HomeMy WebLinkAbout0291 STARBOARD LANE - Health 291 -Starboard Lane
Il _ Osterville
r .A=,166—045 - 001
r� TOWN OF/BARNSTABLE s� i
LOCATION dp9/ �5 6i kA,1tvc1 1A1
SEWAGE #
VILLAGE e <C°�_ ASSESSOR'S MAP &LOTO —001
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
�v o d �Zcf f 5
LEACHING FACELrrY: (type) f iv x.?P'A a e/ iw. (size) .
NO.OF BEDROOMS 7
BUILDER OR OWNER Ioe
PERMIT DATE: COMPLIANCE DATE: ? r
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
0 !DOD aa
iJ3
s
No. [ C J V ✓ Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y_
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
01pprication for Migpogar 6p5tem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.V 9/— .57,4V4 yd Z� Owner's Name,,Address and Tel.No.
�..5 t,e vi l�o �Aix. ).t a, 5'0 s,
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
�� /a h � �111S
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
rf
Other Type of Building U No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S. cc� s S
Description of Soil
Nature of Repairs or Alterati ns(Answer when applicable MA L, 4 s c �� e Z
C
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued t is B and of
Signed Date -b
Application Approved by _ Date " 3P
Application Disapproved for the following reasons
Permit No. Date Issued
No. ' V U 1
„ .,r Fee
- THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
:z
t [pplication for•Miopozar *pgte'm Congtruttion Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.Z g/ S T (J Lu Owner's Name,Address and Tel.No.
s row.row.
Assessor's Map/Parcelv
cel �/l L ✓`�"' S'��"+
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
411,o A s IJ41//S . ni�}`�i 1 i
Type of Building: ' '! t
Dwelling No.of Bedrooms j Lot Size sq.ft. Garbage Grinder( )
Other Type of Building Is No. of Persons Showers( ) Cafeteria( )
Other Fixtures 1.1 lA
Design Flow 11 ons per day. Calcti ated daily flow . gallons.
j Plan Date Ntrrnbe'r of sheets Revision Date
Title'Size of Septic Tank �Jvv # `' )ype of S.A.S. *�w s s T.
t
Description of Soil ( , r I A o
v.., _M
.+i�+:V.=.. r 1 Il q,,�"'( /'d',,,/lam` ��i�i Y 9 {✓tom! 9 '✓!
l
Nature of Replairs orAlteratign�s(An fiver when applicable /1/�'v Q 7 wvv
� Y �
r Date last inspected:
Agreement: /A!
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued y is B ard of
Signed !17� Date
Application Approved by Date
k;. Application Disapproved for the following reasons {
Permit No. Z Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( W1.15pograded( )
Abandoned( )b� I
at F,q/ �a.,to(7 Gtti cX L.ow.2 0 w /lR has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer Designer r_a
The issuance of this t shall not be,construed as a guarantee that the s stem will/function a��designe�.
Date , / Inspector 171
1 1 "'
--9---- -----------------------------
Zgf—
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
,X0jigo5a1 *p!5tem ongtruction hermit
Permission is hereby granted to Construct( )Repair( Upgrade( )Abandon
System located at 2 �� ..T G�tfJ d Dta /a," d S it v f 1L
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this ermit.
elI Date: (9 r�
� / Approved by
N 79'45'20'E 1
I6J.34'
N —
v
PROPOSED ——
BOAT HOUSE o�ti�
? S O sop ' .
.
3b
20
x
h
LEACH PIT 1 o I LOT A
co PER OWNER U 47377 + S.F.
`y
cb \ �"
InLEACH PIT \\
\ w
PER OWNER O \\ \\ w
0
A
\ m \
*29/ \
Z r
t r
O \
133.88 95. 15'
' '
\\ S 82'43'J6'W 2I'02
S 76 26*06W
� \\ S B7`57'SB'W
65A CH PLUM LANE
THE LOCATION OF THE EXISTING DWELLING
SHOWN HEREON EITHER WAS IN COMPLIANCE
OF BARNSTABLE ZONING WITH THE LOCAL APPLICABLE ZONING BYLAW
IN EFFECT WHEN CONSTRUCTED (WITH RESPECT
INE RF— I TO HORIZONAL DIMENSIONAL REQUIREMENTS ON'LY) ~e
CXS OR EXEMPT FROM VIOLATION ENFORCEMENT
ONT JO' ACTION UNDER TITLE VI CHAPTER 40A SECTION 7.
DE - 15'
'AR - 15'
THE LOT SHOWN HEREON. IS IN FLOOD HAZARD ZONE C
-RTY LINES SHOWN HEREON AS SHOWN ON MAP 250001 0016 D. DATED JUL 2. 1992.
COMPILED FROM AVAILABLE
OF RECORD AND DO NOT
'SENT AN ACTUAL SURVEY
'E GROUND.
'WELLING DEPICTED ON THIS PLOT PLAN
WAS LOCATED ON THE GROUND
'RVEY ON JAN. IJ. 1998 AND IN
TOWN OF BAR�NSTABLE'
LOCATION _C9�/ (jt,/
SEWAGE #
VILLAGE
4-ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO: .-w In 14,
SEPTIC TANK CAPACITY ,
LEACHING FACILITY: (type).-/ /v x:z,>'x (size)
NO.OF BEDROOMS 7
BUILDER OR OWNER toe
PBRMTTDATE: 5 ' COMPLIANCE DATE: " `�c7
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom ofLeaching Facility Feet
Private Water Supply Welland 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)
Furnished by Feet
�' v�►9 \
V9
PQ
1/10 ?P
TOWN OF BARNSTABLE
4 LOCATION SEWAGE # 73 —/0
VILLAGE r
ASSESSOR'S MAP & LOT ,,�,• b
INSTALLER'S NAME & PHONE NO.49 6J,1 6� 5 r
SEPTIC TANK CAPACITY 02
LEACHING FACILITY:(type) ?,0?6 G,4 s'?' (size)
f
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATERS
BUILDER OR OWNER �"_ Tl1 3,c
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No.
r
z .
�s
Di3b!(
Db0
Y
/;F iRcs.... .....
THE COMMONWEALTH OF MASSACHUSETT APPROVED
BOARD OF HEALTH larnstable Conservation p3
TOWN OF BARNSTABL
Appliration for Diripwial Wurlw Towitrurt"tun Frrmit '
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at
-----
Location \dt csti or Lot No.
W ......................
.}- � ony
rL------ --- ,.- ----------------------------------------- -------------------------------------------- aa«55_........------------..._._....---.......__
n
a ....................../'% G C��~ -7 ....................... ......---------......--------------------------------------------------=------.....---.........---
Installer Address
UType of Building Size Lot............................Sq. feet
.., Dwelling—No. of Bedrooms............................................ p )Showers g ( )04 Other—Type of Building ............................ No. of persons...........--.--._. ( ) Cafeteria ( )
Expansion Attic Garbage Grinder Other fixtures ------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacit�2-:9&c�allons 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........................................
Test Pit No. 1............."..minutes per inch Depth of Test Pit.................... Depth to ground water......--....-.-.........
444 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................
P4 ...........................................................
-..............
------------------------ --....
--........
--.....
--------------------------- -----
® Description of Soil--------------------------------------------------------------------------------------------------------------------------------- --------------------------------------
x
�f p�rr Alterations—Answer when applicable.-.-.... _�-�.�._...-T---...-_-_�"."........__.�
U Nature ..
............ f
x ...-"..... �....
-
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 n issued by the oard e
Signe�, ... CJ:......
Dare
Application Approved By ---- -- ----4 ..-- --- -------0........... .... ... ........................................
Dace
Application Disapproved for the following rearonr: ...
................ . ............. ..................................................... ....... -- --
.. ..... ...Date...............
PermitNo. ....'�........... .... Issued ; .. -----. ......... .. .......—....... ........... Dac ..... .... .................
No...
THE COMMONWEALTH OF MASSACHUSETTS-
BOARD OF HEALTH
F " TOWN OF -BARNSTABLE--
i
Apphration for Uiripltoal Wor1w TonotrnrtiLln Urrmit
_ `A lication is hereby made for a Permit to C L_,;truct or Repair .✓ an Individual Sewage Disposal
PP Y ( .) P� ( ) g P
System
: .�?A�Z�o.g2 •C�STr=� �� //�
Locaiion-Address or Lot No.
W f� ,y owner, Address
T f
InstallerPQ Address
Q Type of Building // Size Lot............................Sq. feet
Dwelling— No. of Bedrooms._b--------------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
QOther fixtures -----------------------------------------------------------------------..............................................................................
W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid capacitw. - allons Length________________ Width---------------- Diameter.--------------- Depth................
x Disposal Trench—No. ..................... Width.................... •Total Length.................... Total leaching area..................... 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......................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fX Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a •-•-----------------------------------•--------•---------•-•---------•--•-----------.......-----•---.........................................................
0 Description of Soil......................................................................................... ----•-----••--•---•---------•••----•---=---....._.........------•-•••.........
x
c, .............................
w •
U Nature of aepairs or Alterations—Answer when applicable_-_-_ :..................................................................._._1... Ar PeS_
-------S-------------------------------.......................................................................................................................................................
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 •rhas-been issued by the board ohealth.
`Signed---- - ----- ...................:: . .....:: r -
.�.:.... �... .. ..............Date
ApplicationApproved By ............ ... .....................a.......... .. .7............._�{................ ...............-�.... .....
Application Disapproved for the following reasons: a/.... ........................................................ ......,.......-- ----------- ................-............
........................ ............. ..........._1�-................ ..............:...................... ......._..........:........_...................................../�./�]..../. /�/' ... .................................
' ..-..� .-5./..I..�..... ...Date
Permit No. ..........�...................... .. . _ Issued ...........:... .
....
1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Oler'tifirate of �'1����TT-amplianve
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( l
by �� � i-/
.............. .......................... .............................. . .............. .............................. ............ . . ...... ................ .. . --.......... --
� lI',t:dlet
at ................__. .... ... ....._. 7s�2 ivRrz�� "v-............D- -�
has been installed in accordance with the provisions of TITLE o�f The St n ironmental Code as described in
the application for Disposal Works Construction Permit No. __........... to dated ........__...............................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C NSTRUEA AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE. ........... -.3.."... ..._..-.f..3..... .._......._....._._......_...... Inspector _....�...: .._------._.:.
THE COMMONWEALTH OF MASSACHUSETTS
-- BOARD OF HEALTH
TOWN OF BARNSTABLE _..
No !.._!/ FEE........................
Ropnoat Workn Tanotrudinrt rrmit
Permission is hereby granted___________________ �. ..... -_ _ _...
to Construct ( ) or Repair (✓')an Individual Sewage Dispposal System GS-
atNo................... ----_-.. . / •off 2 ...................
Street ®
as shown on the application for Disposal Works Construction/.f-e"rlmit No.. .7T....... .... . Dated___�&_�!...4_ Q
q �3bard of -Health
DATE---------�-----•-1 a----- ------•--------------•-------------
FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS
"
Fee----= --
BOARD OF HEALTH
TOWN OF BARNSTABLE
Applicat ion-ft lV ell Construct ion A9ermit
Application is h eby ad, for a permit to Construct ( ), Alter ( ), or Re air ( )an individual Well at:
s a 001
- - -- ------------------- - --------------------
- � ��� �� --------------�--�-----'----`��'----------------------
Location — Address Assessors Ma and Par el
Id
Ow er Address
r
--------------------- --- dam d'� y3 -------
Installer — Driller Address —
Type of Building
Dwelling-------------------------------------------------------
Other - Type of Building---------------------------- No. of Persons------------------------
------__________
��61Type of Well------�. -�--------- ---------------- Capacity-------��----��-�'�'1----------------
Purpose of Well------.1����-� �Q?^=- ------
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in operation until a Certificat C mpliance has been issued by the Board of Health.
Signed ------------ - --�y 'date d----
Application Approved By - -.c.sc-- -- ---------- '-t tf- gym
date
Application Disapproved for the following reasons: —--------
-- -- — ---- -----------------------------------
--
� � -------------date -----
Permit No. --V%0c=-L6io ---- Issued----- -- - ---- -------------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of Compliance
THIS IS C TI That Vhhelldividual.-Well Constructed (Altered ( ), or Repaired ( )
by
— L -�J� ---
lnstalle
at-- Cal/ G'y , �---------
-- — ------- --
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No.W40—fZQ�_-Dated—„-3- 6
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----- -- - - Inspector------ --- ---- —------
k I
Fee----: �- ---
BOARD OF HEALTH' '
TOWN-. OF BARNST-ABLE I
pplua ton-*rMelt. Congtrutt[o* Permct.
Application is h eby made'for a permit to Construct ( ') Alter',( ), `or Re au ( )an individual Well at:
1 ri Locationk yAddress r < Assessors Map and Parcel 7 `
Ow er Address
- ------ (�/ff <?Oc�
- - - - - -- - -- ----
Installer = Driller Address ,
Type of Building
FDwelling --= ---- - ------ --=-- --
Other - Type of. Building-------- --------- No. of
Type of Well aP Y
GG --- C
YP ad _
--- _ ---- ——
Purpose of Well-----IA _!-CQ4�-i-^------
Agreement:
}
The undersigned agrees to install the aforedescnbed individual well in accordance with the provisions of The
, Town of Barnstable Board of. Health.Private Well.Protection Regulation The undersigned further agrees not to
• place the.well in operation unt�Certificatmpliance has been issued by the Board of.Health:
Signed
- ate '
Application Approved
date .
' Application Disapproved for the.following 'reasons: ----- ------ ---- ----- _:
date
Permit No. an d
f° _
- Do Issue --- - --- ---- ---- -
date
T.-7z!'wT��ry���s3i3s9:,e,�!al'�sarza?ariaa'!+.!sytil .Tess«�p.e���ge..�.:fres.�a:e�.aesnw,paeaaseaesxeseaeaesasramieasen+ea��es+avb€eses.Heavy*asrarsasoresaress+cefaasests-r,�aa:,ta^v�aw
sF�
BOAD,_OF, HEALTH --
E TOWN. OF BA'RN'STABLE
• ��ertfitate,��f����m�riance
THIS IS:,T0 C RTI That the I dividual Well Constructed (Altered'( ), or Repaired ( )
by, -�� — --all --- -- - - -- - - -- — -
t Installer
at- - / Ct.��e W � U!/iL — -— -- -------
has been installed in accordance with the'provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the-application for Well Construction Permit No.Ww_-A2_K Dated----? ,1-�6
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
it
DATE---- - -- Inspector-- -- - - - , ----- — ---
e8�a�btrr�aefra�rr-rro+6wrw!Vi91hses41h4�7aea±arr.seines l.et±fssasaae�seercvnae.H�.rw_sxiwe�.e.9asaerp+es+sRavu.sT,ieees!rrra��Trss,+..�:.vrRisb�r.:!3K.asaea.4i!i�as<aRSpr.±i...ss4ve:K
'II -BOARD OF HEALTH
TOWN OF BA°RNSTABL`E
Melt Cootruction3otmit
1\10.�N go , 60 F t .
---
ee 7
Permission is hereby granted
to Construct (l Alter ( . ), or Repair ( an Individual Well at:
Street
as shown on the application for a Well Construction Permit.
r /
No.- ------- Dated-=
//�/
. --------� � of Health
_ -------------- ----. .-----
Board
DATE
' j
.......................
J TH€ COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.- -------..OF... a. .. ,..
Appi ation -for Miy o iial Workii Towitrurtion Vantit
Application is hereby made for a P mit to Construct (�r Repair ( ) an Individual Sewage Disposal
Syst
------. --•- = = •---------------------1--�- •--------------- - ---
//ff L0. . -Ad ress aA (}., / r Lot No.
,--1--,�- --- -----;
Ow, r dress
W / ---
Inst ler Address
QType of Building) t Size Lot...Z.S... Sq. feet
DwellingZNo. of Bedrooms._ ........ .......................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons._____-.__--..---_--_---__ Showers ( ) — Cafeteria ( )
Q' Other fixtures _.__
W Desi n Flow_____________ �] gallons per person per day. Total daily flow................. :_� ... -----gallons.
gf:!
WSeptic Tank k Liquid capacity/ gallons Length---------------- Width-------.------.. Diameter---------------- Depth.___---...__.
x Disposal Trench—No..................... Width tal n t . ...,/.. Total leaching area--------------------sq, ft.
Seepage Pit No..� ............ Diameter../ .___ p e ow in et.................... Total leaching area------------------sq. ft.,
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY------'----------- ----------------------------------------------------- Date---------------------------------------
,4 Test Pit No. I________________minutes per inch Depth of Test Pit..------------------ Depth to ground water-----------.-____-.__.-
G%, Test Pit No. 2................min:;Z42
h of Test Pit.................... Depth to ground water_-__-....__--_--_._____-
a •------------ --•-------•--•----•--•-----••----------•---••--•--•-........................................................
O Description of Soil____________________
W ______ ' -_-
____________________________________________________________________•--•-----------------_____----------------•--------___----_- ---_---__-__-__ ____________________,_--_--_-__ ____.
-------------'----------------------------------------------------------------------------------------------------.-- ----- --
U� Nature of Repairs or Alterations—Answer when applicable.__--__C-- _--.__. .�,e ..------------------------------------- '
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
IL the provisions of Article XI 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.
Signed- --- ---------- ----------------•-------------------------•-------------------- •--•------------•--------
� ` , � � ate �
-1 Application Approved B Li=n''-rf•....• �� c --------
Date
Application Disapproved for the followi g reasons:' . ;
`� • ? ® Date
PermitNo.--•-•-------••••.....`----••••.i...................... Issu ... ------••----
tert .._....
Da -
_ _ -------------------------
�! iJ / a
. ;Z.
No. FBI . ......... .........._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_ OF... ... .:.: .„ • , - -:,...................
Applirtttion -for 43itipoiial Works Towitrurtion Van it
Application is hereby made for a P mit to Construct ( or Repair ( ) an Individual Sewage Disposal
--- .t,,� ---ff``.:._. ^! ""A'.r:P_,w+ '_-- -ae '"''•r `=-•-------- --------------------•--------•-----••-------•--.........--------------
v occation•Address t //�•/ /� M rreL./�ottt-pNo F
' _. f—----..._... Se{ --- ------------------ --- -S__.i .^ I�V�_.L _.2C=-tl_ ._.__............._..._..............___
Owner Address
a --•------•----------------------•---•---.....-----•----.....•-- ......................_........ .... ......
Installer Address
QType of BuildinS 4 m" Size Lot._: ___ ,� Sq. feet
U Dwelling—No. of Bedrooms___________________ __ _____---__-_--Expansion Attic ( ) Garbage Grinder ( )H
per, Other—Type of Building ---.--__._�y,________________ No. of persons.........__....._........._. Showers ( ) — Cafeteria ( )
0.1 Other fixtures ----------------•-------------- - - •-
W Design Flow................... T Mons er erson er da Total dail flow.._.._.._.....: .-_ -.--. Mons.
g �- --------�--g� P P P Y• Y00 g�
WSeptic Tank I-Liquid ca��acit\fW3._._.gallons Length---------------- Width................ Diameter................ Depth--..._.-_--.-:..
x Disposal Trench—No_____________________ Width._..__....._(.a_��.,,��i'-Total en tt _.el Total leaching area--------------------sq. ft.
Seepage Pit No.. _...__...___ Diameter _� 'Delp e o`w i et...p Total leaching area:___________ _____sq. it.
z Other Distribution box ( ) Dosing tank ( )
Date
a Percolation
Pit Test
NToRisults --- minutes per inch Depth of Test Pit_...........:...... Depth to ground water..--_-_--.--.-_._-.-. --
� I
44 Test Pit No. 2________________minutes per inch Depth of Test Pit.................... Depth to ground water......................
---•-------- >-....
D Description of Soil------------ ----- -e ------- -------------- ------------ ------
x
U
W - - ' �
� --
V Nature of Repairs or Alterations—Answer when applicable.-"-- r' . .` �
----- - ------- - - ------ -
------ ------------------- -----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI 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.
Signed ----- - --------
�';ih r 1 ate
Application Approved B �� -_.__.__.exs,..`���'` .>��' � � -
----••-
PP PP Y--=-- - -� °'r� -- -- -�----fit- --�-- -- --------
Date
Application Disapproved for the following reasons:-........................... '
.................................•--------•---------------------•--......-----------:._.---------------------------•--------------------------•-----------------------------------------.-------------
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH y" , AF
. ...........O F.... . ....................
Cnrrtifirttte of womplialtu
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ), or Repaired
........__.. R
bY-------•• ---- --
• , Install �'1
at----------- ram` --- ----- rF' ----_..... ------------------------------------------------------------------------------
------------------------------•-------------------------------
has been installed in accordance with the provisions of Article XI of The State Sanitary Code as desc ibed in the
application for Disposal Works Construction Permit No------------------- ------- dated.._ _... .17 _
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------------------------------------------------------------------------------- Inspector----------------------.............................................................
THE COMMONWEALTH OF MASSACHUSETTS
p
BOARD OF HEAL T � ��, �` � �'`�``
.....................
No.............. --•---- FEE........................
r �i����ttl �rk� C�l�t��trttrti�it �rrtttit
Permission ereb granted_______
to Cons u t e Ir ( an Indiyidpl�Sew�ge DisposalSyst
f�
at No.. :: 7 `. > r"r ------ � -- -----------
as shown on the application for Disposal Works Construction 1'eitittN =.` Dated.:t�'/ �
DATE--------------------------------------------------------------------------------
Q Board of Health .
FORM 1255 HOBBS.& WARREN. INC.. PUBLISHERS —.-•—
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N 79045'20'E , '
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t 163,34' y
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�t-,PROPOSED 9 I
BOAT HOUSE
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p 1 LEACH PIT 1, LOT A
V ? PER OWNER
47377 * S.F. LA
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ZE LEACH PIT
PER OWNER \ \ N von
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{'E 133.88'
S 76°26'06'W I �� S 82°43'36'W 21 'O2
E ACH FL UM
B LANE
THE LOCATION OF THE EX I S T I NG 'DWELL 1 NG
F # SHOWN HEREON EITHER WAS /N COMPLIANCE a
"TOWN OF BARNSTABLE ZONING WITH THE LOCAL APPLICABLE ZONING BYLAW
IN EFFECT WHEN CONSTRUCTED (WITH RESPECT
`�zONE RF— TO HOR/ZONAL D I MENS l ONAL REQUIREMENTS ONLY)
SETBACKS OR ,EXEMPT FROM VIOLATION ENFORCEMENT
FRONT 30' ACTION ,UNDER TITLE VI I CHAPTER 40A SECTION 7.
SIDE - 15'
k REAR I5'
e- THE LOT SHOWN HEREON /S IN FLOOD HAZARD ZONE C
PROPERTY L I NES SHOWN HEREON AS SHOWN ON MAP 250001 .0016 D. DATED JUL. 2. 1992. Q
WERE COMPILED FROM AVAILABLE
L
• PLANS 'OF RECORD AND DO NOT
REPRESENT AN ACTUAL SURVEY o
ON ,THE-GROUNDr` .
THE;DWELLING DEPICTED ON THIS _
lPLAN;'WAS 'LOCATED ON.-THE. GROUND r Q PLOT PLAN
BY SURVEY ON JAN. '13,. 1998 AND : IN
i. EXISTS.AS SHOWN AS OF THE DATE I" OF 4f, � � � BARNSTABLE, MA .
' OF LOCATION.
�• mac`' SCALE: .I.'-30' JAN. 14. 1996
MANK
THIS PLAN IS FOR PLOT PLAN s
AlNo.2986 EAGLE SURVEYING , INC PURPOSES ONLY AND NOT FOR '- `
a
RECORDING. DEED DESCRIPTIONS . ,�F��` l� °i�r..w`�`a; 923 Route M
av; �°a Yorrmuthport, 1 k. 02675
OR ESTABLISHING PROPERTY LINES. —'�/ (soe)a3e2=8132
(508) 432-5333' .
THIS PLAN I S V01 D IF NOT
STAMPED AND SIGNED 1N�RED. ;n'`�
PROJECT NO. 98-142
^, - - - - —