HomeMy WebLinkAbout0030 TY-DEE LANE UNIT #B - Health (2) n Ty-Dee Lane
Cotuit
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TOWN OF BARNSTABLE
LOCATION" Q SEWAGE # "2 1
VILLAGE COTU-J,T- ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY /000 �
LEACHING FACILITY:(type) P 1 �
NO. OF BEDROOMS 3 PRIVATE WELL OR CPUB�LIC:W�ATER
BUILDER OR OWNER AAQ CU A
DATE PERMIT ISSUED: ���
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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.ASSESSORS MAP N0: Fss...�.Q....:."-
TFHEr'�DI�i A_ Sr S_ ACHUSETTS
APPROVED BOARD OF HEALTH
Barnstab Conservation Department TOWN OF B A R N ST A B L E
Application is hereby made for a Permit to Construct ( ) or Repair ( ' an lndividual Sewage Disposal
System at:
............... .. ....................... ..... ma y !'!. -- --•---•---------------------•----•-----.....---------- ----
-•---..... _ ...........................
t ....
Location.-Ad ress or Lot No.w ......•••-•----------------------•-•-----•--------......----•-.....................
- ..
e owner � Addre� �
Installer Address
Q Type of Building Size Lot................ ........Sq. feet
U Dwelling No. of Bedrooms-------......----------.----------------- .Ex ansion Attic Garbage Grinder
aOther—Type of Building ............................ No. of persons------_-----_.___---..-.-. Showers ( ) — Cafeteria ( )
Q' Other tu�res . P9
W Design Flow............... ...-_gallons per person per dam. Total daily flow...... _�. ..--....................gallons.
W Septic Tank—Liquid capacity/j: . .gallons Length.-..-. '. .. Width -daily—flow
.'.>...-- Diameter................ Depth................
x Disposal Trench--No. .................... Width.................... Total Length..-_.... ..r.._... Total leaching area....................sq. ft.
Seepage Pit No........I......... Diameter...�A............ Depth below inlet... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1----------------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..........I.............
0+ •---•----•-•.....................•-•-------•---••••--...--•--••-•-•-.............................---.........................................................
0 Description of Soil......................................................................................................................... --•------•----------..........................
x
W -•-••--•-----------------------------------------------•....----------------•---•-•--•-••••-------••-----......-----------------------------•--------------• ----------------------
U Nature of Repairs or Alterations—Answer when applic le.. .
---- --- � - Uh.�. U ��'?'�''
1. .--. I_ --------------------------------------------------------------------•---------.............
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 ...--. ® Al` 1-............... 6 .. ..3.. . ........ ..............
ApplicationApproved By ................ �..,, =-•�---- ---------........-------------------------------------- .----- ......�.a
Application Disapproved for the ollowing earonr: ............................. ....--. ...............--........ • . ...............................................
................................ -------------------------------------------------------------------------- ........................................
p
Permit No. .........:../--.:.��..-....aZ -. ...-..... ...-.- Issued Issued ........................................................3...
Daze
_ Y V".:.=�Lw-:r'+„ ^-...--:5'V c�a..✓ �"w-----"`'ter:id �r-.-�,--� W W':"'^„y0..r":''`+y'"-'' .esw`_'"-*•.w; s-,-�'-v.�w-`�'dvj�'-r.� L �ri;,,r•'„�,.
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THE COMMONQE2OF MASSACHUSETTS
BOARD, OF HEALTH .,
- - TOWN OF BARNSTABLE ~.
App iratiun for Riripuiul Wor1w Tunutrnrt"tun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
.........................................0 :T - D E e (,..................
Location-:\d 9r7
s or Lot No.
...--•---•--•--------•----•-------•-•--•---•..................................•---._......._--__•-
owner Addre
Installer Address
d Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms:______J-------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
a' Other fixtures ..
W Design Flow............. Tom_,.____..gallons per person per da . Total daily-flow_____�_3_6_.______....._____..__..gallons.
WSeptic Tank—Liquid capacity/W.0galIons Length------ '_ ._ Width-5_,.5_____ Diameter................ Depth................
x Disposal Trench—No_ ____________________ Width-_..___-...._._-____. 'Total Length........._.__...._ Total leaching area_...._...__.._......sq. ft.
3 Seepage Pit No........1.---...... Diameter---4�__--._._.... 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.......................
fZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
04 •-••••-•---•----.......••-•------•---------•---•-•-...._..•--••--••---•-•--......:_•---._._.._..••--.........................................................
0 Description of Soil-----.....-•--•--••--•..................................................•---------------------------•-•--------------a--•----•----•-----•---------•----•___•-••-•_•-••--
bC
V
W
x .............................................. -----•--...---------•--......------•--••---------••-----...--••---------•-1.4C-•••••••-----•----• --- •• ----....._-••••--
U Nature of Repairs or Alterations—Answer when applic blew_-_ �...............
� e
� � _c���.�'�_�.� ./mot-SUC,�►�1-.�
..-----•------------------------•------------------------•--••-•--.....-----..............__.
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 ..\ � , -.....k.-_---._. ................................ ..G./... - .. ...
• Dare
Application Approved By ................. q.
Application Disapproved for the allowing-•easons: ...................................... ... . ............................................. ....................
. ........................ . . . . ....... ..................... ................ ...... .... ................--.................................... ........................................
l Dare
Permit No. .........: Issued .............................
Dare
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of Contyltttnce
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (C-)-
by ....... '�.- ��'I�1-- --- -
--,��..Y4 C....(C_�� -r1 �.-- - �t...1.%(Z. t..................................
at � 3.0 T�f---'... .G. .........(_A wlF.-1---- -------------------------------------------------------------- -------
has been installed in accordance with 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..................&..._- _...C.. ----------------- .......... Inspector ................ ---
-----...----------
_----...------.....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
FEE-��_. J._
14sputt1 Workii Tunutrurtion Permit
Permission is hereby granted _ _..- ..--------•--------------------------------------------•--•-
to Construct ( ) or Repair (4.4-a;n IndiviA ual Sewage Disposal System
at No. U ------ --------------- -----------------------------_-scr«c------------------------------------------------------------------------------
EC
as shown on the application for Disposal Works Construction Permit No �- Dated...........................................
..............•--•-•--- �.` . -----------------•._......•-•---------••••--•--•._....
ar of Health
DATE------. •-------------
/ q ----------------------••-•-_-- Bod- r
FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS
Potosi I
S 87.05 10" W 165.29' 6A ft
SHED 10.4ft _--=—
_ 52.3ft
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PARCEL B ®
.— 27,700f SQ. . F T.
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FAS DRA'AW MM TIM
7OWN OF BAIRNSTABLE (51
^Do }' SEPTIC MSTAIJ.SR.S CARD
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N 89'21'-20" W 1 13.29' N 8 '53 50
TY— DEE LANE
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LOCUS MAP
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�n ---- PARCEL B N PLAN REF 271-47
27,700t SQ. FT. . o, DEED REF.
12948=338
T PARCEL A ASSESSOR'S MAP- 023-028
ZONING. "RF"
SETBACKS: 30'-15'-15'
o FLOOD ZONE. »C,,
-..:
;.,.; r PANEL NUMBER. 250001 0021 D
�.r t` DATED. 07-02-1992
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C/, ,::...`::::: - PLOT PLAN OF LAND
LOCATED AT.-
�;:.., 30 TY=DEE LANE
COTUIT, MA
S&T
i
84°53'50 E
A N 91 .90 (Fain) a 4�d PREPARED FOR:
� N 89°21 '20" W 113.29'
JARED J KELLEHER
Q STEPH-.
TY- D E E LANE A JUNE 15, 2009 .
r DOl LE €
' r� 06, 2009
.:
®� EV. JUL Y Al,,o u REV SEPTEMBER 14, 2009
REV
(F,JO)
YANKEE LAND SURVEY
_ GRAPHIC . .SCALE CO., INC.
30 0 15 30 60 40 INDUSTRY ROAD
MARSTONS MILLS; MA 02648
TEL' 508—428—0055 FAX 508—420—5553
1 inch 30 ft.
SHEET 1 OF 1 JOB , `' 54515 JF