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HomeMy WebLinkAbout2380 MEETINGHOUSE WAY/RTE 149 - Health 21380 MEETINGHOUSE :�.A`f W. BARNSTABL.E A = 155-046-003 a s { i f No. 4210 1/3 BLU 10'0 ® a 140,1 W2®o 3—OL(3 Fee---- -- - zi BOARD OF HEALTHTOWN OF BARNSTABLE SEZpp[itation,for Well Construction-permit T°`"N HE Application is hereby made or a permit to Construct (�), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and_Parcel Owner Addre s — Z Installer Driller— Driller Address Type of B n Other - Type of Building----- -------- No. of Persons------------------------ Type of Well Purpose of Well--- ------------------ 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 a C"fi cate .of Compliance has been issued by the Board of Health. 4r Signed -— - --— — -- --- ^� dat� Application Approved By-,, - date Application Disapproved for the following reasons: -------------------- —--- ------------------- - ----- --------------------------------------------- ,,� ' date Permit No. W 2-003-oq -- Issued -- date BOARD OF HEALTH TOWN OF BARNSTABLE C ertif icate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (.-I, Altered ( ), or Repairedby ( ) Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Wel Pr tection Regulation as described in the application for Well Construction Permit No Dated -S THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-—------ — - -- Inspector----—= -- ----- ------ No. 2oa 3_ay _ t Fee- �----- . BOARD OF HEALTH `+ TOWN OF BARNSTABLE ApplicationforlVell Cootruct ion Permit Application is hereby made for a Permit to Construct (✓), Alter ( ), or Repair ( )an individual Well at: jam- f !/ Location — Address Assessors Map and_P. I 2 Owner Address Installer — Driller Address Type of Building /Dwelling- ------------------------------ ( Other - Type of Building No. of Persons------------------------------ Type of Well a C-------- Capacit ------- Purpose of Well---- -------- -- 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 a C.rtiica fte.of Compliance has been issued by the Board of Health. _..� Signed --- � - -- /dat — Application Approved By -- �—�s --------— -- date } _ Y Application Disapproved for the following reasons:----------------— --- -- `.— date Permit No. ZOO -- Issued----- �_' D — -- -` -A date � BOARD OF HEALTH 1 4 TOWN OF BARNSTABLE Certificate Of Compliance ` THIS IS TO CERTIFY, That the Individual Well Constructed (/), Altered ( ), or Repaired ( ) bY-------- - Tr �� i/� — ---- -- --- — - -- Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Wel.Pr tection 2va3- 9 o Regulation as described in the application for Well Construction Permit No W--------�-Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. ` DATE----- -- — - - Inspector---------------- —- --- .__BOARD OF HEALTH TOWN OF BARNSTABLE Ve[C Con$tructionvermit No. 00 -b - Fee-'" -- r Permission is hereby grantedto Construct (/), Alter ( ), or Repair ( ) an Individual Well at- No. —_ - Street as on thefor a Well Construction Permit No.shown Zoo ?application 3n t o Dated-- 9 7 3 V � `. --------- -- - ------------ Board of Health R DATE-- -- r No....5ZIzI.Te COMMONWE LTH THE BOARD AOF FHEALTH rs � �L� -------- 0W .........oF_ .......&.9.P.&_5. 164. ....................................... Appliration for liopnsal Works Tongtrudion ramit n1kation is h preby made for a_Perunit to Construct � ) or Repair ( ) an Individual Sewage Disposal ............__------�....� t.��.._...ld zWf,��l�l�.... _ .................................................... Location-Address or Lot No. .. ........... tiCL�. .��... ... .... W � ..._ V- ( Address........................................... a .......... ............... Installer Address Type of Building S� Size Lot......j �` .......Sq. feet �-� Dwelling—No. of Bedrooms....................................... ..Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building ......._. No. of YP g _____________•-•--- persons.-.------------------.--.... Showers ( ) — Cafeteria ( ) 04 d $Other fixtures .............:....................... fL•--•-------------•----------.-.----------------.------••-----.---.---------.----.-.----------•-----•-- Design Flow...........1.1.0.......................gallons per gegc*p per day. Total daily flow............................................. orw pt� W / Septic Tank—Liquid*capacity.l�- gallons Length____________n____ Diameter................ Depth..5...&... x Disposal Trench—No- -------------------- Width.................... Total Length............._...... Total leaching area....................sq. ft. 3 Seepage Pit No......Z....... Diameter.....AD....... Depth below inlet....... ...........Total leaching area.'�'3._ 4-P..sq. ft. z Other Distribution box ( Dosin tank ) '-' Percolation Test Resulltts2 Performed b'... �..F lTZ IL Date........ ,.a Test Pit No. L.- ...............minutes per inch Depth of Test Pit-. 6 8.. 1--1 Y7... Depth to ground water....- `� .. fs, , Test Pit No. 2..L Z.r_minutes per inch Depth of Test Pit.... s�2.._... Depth to ground water............. ... -----------------••••- ............................................................. O De ption of Soil.. .'rC�l ,t._... ------- o Zz —l6� cEa � Cc; .uzs y.............. Uu tt _...._..-•-•••-••--•....._.-•••-�---••-•--•••-•••••. svoa '�....3 ' �".Si `�ar`otc.w. Kc� U Nature of Repairs or Alterations—Answer when applicable...........cL 6......-_L10�3-_- LLE-w caadtS 1 .........................•................. ....... .......................................................................................................................... Agreement: The undersigned agrees he aforedescribed Individual Sewage Disposal System in accordance with the pr©visions of:I':LZ the S e Sanitary Code— The undersigned further agrees not to place the system in operation until a Certifi pliance has been issued nn by the board of health. Signed_ S ! K .. ----••-•.............. l~l�ZC�� ....... `� r Date 'Application Approved BY w.......+, -•----......I...:'./1-n . ....... �:......... ...................... Date Application Disapproved for the following reasons:............................................................................................................ ...................................•-----•---•---•------•----•----------•--------•-•-•-•--••------................................------......---...---••-------.......................................� Date PermitNo............Tl.: J.q........................ Issued..................-----............................... • 9'a — S�� Date _ *-�_ ��►> •�" � ti i 1. ��� '. +,F •� �. I N45..............» ..» , r.. , --; r�FEs.. ;...... ............_ THE COMMONWEALTH OF MASSACHUSETTS r ' v »' ` � BOARD OF HEALTH ._...e:... . r.... ....OF........r. n..I..STi�4FaL: .. f Appliration for biop mal Works Tonotrttrtion 1rrmit A llica on is hereby made for a Permit to Construct or Repair. ( ) an Individual Sewage Disposal Location-Address or Lot No. Owner € ess ...................................... Addr . � Installer - _ .. Address t Type of Building �- Size Lot.......S.....3.... ......Sq. feet Dwelling—No. of Bedrooms._:..........................................Expansion Attic (' ) `I`'b , Garbage Grinder ,( ) Other—Type of Building No. of persons............................ Showers 1 a YP g ...........................• P ( ) — Cafeteria ( ) dOther fixtures .........-•..--••• -•...............,e�, :-.......:.........................................................:....................................... W Design Flow............ - ......................gallons per person per day. Total daily flow...............................................gallons. W Septic Tank—Liquid' capacity. S gallons Length Width:. ,..4..... Diameter................ Depth..5....(n... x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. 3 Seepage Pit No.......Z-....... Diameter........1. ....... Depth below inlet....... .......... Total leaching area-5;�.-.v..sq. ft. Z Other Distribution box (>) Dosing tank-( ). 1-.4 Percolation Test Rest Performed by.....�L�... A?. C� .�� ram.0..::........ . Date......`...'. l 1pj�6 . Test Pit No. 1.. 2...minutes per inch Depth of -Test Pit... ....... Depth to ground water......A..lT. 44 Test Pit No. 2---4:7_:.minutes per inch Depth of„Test Pit.... Depth to ground water..... _-L-- O Description of Soil.. T D 1�......... . .....:•-----------.. ::- ........" ....... .... .......... - ......... ..... .........,.... =' ...... .. . U t�l 1 0- 6" L oAr-1 G' --17 fit_ �-�( -lZ -1 b°� LE a,•i Cora �2 SC —A - .............................................. ►'1 ..... ._......... ....................-••-•-•••••-••.....-••---...•--••----•--....---•-•-•-••••••-•...--•---------...........---.... x ;.. tJall.... _ll(w...jQ..."...._�?(nt,•C tt"A1�1 �1st11 l7._.. �r?_,__^� Go.. -Cy CS&,N0-t LL.aq 4 _t-10 ............s 9 6 U ti Nature of Repairs or Alterations—Answer when applicable................................ ......... --------------------- " .......... .......................••-••••-•...........- ..........•..-•- ��-•---...... ......-•--•-------------------------------.......-------------•-•----------•---..................... Agreement: :. - .. The undersigned agrees toinstall_ the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL:�5 uf�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 b-o�.arrd_of health. Signed...:'_.- rl,sA .;_..c^" ............... t�'Application Approved By............... ...`� .��.a�.=_: / _► r........ Date Application Disapproved for the following reasons:............................................................................................................ ».. •� ....................•--...--••--••----•-----.....----•---------•--------.....---•-----..............................-•-----------•-•-----•--......-----------..............••••...-----.........---.... - Date Permit No............ Issued-............................ 5-:1`6^ Date ---v.v.s-s-----­-- ..... f=----.-------'----ov ---------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .M!�n .............. oF.......�� .,�.......................................•-----•-----...... (Irrtifuttte of Tontphattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( %,,)�Repaired ( ) by...... ............................. Z�_......•--••----•••.............•-...................................---•----.....--•------•-- Install"er at.....) '......... 1.. has been installed in accordance with the provisions of TITLEP 5 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_,, ... . ---. ---.............. -----------------------------------------------...,,..-_.._a-.,.,....,....___....... ----_-.-_----- . ----.__..----..,...,...._.._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.. rx .....r Ropoottt Worko Tonotrurtion Permit Permission is hereby granted......... W.-�._-A.A..---•---- ------------------•-----•--------------.. to Construct ( �)or Repair ( ) an Individual Sewage Disposal System l- _2 k?— l v.C, t..a ems` t __., at No.................. .....--•-.... ........ ......... ......... ......... .... - ^* "- -----••-•-------- ......•............................ - Street ��� as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ........................•------•--....-•-------------------------•--...................................» Board of Health DATE......�..................................................... .................. IIY5 0 u-UW ON5­LOG5'GEN ERAL'NOTE5 0 V M'�l GN ,,,CAL G IN TEST MOM ll�- IEL-a 4 T..3:�5EPTIC SYSTEM NEITHEk DRIVEWAYS NOR PARKING ARMS ARE ALLOWW IL IL WX-,OM SOL, OTHER -4 FR�.,VNLE55,M-20 CoMrONIt Z USED. :, ,, , , .:. FACE ftORIZO1 Coc'(DR NT5.AP c, A,UK aim)(IN A) IB.).TME DESIGNER WILL' 0`17 51!MrON551BLE FOR t-,S"N lr� TtM LIN 'LEAX_4-MROOM5 tMvj 6 -,440 PD PZQUI I rp RfD LE55,Com5TRIjcrED AS 5mowN.;,AW ChANt-M SMALL Ot APrPDVrD 4N WRITING, geD I M 3/2 NONg B lit loam 2. NONK a)C1:3NTRAam 5mALC BE raiR vmrvif4r,THE LOCATION`or ALL!� 1511t Lorm I'm N EFTIC TANK CAP,�CITYREQUIXEV-AJLY 40 D 200% &50 FLOW Z� J I UNDERGROUND AND OVEKIEAD LITILME5 MUM TO COMME14CEMEW OF WORK. A- 6 GAL"dUIRM,,, M�P'l 55,fc JI'mn rmn526d I M I NONE I '5tPTIC TANK CAP,�,Cll)-rROVIDED:TEST]MOLE 21 n-4G.o* 5OIL- OTHER IL Em FROM SOIL NOTE5,CON CT I 0 N IL 06R MOTTLING :1EACMING 0�1 HORIZON ITsawn CAPA&t�,'1A _09W_'i_2�_tfACflINGCM DER CAN i. CON5TRUCnON SMALL CONFORM TO.TME STATEINVIRDNMEWAL E (IJ6DA) ONEP)"49'A IM /3 NONE Tim 15,AND THE REQUIPtMMM Oft THE LOCALZOAW Of,MEALTM. ?i33x,2)2 .4�,t42x2)21*0.74rPV)5Fm5GI'6PD, WeI 94 5.91 6FD>440 GF'D REQUIRED-,-2.)5t"C TMK(5),l;REA5r_,TW(5)._0051NGCHAMBtR5�AND DIS�RIBUTION NQN:�BO 7r. C I I M G/I NON NOTE-A GARBAGI f5rOSAL 15 NOT M*RMn'=MTH TH15 LEvn X(E5)5HAlL BE 5ET ON A' STABLE 5A5E WHICH MA5 BEEN MrdHANI0qiY DESIGN.OYRt/4-OKON A G HED ST IIDATf OMfAC= 5, C AND SMA\/E 410-MFET A5TM 1127-93 OrTnTING" 3 S.)5EMC TANKt5)SMALL AN - 500 GAL AN M V15TRr�CiNr J5UTJON BOX(H rMCOLA'nONfZATE!�'Un5TfiAN20NANCHINVLAYEf�5.- _5 OL -,So R�LEAST THREE 2(7 DIAMETER MAN OLE5� 1*Hr MINIMUM DEPTH FROM THE BOT- -2.83,x 2 LEACHING CH BER 0_OM r THE 5EMC-TANK TO THE FLOW LINE SMALL BE 4&. ONE(1)-421 x I AM T,_ C�CAI_f:WITNE55tl)BY. MATNEW T4 FARM4.EIT.,BENNETT 4 af�fjtjy,INC. N 5C IEDUIZ,40 fVC IN INIUM0 h 4 LET SMALL A OF TEES SWHITE,AGENT.BARN5TABLE'HEALTH DEPARTMEW PLAN Boo?� 9 TER fWCOtNrM­A60VE THt FLOW LINE OF THE 5EPnC TANK AND SMALL BE INSTALLED ON THE WA P&GE 1 3 45 M�IdMOIZ A:Lt)AbI NG 1,Mr?,MS PAGE-0.74 G IZING Or 2-011.A5 oRpnoN 5y5Tt CENTMNE OF THE TANK DIRECTLY UNDER THI!aMOUT DEED�50M L15E RATE Or RA15E CoVrR5 OF'TME,5 flAIRC TANK AN15 DISTRIBUTION, 4 .77 W CONCRETE WATER TIGHT RISERS O\/fR INLET AND OUTLET TM5 TO Mli-IIN 0 Or I45 wm wl G�OF 41 5CHM'ULE PVC OR MUI ALENT. 1 5C,, I FEET FI VL MMN MAU CON515T N D'BE WD CiNr A MINIMUM CONTINUOUS GRADE OF NOTLE55 THAN A9 IUp fX5TING CONTO SY5TEM(AS REQUIREV)SH 7.)DISTRIBUTION uNr6 For,SOIL ABSORMON ALL BE 4'DIWETER 5�EDULF_40 PVC LAID AT 0.005 FTlFT.­lJNI!5HALL*BECAMM f'R0r05F_D'JCONTOUP,-AT END OR A5 NOTE 41 iqthM,th .3tffk3 448 I5110T_D� Locate :+ b(15TING "AM IN Jeop cvt thr"h in the Exi5tvM At V A '45T 24X RAD tPE5 FROM r) 50 ImP65io 52AI W 2'5r:FCiRE PITCMING TO SOIL AB_�l ON SYSTEM..WATER TEST 1)15TRJBUTION'�To AsSuRE In^DISTRIBUTION 0 OVMf�AD EKVICE LMON boXS HAU HAVE A MINIMUM SUMP OF G'M!A5URtD 13MOW RVICE THE 001LET INVM, u UNDERGKUND UTWY5E LEACHING fACILITY SMALL WN5:1 0.)BASE AC-REGATE z TE5,T-1,110LE -jNG LOCATION FOR THE M C V4V,TO BOP"d STONE FREE OF,IROWFINIMAND DUST AND SMALL 5T TM I 1/;?*DOUBLE WASHIf BE K INSTALLED BELOW THE CROWN OF THE Dt5TPJ5TION,UNEOHE BOTTOM Of THE BE COVERED MT11 A 2# LOT I I5 L 90PIMON SYSTEM. BASE AGGREGATE SMALL 6a A56ORPTION 5Y5TE U5T.LAYER OF 4 le�TO,I,r2'DOUBLEWA5MED STONE FREE&,IRON. FIRES.AND D 45 RE5ERVeDTOR FLITU-,OIL fMT; +47.32 AD50MON SYSTEM;MMEN DISTRIBUTION LINM EXCEED 50 �'Poj F rART WHEN I.00ATED MMM IN WOLI!OR IN UNDER DRJWWAY5,rARKING APMAS,TURN;NG'AREA5 OR OTHER JMfr"OU5 IMATMAI LL OR WHEN rR 5URf Do SED. A0 60f L A55ORMON 5Y5TLV 5MALL BE MINI M OF 9'C r, CONCRETE'BOUND,MUND�,,CLEAN MEDIUM bAND(EXCLUDING TO _Tof"OF"rBANK'BEA-MAXmuM OFL O�OER THE Top'or ALL 5'f'5_rW, Uml I OF wom:"CHAM13ER:�OOMPONEM.INCLUDING THE 5trnC TANI,`DISTRIBUTION BOX,DOSING, S EDGE 0 AND 56CA1550MION 5Y5TEM �.,;5EFTIC TANKS SMALL HAVE A MINIMUM MIM lip 4C60 F:C�F'l N G of 9% 3 THE DATE OF IN5TAUAnON Of 501 #2 1 4 FROM 4AMRI"TION 5Y5TF-m:UNTt CEKrIfICA_M OF COMFUANCE.�THf_RECEIPT Of A OIL AB50FP 5A5 10 TION MTEM SMALL BE STAKED AND M-AGGEDT6 PREVENT"it V5E or THAT MIGHT VAMAG 51;!�YTEM.AREA MR E THE IVY 44v ALL ACTIVITIES .77 J 5.) E50A RD OF HEALTIi SMALL REQUIRE IN15PECTION OF.ALL CONSTR MON 4X Br AN AGENT or THE BOARD Or HEALTH(ORTME DMIGNEk IF,TH15 SYSTEM RE- .44 VAI ANCE)AND MAY RfQUIR,f,5UCh PERSON TO CMPYIN WRITING O(AP THAT ALL WOM HAS BEEN COMPLETED'IN ACCORDANCE.WITH TH F TERMS,OF THE POWIT AND AITRC�-KM5. -48 HOUR5ADVANCE Nona!15 REQUESTED., .44 ALL TOP50L.5U5-',OIL 4 5ILTOAM 5 HALL BE REMOVED fOR MOVAL.1 G.)5OtL�_A VISTA, CE OF:5'FRW THE SOIL A135ORPTiON 5Y5TCM To C N 42.70�2,SAND LAYER(n-3�t,7).'�AREATO BE DACKFILLED WTfM CLEM�ANID�AND COPACTIED TO 5ETTLING.; 42:1 7.) OWNER CONTRACtOR SMAUL REVIEW MOMEtOCATION AND GRAVING Mop'70 VCAVA'nO 2 COMPLIANCE WITH ZONING I a.) CONTRACTOR smALL VERIFY WLDING 5ETBACK5,5ETBACK5 Tpf I 15 NOT 0"MWOR MWLIED fiEPMN, + CV 'V -r*.Inj LAN 4,�y'FLOWTuf I LE rr.0110- A4 IiC 25 NOTTO ALE 4 0_TE COVERS 241 DAMUtRo6Nl,lft "THIS IS'A'RE 'N TOF FOUNIDATTON RA15ED TO WTt"IN I RNISM 4 7777 :E�-48. RAM�OK)115 NOTED) REV. DATE.-7 L ALL"PRIOR,P AIN�'-47.00 EL sad ft,* 46.0- Dr rL I3i7 Fn Mill M 30 mxo 430 Tr 43.75 We5t E3 trian 0-BENCHMARK 5 .I�arm5tab e,21 LAM 1/2* 'Wr 'or�JA5' `o ke I MA 02 30-4425 lli� 9.87,(As4med)'I-1 12*STONE I 0! �44.00 1 4' M 2 AL 43.00 5FWAGE: EASIP 05 T et)ni�3 OU5e, ay,4 I U5E-4_�v t"CAST ACH CH I I .I . r - , R NN T 41 AMIMRS E T LLY'STONE ON N'AMON LE 1`4 ANO -C OF Iying�ZV'"' STONE ON 94TH 4t OF,STONE AR CX*LLO 5W GA RouU 6 73 Jkla et''TAN K -LEA NI�'_r H A M B EK 6f tii�f t _p 0 '131-1 2h3'i 2�W:, 1 Gj7 Dx;42.W,x 6 ax BY- C44EM- NUMBER-fu)w D*tW WACV IRED DA JmQ/d�026 1 7 I 7pfi�4 7