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HomeMy WebLinkAbout0191 STONEY POINT ROAD - Health l int 191 Stoney Poi' Barnstable a y 1 _ a i _ i No-----73_ .1' f F�s... ................. THE COMMONWEALTH F T BOARD OF HEALTH D B TOWN OF BARNSTABL ®�rtmea�t 2;4Z2 �3 Appliratio t for Dtivnsat Workii Ton,15tra t eruct Date Application is hereby made for a Permit to Construct ( ) or Repair (✓) an Individual Sewage Disposal System at: ocation-Address or Lot No. .......... ........... a.+�a �-�`..------------------- -- ..._...--.......---------------------................ Owner Address FWj ......C. y ......CA. c o........................................... ��._ �\W s .. p R.- ...._........._: Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.d.......................................Expansion Attic ( ) Garbage Grinder ( ) 04 a Other—T e 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........................................ ' 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........................ 9 -••••----•-••---•-••••••••••-•----••--••--•--••••••-•-••-•-••--•-----•-•••---•-•-•-•-------•......:......................................................... 0 Description of Soil............................................................................... -----------------------•----------•----•----•--•--------•---._...-••--•---•--------•-••- x x ................. ----- U Nat e f Re airs or Alterations—Answer when applicable. �/ S�f .........---- - °. 1 PA_A.. ..r----• •- •- .....•------- -- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Env- on tal Code undersigned further. agrees not to place the system in operation until a Certificate of Co m 1 nce been issu y the board of health. Signed ------------ ----------- .. ..-------..--...---- -------...-...-..-.--..--...-....---------- ......... Z 93 ... . ;�..u+�. Date Application Approved BY U.. .' ---------- e Application Disapproved for the following reasons- -----------------...-------------------------------------------------------------------...........------.-.-....-------------.....- ---------------------------- ---------------- -- -- ------------ -- ---------- --------------- --------- P Dace PermitNo. 9 /Z _------------------------- Issued --------------------------------------.............................. Date No Fps....:; .2.................. ---.-THE COMMONWEALTH OF 'MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ' 3� Appliration for Disposal Works Tonstrurtion Prrmit � Application is hereby made for a Permit to Construct ( ) or Repair ( ✓) an-Individual Sewage Disposal System at: - Location-Address or Lot No. _;�A 2 l�F l2 __ a O ---- s^� Address ner � � ------------------- �-....---- .....: ......_...------------•---•-------_.. Installer Add_ess UType of Building Size Lot............................Sq. feet .-� Dwelling—No. of Bedrooms.,.".......................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building _....._..... No. of persons............................ Showers P�•I YP g ---------------• P ( ) — Cafeteria ( ) 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 ( ) aPercolation Test Results Performed by-_---------------- ..................................................... Date........................................ Test Pit No. 1...............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........................ -------------------------------•--- -------------------------------- .--------------------- •------------ ----------------- -------------.... "-------------- P •-• Descriptionof Soil------------------------------------------------------------------•----------......••-----------------•-••------------------------------•-------•-•-••-•-•-------•---••- "W U ..............................................--•---•-•-•-•-•-•••......•••--•--•-•-----•---•---•---•--•-•--••---------•-----••••-••••---•---••......•--_•-•.................•---•--•--.........--------- UW .•••-- ----•---......•-----•••••------•--•-•••-•--------------------•-----•••-••-•----•-•---•......---•--•-- --•••---• ••-••---•••-......'•---••- Nature.{10-f Repairs or Alterations—Answer when applicable Tc?__six�.�t'�ti 't-2.t1°f?._...V_.-�ZtA-�2x^� �0 �.�, �.-d M {�JS!1.4� A__, g,c?�_�c�s �t n r• =........--•--------••---•-----•-......•--................ ---•- ......... .....---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Envir'o mn ental 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. l� � Signed-\1.. ..... 1.... - :" '--"9, -... Date 43,'. Application Approved By ----...--- ...-0��-t .. r} ... - /M.fg Application Disapproved for the ollowing reasons: .. -- ------------------------------------------------------------- -------------------------------------------------------------------- --------------------------------------------------------------------- -------------...................... Permit No. Dale --1 r.�-------------------------- Issued ------------------.---------- -----------....... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE r (fe>rtift ate of C�amplinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( L-4 ) by............R.:fit�...-...;Am J.0�------------__.............................................................................................................__.......................................... _ �^�-;� Installer at `� '�f,..� d N-------------------`----).�• .V.M`n.1M. �11. -- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....... .—...// ........... dated .....-------......---------_.................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------------- -------------------- I ! Inspector ... .� = v� i C� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No._.��......... FEE..... ©.:......... Disposal Works Tuuutrudion Vvrrmit Permission is hereby granted...... " A_fJ _ .-•-------•-----•---•-------••---••--•.....-••-•-•--.......••••...............•----_...... to Construct ( ) or Repair ( ;,�)lan Individual Sewage Disposal System at No......49 A-••-•<•',!A .!E+J. - ?C�,�-F'' -1�` --.--•---C_uVr._lnnlol_- - r Street C� as shown on the application for Disposal Works Construction Permit No.. 3�/f -• Dated.......................................... ^l-........................................................... DATE—.............-� --•----------------------- ._.. Board of Health FORM 36506 HOBBS&WARREN.INC..PUBLISHERS l TOWN OF BARNSTABLE TEOCknON�%9/ ®h�� �i�� 2�, SEWAGE # g VILLAGE eum ASSESSOR'S MAP & LOT :33 L-- O INSTALLER'S NAME & PHONE NO. A & B CANQ 775-6264 -SEPTIC TANK CAPACITY 1000 LEACHING FACILITY:(type) (size) X NO.OF BEDROOMS 3 PRIVATE WELL O PUBLIC ATER BUILDER OR OWNER '3atker DATE PERMIT ISSUED: � 13 -2 3 DATE COMPLIANCE ISSUED:: —9 VARIANCE GRANTED: Yes OK- No I/er'b �. PF TOWN OF BARNSTABLE LOCATION LT��EWAGE # 71K r A� J / �(VILLAGE Uti` i y�� ASSESSOR'S MAP & LOT tf/ 10 INSTALLER'S NAME &'PHONE SEPTIC TANK CAPACITY /va Z> G, LEACHING FACILITY:(type)Lrvc.� (size)_7X3 X a NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER Ak BUILDER OR OWNER 6 It 9A/ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes o � V r i S'To.uE i IV �� y _ t b.: Fins THE COMMONWEALTH OF MASSACHUSETTS B ARD F HEA TH ....TAU kL .......OF..... �� -v�'-...........:._: ��1 t1trtt�tutt for.Dispas 1 lVorku Tutlitru in Permit Application is hereby made for a Permit to Construct ( ) or Repair ) an Individual Sewage Disposal System at ...............h 2 of Pot t�.� � rD ... ....._._ M6�l c k�►D................. ... -- - anon-Add re //'� or Lot No. .............. �Th \.. 1.! .... .............._..._......................... .............................«.......... Owner Address ........ • ....................................................... ......................... ........*------.... ....... Installer Address Type of Building Size Lot.]A. .......Sq. feet __.__....._Dwelling—No. of Bedrooms................. ....Expansion Attic ( ) " Garbage Grinder ( ) Other—Type T e of Building .............. No. of ersons__..........._.._........... Showers — p., yp g .............. p ( ) Cafeteria ( ) Other fixtures ..................................... -ei ..................................•---•------......--•--.....---.......--•-•-.......................... Design Flow............1.1-0......... gallons per psssm prr dlay. Total ( M laily.flow_._......Z _ .................. rs. �i�0 Septic 'I k—Li uld acity.__..___....gallons Length..r�.._.4z'..:. Width:-+16"... Diameter:............... Depth._G.4-._... W x —. o. ........I.......... Width......'.......... Total Length......l..l.......... Total leaching area...l5:? !:...sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0-4 Percolation Test Results Performed by .1�:. `p�. .... t...---- ..................... Date...... �/ter.IL6 minutes per inch Depth of Test Pit....12£?p..._. Depth to ground wTest Pit No. 1....._�___. ••-..-. rzq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ . -------- --.....•----•- ....... Vt.... O Description of Soil...... .....�t2P...t �1jP,J` ?14-........fi r..._-................. .... r.�..���.��K?. x -------- {:.A�20PPf ..............•--.................. W _ __ U Nature of Repairs or Alterations—Answer when pp1�a 1IIT ............................................... OaTlar�r� '�g •........................•---.............................-•----••--................ ING ....._..- — sv�1 ALL�aYi: r' AND CEIT.IFY.I[J_WRIT................. ....... Agreement: HE SYSTEM WAS INSTALLED IN STRiG r The undersigned agrees to install the aforedeseribed pFndivi'd h6€Vage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b en issued b the boar of Sig . . .. .-•---....... .................................... Application Approved BY I -S ...... Date Application Disapproved for the following r ns:.............. .... •.............................:��-J \��.�.-•--•-•-•---..__...............-----......--•--•--••--•--._..... ..:....._..._.........Date...... ...._ Permit No..... ...._.. ............... Issued.................. Date •" ��t � ' THE COMMONWEALTH OF MASSACHUSETTS r � BOARD { [OA R D OF HEALTH "` ? ` ...0_��J.t�,:l......OF....... ................................ 1 Appliration for Disposal Workii Toustrurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair( ) an Individual Sewage Disposal f System at.� 3 . . .. .._ ..... ...... ... .....f .g�. Location Address, A or Lot No. , .. t Owner� .... ......Address...... .......................... ,.� ........ ....................- ---------- ....... -----....... ........:..---........................ M Installer Address Type of Building Size Lot.1 ::�?�:x�.......Sq. feet U Dwelling—No. of Bedrooms............... .....,........._..Expansion Attic ( ) Garbage Grinder ( ) P4 Other—T of Build in yp1e, �ill g ............................ No. of persons............................ ( ) — Cafeteria d �/6t 6r fixtures .....................................rim-r._...... ...... WDesign Flow............1 .'0................;�---.gallons.per•person per day. Total daily flow............................................gallons. WSeptic Ta�nk`—s�Lgquld�catpaci yc� p._gallons Length.`LR........_ Width ;�...... Diameter................ Depth.��W` ... x Di osalzTreneh—No.� ...t�.......... Width.....'"......-.... Total Len 1 1 Total leaching�SP �................••• area..t►:- Z-...sq. ft. 3 . Seepage Pit No...................... Diameter.................... Depth below inlet.....................Total leaching area..................sq. ft. Z Other Distribution box'( ) Dosing tank ( ) 1`iaslle N� Q 0.3 Percolation Test Results Perform bY --..............................:�....:_G i;.................... Date.....!t .�...f f .. ,.a Test Pit No. 1..... ?..--_minutes per inchD Depth of Test Pit....1 1�_...... Depth to ground water. i4at,��-p..... I . - rX4 Test Pit No. 2........7..._...minutes per inch Depth of Test Pit.................... Depth to ground water........................ or .............................................. ;O Description of Soil..:...? -rat' ��11Pa,.tga . 1 51 - "��` -��ts.`f ... ! ` 1 L -4,w f)�R'l L, ------------------ --- --•• -••-... .......-- x I� l oil i2 Q11 11p,20Ppa� -. . V ••••••••--•-----••--...-•--••.....-•••.............•••••----•----•--•••----•-•---••-••-•-••-•••----••--............_.......................-•'---••--•--••--...... UW ..........-•--•----------•---------•-----•-•-------------•••------....-•----•--------••••-••••-•......-••------------------•--=----•-• ••------••-•.....:?..... Nature of Repairs or Alterations—Answer when applicable.... C-r—F:(` Agreement-: `` ,.... P � �--- .. . ................. The undersigned agrees to install the aforedescribed Individual Sewage-Disposal System in accordance with the provisions of TITL-. 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 ieilth. Sign! � '". ...... ............ .. ..... Date Application Approved B 60-A -Q _�1 - 1 Z - S�'.PP PP Y-•--•--•-- ................................ ..... -----.----._� •.............---....................... Date Application Disapproved for the following reagssons:.....................................'..._.......-.__..__......_...._..,......I.............................. ....-•..........................•-----. /•------••--jj-•-•--........................................................................ . ....... .. .... `......... .... / b r l� ! } f �'t' Date L '' Permit No..... ....... �._.......__.... Issued.. , , --. I....I...'....--..:"I..::: . %. .: . :Date l�*f:t".�r+"a:---.,R.dF x .C_...p.. '.:-.e—�• :s...-...-.-.wcs� v- — —�n F.—.— s. ...�a....- r - . I .:� F ..... .w .-- � ' ..a_. - _. - v._... .�. ". - -,.. '.sr ._-.�«. - r .. �. '.py'.::.,-�r*ti T.: -inv✓- .. w.a.:.t .. --...-�.-..u.:r 4s+;n. ..sires. . THE COMMONWEALTH OF MASSACHUSETTS 1, BOARD OF HEALTH ..........................................OF.............��.......................'................................... Tertif irate of Tomplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........ C-�1-1C--•----••---.... ..... ....---- ----- . ........-n ----•-....------•.................. ............................ bT ? Vv C�_ t d Installerf 1 �i � !Wl.dL�Ix at.. --••........... .............. ..... :............ --:........._11! ................. �.. ....................... has been installed in accordance with the Provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.,9�6-.1:�: .-........-. dated....... ...." 5'"� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............`.............................................................. Inspector------ ! _ ................ THE COMMONWEALTH OF MASSACHUSETTS �1 BOARD OF HEALTH .. " OF.. 1-'!�'� FJl t�i .......................................... ................ .. ...... ........ ................................... No......................... F ........................ Disposal Works Tonstrur#ion Permit Permission is hereby granted...---- r� .� ........---....................•--...............•-•...................................................... to Construct ( ) or Repair ( ) an Individual ewage Disposal System at No.....ln ......2_ � .�u-�� st as shown on the application for Disposal Works Construction Permit tNoh- ..127? -Dated... .�Z. . ?� ...... .........................................t. ........................................ DATE......... > I', l��s7v Board of health 362-4541 926 main street rt 6A ' yarmouthport mass. 02675 down cope engfineefiftf civil engineers& land surveyors structural design Arne H.Ojala P.E.,R.L.S. land court Richard R.Fairbank P.E. surveys site planning February 5, 1987 sewage system designs Howard Woollard 2727 Main Street inspections Barnstable, MA 02360 Dear Mr. Woollard, permits This letter is in response to your telephone inquiry regarding a letter of certification of the septic system for Margaret Gorman on Stoney Point Road, Cummaquid, which should be sent to the Barnstable Board of Helath. I am sorry to inform you that I am unable to do this because I did not inspect the installation. You informed me that the work was about to begin, however, I was not able to stop that afternoon. I informed one of the engineers on my staff to proceed to inspect the installation upon a phone call from the installer. The call never came. I went by the site a couple days later and saw that the installation had been backfilled. It certainly appears that the installation was according to the plan, however without additional measurement data, I cannot so certify. Perhaps the installer made detailed measurements at the time of the installation and could provide weigh slips and other data to document the installation. If we had this information, perhaps we could satisfy the Board of Health. Please advise. Very.truly yours, Arne H. Ojala, P.E.,R.L.S. AHO/amp 2/5/87/14 n'�L~5s..i1, u• �i� leebCLfl M'iiC y Rom) :?TALLATION AND CERTIFY IN WRITING 'AS INSTALLED IN STRICT 0 MAN 1 yy� 'roP o "" I 1► r�� ,TM• — 1_ � li� 02 07 40 ;�,, J a * k1 C/ c C- �, _ .���►'' ;��-; �` 3 Lai '��'�� C�PD� l.� �aY = .4q�, �,4 L VIP: AlTa c. 4 � -T _ ,�_. _____�''_ ..,"�' f�,' - \ ��,�.� f '• ?c"� t_.U� if� x '�,' 1.�1 I� X '�� CEP +It�r. �t Utl l Cl PG,L, k.IATEe L15\ i,.,5 ��PE PtiGG 1A4 f F i rirG�t���l .01 r,Cl � f�G�GAT �P iLTS A 4+ s MII.It ML M 6,zo+_ NIQ GC\iEP- CV51 semi !_-�- y T .� SG Co PPG: i"n P. MA\(E ;'14ATeF-11C;HT 7 _TM-E �_.:MAOV�C'- IAA ,,IT4�j r- ice' ",Ter" 14- _ l�NIJ E�1G�.' G i►.l C�(�L�E:E �5Y 2' T� r,le r �c�-� �t(" �� P.�� R �,�, Stu u i � �a��rrtTY. - • f/l L\r:.-C Far 4� Al Te 7 �7.7ttrC ,