HomeMy WebLinkAbout1183 OLD STAGE ROAD - Health 1183 Old Stage Road �..
Marstons Mills
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LOT 1-2
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70W or BARNS'7AM 6b.
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1183 OLD STAGE ROAD
LOOD ZONE "C" DECK CERTIFICA TION RES ZONE "RC"
TOWN CENTERV= SCALE 1"--80' PL REF` 338-22 ELEY N/A SETBACKS-.20'-10'-10'
b%-A "4 YANKE'E' LAND SURVEYORS
ajA s. 1.,AS,� & CONSULTANTS
I CERTIFY THAT THE `��c"'tFp chGJ v
,. P.O. BOX 265
"DECKS" ARE SHOWN sTEP. c UNIT 1, 40 INDUSTRY ROAD
ON THE PLAN AS THEY DOYLE MARSTONS MILKS, MA 02648
EXIST ON THE GROUND. `�, �; 755 TEL 508-428-0055 FAX 508-420-5553
s�o�oF
JOB
��e DATE 09-14-07 NUMBER 54222FND
TOWN OF BARNSTABLE
LbcNTxvN ' /f j9,3 p1D-571�n-' kQ SEWAGE #
> 4
VILLAGE ASSESSOR'S MAP & LOT3.4�/•G�3
INSTALLER'S NAME & PHONE NO. ��t4��C• S �
SEPTIC TANK CAPACITY 1 CT?Ib
LEACHING FACILITY:(type) (size) Qa;c--(,
NO. OF BEDROOMS .3 PRIVATE WELL OR BLIC WATE
BUILDER OR OWNER C XM,6-4 ,—
DATE PERMIT ISSUED: y Ip;x.
DATE COMPLIANCE ISSUED:/
VARIANCE GRANTED: Yes No �~
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
Allp iration for Dispaiial Works Tomitrnr t � — r
Application is hereby made for a Permit to Construct ( ) or Repair (L11<'an In ividual Sewage Disposal
System at:
................�1.. ...o .. ............................. ............... .---------------------...........--------------.................
Loc ion-Address or Lot No.
----------,� _!U_. �. �--------------------••--- •---•--•••••......-•...1.................•.... ...-- -_. ............_---_..
Owner 01
06 ress fl�
14 Installer Address `
� feet Type of Building Size Lot___________________________S q.
U Dwelling—No. of Bedrooms.•-......................... .....Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
04 Other fixtures ................ .................
W Design Flow......'5.:'50.........................gallons per person per day. Total daily flow__._.Z.:7•P.......................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter__---___-___-- Depth................
x Disposal Trench—No..................... Width......1.............. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No......... Diameter..::. ....... Depth below inlet...1P............. 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 Test Pit.................... Depth to ground water___________-_-__---___-.
Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water........................
-------------------------------------------------------------------------------------------------•--.........................................................
0 Description of Soil--------------------------------------------------------------------------•-----------------------------------•-----------------------------..........-••-••-••-•••••--
x
V .........••••••••-••-----•••-•-•••-•••••••-•-••-••-•••-•-••••••••---•-•--•-•--••••-••••••••••-•••-._......•••-••-•-•••••-••••••-•-•-••••--•-•----•••--•--••••••-••••••••••-•........--•-•-•••....•-_.....
W
--------------------------------------------------------------------------------------------------------------------------------•--•- ••---•-•-•-•.... --••••......••--.•-• ---•••..........
U Nature of R pairs or Alterations—Answer when applicable..-m- ------t�__. �c h................................. .............
-•--
-•-•-4��--------------------------------------------------------------------------------------------------------------------------------------------•
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has been issued b the board f ta�th.
Signed. ---------------- ---------- - ----------- - -- ------------ .......&----�`-��.
Date
Application Approved By -------- t ..�."� -� -------=�
Date
Application Disapproved for the following reasons- ----------------------- - --- -------- --------------------------------------------------------------------------------
-------------------- ----------- --------------------------------------------------------------------------- --------------------------------------- --------------------------------------- ---- ---------------------------
q►
Permit No. ......../... *.. Issued Dare
----------------------- ate ...
Date
--- ,
O O b
THE COMMONWEALTH COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
A liratinn for Bhi noag
�� � 1 .�rk,� C�.�n��rnr�tlan ,-rntt�'
Application is hereby made for a Permit to Construct ( ) or Repair ( V)an Individual Sewage Disposal
System at: ,
,
.---.......................... -= ........................... •-----•-----•-•••••---•---...---••--•-•--•......................
Location-Address` or Lot No.
• ��/c��I Ste/ ��( t /h(�r ....... .................. :... . Addre
... ..... .............-...._
Owner t
a .......... . ��.�ra <� `71 C>�t t,sc� D, (�o ` tkl ss :. .�f C+. - ------------------•-- •--.-------------------------- --- -
Installer Address
Type of Building Size Lot............................Sq. feet
V Dwelling—No. of Bedrooms....S....................................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
d Other 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.
3 Seepage Pit No...___... .--- ..... Diameter.....f�� Depth below inlet.... _........... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
1-4 Percolation Test Results Performed by------- Date........................................
0.4
Test Pit No. 1.................minutes,per inch Depth of Test Pit.................... Depth to ground water........................
fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a -----------------------------------------------------------------------------------•----------•.....•--------------------------------•-------------......-....
ODescription of Soil........................................................................................................................................................................
x
U -----------------------••---------------••---------••--•-------...-•----------•-----------------------•-•---------------•---------------•----- .........................................................
W
x --------------- ------ ------- ----------------•-----------------------------.....-----------------------------------------------------------------•--------------------•----------------•---•--.......
U Nature of Repairs or Alterations—Answer when applicable._-_-_T `�'.Q.t(.____/0-?D L.�31.i'-?..P?7"
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental 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.
Signed ........... .:..` - ....'� -----------------
Application -Approved By ------..... ��"` -.-.... --------------------- ---------Via.-.-.-...-..--'-----------"..'...----"- Date
Date
Application Disapproved for the following reasons- .............................................--------- -- -- ---------------- -----------------------------------------------
- ------------------ ------------------------------ -- -------- -------------- ------------------------------------............................................................ ---------------------------------------
Dace
Permit No. ........-— --.------Iy Issued
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
%!�ertifi ate of 010mplian.ce
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (
by----.............. ._ :P -..... - c . .. Y..�� c.. ......--------------- ......
f Installer
tom- ' t 1 2� C'-�.1...D �,-f-��`` ���-6 0 � E'Y� t
at . ........
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. .........9I.-A......Z.. ........ dated ................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE . 7 �-a�-------------------------------------------- Inspector ...... ................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
GG TOWN OF BARNSTABLE
i rya 1 orkn T-1nnitrnrtion "permit
Permission is hereby granted..............�'_- �-:.. __5_�cT'(-y ........................................................Ir `
•. --•-----...-
to Construct ( ) or Repair ( 0--an-Individual Sewage Disposal System
at No............... !_n.,STDG- ---........�-- `L'T
Street qq
as shown on the application for Disposal Works Construction Permit No.._1 -. y/_ Dated..........................................
-•.............................. '=Z...---------------------...-----•--•------•---••---•---•----
cy V DATE........---- ` Y ' ....................................... Board of Health
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS ��
i ..
cou
TOWN OF BARNSTABLE
LOCATION l 010 5 . SEWAGE #
VILLAGE C ;.
'ASSESSOR -MAP &`LOT:�` ,�•Q�LGa3'
INSTAL:LER'S 14AME-6 PHONE NO'.'.r -
- • is
SEPTIC.-TANK CAPACITY , bS Yk I[T21b "Tlc
3 �vallo
LEACHING FACILITY:(type)_(
` NO. OF BEDROOMS , PRIVATE WELL OR BLIC WATE
BUILDER OR OWNER L-YIVSY CS``+G�
DATE PERMIT ISSUED. J
DATE '.cbkPLLANCE ISSUED:
r ,
' VARIANC,E GRANTED: Yes No
.41
.�; \` -.�''.s,�y,,F � ,
i
L O CATION ` S W A C E PE RIAIT NO.
VILLAGE
1NSTA LLER'S NAME & ADDRESS
BUILDER OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED 5_ z ;- s�
r,
� ,-
f �
� I
LO CAT IQN S WAGE PERMIT NO.
d&e�lLy go - 6/ �
V 111 A G E
I N S T A LLER'S NAME i ADDRESS
S ear_
BUILDER OR OWNER
0 . N�, �C IIp lz
F'
DATE PERMIT ISSUED /0�L9���
DAT E COMPLIANCE ISSUED
30
p
f
.� ..........•-------------•---- ...._
t 1'41E COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
®W AJi ........ .OF.....IAA.IZ.LSD..a�i"�4.F .[� -----------------------
Appliration -fair i,gpa1g al Work,6 Towi#raartioaa Vrrutft
Application is hereby made for a Permit to Construct (>() or Repair ( ) an Individual Sewage Disposal
Sysern at:
-------kc).^.,�................................. ----------------=Q`-r-�-7----------------------------------------------------------
oe t; Address .._f _W....__ A -�e� c,c
Address
a � -
ype of Bui ding ------------------------------------------------------
Installer Address Z 'J��
T Size Lot___ ______________________
Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ___________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ----------------------------------
W Design Flow...................................;5��_gallons per person per day. Total daily flow_______________________2Z_d._.-..-gallons.
WSeptic Tari�_- Liquid capacity_OPPgallons Length_ __` ___ Width.4-1. .. Diameter---------------- Depth-�.'¢.
No.�L/NK!t. Width--54?__�d... Total Length-/0(---� Total leaching
area ��� sq. ft.ofC-rP,�,
Seepage Pit No------ ------------ Diameter____________________ Depth below inlet.................... Total leaching area------------------sq. it.
Z Other Distribution box (D4 Dosing tank ( )
Percolation Test Results Performed b rf-Cr.../��C.L�- __ __.......__------------------------ Date �
,a Test Pit No. 1....2Mtt »inutes per inch Depth of Pest Pit... --- Depth to ground water. .0.__....
Lz� Test Pit No. 2-----:;�------minutes per inch Depth of Test PitJ2. -_®... Depth to ground water../Z-®__._..
x - --- - ----------•--------
Description f Soil -Q ® �q `� y - ---
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 f the State da1i91,_Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b n issued by the board of he lth.
Signe
ate
Application Approved By-- --- -----------&A4 --------------------- 1!-..."2-.`1_ ...
Date
Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------
.._..--------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued........................................................
Date
}
a
"ikE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
L- - ------.OF.....BA.ZNN % - -
Appliralintt -for Di_qVv13a& Ularks Towitrurtilarc Vrrmit
Application is hereby made #or a Permit to Construct (K) or Repair ) an Individual Sewage Disposal
System at
............................................... � I. �5�.� ---------------------------------- ---------��T-----�------------------------------••------•-------
on
.................................. -JVtt'u_ a I�& fit►_.`�®__.`...0.. ? 3�r" + U/C� ,L
--- ------------p
Qwner• Address •---- -
W -I
d --------• --- - -- •------•--- ---------•'--•--•-----------•-=---•---------------•- .........................................--............... ..
,< Installer Address
TYpe of But ding Size Lot--e.
Dwelling—No.' of Bedrooms.._-_--�__________________ Expansion -Attic ( ) Garbage'Grinder ( )
pa Other Type of Building .:--------................... No. of,per sons--------------'"---------------- Showers ( ) — Cafeteria ( )
a
� Other fixtures ------------------------- �_` - --------------- ------- _---------------------=---- -=---------
__ .
Design Flow`____ ' ..........' $gallons per person'��r day. Total daily flow_________________ _ �'� gallons.
W � 10
ic to Liquid ca1��it �agallons Lengaa .. ..®_._._._ Wtdtl et Diameter___-- :- .---- De�tla _ ..--
xTAQ Width__ C _ Total Length 0 Total leaching area-- -----sq. ft.ti r C-;�A.
Seepage Pit.NO..... ia............ Dmeter................... Depth below inlet.................... Total leaching are a.
-------.... ..--sq. ft.
f Z Otl er Distribution:box,( 4) Dosing tank
~' Percolation Test,Results Performed by. ! .�`- . ................................. Date__B _
a x
Test Pit'No. 1___ ninutespermch Depth of Test Pit--- Depth to ground water ® .-__�a.
tz \ Test Pit No: 2___._ _....mmutes.per inch Depth of Test Pit__ ........ Depth to ground water../. _ -- :'.:_-
��------------;----------------------------- -
D Description' f Soil--®------��----.aam----o�t ba s ®.�f ....- �r�"` � ' `}a�`� �d _
x s ..
- - -------------------------`------=-------- -------- ------------•-----
W k
U %.tfure of Repairs.or Alterations'—Answer when applicable ________________________________________-_-.--------------------- _.. .---.-_.____.. .
------ --:-`------------------------------------------------=---------------------------------------------=-----= -------------------------------------------------------- --------------------------
Agreement-: . '
The undersigned agrees to install the aforedescribed Indiviidual Sewage Disposal System in accordance with
the provisions of 6 $ ofi=the State ,�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.
f Si ne " Dte
Application'Approved BY , "` ........ - - :lf *R a ._.
• '
Application Disapproved for the following reasons---------------------------'----------------------------------------------=-----------------Hate--------------
...........................................................-------------------------•--------- --------•............-----------•---•- -----------------------------------------------------------------
Date
PermitNo......................................................... Issued.......................-.................................
Date
THE COMMONWEALTH OF MASSACHUSETTS -- -
�, BOARD OF HEALTH
OF..... .. "`f'....'......................
r U.Prtifiratle of Tantphaurr
S IS TO CE lFY T13at the Ind�idual Sewage Disposal. System constructed ( or Repaired
by /�L l all
-
_
z
� nstat _ - -- - �
has been installed in.-accord,nce ith the' rovistons of Ai I f The State Sanitary Code as described in the
P ff l `
application for Disposal.Works Construction Permit No.."�il:_�i�_r.._..... dated.. icd.!......
THE ISSUANCE.OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE:THAT THE
SYSTEM VILL.,FUNCTION SATISFACTORY.
DATE• = '1�' . = Inspector ------
-
THE COMMONWEALTH OF MASSACHUSETTS
„�• � BOARD �HEA
(p � .
No... ............•........ w FEE_.31j............
V.
4. 1 grk �a�ctrurtiut� rr�tit
Permission is hereby ranted :.._. .: ..........................................
to Constr t ) rger ( ) I viduar e emat No.--- lei'" ----- ------ �!1'f -�........ -- �------YY ��` -�/Tu`------------------------------------------------------
! reet
as shown on the application for Disposal Works Construction r it N .___ _____ ated_. _ ry
......................
:..- .
loard of Health
DATE-I -------------------------••-•----------------------. ---------------
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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