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HomeMy WebLinkAbout0030 TY-DEE LANE UNIT #B - Health (2) n Ty-Dee Lane Cotuit A= 023 —028 0 0 z 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 1 i 1 �3 5 e r 1 W qq 6 .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•'„�,. x , - 02 3 i�`1 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 37. _ HSE #_30=— ( —COTTAGE_ __ __ __— \ =_===--== —__--_— Z U PARCEL B ® .— 27,700f SQ. . F T. :: . PARCH 77M S€D'VC SYSTM( FAS DRA'AW MM TIM 7OWN OF BAIRNSTABLE (51 ^Do }' SEPTIC MSTAIJ.SR.S CARD (n a E 91.90'. lI N 89'21'-20" W 1 13.29' N 8 '53 50 TY— DEE LANE cB ,► (AM) v SN i °� F� F� sm ♦ 4 STEr'EN ♦_ O N YLE GRAPHIC so 0 15 S i inch = __ I f - l � I o K 0 I I C !�l• C � I I I i I i � I I n I I , I I i S AIQ Nu I � l 4� 6t�.y0 .4 1 9 Vi L Y A;z' 6.1 ft � ; . SHED S 87°05'10 W., 165.29 i r ti I. } 15.5ft 10.4ft ___ - 15.Sft ;, --___— __ _—__ 52.3f + 37. _---_- - -- _= C Q x ' ==HSE #30 Fn _C_OTTAGE_ ------------ f J .z = _ .4 - s 2C09 YLua:lt:i R¢ y# .', �" :.: = =_ �.: • A1a btn Z'2tiC9 NwvTEW.TttL4Als LOCUS MAP QO �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 :! 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