HomeMy WebLinkAbout0057 THORNBERRY LANE - Health 7 Thornberry Lane
enterville
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S M E A D
No. H163OR
UPC 10259
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TOWN OF BA.F:NSTABLE N
LOCATION �,d:ti�C�i (,�,,,� S W q o —Ll Z�
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L VILLAGE �`'K��'�� ASSESSOR'S MAP Q LOT
INSTALLER'S NAME & PHONE NO. �- ��.Sc4�� 771
SEPTIC TANK CAPACITY l Sd0 y���dv.S
LEACHING FACILITYAtype) y �'► ��5 ��� (size) '
NO. OF BEDROOMS 1 PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER g117514
DATE PERMIT ISSUED: S Zt> qZ
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes 0
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No. .............__.. .. j Fnaz
THE COMMONWEALTH OF ASSACHUSETTS j
BOAR® OF HEALTH �..................... ...............OF...... sT ...
ApplirFation for Ui_qpnial Works Tonotrnrtion rnmit
Application is hereby made for a Permit to Construct („ 1 or Repair ( ) an Individual Sewage Disposal
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System at: t- J
�'i? ! ._ C.rF �!1. .. -,y 1� �_U?!Vc�/�c¢-......................
.� LocatiI Addres
- l�ll13 � or Lot No
. /� ---s E . .........
Wa O
jAdress
--•- .m .....
L -----------------------------•--•....------.
(� Installer Address
U Type of Buildin Size Lot._6_e.JA A.?�_._..Sq. fee(/s'?-4t
�--� Dwelling No. of -Bedrooms.......................................Expansion Attic ( ) Garbage Grinder (,N-)
`4 Other—T e of Buildin
a yp g ............................ No. of persons___.___.......___._____._.._ Showers ( ) — Cafeteria ( )
dOther fixtures --------------- ---------------- --------•-.......------------------------------.....------------
W Design Flow..%Vr.....................gallons per person per day. Total daily
WSeptic Tank Li capacity.l;rO.U.gallons , Length................ Width................ Diameter---------------- Dept-I____-__-____-__
x Disposal Trench—No..........::K....... Width_10' Total Length-/_(o t. 's'AoTotal leaching area.a3'..Af-- sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box (_A� Dosing tank ( )
Percolation Test Results Performed by........2;4X,E.e...... . _........................ Date..... ........ . .
Test Pit No. 1.......?- ---minutes per inch Depth of Test Pit. __ ®.....__. Depth to ground water.._/IID�f.�
(s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
R4 -----------------------------•.........------.................
, / p z d
Description of Soil �`' 4 .��/ -- - -- - - -
U ............................................. ........rn.e.dr1'e'laxr......%:, ----------DESIG ING..ENGINEER.M4J$T SUPERVISE------.
, . INSTAl.1.�1TI0N AND_CERTIFY IN WRITING
V re of Repairs or Alterations—Answer when appli`�ble--------THE-SYSTEM WAS INSTALLED IN S-TMOT'
------------ACCORDANCE Tb PLAN...........................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal S tem in accordance with
the provisions:of ilTli; 5 of the State Sanitary Code— The u9bo
sign rthe agree n t to place the system in
operation until a Certificate of Compliance has b s ed by th - he lth.
Signed ---- -•---•----------- ---- ----- •. .....................
tAppl � �ate
ication Approved By-------`•�--'6[a��--�.s ..... .... .......•--------.:.--•--•----•---....---------------•-- ------
Application Disapproved for the following reasons------------------------------------------------------------------------------------------------------------•----
......................---................................................................................................................................................................................
Date
Permit No.----�....._...� - Issued-.............. 2. .
ie
-- Q -L_ ---
..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...............................--.........OF.......................................-..
Appliration for Disposal Works Tonstrnrtion Vprrmit
Application is hereby made for a Permit to Construct (4-)' or Repair ( ) an Individual Sewage Disposal
System at:
IL 0—Y 0. .. el-
............................. ......•. -•-•-------.......................••••• ••••-•.................••.................
Location-Address or Lot No. _•
Owner Address
r
Installer Address
Q Type of Building Size Lot_'..r_..... ......Sq. feet e f+
Dwelling,m�No. of Bedrooms........2-...............................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.,-'.',..L ................_:: !gallons.
W Septic Tank=Liquid capacity.....-.......gallons Length................ Width---------------- Diameter................ Depth.............__.
x Disposal Trench—No. ..........:......... Width.yKt;?'•...._.. Total Length.......:............. Total leaching area::Q!;4........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.__---_----1:!.r:...i__..__. .._'::_!��............................ Date._..!.___'.�.��__._
a -•--•-•••---
Test Pit No. 1................minutes per inch Depth of Test Pit........: _....... Depth to ground water_._ ......f I; ,
fX4 Test Pit No. 2................minutes per inch Depth of Test Pit-----_.............. Depth to ground water........................
D Description of Soil.............:.......... - r A = /
x ------------------ ------------•••---.....................................................................................................
V . ..-
W
U ---------------------------------------------------------------- ------------------------------------------------------------------•--------------------------------•-------------------------------
ure of Repairs or Alterations—Answer when appli ble.-----------------------------------------------------------------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal S stem in accordance with
the provisions of TITLl 5 of the State Sanitary Code— The u rsign 'further agre not to place the system in
operation until a Certificate of Compliance has tf
sued by th bo liealth.
Signed./ �=� .••....
= .... f.
Da
Application Approved BY =- ` .....'_ � rf -= - -�, .
g-
ate
Application Disapproved for the following reasons------------------------------------------------------------------------------------------------•-•-•----••••----
------------------------------------------------------------------------------------
-_,r _ Date
Permit No.- .............. -•----------------- Issued-............. -%C L 'r' •-----......
Date :.r..
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............................O F.................. ... ............................................................
(9rdifiratr of f umplianrr
THJ IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( () or Repaired ( )
by... ......................................................... ----- • ------••-•-•-----------••--•-------•-•••----••••......••------•-•-
�' � rv. Installer
r
-,n
a+ n - _
at.. ! -------------- ---
has been installed in accordance with the provisions of TIT E 5 of T e State Sanitary Cgde as describ d in the
application for Disposal Works Construction Permit No.__-_-_`�. .. -_. P 1 '"
dated ------------------•-•--------•----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARANTEE THAT THE
SYSTEM WILL FUNCTIO SAT SFACTORY.
DATE ..................... ....................... Inspector ------ .................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...1..�...-................._OF...!.!'..:.....!�c.......................'..._................................
N6.........-•--. ...... j
FEE. f. —..........
Disposal Yorks T-IMmitnution Vrrmit
Permission is hereby granted..........i!�i.....'1.
to Construct ( .),,or Repair ( ) an Indivilual Sewage Disposal System
at No... ` ? 7 - �-�
Streetr-
as shown on the application for Disposaf Works Construction Pe . it No 1 _��! Dated..........................................
/ -
Fle Board of alth
DATE----------------`-F------=----..._.....-•--••-----..:..----•--•------------•---- I/.
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
` - BAXTER & NYE, INC. _
Professional Land Surveyors and Civil Engineers
812 Main Street •Osterville, Massachusetts 02655 Tel. (508) 428-9131
FAX(508) 428-3750
WILLIAM C. NYE, P.L.S.- President PETER SULLIVAN,P.E.-Vice President-Engineering
RICHARD A. BAXTER, P.L.S.-Vice President
May 26 , 1992
Town of Barnstable
Board of Health
P . O. Box 534
Hyannis , MA 02601
Re : Lot 22 Thornberry (formerly Lot 27)
Map 186 Parcel 90
Dear Board :
Per the conditions setforth in the Disposal Works Permit I
have provided engineering inspection during the installation of
the septic system. Based on my inspections it is my opinion
that all work has been performed inaccordance with the plan of
record .
I trust that this meets your present needs .
Very truly yours ,
Baxter & ,
Ny e Inc .
Peter Sullivan , P . E.
c .c . Bayside Building Inc .
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No. 2W33
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MEMBERS OF
CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING
MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS
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