Loading...
HomeMy WebLinkAbout1429 OLD POST ROAD (CT & MM) - Health 1429 Old Post Road , Marstons Mills f A= 057— 023 TOWN OF BARNSTABLE )2�`�"� "- LOCATION o y`> SEWAGE # 2-e o o -+0 z_ VILLAGE 14 g-snu J- p ASSESSOR'S MAP & LOT 3 INSTALLER'S NAME&PHONE N0 j�/ � �� i✓o.. ��, 3.9° -547 J SEPTIC TANK CAPACITY /Oo o G✓1c c a�J A LEACHING FACILITY: (type) 3 (size) NO. OF BEDROOMS -,>- BUILDER OR OWNER . (jn-t-3 rasa G. �v r PERMITDATE: _y COMPLIANCE DATE: 42/ w 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 Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by f r,, No. Fee —S THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pplitation for Migpoml *pgtem Congtruction Permit Application for a Permit to Construct )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. /,47_9 O LSD Po s r /J 111�1,c.C-s 4 2-6 - 0490) Assessor's Map/Parcel OS'"? ®21 3 Installer's Name,Address,and T No. 3 99—9 '7 44- Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size �3 6 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /o° y G Type of S.A.S. Description of Soil Nature of Rwirs or Alterations(Answer when applicable) JZ&f J "-!3;— 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 Ce cate of Compliance has been issued b this Board of Health: Signed Date � Ov Application Approved by Date Application Disapproved for the following reasons Permit No. 2,6 Date Issued )Z-`p 4 _ TOWN OF BARNSTABLE LOCATION j�1'�t 0(- ��'' SEWAGE # VILLAGE /�i9�.STV) �'`� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. Uwe n,9sa.. w� �j✓°..n�v-titi 3 50 -y4;7 SEPTIC TANK CAPACITY LEACHING FACILITY (type) 3 �J«``' 33u ' (size) �°'= ' �* NO. OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: -7 6 COMPLIANCE DATE: 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 Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by. _.- ---------- ' c7 0 0 �- No.ro �U'' e Fee v/ e THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' Yes ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zipprication for Miopaar *p.5tem Construction Permit Application for a Permit to Construct A)Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. .4.Z9 04D )-'O s7- 07 / �f �jiL4.i W/LG., 41-7 /-49,�. 7 4 Zv . SOco,0 Assessor's Map/Parcel 0 3 ¢�g Q(•,'0 Rd S r A? Installer's Name,Address,and Tel- No. 3 9,0, " `�4 7 4- Designer's Name,Address and Tel.No. Roy e4n5 #_.21-ve/Z ki Type of Building: /hy �7V-�/ /,i t✓,--/ Dwelling No.of Bedrooms Lot Size �j sq.ft. ,y, Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revisibi�Date ' Title Size of Septic Tank °° o G i Type of S.A.S. Description of Soil Nature of Re�airs or Alterations(Answer when applicable) L�E� �'� �= L� -2 / '� v.� r» 3 (�✓c.T Lc C S 3 3 U r3 3 ' O s -a r t` 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 Ce ifr- cate of Compliance has been issued b this Board of Health. Signed Date ,2 Application Approved by s Date Application Disapproved for the following reasons Permit No. Q-Z Date Issued --------------------------------------- THE COMMONWEALTH OF,MASSACHUSETTS BARNSTABLE, MASSACHUSETTS QCertificate of QCompriance THIS IS TO CERTEFY. that the On ite Sewage D' osal System Constructed( )Repaired ( )Upgraded( ) Abandoned(, by ( / 1 C? at J1 )l ( L i _ has,been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 00-W&-dated Installer Designer / I/ A - � The issuance of this pbe t sha I not be construed as a guarantee that the syys�te�m_will,function as/des ig�ed�i Date , Inspector 1{ / � } i �(1 'f "V t J \/ ----------------------------- ------ r No. ZO'TlCJ " Z Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mopozar *p!6tem Conztruc ' n Permit Permission is hereby granted to Cons ct )Rep Upgrade( Ab ndon System located at 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:Constructi n ust be completed within three years of the date of this ;rQ�rit. t. Date: Z ` �� Approved by 7/ L. c R V I d s' � ✓ ,✓T No..0.1..4�.y. F��.. ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH CL /�. e . ......... .. .OF.............................�.....-------------------------------------- Appliration -fur Di,spuuttl Workii Towitrurtiuu Vrrutit Application is hereby made for a Permit to Construct (k ) or Repair ( ) an Individual Sewage Disposal AS t t f, (� 1� Loclo.._Addr . e gI' Cs5'e / Lot Pp----..... -------------------------------------•------ ..................................�o �y-S-----. Owner Address Installer Address Q Type of Building Size Lot... .7/ 3 _..Sq. feet U Dwelling—No. of Bedrooms-----------2____________________________Expansion Attic ( ) Garbage Grinder 1\0) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- Design Flow........................ma.........:-gallons per fe}so er day. Total daily flow-__•-______-___-----__�3__®__._..gallons. W Septic Tank—Liquid capacity/�-G-gallons Length----Pt `� Width-�-_--C-- Diameter_------------- Depth.5__!�_P... x Disposal Trench—No..................... Width...............----- Total Length-------------------- Total leaching area.........._....__...sq. ft. � o - Seepage Pit No.......I.......... Diameter......`d__.---- Depth below inlet.................... Total leaching area.-- _.sq. tt. Z Other Distribution box ( !/j Dosin tan ( ) ` a Percolation Test Resultssss Performed b 1_--.-.._- ---fi r---_--- .................. Date---.----------------------.------------. Test Pit No. L-)V_A�-----minutes per inch Depth of Test Pit--------- _�. Depth to ground water........................ 4, Test Pit No. 2___;-i-0------minutes per inch Depth of Test Pit---------/j'_--- Depth to ground water-------------------- ------------------------ ----- ------------ ---- - -- -------------------- --------- D Description of Soil-----------------0_ --Z-------- G a �. �i ,2 �— /.2 c a 1^ 3 r S9� w x U -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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 Article XI of the State Sanitary Co. —The d gned further agrees not to place the system in operation until a Certificate of Compliance has . e sue e rd of health. Si ............. --- •--------- ---------------- ---- - --------- -----------• ........--•-•--•--------------- - Date Application Approved By. d � /� ---------- 3/..-� Date Application Disapproved for the following reasons------------------•----••-- ..............................---------------------------------•.................... ........................................................................................................ Date PermitNo........................................................ Issued......................................................... ^ Date .................................•............•..••.•..•.•.••......•...•.•••...•..•....•,........,.....•.•..•.....•.. HE COMMONWEALTH OF MASSACHUSETTS HEAL�,�// BOARD JAL .................................OF..................................................................................... �rrtifiratr of 'T"uutlinrr THIS IS T ERTIFYyThat t�idual Sewage'Disposal System constructed ( or Repaired ( ) r by i'c' ' � staffer at-------------- --------� ------- - A.,- has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the $J _application for Disposal Works Construction Permit No. _-_1_2_Y-------------___ dated----------..---._ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector............................. ••-•------------•-•-------------------•---•---------•- _.---------------------- z. � ti •� j NoWTILAY.. 300 THE COMMONWEALTH OF MASSACHUSETTS BOARD �,,QQF HEALT H O`A- .............. .OF........ l?,IA �`h f/�2 ..... .-..... ..-.-..... ......... .............. Applirtt#ion -for Bi,ipuiittl Worko Totuitrurfinu Vamit' Application is hereby made for a Permit to Construct (;"*)*'or Repair ( ) an Individual Sewage Disposal u�S st�I t --......1.5 .. 1..---...----............r . .................... --•- ------ Locap�on-Address/ or Lot 6siJ( �l t !'� e� { ram✓ 1 .�`C A--'-V -------------------------------------------------------------- C Owner Address... Installer Address UType of Building Size Lot_- .7.,. _ ____Sq. feet Dwelling-No. of Bedrooms____________________________________________Expansion Attic ( ) Garbage Grinder (Ive) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ----_------------------------ Design Flow________________________/Z0.__.._.__--gallons per q)@woRi per day. Total daily flow________________________? 3__0---_--gallons. W G ��/ Width_ .a _ Diameter.___.--_---___- De>tli_ ' F�/ Septic Tank—Liquid capacitvf_________gallons Length_.__ _.__� __ 1 .`- xDisposal Trench—No- ____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No-------I----------- Diameter------/-C/_�____ Depth below inlet-------r_1..... Total leaching area-_ X --sq. ft. Z Other Distribution box (Pj' Dosing_tank Percolation Test Results Performed by. __fit�-` Fr/="�. ��:' h '�_/ i_ __ Date._ °'----------------------------- Test Pit No. 1. s____minutes per inch Depth of Test Pit---------/4 . Depth to ground water-__----___-__-_-_---- 1:14 Test Pit No. 2---;_.Ce------minutes per inch Depth of Test Pit--------- Depth to ground water________________________ ------.....- t------------------__--• -r--- : -- ------------•--•---------- o�ODx � � r'c 1 5 ` hc �' escription of Soil----------------6--- .. ---- -•-- -••- -5- -------- __ ------ --------------------------- _-------- V ----------••-•-------------•-••--------------------•--•-----------------------•---•------------------•••-••-•••-•-•---------•------------------------------------------------ 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 Article XI of the State Sanitary Co e—The d gned further agrees not to place the system in operation until a Certificate of Compliance has sue 'b e and of health. Sig -•••- •••••.. ----••••--••• -•••-•-• ••••----•-----•-�--------•---•••------- ------------Date-------------- Application Approved By---------- - ------- ----------------- ....... 3.0 Z----------- Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------•-•-• •---••-••-••------. ............................................................... ---------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued........................................................ Date HE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTiH ...........OF..........................:.......................................................... 0111rrtif iratr of 0111mVliaurr THIS IS T ERTI-FY, That tl4 IncVvidu4l Sewage Disposal System constructed ( or Repaired ( ) --- llsta - •---••--------•at ...�3•-•---- - ---- -- -- t �rff� ..................................................... has been installed in accordance with the provisions of Article X`I of The State Sanitary Code as described in the application for Disposal Works Construction Permit No f -_✓_- ________________ dated................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.- DATE................................................................................. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEA T f/4�- ..- >j ...... ........OF. ,..-.-. FEE D............. %ripaiittl Pnrka Cltt rur ion Errant Permission is by granted----------��---' L!t'"yN_- M- ----- -- --------- ------------------------------------------------ /------------- to Construct ( or ep 'r ) I ivi Se ;�Di sal�tem ''''f //� Street as shown on the application for Disposal Works Construction Permit No--------------------- zted--------------------.-------------------- -- --------•----=----------------------------•- DATE------ � --------------------------------------------- of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS / o `�` /2 y k f O G �v �A I .i _ , t P 7 - /• Y} g .. _ �1//� y xY JL k �'Y3. O / 4 '.17 ® y } N'` /y " , �`. 4l ) C`17 G - r e'f *p�_J ,.� t'` ffVV„` ' 'Qt-'� ,r, .�. }..,. a - t� _ . c .NI , r : 11- F> , 1 'r f .f't �Y Y I Y h ice,.h a �r1 air ` .5 3 5: � ;j , /yj/ h.: ''; c' flr r° Cp c^�_. *1• _ ux v/ ;- x 1 `!� L h �Y "C ypy i * ` 4 L i-. 5.. z. ` ,r {. � ` �. sty _ "� 4=.3 A'. _* *� 1`O'. IO-!t �,��: i` 'tom ?;?i q.*� _, r a w t t v= p S£ , ° �; s g o. - • I. ff = s 1 a J / v }+ _. ' �, / { t _ `x. ,-, �- k . 1 _ _ k �, , �'- w �.�."��' _ _ fly _ _ y _ y. £ - x- - - -c LEGEND v CERTIFIED PLOT_- .lAl z r EXISTING tiSPOT- ELEVATION OxO *\� Ur;y� -, EXISTING CONTOUR` _ - r 6 s*! `, 40�' 9.3 o; a} 13o T R a,v FINISHED _SPOT ELEVATION 0 0 � ROBERT, tiG I.14e. ZV FIN"ISHED-.CONT'OUR 0� s P n+ � ,a;� fir- /a �, + r >." v BUNIKIS O N �'",iW! 11 APPROVED t B4OARD OF HEALTH ;pdo zI O Q � 4 } { T�, AGENT ..�y°FIAT_EN6 ,; , -- a SCALE / ._ 4 DATE= �;' QA.,- E D a s -.— _ -- 6( NA e�'P LDREDGE ENGINEER/MG COlNG�' CLIF"NT -_ - i 'CERTIFY THAT THE PRf� .. ._ EGISTERE REGISTERED JOB NO �� z1,2 BUILOJN(3 .SHOWN ON THIS P m CIVIL LAND _ CONFORMS'' TQ TFFEZONIN6x DR B'Y ga �F• tz? BA BLE , MASSI 24 ��,? ENGINEER - 3` URVEYOR OF RNTA 712 MAINST CH,IY= /63k f. r HYANNi�, MA�� ►^^ L`1M SH>xET L OF DAT1t REG v_. a _-�, �;'- ricer":, £ ,, x.4 .c _ ' . -s. = _ - ..A t- _ r,. .. - V'x�', 4 1 , IT cai14 g-� -*&VAT 17", zo our. .IV 64W 'Ell Cj 40wr ZP*T ; IVFJOVA -0 w jor MIN CZk M'f, TAN, 'c f*Sd li. CAST vt� r lyi N /aP 0 V, AREAMM Vvt*,old a 7 IMP-4-A-r &Z E VA 77 4&�s �44 41 - N CP 6Rr' 6 1w SEE 7.-j _T_)0"r1C -r.4;vK cr 9 0U74e77.$&Pr1C TANK S Rr '80'y 74 SECT/ON OFan't-r,01 57--wa onwv'wx FT '41 ! 9 9 AME 01SROSA AFT, 1 ST wACRIIVO- AVIr I " LEAC"IveYr AW 0 V ON SCALES A PT". CARSA6X-PISR05AA.JAVIr S011- LOG AL L,1AA V -S W 4 TEST' SO/I—MS7702 lb, a ri,07' Av 3 3 'K0 'DA rLW 0.0' 0/1 fug a'a-r4'-AC'qjAAS .40 0, AL S S14ff4&AC.qJvc PER C/ 5q -r i REsalrs A 'T'"ffSSff0 Y y 78 OOTTOM4a4c'q1Afr'j&&)t P/r a{ TOT1C A Rr Apr 41 s. AA K44, '4 At 41 S'Q =r . OF k j6'„' - V,