HomeMy WebLinkAbout0780 SANTUIT-NEWTOWN ROAD - Health 780 Santuit-Newtown Road
Marstons Mills
A 028 --106
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TOWN OF BARNSTABLE
LOCATION_ t � JYtn� SEWAGE
VILLAGE ASSESSOR'S MAP & LOT&fcAY--/Qe
INSTALLER'S NAME & PHONE NO. ,eCIV046-4 7
SEPTIC TANK CAPACITY I--"�
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR [IBLIC WAT
BUILDER O OWI
II'I DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: 3 `B
VARIANCE GRANTED: Yes CN6777
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THE COMMONWEALTH OF MASSACHUSETTS
=ar J BOAR® OF HEALTH
CA OWN OF BARNSTABLE
Appliration for Biopooal Worko Tonstrnrtion 1hrmit
Application is hereby made for a Permit to Construct ( ) or Repair (-^< an Individual Sewage Disposal
System at:
................................ •---•....------------.....--•------------•---•--•-•-•--•----•----
Loc t n-Addr s Ij q r Lot No. _
Q!lrl_G.!��w Own OV�� /6 y Addrell�S
•• ... ................ .................. .............................................................
Installer Address Q�.�L
UType of Building Size Lo��l..................Sq. feet
Dwelling—No. of Bedrooms.................V.�.._..........._.........Expansion Attic ( ) Garbage Grinder ( )
Other a —Type of Building -------------•-•---------... No. of persons............................ Showers
Cafeteria
Other fixtures ------------•---••--------------------------------••----------•-•--•-----•---••-----... --------------------------------
(. ---->-
W Design Flow................... .........____..gallons per person per day. Total daily flow............ ®..................gallons.
WSeptic Tank—Liquid capacity�Q�_-gallons Length---f?57. Width................ Diameter---------------- Depth.,..............
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... 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........................
�Z4 Test Pit No. 2................minutes per inch Depth of.Test Pit...:................ Depth to ground water........................
9 ------•------••-•-•--••--••----------------------------•-•--••••----------.............-•--------•-..........................................................
0 Description of Soil...............................................................................•--------------------------------------•--------•----•----•------------------........--•-
x
U --------------------•-----------•---••--••---•------------•---•-------------•••--•--------------•----------•----•-•------------------••-•-----•----•------•------------------------......---------------
----•--------------------------------------------------------------------------------------------------------------------------------- -------
Nature of Repairs or Alterations—Answer when applicable _ �!N �
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 bee is ed the boa d of health.
Signed .... ................. ...... ...... ........... ........... .. ......................
-- -� . -- —
- ----
ce
Application Approved By .........
- ... ...- ` - .°/. -----
Date
Application Disapproved for the following reasons- ............................................... ...................................................................................
------------------------------- ---------------- ------------------------------------------------- ---- ------------------------------ -- ------- ------------ ---------------------- -------- --.....................................
Dace
PermitNo. ........�-� ----------_--------------- Issued ---------- -------------..._............------------.---------
Dace
No._-.,-c...........Z2 A, 6_�ff- Fim-,-3d .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
a--TOWN OF BARNSTABLE E
Application for Disposal Works Tonstrurtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (Xj an Individual Sewage Disposal
System at:
Locat' n-Add s or Lot No.
................ dtfA�J c�! ................................................J .0 d.�J gJ_./�"J_..--- `-"---•
Owner
/��0 /iQ�IJ�J Address
-•-•ram---...... .... ..._...-----...---•---- -------._........-------------------------- --.....---....------•---------..........----------------��-- _._.__.....-----•--..
Installer Address
Type of Building Size Lot .0�-____.-..---`-..Sq. feet
Dwelling—No. of Bedrooms.......................__......_._.._.......Expansion Attic ( ) Garbage Grinder ( ,)
P`4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Pa Other fixtures
W Design Flow................... ......................gallons per person per day. Total daily flow............ .......-----......gallons.
WSeptic Tank—Liquid'capacity/440--gallons Length-•• "_ _ Width---------------- Diameter................ Depth--------------_-
x Disposal Trench—No..................... Width.................... Total Length-------------------- Total leaching area_...............--•sq. ft.
Seepage Pit No--------'------------ Diameter-------------------- Depth below inlet.................... Total leaching area------------------sq. ft.
_ z Other Distribution box ( ) Dosing tank ( )
0.4 Percolation Test Results Performed by.......................................................................... Date----------------------------------------
1.4
Test Pit No. 1................minutes per inch Depth of Test Pit-__-__------_.------ Depth to ground water........................
LL, Test Pit No. 2---•-•.-__----.•minutes per inch Depth of.Test Pit-------------------- Depth to ground water........................
0 a ----------•----------•-----------•-•-••-••-----------•-••------•-•-------•----------••--------•-•---.................................................-------
Description of Soil............................................................................... --------------------------
V ----------------•--------------------------------------------------------------------•----•----------------•----------------------------------------------------------------------------
W
x ---------- .._..
U Nature of Repairs or Alterations—Answer when applicable------- 1 �D�___ �17-_W--_ S'itiN i
-----------
-------..........------...........-/S.... ^..........----. ------------ ------------------------------------------------------
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 Compliancdhas bee is ed b I the board of health.
Signed ---- 1-- --- n -------------
Application Approved BY -----_---_-------------_-------------------------------------------------- ----3', �1
Dare
Application Disapproved for the following reasons: ------_-----------------------------------------------------_------------------------------------_------_---- -------------
- - - ---------------------------------------------------------------------------"- ---------------------------------------------------------------------------------------- ----------------------------------------
Dare
Permit No. :9 ---------_-------- Issued ------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(9Prttftcttte of (gompliance
THIS IS TO CERTIFY, T[ha_t-tjie Individual Sewage Disposal System const. ucted ( ) or Repaired (X )
by-------------------------- ----------------------- l��T"GlP�117 - 'Ok� _X�77e�lr
Insraller
..................................................
has been installed in accordance with the provisions of TITLE 5 ojThe State Environmental Code as described in
the application for Disposal Works Construction Permit No_ -------- _ a-- - ......... dated ..____..._._--._..--------------------------_---
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BEC C,Ok'ST�UED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.,
DATE f � ' �) Inspector r - r `-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE S
No.. �r ....17 7 �5 Q
FEE........................
Disposal Works (9unu#rnr#iun Errant
-2
Permission is hereby granted..................•__---- -- /.---------.--- 63i7------C_ds�
--"----------------------------------•---••-•••-•----••----
to Construct ( ) or Repair (Y) an Individual Sewage Disposal System
at No.....................................::2�R -----..../1 .�J ! ?. J `>'f� ' "'--p, / /L C�S'
------•-•------------••-------------
Street p�^��
as shown on the application for Disposal Works Construction Permit N,Io._-T_.Z___.. Dated..........................................
......................... �---`---- ------------------------------------------------------------
[� — Board of Health
DATE........... - r- .....................................
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
AsBuilt Page 1 of 2
!- 5 TOWN OF BARNSTABLE
LOCATION SEWAGE # —97
VILLAGE W,44'&Z.6 ASSESSOR'S MAP & LOTd---;LT- AZ
INSTALLER'S NAME & PHONE NO. Z- C74714 , 7
SEPTIC TANK CAPACITY lCkjd-('
P
LEACHING FACILITY:(type)
NO. OF BEDROOMS PRIVATE WELL OR<P! BLIC WAT�EB_+
BUILDER Oxj
DATE PERMIT ISSUED: 9 s'a
DATE COMPLIANCE ISSUED;
VARIANCE GRANTED: Yes No
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http://issgl2/intranet/propdata/prebuilt.aspx?mappar=028106&seq=1 3/9/2016
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THE COMMONWEALTH OF MASSACHUSETTS
0_2_% f 0(p BOARD OF HEALTH
...... ....................OF....... ... ... `l .ttt .0 ..........................................
Appliration for Dhipuii al Works Tontitrurtiun rantit
Applicatio is hereby, made for a Permit to Construct ( �or Repair ( ) an Individual Sewage Disposal
S stem
.. (J ._......�.�t !W.._....�'....Ue °�1.... .. -.-•----- -------------------- ..........----..
Location.Addre s or Lot No.
. ty`�= .1.�__.......... r-Jr.t LWI............... •
Owner Address
d
Installer Address
Type of Build Size Lot..... _ .............Sq. fe
Dwelling No. of Bedrooms__ _.__��____------•----•-_---._..--_Expansion Attic ( ) arbage Grinder
Other—Type of Building No. of persons............................ Showers — Cafeteria
aOther fixtures -•--••-••---•---•---•---•-------------•---•......•••••••-••••--••-••••••-•••-••---•-•--------------•--•-•----•-...----••......------.........--------
W Design Flow..................`.! ..................gallons per person��er daey. Total daily flow............. ..............g;41onsi
WSeptic Tank—Liquid capacity _.gallons Length__ 1417.._ Width..4.l�__- Diameter................ Depth..! ;!-�--
x Disposal Trench—Noa................... Width _-_------_-_-_-. Total Length.................... Total leaching area_...�.____.._...sq. ft.
Seepage Pit No....______.j..__..... Diameter....... ...... Depth below inlet_.....?-......... Total leaching area... ? ..sq. ft.
Z Other Distribution box ( :� Dosing tank ( ) n
'-l' Percolation Test Results Performed by- 4 :_. .��.._..'.j.'J® -..1" ..._._. Date.... _ I .�. ..........
F4 i
a Test Pit No. 1...��..minutes per inch Depth of. est Pit.....M....... Depth to ground water________ ____________
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Q+' •-••-----•-•••••------------•••---•--•._....---•-----••.............•---•-------------------•---•---.........................................................
0 Description of Soil...........................---............ik........ . ......
x �` _.AP �._._, 19 ------- -----------------_--- ....---
c�
U Nature of Repairs or Altefations—Answer when pplicable.......................................................... ....................................
---••----•--------------•---••••------••-•-•••-•--•-•----•-------•------•------••--.......-------•--•-••--•---•••-••••--•••••---••••-•---•••---•----••--•••--••••••••-•••-••----------------•--•-.------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITL E 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.
Sign ----•---------------------------------------------••---------•----- ............ .a................
Date
Application Approved BY- / . ..__..._.._-_-- .L!/l�l- --
• ;A � �� Date
Application Disapproved f or'the following reasons--------------------------------------------------------•------------------------•---------------------.......•--
.................•--••--••........................---••------.................-•--------•-------•----••--------•-----•--•--••••-••-••••---•-•-•------•--------•--•-•-•••---•......-••-•••-----...._....
Date
PermitNo.......................................................- Issued........................................................
Date
Nd...................I- Fim. . ..........
THE COMMONWEALTH OJO IASSACHUSETTS
BOARD OF. HEALTH
. ...... ---- --- ------I........:r�!OF....
��,W45FAA.ax
L&o...........................................
Application is hereby made for a Permit to Construct (�<or Repair an Individual Sewage Disposal
System at:
........................... 144. kyv..o.... --- --------------------------------------------------------------------------------------------------
e— Location-Addr efs or Lot No.
............... ........... ....... .... ................................................................................................
Own
Address
...............................A.(!I:I�........... ....... ...... ....................................................................... .........................
14 Installer Address
Type of Build' Size Lot____ ---------------Sq. f t
'�''arba e Grinder
U ul rNo. of Bedrooms.jtt-.... arbag Dwelling -— -------------------_-_-Expansion Attic
Other—Type of Building ............................ No. of persons..........__.........__.____ Showers Cafeteria
Otherfixtures ------------------- -------------------------------------------------------------------------------------------------*------------
Design Flow............ 5.. ..................gallons per person Per day. Total daily flow-------------------�`�o.............gions.
WSeptic Tank—Liquid capacityf.",_.X!..gallons Length.44.4 . Width.A':40.*.. Diameter________________ Depth.
Disposal Trench—No ...............: Width Total Length............._...... Total leaching area....................sq. ft.
Seepage Pit No,...........I--------- Diameter.__--_ Depth below inlet.....iA.......... Total leaching area... P...sq. f t.
Z Other Distribution box Dosiqg tank
Percolation Test Results Performed bv._�).,�ATITLOIK......................... ....... Date.... 1.1-7..........
i 71-1
Test Pit No. 1.. .<... ---minutesperinch Depth of Test Pit...... ........ Depth to ground water--__--------------------
fi Test Pit No. 2................minutes per inch Depth of Test Pit..............._.._. Depth to ground water.__........._......._...
.............................................................................................................................................................
0 Description of Soil..---------
----------------*......*--------------------------------------*-------------------------------------------------*........... ------------------
�4 L,, ) /24............I.....�Q__>
................. .................t a: 7-----------
4�id A,
Alt
Answer when U Nature of Repairs or Alt ations 7pp I ble............................................................... ................................
........................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescril5e'd Individual Sewage Disposal System in accordance, with
the provisions of TITLE:, 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.
Siggnp-d........;.4;................................................................. ...............................
Date
Application Approved By.... . . . .. . .... ... ...... ......
Z11- 7------------------------- R ...........t...
Date
Application Disapproved for the following reasons:................................................................................................................
.............................................................................................................................................. .........................................................
Date
PermitNo--------------------------------------------------------- Issued.......................................................
Date
THE COMMONWEALTH OF MASSAC14USETTS
BOARD OF HEALTH
..................OF......:. .......... ...................
Z
(Infifirate of Tamphaurr `i
THIS 1 0 That the Individual Sewage Disposal System constructed (//)_10r Repaired
by... .... ..............
;;-L------��--A......................................................................
at...!n.... .....................................................................
TI 5
has been installed in acclidance with the provisions of ` r of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No... ... ......A_?_�......... dated_-- .............
THE ISSUANCE OF THIS CERTIFICATE SHAL OT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE__...
........................7---------------------- Inspector-- -----�_ ............................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................................(W ........
........
Is0.............. ....... FEB.,�..............
11 ...... apre
Permission hereby granted;;...... ...... ---------------------------------------------------------------------------------------------
Uzi,
9� V,I
u
to Const ct -1 IV) or Repair t( an"11ruilvi u w e Disposal System
atNo.. �44*14"------- -------- .................. ..................... ...........................................................
PC Street
as shown on the application for Disposal Works Construction Perqit No.').._ --A Dated....
7.
4-��-Av/_,,.:------------------------
DATE......_..--....... ........................................ Board of Health
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
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