. BOTTOM OF STONE LAYER = . . "r.