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HomeMy WebLinkAbout0651 RACE LANE - Health 651 RACE PLANE,MARST. MILLS ,A=103-003 i. i i I i TOWN OF BARNSTABLE . LOCATION ! G �-Gt� N SEWAGE # VILLAGE_ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.�C�c7 �� �— —2 73S M ciS . SEPTIC TANK CAPACITY COX ( oa © SOX LEACHING FACELrrY: (type)UMN� t,�kn kisrs (size) NO. OF BEDROOMS B UII.DER OR OWNER�(,.cv.l' I�C,ecJ bO r ' PERMIT DATE: ��i(o l�►y COMPLIANCE DATE: Separation Distance Between the: I� Maximum Adjusted Groundwater Table and Bottom of Leaching Facility �"�a Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) �QQ Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) lJ� —` Feet Furnished by °t � O �c�cK a A-Ibs-� y 7 x � No. � 6 Fee J v w -/ i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: +� Yes LOTBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 0(pphratton for Mtopooal *pztem Congtructton Permit � Application for a Permit to Construct( )Repair( " 1 Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. - U_ a J3 M Owner's Name,Addrefi sand Tel.No./ 1/ Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank ��S��d d Type of S.A.S. Description of Soil Nature gf Repairs or Alterations(Answer when applicable) ce— C e—S / 0 L, v_ C 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 E tal Code and not to place the system in operation until a Certifi- cate of Compliance has been is ed by this oard o He lth. _. Signed Date Application Approved by Date — G Application Disapproved for the following reasons Permit No. Date Issued —/ — 7 TOWN OF BARNSTABLE LOCATION t0� G� d(.t� SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ��c7 GCt..�� ����-ns1f SEPTIC TANK CAPACITY EX I zk 1.oa © Qox LEACHING FACILITY: (type) (size) NO.OF BEDROOMS G1�UUnJ C(i"CnC1�Z.f BUILDER OR OWNER Yor ;i_ PERMTTDATE: ��1/6��► COMPLIANCE DATE: Separation Distance Between the: Xb Maximum Adjusted Groundwater Table and Bottom of Leaching Facility �e Af- 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 x°fl 4 0�d N �J 0 0 No. � ! Fee t r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes✓ PAJBLIC HEALTH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS �✓ ` � J ' ' ZIpprication for Mt,5 po!5a[ *p5tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. ()3— a33 M �Owner's Nam ,Address and T t No.r� ' -/b r Assessor's Map/Parcel , " Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms c Lot Size 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 U Type of S.A.S. Description of Soil Nature p£Repairs or Alterations(Answer when applicable) eK(3+ S dv 13 /4C, L .v` 10 L C C( -4 `> cs.-e E"1 can C� e4— �l A c s cl�cr 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 E ntal Code and not to place the system in operation until a Certifi- cate of Compliance has been i ed by this oard ok Hoglth. Signed Date �( Ct i Application Approved b Date — �r Application Disapproved for the following reasons Permit No. 9 7- 1714 Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO C/E,RTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (V")Upgraded( ) Abandoned( )by �_ YC"f VQ at ( fin( LCA^-f 1l has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. `� 9 — dated y— Installer 'J: .o —.A '\"-'-r... Designer The issuance f th's pie/r fit/sb 1 not be construed as a guarantee that the ysfei will,function as d signed. � Date �l� 1)I I Inspector / O i !./i i' �'/✓1 ' l --------------------------------------- No. / r A Fee �— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,. MASSACHUSETTS &5pogaf *p5tem Con5tructiou Permit Permission is hereby granted to Construct( )Repair(✓)Upgrade( )Abandon( ) System located at 6aff A3 2a CR L(nn--e M n-� 1�r 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 cbe completed within three years of the date of this it. j' n Date: _�G— / / Approved by I ✓ 1/6199 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 DESIGNED PLANS) h 5�C O eby certify that the application for disposal works construction permit signed by me dated ' [ cl , concerning the property located at Qcll�C e" , A ll\ meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system • 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. • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed V leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) , B) G.W.Elevation +the MAX.High G.W. Adjustment. 7 DIFFERENCE BETWEEN A and B SIGNED : DATE: /A [Sketch proposed plan of system on back]. q:health folder:cert ,,� d �� i r� c � ��� psi V-19-t-6-2 ............ Ov ------------ 1- O ---------- ------- AllvJ DLL .......... ------------- No. t�Q / Fee / l./ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for Disposal *pstrm Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.6,,<j .9kke_ Ah Owner's Name,Addres�sy and Tel.No. /C, vex Assessor's Map/Parcel 1()� "(��j3 g Installer's Name,Address,and Tel.No. ' � /* Designer's Name,Address,and Tel.No.Y W Type of Building: Dwelling No.of Bedrooms Al Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) fijn Al&-. -.SC' /47 IZ 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 a Certificate of Compliance has been issued by this Board ealth. _ Signe Date r J r3 Application Approved by ` r Date Application Disapproved by Date for the following reasons Permit No. Jul / Oil Date Issued v No. �Q! / 0' Y Fee t �V THE COMMONWEALTH'OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -_TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Disposal, *pstem Construction Permit Application for a Permitto Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. e- 44 , Owner's Name,Address and Tel.No. j �C v e✓� v!/� { Assessor's Map/Parcel• 103 --v3 2 4- Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. y el, 3_3Z 672 Type of Building: f v/� i Dwelling W.,allo.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building X No.of Persons- - Showersl( -) Cafeteria( ) Other Fixtures' t, Nc Design Flow(min.required) �,,.,a gpd Design flow provided gpd Plan Date Number of sheets Revision Date t Title * i Size of Septic Tank Type of S.A.S. ` Description of Soil f / Nature of Repairs or Alterations(Answer when applicable) ,� e,.✓Se ji f/O/n 1i �d v 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 a Certificate of ~ Compliance has been issued by this Board ealth. 6 Signed Date f�_�3 Application Approved by . . .__�`._. ._ _; = -_ _.., _: Date I_/s_f� Application Disapproved by Date for the following reasons Permit No. (,-9(7/3 r o i l Date Issued ---------------- ---------------------- e P C�, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS �.--� Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( - at �> 1 1 has been constructed in accordance I with the provisions of Title 5 and the for Disposal System Construction Permit No.?0j 3"6tj dated Installer Designer A / f #bedrooms /V Approved design flow gpd _ The issuance of this permit shall lnot a co trued as a guarantee that the system al1 will fun 'on as de ign d. Date - 1 D 3 Inspector - - = - - - - - ---------------------------- - --- -- _ - --- --- -- - . _ h No. v( J`�_ 5 Fee THE COMMONWEALTH OF MASSACHUSETTS -PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construttion permit It Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at ` 5 r I� k. r 0,0 and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 permit&- Date — f ) Approved by f i ............... f YdVNZ_ OF' -7t AA 7 24AX. :)AT- s77 UM PL q ........... ............. -7-7- r • 12- �Ac 0 . ............. Ct-W" ttr,r AJ eul vp Je-4 7L4feA) -7 /L'r 6. It FWA,0 Fit 'A' ........... t4_1 Zj 7-TCJ ---------- ?Y� -- ----------- U(9 • .......... 57VO I� ----------- ---------------- 01410,Yl q L,�6 iurT A)o L)) C4-T7&v ar s;L 71A) cx\�� "i I ............ ........... --_------_-_-------------- ------- p r TO.�"� OF BARNSTABLE _ - . _-._-. .__z_�a�_xTr.._-�aa�a,.s_�-.z:_--�-�---�-.. .=---. .. ._ __� ..._.�-. _.;,-•_•_�-�—.. _ � --�^-"--�.:�,�. .-.,_ .. .._ __ �.b.�.1. �.i1 f�41��� SI _ - H�..r nn ' D 17,q rb � � t o - 1 s T-1 CIO t � f� o ' P _ ASSESSORS DATA: MAP 103 PARCEL, 33 .. WEBSTER RD LOCUS ADDRESS':;: ,#651 RACE LANL' LOCUS LgNE DEED REFERENCE.' 14253_,?09 �� � N1UJ�Gr ME ZONING DISTRICT .RF O VERLA I' DhS-2618CT AP & RPOD BUILDING SETBACKS- FRONT 30 \> CCU �c, SIDE & REAR — 15 SHUBAEL FEW DATA: ZONE "C" POND PANEL 250001 0015 C MAP REV AUGUST 19, 1985 : cp0, .;.: HAMBLIN �F< POND EXISTING LOT COVER BY STRUCTURES=9.6% PROPOSED LOT COVER BY STRUCTURES=12.17. h OO l,, ` :ice �,.:, :{ ,{•.; _ \ 101-1 O \ APPROX. SEPTIC j PER T.O.B. AS-BUILT CARD PLO T PL,AIV Off' LA._1\TD \\ �®AdA A-4 Prepared For.- L 0 T . 43 of iVIAssq a \\ 20,000± S.F. o° o° ,��o�' P���S?ERFp`tiG� : #651 R.A. C_E7 L,AIVE7 A °�A\.s71. 7�s ��O�h� o STEPHEN -, W. . In c� J. YLE 9GF� °� °°• �°� °� � ® Barnstable, Massa ch use t is °i-4 s Scale: 1" = 30' Date: March 14, 2012 `\ v Prepared Br.. \\ Stephen J. Doyle and Associates \ 0 30' 60' 42 Canterbury Lane, E. Falmouth, MA 02536 Telephone: 5081540-2534 CD visa ® _z-__x -ZE3_z ® c -7-<7 NO. DATE DESCRIPTION BY