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HomeMy WebLinkAbout0019 WHITEHALL WAY - Health i9 uh�� h4n u�v •, �,m�r ,�- ---- asa / t b�3 - - � Z _ `� . m i n o4adwo zoo TOWN OF BARNSTABLE LOCATION 3 (,t/�/' g / �� w ,/ SEWAGE # O� VILLAGE S ASSESSOR'S MAP & LOT r INSTALLER'S NAME & PHONE NO. ��c : 4 L c ( C d0 SEPTIC TANK CAPACITY 1 ibo o Gc LEACHING FACILITY:(type) (size) 9 NO. OF BEDROOMS PRIVATE WELL O olQjjTERp BUILDER OR OWNER Ij DATE PERMIT ISSUED: DATE . COZIPLIANCE ISSUED: VARIANCE GRANTED: Yes No ,� gas r,,,,� .�� • t CA . ITT- d 0 ASSESSORS fVIAP NO: 2Y'U _ PARCEL NO.: l�2 N4 Y. ..: .S.Z Fxs..... :...�.... THE COMMONWEALTH OF MASSACHUSETTS __--,---B OA R® !�-I E A�`'T U '1. oF.... sV' .. ...5 .T.tc Appliration for Diiipoiial Works Tomitrnrtion tirrutit Application is hereby made for a Permit to Construct ( �or Repair ( ) an Individual Sewage Disposal SZystemit --- - - -- ------- --�,Location-A ss �. o r/�.. �!.� _...- ��. ............................. ----------- ------- ...'�.... ..��--•---.�!�...:e�'C�� /' P Owner �/ Address W 5 ....�---•........................ .........�...... .......... ............................................. Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.__..... ..............................Expansion Attic (70) Garbage Grinder (�,p aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures ..--•-------••-•-•••---•....•--• . W Design Flow..........!... .....................gallons per person per day. Total daily flow............._...0.................gallons. 1:4 Septic Tank—Liquid capacit f0c_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 to�j. ) ,. `-' Percolation Test Results Performed by_._.12L on lc-pe �'-_...Z - /27eeori_�` Date..................... Test Pit No. 5S__._minutes per inch Depth of �P'est Pit....__. .._7..... DeptIr o ground water................... .. . f34 Test Pit No. �_A..nunutes per inch Depth of Test Pit____________________ Depth to ground water--------�.�1�-e., 0 Description of Soil----------------------------------- -----••----------_.�.._ 1............................................................�7f .................................... x ---------------------------------------- •-•-•- 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 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 board of health. Signed. _'_.. ..... ......................... Date Application Approved By-••••......- • •--•...... 6$..=b'� Date Application Disapproved for the following r ons:................................................................................................................ -••••-•••...--------•---------•••••••-•-•-•••-••-•-•--••-•--------•--••-••-•••---•---•--•-•••------•----•---•-------•-----•--•-•---•-•---•-•-•-•-••.................................................... _ Date PermitNo..................................v................... Issued....................................................... Date N0.6....!---. _ FEs...7. ............ THE COMMONWEALTH OF MASSACHUSETTS EOARD E HE TH Alip irFatiou for Dispvii al Works Toustrurtiort Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal y ii •1 _..r. -li .....__ Location- ess or„LcatrN r . -•--•-- Owne Address --- --------------------•--...... ---------- ---- ------------...........------•----•---•-------•--------------...-- Installer Address UType of Building Size Lot............................Sq. feet t ; Dwelling—No. of Bedrooms......... ................................Expansion Attic #.0) Garbage Grinder+'( •a Other—Type of Building ____•____________________•-- No. of persons..........................._... Showers ( ) — Cafeteria Other xtur W Design Flow..........-S-••_ ......................gallons per person per day. Total daily flow..._.__ . ..................gallons. Disposal Trench—:`o_ _____________ dth. ......... Diameter................ Depth................ p ...e Wic th................. . Total Length. P q T p g ' g --,., .-----••--• Total leaching area--------•-----------sq. ft. 9 Septic Tank—Liquid capacity _ d__ ons Length................ WI Seepage Pit No--------------------- Diameter--------___-- -___- Depth below inlet................_.. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tan ) f Percolation Test Results Performed by. '� _ `._..+ r"�- ear". '", Date........................................ Test Pit No. l €' ....._minutes per inch Depth of Vest Pit____________________ Deptlf'to ground water................_........ (s, Test Pit No-, F, _rs�_.minutes per inch Depth of Test Pit............. Depth to ground water........................ a ---•------•-------------=--------------------------•-••-----------••...:......-----•----•----------......................................................... Descriptionof Soil........................................................................................................................................... ... V ..............................................................-...................................................................................................................................... W V Nature of Repairs or Alterations—Answer when applicable--------------------------------------•--..•_-________--___-_-_---____-•_----_----•---••--•---. a: .. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iT"I p 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 board of health. Signed __' . ..... �. Date - Application Approved By...... / -%-mil x�................•-------- Q ! ......-- Date Application Disapproved for the following a ons-----------------------------•-------......----•••----•----•---•---------------•----------------------.....----•- ----•-......---••••••-••••••--•-•-----•••-------•---•---••-•-•••---•-•-•--------•--•----•----•••--...•-•------------------------•------•-----•---------------------------------------------------------- Date PermitNo.--- ........... -------------_ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH, ...... ® �..............ORA'��"�l,�.{ -. spa' ................................. TyrrttfirFatr of TuutpfiFattre S IS TO CFTIFY That the Individual Sewage Disposal System constructed or Repaired ( } Installer has been installed in accordance with the provisions of-i i i iL i The State Sanitary Code as desgibed in the application for Disposal Works Construction Permit No.__ _ _=::_ _ :_Y2.-______-•-•-- dated------ 4...._ �j THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT ifHE SYSTEM WILL FUNCTIO S Tt FACTORY. I— DATE --------------------- Inspector / THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH ..- y Z ©F... - '` ---------------------•-••........ NO..�1.................. t FEE.....a:1:_ .. ; Utiolposal Worko4onstrurtpu rrutit Permission is hereby granted..'I --' -f_ a-C ... to Const act or R pair ( ) an Individual Sewa Disposal System as shown on the application for Disposal Works C-onstruc Street '._� ! 6 :�y� b . tion Permit N ...... Dated-----±-------------=--.................... r; r F�1 1 `— and rd ........ ot Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS , ra i )11 A 55�o �• sew �!tffc SG�.�5 qql ' I' f.4 �i q / 107- Q � -0,1coz, ti 1Y Di5r1 3. I I R�-Etl15- /. 8OK i � IZvj,00 _ f I I ►O' ' j NorMQ.� G �� sg�, PAUL A. { CJ/� �' a� DAVID P. _ yG LEVY Pl L_L MARIANQ rn No. lo6lZ Vl i CIVIL No.31115t� LEGEND A EXISTING SPOT ELEVATION OAO CERTIFIED OT PLAN EXISTING CONTOUR --- 0 --- FINISHED SPOT ELEVATION hiN AY FINI SHED CONTOUR 0 LOT 3 VOY'L: The location of any existing undergl ound sewerage, N Y wit S} 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 j '=L/r7 � DATES LEVY & ELDREDGE ASSOCIATES, INC. CLIEN 1 CERTIFY THAT THE PROPOSED ENGINEERS-LANDSCAPE ARCHITECTS .JOB NO. 10y� BUILDING SHOWN ON THIS PLAN PLANNERS-LAND SURVEYORS CONFORMSWg;;NR S DR.BY OF BARN gas) w. vVIAIe4 sTP-r T CH. BY GEr��iEI2U1c1.E� ._..YHSS' SHEET1 OF Z fA/OE ?O FT. M/N. IV0TF /F E/TNER THE SFP77C TANK OR /Ei4CN/ivG P/T ARE MORE THA./ /2"SEL0JW /o pr. /y/,ol iRAO6, i4 24"O/AMETEK CONC'RET� COi/ER SHALL BE BRduGNT TO G/?AL>.E. EXTRA q'PYC O/Pt GONCRCTE t•/EAVy CAST /iPON COVER Sf/.4LL DE C/SEO O COVERS M/N. P/TCH /F/N ,DR/VEN/A Y /B•PER FT r� -��: - - 2 q• MiN. CONCRETE • A a: _ GhAOB COVER CL EAM -TANG 2LAYER /RON P/PE /ODD GAL. ° ` ' ' °o OF vs,-J18 '¢ M/N.P/rcly D/ST, • I • • ► • I ' �4 WASHED S701YC SE'PT/C TAAIK34 ° • a I • • • • • • • • a a �•`:: BOX c. • I $ • • • • • � .•• • • ra / .. f n + ��� ' • • � � •Ef-FECT/VE � � • r yyA3hlED/STaiYE �:: • e � I • pEPTN • • I � • n ?,77 tea••• 1 1 • • • • • • � o p o • a. � • • • • • • • � o� • p PiPEG45T SEEPAGE Il3Xl,d sl/?,D — O y•• r1 • • • • � � a •p P/TOREQV/V, lNNPX'P C'LEYAT/DNS - • a �G 57 5 piT-cp�Nc,rc.. /NYERT AT BU/LD/NG (02•8 FT, I /HEFT SB'J�T/C T.4NK IL?-G FT . FT M. 1 C SEE TABUL.4TJON, OUTLET SEPT/C TANK FT, T- - 1,vz,FT D/STR/S!/T/oN BOX �OZZ FT, SECT/O/V OF GROUND W,17EK Ti4dLE Ol/TLETD/STR/BLIT/ON BOX &2!,o FT. //VL6'T LEACH/,VG O/T I FT, SE14JAAGE OI�'POSA L SYST,E/►� 7A5lJLAVD/V L PACH1 VG P/T t.2- FT. SCALE D/MENS/ON A, DE'S/GN CR/TEJ4/A o/,bfk/vs/O N 8—4-FT. NUMZFER OF®EDROOMS 3 D/MENS/ON C + FT. work SOIL LOG AR G / POSAL iy/T / I c �A .Ens U .� TOTAL E3'T//r,4-reD 1=:LOW_310 GAL.10Ay SOIL TEST Al SO/L 7X=S7-*,2 SD/L TEST NUMBER OF LEACXf VG P/r4 �_ Fce V �Z B gL�Y, DATE Oc- SO/L TEST 5/ S/OE L,.EACH/NG PER P/T SQ, PT. RESULTS I•t//TNESSED BOTTOM CN/IVG PER P/T�3 pT. O-/ SvUSnL PeTC04AT/ON RATE / 47- M/N /NCH L� s� # / TOTAL LEACH//YG AREA —so. FT. PENC0, AT/ON RATE,6LL2 M/N.///VCH RESERI�E LEA EA Z1-4- SQ. FT. P�,(HOFMgss G07 o MARIANO CIVIL ` No.31115 Q CIssE�'��`� LEVY & ELDREDGE ASSOCIATES, INC. � L �' '.] G"L 53,8 �`� lyt/T i y ST��FT CE�'TEt'1/�[LF� yJ►,d, NO G,TO fJN p y{i,4 TLaR ENCO UN TER-crD G'L/ENT:,� EDUlwo_ DRTE � V/p B 6 �I GRO UVO kVATE.F' AT ELEL! - JOB NO; /O¢$ SHEET?OF z