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a' a '7 3 '5 THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOM BARNSTABLE
...........................................O F.......................................
Appliratuan for Bitipaagal Warkii Tanstrnrtiun raerntit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at:
............................ipjLA43.........-•-•--•• .---
Location-Address or Lot No. y�
Gaps �3• c �t .'J'�1 ------ .-----•--•----•----•---•----- ........,SUZ1Yl.�7.... -1Jrt...............
W Hyann _Address
...........................
Installer Address
Type of Building Size Lot_.15.f.021...........Sq. feet
Dwelling—No. of Bedrooms.._.__3....................................Expansion Attic ( ) Garbage Grinder (rx)
aOther—Type of Building ............................ No. of persons............................. Showers ( ) — Cafeteria ( )
dOther fixtures ----------------------------•--._...---••------•---•-•------••---•........---•--•----------------••--•---•--
W Design Flow.............................55..........gallons per person per day. Total daily flow.._.................a30_...._...........gallons.
WSeptic Tank—Liquid capacityl00-Q--gallons Length._8'-6.'.'__. Width__-4-'.:71Q" Diameter................ Depth5'_-4".._
x Disposal Trench—No. .................... Width.................... Total Length.....................Total leaching area....................sq. ft.
� p 67 Seepage Pit No...........:......... Diameter.__....12�...._. Depth below lnlet__3x. ..._._.:.. Total leaching area---251.......sq. ft.
Z Other Distribution box ( x) Dosing tank ( )
aPercolation Test Results Performed by....Cape.-Cod..Sursrey..Consuitw ts..... Date....1,���1$4a
Test Pit No. l................minutes per inch Depth of Test Pit.................... Depth to ground wate,'a' �4 U_
(Z4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wai . ................
9�
----•------------- . •-----..........---•---•-•-..........-----•--•--........---•-•......-••:;::; ...STEPHEN... �G
O Description of Soil......0-fi"--k�--loath;...6":M3ja"..Brn_..sandy...slbsf�J.�......................•---••-- of •--- ALLYfV
v 30! -96 medlum--coarse-sand.and..graweL,...9.6-=A4...._stEatifted._ama..............••-��
......................................•-----•----...................-•--•-•--•--------•----•--._...--------•---........_.....---.....--•-----........ iO90 CrS'f� ��
U Nature of Repairs or Alterations—Answer when applicable....................................................................
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------•---•-
Agreement: s.
—2 r
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITI.E 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 b the board ofth.
ignedQ1 ....
,. ------..... •-••............
Application Approved ............ le
..... ... ... ------
Application Disapproved for the f oll, ing reasons: Dace
...................................•-------•-•-•-•-----•-•-•-•-------•---..--..-----••-----......----•-•••••--••-----------....-••......••------.....-••-•----...........---......••--.........
"7 Date
PermitNo.......... - a- •................... Issued-.......................................................
Date
No......................-- FEE.............................
A THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN BARNSTABLE
................ ................OF........ ....
Appliration for Viipooal Workii Tonitrur#ion j1prutit
Application is hereby made for a Permit to Construct ( x) or Repair ( ) an Individual Sewage Disposal
System at:
................................................................................................. ..............................I'4t..#43...................................................
Location-Address or Lot No.
.......0 a� as +1-1 �-- ...................................... .............................Snnny-....DbO&Jang.............................
W Hy�4ddress
. ..... .. ----------•------------------------------------•-..................------•••.....
..............
a Installer Iff Address
Type of Building Size Lot----15,_02.1._.........Sq. feet
U Dwelling—No. of Bedrooms...3.....................................Expansion Attic ( ) Garbage Grinder ( rj�
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
dOther fixtures ..........................................................................................•---------•----------------------------------------...--•---
W Design Flow..............................55.........gallons per person per day. Total daily flow......................3.0...............gallons.
W Septic Tank—Liquid capacity.100Q.gallons Length--- Width...4'!7rl.Q°Diameter................ Depth..51-411_.
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area..........•.....-_._sq. ft.
Seepage Pit No...... ............. Diameter........12...__. Depth below inlet__..7...... Total leaching area..._251......sq. ft.
Z Other Distribution box ( :� Dosing tank ( )
aPercolation Test Results Performed by.....C4)e_00d-SUrVP_Y.001MA.=t4.-- Date----- 2/618 �!
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_,; ��%11A Q M9ss
fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wat
a' � A�LYP*--
•`' .. N
O Description of Soil.---- ?1---------------------------------- 1�110N 4
v 3II"-�o"_�^ n.cz�ar�e- -�r�d--s �,vel.:.._� "- 9� ." St .. --------------------- .o �, o_sozi.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable............................................................................ S�QNAL��
----•-------------------------------------------•---------------------------------......-•----------------.....----------------------------------------------------------•-•••.
Agreement: cJ#/_L6-
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TiT1 ,
p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee issued by the board of health. l
S. tied
D.to
lica.tion Approved ,} tlal�'�_ 6 • '1 V
Date
Application Disapproved for the f oll ing reasons:--•-------------------------------•---...-----......-••--•-•-••••----....•-•-••......-•...-••••••-•...........
------------------ --------•-------•-------.............-------•-----•---•--•---------.....-----------•••--•----••••-•-••••--• -••-----•-••--•--•-------•••---•-•-•---•••--••-...-••--•-•---•••.......
y -f Date
PermitNo....... -S........E2�_-_5....--•-•-•--••-...... Issued.......................................................
Date
r" r THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.......................................................
Tyrrtif iratr of Tontplianrr
THIS IS TO CERTIFY, ,J t the Indivi u Se ge Disposal System constructed (� or Repair4,.( )
b .................................................................��&r�.�►.-+k-« -- /
�� a In er
at-•-••-4---I--------------- -------•-----------------------•---------- ----------------------------------------------------•--------------•----------------•-•------------
has been installed in accordance with the provisions of TITS. j of The State Sanitary Code as described in the
application for Disposai Works Construction Permit No----------- ..... dated_...._-�_-.a 3.-_-e5.......
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. ,
DATE.....--•-•.......--•q............��...-............. ........... Inspector... . ------ 64 .........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
0�............ .... .............----•-••••••......---•--.. ----•--...... C7 0
NO. .. FEE....
ks,.(go #rttrtilan erntit
Permission is hereby granted............. . ••-• ........................ . --------------------------r------------------------••-••.....••---..........
to Construct (�) or Repair ( ) an Individual Sewage Dis�josal stem
atNo.10--i-----...... ........l..... .€)- . ;`..t---•---- --------•------------•----_----- -----.
Street
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
.............................
� ." ✓�v a• •--
ealthor
DATE............... .� : ...................................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
. .:- 1.- ....mn@, ..MHnf vr.w.uws'.un✓X. 'se•5.+.`,+..aMkr+,vs3r.,aM•,w.x'tas•.]A.cw.aT.T«mzf..9Ni.w., rw<*wn...: r.n':.,.....+ amw mmmv>u va . .. >aad•nb.wws.'ne'wlaF., cexa+ua+bwru...ner.w.nwew.+u+l..w`w.Mv9' : smba. bcaF•snTwaaw. yrp.M xwMb*2. k .ww'wv-+4.+•[fuA+Vh[iYwreuuMweNF.nw.muwisw. sw.i?as.-wnwwsas,x+p'+LYWY•a„w+.anxeum .
t TEST" AP fPLICA?"/O/"�r REVISIONS:
- ` '` as°� a r ,/ • A�,..._. f) », C.
„� ,. .. d ,a � 6 e�r'� ��.` •y 7 i s y �, a- �. a < r�1 �" NO. :SATE
{ > - C L OF TESTING _ �"� / X_1 �'�r� �: g l/ �( /$ �' pyw � pf
"�... I p —__.._.._ : $ " ., »w... 'aa.:•" y....�' 1` ;,A' ;'�.«.+ 5 ±� s "twd' P .N'"'• .8 H - ,. $ ''"°`y a f• � I � "'�Jb : ' 'l� • a4`..« x;,s+.' < .. r ' � / a� °:•,..i° "--. � n
TES7" BY �1G�Az_ s, 4.��L_ € •
-> - � " ,= - +',f.�l _�.�� `t _ TANK TO CONFORM TO T/TLE 5 REOU•�REMENTS TO CONFORM TO TJTGE 5 REOWREMEN7-S-
T P. Z i�f�`/TNESSED BY, _1z<__ �F__. ��' _ %___ ,�
-- WITNESSED BY y ----
- ----- --
S/ ..�. 4.t L
%n--. -r�;;�� �7rr�'i :, , `, . - —___ _-�=�`'._ � � �,- R£MOVEABLE COVER
r
I J2 --�-- _ __ - 'MANHOLE BROU�N TO
! • . . ".:. ., - .. o FlN/SH GRADE. ' ~ ---._• .. 2 FIEAtiSTOA LaQMBFILL /2 M/N. _
f31Ry� N S .vt7Y 1 ' -
$ CL CA • 3 EAR ,rPIPES
-
3 CL r - �
,. __ i. OUTLET P!
DEPTH OF TEST: 6 M,'N_�-$ MJN. 6"M/N ol� 1� AS REOU/R OS
P� C r RATE -----� -_ - --- -- -- -- ---- - -- INLET-- --
6 T _ . .
_E TEE ;� i 11
Ml1V
' -OUTLET TEE - 11 I y BOX
t ., JNLE7 AND OUTLET 4' 0" MINIMUM - PTK TAN�I' II `-
f � ' 4 cuTL£T TEE DEPTH� �. � � GAL. � t------�----- � ••
!�---------
_._ I • • TEES TO 8E CAST LJOUiD DEPTH J4"AT L!OUID DEPTH OF 4' 2' / ' PRECAST OR BLOCX
----- ----- -.. /9" 5' J CONCRETE SEEPAGE P1 T
--
- IRON SCHE 4 '� " ` /
JEPTr! CJF ; T ° ° 24' s' — --- ---- CONsrRvcTJD/.' o' ,
PVC. OR „ASTJN i T, oi„o- .r ": t
` PLACE CONCRETE �t 29 y °--- b _ ' •— MIN. ---
.D RATE' CONCRETE ..� 34" g' BOTTOM ON LEVEL STABL£BASE
_ _ ---- -_-- -__. -- -- _.
-- __� CONSTRUCTioN -- �
''�- ---- - - - (WA TER TJGHT) ( I r I }
ST T '�: • ••-•t.a,_..•s`-�,•, . •. : - , ••• e, INLE. lEE PROVIDED WHERE Sf.tOPE F>'JUNDATlON t• -----____.-- t -___.
i
_s ---=- plc TANK TO 8EA8LE TO WITHSTAND — OF INLET PIPE EXCEEDS 0-08 / OR
�',•, -'
- P 80TTOM OF TANK ON LEVEL STABi E BASE IN A PUMPED SYSTEM. 210'M/ti
--_- ----._. -_--- --__ -- --- -- ----- ----- - _-- -------- -- -- -- _ - ---- ------._ ------ .�.. H / L A /NC UNLESS ND R ---------- __.____-_ _ __- - --- --- - t
( - O O D U E ; (•*— --- - / 'WASHED STONE' t
PAVEMENT OR/N DRJVE.H-20 t
5 N!7 I L OA D/NG UNDER PAVEMENT OR i
k DRJVE P
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a • i .t°.x,.. / r r �..' �f' #' t� * !' .... ,gyp' • i t
I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION OF rHE SEWAGE
DISPOSAL FACILITY ONLY. SCALE 1 = 20 ' t ;. �, •
INV. AT BUILDING _"/ `
2. ALL CONSTRUCTION METHODS AND MATERIALS SHALL CONFORM TO �� SSE°"r" �
/NV AT SEPTIC TANK(/N1 __._ t _ x �E-t- rti ��
MASS. D.E.4.E. TITLE 5 AND THE_ �Qvsl'.gE BOARD OF __. ._. _ i � J €3
HE'AL.TH REGUL AT/ONS.
_INV. AT SL�PTIC TANK(OU7)
?`-C��..•�4f It�,<? 7C f'C' V S .9 t! `�/c 4,6G,5- 7D
INV. Aro/sT Box(IN)
3 d --__INV. Ar DIST. BOVOUT1z, .<
AT LEACHING FAC1L>TY�
AT BorTOM oFPlr: Vc= r SOSTON. MASS. ORCESTER, MASS.
- = --- l HALIFAX, MASS NORWELL, MASS.
BEDFORD, MASS, t.EXINGTON, MASS. �
HV ANNIS, PASS, MANSFIELD, � t
CRANS'FON, gip, . r)f.:r�
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LOWS
REQUIRED SEPTIC TANKS
GAL. b�,R
SEPTIC TANK PROVIDED = _ GAL. -APE COD SURVEY J
CONSULTANTS
�- gEQUIREO SIZE LEACHING FACILITY � I
3261 Main Street Route 6A
Barnstable Village, Massachusetts, 02630
,
Number: (617)362-8133
DIVISION OF
' n3k /t `� j �' f ( B(}STON SURVEY CONSULTANTS INC.
p ! ± SIZE OF LEACH/NG FAC/L/TYPROV/DED ;ENGINEERING • SURVEYING PLANNING
7 YPE OF SYSTEM: `
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V + •ram I C(I Nr- tv?' I r L`` ly i� zC.s�Sc7 e�7 Pl.Y�" ' L �A7[ '�7 S 'iN��; � DISPOSAL �`.".� ,`.
_._._.____.ram--._-___.._.__......___•�,,,.,
t fit• -"w. � � �� `wfi "+... ..,v 9�n;,
t
.Pt! , .- _ _ � � �� L'A/G'R 1O '/4' R,4'44.7'y 7"�r 067'
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,'"/y,R•'.,PAY<<-�!%,.•fy .o-%Y c'�'i' ''C`y f/'J',,,�/L G .C3/'7''� 1 'f1 tI' f Y / p F ;f Cs'• �..�� A.......-'r L..� / . / lG'• .. \ 4 j'� J \ -'' �
\ _ \'`. SCALE: AS SHOWN
? r-,9A �'v��'�G�... -n.� :r R, �•-r�.%rgv SEiY J' ; z �.� METERS
-4� .a ,. < r C. j'' ?'' < /v i'^ r`- G, �i" 'iti,C %0C r, T
t , FEE 0 lG7 20 y!C> 4! t
DATE. JAI\/: � 14 ',•�,
� o
ve
COMP./DESIGN: '.p rn /S• ,•4,u,',
CHECK: '. ' „ /
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/ V JV! • 8.1�;1. u5 C fl= ;it .�,...... .,,..., DRAWN: ,�, � C, 1..5•r�A•,!.�t,.•!
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,r,'�- r'.�'" sEr i•v �9 icy ' c.RCc�s+• ' C'c>�vC. FIELD:
r����tic-sy EN r . c�firr'G� av TNT' �rN FILE N O:
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