HomeMy WebLinkAbout0036 EDGEHILL ROAD - Health 3l, &�je I�tq A�tmi3
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TOWN OF BARNSTABLE
LOCATION ' a SWAGE #
VILLAGE - 6'L� ASSESSOR'S MAP & LOT
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sq���
INSTALLER'S NAME & PHONE NO.
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SEPTIC TANK CAPACITY -) �X(�
LEACHING FACILITY:(type) 91x <. (size)
NO. OF BEDROOMS �Z PRIVATE WELL OR PUBLIC WATER jQeX-"-
BUILDER OR OWNER
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DATE PERMIT ISSUED: /
DATE COMPLIANCE ISSUED: Z,J
VARIANCE GRANTED: Yes No /�
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ID
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THE COMMONWEALTH OF MASSACHUSETTS
_ BOAR® OF HEALTH
..........� ...............OF.. .1 9�A cS l....L°-.........---------.._....................
ApplirFation for Uiopos al Works Tomitrurtio n amit
Application is hereby made for a Permit to Construct ( ) or Repair (�O an,IndMdual 5e{wage Disposal
System at:
36 fie-Zi-1%LL V-�� -1 �� Y �-+,►s`tamn zr�
.... _. ........................../.•..... q T --• -
Locatt
Lot
......�.,� 1''11. 1. 4 `'�a !r a o� ..::.1�.A.:19��_
ner Add ss
:�.1. ,e7.._.�tME;.. � . ..--•----•-------•--------•-•--.... ,... 't�2ni S ...��/
P �3s... .�- .... -•--•......:.............. ...
Installer Address
Type of Building Size Lot___Z419(p.....Sq. feet
eEi»GV feowi 10 '``11
Dwelling—No. of Bedrooms ........................................Expansion Attic (W� Garbage Grinder (�Cj
Other—Type of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures .____•-_-----------------------------------------------------------------------------------------------------
W Design Flow........5_J�..................... .gallons per person perday. Total daily�flow.....�?Q.........................gallons.
WSeptic Tank—Liquid capacity=)_gallons Length�l.'l.%...... Width.C-.G.__.. Diameter................ De tl . .. ....
x Disposal Trench—No..................... Width....'13............ Total Length_-_`"&Z......... Total leaching area--- a....sq. ft.
Seepage Pit No.--_____.--_-_-_--- Diameter.................... De th below inlet.................... Total leaching area..................sq. ft.
z d� nk i
a Percolation Distribution
Results Performed bying� I- -'............... Date........................................ _
y ���jj - I
Test Pit No. 1.4..Z.......minutes per inch Depth of Test Pit-----�0......... Depth to ground water._ul`�Z:_�_woo_ CQ
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit__-______ ___-.-- Depth to ground water........................
---------------------------------------------------•----•--•---.....----•••••••• ..........
..---------------------------
..:...............................
0 Description of Soil........ ��' 1 OAtwl _�B Ol.4�..z'1�� C ¢ 1.17
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 Enviro mental Code The undersigned further agrees not to place the
system in operation until a Certificate of Com ian e h bee ' sued by he board of health.
Signed . .......... -- ..'..'............' ..... ....................................... .. I f--------------
A lication Approved B 4— -0;5,
I
Date
Application Disapproved for the following reasons- ........................................ -------------- ---- -----------------------------------------------------------------
------------------- ------------- ..--------------------------------------------.......----------------------------.•-•----------- --.......-------------------------------
Permit No. -------- '.-.. Issued ---------e r ......"QA�f...
�� Date
No........!...........� FE$... ���.1....f
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........................................... .........................................................................................
ApplirFation for Biopoiital Works. Tonitrur#ion ramit
Application is hereby made for a Permit to Construct ( ) or Repair (K) an Individual Sewage Disposal
System at: r, I
................__.......... ... .. ..............................----... ..................................................................................................
Location dr ssa 'r Lot No.
Owner Address
W
Installer Address �`
Q Type of Building . _ .,. Size Lot. ..
..... ....t..............Sq. feet
Dwelling—No. of Bedrooms...........................................Expansion Attic (A.+ Garbage Grinder ( )
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures ---------------------------•---- ---
W Design Flow........n.............................gallons per person tper day. Total daily Pow...... .-r!0..........................gallons.
1:4 Septic Tank—Liquid*capacity r(X`'�-.�.gallons Length;) E.t.._. Width_ .. Diameter_''............... Depth ...............
Disposal Trench—No..................... Width.....��' ........... Total Length_._1�2......... Total leaching area___~.. �!;t....sq. ft.
Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box (` )� Dosing tank ( i 4
Percolation Test Results Performed by............................._i 4... ............................... Date........................................
,aaa Test Pit No. 1_A.7....._..minutes per inch Depth of Test Pit------- ________. Depth to ground water_,s.'. .-A....
�T4 Test Pit No. 2................minutes per inch Depth of Test Pit______-_-...-____--- Depth to ground water--__--_____-_--...____
ODescription of Soil........ -- 'o .t.... ` - ---"•-" "--....."-- ..................................................
x
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 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 .................. ............_._.......----...---- --- --.........................--- ........ ........................................
Application Approved By C ' ---------------'`-t�----�r
- ...------......-'��.r ...--'------------------------------- Dace
Application Disapproved for the following reasons:
-- - ----------- --- -------- -- ---- -----
� ------------------------------------------------------------------------------------------------------------------------------�- �
-----------`-
j---Date----
a`
-- --'-----------------Permit No. Issued _f
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OFdt�ilktss4.�.„
Certificate,cate, of CIlumplianre
THIS IS TO CERTIFY, That Individual Sewage Disposal System constructed ( ) or Repaired ( )
:�.. ...--= .. -.�- .
Y ......................... -----_--------- - ...... ;
� - ---------- Installer
at ..--- .... CzisH9t i. i7 ,a�a E.f: .. �'. ......- -- t ,n+``� _......
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 _--_, ...""...�.""F�....1
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.......... . ..... ................................................... .................... Inspector ............. --------------------------------....................--------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF `'HEALTH
� o fit+.! -I t t ..
,., .......OF.....................................................................................
No... ............................. FEE. ... ...h'!:
Disposal Workv T-Fonstr ion rrutit
Permissionis hereby granted............................-------•-•.....----------------------•-......•-----------------------------......---•--"•-"--•"•---......---.....
to Construct ( ). or Repair (A,) an Individual)Sewage Disposal Sx; stem _
at No..... .+ � < t . -
................................. CF , ,/ 2c1� .� t' \V ...............
•""-""......----•---
Street // ,�rr
as shown on the application for Disposal Works Construction Pero, !_'"'� ._ Dated... ' _/�.,`.-_ _t:f_-........
4
00,
p�
„ ,. Board of Health
DATE------. .......................
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
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SMITH
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HYANNISPORT
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SCALE 1 • 25,000
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PLAN OF LAND
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GAR SCALE: AS NOTED DATE: FEB.8,1991
AGE J
99 STON �6 BAXTER & NYE INC:
CB FND CBS e �R�� \ REGISTERED LAND SURVEYORS
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FND OFF GAR _ _ l lg S6 OSTERVILLE, MASS:
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PA suulvAN �' Rrc�AAo
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SCALE: 1' - 30'
DEED REFERENCE: BOOK 7416 PAGE 252 # 910 11
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HYANNISPORT "'►' K 1 1 O = _770 C�P�
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PLAN OF LANDIN
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GAR ' SCALE: AS NOTED
� � DATE. FEB. 1991
A �
GE
CB FIN 99 SrpNE 6
R1 BAXTER & NYE INC.
D REGISTERED LAND SURVEYORS
VC
CB wq Y 62 CIVIL ENGINEERS
FIND OFF R: 1 118 5 OSTERVILLE, MASS,
GAR, 6
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\ c> CAS .�R� ZN OF ,�
T l�Y PA V SULLIVAN AM AM
E �l;S I v \�R/V�� No.29133A.
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ti f ONA L SCALE: 1"= 30` �' ,_.
DEED REFERENCE: BOOK 7416 PAGE 252 O # 91 Oil
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