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Home My WebLink About0169 WHITEHALL WAY - Health /GQ �Iii��Z� �a e�� s _ _ _ __ � _ __ _ 1 _ _ ,,,1 I' I i F, i i I, �� ;. , - _ _ y y ., ,. . .? .{ ,; TOWN OF BARNSTABLE LOCATION Cod IS' Liklf He II xw SEWAGE VILLAGE y11,S ASSESSOR'S MAP & LOT r _ INSTALLER'S NAME & PHONE NO. d �� g.SC,C�fI 7 %i A 13 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) t'; —(size) � ,"�a � 1 {� NO. OF BEDROOMS 3 PRIVATE WELL OR UBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: Oc.� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No yy� 30 IL a r� ASSESSORS MAP NO: � �2 PARCEL NO.: No. Fes$.........?..`.... ......_ THE COMMONWEALTH OF MASSACHUSETTS EOAR® O,,F I-IEA TIHr ......-----OF......L4 �'.. /�..... ........................ Appliratiou for UWVvia1 Worse Towilrurtinn ramit Application is hereby made for a Permit to Construct (1/111"or Repair ( ) an Individual Sewage Disposal System t: � / t-IC17ra A'/'Jacn Location ddress �- or t No. ........................... ------ --------7 -./ ---- ------ --- ----- W Owner �t Address ..... .-..•-••...................•-------.._..--••^----•-.........---- Installer Address Type of Building Size L�._l __�.Sq. feet Dwelling—No. of Bedrooms.___..__..............................Expansion Attic (�jy Varbage Grinder 4 Other—Type of Building No. of persons............................ Showers — Cafeteria Other fixtures ----------------•-•------------- ----------------- •---------- •••-------- W Design Flow.._......._f�..__�..................gallons per person per day. Total daily flow.............. ....30..............gallons. 04 Septic Tank—Liquid capacitVI OO.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 ( ) Dosin tank ( y Percolation Test Results Performed by l ft1i ._. 1 //.Af�. ...fj...e�_711,".ZjDate... _._Test Pit No. �L.:55-__--minutes per inch RZh of Test Pit_ __ Dept ground water_. f,p L=, Test Pit No.,2�A.I.minutes per inch Depth of Test Pit.................... Depth to ground water.�_�._�....... Description of Soil_.._ _ d ___ _.` 5 _ -'/............... rr •--- -------------•---------------•--••-----•---••-----------------------------------•------...---.........--•-------•-•-----....---••-•-----------------------•-•--•--------•-••......-•••-...------ 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 bee sued by the rd of health. Signed-- " -- .. ----- .-•-•--••..---- ••............................. p� �r Dat� ,Application Approved By--••---•-•------••-----•. ...---9�.---•- ------------------------- ......•..f/?Sj�--6--- -•-------•-•--..... Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued-................................... Date r - w7 No......................... Fmz............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD E HEA TH € � ,/ . . ---....OF..... r, !/ e.. .... ':.-�......................... Appliratinn for Diipoiittl Works Tomuurtion 1hrmit Application is hereby made for a Permit to Construct (�or Repair ( ) an Individual Sewage Disposal System at: � . ` !'T __!( .'fi !• a ! ------------------ --------- Location/'Address Lot No "`"� � Owner r Address installer Address Type of Building Size LW. -- a`... .Sq. feet Dwelling—No. of Bedrooms........................................Expansion Attic "LGarbage Grinder4 `_l Other—T e of Building ............... No. of persons....:_....__......_..__ Showers — Cafeteria Ga• _ Other fixtures --------------- -------•------• - Q -- ::ay------.---•-••-•----•-----•.... .... ......... W Design Flow.........!A per person per day. Total daily flow__._..:_...•.:_.. ...............gallons. 9 Septic Tank—Liquid capacitt6�°�_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 ( ) Dosm tank ( s- '-' Percolation Test Results Performed b ' �!�°�'.! ... �'."n177e._ez1_. late. ....- gS ____minutes per inch Dth of` Test T'it.. _.. De t2 ground water Test Pit No.,___..-___. p p p fs, Test Pit No ..o �i_.P...minutes per inch Depth .of Test Pit ` .._...___.. Depth to ground water t _ O Description of Soil .. f ✓~*''� (� i ' v ... --------------------------------------------------------•------------------------------------'---------------------------------------------------------------------------------------------------- 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 i? ? y 'g g p" y of the State Sanitary Code—The undersigned further agrees not to race the system in operation until a Certificate of Compliance has bee ssu'd by the bg rd of health. SignedW --------------•----------•---------------- .•-•-- ��QQ d Da Application Approved By--------•------•-•--••-••-•--- ---- 3.. . .............•••.•... ! „ Date Application Disapproved for the following reasons:.............. ----------------------------•----------•-----------------------------------------..•..---------------...----------•--------. >-------•-----•---------------••---•----•-•---•---------------•---------- Date PermitNo........................................................ Issued-..................••---••-•--•---.._.....-•--•-----•-. Date THE COMMONWEALTH OF MASSACHUSETTS �-- BOARD OF HEAL H ............OF. : "• .. .....:....................... Trr#ifiratr of Tomplianrle T S IS TO CgRTIFY, That t�e Individual Sewage Disposal System constructed or Repaired ( } b ' r' °� .. ._- . ... 3. --•------•-----------------------------•---------------•------••--•----------------- y. ... ,,,,. �Ins filler at... has been installed in accordance with the provisions .of iiiLG 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit Z............ dated_..q__l_�'S.{-�y_ -----_•----- THE ISSUANCE OF, THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUIRANTEE T AT i HE SYSTEM WILL.FUNCTION SATISFACTORY. DATE...............,!...ram. -• ............................................. Inspector-•-•-r ------------------------------......--------•---------••----•-.----- THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH '' dI ........oF... ...............................................� No.....0.6 � FEE....................•-•- Niapo. l orhf Tonstr ion Fermi# Permission is ereby granted _'4"`.:- " �. V-- -------------------------------•---........................---•-••-- to ConstruZ_ o Rep ( ) a Individual Sew Disposal System at Street as shown on the application for Disposal Works C nstruction Permit NoSG--1.V-1.z ��7 . Dated'._. � �G of Health DATE:= ---------------------:...---- ------...r.............................. FORM 1255\�HOBBS`v& WARREN. INC.. PUBLISHERS . "ZONE RG- 1 Ass u"E z> Lo T .P�o T_CTE,jj A`. 5 G0 F TC WN R�.� 3, r„ 30 F20N'�' SET�F�CK �� C"I lS �S� GT D>= Vf�R>j' N >'Z°�i4' 39"C / \ p 15 k'Ef� SE 12S 08 )i 1 La I s s4 ,a' lo' I 21�°151 S.F zLu \ � � Lu 3 N \ :? L._oT A�1I � /`�i�C�Mry `f•\� a to 14 ' Y1 LEVY t N► -10.S u,l No. 10617 y A. J W ��^ >T to )9. 7, . eprlc041"; eat 21 4 I �p Sox x12 � 5� Spy S0, 5a„ 125.00 W 14 I T Eta A L L (5'0' w IT E -P RN Pt I E_ W pq L EGEXD EXISTING SPOT ELEVATION OxO EXISTING CONTOUR --- 0 --- � CERTIFIED PLOT PLAN f FINISHED SPOT ELEVATION ( i FINISHED CONTOUR 407 /S W)Y/TENALL WA NOTE: The location of any existing under wound sewerage,' —r— wells, or other utilities shown on .this plan is approx- !N imate only as determined from records and/or verbal 8,4,_N5 T R$LE �4ymvt llS�, MA information. The contractor is responsible for the ' verification of the existing locations in the field. SCALEt �I�=yvl DATEt 0112W18(. I LEVY & ELDREDGE ASSOCIATES, .!NC. CLIENTGREENRE)EE I CERTIFY THAT THE PROPOSED. ENGINEERS- LANDSCAPE ARCHITECTS ,®® NO. l S� . BUILDING SHOWN ON THIS PLAN PLANNERS-LANDSUkVEYORS CONFORMS TO THE ZONING ' LAWS _ DR.®Y+ _ OF A s�>�-E7-^ , MAS 712 M A I N STREET CH. BY, I HYANNIS, MASS. 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