HomeMy WebLinkAbout0052 KETTLEHOLE ROAD - Health `52 Kettlehole Road
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'West Barnstable
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TOWN OF BARNSTABLE
LOCATION ��LC�IIJ�� �� SEWAGE #
VILLAGEA�3 • ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. 1`II t2Z��
SEPTIC TANK CAPACITY '
LEACHING FACILITY:(type i ' (size) C�1.>
� tb
NO. OF BEDROOMS IVATE WEL OR PUBLIC WATE
BUILDER OR OWNER
DATE PERMIT ISSUED: 0-11-1 I
DATE COMPLIANCE ISSUED: :7
VARIANCE GRANTED: Yes No �'
F =58
F
356;12 s�
j
YOU WISH TO OPEN A BUSINESS? q
For Your Information: 'Business certificates (cost$4-0.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (w hi
h you
must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office,.lst FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
l �i' 1MO,ON . r DATE: Fill in lease:
�� ..g€ 1 APPLICANT'S YOUR NAME/S: p
�(/!D T l��RlY
P BUSINESS YOUR HOME ADDRESS: 3z k. Jee �,�.�,(
roy 2yyY�rl� w13-t f3qvnyfz, /Ul f12 6
TELEPHONE # Home Telephone Number_ 09
NAME pF CORPORATION Tl�,� a`/lCF. Fi9i'fh Gyr„9C Ij�
NAME OF NEW BUSINESS /ALC g /f �/. . Ct� TYPE OF`BUSIIVESS r
IS THI5.A HOME OCGUPA�IpN? YE5 NO: Cv /✓
r
:ADDRESS
MAP/PARCEL:NUMBER_; (Assessing)
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth
Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING COMMISSIO ER'S OFFI E
This individual h e i d f y arm' re uiremen that p main to this type of busin44UST COMPLY WITH HOME OCCUPATION
u Hz ig a re* RULES AND REGULATIONS. FAILURE TO
0 MEN —� COMPLY MAY RESULT IN FINES.
2. BO RD OF HEALTH
This individual he be
or f the permit requirements that pertain to this
�� _ P type of business.
COMMENTS: Authorized Signature**
S. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
J
A 06,
1 aq-or�) o
I Fics.. '...............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
A1111 iration for Uhipa t Works Tonotrurtion Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair (Lj-�an Individual Sewage Disposal
System at:
.......... .tea.... :. � --------------W� = -Y�'.1.
.............
. cc n- ddre or Lot No.
wner a
Installer Address
Type of Building �{ Size Lot............................Sq. feet
U Dwelling No. of Bedrooms..............5 . -.Ex Expansion Attic�-+ g— -------------------- p ( ) Garbage Grinder ( )
Other—Type of Building .............. No. of ersons.....................--.---- Showers
a YP g -=----------- P ( ) — Cafeteria ( )
dOther 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water......--.--.............
fT4 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................
W ............................................................................................................................................................
0 Description of Soil...............................................................................------------------------------------------------------------------------................
x
c.�
W
U -Nature of Repairs or Alterations—Answer when applicable----- --- --- ....� �.........................................
`�,� ►��r -- � �-------------------------------------------------------------------------------
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 t place the
system in operation until a Certificate of Complian s e e board of health. pp l
Signed. ----....... --------- --------------------------------------- .......................... ............. �..
Dace q.
Application Approved By .........
Dace
Application Disapproved for the following reasons- --------------------------------- ----------------------------------- ---- ------------------------------- -- --------------
--------------------------------- ------------------------------------------- --- ---------------------- ----------------------- ------------------ ------------------.......................... ---------------------------------------
/ .� �+— Date
Permit No. (...- �F7... .... Issued -----........................................
Date
Fmc. ..............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH r'
TOWN OF BARNSTABLE
ApplirFation for DtupuuFal Workii Tomlrurftton Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at
< ........ �, M
...................... .................W
............ ......... .Y..
oc . n• ddre or Lot No.
... �_:
� .......- .. .............................. ..._....._...-.....
.caner ddr
`�
Installer Address
PQ
1� Type of Building Size Lot............................Sq. feet
v Dwelling No. of Bedrooms...............5_---_.._..__.___-_---Ex anion Attic� g— p ( ) Garbage Grinder ( )
�`4 Other—Type T e of Building No. of ersons____________________________ Showers —
YP g ---------------------•------ P (----)-----•.Cafeteria ( )
Otherfixtures -----•---------------------------•-----•-------------------------------------..... -------------------•------ -•----
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--_-_._______-__--_-_-_.
Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 --------------------------------•-----•--------------------.......----------..............--•-------.........................................................
0 Description of Soil.....................................................................................................................-..................................................
W
U •-----•--•----------------- ---------------
--------------------
•-----------------------
•--------
•••-----------------------------
•-------------------------------------------
•-------
••--------------
W
U Nature of Repairs or Alterations—Answer
when ap licable............� ��__-�.........................................
.. . . •---- ---- ----------------•-.....-----------.._......-•-........._--••-------••--•-.----
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 CokpliaV7]� e.y e board of health.
Signe --....------------------------------------.._......7..------ -----�J----------.. .-.DateApplication Approved By ...---.... -�--- � ------------------------------------------------------------ ...........��-- --.- /.
Date
Application Disapproved for the following reasons- ------------------------------------------------------------......................................................................
............................................... -- ------------..........-- ----..........-- ---- ...........---....------------------------------------------------------- ------------------- ........................................
/ q Dace.....
Permit No. ---- C�l_.--.... -.1-- -------_---------------- Issued .........................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
• TOWN OF BARNSTABLE
QlXrtifi ate of CIJortylinure
IS CE Y,._That Individual Sewage Disposal System constructed ( ) or Repaired
by.. ....... - ..... ..... .... ... . . ......... .. . .... .... .... ----------- ---
I tal r
at .................................... - ------ -------------
has been installed in accordance with the provisions of TITLE 5.x�f The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ---__. :...Q��......
pP � p �°... -....._ dated --------------------------------------- ----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.................... .-P _.. /'' Inspector .........-------- .........---....................... --------... --------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
� � TOWN OF BARNSTABLE
No........... .... . FEs ..... .............
Diu u . ,� u�rnr�ion rrntt�
Permission is hereby grant --- --- - ------------------ ----------- ----- ----------------------------------------
------
to Construct ( ) or a' n iv dua ew age is as System \
atNo........... ------- ----- - -- - . . -- ......... `-.... -- ----- .......................
Street q.
as shown on the application for Disposal Works Construction Permit No.-,l_n.,U.�. Dated..........................................
......................................................
-
DATE................ _ r ) Board of Health
FORM 36508 HOBBS 6 WARREN,INC.,PUBLISHERS
TOWN OF BARNSTABLE {�
LOCATION Ct 2.`l—SEWAGE #
VILLAGEU3
ASSESSOR'S MAP & LOT
INSTALLER'S NAME PHONE NO. I1 Gas,
SEPTIC TANK CAPACITY L
LEACI�NG FACILITYAtype t (size)
`t lb
NO. OF BEDROOMS_ IVATE WEL OR PUBLIC WATE
BUILDER OR OWNER i ..qq(A `
DATE PERMIT ISSUED: (Q 10--i i
DATE COMPLIANCE ISSUED: :7-
VARIANCE GRANTED: Yes Now
• . ��,� �= as ,
i
a4'
9
LOCUTION ' SENN&C;E PERMIT UO.
'VILLAGE —
�na�p fz
IW5T&LLER 5 1 &ME F, ADDRESS
Iv- Ld - - - - - - - - -
BUILDER 'S Q &"F- e,: ADDRESS
DATE PERIAIT 155UED o'is`_7 — —
DATE COMPLI &&ACE ISSUED :
No......... ................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEAL H
OF.............. .... .
VZ
Application -for Uiopoottl Vork,6 Tonu4rurfion Vamil
Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
Location_Address or Lot No.
Wcaner Address
a r
....A........................
M Installer Address
Q Type of Building Size Lot____________________________Sq. feet
U Dwelling—No. of Bedrooms.--_._....3-------------------------------Expansion Attic (�}- Garbage Grinder ( )�
aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ----------------------------------------------------------------------------------•--•------------•-•-••--.....
W Design Flow.....50................................gallons per person per day. Total daily flow___________ ___-_----__-.__...--_.gallons.
WSeptic Tuck—Liquid capacityA 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. it.
z Other Distribution box ( ) Dosing to ( )
aPercolation Test Results Performed by.- ems.. -�___________________________________ Date....��z-j,____----- ...
a Test Pit No. 1----------------minutes per inch Depth f "Pest Pit-------------------- Depth to ground water-----------..-_.--.----.
Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground
water__... ___-__.-_.-_----.
---- - - A--------- -- -••-•----• - ------------------
5` x
N
G 1
of S lW -
`{ ...'
----- ----- ---------
j
U Nature 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 NI 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.
F>, ?
Sig / .. ...........
f j ate
/ �. 7APPlication Approved By. -: �1✓ � Date
Application Disapprovedfor the following reasons:.-.-.----•--------- --------------------------------------------------------------------------------------------
...-•--•-•-••---••-•-----•---...------•---=---•---•--------------------••---------•----••------•-------•------•-----------------•--•-----•-------•-•-----------•---••---......._------------....._.-----
' Date
PermitNo......................................................... Issued..."........ ...............
Date
f , '
Iv
No......... Y F��.. .�+#....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O F-OEAL
ioyt .. -..-.oF .......... .,/f ................
Appliration -fur Ii.ripwial Workii Tomitrurtion Vrrutft
Application is hereby`made for a Permit to Construct. ( ) or Repair ( ) an Individual Sewage Disposal
System at:
_____ L cation-Address ---•-•----------------•--_-••---•- or•Lot No.
-- .......4 ---- i�` - •--.. ..-------___'-_........ .-'--- •--•---•--•----- ------------'--...-----
caner . Address
Installer Address
d Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms--------- -----------_-------------------Expansion Attic Garbage Grinder
a Oto-
Other—Type of Building ............................ No. of persons---------------------------- Showers ( ") — Cafeteria ( )
Otherfixtures ---------------------------------------------------------------------------------- ---------------------------------------
W Design Flow----St_................___ ___________gallons per pet-son per.Aay. Total daily flow---------- 4f'"0._...._.._.__.........gallons.
__
WSeptic Tank—Liquid capacity _-gallons Length_. --__-__-_- Width---------------- Diameter................ Depill_-_---___-_..-
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 t c/of)
'-' Percolation Test R lts Performed b ___ Date-- �+':`.�*--�-
Test Pit No. 1.... ._----____minutes per inch Dept ._----------------- Depth to ground water..-.-___-.-.---.--.-_---
(� Test Pit No. 2-----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------
--- -- • -- d �.- r ................ /- a___
D Descriptio of S 1 G .. e� +� y -
c ---
W --- -- r 1.�' .----------------------- ` .
V Nature of Repairs or Alterations—Answet'when applicable.----- ---- ------1-1.2--- s
----
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.
Sig d - -- � �"' :_-- - ---- V---�/
D to -
Application Approved By.. _ _
`Date
Application Disapproved for the following reasons------------=---':...--------------------= -------•---------------------------------......_.-----------••-••-
------------ ---------------------------------------------------------------------- ---------------------------------------------------
Date
Permit No.------ -•----••--------•.._..--•-----••••-• l
Issued �. . ----• -••---
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9f HEALTH
�p � irtttr �f f�rrttt�Ii�tnrr , �,,,- •
:HIS IS T E TIFY, t th vidual Sewage Disposal System constructed ( ) or Repaired
byQ - -.--- •--....--•-------------
- Installer
at Ret�i
has been installed in'accordance with the provisions of _ X o The State Sanitary Coe as es bed in the
application for Disposal Works Construction Permit No. :_._.._._ -✓------------- dated_._.. .-1' '""_!.-_�,_.___._.._.
Tk ISSUANCE OF THIS-CERTIFICATE SHALL NOT RE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.............f �- ..-------------- Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 'OR HEALTH
OF......... .. ......... ...-......
..... FEE...l.__V.............
�i���� irk n� �trtilatt �rriatit x- .�M. •
Perils to i� e�eby gra ed �- -- -------------------------------------------------- ----------- -•
to Con�>€i �t�tf'�t or R In i fd ge tsp 1y�to -`
at No.
Street
as shown on the application for Disposal Works Construction Dated----- .-"---�----�---�----7----f'�j-..--------. � - •
�/ 77 Board of Health f!
DATE--- -•_..:l...---------•...........:........................•-----•-- -
s
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS / 'r
►:, 0
OL E --- -R0A ,D-
40• vvA v --- - --
/60. 00
PROPOSED
3-BEDR00/4 H
�( 38'
75 �t
le
)0 -1000 GAL.
O SEPTtC
p 20#+ BOX
T /6
w
0
L� W TOP OF FG UST 17.
� 0
J t THE LOW 0'0/NT
0 0 W N //V RO,90
�w
i
- �- /60.00 - -
LOT / 3 ► LOT/ z
Gr�r,�, ASH OFM
RICHARD cy
�n ,1_b _; � JAMES
No.27871 O to
l s= QlSTf- 0�� CERTIFIED PLOT PLAN IN
SUR*J MASS.
LGTCIS - �FT"T! EE(5 J— eO/9 r-")
I CERTIFY THAT THE RICNARD U O'NEARN R.L.S. R. S.
SHOWN ON THIS PLAN IS LOCATED /91 MAIN ST. (RTE. 28)
ON THE GROUND AS INDICATED AND WEST DENNIS ) MASS .
CONFORMS TO THE 20/VING LAWS
OF�.9�z�/sTAa�c MASS. DATE: ' ? SCALE:
JOB NO. c/ CL/ENT.
ATE ,-REG. LAND' SURVEYOR DR. 8 Y SHEE T / OF
20' M ink.
4'PVC P/PE CL EAN SAND
A9/N. P/TcN-CONCRETE CONCRETE
_ �B~ PER FT"
COVERS COVER
LIQwD 2" LAYER
LEVEL OF Y8- 3/8"
4rCAS7 /ROA( /000 GAS WASHED STOJ�,'E
p/PE-MAN. 4,° W o /4_I/2 N
P/Tciy %'PER FT SEPTIC SST. o o , 0 3
TANK ti WASHED STONE
";:• W S
� o
o V " °
0
o W W PRECAST SEEPAGE
o
o Lk
tk O o' P/T OR EQUIV.
O W o
o
SAAAAA
` �FT ,O/A• �� i
I O FT.
O,�c`SH OF fA,,sfc
GROUND WATER TABLE
RICHARD yG
SECT ION OF Zi JAMEs ^,
SEWAGE DISPOSAL SYSTEM v O'H y
No. 69494 Q
INVERT ELEVATIOAIS A/Or TO SCAL E �FG/sTE�X/
INVERT AT BUILDING FT. aNlta
R
INLET SEPTIC TANK FT. SOIL LOG
OUTLET SEPTIC TANK FT.
INLET DISTRIBUTION ,BOX FT. DATE OF SOIL TEST SLf/NE ollA OF 4fl
OUTLET DISTRIBUTION BOX FT WITNESSED SY 41-AN W,
INLET SEEPAGE PIT FT. PERCOLATION RATE MIN"//NCH RJAMES I.
q JAMEs C �
ELEVATION 7 O'HEARN
� No. 27871 O H
DESIGN CRITEPIA 7-— �OPSOfL v�,FG/sTE��oQ`
AIUMBER OF BEDROOMS 3 —6
GARBAGE DISPOSAL UN/T /\/o s u B so/
TOTAL ESTIMATED FLOW 3 ,00 GAL, D Y : -/R -7, PINE, �iE�LO►.v i
NUMBER OF SEEPAGE PITS �_ Pacs�E s of i>7.q�c J
11 T /S- �F7-T'/ NO! F- '
5/DE LEACHING AREA / '�•`7 SQ. FT. ;a,eowH CLAY
BOTTOM LEAC141AIG AREA 78- S SQ. FT" —/08"
TOTAL L EACI,I/NG AREA 2(�_, 7.o SQ. FT. E.o., ro RIC14ARo J. O'NEARN,R.L.S, R.S.
COARSE BE'UwN Si9ND, I91 MAI/V ST.
RESERVE LEACHING AREA 2 6 7 U SQ.FT. G.e.9vEt STONE WEST DENNIS s MASS .
.JOB No.O/�f CL/ENT:PCTF,eSG//
NO WpTE2 •ENCOUNTE2B1� ..
UgrE: //317 2 SHEET 2 OF 2