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Home My WebLink About0137 BAXTER ROAD - Health r k � 4 t i • e Y f J yo LOCATION SEWAGE PERMIT NO V .LLAGESEWER ' ' .y.•d.,h Y. -, I TA LER'S NAME i ADDRESS W -3UILDER OR OWNER ` J. DA T E P ERMIT ISSU E D D A T E COMPLIANCE ISSUED �.._ --� �� . ► .*: -o. .t. � ,� ., �� \ �� N 2� '. �s �� r V A y� bl R ' N^� .3 . ►,� �� a��,s L� �``� r, -� TOWN OF BARNSTABLE LOCATION ;79-1 —&Xa-d--Q` SEWAGE # AP j VILLAGE PV y t c-o ASSESSOR'S MAP & LOT3/O-v o6�0001 r 37 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER a- PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 t1 RSA. }5, s\ Y 1 1r/e 'A, IN 'V L {' l.ry= d, s 79 WSJ C) :l% , ,, 4 r►'�f,�+ 3.1 Aj 3 d n V. vo ij ''.� R.- 1• .V/ V* ' 1•lrE M ch ` . • try,p.�+'Z. �,1t , �;, l wax""• ,,,��- .I..� _ In �d.� �t�• �(,� AO 1V R08ERF LA SUNIKIS No.22162�Q i _+ •�Z^.'�r�� .:��•' �� IFS ,ra, � •S� ' 18 i3POTGE�LDVAT1o64..4x0 CERTIFIED PLOT ,Y P 'I f •c F a 1930 CONTOU -- 0 -- - Tfi r 2S ti ISth SPOT ELEVATION wy +/fit e S .�;;.,• f"tIHCiO CONTOUR 0 IR1 �iky}+; VEO BOARD OF HEALTH GALE+ r�= 3 v DATC-t 4 �¢ AGENT , ENGINEERING Cat /AI CLIENT I CERTIFY THAT TOLE# : �' o-i `+e 79079 BUILDING SHOWN Olit 'T#�I :i� REOi3TE'REO JOB W0. r ..�,. li®R, k, ��x�CIVIL LAND CONFIOR23S TO THE Zvol DR.9Y 1�� A ,M, R ------�-� OR BARNSTABLg Tit MAIN ST. CH. ®Y 1 Iz� >2 ��_.'►'r�' "� HYAN413, LASS. MEETS Of � QATE REG. -io A V "7. -�-7 .4 VY IV ",4 4, co IN "p. CLEAN .SANG AA CC)vzrO ILL 4. MTh 2*1-AYER 4"CAST OF IRON P/PZ /4000 CFA 4. • 10 WASHED SMN46 DIST'PEIT IT SEPTIC TANK do v 4 / I * WASNAEP STONE 11 Io0 5SErZ f 0 p Pop P17 OR ZVVIV. IMV,CA�r 4eL4EVA7'1A0N5 0 IA?YE,R7' A-r 04VILDIN6 9 7.0 Fr IN4,ET SEPTIC' -r,4,OVK 96-5- Fr a FT 01,4 1-1- 0-1 C 7-1WILA-r)O.V,) OUTLET SEPT/C TANK 96.3 Fr sox 960 P7 -T4EC-r1oAf OFGROOND WA-r ej4T TABLE BOX 9 s•9 F7 7ASULATIDIV SEA CH IV6 -=/T oim-olv-TION A -3 DR515M Cql7-,=,TIA a 6 FT. 3 DiAlerNSION 0 4- F 7-IV) I.: NV,Af8"=R OF BEDROOMS G,4A?dAG,CA0P15.oP05AJ-41-V I r 6) SOIL I-00 rD TA It e-771MA7-et> F-LO AV. 3 3 G-41-1PAY S014 7-E57- 0/ $014 7XrST#,Z A(41,418ER 0.1-' LEACHING JID/7'S-- 97. jPEfit jml'r / Fir S- 5v. PT. RESULTS PV17-HOSS.-D 19Y A*e,,#q C OL A 7,#*ON *Q.4 re jof 4&0r'rOM 4Z4CN1AlCr PER P/r so. pr 'L MJAVINCH T07A4 ,4ZACH11VCr AREA Z 614 F77 C pZpCo g�A 7/0 V RA7a 0 f -L MjjV.11A(CN -TOP. RESERVE ZZACNIMS AREA a 54P. F7.' f 7- c 0.4 M. Aj ll S- ,el w", :4P ROBERT, coA,4z S a VA P. E?UNI.Kls No.22162 0 1 C-,0.4 11!;S I G 5A-DMZP C W ffM&l J VAM WAS J IX ti 71-2 AIA 11-Y or, AL 7-- k" 7 S No...........l ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF.......................................................................................... Appliration for Dispaii al 1Vvrk, AvuiArurtWn amit Application is hereby made for a Permit to Construct~( or Repair ( ) an Individual Sewage Disposal System at: ........... . .... .._____--•-------•---------- ----•--- -.. :.__......... ..... Lowti0�:+G � ��r --- or Lot�0 ........... Owner Address -----------_----------------- -..... ' ................. Installer Address dType of Building S of................._..........Sq. feet V Dwelling—No. of Bedrooms ...............................Expansion Attic ( � Garbage Grinder (• ) Other—T e of Building ............................ No. of persons____________________________ Showers — Cafeteria a Other fixtures . ------•---------------------------------- _______________, ----- Design Flow _ ��.� .__.___.gallons per person per day. Total daily flow__._.._._.__:� v_ _.___._______.gallons. W "" W Septic Tank—Liquid capaci t)P453rQalIons Length................ Width................ Diameter................. Depth................ x Disposal Trench—No. __�_________________ Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..______`...___.. >ameter.____.__,s' ... Depth below inlet........a....... Total leaching area_.W.�,P__sq. ft. z Other Distribution box. (� Dosing tan ( ) '~ Percolation Test Results Performed b ec k.......................................... Date...... __ '.... � Test Pit No. 1�.��_..minutes per inch Depth of Test Pit.................... Depth to ground water_______________:______.. (% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ w -- --- 1 .. --------------- ------------ Description of Soil. S J: -_- _-__ `r �"' l` -. r '--•-• -•-- -----•.G--- ---•----"""-r-...__..._.-7- --J ----------------- - •--- ... 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'TTLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be i by e`oa d _liealt� Sig - - - ------- ° Date -Application Approved BY -Gi�r///1 ------------------------ - _•-�?- �J- Date i APPlication Disapproved for the following reasons----------------------------------------•--------------------.................................................... ...............•-----•.....--------•------------------------•-•-----------------•------=--•-•••----•--•-•-----•---------•-----•-••--•--------------------------------=-------=--------••-----•---•---- { ac PermitNo......................................................... Issued.......................................... Date No:.......... ... w Fm$....-^�d............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................................I........OF.......................................................................................... Applirtt#ion for Bhipogttl Work ontrur#ion Errant Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ........................ ....... Y f Locatiy�rddress 4e �G or Lot No --- . � 4 r !Gro!' ----•---•------------- ---------------------------•---...... w Own er �rAddress a � G.!r-.......k^. ....... �1�.................................. ... � is rc�r. --... Installer Address Q Type of Building Shy' e-I-of............................Sq. feet V Dwelling—No. of Bedrooms..;; .-----------------------------Expansion Attic (� Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures . _. Q -------------- W Design Flow................. .._...._..........gallons per person per day. Total daily flow........................... WSeptic Tank—Liquid capacity allons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. ...:................'Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......... ....... ameter........ oOl _. Depth below inlet......_......... Total leaching area..W.?0..sq. ft. z Other Distribution box ( Dosing tan ( ) '~ Percolation Test Resullxs Performed by........1144,141%.�lI..��----------------------------------- Date.....•1'?'i�../.p''... aTest Pit No. 1. ,,_`5_.minutes per inch Depth of Test Pit.................... Depth to ground water........................ (T Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1. . . P O Description f Soil_._...._ �... .��..... _ x ry -- 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'TT LE, y g g p y S:of the State Sanitary Code The undersigned further agrees not to lace the system in operation until a Certificate of Compliascgeri as beeg�ii�'��y • eibo�a>d ----kealt�•�•tom..•-�� I Date Application Approved B �s�:��> . ii%�'r- PP PP Y Date Application Disapproved for the following reasons:---------------------------•-------------------------------------------------------------------------.......---- ..••••-•-•-•----•-----•-•...----•----•-•--•--•--••••-----•--••--•---.......-•-•---•--•---------•---••-•-----•--•-•••-•-•-••----•---------•-•------•------------•---------•------•---- ----- ---------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OFF HEALTH .......O F......... ......F/"•�.......................................... �rrtifirtt#r of Tontplittnr }, TH I TO CE IFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...... �A�l.......... . . ..... �,( /- ins viler. at ". �`�` 'z 5..._.a d3 l� t? - ----- �-�1'Yf'�'_GQ--„-- ±..�?�y has been installed in accordance with the provisions or--- f T / ` The State Sanitary Code as described in the application for Disposal Works Construction Permit No. [�.��-_-_____---_------ ' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRI! D•AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � 7 DATE:........::....�.�.... •-••-•---. Inspector... . �} THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH alp , y�� ............0F......... - -'.................................................. NO.......fd._L......... FEE-,.,?................ uhipastt1,� k� , o rtir ion �ernti# Permission s eby granted. -• ---•- - ----'�--- to Construct�j or Rep ( ) an Individ 1 Sewage_ isposal System�j �D, Street as shown on the application for Disposal Works Construction P i No..............�__ Dated.....�a.��.. I..... .. ..................... � 'g j Boa d of Health DATE...........- ...,... ( ..................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS