HomeMy WebLinkAbout0017 CHICKADEE LANE - Health� - ' BOO t'
TOWN OF BARNSTABLE
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LOCATION J�L�/�� X'�4,t�iliG �sil� SEWAGE#
VILLAGE &it/,1.4 i 4e3 L,e ASSESSOR'S MAP&PARCEL 01
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY /00P2
LEACHING FACILITY-(type) e/cl C " r✓ (size)
NO.OF BEDROOMS- j 3 2
OWNER J0 r9/aiy'/1 Jel:�!IV14•mot4ot
PERMIT DATE: :j _ COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /2 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
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_ Town of Barnstable_ it i 1 In
1Pos_4_� That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept k
unnMASS.uE� Posted Until Fin i •
t This Card So
M^� � � al Inspection Has Been Made. � - t
a ermit
163� �� I~ a of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.
�rxa+ Where a Certificate
Permit No. B-17-4360 Applicant Name: Michael C. Broughton Jr Approvals
Date Issued: 02/26/2018 Current Use: Structure
Permit Type: Building-Family Apartment with Construction Expiration Date: 08/26/2018 Foundation:
Location: 17 CHICKADEE LANE, BARNSTABLE _ Map/Lot: 234-012-B00 Zoning District: RF-1 Sheathing:
Owner on Record: BEDNARK,JOANNA Contractor Name:'°,Michael C. Broughton Jr Framing: 1
Address: 17 CHICKADEE LANE Contractor license: 189811 2
_CENTERVILLE, MA 02632 _ Est. Project Cost: $ 17,500.00 Chimney:
r
Description: Family Apartment with Construction Turning existing garage into Permit Fee: $ 164.25
family apartment. 4 I I
? Insulation:
Fee Paid: 164.25 fi:
Owner Joanna Bednark will be living in the ma $in house and Father- Final:
Walter Bednark will be living in the Apartment Date: 2/26/2018
Plumbing/Gas
y' .ter
Project Review Req: p ` Rough Plumbing:
\Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within' six months"after'issuance.
All work authorized by this permit shall conform to the approved application and the approved construction documents for.which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same. } I
# — Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
Minimum of Five Call Inspections Required for All Construction Work: `'Ff Service:
1.Foundation or Footing "
2.Sheathing Inspection I Rough:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection .Final:
5.Priorto CoveringStructural Members Frame Inspection) .
� p � Low Voltage Rough.
6.Insulation
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
Fire Department
Building plans are to be available on site
Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
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D THE COMMONWEALTH OF MASSACH�U-SETTS
b �2 BOA R® O !-i EAL 1 I�-!
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1: OF................................ - - ------------------
J
Apptiration for Disposal Works Tonstruction Urrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: p 4Z�
I .'' =P�"'�'� -------------------------------------------- ---- -----.------..---.------------...
Locatio Adams or Lot No.
. . . .. .._-_...�=.7WIer_•-..-- ------•------------------------------ -----
�e Owner Address
!' ... ----- •- ----------------------------------------•.------....----- ------------
14 Installer Address
Type of Buildinlg� Size Lot._ 6-__7 /_J. _- ..Sq. feet
U Dwelling-ZNo. of Bedrooms..................... � .....Expansion Attic ( ) Garbage Grinder ( )
a Other—Type of Building ............................ No. of persons-______-____-___----_..----- Showers ( ) — Cafeteria ( )
t
Q' Other fixtu
W
Design Flow.................. ..._....
..per person per day. Total daily flow......_.... ..........._..-- ey I�_--gallons.
WSeptic Tank—Liquid capacity_..___..._..gallons Length................ Width_............... Diameter................ Depth................
x Disposal Trench—No`o...................... Width........._.......... Total Length.._...._..._........ Total leaching area.................._.sq. ft.
`� _
Seepage Pit No..................... Diameter._.._l�_.._.__.. Depth below nlet......�..._._ -.. Total lea in area.. ..s _ .sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) ® ����7 7 — —
�i c
Percolation Test Results Performed bY........................................................
---------
--------- Date....................................--..
R
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.......1.44_......
_. A
O Descriptions Soil......��_-�--- `' ---.------•-----••....._ ...
x .�
U Nature of Repairs or Alteration —Answer when applicable...................................................................................�;...__._.
Agreement:
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 bee ' ed by the board off health.
Sign - -�-v_ ..�(/®�t�
ate
Application Approved BY Z
---- -------- ----- --'�--.....
� 4 !
Date
Application Disapproved for the following reasons:---------- . -----------•------------------------------------------------••-----------.....
•------------•-------------------------•••----••••-•----•-•--------•--------------.--............•---......•-•••-------•---------...--•-------------•-•-------------------------------------------------
Date
Permit No......................................................... Issued--- ,? .
Date
1*4
No... ....... Fn ..............
THE COMMONWEALTH OF MASSACHUSETTS
i ®AR® HEALTH
'} --- OF............. . :.: .:: fit..............
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
f �}�1 f fl.. tR�''.ar" !V l
....ice. ..----- .................................................... -...-•-----•-------------------------•---•. ------.........-----..-........•.
Locatio A _s � or Lot No.
r'r ;.�• '� Owner Address
a . ....... c..... = ........ ....................................................-------- .... .... •-••-•......
Installer Address
Type of Buildi g Size Lot ..................Sq. feet
aDwelling o. of Bedrooms__________________________ * ____-___Expansion Attic ( ) Garbage Grinder ( )
pi Other—Type of Building ____________________________ No'. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtu �-;•_____
Design Flow________________ ......................gallons per person per day. Total daily flow... f�•-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 nlet_______ ______11___ Total lea in a e__ _k_sq. ft.
z Other Distribution box ( ) Dosing tank ( ) '� � 7 AY
Percolation Test Results Performed by........................................................................... Date..............................
Test Pit. No. 1................minutes per Inch Depth of Test Pit.................... Depth to ground water.........................
(s, Test Pit No. 2................minutes per inch Depth of Test.Pit.................... Depth to ground water______.��_.____... . .'
-- `-------
Description Soil-----4--~--- t- :.
--• •---
U . .ors
-----
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 XI of.,the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee ed by the board of health.
�ig.ns � ......_.
fl
ate
Application,Approved By_•--•--- -• - -- ---- ._._:_..... . ' _. 7
Date
Application Disapproved for the following reasons___________________________ ____________________________________________________________________________________
........................................................ ----••---•----•----•••-•--•-------------•--••••-•-----..__...._.:____-.-•--••---•--•--•••••••-••-•----------------____...••••----•---_._..
Date
Permit No........................................................... Issued--- t v!!---._ "�--�-------•----
Date
THEICOMMONWEALTH OF MASSACHUSETTS
•. BOARD HEALTH
..........r ... .........OF........... ....... . ad
��: f�r�#���r��r aaf�:�aai��rlitt�trr • . `
THIS TO TIFY _ `a the Individual Sewage Disposal System constructed ( ) or Repaired ( )
b --- _____......
Y ==
f Ins_ ..,�/
at 4"----- • - .may y�-�__._ -• -_�. ,..----- -� "{�`---- L�� �
has been installed in accordance with the provisions of Article XI pf The State Sanitary Code as descr ed„>n the
application for Disposal Works Construction Permit No---- ________ dated---,?- ---- '
TIE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector—..................................................................................
R THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF EAL H
.. ...OF................
.... t Z-a! ....................................
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FEE...,/4f .........
t as Gotta lulton Prrmit a
P.crmission is reby granted.--- e&,
...-
to Coil ( ) oru,Repair ):an ndividual ewa e o 1 o . . .....
st
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at No.•• t,[ '�...... -,tf = " �:
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{ Street
<' as shown on the application for Disposal Works Constructio�Per NQ'.___ r___ Dated , .......
"" ------•--•------•--•••••-•-_--- Board o "Health
' DATE---..�..:__... ..r------•--,�
jti{sic+ct..
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SCALED FROM MUEPRIUT PLANS ON 7-99 TO
THE HEATIN�S CONTRACTOR MAY /NOICATt UPON THE PLOWS THE TrF! Of HtAT* 4 SYSTEM 70 BE 64SE4 '
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DETffIUMIJff ExACT SiZLS OF CAdAVETS AMR wALL& FINirm /S
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