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HomeMy WebLinkAbout0750 WAKEBY ROAD - Health 750 WAIBY RD. MARSTONS MILLS A = 012 003 001 - - - t' i ' TOWN OF BARNSTABLE ,*CATION 2= 1,JAN.4y QP _L4ZA SEWAGE # , — A VILLAGE. 05V6.JASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.N<,q 7EG 5Yss'lEMS SEPTIC TANK CAPACITY f O Z /fo 0 6fl- Zldle 'o �X i�i�✓� �jlf /%.S LEACHING FACILITY:(type 31/ f4- (size) NO. OF BEDROOMS PRIVATE WEL BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No C I 3 l a 6 AL. LE~ P 1%� ASSESSORS MAP NO• Q /r �' PARCEL NO: J6 2- 6 0 f Fee---- BOARD OF HEALTH TOWN OF BARNSTABLE Applicat ion-*r Well Con5truct ion Permit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair (fin individual Well at: N,P V Ad Location — Address Assessors Map and Parcel Owner C/�/ Owner q4 Address - ,-r_1--=_ � `�"e— e��_4�tt, .,7 '4P <6-0----M ar d`i�l u.—/�t a 036 - Installer — Driller ( Address Type of Building Dwelling ------------------- Other - Type of Building--------------------------- No. of Persons---------------------------- Type of Well-/�`�C ------------ Capacit — Purpose of Well--QQ �sl'�� Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until aCCe�ertificate .of Compliance has been issued by the Board of Health. Signed —-------------- - qr k _IA- ------ date Application Approved ByC�44 -�----- —L5 �'-_7- 'ram date Application Disapproved for the following reasons: ------- -------- -------- --- ------ -- — --------- date Permit.No. �V��� Issued-- = 2 -"- �'°'-- 3- ------ date ------------------------------------------ BOARD OF HEALTH TOWN OF BARNSTABLE (ertif icate Of (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired (4-1 by----0 A LC ��// - ---- - ---- --- ---------------------------------- Instailer at Q V Rd /Lt A-t . has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit�'�Qd `�-lL - 4-'_4 Dated--''- -Z THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------- - -- Inspector---------- ---- --- --- � _ _ - - - --- - - - - - No.- �' --?�-"--��- � _ ��- " Fee---=<-=- - �-r-� BOARD OF HEALTH 1} _TOWN OF BARNSTABLE ', ' - ZipplitattionArlVell Con�truft on Permit i el Application is!hereby made for a-permit to Construct ( ), Alter ( ), or.Repair individual Well at: Location Address . �� S Assessors�Map and Parcel ' w.. Owner / Address � Installer_....DraBer-----f - ---• — Address Type of Building . t Dwelling -�1u�S 4---------------------------------------- Other - Type of Building--- ------------- No. of Persons----------------------------r----- Type of Well—`--— ' ---- - -- .---- Capacity--- - -----—--- — \ Qon. Purpo of Well----------------------- ----- �., AAement: / i Vy. The undersigned agrees to install the aforedescribed individual well in accordance.with the provisions of The " l ibwn of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certifi ate of Compliance has been issued by the Board of Health. Signed rj� ( — _—_ _ — --- < (//////] date � �f H ��I�O� � �—�-tee..--+----:--�-�•...._._-.-__ .,,� '�. Application Approved Bye/"' r �u 4U�•_ V date All - Application Disapproved for the following rea sot3s. -r `_'� — - —------- y�--------•=-�-�—- 'date----- Permit No:'ley �� -- --- Issued--- "-- � '-'%� - 3— ---------- yI q date lmtfls9.btis#urlrlii$?w!t$!w!$9.o!i!$!'ei!i!!!$4c'� 4iTS�i"w ii1!i!itit64ili?i!i!i!i!_9aluliwt"!5!!!i!f!8!1w9i98litiRiliTi/l!eb'�blitMtBl6Zil6ldfiT64ilolM4li9ili'liS6SililA!itoh.4 BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Comphance THIS IS TO CERTIFY, That the Individual Well Constructed ( j, Altered ( ),.or.Repaired (1-o ) Installer -- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Perm4 .7 -��Dated THE ISSUANCE OF THIS CERTIFICATE"SHALL NOT BE CONSTRUED AS A GUARANTEE'THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY: DATE----- -- --- Inspector _-- -_- —- , �I /6 o� /a y BOARD OF HEALTH TOWN OF . BARNSTABLE . Yell,Construct ion 3permit No. �7 Fee- =- —f' Permission is hereby.granted to Construct ( ), Alter ( ),'or'Repair ( an Individual,Well at: No. 7So �,u Kt� /?,l. -t'►ti�1 -- --------------------- --------------------_----- Street as shown on the application for a Well Construction Permit Dated ' '� -''— - -- -- Board of Health DATE -- t k F •g Ole No... ........... .A THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........OF.............. _...... Appliratiou for Di_qpoiial Norks Tonotrurtiun amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location A/dress or Lot No. ? - �� ?J.,t�.1.f�1" ...................................... ��2� ............................•--............-•----------•-•---•-•-•-......... --� Owner ress Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building ............................ No. of ersons___.-___.___................ Showers — p., yp g p ( ) Cafeteria ( ) p' 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. Seepage Pit No-----------­-------- Diameter.................... Depth below inlet.................... 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........................ �14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •---•-•---•----------•-•••..........•-•-•-•--•-•.........--•••.......................•--•---•-------......................................................... ODescription of Soil......................................................................................................................................................................... x V ------•------•--•.........................•----..---.------•---------------•-••---•-•--•-••--••------••--------------•---•--------• •-------.... -•--------•--••----------- W •-•-•-•-----•---------------••-••--•---•-•--•---•-•------•-------....---•--••--••--••••............•---• ....--•-•••-------•-•--------••••--••-••......- ----­-------------- I'U Nature of Repairs or Alterations—Answer whe appcable_... ._ �-e _._ f<[t < ... _._l<t,[Z,C�.....l t�©. �r JIL Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIS 5 of the State Sanitary Code undersigned further rees of to place the system in operation until a Certificate of Compliance has b u health. Signe ........--•- .ems V� � ate Application Approved By.............. ...c^^..... __ Date Application Disapproved for the following reasons:-------•-------•----....---•--•--------••---•-•--------•--------------------•---------------------...-••...._._ ................•---..........-----•-----•---•--......---------•----.....--••------...---...------------------•-•-••---•---•-••_....._.............----••-•••--•....................................... Date Permit No. 1.3-........................._ Issued.. ... Date Ir No...?1.......21_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ••--••. .. ...r.z� '- o...........oF............. , Xpli iratiun for Dispasal Iforks Towit.rurtiun rtrmi# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: // ess or Lot No_T- y IAL) -Location-Addr . - ! .•....................................... . ...........0..d...!=.:_.........__........-_........_...............................--........ _-- 'f- Owner ddress W 'CY 1/l1Ko� ! (` '✓ ���i s ,a 7� U F ,-a ....... ........ _... --•-.-... ..........................................••-•--•--- .. .....---•-•- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) aY4 Other—T e of Building No. of persons............................ Showers YP g -------------•-•---••---•-•• P ( ) — Cafeteria ( ) 04 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. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area......._..........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..............................................---•........................ Date................................... aTest Pit No. I................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___________________________________ W ------------------------------•---•••-•-••-•--......._....••-•••--•-••--•-••••........_.....--••---•---- VNature of Repairs or Alterations—Answer when,applicable-.-___.. �, �.. : ___.. � t r J L Li v �../: !f I S ..../ •jl/✓'c%1 t � l iv sV i ....`-- ------------•-•-•--•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal_System.in accordance with the provisions of TITL>; 5 of the State Sanitary Code undersigned further a frees not to place the system in operation until a Certificate of Compliance has be-n''` u b bQard')t ealth. r ,� S>gne - 1 , . -•--------------------- --------•- --.....----•-•---...----••••. ,. Date Application Approved By.............. "` ,. -- .. _-.Z`--=. ="-= = ------==2--'. .:.&-� Date Application Disapproved for the following reasons:...............-......... .......................0......................---•-•-----•-•-•- - ..-•--••.................•---•.....---.....-•---._...•--................................ -----.........•--•••-----••---•-••••••-••-••••-•--••-••-•-------•-•-------..................__............ Date PermitNo......... r' - �.'``a.' __.... Issued....................... ............------------------------------ ..._............- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. c..:z..t........oF..........k'. c�::=. =.......... ................................................ (Inr#ifiratr of Tumplitturr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.......................• `r'=-= ....... ...............-............................................---......................................_ �J , � q Ir Kel Installer at 4.1.`.... �j J( has been installed in accordance with tit provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..__...-._.......`......................................... dated--------------r•--------------------............ 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 OF HEALTH ?.'.:.......OF............. (!kY?f: l: Ff.................................... No.....'.: ? �- FRE-... .. ... Disposal Murky Tuns#rur#iutn. f rand Permission is hereby granted.......0......... Leg to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo.............................................•---•--•--•---•--•---_......_.............._-_-----•----- --••-•••••--•••---••-•.....-•---•--•....----...._••••-•••---................... Street r as shown on the application for Disposal Works Construction Permit No... Dated.......................................... _ ,i Board of Health DATE----------------�=-•---•-•------•-•�•-'-�-------............................. FORM 1255 A. M. SULKIN, INC., BOSTON L0-`C,AT ION� SEWAGE PERMIT NO. VILLAGE ,f 12- e re .A,) INSTA LLE/R'S AME i ADDRESS i OR OWNER z. DATE PERMI ISSUED DATE COMPLIANCE ISSUED '1 e6 i � No..------.. F�a............._.......... ..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® -. -..1 F HEALTH ----------.--. ----..OF...... t�1/f2.'u... .-' ° .... -••-------------•-----•--•-- App iration for Biipuiiai Works Totes rumon Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ILoca n-Addre s o Lot w _ .. ..................... �7 _ .. _ ' - .. ..... a . ... .1Y1 fe -------- -------- --- ---- ---- ------ Installer ddress Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-,..-.........................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building �_�_... No. of persons............................ Showers ( ) — Cafeteria ( ) P4 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. Seepage Pit No--------------------- Diameter....._-------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) �-' Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-___________--.._---._- G%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---------_.............. ----•--•---•-------------------••--•-----------•-------•---•---••-•-•-----------.....----•--•--..............---•.....-•----•-••-._.........--•••••-•-•....-- 0 Description of Soil........................................................................................................................................................................ - ............... -------•---•. ....... .------------------ •............... .----------------------------------------------------------------------------- .....------•--------------------- W ---------------------------------------------------------------------------••----•-•.........---••------•--... ...... �t� ...• ®s_9'......................................... Agreeme t. FF Th undersigned agrees to install the aforede ribed Individual ewage Disposal System in accordance with the pr9�,isions of iI:'LZ 5 of the Stat n'tary, e— The ers' ed further agrees not to place the system in operation until a Certificate of Compli ce b ssu b oar of health. D Application Approved By.......... ..... $P, Date Application Disapproved for the following reasons: -----------------------------•-----------------•-------------------•••••....... ................•---•--------...•--•-------------------•------------•---------••••---........-------------••-------•---------------------•--•--•---•--•---••---•-•--••••-----•••-----------•------------ Date Permit No. Issued �`� �� ----- Date No........................ FI:s.............- -......._ THF, COMMONWEALTH OF MASSACHUSETTS ` B01 ARD9-F` •HE TH �-+• k . ............... ........OF................................... ---- .............................. Aliptirat ion for Diiivusal Workfi Towitrurthin Prrutit Application is hereby made-for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: fi . ? �l1_(/ 01►.�.....- . . ....R s u �m��............ : � .......................................................... ..S l......�..o.r.... V\ ocat n-Addres + �. •--- a -. ---------------.......... � f__._1� .... . .. ....IUs../1�!./:. Installer ddress QType of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms^.._______________________________________Expansion Attic ( ) Garbage Grinder ( ) p.t Other—Type of Building _N<5__l____ No. '`of persons____________________________ Showers ( ) — Cafeteria ( ) a 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. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................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........................ i �j --------------------------------------------------------------------------------•---•-----__^-----.........._..............---•-•--^----..__.....----•---•- ODescription of Soil........................................................................................................................................................................ x U ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------••- w -----•-----•-• --•---------------------•-----••--•-------•------------------••-•••••-•-------•••--------•---••-•=- x -�-9 U Nature o epairs or Alter ions— nsw r when livable. .. _ {-�- l__.__ d.N_____ __________________________________________ �1� A �S Agreement: The undersigned agrees,,to install the afored cribed Individuay ewage Disposal System in accordance with the provisions of T IT.T;,', rj'of the Sta a itar ode" The 6ders ned further agrees not to place the system in operation until a Cer • cate of Compli nce iss b boa of health. f� W — f 0 CJ ApplicationApprov6d By........... --•------••••--••........................................=!� ;;e----------.- -----------------------------------•--- -`` Date Application Disapproved for the following reasons: ............................., .............................. ---•--••----.._....•--._._.....-•-=`-------------------•----------------.........------------------------------ P Date Permit No. - � �e r Issued ---..........................................7� �. ------------------ Date THE COMMONWEALTH OF MASSACH-USETTS BOARD O HEAL H/ ...........\7 ......................OF................ Cyr ifirate 1f Toutpliattrr.� THIffIl�IE JIF!oAAe' Individual Sewage Disposal Systrn constructed O or Re •- edtirJ t/by ----- ---- ------.....----- ... -------••--- . --� ..... ............. ---- = ..................... been installed in accordance with the provisions of T ` f he State Sanitar a ,in the application for.Disposal Works Construction Permit No.__......................................._ da.ted_..:_.......................................... THE ISSUANCE OF THIS CERTIFICATE SHALL.NO"f BE C! RYID AS A dUARANTEE THAT THE SYSTEM WILL F NCTI 'SATISFACTORY. �1-- - DATE............. --___----- ---.._..... ..- �..•-------•-- Inspeeto :......._... THE COMMONWEALTH OF MASSACHUSETTS BOARD..............V........ ...... HEALTH OF.......................:..........................._.._._........_-_...._........._.. S No......................... FEE........................ t �a� � r uar rani# Permiss n ereby gr ted------------------ ._... ���,nn r /� to Constr rA R � � 2Indi Se agc&D atNo....................= - ----------------------- -•- 3 14 st7�-7 f 7" as shown on the application for Disposal Works Construction ,P �o..__r,__;�" t d_______________________.........._........ --------------------------------- ......------- pn+ ' Board Aealth� DATE........ ---- - - .......................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS