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Home My WebLink About0193 WOODSIDE ROAD - Health 193 Woodside Road W. Barnstable A = 127 031 W00 ' Joe, �►rc Oa d 113 TOWN OF BARNSTABLE LOCATION CG 3 3 A 4 "AV ` D n� SEWAGE # VILLAGE "� IN°sI Azo-ARI ASSESSOR'S MAP & LOT 1 7 63 1 INSTALLER'S NAME&PHONE NO. _Z�U'cd')!.P _ C04"Ve SEPTIC TANK CAPACITY 012� LEACHING FACILITY: (type) C419en (size) NO.OF BEDROOMS - BUILDER OR OWNER /8 4!.A PERMITDATE: - 9 SI. 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) Feet Furnished by f � r h TOWN OF BARNSTABLE cc/ ,, Oda_ aa3 LOCATION o M- Wa �i o SkdiL �� SEWAGE # �-� VILLAGE A)d &OL/1,6 46 ASSESSOR'S MAP & LOT 1 a pu INSTALLER'S NAME&PHONE NO. 6 SEPTIC TANK CAPACITY LEACHING FACILITY: (type j� 3 �O` (size) 30 NO. OF BEDROOMS 3 2)S° 6N1 o, CA,-f^.6J' OUPZ Pc7 ,,// BUILDER OR OWNER �C,/,0W PERMITDATE: COMPLIANCE DATE: �''O!c`'0 Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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) 'Feet Furnished by �, - _T � _ -_�_-=-= �� c l� /,('�' 'kt /,� / � ,j 40 �- _ �'" � � �., _ __ _ � ._ � � � � ( t ,, '� - r S ` No. • Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN.OF BARNSTABLE., MASSACHUSETTS Yes 01pprication for �Digogaf *pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) XComplete System ❑Individual Components `�3 r Location Address or Lot No. 16T 3M 000,11 VI j& A/Z�- Owner's Name,Address and Tel.No. 1 Assessor's Map/Parcel IL�Wl• Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. '�F'- �Alnu^ls 3 (GrrI - i-td3e �'��N �/,ajoyLE' ��SGC/f3 s s y NML Inv 56 3-l 1 "- Type of Building: _ Dwelling No.of Bedrooms Lot Size S 7 sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow—10 110411 E41D/"A l gallons per day. Calculated daily flow 33 o gallons. Plan Date — 2 6 Number of sheets y/ I Revision Date Title pis�S�Z��C /2— )C� /L Size of Septic Tank Type of S.A.S. Description of Soil I /�. ..�� 4 210 Nature of Repairs or Alterations(Answer when applicable) 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 Boar of ealth. 1 Signed Date 7 All"fil Application Approved by 4 Date /1 Application Disapproved for the following reasons Permit No. �y y L Date Issued — < lee- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN , BARNSTABLE3-MASSACHUSETTS .,��} Ytcatia for mgpo'ni *Pgtem Conmruction Permit Application for a Permit too tuck{ `)Repair 6 )Upgrade( )Abandon( ) Complete System ElIndividual Components Location Address or Lot No. 334 064 5- o E' �2�Vf— Owner's Name,Address and Tel.No. r Assessor's Map/Parcel /2-7 °-"d)@/1Ci .3` Installer's Name,Address;aQ I1.No �r - f Designer's Name,Address and Tel.No. `;`°` Type of Buildings . J A ' Dwellin No.-of Bedrooms 3 ' Lot Size . sq.ft. Garbage Grinder( ) Other ' Type-of Building_ --' No. of Persons Showers( ) Cafeteria( ) Other Fixtures` Design Flow '; �! PCJQ &ZRA t gallons per day. Calculated daily flow 3 3 o gallons. Plan Date G'" L 6 -�—Number f sheets / Revision Date Title SI -15Ciz)4GG— 1-- 4-- [—Y 7 Size of Septic Tank /5_0 6 G h L_ Type of S.A.S. 611WNA!54 S��STE�JI Description of Soil (1 '3 .bEn Z 0- Z_,04W A /Vr21_ 4 RL&S „„Nature of Repairs or Alterations(Answer when applicable) ' Date_last inspected: 2 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 EnvironmentaI`Code and not to!plac'e the system in operation until a Certifi- cate of Compliance has been issue .by this'Board of Health. Signed Date Application Approved by Date 1 Application Disapproved for the following reasons Permit No. 9 'boy Date Issued ---------- THE COMMONWEALTH OF MASSACHUSETTS BAANSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )Repaired ( ) Upgraded( ) Abandoned( by t. iat o 4 3,4 &Io vc/ i_& i 6v r gpv,7jy has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. M- �N 7- dated 7 13-V j Installer Designer The'issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector No. 9G !'7 Fee /601 THE COMMONWEALTH OF MASSACHUSETTS s PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS -Migpogar * "tern Construction Permit Percussion is hereby granted to Construct( Repair( Upgrade( )Abandon( ) System located at O 4- 33.E 4✓070614f� n and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to 0tomply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. 6 'Date: Approved by ' TOWN OF BARNSTABLE LOCATION .LG 7 l 32 A P? ; SEWAGE # ° VILLAGE 11n•: 114 / ASSESSOR'S MAP & LOT_!A 1 . 63 i INSTALLER'S NAME&PHONE NO.__._Lo'ayr�.f.` C: X17 SEPTIC TANK CAPACITY .sry7� LEACHING FACILITY: (type) r (size) �� k 90 NO. OF BEDROOMS BUILDER OR OWNER ,�� 2 AVA P 4 I PERMITDATE: �l- COMPLIANCE DATE: Jar —y 33 Separation Distance Between the: . Maximum Adjusted Groundwater Table and Bottom ofLlity 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) Feet Furnished by. fn �� 0� J` /�K L Department of Health,Safety,and Environmental Services Public Health Division Date d 367 Main Street,Hyannis MA 02601 J s �AaNarAlli 1 I . repo //v' g9� Time. /l 44 Fee Pd. ntAaa. Date Scheduled JV/ Soil SuitabilityAssessment for Sewage Disposal Performed By: �, o yam- Witnessed By: LOCATION GENERAL I.VFtDitNIATION 1VG owner's Name f r,91 A4T2/Gk 171,)Ye8�// Location Address p� oT 334 AVS',A& �� ; L• ress l Engineer$$Name ✓OoYLE Assessor's Map/parcel: !a�/ l NEW CONSTRUCTION REPAIR Telephone w 5�3`/99� Slopes(e�0) Surface Stones Land Use ft Wet Area ft thinking Water Well ft Distances from: Open Water Body Drainage Way ft Property Line ft other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes dt perc tests,locate wetlands In proximity to holes) D12, DS�� 3'SS • 1 Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water In Hole: Weeping Rom Pit Face Estimated Seasonal High Groundwater FOR . .... DETERMINATION FOR SEASONALMG" H WATER TAB Method Used: Depth Observed standing In obs.hole: in. Depth to soil mottles:in. Groundwater Adjustment I^ ft• Depth to weeping from side of obs.hole: Ad.factor Ad).Groundwater level Index Well N__.•_._ •Reading Date:,_ Index Well level...___ PERCOLATION TEST 1�tati► �rltae; Observation lime at 9"'` Ilole q i r lime at 6"` Depth of Perc Time(r76") Start Pre-soak Time . End Pre-soak is Rate Min./inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Heaith Division Observation Hole Data To Be Completed on Back—� Copy: Applicant i 1n't"1' Oil 11 f '10k 'IC1N 110LCILOG l color soil Ikpllt from Soil llorlzun S oil'Icxtttre (Munsell) Mottling (Structure,Stones,nouldetes Surface(in.) (USDA) --------------- , �I UC CI'IOBSGRVA x iON 11oM, LOO;:: t�lit # l color Soil other Fvcp�ihom Soil I lorizon S(USDA�Texture (M nscll) Mottling (SINCIUrc,Stones,tlouldercs. Surface(in.) P urrl' OIISCttVA'r 10N !Mt LOO ttt�l�# her . Depth from Soil Ilotizon Soil Texture Soil color Solt other Surfnce(in.) (USDA) (Munsell) Mottling (Simeturc,Stogy es,Douldercs. ---------------- VATION ROLE LO DEEP OUSI;ItSoil Co G Ilolc# lot Soil other Ucptlt from Soil I lorizon S(USDA)ou'remure (Munsell) Mottling (Structure,Stones,goulderes. surface(in.) --------------- Flood Insurance Rate Man: � Above Soo year flood boundary No Yes Within Soo year boundary No Yes Within I0o year flood boundary No— Yes Uep(h of halurally Occurrtnq Cprvious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not;what is the depth of naturally occurring pervious material? Sertificatlon . v I certify that on (date)I have passed the soil evaluator examination approved by the bepartment of Environmental Protection and that the above analysis was performed by me consistent with __ it,.,rpnnire(l ! -;ninp.exnerli -id experience described in 310 CMR 1.5 017. i i 7VP ,�'UNh47WA1 AL, /¢G _ Fiwis,� s eAbE sY�f /N. Of 2% � 6„MAX CoV6� 39 M N N "M�1X- M ,d/ST Bd•4' h/�6 Si1MI° AOI If T-/ /3$,f 3G''MAX. 2"CD✓�J� OF lB'i 3�8�'��IVL� 0901 1�5r�JNP- Sy?�3 3 )Dp& I L/�tJ�� SGN. D Rk d SCy. qtp Ave , A Af5rbv1� / MAC /NV /D" LEVEL .r...... . 3 3 2rmwv. 3�t"- 2 p - 541oY /�• /3 9, 50 /3 9. 2 5 . / If a ' 8T �` v` L"� L"Y S D/ LDAM LDANJ 20•' a a. ,ram o A= AL. /36•4f- its. 1, - - •� LO.9f ' Ll�i ' - - C' N/jUO,/� /D Y/t�7/ W� Use /5� 6r4L.P.e�CA,'T �PT/C �AN.� Z, M 4,�0 �.. Z �-� �pi✓ES! 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