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Home My WebLink About0387 PHINNEY'S LANE - Health (2) 387 Phinney's Dane Centerville A= 230 -093 /// I SMEAD No,2-153LOR UPC 12534 smssd.com • Made in USA OcySO4 TOWN OF BARNSTABLE LOC TION �� ^�' 1 �''^ SEWAGE # , AGE 4-12 GLe ASSESSOR'S MAP &LOT INSTALLER'S NAME&.PHONE NO. SEPTIC TANK CAPACITY 4 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER i r PERMITDATE: 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 '�' --- I o me deck \ �� J. ___ _._�. tank ffl 4 , 66 Existing a ,~,House gravel ' V' 4387 rn drive E, \ septic . r 1 I, f i 1 __ S No.......... o9,-3 o F z.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH l1BJECT TO APPROVA p , i,_ IRNSTABLE CONSEB§7A .. .......OF...-..-... ..s.M-.`-..�.-`-7.... comINIF01if ation for M-4pnii al Workii Tomilruriion Vantit Application is hereby made for a Permit to Construct (�() or Repair ( ) an Individual Sewage Disposal System at: U.......... ... ff.............................. ....... Location-A ess or Lot No. v - �.....` --------=----•---•---- t_ . _...Q .................... Own Address - -..._.-� -••--------------•.---- Installer Address d Type of Building Size Lot__,ZQI_Q_�......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ___________________________________ �s Design Flow............... ................ ---__gallons per person er day. Total d ily flow.............V __._.___.__._.___gallons. WSeptic Tank—Liquid capacity]=gallons Length_ {Q�°__ Width.4_-d0.1° Diameter________________ Depth__.!V.fn9" x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----_------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) TWO"�>"" �� 4 �� .'S`� Percolation Test Results Performed by.l1,�<9TEL. ;.__ �( __L -.;��J �_ Date.__.__41:?'1.713____...__ a Test Pit No. 1----" -_----minutes per inch Depth of Test Pit____-____ Depth to ground water........ (z, Test Pit No. 2................minutes per inch Depth of Test Pit......... -------- Depth to ground water_______ _______.._- r ® Description of Soil..........O.._..�-----••---.. _�+:*----..�_�.....�� -�---------------------------------------------------------•------------- / `mil_.......................... •--•---•- ---/_"�� _____ �___ _ ._- _ - 0......br) --�e- V"___TA'_ - 4_----•-•--••-----____--•-- UNature of Rep/airs or Alterations—Answer whe applicab e................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in—accordance with the provisions of T IT LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue the board of health: ate Application Approved BY 1�.� - -- ..�............................ -•--��=X,-7_j'---•------ t-� Date Application Disapproved for the following reasons-----------------(--/-----------------------------------------................................................... ------••--••---------------------•--•---.....------------•---.....------------------•---•--•-------------------•-------••-----•-•------------------------------•---•---• •--------------•---•--•----••-• Date PermitNo......................................................... Issued....................................................... Date /) THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........1.rC�1+13•i�J...............oF.... .td.` r�r ..................................... TrtifirFatr of err t li�attrr THIS IS TO CERTIFY, That the Indivi u I Stwage Disposal System constructed ( ) or Repaired ( ) by........................... Z... 1.:-•- :. In�al at1.� ... e41_&......if -------------•-•-------------..------•------------------------------- has been installed in.accordance with the provisions of T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No•________,__2;;�YO___________________ da.ted__A. :7/t,/o_-__7_'?.____________.___..._ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE.THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector................................................................................... a: �� ., � � � j . � t _� I i ll g 4,iye s :' �< �,': _. .�� f` r_�'.: � , t '.� �' �� Sti � i Y �, M J`. w ' - ..� � 7 J � No---------1------ --`•--- �'" _• FEs.....�................ { THE COMMONWEALTH OF MASSACHUSETTS r BOAR® OF HEALTH dht.. ......... :..OF....... h,? >�i`��f tt .................................. Applira Lion for Diipoiial Worh i Tonitrudion ramit .,; „,Application is hereby made #or as Permit to Construct O or Repair ( ) an Individual Sewage Disposal System at: - ---------------- .....----.... .....--- ------ .................................................. Location-Address or Lo No. •. Owner Address W ', ............... .............•---------•----•-•--..........................---•---•...._..-..................._... Installer 4. Address dType of Building Size Lot-�'A.$__'�-�__0__.....Sq. feet U Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of person s............................ Showers ( ) Cafeteria ( ,.) a Other fixtures .1 . W Design Flow.............. ..... -'` gallons per person per day. Total daily flow--_____ ' ? ................R ffallonsW. WSeptic Tank—Liqui�dycapacity� gallons Length �_' *�_.... Width__:" __ Diameter________________ Depth_. ._' __. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No ........... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box (' ) Dosing tank ( ) I �"'`' C _566'T 47� '1 '`" Percolation Test•Results Performed by-S. °1.0 _�' .__; � ?' .$ Date-_ '`A h�7:4.�. ........... Test Pit No. I... _____minutes per inch Depth of Test Pit-------1.......... Depth to ground water---------`"__f.....,... Test Pit N,o_2.._ "._._minutes per inch Depth.of Tent Pit_________ _________ Depth to ground water-------!-!?............ fYi .......... ---------------------=--------------------•------•---• -------------...---------------•---•----------------------- 0 Description:of�Soil::-.•-•-•le•=-- ----------- _+ .......S ---•--. � ` ' ?.i t.._,.......------------------------------•-----------------------------------• __ I •_ �_•_• V Nature of Repairs or Alterations—Answer whe>S applicaule.-.............................................................................................. --------------------------------•••..--••--==-•---•----•--•-•••-••-•••••-------._.............•-•--•-•---•--------••----•--------••------------••-------•--•----••.----------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 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 health. Sd--- -----•-----------------• '-----------------•----••--•-•----••--•-•- ....................-- •a ` ♦ •Date Application Approved By... x.. " =Date Application Disapproved for the f ollatbi'ng reasons:----------------•------•.....-----••--•--•----•-----------••--...•----••-••--••----......--••---•----.....-•---- Date PermitNo......................................................... Issued-.................................. ----------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... t..................OF... ..................................... F Tntif irab of TompliFanrr HIS IS TO CERTIFY, That the Indivi S wa Disposal System constructed ( ) or Repaired ( ) by......•. ... _..JIC.......... ( . -------------------------------•--•----....--•---......------••---------------...........----- Installer ------------------------------- has been installed in accordance with the provisions of 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-__ ----.'z�1;�::_________________ dated..- '=� ��.............. •._._.. THE-ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEK WILIL FUNCTION SATISFACTt7RY. DATE....................................................•-----••-•-••----...._...._. Inspector........................................... ........................................ THE COMMONWEALTH OF MASSACHUSETTS t, BOARD OF HEALTH �.:.� ® ..........G?•t ,?.j ?..............OF..... . ..........................-. €.. ,�, ................ 2�.�+ No..•-.. FEE._..._.. �io�o��a orh� �oaa��r ' n �erntif` Permission is . ereby granted p. _.. - -•................................................................. to Construct ( or Repair ( an Individual Sewage_Disposal System atNo.................... Street dd as shown on the application for Disposal Works Construction mite Dated...s�r1-77.'__________•_•-- t -- . Board o ealth DATE................................................................................ FORM 1255 HOBBS & WARREW. INC., PUBLISHERS e ` i ....+.i«..,...+-.....wva.... -..rm...pass.+.-+.w...,rw..�+.�.:��.�+.....i.........;.+.-.....�..w+.u.r.+.rr:.-� _.............,,mow,...-.-� _-...r-.._....-.._.. .._..-,...e.-...,......_:.....-.........,.+Iwo...,w,..�....w..�,...,....-.......+••+..n•.r....n..«-�.+�.w�-�...a.w..w....+..�..�wr.vv+..+....... +w.w...w.».q:,.a....,.>..+.-,�.e.<....�•;.w+w�. ' iW6o 4�+tin,,��; >IS.Ndr. `CAA tW..:-� F"�.-��✓;, - 3� 11v - '<?>� �r L..� Id i�,, L � +JZ 5f 13f- WALL. 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