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Home My WebLink About0012 VISTA CIRCLE - Health (2) 1a, ,V C�-n�vi Ili, f 'etMMOF BARNSTABLE LOCATION /+4 6� f 9 �s� �irGl SEWAGE # VILLAGE C,0,`T 1171-e ASSESSOR'S MAP &LOT _ - INSTALLER'S NAME&PHONE NO. �u 4," g� igg�tv SEPTIC TANK CAPACITY /ba LEACHING FACILITY: (type) G v0,9 a1 P (size) / 'A 4f ' NO.OF BEDROOMS `3 BUILDER OR OWNER PERMITDATE: 3-2- 9S 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 12 +77' LO ✓1 Py' J ,[ — i No.... . '_......sth-4 e FE$.........N ........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH - ...-----.._to.-WO.........oF.. 1 1��d`� ------------------------------------ ApplirFatiun for Diipusal Workii Toustruktiun Permit Application is hereby made for a Permit to Construct (V/) or Repair ( ) an Individual Sewage Disposal Systemat................�[.. • ....._.... ................................... L cation-Address or Lot No. ---•-- . -•- ..... ?' ----�vdLivia�W1�------- -----------••-------••---•------------....---•-- --••--...................................---... a � 4._1. wner Address------. ---- i � Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............3...........................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria dOther fixtures .---�-----••--•--•...................•-...----------....-•-•-----...-----•......•--.......•-----------------•-------•---------••••............_... W Design Flow............................�- 5-..-------gallons per person per day. Total daily flow.................................�.I_Ce"---gallons. WSeptic Tank—Liquid capacity_1_09C%'gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No____________k________ Diameter........1 P..... Depth below inlet............... Total leaching area......"sq. ft. Z Other Distribution box ( W'_ Dosing tank ( ) . Percolation Test Results Performed by------------ � x�zYL.�-_ ijr...III ......... Date........................................ aTest Pit No. 1.......Z'..minutes per inch Depth of Test Pit........1.1....... Depth to ground water........................ LL, Test Pit No. 2-----_-__-_-___minutes per inch Depth of Test Pit.................... Depth to ground water---_--__--_..__.----___. a ---------•••-----------•-•---------------------------•---•-•---••--••------------------------------•......................................................... 0 Description of Soil........................................... ----- -- ------------------------------- .------ ------•----------------------------------------------1�1fe ..... 110 ----. r�rr&...----- 5 --•---------------------.....-------------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia Signed .. ,,,.. s been issued by the board health. 3_ !y- �L lT6,¢, ........... .................. •3.'D�.r 1 _ Date Application Approved BY ...........& t ," ..... - - "-;.• 4P Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------------- .... .. ............ . ......... .. ............................ .. ............. ........................................ ...... .................. .. .................... ......................... ............ ` p�ce Pkrmit No. --------- ��`- .`..... -{�-.. .................. Issued ....----....---- -- ----- ----------------------------------- Dale ——— c No. ..... :� FRs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................t2WN... oF.. 1"r?. ..................................... Appliraffou for DhipaaFai Warkii Tutuitratrtiun 1hrutit Application is hereby made for a Permit to Construct (,I/) Or Repair ( ) an Individual Sewage Disposal System at 11................................U..........................................................6R.ec.� ......................................�`r' L/q�catioyn,-�Address f j / or Lot No. ....._._._: I`�!IfL�(.�w�t----YY_.'�iL�!rV-V1 S....... Owner Address W Installer Address �,'p Type of Building Size Lot............1 ..Sq. feet U Dwelling—No. of Bedrooms............13............... _Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons___-________-__-_-_--__-__ Showers ( ) — Cafeteria ( ) dOther fixtures -----r•............................................................................................................................................... W Design Flow............................55�.......gallons per person per day. Total daily flow.................................(d Q...gallons. WSeptic Tank—Liquid capacity.1ORPgrallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Vidth.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----------A-------- Diameter........12P----- Depth below inlet........ ....... Total leaching area........ &4wsq. ft. z Other Distribution box ( � Dosing tank ) F-I a Percolation Test Results Performed by--___-__�....r L-- _.� -- -1�--.____._.. Date........ ..... .�. ________.. Test Pit No. I....... __minutes per inch Depth of Test Pit........1.1------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------•----------------•--------••------•------•-••-••-•-••----•---•--••---------------._...---........................................................ 0 Description of Soil............................................... - -------------- - - --- 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 TITLE 5 of the State Environmental 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. Signed ------------------------------------ ---------------------- ..................--------------------- Date ApplicationApproved By ----------------------------------------------------------------------- Application Disapproved for the following reasons ---- ---------------------- --- -- ---- ..................----..................--..................-- ---- -- --..........------..........-- ------................................. ---------------------------------------- Date PermitNo. .........�,`.� --....... - --- ------------------- Issued ------------------------------........--- . ----.. ------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7-0 /ti of ....... . ................ . li ....... ------------------------------ - (1Erttftcate of (Clorapltance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by -------------------------------------------------------------------------------------------------------------------------------------------------------- / Installer at ................640-....... .... ......._Il...-L..V`�_l ...............---------------------- - .-----------...........---......------------------------------ 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. ........7S--------.�. .. .... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---------------------------3- ��rl' ...................................... Inspector ...-----.......b_7,'!Z THE COMMONWEALTH OF MASSACHUSETTS BOARD QO��F `yH�EALTH No...,C1_ .:.a�s- ................T100AJ.....OF......�;.�/t'`.�'1. .................................... FEE....lP2�........... �i��a1��t1 nrk� �nn��rttr�i.aYn lernti� Permissionis hereby granted..................................................------------------------------------...................................................... to Construct (�' or Repair ( ) an Individual Sewage Disposal System at No. �-r T -------- "f-V----------CA-'�---------�^��.,- �a Street as shown on the application for Disposal Works Construction Permit No./.�_).)-.e Dated------ ......... ----.....-•----•--------•-•-------------------------------------------------------------------••-------'- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS =7':r �D'ES161.1 -MrA I.o.r 20 i: PAIL�( .;.F(.oyc/ �C110=3�v �- _!_. ,EPt'lC TAiJk. 330 x, 4q5 LY7Goe lo0o Gam (S,ar�o Sly- 15Po5AL PIT l-moo Gad III �o ooe : ` . . 5IDEW4CL Atq = 132 SF � .1- 30770M - 1I13 SF 11 _ _ a TOTAL�516N - 4 dd3 {tb/ _ a VF. o •. TOTAL DAILY �1-01V = 330 0� i Iti . t / T�EI 6 V LAT1 oN QATE.. "I u 2 XA i�1 110.01 V >� OFOF � :- MnaD �aa PETER 8i3crEA u $. SUU.IVAPd o .. 'o d4tt4U. — N • �•,. a z7A�•uT�seF+ I Ohl(� E, f�8�8G p(_L 215E1ZS �' LoT- I8 l '15 vu%THE/U I2"aF VT;k FG•M8 TF°/09 c#s Pvc •VV „�g iur 1,uv GAL 2073 ;.a:,� .:(o.asp. ; 14►✓ , ,o AW. DKT 607C ia.9 , io7� S 1'IC � t I a TA N L G Wljr - C� • I,r t' 0 -6:IA-L 5(KUTRE3 5ET MOP TIUW 44 VEWSTONE Q4A.(_ ze A-to 7ohlE eC 26 1 o ll o' MAP, 113 PXL 2S-7 71 fT :"4_I . l.pG MOW _ CEIJ I�RVI(1� FEB T7 M'S Pu opc 6 er- Pt-A N 1 C EVZTI Fy T44 kr TRS .nwou.,NG. E ROJC.rr 590WW HezeoN (:�oMF� S wltµ TNT 51�pEU�1� Lor 19 � WIL- TOWN OF BA NJ TA_3c.6 A 1D 15 ar'L-o wl I d nab I-CaaD �-r.e1t,t. PL ;1L V7 _,_. P 55ro�JdL LAU-D SueVE`IorzS '[t415 FLAB IS NcT` �3A�ib oN tiN I�JSTLc)ti4E+yT' I'll SvtzVe'-/ ; AIJ'D THE OMe T'S 4 40uLD u�- t3E aE�►�I N EE>'C.5 Tr_-2v L..La MAC , ,