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HomeMy WebLinkAbout0028 HEATH ROW - Health -®f 28 Heath Row, Marstons Mills � A= 064-047 Lot # 21 No. Fee !7 CJ s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplication for Migaar *pztem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Addres or L/oyt No. Lp T z/ Owner's Name,Address and Tel.No. Assessor's Map/Parcel / 1t4 A "4 //S p / 6 -r � Zy YJ��/�� /�o�.t� X 3''r0 J �/t%LS Installer's Name,Address,and Tel.No. -d Yy,!y Designer's Name,Address and Tel.No. Ut%4..J C cl oY. N1�-dp Type of Building: Dwelling No.of Bedrooms 3 Lot Size ©a sq. ft. Garbage Grinder(We Other Type of Building woo No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //O gallons per day. Calculated daily flow 3,30 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ftt;�Jg_- .' A&I O C,qu— ems[16T J� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions.of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue by this Board of Health. Signed Date 2 rj Application Approved by Date Application Disapproved for the following reasons Permit No. -- Date Issued o No. ' Fee O C7 r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS r 2pplication for Migoml *pgtem Con0truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. L pT' 2-1 Owner's Name,Address and Tel.No. ZY Assessor's Map/Parcel b� M4 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. EAI'4,J c k1vs1t.✓6 -1A 76,.i J Type of Building: Dwelling No.of Bedrooms Lot Size -1-0o sq.ft. Garbage Grinder(„(Jo) Other Type of Building. w o o c No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow // 17 gallons per day. Calculated daily flow 33 O gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i Nature of Repairs or Alterations(Answer when applicable)- f Stun r 5 T IE.nj ) A dl 1" 2�j .�o �R,4��� 3 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site..sewage disposal system g in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi cate of Compliance has been is by this Board of Health. sue Signed C, Date 2 3 6 Application Approved by Date Application Disapproved for the following reasons r' Permit No. �_ If .'Date Issued ------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(kl)Upgraded( ` ) Abandoned( )by at Z / has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No: m dated S407 ' 91- Installer Designer The issuance of this permit shall not b�eyconstrued as a guarantee that the system will function as designed. Date — Ili -- % -7 Inspector No. ��°� �Lj --------------------------Fee Qp,. 00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS f ]DAi.5pomt *pgtem Construction Permit Permission is hereby granted to Construct( ),Repair )Upgrade( ) don System located at i and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. 'Provided:Construction must be completed within three years of the date of this germit. r� Date: _Approved lye f r _ TOWN OF BARNSTABLE LOCATION SEWAGE # q�' - C3 VILLAGE_/ W A Qh_.J•�-t LLs ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. Q�2tA,,) G. t's_st'i J 711 SEPTIC TANK CAPACITY $0 0 6AL LEACHING FAC)LITY: (type) �J�_c,45= lo-.4c 4 ,4;r (size) /o no 4,4 NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: /ZZV9C COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)�e Feet Furnished by 73'r--d as � � F �� J i l t 1 N cQ N (Y) t 1. lu Lo7"z, TOWN OF BARNSTABLE LOCATION 2r SEWAGE # VILLAGE ln.tA.A rr�J .�-c i r - ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 75r7 o a.x;,r"-16. Z S1Fva LEACHING FACILITY: (type) Ak&.r.,45- '�� �,'ar-(size) /van NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: Z�9G COMPLIANCE DATE: ? __P7 9;�— Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by �� �'' '� "' J tv 1 � 1 • o s -. • a -O N (Y t w TOWN OF BARNSTABLE LOCATION 2 2? SEWAGE # � VILLAGEJIM_A S,T J• k-t LL r ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. rldl 8—c>J11111 SEPTIC TANK CAPACITY o C.9L 45- �t X s� •>� Z S�.�t LEACHING FACILJTY: (type) !JT f-c, ,T' �. c_�'Y (size) /-Dego a: NO.OF BEDROOMS 3 BUILDER OR OWNER L ZwlS S o L a 4 o..) PERMITDATE: 9C COMPLIANCE DATE: /,b Separation Distance Between the: ; Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)/ o Feet Furnished by :73 !A/ / / �` �✓�/ Ll `� U o o N t 1 •pw�� -° 1 •V / i 07 S85 g° 5 2 • ; o & •1 x ".9c n , Q �o� 'fit• ' .T/Ie b /'7' 71 cy) _ /Zr 'fOOC1 ! 1 Qrri Arca r ,qV T I C0/r D rry, /rV;�`fj -Ai: 114 OF !o� • GEURGE y\ 1 < 1 Jg J. �•�. LAN IDES �• ' • 1 [�' 22723 O �A3 �" �/ AO 'o 1 J 27 D. `he�f j '. = ✓� �: : �'J�=�._ �.. .. V r Y _ ..... _._..__. .. .. . W I T µ GA OAC.b COj-o t>, lZ '_►IE E , SEPTIG T�,1.1tG 41 too 0,4 U56 ISOO 6.4 ti1SPO-5AL PIT. jr. I cy 5:r A MA ' 1 L6 5 F BoTToA.-� A MA a `]& •er_- RI�L1 CQ 'Bxo4. �+FJ1Tµ PteC.o"'T f oW RA-M l f W 2 WJ Oe CF4 . . t . g/Z2 i 1� G - n Tbr FLrD • Ice _ _ g � � ell ' ', 77 i et`S1 771T47�iV '�„p PE �iG14 i •;� ILJ%t • ' v �. S6PT1G ; .� • ;� 1tJJ. TAN1L i y U O �. EA.:• LiAGL.I ;V PI T CAMS a , Wo Stott SGALEa (''e b.,r E. c. S6% QE�ESLG�.4JC-E GoAAPL-Y 4 wi rH -I-IaC I%- 'AwJD SGT,9AGwC IZMQU r.E-mELL4 r OP TUE v. 35 ` T�41S` PL&W IS. UOT BASED OLI AU ILKTIWA4f_LIT o4Te:.kvI LLd AMASS. �''SVeya'/ TO O+FFSQT; 'S44oVLb L10T ISU U9er> d APF-,-tG A u `. Tv DET_iCXA 0 1_OT L11-Mg. r . _--------- / SEWAGE PERM NO. LO:.0 A . ION } .�9' �• I VILLAGE.;,' IN:STA LLER'S NAME A ADDRESS JOHN A. AALTO BACKH1L' ;i� t lUE M(est earns table, Mass. 02668 I IB UILDE R OR ..: OWNER DATE :� PERMIT ISSUED ��► . � � _ j , ', pAT E OMPLIANCE ISSUED I"1 i it ft 1 1 I' A P y J J ' .t. + L 1 { ��� ���'�� �` � C... 4( �� , J'�,!�r-�r '?� .1 , �f ry ..r L..7 //%//• /oAAf�� � STANDARD LEGEND •, '�' I ''�J� %�'� 1 �L..�'_�tl-.( f/�/1�' / /.F.., ..r � iwtc To e0 sr"+W eppa as IT mep* qFAOj!-' .'.r 1 /_ 5 i- .Y / �/i i h ♦- _f 1♦ ,l �'=� 60EE000RSEEURwn '. DECIDUOUS TREES 1 EDGE OE BRUSH J `i 1 - ~� Jr .` � �' y �Y hair ORCHARD ORNURSERY CONITERIBUSTREES _ _ ' ;l• MARSH AREA .: \_' _ W.�J� ' �' ` `. � •• •'� FOR OF WATER OIRI i•' /'..-f` _ ` • j t ` � �tUAD /.v AVED ROAD DrICHIS (1• i t }7 i ). I `r,`. �� PATH/TRAIL -II 1.i PROPERTYLINFS i / J ��' •1 w. LOT ACREAGE "i + .J '� 1 �';• 21 PARCEL NUMBER 4 -/r i i �'� •;`) •� ROUSE NUMBER s.r,• l� ',, � � �j r PoortoNlouR UNE 10 tool CONTOUR UK[ —..:�� � ;,. r T`• �\ �, ♦ `I , X•• SPOT EtFVAT10N STORE WALL --- ; t 1.09' WE J�• _ T 't .�1\^ ,� f9Y'7Iti t� / Il•� �, ,\ �.' -'i RETAINING WALL RAIL ROAD TWITS ...� '\f�• Cl / 1.r\/ 1 - -r. ```� \\,•� \ .y TELEPHONE POKE 84.4STONE JETTY • �i � � � "'� , � ;�{j. � , (!' •�y✓ ., � 1 - SWIMMING POOL ,,'1'1,��.i I ♦ ♦t I i^I �. (`, �,I�� ,�.' . .�. PORCH/OFR 1��C 1 j I„•,r\ j .�( ( ' ,T �1w••.♦�.�. ) •a��j.` G- BUILDINGS/STRUCTURES 'y/ 1 L • . \/ 7, ' � .. (' j ".`` �� �]32 ASSESSORSAWBOUNDARY JI is � �. y' ;L� . • ;�. �..:. �, : SITE MAP T• ,� •:'�• • 1.01.GIOOIANIIC MI RIAM SVSII15 tlR1T -i I vt s ( lr, sti SCALE:in feet /•/ram �Tif".••-...r��M1 •>� 1 n ;, 105 _`yam ;1,..• ..� ,(./ _ (/ / Ion:nnlanouulr nam sw al�mllE[enl[4n11u�sa 1.%�i' 1.0yA�^- � � `�•_ � �`\ _ \ �r !;,,/% Natm Rinrtrunlotnwleunas..4sn v•.r, t �'i1. %• �� �^ /� ��Y� WQTAINR.tOtOftW AND MM1RK DATA RINIIIIIND 1 53 �T��,r•♦ - .a //� ../✓% lllpllliMR IOssonalllNoluf11[O rldY r-1ar �n= CEO A LFeSID L d kA PA,s i �20 so \\ YPST sg�, 71• 1� `o PFrw- rAWIL V t N / \ i / I $4i i T i<r p s Lo4r.:W 2/ LOCATION 4,,,,. SEWAGE PERMIT NO. S oyovr VILLAGE r IN.STA LLEry NAME 8 ADDRESS OH,N A.AALTO:BACKHOE SERVICE West Barnstable, Mass. 026.68 B U I'L D E R OR - OWNER r i DATE PERMIT ISSUED zo 141T , '� -� ... DAT E C0-MPLIANCE. ISSUED .. .. . . ��� � - .. � -�-. may:. \ e, .. �s,� � o ,.�.e.® � _ , � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �y.... --------OF............... f �. -------------•-•--..........................---- Applira flan for Uhip ,sal Works Tnntrnrtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair ') an Individual Sewage Disposal System at S _gl..... .................. ......X ocation,! es e ,s`�, r or I... No. .....44) � a�{v �j�ll -•sy-!. " ----- ---------•----------...... - .._... p Address W •-------- sta ler Address UType of Building Size Lot___. f�J_�.....__Sq. feet ,., Dwelling F—/N'o. of Bedrooms.-...._ _-__-•----_-•-•_--•---__-_Expansion Attic ( ) Garbage Grinder ( �- Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ....................... . . W DesignFlow................. _........._._gallons per person per day. Total daily flow__.....-:___�fJ_._..._ ,yil--,s----� � P P P Y• Y -.....................gallons. WSeptic Tank 4 Liquid capacity S_..__(allons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area-------------- .___sq. ft. Seepage Pit No........../........ Diameter-------./.•-®--- Depth below_inlet.....__...... wal,leaching area-.).,..� sq. ft. Z Other Distribution box ( ) Dosing tan* ) �01�41 `aPercolation Test Results Performed by_._.• _ . .-.... L� __•_• Date...yC'.-X ....Z.......... aTest Pit No. 1................minutes per inch Depth o Test Pit.__._............... Depth to ground water_....._..._______....__. . Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-•••-•- -------------- - 2 -... ......... Description of Soil------....' -----•-- .. - `!�*�-- - ------- -----------•-------------------------- _ _ __ _ ..__ .._ W -----•-----------------------•-•-•-•---•-------------•-••-----••••----••..........-----•...-•-_ •=--1---- - ------------_- --•--•-----••-......•-----=••••-•-------------•--------•-_.... 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 iITL L 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. igned ----------------- -----•----------- •----•------------- --------Date--•••--- ----- /s Date . Application Approved BY !%64 1 7 .1. Date Application Disapproved for the following reasons------------------•-----------------------------------------------------------------------------••••......_•••-•- ....-----•----••-••---••••••---------••-•••-•---•••••---••••••-•-•••••••-••-•-•••-••....._..••-•--••••-----•-•-••-•-------••---•-••----•-----------•-----•-•------------------------------------------ Date PermitNo....................................................... Issued-.......... ...... ................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF� HEALTH c2.......OF................r%, . �. ------------------------.._.... .. ;;.C;:-4 t: , pptirtttinn for Uhipugttl Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair („�) an Individual Sewage Disposal System at f .......... ::. %� .t......r ��:Gl..%erg .rt :!:� !..................... �!f/ s.. !?!1l. ............................................................. .. _ ocation�-Ad/dress j r f t or Lot No. .. _ .. '. '_.�_.�a`' ..y�.a..•?•- .d. .__5:�.. .. r -•---•---.......--••--•........................•-................-•---............---- fOw,r�er� Address a --=='- ' -- d�-•���t'•'y�- ...---.................................. .....---•--------........................... •-•--------•...........................---- -------------- Tnstaller f-G w`�- t_.'ri Address Type of Building Size Lot..... __`_'2.Sq. feet U Dwelling L�'No. of Bedrooms..........-3..........................Expansion Attic ( ) Garbage Grinder ( t "� r Other—T e of Building No. of persons............................ Showers — Cafeteria QI Other fixtures ................................. . WDesign Flow..................r_.�......._.._.._...gallons per person per day. Total daily flow-___--_--,____-, .4 .....................gallons. WSeptic Tank 1 Liquid'capacity_l�_jL&lions Length---------------- Width---------------- Diameter................ Depth................ x Disposal Trench—No..................... 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 ( ) f _- 2 2-- Percolation Test Results Performed b .__---------- .............. Date....p� Al Test Pit No. I................minutes per inch Depth of�Test Pit.____......_...._... Depth to grou4 water-____________-__-_--___. i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Phi '............................................... r r Descnption of Soil.---------�-'....-_..--......... --•-- T-••------�------------�.,---�(,,�7.,<2__e�..✓�_.:�'c_��------------•-----------•------------- O .--•----------•----------•----------------••---•----•------------------------------------•-------------..L.••-•-------•--•-•--•--•---••---•-•-•---•-.•••-•-•----••--.......--•--••---••-•-•--•-...--- W ............................................................---------------- -------------•...ulv.----- :............................................................................... 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 TITi.;... 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. Signedr` ---------------------------------------------------•--------- ....--.......................... , , Date 'c /-fij �t �f/J Application Approved By------j-i---=-------- -. ,r ---�--�-•-.-•-j=-�-��-"-----•------- -----�'"--"-,,2.-_D teM---�,�- Application Disapproved for the following reasons:................................................................................................................ ....-----•----------•-•-••-•-----------------------•---------....-----------------•---..........---•-------•-••••••--••----••---•--•------•••-•--• •••-••-••--•-•------•-•---••-••---•-••------------- - Date // ---- . Permit No. Issued -l---- -•---- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ALTH ....................OF............... �' '" ! 'TK ,....................---....... _ �, �rr#ifirtt#r oaf (�la�t�littnrr T IS 0 CE / That the Individual Sewage Disposal System constructed ( or Repaired ( ) ,.. . . • ------------ '� ..... nstaller +- I ` has been installed in accordance with the provisions of/X, jj�T,, 5 of The State anitar Code as described in the ,�r application for Disposal Works Construction Permit No: _ ___.._�� ______.__._ da.tedy_.C�'-`:__�_I__,�-r__� _..__.__. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE ' "S'YSTEM WILL FUNCTION SATISFACTORY. ,. f 7 DATE �. " <-.- ..................... Inspector_... .•--- ---•---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH . ............... ...... .................OF......... / 4r'.. . '�..'" ........................................... No()7..,YA... Disp asttI ( or �n inn amit Permission is hereby granted. a••----. -•--- --- ----- to Construe or Repair ( )r at!%In ' i , al S'.} age Disposal Sys f / r at No..... �r �✓-l- ---•- $t ` reeW' as shown on the application for Disposal Works Construction Pe;tliV Dated.. __ '. !_'_ , ...._.: y .......... ...........--•••--- �y f/_� .....••••-• Bo d of Health DATE............................. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Ota, 4.`f F'Ww = tt0 t 3 )*d,y=Ai5G.P.D. Sr--Prt G T At.1►C - 41R S Sao ajL *jL� Cam, U;E I SOO 64-L, %>tSPOSAL Pt? V;E �100044 ,., 3tc>/At L AV-GA _ \66 y F t SBliF, c S 4.`10 GP'[? t30TTOA/M AtZEA = TOTA�- Utz►GN t7 �»CJ� -11 9 C-AT PEV-C- >"-r coN P'ATC. C t W Z ftW oQ Lam. < r• � to �• �t / t .i '9 T"oP F►m = too' ja cA,yt v ,.A � t fox. QG Ssp'tG , PiT W 4 -•-� g/4-l�z WASUED M c.7 Cf'b 416. Q9•o p StatJ C7 + i cMJ2 T i Ft as vt_oT PL.A ir-4 MAeSTw, � ��.:a5 1�� �•lo �A� So� 1`= tea t r-G6 Ti FY T µA-r T�+E w>,'X-rt C,14 5uow►-i Pt-a a.l QEF E3Z C E" ► F-CLE.C>11.4 GOMP`Y S W i TM -TUF. 4tVeU*-4t-- Aa1D Stz:x AGK. OF TWE T Tov-/ t OF DATE- 5�3l "14' �'+ ,cam C.�.�t...,... �.✓���Cwt,.+-- • BA�[T�Q t�tYE t�G. V ia,--t,-r a TZE > LA 4 r> r, Tt4tS PL&W IS. SLOT $A5ED OL! AU t"4TWMF.W MAA.G.S Sur-,/Mf 4 T6AG OFFSET; -Y"OULA WOT 8E U',t:t> ApPL.tGAuT To -PeTr-ZM1 WE. t-. T t,,.tWS4. • � Sti SET '� OF�. Tt��tt! PAAvAr-ASQ r i ZAA aj-- — Para ?AiAL AR 04, '2 l x