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HomeMy WebLinkAbout0103 MITCHELL'S WAY - Health 103 Mitchell's Way Hvannis A = 290 151 1 0 0 e a � e � TOWN BARNS LOCATION. C �EWAGE # VILLAGE0 nazi c' " ASSESSOR'S MAP& LOT '-INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPAC,= 110 ©j GaI LEACHING'-FACII,=: (type) e,/t (size(a Q mail, NO.OF BEDROOMS `=xa _. BUII.DER OR OWNER cm PERMU DATE: 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 6 Edge of Wetland and Leaching Facility(If any wetlands exist 0) within 300 feet of leaching facility) Feet Furnished by � � � - - � . � � � r�'� �. �_ t � f �1�..+, `fly J �R+ �� „ - 0 �,� ... �.l�' G �.: v�`a .� ��., .��, ;w L` t TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION / MAP NO. PARCEL NO. /.),1 ADDRESS OF TANK: i 0 3 � VILLAGE: I : Numbwr atr�40t MAILING ADDRESS ( IF DIFFERENTFROM ABOVE) : OWNER NAME: 21 C __Lo( -3=1'y)y) PHONE: INSTALLATION DATE: _ BY: 1rLwyNe's INSTALLER ADDRESS:n J. �4' -We- 1 4W / "CERT.No. *TANK LOCATION: _t�aseW6Cr' c o c a on z a a TAN K L O O A T I ON W I T H v�Q O P Q C T T O a U 2 L D 2 N 0) CAPACITY X9 TYPE OF TANK :]fd AGE YRS. FUEL/CHEMICAL TESTING CERTIFICATION [ ] PASS C ] FAIL DATE LEAK DETECTION C 7 CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ I YES C ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ) YES C ] NO DATE CONSERVATION C ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. C J3 s-y ] DATE 11.1g * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD i j4 TOWN OF BARNSTABLE !- UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. 0 PARCEL NO. I ADDRESS OF. TANK:... Q J , c4 o VILLAGE: �""�UR Y!Y1 I Number 0tr�40t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME: �I YI r) PHONE: x INSTALLATION DATE: BY: r QYA INSTALLER ADDRESS: 4 d�-4/-CERT.140. *TANK LOCATION a eyo-C, . (L)GmQP7 2 me TANK L_O(=AT 2 ON W 2 TH AQOPQQT TO mu 2 L-D 2 NO) CAPACITYsn5 TYPE OF TANK �l AGE -C> _YRS. FUEL/CHEMICAL TESTING?EERTIFICATION C ] PASS [ A FAIL DATE LEAK DETECTION C 7 CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ I YES C I NO DATE CONSERVATION C ] CHECK IF -N-/A L P DATE / BOARD OF HEALTHLLTAG NO. [ ] DATE �C. PLEASE PROVIDE A SKETCH SHOWING THE TANK ..LOCATION ON THE BACK OF. THIS CARD .,--:.. - :h - '!t=... :..a.:..r.�`'�,'rt't:.d'-•.�...»x},",ncw r'�•'•(+�.,-.^y'`.�*i°��..-.�v-,,,.rq�'"`4v.Gc'sra...•r� ...r��,r.'ta, `s•-asT^...,..•..-.. . .x...--.�.. - -. '+,tr ,,..-..r-.x,'r`"t •-_ _, - TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION o MAP NO. >ll() PARCEL NO. 1 _ 1 ADDRESS OF TANK: O `` = f' S r.11 l�Ii VILLAGE: - .!!. 'v 1 Number @tr��t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : OWNER NAME: Klchx� t a�Yl PHONE: INSTALLATION DATE: BY: f INSTALLER ADDRESS: , t n —W'CERT.iJ0. gn *TANK LOCATION: ' tl �rr'��r (D @@ C fV 2 D C TANK L O QA T I ON WITH R@ O P@ C T T O mlJ 2 L D I N 0) ' CAPACITY .)-9 TYPE OF TANK aI+' I AGE r> YRS. FUEL/CHEMICAL TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO -DATE CONSERVATION [ ] CHECK IF N/A -DATE BOARD OF HEALTH TAG NO. [ � ' ] DATE * PLEASE- PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD y�g J No. / / �� Fee too THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Migozal *pgtem Com5truction i3ermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon(Per_❑Complete System ❑Individual Components Location Address or Lot No. �'� o �f M Owner's Name,Address and Tel.No. fiF7t�d'hn1� d�.,� Ct<l1Jf� i�"OlgA3rS .. Assessor's Map/Parcel F.0, Deb j 3 S 044-11 Atit AJA. In aller's Name,Address,and Tel.No. Designer's Name,Add sand Tel.N A UVIS1C � 3o�es CANAL LZa S%ALVe4tnq .o . �0 6 3 S W a►IG e.�q W�A n 5'7 i 3 0 6 et.� T"u!wo w Z.ZA&b c . IS s'2- Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building�( W]e_ No. of Persons Showers(/ ) Cafeteria( ) Other Fixtures �'ti Design Flow '��� gallons per day. Calculated daily flow �'7q gallons. Plan Date ® "2:5• cly Number of sheets Revision Date Title Size of Septic Tank �� Type of S.A.S. _Gt,`m b e{—(2) 5 Description of Soil (r.d&VSA- `9I ­,�k rrN APR ftha_ Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure t co 'ction and m enance of the afore described on-site sewage disposal system in accordance with the provisi ote Envir al Code and not to place the system in operation until a Certifi- cate of Compliance has bee issue y th oar ea Signe . Date J Application Approved by Date ter-—I Application Disapproved for the follo ing reaso Vs Permit No. 25 Date Issued TOWN OF B STt�B % �1 , �+ �(� LOCATION 'f C `SBW,AGE # VILLAGE_ ASSESSOR'S MAP & LOT . INSTALLER'S NAME&PHONE NO. G f ZA j—Tan SEPTIC TANK CAPACITY I G D Ca a 1 LEACHINGFACILITY: (type) Uj(size// d orl NO. OF BEDROOMS BUILDER OR OWNER -� PERMUDATE: 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 i G� -d No.' t� $` Feed 1 THE COMMONWEALTH OF MASSACHUSETTS Entged-m computer: Yes PUBLIC HEALTH DIVISION -TOWN.0F BARNSTABLE., MASSACHUSETTS 01pprtcation for Mtgpozal *p!tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon(&4—O Complete System O Individual Components Location Address or Lot No. �� C. "/' (,eta Owner ' ;s � 1 Name,Address and Tel.No. Go— s " -7 /- R Assessor's Map/Parcel .�gU�f P,O . Sax- b y S WAZf lj&?4 0A . l 25 In let's Name,Address,and Tel.No. 00 � Designer's Name,Addre s and Tel.No. o 6 • , w_a 3awo-S CANAL- LAWth SkAp_v"109 I,°. Q , O � 35 "WAR e(N4a+� tMA oZ5'7( 3 U(o 0 ,'b �� naa�rN uZ2AR-�S � MI� 53 `2 �. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Trdtm e.. No.of Persons Showers(/ ) Cafeteria( ) Other Fixtures Design Flow 3 gallons per day. Calculated daily flow T gallons. Plan Date Number of sheets >' Revision Date Title Size of Septic Tank Type of S.A.S. Ar Description of Soil R f1C V�iQ. � 171(1Grr�" A y�,�t Nature of Repairs or Alterations(Answer when applicable) t Date last inspected: --- Agreement: > The undersigned agrees to ensure co ction and m ' enance of the afore described on-site sewage disposal system in accordance with the provis' o he Envir al Code and not to place the system in operation untila Certiffii- �, ,cafe of Compliance has bee a issue y th oar ea 5_ �J Si ne Date Application Approved by Date..,t— 1 2,=� Application Disapproved for the folio ing reaso VS Permit No.�7 p- �k. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACH�ISETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by at .�..� has been constructe&in accordance with the provisions of Title 5 and the for Disposal Ystern Cons ction Permit No. — dated Installer Designer ., n. The issuance of this permit no L e :trued as a guarantee that the,. 9telnwiilll,u/ iio as dls e Date. 1 Inspector PIA; --�-'----------------------------�-- 17_3 No. Fee ) a THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS Mttpogal *potent Conotruction Permit E Permission is hereby granted to Construct )Repair( )Upgrade( )Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: — 4 , ' / Q Approved by �. \� .. m •� o 13 ' 1 ' CIO I A 20 PAoS .ays� LOT 1 17 7. ' 10064f S.F. 108. 80 , THE FOUNDA TION SHORN ON THIS PL AN WAS L OCA TED h J BY AN INSTRUMENT SURVEY ON 516199 AND EXISTS ON THE GROUND AS SHOMN. OA TE PROFESSIONAL LAD UR TYOR PLOT PLAN LOT 1 MI TCHELL S MA Y, BARNSTABLE MA SCALE I " = 30 ' MA Y 6, 1999 CANAL LAND SURVEYING 306 OLD PL YMOUTH ROAD, BUZZARDS BA Y. MA PROJECT mumaF l 99-040-01 GENERAL NO TES.' 'ror ovY2fE-r rE SOIL TEST PIT DATA J. THIS PLAN IS FOR THE DESIGN AND INVERT ELEVA TIONS.' L'' Z ' b T.P. -1 T.P. -2 GRND. ELEV. GRAD. ELEV. CONSTRUCTION OF THE SEWAGE DISPOSAL S.w. ELEV. G. W. ELEV. FACILITY ONLY. INVERT AT BUILDING Z ,20 R. ALL CONSTRUCTION METHODS, MA TERIAL S AND INVERT IN AT SEPTIC TANK 2 MAINTENANCE FOR THE SEPTIC SYSTEM SHAL L INVERT OUT A T SEPTIC TANK 2 0 .00 ACCESS COVERS MUST BE MI THIN 6 " OF FINISH GRADE. CONFORM TO MASS. D.E.0.E. TITLE 5 AND LOCAL F)os I $o GR..}-v�- BOARD OF HEAL TH REGULATIONS. INVERT IN AT DIST. BOX 23.g�_ ,�5 �Qe OV�I�- S • •S PERC C TEST INVERT OUT AT DIST. BOX Z3•?d ' L,, 27, 0 p 3. . ALL SEPTIC SYSTEM COMPONENTS SUBJECT TO 'Z 3 •�b -'' VEHICLE LOADING (I.E. UNDER DRIVEWAYS, ETC.) INVERT IN A T S.A. S. 2 3.sd �-`- -'� MIN. 2 OF SHALL BE DESIGNED TO WITHSTAND H-20 LOADING. - 1-1- s`p 2- ' t 4• MIN 1/B -1/2 DIA. BOTTOM OF S.A. S. LIQUID -� rl� WASHED STONE I B�EAV OS 4. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR OBSERVED GROUNDA'ATER o APPROVED EQUAL. DEPTH GROUNDWA TEA ADJUSTED GROUNOWA TER m�� r p p BOX 3/w SHED/STONE 5. BEFORE STARTING CONSTRUCTION CALL DIG SAFE -�} GAI.. 1-800-322-4644 FOR LOCATION OF SEPTIC TANKTfS UNDERGROUND UTILITIES. 2.1. 6 ITDIT PIT SEPTIC TANK 6 D-BOX TO BE SET ON A 6. DATUM IS A S S UM'E D 6' BED OF COMPACTED'0MED STOVE. CONTRACTAH TO WATER TEST D BOX TO PROP. S.A.S. 7. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE SHOW LEVELNESS, WITH DEED RESTRICTIONS OR ZONING REGULATIONS. IT SHALL REMAIN THE OWNER'S RESPONSIBILITY TO OBTAIN ALL REQUIRED PERMITS, SPECIAL PERMITS, DA TE.' VARIANCES, ETC. FOR THIS PROJECT. P S 7 5 9 , TEST BY.' 6, IT SHALL REMAIN THE OWNER'S RESPONSIBILITY. S_Q I L L�LCL WITNESSED Sr' TO HA VE THE PROPOSED DWEL L ING FOUNDA TION DESIGNED TO ACCOUNT FOR THE EXISTING GRADE 0, E N O. Z AND SOIL CONDITIONS AT THE LOCATION OF THE PROPOSED DMELL ING. ,, , „ Z 0 PERC. RA TE MIN./ IN. 5 A o o-i Tot) &,i n ✓ V.✓ Z) •' 13 5 v13 70IL— s� 2 5 3 - DESIGN CRI TERIA. c -To H-G) 6fwn N" I.l Z 3 DESIGN FLOW. u Nl r�� s o M c `, M 11 1.1 i 5 " 80 N __3_. BEDROOM DWELL ING 1 10 GAL/DA Y PER BEDROOM EQUAL S 6 b GALS. PER DA Y. ., Aso ��°►R8�6� G�-)���� 7 SEPTIC TANK REGUIRED.' L� Z 0 _ t 8 w 132 GPD X ZOOX - aG0 GAL. ---- 9 SEPTIC TANK PROVIDED.' 10 O GAL. SIZE OF LEACHING FACILITY REGUTAED v 12 DESIGN PERC. RA TE Q G MINUTES/INCH G v I ni Z-, r — ___._, , -c7�%'C9'J - 7 GAL z u;� PER"uA4-, No 0)Al `.R L - 1 4 --- I SIZE OF LEACHING FACILITY PROVIDED.• 15 cAp r'r� PERC TEST RESULTS PERC RATE : <_ -4ti� , �.�_./ _,�/L / __- SIDEWALL t S.F. X - l 1 Z GPD BOTTOM 3 2 5 S.F. X 0.-Iq ' ZL4 0 GPD WH ITNESSEO BY: ro _M V-Cor� _ TOTALS 4`7-1 S.F. — GPD A�ZSTn►iLE BOARD OF HEALTH �ti�''° DATE: _ -Zl-7laco_ REVISIONS.' NO. DA TE REVISION 13 ' m vj crj ih �A,,t ,,ras, i FtoGEFj PAUL .� C 1140.3(A20 , ? , ��--- - zv rn CSC 'CD O PLAN SHOWING THE DESIGN OF A PROPOSED PAUL s`` ' SUBSURFACE SEPTIC DISPOSAL SYSTEM LOT 1 17 7S. F. T MITCHELL S AA Y, BARNSTABLE, 10 MA 0 # ' 10064f 2'!X� � No.s�aaa ��'; _ � . SCALE 1 u = 30 ' MA Y 14, 1999 8. BO � � o�-S,,c, c�''� 05_ CANAL L AND SURVRYING 306 OLD PL YMOUTH ROAD, BUZZARDS BAY, MA i� o �_�__ I 0 �COJU2NO 1531/3 RED 10% 0 0 0 0 TNo.. w j �.....140........._ ®O�QbeS�PCXM0t= THE COMMONWEALTH OF MASSACHUSETTS g .,k4el BOARD OF HEALTH V/ Sig Data TOWN OF BARNSTABLE T Appliratinn for Disposal Works Tonstrnrtinn Frrutit Application is hereby made for a Permit to Construct (A or Repair ( ) an Individual Sewage Disposal System at: /D.3 A,rr H EL GS Vif,�y /��/�vn/l S L p �/ z U J�i9_,e / r.5anon-Address ^ v or Lot No. l' .._. ..tt --------- Owner Address W Address . ^q. � Installer Address Type of Buildii Size Lot_._f a,.J lq�..S feet , XDwelling No. of Bedrooms............................................Expansion Attic �/(9) Garbage Grinder VO) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures ---------------------------------------------------------••-••-••-------•••-------------•----•-•-•--•---- { }} W Design Flow...................�ll�.........___.gallons per person per day. Total daily flow...2.,1 S S x .. L 3ggallons. WSeptic Tank—Liquid capacity_ 4Ae.gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length....... .._�._.._. Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter........ .......... Depth belo�) et._...._._........... Total leaching area....9.lQ.6__ q. ft. Z Other Distribution box (><) Dosing tank ( ) Y'�Z ! OF 57041E .549 �7/D '-' Percolation Test Results Performed by...__..___1�_l.LIL_! .'t!... L _ c! Date...2 _(�5ZS.%, Test Pit No. 1...<_-?,-___minutes per inch Depth of Test Pitr3.�./­'f' Depth to ground water.LLaN ...A�'c rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --- -----------•-----•-•--.------------•--------..------------------ ------ -----------------......-.-----------------•-------------- D Description of Soil-------------0..... EET......5•`�� 7-?- �-n--�--`J �'r o1�- ------------- � 2--11--F6 �--4 �-a. -Ta �'/�� ��'�� Wi?N l�/??�GL••Sjv.�6S- w Z. ----------------------------------------------------------------------------------------------•--------•---•----...--•-------------••-•---------•--••----•------------••--•-••-•--•-•-----•--•--•------. 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 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 .. - -/ --------- --------- --------------------------------- / v ;���---1,�--[:l G 1/� �f�?/lVf� Dare Application Approved By ................................------............................. ----7-== l�r--9�1� Application Disapproved for the ollowing reasons: ---------------------------------------------------------------------------------- ------------------------ ...................... . -- -- ----------- ------------- --- --------------- ----....------------...... ---------------- . ------.....--------------------........-- -----. ........................................ Dare Permit No. ------------v.---------- �, �................ Issued .............-..--...--------------...--------...--------- ...... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certi irate Df Compliatt ie THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( X ) or Repaired ( ) by-------------.......................................................----'--- ................................------------------- ------- ---------- -----------------------------..........--- at .-/O.3 �.. �--� .�.. L.�......-Y--�//�-`Z / 12." '�V/.� PA....................... ....................---- 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.. ...--...-�.�j��. "--- ---------- dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU D AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------- ---- ------------------------- ---- -------=----................------ Inspector ---------- --------...----------.....--•---. --------------------------........------ -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , TOWN OF BARNSTABLE No.... FEE..../a.�....... Disposal Works Tonstr inn antic Permission is hereby granted-----------------------------------------------------•--••----•••------•••--....----•----•----•------•-•-••--•------....-•---................ to Construct (,X,) or Rjpair ( ) an Individual Sewage Disposal System at No............6 v. =1 T Gy LLf` Wf Y. - /, 14 iUAJ/ 9 ........................................................... Street as shown on the application for Disposal Works Construction Permit No.. _�_.•_.�y.. Dated.......................................... ------------------------•-------------•---------------------------------------------------••-•------•-.-• Board of Health DATE............................................................................... FORM 38E08 HOBBS 6 WARREN.INC..PUBLISHERS t No................-.....-- Fss............._................ THE COMMONWEALTH OF MASSACHUSETTS �-- y BOA Rff F HEALTH O ITOWN F BARNSTABLE 7 ' Appliration for Disposal Works Tonstrnrtiun Prrutit Application is hereby made for a Permit to Construct (A or. Repair ( ) an Individual Sewage Disposal System at: /D N G,N EGG E'/A s ,T .s ....----�'-- !..�.�N�s Z� T�/f �.z� ��.... - ......... ----;- ..... -- .. Lo ation-Address or,Lot No. .. p. .n%�_. .......... 2. / oi_�ae�••----1�---A:.. t) �- �'h_T_l �� /./.:.s...t�I_./...`�--•----------•-------------------- •--• Owner Address W Installer Address Type of Buildin Size Lot---� a.!a 4---Sq. feet V XDwelling-2No. of Bedrooms............................................Expansion Attic ,(rfo) Garbage Grinder 00) Other Type of Building ............................ No. of persons.:.......................... Showers ( ) — Cafeteria ( ) d ----04 Other fixtures .-----------•-- --•----------------•-----------------•-- --• - .................................... ------- * �p W Design Flow--------------------��..............gallons per person per-day. Total daily flow--- --!`-5.-S K........_ gahons. 1:4 Septic Tank—Liqufd capacity-�®M!gallons Length-----..�--..... Width---------------- Diameter---------------- Depth................ Disposal Trench—No--------------------- Width._---.�-------•.--_ Total Length--.--------_.._.--- Total leaching area--------------------sq. ft. Seepage Pit No-------- ---------- Diameter........�L-.--.... Depth below inlet-._-6..._.._..... Total leaching area•_...96..��.-. q. ft. Z Other Distribution box (X) Dosing tank ( ) � Z 6 F 5Tvti 6 549 �D Percolation Test Results Performed by--------- Date... a Test Pit No. 1---<--Z...minutes per inch Depth of Test Pit/.3. -� Depth to ground water./l/N --. NG GT., Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...---.------.-..--.---. 1:4 ...--•-•••-------•---------------•-••--•••--•---•--•-•-.....---•••••--•--•----•-•---••. ----••-•......................................................... 0 Description of Soil------------•Q- -�--F�Er•-•-..�r Y...T�.�.-/AND _�J-_( _ �{-=--------------------•- U /o n4C•_7a__/%l n_-5r � !`�i N Si�IA __STdn-j 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. Si wok—'- .............................y. wo ! M 14 rz/Q /'� )4 L I G 1/4------e A )/N Date Application Approved By .. 4 J. ..a_ .t�<,�, .� j----------------------------------------------------------------- ..---- Date Application Disapproved for the following reasons: ......................................................--------------------------------------------------------------------- -------------------------------------------................................................----------------------------------------------------------...................................................... ---------------------------------------- 1 Permit No. - - .L` .,.� Issued ............................................................ f Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CgE1ttfirate of Tamplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed',( x ) or Repaired ( ) by ------------------------------ --------------------------------------------------------------------------------------- ----------------------------------................................................------------------------ --------- N Installer at l..Q-.. ..-..�1 r..2. .-/ ..fs— � JA;��y-1-2-r---m— L{......IV� - .......-.. 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. ---..-.-.7U ... 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 TOWN OF BARNSTABLE No.. ....-_.... FEE.....1........)........ Disposal Works Tunstrudion "pamit Permissionis hereby granted.............................................................................................................................................. to Construct (,C,), or Re air ( ) an Individual Sewage Disposal System at No............/!2 ......- _ T N_ _/:�'`a----�A---I........Z71/AAIIdZ!_.4--4"......................................................... Street as shown on the application for Disposal Works Construction Permit No.,...y.-_ .4-_ Dated.......................................... -� � r 5 Board of Health DATEL--............................................,............................. FORM 365de HOBBS 6 WARREN,INC.,PUBLISHERS �r jr 1 4 1 ....... 'Ic 't �S 0 1 L NO� 0 , �NO. ' 2 '5'A 6 4 70 V P.,L 5 t>4 It- 2 2 3 4 C som 'M h LL-�l TOP. 0 F F 0 U N OAT 1 0 N E L -7 8 L L 0 F_ 9 LO I N E L I N r IL 6 0 0 V Er? I N E L E L cp co, ip ." _'L I I i, I , ,,%, ' 1,� I,� I L I I I , .\\ 1- 12 0 0 I N E L COVER 1/8 WAS HEO S TON E I N E 2 3/8 P Ll V I 3 E L 11/2 WASHE 0 -STONE 0/8 W/,6 S UM 0 0 V C 4 LIQ 14 UIO LEVEL 'p L� 17 d u 0 3 5 6 0,49 00 6'E FF. DEPTH 0 t7 RESULTS 6 r a 6 4; it 'o v E LIT4 Lp T.E ST, 0 g> LEACHI NO PI TS :, 1 11 � ­ - -Z" \�j PRECAST SEPT I C �ANK W IT H 0 0 PERC RATE: PRECAST 0 .0 , 0 0 F 1>er.,r I b 6 NO. ' AND E L S I Z E CAST , IN ILACE INLET, WHITNESSED BY M TA 9 L r=. BOARD ff HEALTH OUTLET T'S PER T I T LE it -7 0 CIA DATE SIZE CIA ROFILE - OFL­ �IPROPOSED ..' -SEWAGE SYSTEM 'SYS TIC W N 'D F V73K Q 5 1 ik ft I-c- AND TEM ES IGNED ' BY T HE REGULAT IONS S 1 0 SCALE -1/4 STATE T ITLE V FOR SUIB U R FACE D I S P 0 S A t OF SEWAGE y '0 N . B . TD 10 'SEWER ' I ALL-, P.1 PES SHALL :BE SCHEDULE 4 0 P.V.C. P I E 2.,_ ALLIPI PES SHALL BE SLOPED' 1/4 PER. OOT EXCEPT FOR WL DFL THE - FI RST- 2- FEET -OUT OF THE 0 B' W H I C H SHALL B E,� LEVEL .-3 DESIGN FLOW -BEDROOMS AT I 10 GALDAY PER " BR. 330 ' GAL/DAY e;g_7',r3 r>(J'L Z GAL. 10 X S EPTIC TANK SI E ql Alto N W In L)k ID 0 10 GAL -GARBAGE DISPOSAL LEACHING SYSTEM: USE I \AI 50 4 E FFECTIVE AREA SIDE __7 5 L t, _TbTn L I D - 44 49 /T) TOTAL FLOW 3 0 X :3 311 W/ DISP TOTAL REQ'O F LOW-- 06T GARBAGE OSAL p R A RESERVE FLOW 3 E 19 GAL/DAY 0 Ito —1 S REFERENCE* PLANS : -T D E: E:D APPROVE BY C A L E 2 0 5 T N BOA R D, 0 FL HE UT H ?i li I Al A DATE AND SEWAGE . - � PLAN PROPERTY OWNER 0 C f i A 1) 4) L 6(Z. (z OFL A L Ic-t��AX FOR : m WIWAM MLIty BEDROOM ;- SINGLE -FA LLING OWE MAN _/ t _r c3 -23971 iP L 0 T \AAN NO.l.s DA TE_e 19 9 tE r 10j% iL L r- z M A 12—L _z_ s rL s-rc,Aj 14 A c z&/A N P -5 7�59 SOIL M NO.' l NO, 2 7— O S IT E P :L A, N N -i To O ' K0 1) 7-7 5 o13 t>11 It- 2 3 I .4'To z3 FOUNDATION EL-.TOP 0 F vj (rv� s 0 Mr- A LL 5 Z.z C 6 foe L-L 8 co, L M 9 L/p 10 IN,EL D v Fat,6 I N.Ej. E L 9— COVER 1/8 3/8 WASHED STONE 000 cy IN.E L,Y. �E L' 0;4 12 IT.& 11 L� -, . ! I. IN. E L.boo O/B -W/-s SUMP 0 0 -3/4 1/2 WASHED , STONE c' AV I 13 LIQUID LEVEL cx 0 p 14 .A Q u ri 4 No 2 6-EFF DEPTH , 15 0 0.0 15 IE PERC TEST RESULTS 6 c, 0, PERC RATE . — <PRECAST SEPTIC TANK . � WITH 0 G PITS 0 40 I 00 0 6 F F r.> r i ITNESSED BY:CAST- IN ,%PLACE INLET AND E L. I NZ5 TA 9 L L. HEALTH OUTLET T'S PER TITLE Y —BOARD OF 9 DIA, DATE:SIZE : k iD C) 6 DIA, 0,. .,PROFlL'-E- , ,'OF­ PROPOSED," EWAGE " SYSTEM ' ' 'SYSTEM DESIGNED . BY . .'., THE TOWN OF REGULATIONS - AND TU 'C E DISPO'SAL ' O F S F WA 6 F SCALE STATE Yl E , "Y �­-'FOR ,IUBSURFA AX 1. 0 7)�4 Nul .0 r tw I ALL PIPES BE SCHEDULE 40 P.V'C.: SEWER �PIPE E XC E PT FOR ''BE '.,SLOPED ' 1/4 'P E R OOT . .....I 11PES SHALL'2 ALL VWLt DF LEVEL o-.JHE -,.'FIRST 1:*: F EET,� I U T OF, THE 0 B' - WH IC ll ,,� SIHALL E Oul" 625 'GAL' AY PER" BR GAL/OAY`" DESIGN BEDROOMS ' -0'A T, 110 IV A EPTIC 'JANK ,:,S I ZE X L.-GAL W b Jr ;,GAR BAAE,��.­D,ISPOSAL�'AEACHING ­ SYSTEM:'� UTSE .1 �'z 01 LL r 4 EFFECTIVE , -AREA: �','SIDE 7TOT n L I D oD 0 TTiO M­"'FLOW : .44 q 6-,TOTAL t3 0 21'ft� 0 7 p,:TOTAL' '-,REQtD F ;,, , W/ GARBAGE k x R.LOW-�`FLO GAL/DAY,'RESERVE W tPLANS E F E RENCE S 39 E 'T, 0 09,, APPROVED BT:t5C ALr­ lz 0 2 N BOA R V, OF � HE "A'A MD ' ANDr� SEWAGE-,`- -PLAN DATE:� S ITE PRO PE RTY -OWNE R tOf k FOR : ,M ktl'01.,,A IV f3 EDROOM 'SINGLE' FAM 11Y DWELL I NG 1A E AN tLOT'L 0 tNO. 23971 C %A' V� 12 OAT E t \k/.I-4 L-L I n� �-1 42 77/ L M P\ -rC>A,/<_' �f4 11 &4d'S A