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HomeMy WebLinkAbout0020 EVELYN CIRCLE - Health (2) o 45 V Zi { S M E A D KEEPING YOU ORGANIZED No. 12134 2-153LGN FOOR�E MIN.RECYCLED INITIATIVE COMW107 Certified Souming POST-CONSUMER www-,dipmprem g sttotzao MADE W USA GET ORGANIZED AT 3MEAD.COM a - No....ql.--_-5� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Alip irFa#ion for Bispaii al Work Toustrnrtiun rrmi# Application is hereby/made for a Permit to Construct ( `)/for Repair ( ) an Individual Sewage Disposal „System at�• .--�V .. ............. .._... .. .- - o'� 1 - - ...................•------.--- ••- j/l c lioV-6.7 or Lot No. �/�Ilh/.,a(o(k - - ------------•-----.-.--_- ....................... W ----9 Owner Address ... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms........._ --------------Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ............................ No. of persons.....--..............--.---. Showers ( ) — 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 ( ) Percolation Test Results Performed by.......................................................................... Date....................................... 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.........--.---......... 04 .......-............................................................................................•--•-••••................................................ O Description of Soil....................................................................{ x W •--------------------------------------------------------------------------------•---------------------------------------------------------------------------------------...--••-••----•......------... V Nature 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 Co ce has been ' the board of health. Signed -------- ----- Application Approved By .... . / e. / ---------- -------------------- - ...... re Application Disapproved for the following reasons: .............................................. .. . . -- --------..-..-------------- -- ------------------------------- ------------------- - --------------o.------- q - ----------------------------------------------------- Permit N .... ../---- Issued / �' Date No.......VJ...... _ s� FIZIC THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Uispuial Work Totes urtiuit erati# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System rT_j n ...... l .. V�� C. ............ !lam-•-------------------------- ---•--------.........----•--•••-•••----•- A!• -------------------------------- Lot No. W Owner Address X___ ------------------= Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms_________ ______•--_•--__.__•--___.__-Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Buildiii YP g ----•--------------•-------• No. of persons....,........................ Showers ( ) — Cafeteria ( ) Other fixtures . "7---------------- ............. 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........................ fXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ........................................... ---------•--------...•----._._._._•--------•-•------•-......................................................... 0 Description of Soil.............................. �' / r ---------------.............................................................•-----------...........----•- x U ------•------•---•---•-------•--•------••...--•---........-•---•••------------------------------••••-----••----•-•---•••-------•-----•-•--•--•-----•-----•-------...._...--•--•-----------•-----•••--••. 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� h is beerri°ssued-by the board of health. Signed - ................. .......-- - ... ................. re Application Approved BY ���-.W ---......�.. ------ ....-- ----- ----- ............................ ---- l / to Application Disapproved for the following reasons- ...............--- ------------------------------------------------------------ -------------.................-------_-------- - - - ---------- - -- ------------------------........................----...----...-------------------------------- -----------------D. ------------------ Date Permit No. --------------- ------- Issued ---------------------------------------...-- ----------------..... ....---.--.1 --- f.......................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF. BARNSTABLE %Eertif rate of C�amyltttnce 'TH S IS TO C�Uf TIFY T t t I iv e age Dispos S ste ons 5ucred`� or Repaired ( ) ....... ........ ..... .......... .¢.... n r.. V _LL.0------..---- - nstQ le ..�......... �c �� a ry 1.. � . ....... .................................................... ........................... has been installed in accordance with the provisions of TITLE 5�f he fate E vironmental Code as described in the application for Disposal Works Construction Permit No. ..-- f...-A v� ..�......... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................... -��' - Inspector ------------ --------- ---------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 641 TOWN OF BARNSTABLE 00 No._. .�............... FEE......I............... iu uu M \ uuufrt iun �erutit Permission i hereby granted._.____....'_ . to Construct or Rp air 1) an I d-v'd al Sea=a� ispo Syst J atNo.- 1 = �!. f �t_ys .--. -- ............................ --• _ --•... ........ Str�t / as shown on the application for Disposal Works Construction Pe- No�. Dated...../. ._ ..... ........7. -- ----------•- ---•-•------------------••....-•------- ...___ / ✓�j - Board of Health _ DATE........................ f/,/-�- -•-- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS ASSESSORS MAP NO: �t -¢ - m No.---... :_`��� PARCEL NO.: �� - Fim s .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH ..............OF...... G� .�tL .. e_... Appliratinn,for Digpnattl Works Cnnnitrur#inn 1hrutit Application is hereby made for a Permit to Construct (lJf or Repair ( ) an Individual Sewage Disposal Syst at: ....:. . ... ---.c... ....�.L .. ........ ----• . . _ . . . ............................................. �o ati ress o.�..... . . n . ..... 5......................Owner Address Cr 0.�. .............................. ..........••.... C�� L ........................................................ Installer Address UType of Building Size Lot.a6 9�s^...__..•......:...........Sq. feet Dwelling—No. of Bedrooms...........3.............................Expansion Attic l(laj Garbage Grinder (f.0 Other—Type T e of Building No. of persons....................... Showers t� YP g --------•------•-----------• P ----- ( ) — Cafeteria ( ) a' Other. fixtures .................................. g W Design Flow.............. ................gallons per person per day. Total daily flow.......... i.5®__..._...._.._....gallons. WSeptic Tank—Liquid capacityyo.�9gallons 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 to ) Percolation Test Results Performed by._..�_ mac __ .._L?_:.!il.�� � _ Date___.___lZ1171h' 9 Test Pit No. 1 p��55_..minutes per inch Depth of St Pit._.. {. 4 Depth ground water..... 44 Test Pit No.*&A-_minutes per inch Depth of Test Pit.. .. ...... Depth to ground water........................ M --•-- ................ ................................................................................ O C auk._...f' :- �L.3 o`* Description of .,oil.._._.�__� .�:. VW -••-------------------------•.----------------•-•-•------•--------------......-••----•..----•--•.•••---•-•--•-•----------------.-----•••-----------••-------:•.--•-.....•---••-••••••••...............-- Nature 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 Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the rd of he Signed ...... .G .........------•--------------------•---•- -- `�K7D �Application Approved BY ... -•----•---••......-•••_... J-g Application Disapproved for the f ollo ing reasons---------------•--•-------------------------------------•------•-------------•--------------•-••--•••••••--.._._ -----•---••---•---•-•---•-•-----•-••••••-•......••--•---••-••----•--•---.....----•-•---.......•••--•--=---••••-•-•-•-•-••---•-••-------•--•-----••-••-••---- ........................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..�'✓. ...................OF.... .... 6 z5. 4... ... ........................... Tntifiratr of Toutpliattrr jTHIS IS TO�RTIFY TlW the Individual Sewage Disposal System constructed (�r Repairedby.. t' :5..._...t.._t'l�.S..�.o................... ------.._.........--...............................................................__.......--...-- Instalyy�� has been installed in accordan:�with the provisions of TITLE 5 of The State Sanitary 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........................................•-•-•-----••••-•-•--------•-------•---• - Inspector.................................................................................... -------------------------- - - - - - -- - - - --------�- -----• No........-R6.:4-I _ Fics..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA -'H ..._.. " a .............OF...... �" :. 1.. ....................... Appliratiun for Mipaiial Works Tonutrnrtion Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at ,„. ....... ....... Locate - 6.n1:1 ss Owner (� /[�. Address . .............................. ............... �:. ........................................................ Installer Address U Type of Building Size Lot_ : . _ �Sq. feet g— _____________________________Expansion Attic (f9dl Gar age Grinder Dwelling No. of Bedrooms____._______ a`4 Other—T e of Buildin yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures................................................................................................- . --- _. ............................... Design Tank—Liquid� .gallons per person per day. Total daily flow..._._...___ ..................gallons. p capacity.5�gallons Length................ Width................ Diameter....:........... Dept h................ W Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. x 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq.jt. Z Other Distribution box ( ) Dosing��ta„ ) Percolation Test Results Performed by.... ....... :r:_ .__c :'.... " ? ' r Date._ ./� 7A.. Test Pit No. 1 �"_ ___minutes per inch Depth of st Pit__ `� _ Depth ground water_. 44 Test Pit No., _1A +minutes per inch Depth of Test Pit................... Depth to ground water..................... ......._._._rF— __ _ D Description of Soil �rP " , ? t3 U ----------------- ............��---- --- .............. 'cf ... .Y': . Gx�-� .. .................................................t ... .-•---- .�, � - �--••-•------------ W U Nature 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 Sanitary Code—.The undersigned further agrees not to place the system in. operation until a Certificate of Compliance has been issued by the)e�rd of h t f igned.... r'r� s j....................} Application Approved BY �44,E •-� --------•---•-•-•-•---•-----•- ---- ----- r ' Date Application Disapproved for the follo ng reasons:......-............................................ ...............................Date............- -••--•----------------------••----•-•---...--•----------••-------•---•--•--------...---..._.....-----•---•-•---------•.---••-•------•--•--•-••--••---•---•----•--••-----•••••......-•-••-•--•-••------- Date PermitNo......................................................... Issued_........................................................ ate THE COMMONWEALTH OF MASSACHUSETTS BOARD QF HEALTH Tertifiratr of Tompliatta T IS TO,GF RTIFY, Tljq the Individual Sewage Disposal System constructed ( or Repaired ( ) .--- ----•-• ............... --.................................................................................................... Installpr has been installed+jn accordan with the provisions of TITLE 5 of The State Sanitary 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................................................................................ . Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS n�i' " " '{^�"f" ` ✓ BOARD OF HEALTH Mtn FEE...... .. ........ .� Disposal War Tonufrurtion Beni . J XAv lk4luis6onAs4oreby granted---- -r?e _._.S11.1cp 11.................................... .t v.+-_ . .t.i.......... to Construct or Repair , I an ndivrd al Sewage Disposal Sr tem `�' 1 at No...... `Sati'_�. U"..... ­: t �'�'% " y�a.`.��. ��. Street . 1- I, ( \ f as shown on the application,for' Disposal Works Construction Permit No. _________________ Dated_:__:_ - ' Bo6diea " DATE(f.)�.1�...... ©t • ............................... FORM 1`LS A. M. SULKIN, INC., BOSTON t;7f -^y _ 14 -d 4 �_, u t t q -.1, .' r r, a' r�•v r Pr L '.t h'Ce"v r 3 a F'yr ,rl tl- d%. l .1 y 1; ��1. �.,�.tt/, - /'� , I ary d ;" ''43 $5••t Ii F'i 5'i '+> -v-' Y b yi' x �; V �l •I• ,,,;., *, f ! rtF.or �I P_ I~"' !k,;; S'' " z'.'�-". .k',t r*" s •.+ s.§ ,.S.,C�'�fi `'rLp ,� ' t t �+` ...sy s,a t�nr Sly a F I - " . rt A, z+r�n"7 . t t.. 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NG11 i he location of an ex�s tin s.bfi -�ground sewcra c f►' , .,wells 11,'.or other 'ut�l tze5 S.hoy�n o�� t,ss �1.an �S;Xappry � c ti - { I N , matQ .onl as c ot.ermined°fVI,rom recorc�� , nd,or Zaerhal •, ..�� � \� •�r •,r �.1 e� information Thor cont.ractor'`�is�resppnsibleifor` the r -iri Dd'" L `r '�° IYAZ) � �+ d v r fi atibn o 'tll�rex s,*pn locatioris� ant thQ rfiQlc� ;x;;f - y CA:L ! ' .4 _ 4, , b. $ E � o DATE I .y�4yG hG , a A .DREDGE ENG/NEER/N6 C4.. IN . t�; t '�� i . ` ,�j�M$` y 6 � f -.-�-�1, . CI.IENTt � Jt`FI` C}�RTIFY�3.THAT THE' PROPOSED'w { J "' EGISTERE REGI3:TI:REO J04 NO : 5�/- BUILDING ;SHOWN ON THIS: PL AN j `°� :CIVIL _LAND ,`r1., �`.I� + §"_ +* ;CONFORMS TO. THE .,ZONING, '' •1*'g 1' ` '. t 7 11 i - h -t ` 4i-� EN0 VEER 'R`V � ,: pR.,I Y .! >OF,.t' -. � , E� A s F t F,�� � s Sr i YX, L v�.� ?a- 2 ' ;"t Z. -r <�f ,c. x�� ;7.12 MiAI N STREETL�� SA,: CN;QY ��Mll1��?�� ,,' � � �_ '' >- .r'if w fa'w•51 'c o,Iri',,t i,* t !r "F x w _ ...,a 1 ,....r,'; 'Y•'. d ;`s ,- '.HYANN I S•` �MAp9S: f SHEET ��-4f A E; � s� REG: LANDiSURVEYOR �- 1 ;•Y �._ �' . ^+ :> y 1 �..., f. t->'a ) r� AC (} `• p \ gre tee.: �,x+ },-y, '. z, , -ham' s'a..G a's;.."•-'1 6 it�' ,� a., 't.��` f .p. i t hit ... n ra .I"I� s,l r- { ' s a '"14 .:t u a: i •*ki:#y:', y. w'S§ #' z ysA',t14�'Ejc. y q F�a 5...k. tr., 1 e'•,ry riy�: .. Y4 s ,x ..^k.f, + .. .. ,.<K a,. S'i,er r' v,3... ..•?_ .aan xc `:i,'x �dI. J,I,,s..+Y:1..,._. ,r.�: {:tY' * h",. ,t .xi,.-.x.`:r .. E/TNER ?'NESEPT/C T,4/V�AC DR 20 FT. M!N• _ P1r ARE MORE TH.9;/ /2 SELOW - - =KAOE� fa 24'O/AM ETER COyC'R�ETE COYERk /D FT MIN sgALL E ,aROUG�yT TD GRADE. i;N EXTRA ,j".PVC PIPE S 1-YE,4Vy CAST /?O/Y CO1/ER Sh'ALL 9E USED P/TCN T! /1= OR/�/EN/.4Y �! �-- � �- CODERS-•.,.-� �B PFiQ FT; . 2 MiN. T— CU VER CLEAN SANG I f (. 4"DIA. - 2"LAYER � !4: SCHEOULS44 P o p.Y.f..P�PE :� � /UO�J GAL. - � -• ao 1.`��• • • • • • -Rp`4� aF //B• '!��.4 M/N.'P/TCN o o WASHED STOA/Z D/ST SENT'/C TANK o „ . • • •i . . . . . • • ,oo a , BOX v v o • • � $ , , • . • � . , • :- .. - • v a � • • DEPTtI • • � • o o 1�,45HED STONE ` ;, o - ��_ •;, /SIX Z,S' 377 • • • • c�asr SEWAGE C � moo, • � • • • pp a !<' X/ j v �o• r • • • • • ' e o / � i/3 0 // INYFRT AT BUILDING C SEE TABULATIOAV) ' 3d"f1 PST fA?AC17- /2 FT O/Al+f• INLET SEPT/C TA/VK FT. / 17 Gl/TLET SEPT/C,T.4NK. FT * GROUND, PVrATER TABLE xT my.,FT D/STR/BUj/ON BOX 0 FT. r SECTION 0 A' -. . OuTLETD/sTR/�B/lr/ON BOX �G'£' FT SE /AGE O/SPOSA.L SYSTEM /IYLET LEACHING F'/T 2 FT. : -rABULAT/DN 1 /s v" O/MENS/ON it $ DFS/61Y CRITERIA . GALE /4 X-NS NUMBER OF BEDROO/�95� � DIM NS/4N C F GARgAGE.O/SPOSAL UNIT it/ri � , = SO/.L LOG P-S2.4Z (i-vTZ� TOTAL E-ITIMA'T•ED, =LOH/ ^6gL. DAY SOIL TEST#/ SOIL TEST#P SOIL: TEST 3.o ELEV /8.0 ,DATE OR- SOIL TEST 12 6� NUMBER C7iF �EaCNlNC: PITS -... f ! FLE✓. i S/DE LEACHING PER API T, / ,SO. RT. f — _---Q TO�1���� Sv/3I04PSl/LTS /w/ITNESSED BY Z X COic/LO�I 9oTTOM`LEt1CH/NG DER P/T_��3 S4. FT ' '/-S� IJSCLSfi�WC P&RCOLAT/ON RATE / TOTAL LEACH/IYG AREAr� xCOLAT'/ON RATEI�2 MIN. /NCH RESERVEGEACHI)VG AREASQ. FT. I. >A•", 44 s_A 6' 70� Sv3r0lG SOiLJ,. 1j-'' l' .mow L T 3 E✓ELY1/ C/2C4' ALBE �r A. T� �� Rj? ��i, ` f91G`f7/rise CENTER✓/G[E u MORSE 1 >y ?.e Sttrvt� C,✓I y ' �� ram`/ ' '�,,��; � ,�, �,��, wz �'�' car,✓ .meD . '= EL DREDGE'ENWVEER/NG CO,l NG. 7/2 MAIN S7 NYANNl9, MA.>S•UPIATER ;�'ovn< /ZO -- "•% „ NO GROUND yYATER ENCOUNTE.�EO C`t./.Ek Y �eEEN6'R/F GATE ,` GROCJNO Lv/aTER AT EL.E✓. . /2 $ /y�i SHEETZ.a _�— . - ...„•.,,n-,,.9,�.r.:z•- ..;-...Yvc«..:�»r-•sw:aax,....r•us.x .,tea.,:�!�i+ar-.A-.w„n - •. • rompteted by: HIGH GROUND-WATER, LEVLLr COM!'UTAT.I OW` _ Site. Location:'.` . . YE,LYN ::�/�CLE tot No 22 Owner: ddress. �ou .s/O CCAOrZV'iL < _A OZ632- ' Contractor: Address: ` Notes: f; I STEP l Measure depth to water table to nearest 1/10 ft. . . . . . . . 12117. - date l:. f' STEP 2 Using Water-Level Range Zone and Index Well Map locate'.- site and determine:. n ' A), Appropriate index well_ Y B) Water-level range zone STEP 3 : Using monthly report'''Current:'`. Water Resources Conditions" determine current depth to water level for' index well /2/ $S mo yr STEP ` 4 Using Table 'of Water-level f Adjustments for index well STEP 2A , current d&pth to water level for index. well " (STEP 3) , and water-level n STEP zone ( 26 determine) t ne water-level adjustment l STEP 5 . Estinate depth to high water f by subtracting the water- level adjustment (STEP from measured depth to water ��' level at site (STEP 1). . . . . . . . . . . I. — n