HomeMy WebLinkAbout0007 ABBEY GATE - Health �hb!� act,+e
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THE COMMONWEALTH OF MASSACHUSETTS 'NVld 01 :-J0N 1C!L-10_,1-,
BOAR® OF HEALTH13Ia1S NI a3.1-1b1SNI SVM A131-AS 3H1
� lv ..................OF....... /! � ON1118M NI AJ11830 (INd NOldllblSK1� S1Sf d33. WNIJN3. JNiN;71S30
Appliration for Di-epos al Works Tonstrnrtion ramit
Application is hereby made for a Permit to Construct K or Repair ( ) an Individual Sewage Disposal
S stem � .�_..._.:-... ..
o ti n- ddress or Lot No.
•-•�........ .............................. ......._.._..._______.-•-.---....___......____•••••--.•--•-•--•--.•••.•-•••-••••.........___••_...
W f 'Owner (� Address
Installer Address Type of Building Size Lot__�i+._---"�-.___aat�4-tt>...Sq. feet
Dwelling—No. of Bedrooms......................................Expansion Attic (Wb Garbage Grinder " S
aa Other—Type of Building No. of ersons____________________________ Showers
YP g ---------------------------• P ( ) — Cafeteria ( )
Otherfixtures ..-------------•-----•-••-----•--------•-•-•--•-----•-•--••---------••-•••-•-•--•------ ----- •------•--
W Design Flow.................. 'r'7__....
______-gallons per person Ver day. Total 4aily�Pow_.______.___._. �,_._..______�allog4.
WSeptic Tank—Liquid'capacity`s gallons Length_6c� _.. Width_5"�_____ Diameter________________ Depth_______
x Disposal Trench—No_____________________ Width.....a.............. Total Length_____________a..... Total leaching area______ ..___ sq. ft.
o
Seepage Pit No-_______-V.-_ Diameter_.__. 0...... Depth below inlet____��____...._. Total leaching area__ ,__sq. ft.
Z Other Distribution bx Dosin ank (
Percolation Test Resul Performed b ..__ - ��__.l_ _ -" '
Y -....... _.. --�-- Z� _...---•--- Date------------------------�--•-----
�yttll
Test Pit No. 1_____-___�ninutes per inch Depth of Test Pit____________________ Depth to ground -------....
f.4 Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................
�.... -;
Description of Soil_.�J._-�_....._� _�_�°' ` I�'..�--- -"-- --"---•-- -- -- . G4 t
V ---------------
•...........-----------------____----------------------------------------------------------------------------•-------------------------------------------------
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 TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be sued by the bo d of hea .
Signed... ........ ..........................
Date
Application Approved By...............-`-=1- ----- ---•-------------------------------------------------------------
----._.._. ---------
Date
Application Disapproved for the following reasons:----•---------••-•--------------------------•-------------•-----------------------------------••-----••••-•••••
..---•---••----------------•-------...._....----••-•----------------------------------...._..__.-..--•---••••-.__._..-••------•---.._.____._.-----•-•- -----••--•••--------------••-----••--•---------•-
Date
Permit No..._•••-_.; �'�6 Issued_........................................................
Date
BAXTER & NYE, INC.
Registered Land Surveyors and Civil Engineers
7 Parker Road/Osterville,Massachusetts 02655/Tel. (617)428-9131
WMUAM C.NYE,R.L.S.-President
RICHARD A.BAXTER,R.L.S.-Vice President PETER SULLIVAN,P.E.-Vice President-Engineering
June 12 , 1987
Town of Barnstable
Board of Health
P .O. Box 534
Hyannis, MA 02601
RE: Lot 1 - Abbey Gate
Cotuit
Gentlemen:
Today, I have inspected the installed septic at Lot 1
Abbey Gate. The system has been re-installed as per the
approved plan, revised date September 20 , 1986 .
Very truly yours,
Peter Sullivan, P . E.
Baxter & Nye, Inc.
PS/fmj
OF 414'
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kwt.SiQ;Aity,
MEAMERS OF
CAPE COD SOCIETY OF PROFESSIONAL ENGWEERS AND LAND SURVEYORS/AMEWCAN CONGRESS ON SURVEYING AND MAPPING
MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGRVURS
N0.. ..��. > ��...-...-...-_
THE COMMONWEALTH OF MASSACHUSETTS
(� BOARD OF `HEALTH
1-�.�.�-------------- -OF...... ..................................
Appliration for Disposal Murky Tontrurtion Prrutit
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
system at:
t
.. _.. �............ ........................... - BJGa----� - ......-----••-�-----�'-�.---------•-------------------
o t' n- dd es or Lot No.
. . ...
Owner Address
................................................... ..---•--•-••••••-•-••••-••••••-•--•--•--••---•-----•••--•......G ........... .................
Installer Address ._._...__t
d Type of Building Size Lot. _6..4.5...Sq. feet
V Dwelling—No. of Bedrooms....._._%-J..............................Expansion Attic (Wb Garbage Grinder QJ�j
�4 Other—T e of Building ............................ No. of persons........................... Showers — Cafeteria
Q' Other fixtures :----•-•---•••• •-••-•......... -
W Design Flow....................SS................gallons per person per day. Total dail flow.............. ............gallops.
WSeptic Tank—Liquid capacityN( .gallons Length((J-:�Ic"i... Widths....... Diameter................ Depth.....
x Disposal Trench—No. --_----.-•---__.--- Width.... .............. Total Length_._..........A..... Total leaching area--- �...r____sq. ft.
Seepage Pit No----------
_.__.. Diameter._'_..,_C�___.._. Depth below inlet.... .......... Total Total leaching area.. v _.sq. ft.
Other Distribution box Dosinank
Z Percolation Test Resu�s Performed by..... e`_ :'9c�._ ... '�-..l. .t.-......-.. Date...... 3. �I�`.........
`-4a Test Pit No. l..C. z-_minutes per inch Depth of Test PitV�_-Z ...._... Depth to ground water..�v ..'�_.� ''
t=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
- .
0 Description of Soil..U.--a___.. ...._ .`........................`
x
>-------------------------------
W -•••••••-------------------••------•------------•--••----••-----•--•••--•--••---•---•••---••••••••-••---••••---•--------•-•------•--••-•----•-----••-•-••••••-••-•••-••••••---•----••---.........._..•--
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 TITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee ' ssued by the board of hea f .
Signe -----
Application Approved B !l.�i^: ^3�yt'... .......... z_ a`C'.�:b........
Date
Application Disapproved for the following reasons:--•------------------------------------------------------------------•----------------------------._......••--
....-•-•-•-----•••-•..........••-•••••••...•••-• -••---•••••••--••-•-•••-----•••-•••---•-•••••••--••••--'•••••••••----•-••-••••••••-••-••-•••--••••-••---•-----•--•-••-•--•-•••----- ..............
Date
PermitNo.........•` •--....C. 01'-------------•-•------- Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........................I................OF......... ....1.51 .....LC ...............
(9rdifirate of Tomptianrr
THI;5�IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( b1f or Repaired ( )
by............ T_�=.Z.�..C�------------- -------------•----------------•----------------------•--•-----------------------------------•--.....-----------=--------......------.
fy� t �� Insta r "'—�--
at-•••....A. � -` -••--•.....� .�._..`z..............-•••-�G-�' � \�1 \
has been installed in accordance with the provisions of TITI.,E 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..................e......... _ -_-. ................................ Inspector.... �-
Z THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....... . ... ..... ................. .. . . . .............OF..---..1 ..
N .' �...b
FEE........................
Disposal Works .Tonstrion rantit
Permission is hereby granted.......•..._..."..v. ..... -.__ __: ��- .
• ••-•••---- - -------------------•-•----------•••-•-•.....••.................
to Construct (✓) or Repair ( ) an Individual Sewage Disposal System
atNo............_uT .......... --------- -•----....... -•---•----------------•-------•---------••-------••-•-•---
Street
as shown on the application for Disposal Works Construction Per�mmit. No...................... Dated..........................................
Boar
•---.-- d 1.
d of H ealth
DATE................................................................................----•--
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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TOWN OF BARNSTABLE QC°
LOCATION. '7 /¢hd�Q y Z�� SEWAGE #
VILLAGE IASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. / LarI
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: '��Z -4 COMPLIANCE DATE: �®
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
0 7 NOV �
5r3 Q o z 3
�3~ .
,���ey�d
TOWN OF BARNSTABLE
I;OCATION 44v ag a 11v SEWAGE
VILLAGE` }1'
ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. IfV0 to4.0Mii/l� Xo
SEPTIC TANK,CAPACITY / d 0
LEACHING FACILITY:(type) �i� (size) 6 UU
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER C� v �/✓
F �
DATE PERMIT ISSUED: 7 - 161- 46
DATE COMPLIANCE ISSUED: - t - "7
VARIANCE GRANTED: Yes No , /
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