HomeMy WebLinkAbout0005 WHITEHALL WAY - Health h;4eh&u wl 1
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Certified Fiber Sourcing PDST1ANSUMER
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SFW1290
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TOWN OF BARNSTABLE
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LOCATION Hkl( kr SEWAGE #
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VILLAGE it nk ASSESSOR'S MAP &ILOT
INSTALLER'S NAME & PHONE NO. J t. •G,( o
SEPTIC TANK CAPACITY
r LEACHING FACILITY:(type) l.- `c-tc-\-,i P t (size) 4 Gt�
NO. OF BEDROOMS 3 PRIVATE WELL OekB CIL WATER
N.
BUILDER OR OWNER ate a r
DATE PERMIT ISSUED:
DATE . COMPLIANCE ISSUED: C
VARIANCE GRANTED: Yes No �!
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ASSESSORS POW NO: Z��
?ARCEL NO.:
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No..6.L-.` Fps.........J.................
THE COMMONWEALTH OF MASSACHUSETTS
®AR® HEA T
Appliration for Biipuaa1 Ifork.5 Tnnitrnrtiun Famit
Application is hereby made for Per it to Construct ( or epair ( ) an Individual Sewage Disposal
Sys7a ' .GtJAIii'C' --------- ----
LoAation-Ad es or
Oy rer Address
-- ............................
....... ... ®-✓L...............-----------...------....-.---•-----.._.....------•----
Installer� Address
Type of Building Size Lot.................._---------Sq. feet
Dwelling—No. of Bedrooms.......... ...........................Expansion Attic k6 Garbage Grinder (ate
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )l
dOther fixtures --------------------------•------------•---.-.----•----••-•-•••••-•-------•------•-••--•---••------------•--•---•-------•-••-•-----•....-.......---•
W Design Flow............ _.__ -•_.................gallons per person per day. Total daily flow............. _...............gallons.
P4 Septic Tank—Liquid capacity.l allons Length................ Width................ Diameter................ Depth................
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 ,
0-4 Percolation Test Results Performed by--------- rTf"�_.e.Z;q� W Date.____--•_. �-----
Test Pit No. S�_____minutes per inch Depth oflt._._.v.______ Dept ground water___________________
(_, Test Pit No,4r j. rninutes per inch Depth of Test Pit.................... Depth to ground water. ____
G4+ --•-----------•••--•--•-•-•----•------------------•-----•...••-----•-•-•-..........---•----•-...-•---•......-----•-----....... -------•..•..-_...---•----
0 Description of Soil.................................................................................................0-�--�-�--.........--j��5�4
---------------------------------
-------------------- - -- - --------------------- --7... ......................................................... �
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 iI TiLE 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 bo of health.
Signed --- ----------•••......----•-• _..._
Vat
Application Approved B •--------• l •.
PP PP Y
Application Disapproved for the f ollowi reasons--------------------------------------------------------•-------------------------------........................
---------------••••-••--•••-•-••------•----•-••-•--:_.--.-----------------------------.......-------•-------------••----•--••--••-•--------•------•------•-•-----•---•-------•-----•---•--•---•--•----
q Date
PermitNo..... ._....`. ------------------------ Issued------...------------------------------------------....
Date
No.S.�2....... ............................_
THE COMMONWEALTH OF MASSACHUSETTS
�__--- BOA R'D fQF HEAL
Allp irntiun for Biipuunl Works Tunitrurtiun rrutit
Application is hereby made for a Permit to Construct (G'`)or Repair ( ) an Individual Sewage Disposal
System,at
//� 7 !mot.j�(i% /_. :".�..lt t� /rl_„_/_�//'/ /._)
.. F ................ ...._ ..... .... ..............
�1
L¢cat:on-Ad ess /
i
. ...................................................... '`...... `............ ..............L.:...........•. �' .....•....._.....Lot No.
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Owner Address
'C r [
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic (t f) Garbage Grinder
pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures .----•-••-•------------•------•. -
W Design Flow............................................gallons per person per day. Total daily flow..................... .: ^'......_...._..__gallons.
C4 Septic Tank—Liquid ca.pacity!_(''___--gallons Length................ Width................ Diameter---------------- Depth................
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._.:-'.__�r�/.� r`'�'...../':�Z�_ %'.��.'�?��Date___._____��?_j_l�_L..
a Test Pit No. 11_'5 5___...minutes per inch Depth of Test Pit................... Depth-fo ground water........................
Li. Test Pit No,,2. .........:..minutes per inch Depth of Test Pit.................... Depth to ground water._____(,1 �
---•--------•---------------•__ .._.. ------.-----•-----------------•--------•----• ------------------•-•- •..---.------------•---------------.-----
Description of Soil_________________________ /, ---' '�
--•----------------------------------------------•••......-----•......• --...!: •----• -•--•-------••.;4reS 5 C
U ------•-••------•-----••••---•-•--••....................•--------•-••----------•--------•---•--•-•-----...-•--•-•••---------..................•.. �. �.-----•-• ------/t
W -••••••••--•----------------•----............-•----...-••--•-••-•-. _ ....................r -------------- '�� 5
VNature 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 1 T1_77 ; 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 board of health.
Signed....1 r ............................................................
ter...!-`'4..
G-• Dat
Application Approved By... -----------------------•-•-•--- ......-.
•-•---:. ;.... �'�
--- ate
Application Disapproved for 'the f ollowi g reasons:------•-------------•--•-------•----•-----------------••------------------------•-----------------------------
...--•-•-•••------------------•--------•----•--------•-•-•--•••-------•---•-----••---•---------••-----••.•------•------------•--------••-•--•-•--•--•-••-----••------•-•-------•-----•-••---•-••--•-•---
Permit No....Y~_ ...... S__0-------------------•---- Issued...........................................Date.......
Date
THE COMMONWEALTH OF MASSACHUSETTS
�� ----- BOARD OF �HEALTH/
} / _•-
..
Trrffirn#r
��-
of f�untplinnrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ',—)-or Repaired ( }
� ............. . 'Z C. r. ._. . ... • ---•.......................... ......................•--------------......_........_.................
tInstaller f--- -----------••-----•---•------------------
........•................................... •-••••--•--•••--•._....••--••••--••-•--•-
has been installed in accordance with the provisions of TITIE,y5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No----- c
dated- ------ -----------------
THE ISSUANCE OF IHIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCT O ORY. �!
DATE..........................l_ ..... .........._.... Inspector-------- ..........................................................................
A = Z Sb - 1
THE COMMONWEALTH OF MASSACHUSETTS
-- `" BOARD OF HEALTH r�
l
No......................... FEE.....:.................
Rapo-jtl Works-Tunu#r iun rrntit
Permission is hereby granted....`-'---------------......--.............---•-•------•,`-':.-------•---------------•--...............---------.........................
to;:Construct (�(/I o/r Repair//'(f ),,an IndividuaL.Sewage Disposal System
at�1\TO.--__��__.------••`..../•�ti •;�'r'/'%i r f c,,-!//-�=5-----------------------------------------------------------------...............
Street 1 6 )`
as shown on the application for Disposal Works` onstrugction P mit Noll--.__�_�_0 Dated......_G�............... .4.........
_
Board of Hea th th
DATE................................................................................ ,
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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LEGEND C®
EXISTING SPOT ELEVATION 0,0 Np,
EXISTING .CONTOUR ——— 0 --- CERTIFIED PLOT PLAN
FINISHED SPOT ELEVATION
FINISHED CONTOUR 0 LOT- 2 �fflr� A�� why
NOTE: The location of any existing underground sewerage,
wells, or other utilities shown on t;is plan is approx- IN
imate only as determined from records and/or verbal
information. The contractor is responsible for the
verification of the existing locations in the field. SCALES /< ND DATE 1719 ,?G
LEVY & ELDREDGE ASSOCIATES, INC. CLIENTC2 ��MLl- I CERTIFY THAT THE PROPOSED
ENGINEERS-LANDSCAPE ARCHITECTS JOB NO. BUILDING SHOWN ON THIS PLAN
PLANNERS-LAND SURVEYORS DR.BY IZT�� CONFORMS TO THE 2ON1 LAWS
OF BARNST E , MA 9
88C-) W. m4i&l ST�15-1T° CH. BY��1zSl�lAm A
� I� VIt-LC1 h�A5S, SHEET OF 2 ATE0 R G. LANQ SURVEY R
i
2O FT.. M/N. E/TNER THE SEOTJC TAN/C OR
iEftCX/NG P/T ARE MORE Tf1�9./ /2 BELOJt/
/O �, M/N :rRAOE/ fa 24��/AM ETER CONC'R.GT� COVER
StIAL L QE ,9R0UGNT
S+'PYC F/PE
IFE L CoI.SC COHCRC'TE NERVY CAST /RO/Y Co�/ER SHALL !3E US --0
COVERS M/N• PITCH IF"/IV ,DR/VEN/AY
_e,.•_ �9�pFiP FT.
' 2 . M/N. CD/VCRE'TE I
a ,�pE COVER CL EAN S'ANO
4 4' 2*4AY
CrI3T E
IRON O/FE 0 a o 'v 0 0 o qF' �B - 1B
MIN.PIrcl+l low GAL.
D/S • e 1 • • • • • • • o •ems WASHFO S701YE
SEPTIC 'TA/VEC T, o ♦ s 1 r • • • • • r • • e .
J'•: BOX p. • 1 e • • ♦ • • � .•• •
1 u
?!<::; e r rp• 1 • IE'FiECT/VC � � • r 314
r • DEPTl� • • r v e IVA5W.AFP STONE
•J'° I I �C Z.5= 3-77,5 i o i • • • • • • • • P P.p PRECAS T SEEPAGE
'lNlie�"7' L`L E O/V Y�T/ S 113x I• o = I I �.�.o a .i•� � • • • • • • � ' e •o P/7 OR EQU/V.
• e a F-1
piT cor nca Tj
INVERT AT BUILDING S7/•s1 FT.
INLET SEPTIC 7-,4AfK 5:,/ -.,Cr . F?. P/,4,W. ic SEE TABUL.AT/ON,
O/JYLET SEPTIC TANK 57 ,1, FT.
INLET D/ST/i/�3l/T/DN BOX 5 6- " F=7 SECT/O/V OF GROUND kV,4TER TAOLE
ouTLeTDJSTRIOUTioNBox 5;6•'7 -FT .SEWAGE O/SPOSAL .SY.ST�M
/IYLET LEACH/NG O/T 5�.�. FT, 7,446411-ATID/V
LEACH//VG f?/T D/MENS/oN A
SCALE
DES/6N CR/TEFRIA DIA14-N510" IV `I- FT.
NUA9SER OF BEDROOMS
LOG D/HENS/GN C �' FT.
GARaIGEDISPO.SAL. U/Y/T NOJJE SOIL SOIL TEST
TOTAL EST/MIA"TEL> FLOW 37,_00.4L.IDAY SOIL TEST l / SOIL TEST 2
A-UMBER OF LEACHING PIT,S_.I r`EL�K ���� �`-1`LFY, DATE OF SOIL TEST AVC? Z/ , /2860
S/DF,C,E'ACHING PER P/T II s1_SQ, P'T. �/I• � � RESULTS I•N/TNESSFD BY��/�'�'��✓/
BOTTOM LE59CtIINCr PER P/r-LO?—Q. PT ( � PC/�CaLAT/ON /GATE,*/ 'e-Z• MI/VrI1NCH
TOTAL LEACH/IYG AREA Zlo4 SQ. FT. AEIrC0Lf17-/0NR.47-,F1k2 MJN.IINCN
RESacRI�EGEACNJNG AREA 2�¢ 59P. 0=;
50,l Tes i-A P- Co ►Z
W u IT"&L,L wA
�4 DAVID P.
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F MARIANO
o CIVIL
G: Ya No.31115�� , LEVY & ELDREDGE ASSOCIATES, INC.
9a IG LL q8,'S W, MAI"S; CC�Jib�Vl�Jvic�Ss,
® ND G/g0[lNr� yVi4TEf� ENCOUNTL�RED G'L/ENT:CTo-z?UBPiLt DATE ' 71716,
1] GROUNO YVATER AT EL EN - JOB NO: J015 SHEET OF Z