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HomeMy WebLinkAbout0191 WHITEHALL WAY - Health / Ql Whi fehall 104j, rid al A VSn NI 3" o MANn 9/-W991-009-L :auoyd woo-dolesjeniunAw-Nvm ® DLa""44A';BM I U . 0 9t-60-£0 - VSZ i l i l �r-� TOWN OF BARNSTABLE Y LOCATION LC�/ )7 . uj#Ltd C- WSEWAGE # VILLAG ASSESSOR'S MAP & LOT..9-7a- 192- INSTALLER'S NAME PHONE NO. J J S SEPTIC TANK CAPACITY oO® 0 asa m LEACHING FACILITY:(type) � C.K D�i (size) 600 CMG 11 o►tS 'zNO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER�) BUILDER OR OWNER_(Z/(LtityJ `�k& DATE PERMIT ISSUED: )0 b- 1 �' DATE COMPLIANCE ISSUED- 2 2� VARIANCE GRANTED: Yes No . -�, �� ..-Ss _ _� � .��inn'3��L . '—: O � � �, � -.t �, l:. ASSESSORS MAP NO: �= Y PARCEL NO.- 4� No................---...... F� 55...... THE COMMONWEALTH OF MASSACHUSETTS 7. BOAR® . HE TH ....... ��:.. OF........ .......... 1-. ............................ Appliratioaa for Bhiv u al Workii Towitrurtiou Famit Application is hereby made for a Permit to Construct (4,<or Repair ( ) an Individual Sewage Disposal Syst a� l9[ .. __ ........ - ------------•------------------•-------_-------------------- Loc n•Address !�-- ----ha r-? Lot N or oo. - i !... ._. c..................................... RS... t!--- ✓1. t�41�!_�� -�� Own � Installer - Address d Type of Building � Size Lot..` __�C'._.Sq. feet aDwelling—No. of Bedrooms_._..3...............................Expansion Attic (14P Garbage Grinder eilb p,, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ------------------------------ W Design Flow.............. ...................gallons per person per day. Total daily flow.._..........,3..Q...............gallons. C4 Septic Tank—Liquid capacity!j?9-gallons Length................ Width-----------_--- Diameter.______.____-.__ Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------so. ft. Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. it. Z Other Distribution box ( ) Dosing tank ( ) `-' Percolation Test Results Performed b _-.. ..... � G��}.h&?C�_11126e6/ Date..�615_� ltl;------ `�a Test Pit No. ��. __minutes per inch th of Test �it.__....`.J...�Dept o ground water_____ __________ Gi, Test Pit No. y��qMA�_ iinutes per inch Depth of Test Pit____ . .. Depth to ground water._ 0 � 9 --••- - - ---------- ----------- ----------P_/_............_.............................................................._................_........_............--..---..__....._. O Description of _ f��._-----Z�•- ---- -------- -- _, /_--1-------------- --- ------ - x L) --•--•-•---------••-------------- ...............................�C--�----lr''�-c_ _:�� _._.S c��-1 ....................................................... 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 ii '� ;of the State Sanitary Code— The undersigned further agrees not to place the sys min operation until a Certificate of Compliance has been issued by the oard of health. fined. ...._... ---_� CJ Gee - - -� Application Approved By_ �..J! .�......................... .....................•-•--•-•---....----- Date Application Disapproved for the following reasons---------------------------------••-----•----------------------•-----------------------...-•-----••._.........--- .......................•-•----------•••....................•-----•---•---------------•-....-----------•---....•----•----•---•------•••----•-----•-•-•-•••-••--•-•-••......-•--••--------••••------•--- Date PermitNo.......... Issued....................................................... Date 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD PF ' HE LTH .........OF......� .��?%r: "% :--'.:..- .............. ............................ Appliratinn for Uhipoii l Workii Totiiitrurfiott prrnfit Application is hereby made for a Permit to Construct. (6,)"jor` Repair ( ) an Individual Sewage Disposal Syjst�em t ............. ,.. ........................................... � ...................... Lo ion-Address / + or Lot No n ,gat .,•.� {, jam �%t9, — ........................ ._ x....................................,1 'G::t✓r.6(--- ,.y o"'J,I - - ire f _...:.1. ..........._ --------- -------i- "�""�--•- -----• ........................................... «f Installer. Address er U Type of Building Size Lot_/:__. t..__.. :Sq. feet Dwelling—No. of Bedrooms-._ Expansion Attic (KC) Garbage Grinder aOther—Type ,of.,Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixture.................. s --------------• -------•----... . Design Flow__;.. :, ___ gallons per person per day. Total daily flow.......... . .. ................:gallons. W R: Septic Tank=Liquid capacit �9Q..gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—NTo..................... Width.................... Total Length.................... Total leaching area--___-__-:_-----_-sq. ft. x Seepage Pit No--_---------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution.box ( ) Dosing tank ) Percolation Test Results Performed b��.. . .. ...... ... . ...� .___.___.��'_t.���:e^�� Date_____�:.___..__ __ ___. . Test Pit No. ,...minutes per inch •I�"epth of Test'Pit______ "`_ .rt_ Dept1P`to ground water... _ fz, Test Pit Nogg, " minutes per inch Depth of Test Pit.. . ___...... Depth to ground water�'✓. ---_�'•-- . ............................................................................ Deseriptton of Soil ________________ U ..................................-S a- W -----------------•--- ------------------------ •---•---------------.-------------------- ---------•----------•-------------------•-------••---•---•-•----------------- UNature of Repairs or Alterations `-Answer when applicable 'E ---------------------------------- .....................................................-......................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T-T112 5,of the State Sanitary Code— The undersigned further agrees not to place the sy em in operation until a Certificate of Compliance has been issued byth(board of he tl}. X1 ✓✓' Signed" ----------------------------- •-- -- ,ate Application Approved By... = Date Application Disapproved for the following reasons___________________________:_____________.___------------------.--__--_-_------------••-•------•-----........--- ••--•-•--•--•-••--------•.•--------------•--------•-•-•---••---•-------.....-•-............------------•--•...-•-------------•-•------------------•-•-----•-•------------------- ---------------- Date PermitNo.------... -------1 -----• Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ Tntifiratr of Tuntpliatta THIS IS TO CR TIFY, That the Individual Sewage Disposal System constructed ( "or Repaired ( } F............... ............................................................. d»f_ Jf Installer (j < has been installed in accordance with the provisions of Ztii.E 5--4 The State Sanitary Code as described in the application for Disposal Works Construction Permit ��---_-___6�:;?_�_._.. dated------�'_/._���TU_-______--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTIO SATISFACTORY.---•--• Ins 1 Vie, DATE.............................},i-�---�---�------..:.........--- Inspector..............•---.....-------------•------•------------------..................... - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH w < N LL.Z_�..-•------•-- FEE..; -•---••-- �i���a��t1 nr�n--��ntt��tgr�'• Permission is hereby granted.. - , _�--_.1. 3"r?�_ <,,' to Construct or Rep�aryir ( ){p+ an Individual /S_jqv�rage rDisposal System ; at 'd Ld G's..f. C '10..-w-` - t '�i1 _P"'.!-° �(",�f�.�5_�_, .......... as shown on the application for Disposal Works Construction Permit N �._�4�_??Dated_________(_ .__ . li' j. ________________________________________�.., ............ Board - �� �r, B C oard of Health \.DATE----=------------••-----••------••--•--------->' ......................... FORM 1255�HOBBS & WARREN. INC.. PUBLISHERS y ( 'A�SSUMEI> LOT. �f�oT6CTEQ ZO/JE RC-1 UtJD!i TUWN ftG. A.y3' 560 S.F"- 12s' FROtJT1aGE t t CN. ftiRT .71L.,Gr,. 30' FRpn1T SETt3Ac ti 15 SID�yA RD �: �5' REAR S'FTBAU� �. ' l Lv-T 15 LOT 1-7 5 I Lb -M C So �'�ass o O DAVID P. F MARIANO cns CIVIL "J .o .A No.31115 oo r1�O.0�CIS apr c W GJ do-3 . A V) osr a . M, sy �. tsncd i w re5r / 5q Q'p• WkI-NEPALL WA� (6-6, W, t�E- pKWpCr-F- WM) b LEGEND � EXISTING SP®T E`_ VA I I01A X EXISTING CONTOsR --- 0 --- CEP-: 6 !ED PLOT !CLAN FINISHED SPOT ELEVATION ---- FINISHED CONTOUR © LOT /7 - GVff/TEf>'�LL NOTE: The location of any existing under L ound sewerage, --^I wells, or other utilities shown. on this plan is upprox- I imate only as dctCrminCd from records and/or verbal SARNSTA•$LE (Ny�NN15�, MA information. 'Vie contractor is respons:-.')le for. the verification of the existing locations in the field.'= SCALE, 0- 96' DATE , c `2y 18(0 A ' LEVY & ELDREDGE ASSOCIATES, INC. CLIENT YR New I CERTIFY THAT THE PROP0..2E'D ENGINEERS- LANDSCAPE ARCHITECTS JOB No. 1041' BUILDING SHOWN ON THIS PLAN PLANNERS- LANE SURVEYORS DID.®Y I ,M, COCONFORMSTO THE ZONING LAWS OF aMsrzpje I 14ASS. 712 MAIN STREET CH. 8Y� P�'✓� a H YA N N I S, MASS. SHEET—I OF DATE REG. 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