HomeMy WebLinkAbout0075 BOULDER ROAD - Health k
r ulder Road
/ Bamstable
• 315-011
No..........-........ Cam/v ��() FEs... v�..........
THE COMMONWEALTH OF MASSACHUSETTS 7 /r
A P P R O V E D '
Barnstable . -.. .rvation Co^-.-';: sion BOAR® OF HEALTH
TOWN OF BARNSTABLE
Signed pphratt for Uhipoii al Works Tongtrus tun ramit ��,���'
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual 5ewa e Disp sal�j�
System at: ��� Ne
.............. ............ � ... .. ........._._......._ .....__.
-- - - - - - -
1 o ion t No.
Add�7ss �Q
....Q'�-c�-..: _ '� `„'•-
Installer dress
Q Type of Building Size Lot............................S . feet
U Dwelling—No. of Bedrooms....................................................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ...................:....... No. of persons............................ Showers ( ) — Cafeteria ( )
Q' 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........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-____--_-___._-----__--
0�, Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................
a •--•---•-••-•---••••-------•-•..................•••---•-----•--------•....--------------------...............................................................
0 Description of Soil.................................................................•--------------------------------------------------•-------------------------------------------------•-
x
---------------------------------------------------------------------------------------------------•---•------ i
--
U Na
e o Re airs`or Alterations—Answ. hen applicablg. __ Qh: __ ...._�..... �
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 Compliance h n 'ssued by the board of health.
,off � v�+
Signed =-- -----------L= --...--------------------------- -
Application Approved ------ - !
G�%
..
Da e
Application Disapproved for the following reasons- ---------------------------- -------V------------------------------------------ ---------------------------------------------
---------------------------------------------------------------�--------------------------- -------- ... . ........................................
. / q /Date
Permit No. -----FL..-...:-_'5. �':. Issued L '.............
Date
Non Fina.............................
THE COMMONWEALTH OF MASSACHUSETTS'
BOARD OF HEALTH
TOWN OF BARNSTABLE
�nfor Uhipoii l Workii Towi r�r i�rtt nmi# - ry
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal-
S stein at: a
................ y�?. Y ��.e....................... .. - M l ..�. 3.. .. -:7 -
Location- d ess
- ..........
lam.�� if/I
...... - r 1. ! ------------------- •-
Owner .._..... .
a ����v� � •� dlti�'2.:. Gl. = —,.G_. Address
c� ..........-••Installer A
• Address
d Type of Building Size Lot............................S6eet
V Dwellin No. of Bedrooms.............................. ...._Ex Expansion Attic g—. --------- p ( ) Garbage Grinder ( )
`4 Other—Type of Building ________..-_!.............. No. of persons.................... Showers —
a YP >sg P o ( ) Cafeteria ( )
0 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.............-..........................
a
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4
0 Description of,Soil.................................................................-.-....................................................................................................
U -----•-------•---•--•--•••----••-------.....•-•---------------•--=-------•---------••--•-•-----•-•--•---------..... --- ---•--•-• . ........................
-
W •--------•--•---- --------•---•--------•---------------•••--••------------....i &/ � =���- -- -
�._....��.,: Sl
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 Compliance h ssOu'ee�the� of{ealth. —
Signed .......... ...
-- -
plication Approved ..... -------- --- ... ----------
A . --------------------------- -------------- � .��
Date
Application Disapproved for the following reasons- ......................-------------------- -------------------------------------------------------------------
-
y Dare
Permit No. .. � --------------
---- Issued -------------./....:. '
' Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
C rr#tfiratr of Contlatialare
THIS S TO-CER Y, That the Indio dual wage Disposal System constructed ( ) or R pai'red
�.-^�
by .... - 1 )' -- - ---
Installer
at ------------ .. ...-- 1� - . .- ,�t \ / S
has been installed in accordance with the provisions of TITLE 5 of The State Env' onmental C�de-aas&es_c_r_i-b-d in
the application for Disposal Works Construction Permit No. ..-...1-".�. dated ...C,� ...-- '. e.....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION,SATISFACTORY.
/ ✓ r y
DATE "-/_X� / r, Inspector, = C /�. .............. ......._....#.
r r
11
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH ��� 0IND
I TOWN OF BARNSTABLE
No.,.. FE . . �` ......
Permission is hereby granted--.--C- -s "' ..................
_...
to Construct ( ) or Repair an Individual Sewage Disposal System
U J` (�.. �.. ...--
/`S reet a- ...7s ...
/ Vd4,li �at No.. = .� " ......•
as shown on the application for Disposal Works Construction Permit /" .. ated....._ ..............
DATE............ ----�.............................. Board of Health
1
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
C6 TOWN OF BARNSTABLE
LOCATION jp V(,6 {Z ,e® SEWAGE # k3ff
VILLAGE1�Ny�Clf!(�� ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. &J-6 R2c5• Cam) - ��a���
SEPTIC TANK CAPACITY �0�0
LEACHING FACILITY:(type) (size) lcgoo
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER_47&f ltc,
BUILDER O OWNE �Uf�N�12
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: Lq
VARIANCE GRANTED: Yes No
ss ue
s� 1
i
,aScxoo jo
j,
Y A�JECSv�J ItiVi1f ���: 3 J 0
L O'' A J.,FO N PARCEL N0: O 11 SEWAGE P E R.M I T NO.
VILLAGES
2
INSTALL R'S NAME — & ADDRESS
BUILDER OR OWNER
o
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED ��
- �
1
\� 1
� .�
�� �
t ..
.� -,
'7
1
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
eye...............OF........A ............................
Appliration for Mipooa1 ?forks Tonotrnrtion ramit
Application is hereby made for a Permit to Construct (\Xj-emir ( ) an Individual Sewage Disposal
System /'v We�r Ra/
•........ -- ........................ ram ._.... �t ........................................................
..' Location.Address
Ae---------------- --20 ....... e�1� 'vi` .....................
Owner Address
t-a�
-._......._._........... -----•---------•--•--------•-•---•-------' -----------------------
---------------
---------. . ............ . ......�__�.�....--•---...---- ... ... -----�/� INS
Installer Address
Type of.Building Size Lot........................4.....eSq. feet
U Dwelling—No. of Bedrooms.....rhY :e......................Expansion Attic (4 Garbage Grinder ,(�Q
Other—Type of Building ...... ...... No. of persons....� ............. Showers (-1 — Cafeteria ( )
Q' Other fixtures ............................
W Design Flow......................33o............gallons per person pet day. Total daily �w......&4A_•__-__--__- .......•....gallo�.
WSeptic Tank—Liquid capacity.0if tgallons Length..�'-_tP...... Width_.'-/-'k--- Diameter................ Depthl?....r._
x Disposal Trench—No. -•.-•-------------•- Width..... Total Length---.-. ..T___.-._ Total leaching area....................sq. ft.
Seepage Pit No---------I---------- Diameter......1Q.......... Depth below inlet._-b............. Total leaching area..�,T,....sq. ft.
Z Other Distribution box Dosing to ( )
aPercolation Test Results Performed by......orh0.A/1</14,s...-.a--1r-Ll(Y-----------••----_ Date...Q_,CG....2ff.�1.9_. `...
a Test Pit No. l._� L_�....minutes per inch Depth•;of Test Pit._�_.!I/.y...... Depth to ground waten.�lC01Re...-.-...
(s, Test Pit No. 2...�.L.�r...minutes per inch Dep 11 t of. Test Pit----VVY.__._ Depth to ground water...-_/044C.,.
Rai - (� _ - .... -----------------Y7 --. ,
>>__ y -
Descrt tion of Soil----�.QaG�_._..�!�!1�1...6---�-- -----.•.....�.�6--��-�-� - - - - �-----•................ .
W ----•------•-------------• ----•-.....•-------------•----------•--------•...----•------•------.....•--••--------------•---------••--•-••-------------•---------•.....----••--•••---•---------•-•---.....
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 TIT f:-.^. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been ' ued the b dd 4,X444__%
alth.
Sig ���`?`` .. ,�
E Date
Application Approved By--•--- �... .. ........ •. Date
Application Disapproved for the following reasons-------------------•---------•-----------------------------------------------------------.........•••.........--
i
•--•-•.............•-•-----•-•-----•--------•---------------..........-----------------•-•-------------...-----------------------------------------•------------------------------.•-••--•---......._..•.
Z ' � Date
PermitNo......................................................... Issued_............... ..............
Date
fl
�r
EL.4o.4
EL43.7 a
P.eopo,7 v v
Fr,.+NOAT/oN. N a I
/o, I
B.42.7 22' r/Id
FiTaeE
o. NANO '� t r- Box
6aw.arao Y /s' Pir
E[.
,Lo 7-
41.6
K.47.L c A/ Ass�rfc�A Dwr�y
4c. CERTIFIED PL
OT LOT
PLAN
EG.
EDWARD E. KELLt i LOCATION ... .. . ...
COMMAQUID, MASS. 0263/ SCALE . ./,•-30. . . . . DATE p�..s/977. . .
PLAN REFERENCE . .BE!^! Lo r 3
OF ,:V� JNow,v o,v A 1Ct,,9.V_F,C E'DW,q.eo. 49. .
-LLEY -.Boo.0
' No
j> y��G1STG� O� .n/ R77a�/
�•aE{/ I CERTIFY THA TH ... . .���...... -. ......
S� SHOWN ON THIS PLAN *IS' ON THE GROUND
AS SHOWN HEREON AND THAT IT CONFORMS TO THE
SETBACK REQUIREMENTS OF THE TOWN OF
agrrvs7?��c F WHEN CONSTRUCTED.
/yiC�QEL W Tu.e/vE.2 D 7 _
DATE f'
: .. . .
,z CN/Los ST��T G,��,G�ysc�
PETITIONER: C�x/TEeV/cc� �j.9ss. REGISTERED LAND SURVEYOR
FEE.. .✓ ••
t�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HEAL
:.._ Ppt................OF........
, Vp iratio t for RopuBa1 Workii Tomitrur#ion Ilermit
,Application is hereby made for a Permit to Construct O it ( ) an Individual Sewage Disposal
System at: j
�JaSc' err r
.... ...... ............................................. ..................................................
Location-Address or Lot N
P.,1,_�..... . ���..�u/1`'/..�H<...........:..... �r�_r,�/r..� C� �i°.cY,s!�.��� .............
• Owner, Address
W '
Installer Address w;, p
Type of Building Size Lot__t..................v'_.Sq feet
,�. Dwelling—No. of Bedrooms.... + ................Expansion Attic eXI-) Garbage Grinder 1(� ) _.
ype of Buildin p (' ) ( )
44
Other—T g ____ lUi1 _____._ No. of ersons.._. F�______________ Showers — Cafeteria
a '
Other fixtures ------------------------------------------------------
Design Flow_____ ..... — � a __gallons per person per day. Total daily flow.__ : ''� ____________________________gallons.
ifsl PfJ�l�
P Septic Tank—Liquid capacity............gallons I Length................ Width---------------- Diameter--------_------- Depth___................
l Disposal Trench No.
...
._............... Width r_......_________ Total Length.:_ ._._a__.__.____ Total leaching area_._ f ...sq. ft.
Seepage Pit No .___. Diameter f................. Depth below inlet_'''._ :Total leacliingarea .. ....sq. ft.
Other Distribution Box ( " 4 Dosing nk
Percolation.Test.Results Performed by, Fl. ... _�^:.................
... ..................... Date�) e
t Test Pit No 1. .. minutes per inch. depth of Test Pith " +r` Depth to ground water er
i-Test Pit No 2._.... _._minutes per inch Depth bf Test Pit J_._6L1.1_.. Depth to:ground water zg ,-----.._...
• V .
�� �O Descr p on ofSoi % � ' .......................-M - { - //
.................................................... .... . _� ! ..
------------�----`-- -•--------•--•----•---....__...
l--•- ••------------•-----.-. ------•-• ............. •--•-------------•................-------------------------_..--------•••-............------------•..... ......--•••-•----
VNature of Repairs or Alterations—Answer when applicable..................................................................... ............_..__.
ryp'................................................................................................................................................................................. ..................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
' ..the provisions of T IT 1E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance hasbeen ssued,-by the ,,oard health.
rod
Da e
Acation A roved B _:... :: -"" ..
+ PP PP Y----- ` . .
Application Disapproved for�the following reasons: „--- ------ ................------------ - --•--------Date
--------------
............... ................... ._.....----•_............._....._........................................ ............................................................................
r Date
J. "� 'ermit No................. ..... Issued---....__.._
---
e4� Date -
THE COMMONWEALTH OF MASSACHUSETTS e
.� BOASRD '"O HEALTH
.. U F..... . . .a ............................................. . -
d
Wrtifi` atr of Tautpltgurr . a
THIS TO CER , h t�the Individual Sewage Disposal System constructed (Kor;Repaired
a :by ~" ,>.. -• •• ......................,............--••-•-•-••-••........_
( )
f
Aier
t
1 f at :.. i =
r•' h been installed in accordance ,, i the provisions of T ` feT e State Sanitary Co a escrib it .the
pplication for Disposal Works Construction Permit No,___. -__ _.+.i_. dated-.. ''_ i" ......................
THE ISSUANCE OF THIS-CERTIFICATE:SHALL,NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTIONfATISFACTdRY.
DATE.. ..............•...... ....... Inspector..................................................
THE COMMONWEALTH OF MASSACHUSETTS
' QARD F HEALTH"
...... ...................................
Y.
^� 1/ ....... '.OF.....
No. %/f�!... h Fis.
- N.. rJPermission is hereb anted '"` ••. , s----------------------------•------ --------------•--....••---...........•Y In ' t_
to Construct ( Vor Repair .( ) an Individual Sewage Disposal System
atNo. ------------- dam'=-- ----------------------------------- -------------- ------------------------------------------- - -
1_a* Street
as shown on the application for Disposal Works Construction Per o.._... ted.`..� `' "` ..._....
Board or
DATE.................:.........•....
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERSy. -
i
� 4300 I
TOP OF FOUNDATION
CONCRETE COVER
p CONCRETE COVERS
"+1/�1'4,7- ,r mar ,
n; 4"CAST IRON 12 MAX: 12"MAX.
PIPE (OR 4"ORANGEBURG(OR EQUIVA .
' EQUIV.)— MIN. PIPE -.MIN, �
PITCH 1/4"PER.FT LEACHPITCH I/4 PER,FT.
o;C PIT PRECAST ;
o' INVERT 0a LEACHING
`'o EL•3!$8. ••• INVERT INVERT o . o o•: PIT OR.
SEPTIC TANK DIST w
INVERT BOX ..
EL. 39 EL 39..ZS >_ ;:, EQUIV.
, o • _ e: .r= .'•
/000 GAL. INVERT �-
� INVERT ww o•
WASHED
STONE
/2 -- -6'DIA. _
o• ' e w �--- �o' DIA.►-� ear
PROF LE OF GROUND WATER TABLE
SEWAGE', DISPOSAL SYSTEM
NO SCALE ,
SOIL LOG WITNESSED BY
DATE Alb v?�!977 TIME.. T,>ousz �4 BOARD OF HEALTH
TEST HOLE I TEST HOLE 2 77/y.yys e. .rC�cc�y P.� ENGINEER
42.Bo. 43•Go __
ELEV. . . . . . - ELEV. . . . . - •'
-""^_ • �"DW<Y/ZD �. �E'GGG-y .e L.S.. ry
WeoDLvgy - -
DESIGN DATA
NUMBER OF BEDROOMS
za"
S4- 42" TOTAL 'ESTIMATED FLOW 33v GALLONS/DAY
�o
'e'T BOTTOM LEACHING AREA 7. . . SQ.FT. /PIT
SIDE LEACHING AREA . . :�g8 SO.FT./ PIT
sANp GARBAGE DISPOSAL o
•(50 /o AREA INCREASE)
TOTAL LEACHING AREA fi'z�7oo SQ.FT
Sa«a d
e[av
+.xr�er PERCOLATION ' RATE /rJin�zG stT o ivc�( MIN/INCH
144„ i44" '
LEACHING AREA PER PERCOLATION -,RATE „S�Q. SQ.F.T. .
N.e.: .WATER ENCOUNTERED r
NUMBERw OFz.LEACHI NG, .PITS-. . .. .'-1.-: .
APPROVED BOARD' OF;HEALTH
DATE.. .
s
. AGENT OR INSPECTOR
�MARY
P�,tt1DFA1
L o 7- -5 TH tiN
go u e 06-70- . CoAfl x
THOMAS E.KELLEY CO: v l to
JAI, 14260 0
ENGINEERS--SURVEYORS G P�
z C�/iG D S STeELT ST
346 LONG POND DRIVEaN
PETITIONER SOUTH YARMOUTH,MASS.
CC=7�i7 Z-7zV1LL�;� 955.. . 02664
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