HomeMy WebLinkAbout0400 ROUTE 149 - Health 0'7 C0 -7
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TOWN OF BARNSTABLE-"
LC `_'AnON IlO® Rr /yci
SEWAGE # W�;�ly -j
VILLAGE Mcw5jatis ASSESSOR'S MAP & LOT '
INSTALLER'S NAME & PHONE NO. �o�ti �, �p�to
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) .'z = Ise,c4opi S"1,94919(size)
NO. OF BEDROOMS 3 PRIVATE WELL.OR PUBLIC WATER
BUILDER OR OWNER /�O t�,�s ;'�'o Ole
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: :z
VARIANCE GRANTED: Yes No
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
VAppliration for Eli_qpooal Workii Tonilrurtion Vatnit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
................ ® ....�. 71.�5.-----•-------------------------------- ------------------------...........-_......._ .....................•...................
Lo ion-Address or Lot No.
°<••••-••---..... 0.9 �Y. QY.�P.Sl� ... .......... ..._1 _../1 ��/, .....,l6.
// caner ✓/ d� ij/'f!Q
Installer Address
d Type of Building Size Lot..-� .r�1..7Sq. feet
aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ................:........... No. of persons........................---. Showers ( ) — Cafeteria ( )
04 Other fixtures -------••-----------------------------------------•----------------------•-----------------------•---•-------------•---------........._.........._...
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity.&P!4..gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length............._._.... Total leaching area....................sq. ft.
Seepage Pit No..-!2.............. DiametenieO.....:........ Depth below inlet.... ......_._._.. Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per.inch Depth of Test Pit.................... Depth to ground water........--..............
44 Test Pit No. 2................minutes per inch Depth of.Test Pit..._................ Depth to ground water........................
ti
a .................... -------------------------------------------------------------------•--•--..............................................................
O Description of Soil.................�'�!___-_�l .t
/V .................•--•---•••-••-•--.......----•--•-•••....••--• --••-•••.......•-•------•--•------•••----•-------•------•----•-••••••-•--------••---••---•--•--....•--............-----.....--••----
W
U Nature of Repairs or Alterations—Answer when applicable- _. -LQ-P!k'-..!-rP.lO..��
' ........................
kl.G7..- .......------------------------............................
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 Complia e h s b n issued by the board of health.
Signed -------------- - ------------------ .. %^��- ......7= �
Application Approved B .. .��
re
t 'r+ r
Date
Application Disapproved for the following reasons: ---------------------------------------------------- ----------- ----------------- ---- ---------
t
-' V�6 f� / �� Date
+
Permit No. Date
-- ---.��----------------------------------- ---------------- Issued .-------..--..�-------------
No.- ............... F$s.....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for 11hiposal Works Tnnitrnr#inn return
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
.................. / ....................................... ......................................_................._._................_......_......__..
- LOFAio..Add"s or Lot No.
caner // Jam/Add S r/9j��
•-•-------.... C !^1.....11 .1 ................ ^' F U- � IhN s' �f L'�/�s G ......................
Installer Address
d Type of Building Size --:�Sq. feet
U Dwelling No. of Bedrooms.............................. ...._Ex Expansion Attic
� g— __.___.._ p ( ) Garbage Grinder ( )
a Other—Type of Building ............. p ( ) — Cafeteria ( )
............... No. of ersons..._._.__..______________.__ Showers
Otherfixtures -----------------------------------------------------------------------------------•-------•--------------....•--•-.....----'---...------'-----•----•.
W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacityX5�R_.gallons Length................ Width................ Diameter................ Depth----------------
x Disposal Trench—No--------------------- Width.................... Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No....!2................. Diameter.A ------------- Depth below inlet.-_4-.----------. Total leaching area.................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by----------------------------------------------------------------
a --------- Date =
Test Pit No. 1................minutes per inch Depth of Test Pit...-..--------_-__-- Depth to ground water........................
w Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water____----•-•------_--__-_
a --•-------- -----------------------------------------•-------------------------------------------------------------------------------------------------
O Description of Soil................5`1.... :...........................•---•--.....----------------------------------•-------.....•..-------------------------------•--•'-'----
k
U -----------------•----------•--•---------------- --------------•-----------------•----------------------------------------------------------------------- -
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when plicable....._411.. _v0----/ .........
/� --------------------
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
y the board
of system in operation until a Certificate of
�Coa plianVsbssued b �^ `'--' 7-=---- ��-- - �
///�,/' Date
Application Approved By <- !/.
Dare
Application Disapproved for the following reasons- ----------------------------------------------------------------------------------------------------------------------------------------
--------------------- ------------- ----- -- --------------------------------------------------------------------- ------------------------------------------------------------------------------- ---------------- ---------------------
Date
Permit No. � '' � Issued --------------
---- -- .._.----.----_.._ Dare
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(fer#tftrate of Compliance
THIS IS TO CERTIFY, Th4t the Individual sewage Disposal System constructed ( or Repaired ( )
by----------------------------------------------------------�....`� A60
----------------------------------------------------------------------------------------------------------------------------
has been installed in accordance with the provisions of TITLE f The to Environmental Code as described i
the application for Disposal Works Construction Permit No. _�/ c__..........................�._ datedTHE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-------------------------------- -/f-- ��`------------------------------------ -------- Inspector -----------------------�-----�--------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS ,�
BOARD OF HEALTH
TOWN OF BARNSTABLE
No.
---------------•--- FEE...........-...........
���s#inln �rruti�
Permission is hereby granted-------------'074h? ____/ ___.._G___l____ ___________
------------------------------------------------------------
to Construct�D� or pair ( �'an Individual Seeta a Disposal System
at No. --------------��P../5'j------�/Iu.--�_�3_./�/� L-------Af-4.= - -
Street CC��
as shown on the application for Disposal Works Construction Pe . To.l___'� ' F`Rated--__ __.
-------------Ln_ ---f�
-=--
DATE. Board of Health
FORM 36508 HOODS h WARREN.INC..PUBLISHERS
f� OC 5EWQC4E PERMIT QO.
/ 079_079
1W5TQLLERS ► &NIE 6 . ADDRESS
. -
BUILDER 5 1.1 &MF- 4. ADDRESS
ram- - - - -
Dl.\TE PERNA T 15SUED 3_7-4- - -
D&TE COMPLI &MCE ISSUED -
w' T
N J. Fs$..... .*4.._
o...... ...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALTH
...*ftm_..._ _VIO oF............... . ait/ /��--------------...------------
Appliration -fur Uispwial Workii Tnnitxnrtion Valliit
Application is here made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
S st- .............. ... ..... '�'L /�•Location- dress or Lot No.
nor Address
aI di..•-• -----....-•••-•-• .............................................................
I alter Address
Q Type of Building Size Lot----------------------------Sq. feet
U DwellingNo. of Bedrooms........... ._______. _. ---_-Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building _-_________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
lz' Other fixtures ----------------
- --- ----- - ------------------
W Design Flow_ _.___._.`0.......................gallons per person per day. Total daily flow----------__................................gallons.
WSeptic Tank�Liquid capacityit_J_=_ allons Length________________ Width............._.. Diameter........._....._ Depth_._-_-_---
x Disposal Trench—No_____________________ Widtl)------------ al Leh...... _ .. _ Total leaching area--------------------sq. ft.
Seepage Pit No-------- -------- Diameter..__ l Al ` Total 1 chiug are _.........___..__sq. ft.
z Other Distribution box ( ) Dosing tank ( ) �/ �� Aft �
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-..--.-.._--------_.---.
Description of Soil --_ ----y a" --4r---- .-fit-- . -- -----------------------------
W
---•--------•--•--. ........./--2------- ---- ..' .............. --------- ------------------------------------•-----------------
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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has*beeissueldl.by th oard of healtSig $ « .- 3"D tA lication A roved B /. ---- ------------------------ ------- ------
PP PP Y______
Application Disapproved for the following reasons:._.
-•----•----.....---•-•---•-••---....-----•-•-------•...............................-- Date....•-••------
r; ... ,
Date
PermitNo......................................................... Issued........................................................
Date
-- - -------------------------------------------------------------
No......--................ Fly c .f..............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF 1 HEALTH
1 , �¢ .,
_.... ._ ...._..... OF....._..............-_........-._:..., ........I...........
r
Appliratiun -fur R.ipufittl World Tun,itrurtiun Vrrntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
Location-Address i or Lot No.
p Owner Address
Installer Address
Q Type of Building , Size Lot............................Sq. feet
UDwelling f-fNo. of Bedrooms..........______----------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures ......................................................
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank L Liquid capacityl_-........gallons Length----------------I Width................ Diameter................ Depth................
x Disposal Trench—No. .................... Width.................... Total Length-------�:'._.__..i Total leaching area....................sq. ft.
Seepage Pit No........-M:--------- Diameter.................... Depth bel W inl,et.......-_..._____... Total leaching area--._.--.-.----____sq. ft.
z Other Distribution box ( ) Dosing tank
aPercolation Test Results Performed by------- -----------------------•----•-•----•-••---••----•--••----.....-•-- Date........................................ ,r
a Test Pit No. I................minutes per inch Depth of "Pest Pit.................... Depth to ground water........................
�14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-----.-..--.-_-.--_-.._.
9 ----------------------------- •-----
......._
O ... ..escrpton o Sol-- _------.= .----------------------------- .....------......- ......-----�'---...... ...---- --------------------j-----------------------------
x . --.. f / - .r .
U -------•------- ---:-- # ........ ---------•--------------- �
W -r
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 Article XI 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.
/
_. . ...--•--------------- ...............................
Date
Application Approved By._... ,��'' = 1 d^G%P/----------------------- ......
Disapproved for the following reasons____________________ .
..................................................................Date----••-•------
•----------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued............................................•.ate.......
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
101,rrtifirate of TlIm rliatta
THI TO CERTIFY, at the 41vidual Sewage Disposal System constructed �or Repaired ( )
by" ...... 06_,I;------------- = i ............... -�------- ..........................................
____________________ __
------------ ..........................-----------------
at' ta,r
.: 1L1 t.-4
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No------------------ __-'----'"______________ 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 9f HEALT
/
' f ..............OF..-.. G
No. FEE. --------------------
4anIpaividual
Permissio��i 'hereby granted -----e � 4to Cons C ) o ' Repair ( � Sewage isposal Syst
at No®..... ---4..�i/�(.Lt''�'���J , ��� �a'�� ----------------------------------------
7.11
as shown o the application for Disposal Works Construction r t tN __ _ _ _ Dated-..__ _'-_--3-"-..7G_'______--
i -
------ - —-- -- -- -- j
........
-. Board of Health
DATE--- -----���.r_.. _�__�/_
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
_
2°
7
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- -��/��.'��,r� r:�J:-•� �1 �� C...i-)fir��'..•r l�i � � .. _ - � i���»r- a•i .{=..,.-:. /:Y'w.
Q+'��V-S
ALAN W. JONES & ASSOCIATES
CONSULTING ENGINEERS
CARLETON DRIVE
EAST SANDWICH, MASS.02537
TELEPHONE 888-3154
TEST PIT AND PERCOLATION TEST
January 1975
To: Mr. Roger Derosier Personnel Present: Paul Murray
Route 149 Norman Ayotte
Marstons Mills, Mass. Alan W. Jones
Re : Lot #1 Test Location: 95' into lot from
Champagne Acres Route 149 layout
Route 149
Marstons Mills, Mass;.
010" Ground surface
016" To soil
Sub-soil
2' 6"
Average Percolation Rate:
1" drop in less than 2 min. ' 6" Loose, coarse, yellow
sand, gravel and stone
o F.
AN
1210"
c
510 J ` No water encountered
;fib
Water levels indicated, if any, are those observed when test pit was
excavated and do not necessarily represent permanent ground water levels.