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Home My WebLink About0121 SHELL LANE - Health 121-Skleff Lane A '019—159 Cotuit —7 q 0S`� \/A P Ge Fps........F.................. �� •� ��'LJ� THE COMMONWEALTH OF MASSACHUSETTS BOAR t OF HEALTH 65 q3 Applira#ion for Dispoli al Works Tomitrar tiun ramit Application i� 1}@r�by made�'ri Perm t9&onstruct (✓) or Repair ( ) an Individual Sewage Disposal ystem at:fl{ ..... . Qcation- ddress or Lot No. Owner'�' Address . • a�+sn Installer Address Type of Building Size Lot_: .I.j -.Sq. feet Dwelling—No. of Bedrooms.:..........................................Expansiog Attic ( ) Garbage Grinder ( ) aa, Other—Type of Building ............................ No. of persons........?................ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------- ---- . W Design Flow..............155........_.._..._..____gallons per persoA per day. Total daily flow...... ......................gallons. WSeptic Tank—Liquid capacityf i, gallons Length-_...�.._... Width__-.._..... Diameter________________ Depth.5..... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------)----------- DiameterT..0"..... Depth below inletI .6......... Total leaching ar.� ..0.C7.....sq. ft. Z Other Distribution box ( `� Dos' g tangy}( ) 1-6 3 �, { w ° Date*Al 1J � Percolation Test Results Performed b .. _.__.. ___. . .. _ _. _._ C_ Date._. I�-__._�.i_._��..._.. ,.� Test Pit No. 1...... __...minutes per inch Depth of Test Pit---N�{_y_._._ llpth to ground water________________________ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-___--_____--_----_____. ....._......._. .. . .......... ...... Description of Soil Scz__�..... - -- t b t�--------------DESIGN'd1Na-IrRlG0AV iq-_M11SI._SUPEE�YJSE-- c -----------------------•--.��C.__....-� I �.�n-z._� 1�4L•----INST/LLATION.-AND_CERTIFY..Jkl..WRITING-.. W --------------------------------------------------------------------------------------------------- T1�1E SXSTEM__YVAS..INSTA�.LED-IN..STRICT UNature of Repairs or Alterations—Answer when applicable----------ACCORDANCJ T4_P ...................................... ----------------------------------••-------------------• -•-----------•---•------------•----......---------•----------------------------------•-----------------------------------------------••.•-•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code—The undersigned further agrees not to pla the system in operation until a Certificate of Compliance has been issu by e bord iealth. 1. @�............ . - -•-•------ ---- -----------. 7ate Application Approved BY .................... ..•-----------------------......... :. IJ ate Application Disapproved for the following reasons---------------------------------------------------------------------------------•----------...........---•--•--- - I ....................................................-.....................................................--------....--•-------------------------------•-qD - ..................................... J// Date Permit No----- _ ..._.'.. ` ....-•-_... Issued..................... l..l.. .... 9, �-- IS Ab THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Eliopoottl Works Tonstrnr#ion Prrutit Application is hereby made for a Permit to Construct (\/5 or Repair ( ) an Individual Sewage Disposal ystem at: U --- - ... ------------- (� ( J,,ocation-Address I or Lot No. ................. ............................................. -------.......... .......................... Owner Address W Installer Address Type of Building r Size Lot....•-••_.-_..Z_^Z,._S feet aDwelling—No. of Bedrooms..... ..................................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons.........(. 2............... Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------•-.. ..................................................................................................................... WDesign Flow................_.. ......................gallons per perso��er day. Total daily flow........ .....................gaallons. W L { Width-_-....�.�`Diameter................ Dep t h.. _�... Septic Tank—Liquld capacaty.�;.�.C�gallons Length.__..._.._._ �'. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......... ;,_...O. ..... Depth below inlet.-,� . Total leaching area.- �0.... ft. Diameter._ I _. " ' " � - P (.---�,.-------- g .� q. Z Other Distribution box Dosi Ig tank ( ) l-6� Percolation Test Results Performed by �l: .. _.. :t_ {�_.� 1 L!.!K_�J Jg1 ,_..0=Date. l� ,_l Test Pit No. 1.......�.....minutes per inch Depth of Test.Pit.... .......JDdppth to ground water.._...!"........ fP-4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ....---•N__'_.._."`................................I... 1 ODescription of Soil...- . � � _; ..4 SCE.-------------------------- ----------- -------------------------------•--••-•---------. V ' f 1�' I -, l v •--•--------•----------- ... �1 *1=t= _,�._. ............. W ---•--•-•---------------•------••------•---•----•--------------•-----•-----------•-----•--------......=•-------•-------------------•---•-------------------•--------•-------------------------••-----•. UNature 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue by board�ealt�.••-•--..•.. .1__..L-- q:. ---- - - --- -- AppliApplication cation Approved By........- ..�.!!�1. --•---..... �3Application Disapproved for the following reasons:.................................................................................... .................. ....-----•----••---.......--••--..•...--•-•-•---•----------------•-------•------------------••-----------.....-•----------------...........-•-----•-•--•----....... ...-------•---------------....------ r / Date Permit No...... ..��................` -•......_ Issued---------.--•--.. 4.a4.............. D THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '...c?......oF.......G� {j..*...................... (Irr#ifiratr of Tompliattre THIS IS TO CE TIFY TJIat the Incjividu 1 Sewage Disposal System constructed (, e4 or Repaired ( ) by.. .s :Q •--....--••--......•-------••-•---�.........-•-••-•-•--------•-•--•--------------------------•-•...••--•••-•-•--••----•-•------•...................--•--...... Installer — at .. � ...D YJl.�C. .. �`m.. .�.TtrlY........................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector,.................................................................................. � h THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH DESIGNING ENGINEER MUST SUPERVISE AT;A41TION AND CERTIF JYRIT114G l ............oF................ Eev4 WAS T No......................... ACCORDANCE TO PNI E.."•lN..STRICT Diopoottl orko Tonotrur tion rrmit Permission Is hereby granted----•----�-- o-----....�'...'.:y'�. ...---••.......................•--•---•--..._..---......--•---............-•------- to Constru t (al or Repair t ) an Individual Sewage Disposal System /_ 7`� 7 at No...... .P?t.. y4G `'�/ .- ------.. i�.. •----•-------------------•-------•-------••------........ Street as shown on the application for Disposal Works Construction Permit No..................... Dated.z::�..................................... r Board of Healtli ` 1 DATE.............................................'.....•------••-•--••-•----.._..... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS I LOCATII,� SEWAGE PERMIT NO. VI LPLAGGE INSTALLER �N ME a ADDRESS JwJo,v Q OR OWNER DATE PERMIT ISSUED tl - a �� pD.AT E COMPLIANCE ISSUED �' �� - � ;� �V _ ,U / . . '' �� `,. � � ... ., C',d r �� S �.� �� ../rr NoS,� ..!� Fxs..../ ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.......................................------------------.......--------................. Appliratiun for Uiupuuttl Workg Tonuarnrtiun Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: f... .«.Sc.... .. . ........... 4. . ........ ................. .................................................................................................. /� o ation.Addre or•Lot No. ......... ll... .. ... ...................•--•-•---.... ....................................... ....... ...._^ -- ......... ow re.. W :. ..................................... p ....._ ..... Installer Address Q Type of Building Size Lot............................Sq. feet V Dwelling/--No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Ga Other fixtures -----------------••••-••---•--• • W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity..........._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 ( ) Dosing tank ( ) ''' Percolation Test Results Performed by.......................................................................... Date................................... .. aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 44 4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water................. 0 ............ Description of Soil...:_. .___ x UNa ure o Repairs or Alto ations,-, `nsw when applica e.�- -� j-�(.oD PC --- - .............- _ --1.-.l. !1 ......_ ...--•---•------•- . • . ---------•--•....••-•••----••--.....--••-•-------------••-••-••-•••...•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of LITA U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been isstied by the board of lth. igned _- .......... .... •••• - ......................... ;.... ApplicationApproved By.... ....... ----•----••• •..............................•-••-•---•-----•-•-•--•-•----•-_------ ••-• ate Date Application Disapproved or t e following reasons: ---- . •----•---------•..................................•-------------••-•---------- - .........-•--•-•-•••---•••.....•-•-••--•----•-•-••-••---••••-•-----•..............•-•--•..............---•-----•-•------•-•-•-------•••----•-••••--•---•-•-•--•....••••• .........-•--•---_..._ Date Permit No..............................:............••••--._...._. Issued_.!Z.� 2'.« ......_..- ...: Date -- - Nod f).y� Fxs.... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - .............._ ....................OF.........................................................--............................... AVVftra iun for Diipuoal Workii Tomitrttr#inn Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: IIIIII /� o ation Addres or Lot No. ......... ....ff. .............................. ........... ..... /r ----... ..----. .-- ^ Ow ��.. �,,��••` re.- ........ _ .... •......................... ..60...E _. ..:./..... Installer Address QType of Building Size Lot............................Sq. feet U Dwelling `No. of Bedrooms____________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ... No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures .------_.,.....•---------- ...........................I--•-------------•------._...---------••---------------------.....•-•-•---••--------•-•••--•---- Design Flow................................... ......gallons per person per day. Total daily flow............................................gallons. 1:4 i Septic Tank—Liquid capacitya......._._.gallons Length................ Width................ Diameter................ Depth................ r 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 ( ) '. Dosing tank ( ) aPercolation Test Results Performed bY..............................-............................................ Date....................................... Test Pit No. I................minutes per inch Depth of Test,Pit.._..............._. Depth to ground water............. --__._--.-. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ..��,,ee� .....-....--•-•............................•--........•.....-- O Description of Soil___: 4frlat _ ' - ---- -----•------------------•--------------••-------_-_-------•-----•- •-••-•-- -. x W -------------- ------------------•----•--•----•-•-•---•-- -----------•---•-------•-----------------• -- UNa ure o Repairs or Alterations—jtnswgr when applica , lQ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issu d by the board of kieplth. ign ed_: 2' ......... ..2. ... to Application Approved B�or •• --. .....................................••---••------........._..._..-- ---.7 .............. � Date Application Disapproved r th following reasons:-----•--------------•-•-----•--•----•-----------------------........----------------•-•.._...----........_....._ ---------------------•-------------------••-•-----••-----•--•-------------------............--------............---.......---•-•-•------•--------•--------.............................................. Date Permit No......................................................... Issued--.r.~---�- ." A --------•------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... . Trr#ifiratr of Tomplianrr T�.I,S��S TO E FY, That the Individ".Se Disposal System constructed ( ) or Repairedby.4- ......- -- -------•-------- ------------------------••-.....---.----.. ....---•-----•-------....--------•--......._..... at. has been installed in accordance with the provisions of T F r ofhe State Sanitary C e as c ibed in the application for Disposal Works Construction Permit No._ ��. �lr_t�.................. dated__ .......... ...��.........._........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUA AS A GUARANTEE THAT THE SYSTEM WILL U TION SATISFACTORY. DATE...... --•----------------- ---------------...... Inspector... .........:....................................................... W THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH pp ISO.. ...... FEE..A)............... Eliovoott r o ion Pa Permission is her by ran ......... ---•- ---•---------------•---------•-•----•------•-------------•----•-••----•----......----...-•----. to Construe )'o it n n victual Sewage Disposal System atNo------ - ------- --- ------ ----------- --•- Street as shown on the pplication for Disposal Works Construction Permit No.......... '.:_ ated.......................................... ----•------------•------•--- ................................................. J . B r of Health DATE 7 ....-------- FORM 1255 A. M. SULKIN, INC., BOSTON LOCATION SEWAGE PERMIT NO• VILLAGEE INSTA LLE 'S A i ADDRESS d U I' DER ,+ ORS OWNER vvrx.s � /az o DATE PERMIT ISSUED - 73 l DATE COMPLIANCE ISSUED Cn THE COMA/MONNWEALTH OF MASSACHUSETTS ...OF...... ,rl�. ._. ... ..............`.............. Apphration for Uiipuiia1 Workii Tomitrnrtion Prrmit S Application is hereby made for a Permit to Construct ( ) or Repair ( .) an Individual Sewage Disposal System at: . ation `ddyess� o No. W •..............F--/..f ke:b-...-1----j4 71-rdl ---------------------- ..........___�_J_b_l.K_t_7`•f.. r..�...�._U- .o2. /-(•� . a Installer Address ��^• dType of Building Size Lot----- ....Sq. feet U Dwelling—No. of Bedrooms_... ...........................Expansion Attic ( ) Garbage Grinder Other—Type of Building �_' .. _! �___._.. No. of persons.......5__________________ Showers (Q) — Cafeteria ) a Other fixtures ------------------------•-••-•-- Design Flow_.!^......._�_._( ..............gallons per person per day. Total daily flow___.....-3..�-_ --•-___ gal W 0 ----------- Ions. WSeptic Tank f Liquid capacity jL -V vgallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length ... Total leaching area....................sq. ft. Seepage Pit No-----/-------------- Diameter......J..XZ Depth below inlet___: Total leaching area..................sq. ft.r Z Other Distribution box ( ) Dosing to ( ) `-' Percolation Test Results Performed by.......:> __K ------ aTest Pit No. I----------------minutes per inch Depth of Test Pit_________--_.-______ Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a.. --Descriptionoo -- ------. ................ - .----- --------- -- -- ------ x W •---------•--------------------------------------•-•---------••---------------------•-•••-••-•••------•---------•--------------•------•---•--------•••................................................ 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 iT 'L p 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. Signe __ .-•-------•-------.....•------•-=---•-----•-•--••-••--...-----•------ ................................ ate Application Approved By....... --- --'- = t,L •. •--.............. - ............... Date Application Disapproved for the following reasons:................................................................................................................ -------------------------------------•--....---------------------•---------------•----•-•------••---•---.I---•-••-----•----------•--•----------------•-------------------------------- Date PermitNo......................................................... Issued....................................................... Date No._ / '� a Fss...��... .. ................ -1.. . THE�COMMONWEALTH......... �OFUASSACHUSETTS /"C R I— H :...._ ..... ....OF..... ... Apphra#ion for Elhipati al Works Tomarur#ion Urrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: `................-................................................................................ .......-••-•-•-•..........•••-•-•-•-•----...............---•--•---------------•----------•------- Location-Address or Lot No. .......•...•.......•............................................................................. ................................................................................................. Owner Address W ...._.. =` ............. Installer Address d Type of Building # Size Lot............................Sq' V Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder • O —Type Other—T e of BuildingNo. of persons............................ Showers — Cafeteria a F+ :gam, Qther r d -r- W Design,,Flo '.......................... _gallons per person per day. Total daily flow_______ ........_._.._..........•....gallons. WSeptic Tank Liquid capacity............gallons Length__________ ____ Width................ Diameter................ Depth............. x Disposal Tr ich,No. .................... Wid7.;L.............. Total Length___-.V/--------- Total leaching area....................sq. it. Seepage Pit No----------_--------- Diameter-------------------- epth b ow in t__....._._.._._..___ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing '�C'� s) - 4 Percolation`Test Results Performed by.......................................................................... Date........................................ Test Pit No. -1________________minutes per inch Depth of Test Pit.................... Depth to ground water_____________-_-------_. ` (i ✓T.est Pit No. 2................minutes per inco De h of Test Pit its ....... . .... Depth �n wa ,r... ... _ D Description of Soil ---- `------•-•---------------- - A U ----- "'- x '' ------- ------;_------------------------------------------------------------------------- =: ; U Nature of Repairs or Alterations—,Answer when applicable--------------------------------------------------_................................................ A eement: tinders therovisions of T .:..igned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with p x� 'T� 5 of the State Sanitary Code—The undersigned further agrees not to place the system in Aperation until a Certificate of Compliance has been issued by the board of health. Sign .. .... -- -------------------- ��-��-� +;•�•----•-- t Application Approved By.... _..-. ---- (� Date Application Disapproved for the following reasons:................................ :`=_ •-•------------------•--.......r:_...........:-•--•....••-•---•--•-••---•---•-•-•-••-•-----.......................... •••-•--------•••--•---•-•--•--.......................... -----------••. Date a "n Perm* No............................ ,Issued_....................................................... Date �_ w• THE COMMONWEALTH OF MASSACH'US'ETTS 1 BOARD HEALT Trrfifiratr of TompliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) �- zZ ;Poo ` •-----•--•--------------------------------•-•--••-----------------•--------•------ -------------••---•-- ----- { », Installer s ;0 i ' 0 at •-----•--•---•---•....... --• •••--••--•- ••----. ------------------------------•------------------------------- ------ has been installed in accordance with the provisions pf T j�p State Sanitary '�d /desAb/d In the" application for Disposal Works Con&uction Perm t"Noy.................. ................... dated---------------_................................. THE ISSUANCE OF THIS;CERTIFICATE,,,SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE DATE.............................. C - �� SYSTERA WILL FUNCTIOl�1"SATIS ACT PRY. ..............�----------•- ' •- ' �•--•----- Inspector....- f-- ----- ,------------------------ THE COMMONWEALTH OF MASSACHUSETTS / BOARD HEALTH l 3d _...... FEE.. .. ........... �&Vft Q n rrmit Permissi np.here grante --•----•......-•-•. .. .............• �---,---- ------- ................. �.r .... to Cons u � 1.�. spa � i u 'Ewa P40 .`at No .P � e_t .. as shown.on the application for Disposal Works Construction No Dated.._. ._. ..- _ � � GvLC; Board of Health DATE................................................................................ ' FORM 1255 HOBBS &.WARREN. INC.. PUBLISHERS OP LO ' 10 Gx,.,p .,\O�• � .g.�1.boo,4 v `a M i S-e.Pn C. Az-EA r e0OTTOAA A`tz ((2 5 ll3 < tiro TOT'A lOt�t G� Pl coLA-rtc>w 12A- t to T Aw oZLZgF+S. -_. 4.1 A uoi.Es , Tl.�GOW 7x - •• PE IUK• Sv85D� 4 B. vtST t'+vc 4 a t... I t:3�� 1 Box �63 6 SwTtG F;: r '3 �` Imo/� _ Tle►W K 1� ? T-- WkT%4 C 3l4-1'ts ctv a 6 T t F t EID :Qo. A SGht_t (11r 1�46 t CKCI i FY T"AT T1 -. wowU = -iE�Ed�1 " GoMP�.Y� ea�irN TUE. �lDFL1►.a� ( �•� �A�JD 'St=`TBAGK RE!?Ji2.E.ME6.lT� OF T"4.IE - ; B A x-r a v- . q �t t Esc IZ S4.%ST a izM L AAJ o Z C-Ve; TW4 -PL&W IS► LIOT 8o5EID DU AU t.YsTiZJMEMT OSTezVI. , . - MA.4. Isultva( 4 T►.I G Or-PIMT; ''S"OoLD RIOT iSE USED To TE.zmlut; td7 UtJS9. OIVOLMi L TOWN OF.BARNSTAB �� LOCATION ldf. o�� /� S WAGE #�21,2 'f.5 5- VILLAGE ASSESSOR'S MAP 6z LOT 6 j!�_ .16 7 INSTALLER'S NAME PHONE NO. ;Yf�Li,•� �. A� � SEPTIC TANK CAPACITY /O4a �gl LEACHING FACILITY:(type) JOi (size) e)C NO. OF BEDROOMS 3 PRIVATE WELL O PUBLIC�WATE vv BUILDER OR OWNER p h�l� GGy?/ah DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �'- VARIANCE GRANTED: Yes No . � � � `\ Y3 / � � e , � '.33' � <� � ), ' � 3� . i � �� I ",v t7 + I ` � 1 I �� , � �� !� ,. _ i#�r /' l�V No.. �' . Fs ... ............... THE COMMONWEALTH OF MASSACHUSETTS "a' HUvtD BOARD OF ! H B A LT F?arnsiaWe Cansery TOWN OF BARNSTAB1126 Appliratiun for 11iipniiaf Warkii Tonstrur wn Purrmilt y Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at: /�S 'oe� m,#p R. 273 32® G�ATLGD--.cj :.r..1-l �trt�LS = ! ......................P �...®: .� 1Address ��A --------Lot No. .�.. '--.... ....•-----......••....................... ..........................................--...... Owner Add s ----------------------------- _s�.� X---.44- _ .P✓q.,C.Mv.v._1212'-aOCr Installer Address Type of Building Size Lot..____1_2 L`_�C.-s,. fmt, U Dwelling—No, of Bedrooms-------2...............................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building ....... No. of persons......................... Showers — Cafeteria Q' Other fixtures -------------------------------- ••. W Design Flow•--••-------_--�57-6---•--_---•--•---.-gallons per person per day. Total daily flow......S3. -.•....................gallons. 04605f.Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth......._........ x Disposal Trench—No..................... Width............ Total Length...................% Total leaching area....................sq. ft. Seepage Pit No..................... Diameter..../0./...... Depth below inlet.....6--- ------ Total leaching area-5-61 ____ &PIP 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.......--............... 44 Test Pit No. 2----------------minutes per inch `Depth of Test Pit.................... Depth to ground water..----_- -------.---. 9 ----------------------------------------------------•----------..-:..------------......------------........................................................... 0 Description of Soil.....................................................................................................................................................-................. W U Nature of Repairs or Alterat•ons—Answer when applicable..._�1 -�T14_L e--.-.-6 .... ...-X-jam............... 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 Compliance has been issued by the oard of.health. Signed 0...�!. - ----------- -------------- �-2------ e Approved B ------ Application `y pP y --- 6i- . l . l Date Application Disapproved for the following reasons: - ------------------------------- - ......... ---- ---- ------------------------------------------------------------------------------------------ Nate Permit No- -------- ------ -------- ' ----------------- Issued -------� ------ Date 11 No----------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE � S s, Application is hereby made for a Permit to Construct ( ) or Repair ( j an Individual Sewage Disposal System at: A 2 /M 3122... -----------I---•N f'k... ---------------------------------------Z �------------- r ! Location-Address or Lot No. Jl--.- . �5' I ---•--•-----. --------------------------------------------------- Owner Address - .� max �` "� -P U —7;Y Installer Address UType of Building Size Lot........ Z __`..G. .q feet Dwelling—No. of Bedrooms........�3--------------------------------Expansion Attic ( ) Garbage Grinder ( ) � Other—T e of Building No. of persons............................ Showers — Cafeteria Pa Other fixtures ------------•---•------------------------------•-- . W Design Flow...............a. ...................gallons per person per day. Total daily flow........ .....................gallons. W6V10Septic Tank—Liquid*capacity............gallons Length---------------- Width................ Diameter................ Depth-•---__.-___-_-. x Disposal Trench—No. -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...../.0..1.... Depth below inlet.........'......: Total leaching area_.`�l� ...sg.�ft:C�Pa 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--_-___-_____-__--_._--- (i, Test Pit No.,2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GG •-------•-------------------------•----•---------••---.....--------•---•••-----------............._.......-•---..--------••-------------.....----•----...-- 0 Description of Soil...............................................................................----------------------------------------•---------------------------------•-------•---•- x V ......-•-•---•----•••••---••••••••---------•-•---•------••-•......................•-•-•---••....-•-•-----.....--••-••--•-----••••-----•••---••--......•••--------•-----•------------.._............•..... W UNature of Repairs or Alterati ns—Answer when applicable..... lT _ -L-.... _.h___`_XG__`.................... 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 Compliance has been issued by the board of health. Signed -------- ------------ --'-------`-- `---..----�---LL--------------------------------- --4.. ....19 -- ------ ��/" /�%i�� Hate Application Approved By ...... --- Date Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------------------- --------------------------- f .......................................... .......... .................._..-__.._.--._........--_..-____-..._.... .. Da te t Permit No. �'� ----------------------------==---------------- Issued -------------........Z7...- F------ ----------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE _ r Cer#ifira e of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X ) by.... ----E Installer at .. 3 zo G r45 7ZE - �oA_.....C./.. ...G 4 ------- ------------------------------------------------------------------------......................................... has been installed in accordance with the provisions of TITLEj5 of The State Environmental Code as described.in the application for Disposal Works Construction Permit No.rf_Z!.7__--40..11 _--__.... dated ' �C. .�. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. or DATE---- -- "`". ` 1...... ...� �f.. Inspector . ...... fir.._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No......................... FEEL.....�..`..�....Z..:... Disposal Works Tnntrnrtinn rrrndt Permission is hereby granted......_.. OG C-x C11 v/1 ),v_6 to Construct ( ) or Repair (y,) an Individual Sewage Disposal System at No...-'a--=`?�, G� �y . �. ............................................ Street [� y `/ as shown on the application for Disposal Works Construction Permit NI ._�'��?_ Dated.-l.-''._1,17-. .. . ..................... �G �✓.. ........................... Board of Health DATE- ---••---------• •................ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS - .,,we+iY.:�-iidlnlrlVt•ewr,nv�-euge.o�mncx ter,•.a�w.ls�.�ed�a,+,.avrfiwKrcae+.nw,•�wfrtrc.werncm.r..r rw,nr e�*.a.w. w.w,v.,.wr+.�,sa.m.ew.,•snewve,w•+..ax..men.e.rw+.wnn.s.��r,..a�w.avrw+.,...r.r�m�.•>wow..r...vw �ma.-rwxars,ac..e,e,..°au�1vr..nc..eevrwrta.•r,.w�.,.r....aar .wo.nrs.rrr.,s+row..m+sr•:oa+•-°+-c.r ...�.a...,w.,r..<+....e n.+..�rc...a<.wra�na...�....+,.�...r..�.•. a.:.,..�..rwn...•cw.....n...,ww.....a...,ror+.....•..^n.•rr.........,•,.. ..,"..w..ew+.•.vr.,x ..,.r..a�_,......u,�m.,r...».•..v..-,w.ar-.w+++wv S YS T EM PPOF L E NOT TO SCALE TOP FDN. FINISH GRADE 3 z FINISH GRADE OVER EL L . : FINISH GRADE OVER DIST. BOX ''✓ ? FINISH GRADE OVER °'b' D SEPTIC TANK LEACHING PIT -3 3- VARIES / n i p:' " p•: �•..0�.• .. 'o' •o.'•a. o. .e:•.��.o•-:� ..a:�.. ..,. .e., ..e . . .,e• - 3" OF 1/8" 1/2" 12" MAX .,. 0,:6. :.'.•p.• p:,'•: :a.•.'.•e:: .D:.. : .-.e.•°••'o.':o:•. s: �. ."a;d•'o,�o;e' �p• o :o: o. °. .:Q• °:e. ..a. e PRECAST CONC. OR o' , A SHED PEA S TONE — '— BRICK 6 MORTAR 311 OUTLET PIPE LEVEL TO 12" BEL ON GRADE o:p o • a °...e.:° :o.-o:°:p-.:-a., �n- e: o. 'o.• 0 o FOR 2 FT. MIN. o . °•n. 77-: • O: U't� e -717 a . 20. 673 C. I. OR PVC TEESot \H�3 ��+ o,00.o:?•- : .D n oI BSMT. FLR. ° . 0 0 0 GALLON ► D e DISTRIBUTION BOX ° PRECAST CONCRETE INSTALL ON LEVEL BASE 3/4 " TO 1-1/2"EL s PRECAST WAJff'�-%� ° H— /0 REINFORCED cR�s «D CONCRETE '¢ o.°.O. ,o o-o:o:..e:o: :o':o o.p.p:p•, 9,:p:.pQ•'e: 'd. STO/M ~ e .b:;o,•o. °..o.o°.o:o.A•.o:o.o;..n•••o,'••o,. �;�° o o•:o•o•.� ..o:.. a:. o b.°• . �/ .°• o ° /-7— / D REINF. SEPTIC TANK k o o•I INSTALL ON LEVEL BASE NOTE.' EXCA VA TE TO ELEV. /�- o !'OP a LOWER TO REMOVE ALL IMPERVIOUS — c MA TERIA L BENEA TH THE L EA CHING A,?EA I REPL A CE EXCA VA TED MA TERIA L WI TH r-—^�--�•1 - " CL EAN, CL A Y FREE SAND I �� EFFECTIVE DIAMETER \ V PRECAST CONCRETE L EA, ''YIr Y G PIT LEACHING PIT I GENERAL NO TES \ Z$ 0 1. A L L EL EVA TIONS SHOWN ARE BA SED ON 4 S S L)M l'D INS TA L L ON L E. V,=L BA SE N A- � 2. A L L PIPES IN THE S YS TEM MUS T BE CA S T IRON IV OR SCVECUL.E 40 PVC. 'c7, 71,-"'""3 6 3. THE BOARD OF HEAL TH MUST BE NO Ts'FI ED '��.: ,' _ WHEN CONSTRUCTION IS COMPLETE PRIOR _ �° Z�. TON RA TE.' TO BACKFILLING PERCOL MIN. IN. �, 4. ANY CHANGES IN THIS PL AN MUS T BE APPRO VED / B Y THE BOARD OF HEALTH AND CAPE 6 ISL Al�'OS WI TNESSED B Y.' \ SURVEYING CO., INC. 5. MATERIALS AND INSTALLATION SHALL BE IN Z� ,o�" --1 J- ,�� ,�« _s� -.,n ', 1 DESIGN DA TA > ---�" "� COMPLIANCE WITH THE STA TE SANITARY BRD. OF HEALTH *—��a yi ,o• ;� 35- ' CODE - TITLE V - AND LOCAL APPLICABLE DATE.' Y\� ` +- 2 =F m ° RULES AND REGULATIONS L O T '! NUMBER OF BEDROOMS 6. NORTH ARROW IS FROM RECORD PLANS AND r GA RBA GE DI SPOSA L % 5-h t' l� f n..�� a �� I`t , v I S NOT TO BE USED FOR SOLAR PURPOSES , N 1 \ `1FLOODf DAILY FLOW ? GAL 7. HAZARD ZONE L rrtn PPL T� -✓., -__._ SEPTIC TANK REO 'D. GAL . 1 " 8 WA TER SU Y i I S SEPTIC TANK PROVIDED GAL . LEACHING REGUIPED GPD. .III 1 � --y 1. SIDEWA L L AREA = ! ' <? S. F. S. F. X G/S. F. GPO 3b BOTTOM AREA S. F. A SINGLE ROW OF HA YBAL ES TO BE PLACED, ' STAKED 6 MAINTAINED DURING CONSTRUCTION LEGEND S. F. X % '' G/S. F. _ = <"' GPD I LEACHING PROVIDED =" = GPO s o0 o GALL ON L PROPOSED EL EVA TION PRECAST CONCRETE SEPTIC TANK EXISTING CONTOUR OBSERVA TION PIT ,,A AAA,• SINGLE FAMILY RESIDENCE G ❑ DISTRIBUTION BOX PROPOSED SEWAGE DISPOSAL SYSTEM 0 LEACHING PIT PPEPA RED FOR BOARD OF HEALTH AND TITLE V o o SEPTIC TANK s MCSHANE CONSTRUCTION VARIANCE REOUIRED (LESS THAN 10') tRP) RESERVE /�. ,l,; h LOT 24 OA KWOOD S TREE T CO TUI T BA PVS TA BL E MA . PIPE INVERT EL EVA TION DATE: Cc PLOT PLAN CA PE 6 ISL A NDS SUP VE YING, INC. SCALE.• 1 "_ -V 0, , G y SCALE AS NOTED P. 0. BOX 334 MAP 7:r'^ Pt-1 1 177 Pl_ AN NO. A TEA TICKET. MASS. .'