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HomeMy WebLinkAbout0259 JONES ROAD - Health 259 Jones Road Martsons Mills - - A= 047-135 I No. _ __J_l Fee -� ----------- ®� BOARD OF HEALTH TOWN OF BARNSTABLE Zpplication,lorWell Con0ructionpermit Application is hereby made, for a permit to Constr t ( ), Alter ( ), or Repair ( an individual Well at: J. — —ion — Addresl —--_ Map and Parcel ✓el -- wner Address Installer — Driller Address Type of Building Dwelling Other - Type of Building- —__—__--__— No. of Persons-- _--- ..1 Type of Well C� �;��- Capacity-- Purpose of Well- �! __ -- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed -- - - -- -- �� - -- Application Approved By e to �l date Application Disapproved for the following reasons: date -- Permit No. —� — Issued f-� ---------------------- date - ---------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (`Altered ( ), or Repaired ( ) qn taller _ ---__--_— — --- ----- ^-- at- 'l / 12� ----------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable B a d of ealth Private Well Protection Regulation as described in the application for Well Construction Permit No. _ Dated--- -------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE � 3 __ Inspector,-------- - -____�—__—_--- _ � ------------------- No. ®� Fee— BOARD OF HEALTH TOWN OF BARNSTABLE ���[ication,�or�eri �Lon�truttion�ermit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair (kjan individual Well at: Location — Addres!< Assessors Map and Parcel _____ -____------__-------.-_-- Owner Add — _ -- — Installer.— Driller Address Type of Building Dwelling Other - Type of Building __--__- No. of Persons--- -..-----.-_�__—__ Type of Well Purpose of Wells. Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The, Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed -� — — -- _—_ / -3 / -- -- to Application Approved By r - - date Application Disapproved for the following reasons: _Permit No. date _- Issued-�p-�d_ --------------__------------- date --------------------•---- BOARD OF HEALTH TOWN OF BARNSTABLE Certifitate ®f Compliance THIS ISJT,O�CERTIFY, That the Individual Well Constructed ("Altered ( ), or Repaired , ( ) by��? da ----V LT ------ ------------------ n taller at_ / �n�P i2� p has been installed in accordance with the provisions of the Town of Barnstable Boa d of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. d¢--_-0Dated---..---.------. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. p DATE Z'3 Inspector--__—_--- --- -------- BOARD OF HEALTH TOWN OF BARNSTABLE _X/ serf Congtructionpermit No. — Fee Permission is hereby granted- -���441 W&/ _- I v to Construct�J ), Alter ��( ), or Repair ( ) a divvii yaldWell at: j 4 I'I0S �T4 / No. � _�_ ----- --- ---- ------ - - / Street as shown on tl� applic tion for a Well Construction Permit / No.- � '-���� Dated-- - �1_ __- - ---------------•---- Board of Health DATE JjL y LOCATION �� SEWAGE PERMIT NO. o -- t 3-5 VILLAGE / INSTA LLER'S NAME i ADDRESS 8UItDER OR OWNER ' r DATE PERMIT ISSUED DATE COMPLIANCE ISSUED% L r o1v No.............f�°S ��. ..... I �b THE COMMONWEALTH OF MASSACHUSETTS 01 BOAR® OF HEALTH ITown. -- ---.... .. O F............Barnst ab le Appliration for Uiip�iia1 Vvr,ks Tumitrnrtion ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: G Jones Road �/ ................. .......... ............. .. Al1...... . ... . -- --. ®....... Location-Address / or Lot No. Q !t��......cv/Zx,............................................. .....h....... -��lY!�!.�-----.................................................------. Owner Address W ,.a .... 1�,._�a rl..................................................... ...................5t ..t1Z................................................................ Installer Address UType of Building Size Lot...`.2;2.— --------Sq. feet Dwelling—No. of Bedrooms.....................3.................... Attic ( ) Garbage Grinder ( ) ` 4 Other—Type e of Building No. of ersons......_................... Showers — Cafeteria f� yP g P ( ) ( ) a' Other fixtures ---------------------------------- W Design Flow...............55.......................gallons per perso �pe6day. Total daily flow..._._.__33--•--_-.•__----__---:___.__.galloni, WSeptic Tank— _iquid capacit} 000 gallons Length .___'....._._ Width.._-....._. Diameter... ............ Depth__.___.......... x Disposal Trench—No..................... Width...................:Total Length___...__.t...._... Total leaching area--- _______...sq. ft. Seepage Pit No-------1----------- Diameter......10.-...... Depth below inlet.................... Total leaching area...2s7.......sq. ft. Z Other Distribution box (X) Dosing tank ( ) �a e Cod SurveyConsultants Date .8 1.4 Percolation Test Results Performed b ..... ............................... ....___.._ ... Date._..__..............._._.._.__..__..._.. 2 12{---------------- - none Test Pit ;�10. 1________________minutes per inch Depth of Test Pit._._.....__..._._.__ Depth to ground water_._-__-__________..__--. rX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--------_............ _.. 0 Description of Soil...0-0._$_...wood_...loam:;_:_b:$_=2..O...sub:so11...... _�0_ :5...rocky x 2.5-b:0---med: coarse sand--.._.6 0---12-.G-med....... aria------ z oo ----------------------------------------------------------------------------- - - ...................................... . .. W -•------•--•--- ------------•----------------------------------------•---•---•------------•--------- ....................................... ---------•---------•--•- ----------B----------- - U Nature of Repairs or Alterations—Answer when applicable............................................................ �- -•--CHAPMAN-- - -� - N . ------•---•-----••---------------------------- 765 - •-•-•- --moo- � ---•- N Agreement: i,f The -undersigned agrees to install the aforedescribed Individual Sewage Disposa System in i the provisions of iI`:LE 5 of the State Sanitary 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. 12 Sig --•• .. .. .... ................•------------ ................................ Date Application Approved By..... ._ ..._-- �-.. . .- ---1�Z%1!l"----=- -f � � .:...•.. Date Application Disapproved for the following reasons----------------------------------------------------- -----------------------------------------------•------•---- ..............................•-•-----•-•---•-•---...-•--------•-----.....-------••--••--------•-••....--I--••••-••.....••--•-------•------------------•-•-•---------------•------•---------•------------ Date PermitNo......................................................... Issued-....................................................... Date No.......... FE$ ....s................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ... ...........................OF..._.......... .......---•--.......... Appliration for Biipuiiaal Works Tomilrnrtion Trait Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: Jones Road E� o- Lot. Location-Address or Lot No. •--_--••---••-----------•---------. ._ .�. ..... / .. -••--•.................•----•-•----•---...........---•---•_.. owner Address ... .. Installer -••-••--•-•----•---1�'4.'.1./•--•--....Address r�G ..�1......................... Type of Building Size Lot.=_. ____.:_ d YP g ��-�----------Sq. feet aDwelling—No. of Bedrooms____________________ ___..................Expansion Attic ( ) Garbage Grinder ( ) p-, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P-1 Other fixtures -----••-----"-----------------------•---------------------------------------------------------------- WDesign Flow_.....__-•---__55-----------------••----gallons per persogtp%gay. Total jail dqw_____________________..____________-________p1lolij, WSeptic Tank—Liquid capacit}qq'? gallons Length______ ________ Width--1-------------- Diameter-_-_-__._.______ Depth___ ___........... x Disposal Trench—No_ ____________________ Width.................... Total Length._.__._ _t___..._._ Total leaching area__-__ sq. ft. Seepage Pit No-------1.._._..__ Diameter......�:0__------ Depth below inlet____b____________ Total leaching area__ �7__ sq. ft. Other Distribution box ( ) Dosing to ) z a enC d Surve Consultants 6/30/7$ Percolation Test Results Performed b} ___p..............................y__. ___ Date___.___.____.__.___._____.__________.... 2Pit...� 12.T---------------- - none a Test Pit No. 1......__________minutes per inch Depth of Test ___________._____ Depth to ground water_-______-_________.__--. f= Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wat .._ ____- 0 0 -0.8---wood loam 0-:$-= :0--subsoil--•-2-:Q"-2•:5"..•rock Description of Soil__-" . -•-••._,�.... y x 2 -6 _0 med". coarse sane 6.II=T2: hied; sand "" RF:fVwI r •---•---•--------•-------------•-------------•--•--___-•---•--------•---------------•--------••---------••------------------___------•-------------------------• CHAP_M.AN.... V Nature of Repairs or Alterations—Answer when applicable________________________________________________________ o:2765 � Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in acc e with the provisions of TITiE 5 of the State Sanitary 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. Sig ..... 7 �� Dat Application Approved By.. a a� " _ ._._ Date.................. .Application Disapproved for the following reasons:................................................................................................................ ---•-----•---"----"..............•-----••----•-"•-••"---------------"---------"--------------•---.._..---.......................................................... - ----------- --- ---- ----------------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSAC.H:U.SET-TSx­o, • ,--"- BOARD= OF HEALTH 1 ..................r. _................ x CIrrtiflratr of ToutpliFattrr THIS IS TO CERTIFY, That the Individual.Sewage Disposal System constructed or Repaired ( ) bY-----••--•--•--•---•••----••- -••----•---------.....--:_.. :,;tr/4r.h-----=----------------------•--------------......---._....._......._..-----....... •--------.......__ . 1.." Installer at... _d " .! . Ll...__..,,t�}�'�'S.. )L �, > r!-t---"144-1"1--------------"-----•-•------------•-------•--•----•----------------------- has been installed in accordance with the provisions of T 55 of The State Sanitary Code as described in the . application for Disposal Works Construction Permit tiT ',,,,2'. da.ted___.. �-_c :_C _: ".. ! THE ISSUANCE OF THIS CERTIFICATE SHALL-.NOT Bt CONSTRUE® AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION +ATI'SFACTORY. DATE................... Inspector -- ••-••--•••- �` THE COMMONWEALTH OF MASSACHUSET.TSf �, BOARD OF HEALTH '................OF... -,pry ;.... : -, ` .-><•�°- N ,. —� FEE........................ Disposal World TuOntr inn rrntit Permission is hereby ranted'____________ ":�_ a ....................................................... to Construct. �ij) or Repair ( ) an Individual Sewage Disposal System at No.�L•'T o---•- ------ tk_"...... S reet ..__•--4of ed. = ---...�.____ as shown on the application for Disposal Works Construction Per No...... Boa h DATE..--". "' .................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS i' ` SOIL Loa _ 2"PEA 'ONE -OAM B 'ILL 12 MA. T - '.4 4' C.I. DIST Box 1000 ,•4'MIN ° °.• -1 1000— AL�J MIN . e GAL. _ --- ; o,a,• PRECAST O SEPTIC 6 R I ° PE G h, /©5-4 . I� , BLOCK TANK I,•• • •I SEEPAGE PIT Y I°,•°u° n° Ii�U/� �7� ` - 20' MINIMUM T I• ! �YD w,�_ E FOUNDATION I , I %:.1 WASHED STONE - i ELEVATION SKETCH r' 10' -- --I P9ItC. itAT[ 6.v-rge _ern: SCALE i"= 4' TEST BY __L .1�//&iT/•V ._._--- TOWN INSPECTOR _�ske��YJU BACKHOE OPERATOR _ TEST MADE ON Ca v to 4 r C7 ►3! 7• !1- �` 3 \ 1 E �1 Age k'O137lK °U'`/e 1 1 set COMIC. F4q4rv4pfj7-$$# \ \ Ea x //4.A 4 1 \ F poj4c4? 1 4 Iri \ l Al PRO PGs /off Ss/ow 4-1,4'ex o v wev.P 4,nc , 74p eY .�.� /9 16DES/�r�1✓ C��'/T�' /AX ,�rs�o Cp.y�='c. /ems 7�o r.�,�. • D:�<.✓ Et'-G,6's �3 0�-5 i .A AZOW 3 e Q *1 o p lle /day = 330 yap i/daY � Bo7TOm x Al C � c/ry : �8,5 f.lo ja)101 dar 7e- 5;p c��" �,tis�" 7"ai�+'� �s,�' .�,d/.4'��`7iq�� //J�1.�.ss • c/; � 'N/NL? F�/T 5)DAW,944 /46.9,4 x 2 jul/�,/da� x 4-7 i.0 ,9.1 4� L b 1(/ 76 ELEVATION SCHEDULE PROPOSED SITE PLAN 1. INV. • AT FOUNDATION = //O'71 s 2. 1 NV. INTO SEPTIC TANK = pp,4/ SEWAGE SYSTEM DESIGN IN 3. 1 NV. OUT OF SEPTIC TANK = //0•/4 - 4. INV. INTO ,DISTRIBUTION BOX //®,oG SCALE I"= Z,:::, Jt1C,Lr 197& 5 I NV OUT OF DISTRIBUTION BOX = Q '� — '7 6. INV INTO SEEPAGE PIT _ .,/AB• CAPE COD SURVEY CONSULTANTS ROUTE 132 T. BOTTOM OF PIT a HYANNIS, MASS. f' A 01VISION BOSTON 3UNV[Y CONSULTANTS, INC- B. BOTTOM OF STONE LAYER /t�2'Gsu 1