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Home My WebLink About0055 HIGH STREET - Health 55 High,Street A = 035 -028 - C;otuit _ i TOWN OFF BARNSTABLE LOCATION d S-) SEWAGE # VILLAGE ASSESSOR'S MAP �`LT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ey 45, 0Ls�e) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: 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 NCk cmit4 ko 6�f TOWN OF BARNSTABLE LOI,` TION � SEWAGE # 9 5 7L VILLAGE ASSESSOR'S MAP & LOTO INSTALLER'S NAME & PHONE NO.� 3 62'"-3GeC SEPTIC TANK CAPACITY f fib LEACHING FACILITY:(type) �f- , ;1`y�l�,y-/Ctize) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER J() 4 t DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No SLk D � -- � ASSESSORS M#4.'1 N'0:_-,_-._.� No.---- \ PARCEL NO:_�� _ Fxs......... ................. E COMMONWEALTH OF MASS CHUSETTS EOARD OF HEALTH TOWN OF BARNSTABLE Apphration for Diripwial Wi nr1w Towitrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System a� ..d fi `�' ... r .l. I 1/ _. �•- roc;ttion-Address ��. �/•. � •o� -t No. ryt- 1...Ql�!i...._. . t[/__.. . y ---......-------•---...-•......................•----......... 1 C),.cncr ddress Installer Address UType of Building Size Lot............................Sq. feet ,., Dwelling— No. of Bedrooms--------- __________________________._Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 0.' Other fixtures -------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............._______..__.___._.__.._........gallons. WSeptic Tank—Liquid capacity/SUUgallons Length________________ Width...-___________ Diameter................ Depth........__...... x Disposal Trench—No. .................... Width.................... .Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No-----------_------- Diameter__-__-__-_-__----_. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P Test Pit No. 2................minutes per inch Depth of Test Pit--------_........... Depth to ground water........................ ---•-•-••-•--•-------•----•--•--- ------- •------••••--••----•-------------•---•---•---........................---..............-•-.........._....... Description of Soil.... /j! ---------------•----••--•----•----••---•-•-------- ------------ . .. x ` I x -------•--------'------------------------••--...._...--•-•-•----•--•---.._...--••-•..._...--------••----•- ---------------4...... U Nature of„Repairs or Alterations—Answer when applicable._. if �fl .._I UU_..__- i* ff 5_____ ..�' --------------Y - '� ..at° . -Kcry'�5..VK.'......-----•------....... �. -- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia ce s b en issu by t board of health. Signed ------------- .--- -..------- 1s�7.....�. flm Date Application Approved By ..... ... ... b ........... .. _... .. .... ............. .... .. .... ..— ..... .. -- .... ---'------ ................ —-'--'-'--- ----.. Date Application Disapproved for the following reasons: . .............................. ...................................................... ........................................... ................................................. ................�.. -- ........... ......... ........................................... ........ Date Permit No. ....: ..+�'. ............... --------------- Issued .........`.. ... ... . ^v-r.. . .. }! ��/'_��L-.�_��.•-� S:irf4-.j �.�I�`W".��..t"1-..-,r'�.tF a"`r'O�e ' - •�i:, r u.,. r.. r>. ./.. V— a 0 (/ Fmc 0 e�Zo r _ - J�HE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH \TOWN OF BARNSTABLE Appliration fur Diripnial WE ork,i C owitrurtiun V amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: /V hl >r ,r�[/ /r o •- orttion-Address o t No. / -'� ....`.. ..._... ......•... -------•--•••................... u O�cner ddress ....... ..... ...-•---•-••-••••--•---•-------•---•-•--•.......... .............. Installer Address UType of Building Size Lot.................:..........Sq. feet �., Dwelling— No. of Bedrooms........................................___E�pansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 04 Other fixtures ------------------------------------- - W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity5�WzalIons Length................ Width-------- ....... Diameter.-.--.---.--.._- Depth................ x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No-------------_----- Diameter.................... Depth below inlet.................... Total leaching area..................sq..ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by....................................•••-------••-••-•--•--•-•------------- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit..................... Depth to ground water........................ (it Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------- --------------- -............ --•-•••.................... --•----------- --- -.............. ............. ................ .......... Description of Soil.... g-Al. ----... U ...........•------------------ W ---•---•---•-------------------------------••-•-•--.........-•------------------....•-------...-•-•-----•---- ------ . UNature of Repairs or Alterations—Answer when a licable._. ��ti��q//...��-............. ,�.�:........�'...._.�A Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in'operation until a Certificate of Complia ce�as bb en issu!�dby the board of health.1 Signed ............. `"%` .._. - t� ....................................... . ...lf—�`�:.... :5. t /' G Dare Application Approved B �............. � .--- e . !/ _.__ ....l.r..'�.�.(/.. ........ 1 ............ Application Disapproved or the followingreasons: : d ..V - ate - .................... �_._-- - ......... ........................ ................................... ............................................... Date PermitNo.<: ................ ..: .. ........----------- Issued ......-_ ... .p .-...�:.� ........._.:... � l � �/ THE COMMONWEALTH OF MASSACHUSETTS • BOARD OF HEALTH TOWN OF BARNSTABLE (fe rtifirate of (foraptianre T ISgolcE�ZT�IFFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�) by .... .� `'� Installer at ..... .. .�.—.-..�........... /.��-jj.. ...- - � .. ........ ... ..............--------- c'" U has been installed in afcdancwith the provisions of TITLE 5 of The State Environmental 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.........!" �^*""_ - 7�- - ... .... lnspec dory . %... ��'j') , �'' .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � TOWN OF BARNSTABLE .2. .. . FEE. novimat ,rk (ninuitrution 't"IPrrait Permission is hereby granted........... to Construct ( ) or Repair (+`/) an di nvidUal Sewage Disposal System at No. '.........-� - as shown on the application for Disposal ��orks Construction Per t 1 T " � ��._�____�.� L Board of Health DATE:. Jr-•--•----• / j..............•-------------- FORM 36508 HOBBS a WARREN.INC.,PUBLISHERS EXIST. -" BLDG. 245.62' 54.21' 106.03' t t N ,t O 00 �ap0 �G Opp / EXISTING BARN TO BE RAZED BARN _'Q�AND REBUILT ON THE SAME FOOTPRINT v1 / EXIST. i o BARN od J v 00 BOAT o SHED "y EXISTING DWELLING i I DECK tj SEP 2 4 REC'D AIt 13 231.68' 229.27' TO SB FND Emu 155.92' vow LEGEND CONCRETE BOUND FOUND O NAIL SET ZONING: RF PLOT PLAN OF LAND SE CKS:FRO30Fr I HEREBY CERTIFY THAT THE STRUCTURES RI EAR — 11 17 C SHOWN ON THIS PLAN IS LOCATED ON THE PREPARED EXCLUSIVELY FOR THE-PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE GROUND AS SHOWN HEREON. ESN OF M,qs IN y COTUIT, MA DANIEL �N Al N 55 HIGH STREET off 508-362-4541 o. 09 fax 508-362-9880 downcape.com C I DATE REG. �;}LANDFGu�S�y a/-:�0 `' PREPARED FOR dOwII co a en inee�in INC.M/M THOMAS HADLEY p 8 8� civil engineers DATE: SEPTEMBER 23, 2010 _ land surveyors Scale: l"= 30' 939 Moin Street ( Rte 6A) REFERENCE ASSESSORS� MAP 35 PARCEL 28 DCE #04-190 0 15 30 45 60 75 FEET i.DEED BOOK 20432 PG 266 rARMOu THPOR T MA 02675 *, 1 J 01 se - It p� p s}k k VC?L€ ............. 's EI �' .L>C`�`►-> �,. �rC- '-iL. Nam _.. ' i/j� � (�4 APPROVED BY: SCALE: DRAWN BY DATE: /7> 7 l (3 REVISED DRAWING'NUMBER ( or h • kf SCALE: �tr l = i O / APPROVED BY: DRAWN BY _ DATE: �/ I '' t o REVISED DRAWING NUMBER � I t� 1 v 0 , c . , / APPROVED BY: DRAENBYSCALE: REV DATE: (� \�� / O • ° DRAWING NUMBER