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Home My WebLink About0057 WHITEHALL WAY - Health 5� Whifthe,CP IAta� � 41�eAv1iS — ---- - — a5o � id5 f �, 0 0 C& -SJ 'ON "ASSESSORS MAP NO: �� L PARCEL ISO.: -No. .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ��.Ga��'► . ----....-..OF.-.-..&,�/"I�S��u ............................... Appfiration for DiopooFaf Works Tumtrurtion Vrrmit Application is hereby made for a Permit to Construct (i/f or Repair ( ) an Individual Sewage Disposal System : Location-Addr / or ....................... .................._._.. �• Owner Address r .l -:.............................................................. ........••--•-- Installer Address �g Type of Building Size feet Dwelling—No. of Bedrooms______ Expansion Attic .(''j Garbage Grinder ,tj� Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures-------------- --------------------------------------------------------------------- ------------------------------------------------------------- W Design- Flow___.._._____��____...............gallons per person per day. Total daily flow.........3_o....................gallons. 1:4 Septic Tank—Liquid capacit� allons Length................ Width................ Diameter................ Depth................ xDisposal 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 �i '-' Percolation Test Results Performed by-__. _ Ctv_�. ._.G.h_ /__ ?'��x �Date.. l�__ve.______.___. Test Pit No. 1 __minutes per inch Depth of ',at Pit_.._.: De tlo ground water.. _ Test Pit No.�,ry_�_minutes per inch Depth of Test Pit..._._............ Depth to ground water-.!_.............. O /p pp ----• -----•..................................................•-------•--...--------._..__....._.....-••--- Descriptionof Soil =- Qr✓�_,: � t --•----••-----------•-------•••---•-------------•--•--•-----•----------•-•-----•---•--------- .. x .......................................... W�, - ------------------------� -_ � D'Es6£aJ�43d�O E-04?�J� 1f31 ��' V Nature of Repairs or Alterations nswer when appicaf�� E;,�T!Oy_ _________________________ ,r ... y.ATEM..' IAS-INSTAL.EI]_.lN__,9_T_RICT--------•----•------••--- Agreement: ACCORDANCE TO PLAN. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'Tm_.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 by the board of health. Sitied....... ' - - --- -•............................ -•- .. Date Application Approved By............................- a� �. .. ............-•-- Date ' Application Disapproved for the following reasons:........................................................-------------------------•----------------------------- --•--•••••------•--•---••-••---•--------...-•-•••----•---••--•----------------•----------•---•---.._..-••---•-----•••---------•----------••-----------------------•-•-•--•----•-----------•--_.._.._._._ �� Date PermitNo......� __....ec. Issued_....................................................... Date l Fizz ..� .EE_7. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A111111ratiun for Biipuua1 Works Tow4rurtion Prrutit Application is hereby made for a Permit to Construct Cam ) or Repair ( ) an Individual Sewage Disposal System.at: _r"Iot 10. Owner d Address -----------•-•--•------------- ---------•- - - ............................................................... j Installer Address �! Type of Building Size Lot/.. ---Sq. feet Dwelling—No. of Bedrooms.......1; ----•-•-•-_....................Expansion Attic/O Garbage Grinder./(?;-Ps) i Othe —T ` of�Buildin No. of persons..................•........ Showers — Cafeteria f t g P ( ) ( ) Iher fixtures ------------------------------------•--•-----•----••--.•••••-••-----•-----•--•••-•-•-•------••------•••-••-•-••-•---•••-•-•-•••......--•--•.....••---- Q Design 1 ow.........._.. ..................gallons per person per day. Total daily flow........._Z .....................gallons. W WSeptic Tank—Liquid capacit;tf' _.�.gallons Length................ Width................ Diameter---------------- Depth................ x 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 ( ) Dosingnk�( yr�;,r Percolation Test Results Performed by.. ____ 't'% ._ :. ? — ------------- Test Pit No. _.�_-____minutes per inch Depth of st Pit___»__ De th/to ground water _ a_ -- P P �------ P fs, Test Pit ..minutes per inch Depth of Test Pit..... .......... Depth to ground Ovate ............... .. -••--•••••- Description of Sot1`..�'•" ` �'' r`? -- �-- !' er r < t,, ........•.......................................................................................... V ................'•----��'o r.�1 �, = __..............._......._._. ;._...___'y/•-•_-----•------- ...._....____ ,yam' ........ --•-------------- ..'✓' .._.. / ° 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 ITT. '-of the State Sanitary Code— The undersigned further agrees not to place the system i operation until a Certificate of Compliance has been issued by the board of health. c _--'mod----..� /r`x .....i . '" - Date T.Application Approved B ---••---. _,. try �> y D �., Application Disapproved for the f ollo ng reasons:--------•-------•--•------•--------•----•--------••-----------•---•-------------•----------••-••--•••-••-------- --••-•••••--•-••••--•-•-•-...••-•---••-••-•-••••----•••••-•--•••---•......-•-••-•-••....................... --•--------------- Date Permit No.-------- ........ .ram��_ Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trrfifiratr of Tong hattrr THIS IS TO,C�RTIFY, ThAt the Individual Sewage Disposal System constructed ') or Repaired ( ) by �- .--%�� ._3...�"� ��f�''/l ---- -----------••--- - ---•---- -----------••-----------------------------------------------. ---•--•------------ �5�[ r 7 1 Instaler at......................................Sit . `{_r1C°•_t-1e ,:.. has been installed in accordance with the provisions o 1 TT 1V j of The State Sanitary s des ibed in the application for Disposal Works Construction Permit No.� ?.______'___ a -•- dated - -�ANTEE 4_7 c�1`5�-......... ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA THAT "lFIE SYSTEM WILL FU T 0N SATISFACTORY. DATE...... --------------------------------- Inspector .......... = 1 == Y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEATH a s FEE....................... Disposal Works Tonotr fan ramit Permission is ereb ranted_ ?: ':�"'`.: .. .._._ !__" . Y g - -r .. � -------------•-•-••--•..._............•-•-- to Constrr ct ( {}ram Re-air ) I divi sal Sewag )Disposal System at No.....ee....•........d! °'._ i�'� t. E' �.d-f.':6 a' .+'"•. ..... _ PP P r 1.._..s-eet �. J r as shown on the application for Disposal Works Construction Dated-__ _._.... _:_.... Board of Health DATE ...................................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS a- Z0fJ '�ZG- q I Z.S.05' L,oT 1, 0T ^1 N, loch CiAL O 5EPT►C,7x/JK Assur+E7� J j �4.zsi N �� -rawu l o cq y�V aa' iI I DESIGNING ENGINEER MUST SUPERVISE G -M o'L , �o�jlla u�l\ �:STALLATION AND CERTIFY IN WRITING ";?' LII�� -HE SY")TEM WAS INSTALLED IN STRICT I I- a,I r_uGORDANCE TO PLAN. 5i �� ll I�' t� �I 1 L Qt-�0. b 6713 DAVID P. X MARIANO w F° PAUL A. S(91 .(J.(rJ� ! l�ll/ i ) �� CIVIL � � � ., LEVY e' hoc FG/ST S iJ LEGEND EXISTING SPOT ELEVATION Ox0 EXISTING CONTOUR --- 0 --- CERTIFIED PL PLAN FINISHED SPOT ELEVATION L p�-6 FINISHED CONTOUR 0 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 � A•�J J1 A --f A.0 1 A,M ASS , information. The contractor is responsible for the verification of the existing locations in the field. SCALE-1 /= yO ' DATE , `,>//0 66 LEVY & ELDREDGE ASSOCIATES, INC. CLIENT��2'22),Ll f, i CERTIFY THAT THE PROPOSED ENGINEERS-LANDSCAPE ARCHITECTS JOB NO. JoyS BUILDING SHOWN ON THIS PLAN PLANNERS-LAND SURVEYORS �� CONFORMS TO THE ZONI G LAWS DR.BY OF BARNS E , M 8gc5 wr P'Agllq 5 CH. BYt '�; /P�. fwhqSS SHEET L OF 7— G. LAND SURVEYORi � r 20 FT• M//V. /1/07-E /F E/TNER THE S'E PT/C 7-A Vl< OR !EACtliiv�, P/T ARE MORE' TN.9,"/ /2"BEL0W t /0 FT. MIN. 1RA L7E, Ai 24"L7/A M E TER CONC'R E TE CO vER SWA44 eE BROUGHT TO GRA coE.�A/y EXTR.� CoNcaeTE 4�PVC P/PE M/N. P/TCH —`R V Y Cif S 7- /RON C o VER .Sf/A I-L p,E U S ELF e.•. CDIiE/LS /B�AuR FT /F/N OR/VEWA y A _'a• 2 J MiN. CO/VCRE TE = G .4oE COVER CLEAN SA/V A9 u941/D LEVEL F Imo' 4. R Cd PT . a 2LAYER z� S— JG''4.'1,...' f O V O P P 4 G.r //(J• �IB r `b �4/PER r'7: CiAL. D/ST, • 1 • • • • • • r r p �40 SEPTIC �TA/VK • s • • • • • • r r e • WA 5HF0 S701ye BOX v • o • • • • • • .•e •• • • P I e •EFFECT/Ve i • •` 314 :%a - • " r • • DEPTN • • r ' • o 0 1V,451�'ED STONE rr 4. r • • • • • • • ► �e C • • a• • r • • • e • • • r p ••y PRECAST SEEPAGE !Nli2/�T ELEY�TIONS !/ J� /.U= I/ •U o i• r r • • • • • • r e o R17 OR E L11V. /NY,ERT .4T eU/LD/NG ��.$ - FT f'�T cN�r;�le�I 4°�4•S �I�, 6 t-r D/AM. INLET SEPTIC TANK /O1• 3 FT• �♦ _� FT. O/AM. � C SEE TABULATION, 1 OUTLET SEPTIC TANAt G/, / FT• INLET4P157RI411T/0N BOX 60 FT. SECT/Q/V OF GROUND W.ArEA' TABLE i O(/TLETD/STR/B!/T/ON BOAT �0•'7 //1/4ET LEACH/NC, F'/T G 0,S f SEWAGE O/.SROSA L SKS7& W T�gQULATlON LEACf�/NG PIT D/M /OsceLE % q5FT.D65!G ! CAITEI?/A 0/,•f.EN5/0N FT. NUMBER OF BEDROOMS � D/MENS/ON C—�FT. GARf3AG.�0/SPOSr3L UNIT ^�O//i,� SO/L LOG TOTAL —LO*V 336 GAL.�DAY SO/L TEST */ So/L TEST02 SD/L TEST NUMBER OF LL•*ACH/NGs PITS_ / f, , (o�rj ELE1! DATE OF SOIL TEST S/OE(,EACHlNG PER P/T J 7/ TU s.o,L (/ //3 I' RESULTS it//TNESSED BY��i�IS /yc/l«.�. BOTTOM LEi1CN/NG PEf;P/T Sq. pT. / f c'„L Pt1PC0LA-r10" AA7-e A6/ . e-2- /+71N?I/NCH TOTAL LEACH//YG AREA 26 4- SQ• FT. l�� RES'ER{/ELEACN//VGAREA FT. Z/5Q P-,AZCOLA7'laN RATE 92 SQ. DAVID P. MARIANO u' CIVIL -, 7—// I/ No.31115 LEVY & ELDREDGE ASSOCIATES, INC. 8£39 W. Miq//c[ (� NO G�OUN�7 YVi4TL°R ENCOUNTERED CL/ENT,'c�,p ,�/� DyTE q /v 8� C> Gl?OCINo 1-vATE.Q JOB NO; _ /o¢S SHEET ZOF Z 5 TOWN OF BARNSTABLE LOCATION Lrd L� ��_I WC-, SEWAGE # 57 VILLAGE 14 - ��►�+;� ASSESSOR'S MAP & LOT Sy`�(oS` INSTALLER'S NAME & PHONE NO. 7 .l - \D c i-Ice l� 51:1v1 77( - 3(o l fo SEPTIC TANK CAPACITY j , 6 d y j� lta L,f LEACHING FACILITY:(type) (tee a c t, p i t (size) (an-,L(atiS N NO. OF BEDROOMS '- PRIVATE WELL O I BUILDER OR OWNER DATE PERMIT ISSUED: Ly DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No X r i I ��