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HomeMy WebLinkAbout0477 OLD JAIL LANE - Health 477 Old Jail Lane ,Darnstable F/R A = 277 024 m I� I� TOWN OF BARNSTABLE LOCATION �� Q--�Ar/U A�!(� SEWAGE #h022"`'S—�1� VILLAGE ASSESSOR'S MAP & LOT 7-o.2 L4 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY S�C)601/q _ LEACHING FACILITY: (type) d(e`Cf/�i Pei�3 (size) �33,3 NO. OF BEDROOMS BUILDER OR OWNER iT Q IVA PERMITDATE: X 04" l COMPLIANCE DATE: 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 C(y W p �� ® o o- o-, S CO TOWN OF BARNSTABLE LOCATION SEWAGE # VIl LACE G �_ ASSESSOR'S MAP & LOT INSTALLER'S NAME& PHONE NO. SEPTIC TANK CAPACITY LEACHING FACIL=: (type) /L� f� Y (size) r NO. OF BEDROOMS x0e BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facili (If any wells exist PP Y g h' on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leac . g Facility(If any wetlands exist within 300 feet 'ea g Feet Furnished 1 O3 T `/r / i Or� Fee ��• fJ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIppfication for Miopooar *p5tem Construction Permit Application for a Permit to Construct( )Repair(j/)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. / /y A, ��� ,Jam, �, etc Owner's Name,Address and Tel.No. Assessor's Ma /Parcel p d-77—0,; co,a"vt Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No. �IQ.Cc�,'t 5n tlAe P�,,,Mo 4 A s ra c. g—og Gs'rcr..�4 Llas-ssa9 w.r4/Mrrvas2y Type of Building: 21 1y1ge2cf Dwelling No.of Bedrooms K Lot Size ' M-ft- Garbage Grinder�fo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Z&0 gallons per day. Calculated daily flow gallons. Plan Date JF,01—, off, a20C3.2 Number of sheets Revision Date Title Size of Septic Tank 15Oe 6R • Type of S.A.S. S-00 Ce I C#-4 at kliv-j- 3 3,k X Cti?.83 Description of Soil 6_3 Snil/rl 07,1 Nature of Repairs or Alterations(Answer,when applicable)1�r I/ 0 S%atc 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 iss d by this Board of Hea h. Signed 4 7 /���.1 Date Ahem-, 1-3-oQ Application Approved by Date Application Disapproved for the following reasons Permit No. ao0a'15-4/ Date Issued __ // 0—C)X O 0 "'J1Vo.. as ` SL Fee ��• THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: I-✓ -- Yes PUBLICAEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Migpml 6pgtem Congtruction Permit Application for a Permit to Construct( )Repair(k<Upgrade�(. Abandon( ) El Complete System ❑Individual Components � Location Address or Lot No. �//,�� U`Q J/j,'f ;/� Owner's Name,Address and Tel.No. Assessor's Map/Parcel � `fI S/`�`� �? ,15,u A 5`S ol'77—aay Installer's Name,Address,and Tel.No. . 'Atesigner's Name,Address and Tel.No. �c�vC.0 V sTcr LI g 55 19 cv,real;1/"'Ai i,I.C, S?`1 Type of Building: 7/A cr2cS Dwelling No.of Bedrooms -Lot Size M-ft Garbage Grinder(X� " Other Type):of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow e141 U gallons per day. Calculated daily flow gallons. Plan Date JF,.�T. �?, ..2C)0 Number of sheets Revision-Date. Title "" J Size of Septic Tank /5-06) 6A • Type of S.A.S. 00 Gal C#Aal k2j 3 3, Description of Soil F?1 41 Sv, /�0 j;)kry ` , Nature of Repairs or Alterations(Answer when applicable)Jam;r r i,��� i.:?00 CA/ / ,/' 1) - 13 r y f -5;c,4r Date last inspected: �.m 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 issu d by this Board of Health. Signed e /� /7, „� � Date Ala', 13 .0a Application Approved by Date Application Disapproved for the following reasons a� Permit No. 61000—,5-¢/ Date Issued /1 " 13 04 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTI that the On-site Sewage Disposal System Constructed( )Repaired(P"I Upgraded( ) Abandoned( )by J4Qc at ! `� O to Ft I �c `tia,� ,�y i�,1� has been constructed in accordance with the provisions Qf Title 5 and the for Disposal System Construction Peru No. dated InstallerBr�cc. t!—lC_cc_ ,s\cr Designer Jo��1'' )�A( AlkA. The issua ce f this permit shall not be construed as a guarantee that the syste 11 function as de i ned. 0 Inspector No. a0001 ST e' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS Moo-gal *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair(k"')Upgrade( )Abandon System located at 1-1 h 17 (0(t) '3 A',( � 11 �c �rlF_n ��A(, Ic 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 permit. Date: 1 / 3 0 -- Approved by / j TOWN OF BARNSTABLE ,� 1W LOCATION % L}/D-1'4r/lj�Y!(� SEWAGE #r�? 2 VIL.LAG K�JJZA� P ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO SEPTIC TANK CAPACITY 1-50 0 AAA/'7 Qt"®`Cfy01MP&V�3 size d�33, 5 LEACHING FACILITY: (type) (size) ' NO. OF BEDROOMS BUILDER OR OWNS l? 0 LEA A PERMITDATE: L, k- I COMPLIANCE DATE: 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 I . i U, � � b / f it / Qt-( # ��� ` f0 jr �Jb-wjAv,3 x h Q QIagt� 4� J 1s,,c �0�/ HSn7j IY m3N Mir CO -v AtLM flL pleg 0 'Xtj �'t073•Q r 10 w 7- crq 02 ,, 2 Q ate 1 10 �0aO-La- L -- „rt - lib x w o J ci fv- !- , cu Ix SO �`- � o LOCATION y7-7 SEWAGE -HERMIT NO. VILLAGE INSVA LLER-'S NAME i ADDRESS BUI-LOER OR OWNER SIX Oil - d,0AJ&-,e- D X T E PERMIT I,SS_Y E D /0 87 . DATE . CO_MPLIANC,E ISSUED .J AQ e L� 1 ' `ll 10 ` if NAFEB .................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ------.....1 ........... ...OF............. c/�.........--------- ApplirFatiou for Uhgpoii al Works Tomtrurtinaa Famit Application is hereby made for a Permit to Construct (L,-�"or Repair ( ) an Individual Sewage Disposal System at: � - .. % ::... ors #....................... ..........•••---•--•----•-------•-...------.......'� Location-Address or Lot No. ..../..1/L.......cz?%r. .F-... 1. t ........................... ... .................................. W •--..��—f.Y.:v�I.�J��O�!/ rd.. Address Installer Address Type of Building Size Lot..rJ --- __._Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ................................. . W Design Flow..:........................................gallons per person perrday. Total daily flow..............1-ZO...........•......_gallons. WSeptic Tank—Liquid capacity/VPA..gallons Length_.K Width.!!!.!! "o .- Diameter---------------- Depth_:'r-_ --_.. x Disposal Trench—No..................... Width-------------------- Total Length............j_-._._ Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter-------- q...._. Depth below inlet......A.......... Total leaching area..Zd7------sq. ft. Z Other Distribution box ( ) Dosing tank ( )~' Percolation Test Results Performed by....49'��._��............................. 9!•&S%W_Date.... ..k/R/............... Test Pit No. _..minutes per inch Depth of Test Pit... .____..a Depth to ground water------- ------______- f=, Test Pit No. 2 47W--P._minutes per inch Depth of Test Pit... ...... Depth to ground water........................ a ••------•--•-----------------•----•----------•-••••••---••...-•-----------••-•-••-•--•--•--•--............................................................... 0 Description of Soil-...... r_ o� .�✓ 'w =S`�f ----------- ..........................................................rr a f" -X421A x 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,L- p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been �I iisssuedby the board of health. S gned % '� --•-•---------------- ® '� � D e Application Approved By h___Z 6 -----------------------------------------••-•••-••............._--••-•. Date Application is e r the following reasons------------------------------------------------------------------------------------------...................... ....•... •. •-• --••-•---• •---•---•--••----------•........-•-••-•-•-•.••• Date PermitNo...................................................... Issued....................................................... Date NoilvA1. Fmd ................... THE COMMONWEALTH OF MASSACHUSETTS - EOARD' OF HEALTH fn/ APPRi ation for Ui ipnlia rk C� bra r#iun ernti# Application'is hereby made for a Permit to Construct (t.-7`'or Repair ( ) an Individual Sewage Disposal F System,at Location Address or Lot No. - �iJr 1 f r `ems yo." l T_ f/ ter✓ �. � .0 - - .. ........................................................... IY /VAC $E�N er -----. - -•--••--..........................................................Address ... ......• fik. ..... ........................... ... ,- Installer Address Q Type:of Building Size Lot___�fb'p.` g•..Sq. feet U Dwelling,—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of,persons............................ Showers ( ) — Cafeteria ( ) QIOther fixtures ---------------------------•--..._.....--••- -•---•••-•••---•---•-•-••---•----------•--•-----•----••--•-•............--•-- W Design Flow'...........................................� gallons per person per�day. Total daily flow__._._....._._............................................gallons. WSeptic:Tank—Liquid capac>tyfpb® .gal,Tons Length_ _....... Width.` 1 ...._ Diameter................ Depth.`" 8 x,. Disposal. Trench '�To Width ................ Total Length.............•....._ Total leaching area.................:..sq. ft. Seepage'Pit No. . ............. Diameter .__.:fie_ __. Depth below inlet.__...G..._...... Total leaching area... 4 ......sq. ft. z Other Distribution box ( ,: ) Dosing tank '-' Percolation Test Results Performed by... !! ! ._4�_...!'-•-�_Ae C:K_S/, ✓Date..-..�Z�g�............... ►� Test Pit No. 1 4 ___minutes per inch Depth of Test Pit__-�:�...,':.... Depth to ground water........................ w Test-Pit.No. 2:!� _..minutes per inch Depth of Test Pit... :41' ....... Depth to ground water........................ y O Descriphon ox Soil-- Q-----Z4 Woo oo 4)Z0,-------------------------- .. 7i+ .. .ors.. ------`•S-�..!+�,.j U W Talj ! U Nature`of Repairs o.`Alterations—Answer when applicable.--------------------- --�- - , Agreement: The undersigned agrees`Rro install the aforedescribed Individual Sewage Disposal System in accordance with ' tht^f T t1...-. e L provisions of T _ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issuedly the board of health. Signed - ............................... /­--m 1�:,1 tt e. f/------ ;*e Application Approved B ------------------- ()Application , is v f the following reasons-...............................................................-........-.......................................... ! ... ................................................... ................................. ............. ...... µ......................................... ay. x=•„t, Date Il Sly'' d Permit N --------------- •------------------------ Issued , Y �, >r:.. THE COMMONWEALTH OF MASSACHUSETTS 1` BOARD OF HEALTH y 4rawG .............. Jn/1U......OF............. .-?f#'�1. ".s ST. a .......................... S I (9rdifirMtr jaf TA 2tph aurr.._,. THIS IS TO CERTIFY, That the Individual Sewage Disposal System'constructed ( r Repaired ( ) Installer at....... .. ........ '� _ fi13.�/Y �� '�4 rF j i ft- -----'------ -. ---------------•-•---------------- -- • m r has been installed in accordance with the provisions of T�:LE of The State Sanitary. Code as described in the application for Disposal Works Construction Permit No.- .. �..:� ...................... dated ................................ THE ISSUANCEPF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL FUNCTION SATISFACTORY. DATI:._..... a... ............................................... Inspector--- - . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH N�� ` 3�........ ` FEE.. '..c .... Permissiori is hereby gr""'anted••••-• -.................. - �'J --- .............. . --------------------------- to Con trust (�or Repair ( ) an Individual Sewage.Disposal rSystem atNo�......Z...------AQ?....Z_41(-......1./l....•-------------•-----•---•------ ---------------•-••-------•------------•--•-- -- - ` eet as shown on the application for Disposal Works Construction P mit /.t4 �t---------- Dated/y_/6A�f-- •---•--------- Board of Health ._.�1.•................-.................................... " FORM 1255 HOBBS & WARREN. INC., PUBLISHER$ - f Fee----No.- k--<- ----�� -- BOARD OF HEALTH TOWN OF BARNSTABLE 21pptication-*rVell Con5tructionpermit Application is hereby made for a/Jpermit Jt,�o( Construct ( ), Alter ( ), r Re air (Pla indivi ual Well at: If Location — Address Assessors Map and Parcel -S - (A 0 MUC. Owner Address __40A -sAiN__N_ c)e /( -0/ �y�'�' - mS o=e'� `c_ o�c �� Installer — Driller Address Type of Building Dwelling------Hoc.+$ ------------------------------------------------------ Other - Type of Building ----- ------------------ No. of Persons----------------------------------- -------- Type of Well--y --- —---- - ------- Capacity--------------------——-- - — —— — Purpose of Well----&_�t S_rjc '`. °1 - ------- 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 Certificate .of Compl' nce has been issued by the Board of Health. Signed - ---------- date Application Approved By— — — - ------- -------------- ��- -=-21�j date Application Disapproved for the following reasons:------------------------------------------------------------------------ ------------ ------------------------ ----- - - - - - ------------------- ----------- /,, date Permit No. -- .� -� `� 7-------------- Issued--- -- - ---------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance \\.THIS IS TO CERTIFY,4That the Individual Well/,Construc/tf d ( ), Altered ( ), or Repaired (✓) bY----------------------- �Ll-S ati L1'1 e11 Q!!1l!`—----- --- ---------------- ----------------------------------------- Installer N at- -- ?�= QL-`�—��`L l— -- ----------------------------------—---------------- --— - - — ---has been installed in accordance with the,provisions of the Town of Barnstable Board of Health Private Well Protection Regulation'as described in the application for Well Construction Permit No. V-?,5-'�=--A�; -,-ADated------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------- —--- —! — — -- Inspector---------------------------------- ------ ------------ / ( 1- Y'��V''ry.�f.,.�••�T-y w�.+�1.rN?6��'� .:.: , '.A'"�.M�['R 'a^4 � Y '�t}�.� Y _ � t�N� - ' a i 11 No -�- v --- V ---- _' ,� Feed - 1 _ ` BOARD OF HEALTH TOWN OF BARNSTABL-E r Application-ArVerI Cootruct ion Permit t Application is hereby made fora permit to'Construct ( ), Alter ( ),e r Repair (vf an individual Well at: ---` -------®� - ^� . .-�- -- - ---- - ___-E '(i f - -- Location — Address t » a {AssessorsP Ma and Parcel S C u 0 I1�u y M ,C' ,,, -�-------------- -- ------------------ Owner '` Address y" - -Installer I X Driller Address Type of Building Dwelling Other - Type of Building--------------------------------- No. of Persons------------------------_____—__—________ Type of Well--9 ---r-------- - ----- — - Capacity-------------------- Purpose of Well-----Dp+ 9S7iC - ------------------------------ 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 Certificate .o�Compl* nce has been issued by the Board of Health.Signed- -� -- -- - ----------- - t date Application Approved By— -�- - ----- --- --- -_-- _ = - _ date Application Disapproved for the following reasons:------------------------------------_:_"_____________—__—___—__________ date a ^' Permit No. -- - -- - -- -- Issued--= -= - ----- --- — --- t date BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate Of Compliance THIS IS TO CERTIFY, That the Individual Well Construc d ( ), Altered ( ), or Repaired (-I by--------------------------- � f f ------------------------------------------------------------------------------- Installer has been installed.in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -- :-- --- -J- ated'------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------—— — - — ----- Inspector----------------------------------------- - ,.�...�..� t BOARD OF HEALTH TOWN OF BARNSTABLE Well Cmtruct ion Permit No. V) � Fee--- U Cu.vy.� �( c�/� � . Permission is hereby granted--�_--� �� «'-�: -------------------- --------------____-- to Construct ( ), Alter ( ), or Repair ( mY an Individual Well at: ,1 ", Street as shown on the application for a Well Construction Permit No. ------------------------------ - - ---------F-'-- - - Dated____ ��' '�- -------------------------------- yr f�r � Board of Health DATE �--� (,t,J R s -(o 7 ENVIROTECH LABORATORIES, INC. MA Cert. No.: M-MA 063 449 Rte. 130 . Sandwich, MA 02563 (508)888-6460 • 1-800-339-6460 FAX(508)888-6446 CLIENT: Bobbie Jo Cadmen LOCATION: 477 Old Jail Lane ADDRESS: P.O. Box 949 Barnstable, MA Barnstable, MA 02630 SAMPLE DATE: 10-24-95 COLLECTED BY: DA Scannell DATE RECEIVED: 10-24-95 TIME: 3:OOPM LAB I.D. #: E10-344/E10-70 JOB TYPE: New Well SAMPLE I.D. #: E10-344/E10-70 WELL SPECS.: 94' RESULTS OF ANALYSIS: Parameters Units Recc mended Limit Result Coliform bacteria/100ml -(MF Method.) 0 0 pH pH units 6.0-8.5 6.09 Conductance umhos/cm 500 79 Sodium mg/L 28.0 9.2 Nitrate-N mg/L 10.0 0.07 Iron mg/L 0.3 IT 0.05 Manganese mg/L 0.05 0.008 I COMMENTS: Yes No WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. XJIX Date 27--?--5- Analyst IT = Less Than A Z. 'K.9 OF woo #41 - s� tyf 1 /a iNrrN, • - �' � riG^. Jg•7 `O� r�•A'1/6� :+:i.; ✓f'•Sr W 2_ \ ry sepr. 2" I►V/Tit/ SC �$ q ' 1 ! r 6. LQT / lol � a • f MtrIMUM LD h.la 5 f eCAIA — D TO N O Viol- IPA WtiAiN OWe FooT OF 0N161-+ C Ov.St CZa RA►EA GMH►+ . � � AREA ,t. 1Q '' q , p�yfK+Buti� 2 OF PFrA SroNE Fb2: • Mf vt�+:COVE t 0ax. I M PSR V I.04 5 cvv 4z- 'Cb .l�4 1�2t.�r�. 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