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HomeMy WebLinkAbout0359 BAXTERS NECK ROAD - Health 07e- 359 BARTER NEC475� LC 3,M.MILI A=075-007-3 I� i t I r J TO:VN OF BARNSTABLE . LOCATION Jnv- 3 /E/s"#3s9 ��cucs-��eek/2c� SEWAGE # 9F--3V/ t fs� ASSESSOR'S MAP & LOT a,2X-0 0 7--3 VILLAGE---&%a>—s rzn.s 117, INSTALLER'S NAME&PHONE NO. 0acks- [ itaawiz 7) 1 V 1Z9 SEPTIC TANK CAPACITY -_ 2g0-00 Tr-:�y Cb LEACHING FACILITY: (type) 7 — Sao C✓-.- weS (size) &'IJ X 4C 9 'A- NO.OF BEDROOMS Bi:PER R OWNER X,60-J /2eahse PERMTTDATE: 11A1 9 COMPLIANCE DATE:_% -I.t �Y 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 lq\ hhing facility) ( ` Feet Furnished by r 6� � 6 IL 60 B1'9 �.6 0 (D No.,� ' A.. Fee 1 w°,a THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 01ppYicatiou for Mopo.5al *pgtem Construction Permit Application for a Permit to Construct Repair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. r o-[3 j iA 3 S 9 t3Adcc Owner' Name,Address and Tel.No. 1--7 6 l'-769^ Z 22 2 ►plc—ctc t2cfao �M �aav Mt t t19 C— Cast C es�c t-(`�'t?vST Assessor's Map/Parcel AP'7�.Q�t2LEL ?_3 2 J`1�i4►u.'i'OKk Sr ii MoewoocD MA b?_©GZ tawIle Name,Addres ,and Tel.No. D igner's Name,Address and Tel.No. « k-e " &r C®_ �zo E � Su�.LVvata PL V- L-�,..-e- 77 +28� .Z ►�,42� 20�o Cis iv't L L Type of Building: Dwelling No.of Bedrooms Lot Size95 g 97 sq.ft. Garbage Grinder($35 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 5 so + ° gallons per day. Calculated daily flow 8?A gallons. Plan Date i9 L_-[Z9 5 Number of sheets Z Revision Date Nk>iJ E Title g LTC— QL-I,VU RoPC6tp '0,aq-aC. -Ysyem @_ 3S9 & ,1z-e L,ECrLS.c) Size of Septic Tank 2©©o C611tc.c_oW `ZC.e Y4,, Type of S.A.S. 1..l►AGtAIA_Yc>Ct}Aom36Q Description of Soil C� ^ Z q e ,. LaR w&4 S U eSO L L Z4"— l` o�r 1 M cJD !E;A h j0 taco \4_J awe_ Nature of Repairs or Alterations(Answer when applicable) 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' s !!�b�ythis &Bo of He lth. p Signed tt � Date Application Approved by c.�,.,a...•.�� Date Application Disapproved for th ollo g reasons Permit No. Date Issued TOWN OF BARNSTABLE LOCATION in7- 3 pk�� SEWAGE # ��'-�� VILLAGE /�.a rc Ta n S /l'/,/JS ASSESSOR'S MAP & LOT Q n..S-0 o 7-3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) -2 — .5'a0 e� ) / �Y wti�S (size) NO.OF BEDROOMS S �l BUILDER R OWNER -6 x.60 I PERMPTDATE: I / 7 COMPLIANCE DATE: % 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 1Whing facility) Feet Furnished by s 09 Q P l y 'Vr / U`c E _ . F No. a ' �` a. \Fee THE COMMONWEALTH OF MASSACHUSETTS Entered i computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS, 3ppfication for Migoal bpotem Con5truction Permit Application for a Permit to Construct( ,X)Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. �l 3 j 1* 3 S 9 E Ax TC4 Owner' Name,Address and Tel.No. --7 8 t-769- Z ZZ Z cGIC (?c�.o �Ma,2scaty Mt } t rU C C6, C V CA�r(`='2.Vs'i- Assessor's1maplPamel M AP7 J- T fie.C.0 t--��—J "72,5 C �u vo K S fA01ZWOe%-,) MA 0Z0GZ nstal e s Name,Addre and Tel.No. PCigner's Name Address and Tel.No. I'tre- + n.iv Co- ` A,( .. E!'�(L. � UL_L,kVA1l PC oS�- 7Zt -U'2 11 (��r.c "Z ►�n.rZ.KCc�. (ZoRO �5"�2.�/t t...t_� Me. Type of Building: Dwelling No.of Bedrooms Lot Size93)4 9 7 sq. ft. Garbage Grinder��S Other Type of Building No-of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow S?A9 gallons. Plan Date Ou r-`4 Z9► 9 Number of sheets 2. Revision Date IBC» L Title S t rC— PL P,"U 20 c—PTl(_ S1(ST-r AA (R. 3 S 9 1,24,x m U ELt=e\'D Size of Septic Tank Z� V 2 L,0A GCAL(_ 'Q -2COMPe Type of S.A.S. ix(-"1 C-ta N►NG.C �BC:e Descri tion of Soil Q "' Z.q C.L7 �I�.t v L'7 1�C> !�A i�r�'.. (=t•,.a L oc.�ti.d TLC?�'4� Nature of Repairs or Alterations(Answer when applicable) 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 is Bomqof Hgalth. Signed Date d Zt S' Application Approved by Date Application Disapproved for thVfollovQg reasons 5 Permit No. Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired( )Upgraded( ) Abandoned( ) at 35 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. $ ' O/ dated Installer _ Designer The issuance of this pyrmit shall no byconstrued as a guarantee that the syste will function as designed. Date / / Inspector --------------------------------------- Fee { THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 4, lioogaf *raem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) n/� System located at 7 f�X"C tZ CL1C ZOAD 'M AP_STZ)N S `",Z Lk-5 0i0-a I A)c u V_'V-� and as described in the above Application for Disposal System Construction Permit.The applicant recognizes hislfi r duty to comply with Title 5 and the following local provisions or special conditions. / D Provided:ConStructijA rnu t b completed within three years of the date of this pe - it. J y Date: Approved by NOTES DESIGN DATA 1 LWaterSupplyForThisLotisMunicipa!Water Single Family=5Bedroom With .Garbage Grinder 2.Location of Utilities Shown on This Plan Are Approx. Daily Flow=110 x5.=550 GPD At Least 72 Hours Prior to Any Excavation ForThis SepticTank.550 x 200%=1100 Gal Project The ConlroclorSholl Make The Retired Use 2000 Gallon Septic Tank With 2Compartments. Not ificationto Dig soft(1.800-322-4844) LEACHING AREA 3 The Contractor is Required 10 Secure Appropriate 825 GPD>0.74?1115 SF Required Permits From Town Agencies For Construction Sidewall=2(12.67.)2=316 S.F. Defined byThis Plan. Bottom Area=dx67.'= 804 SSE. 4 Install Risers as Required to Within 12"of 1120 SF.Total Provided Finished Grade. LEACHING CHAMBER DESIGN 5.All Structures Buried Four Feet or More or Subject' All Pipes lobe Schedule 40.PVC to Vehicular Traffictobe H-20Loading. 7-500Gal Leaching Chambers in 66 Septic Systemic be installed in Accordance With 12!x 67'Washed Stone Field as 310 CMR 15.00 Latest Revision And The Town of Shown. Barnstable Board of Health Regulations. 7. All Piping to be Sch.40 PVC S.Septic Tank Shall be a 2000Gal., 2 Compartment. The First Compartment Shall Have a Volume of Not Less Than 1I OOGa1.And The Second of Not Less . Than550 Gal. F.G.34.0 F.G. 33.0 94 31.0 29.1 30.8 SEE NOTE 30.6 a Top.E4 30.1 No.8 29.5 Sot.E1.27.1 29.3 s.•. •.. Bedding as 9.1 Per Title 5 10, 10.5 55 10' 1 Bottom of Test I•lole El.I8, No Ground Water. DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM Not to Scale Finish Grade 2 Filter i 00 Fabric mpacted FIII N Pea StoneOF io PMp Leaching 3/4"-1 1/2Double SU"AN a Chamber Washed CML W " 1 4-1 I f I � W-0�� 0 CROSS SECTION OF CHAMBER .NOT TO SCALE SHEET 2 of 2 LOT 3, PRINCE COVE REALTY-07/29/98 .� t 1 r y b75 s T. No....................... t._o-r -7—3 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ApplirFation for Dhipwial Workii Tomitrnrtion ramit Application is hereby made for a Permit to Construct (Y) or Repair ( )---an-Individual Sewage Disposal System at: 4j j 9 ' ��yy /J Location ress` �y �f j �/ �/Jor Lot o. �m ➢ ���/ Owner Address W ...._ ........................................ •--------------•--....._............................•.. Installer Address dType of Building �� �A � Size Lot... ... ...Sq. Ve Dwelling�o. of Bedrooms..................�.......__..__.__..__..Expansion Attic VY0 Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ................. ...... •-.----- W Design Flow................................. Ygallons per person per day. Total Jagiv Dow----_................ --.---..! agons..., WSeptic Tank�Liquid capacity' gallons Length.... Width . ....... Diameter:_-— Depth.. -.�. x Disposal Trench—No..................... Width.................... Total Length....... _._.._... Total leaching area....................sq. ft. Seepage Pit No.-.------a...... Diameter......... _.q.. Depth below inlet...... _....... Total leaching area.....F<Xsq. ft. z Other Distribution box ( ) Dosin tank ( ``LL aPercolation Test Results Performed by. .. .1 �� �-............... Date_..v�.`.. /6r a Test Pit No. 1................minutes per inch Depth of Test Pit....//.......... Depth to ground watero_..�..._..__. (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------------•-•--------•---•--•-•---........(---•------------------------------------------------------------------------ O Description of Soil---j52--!�F---------------- K s `�L�" ........-�--- 0-----.C� tl__I_V'14v'...5�4....... x U W -----------------------------------------------------------------------------------------------------------------------------------------------------•-----------------------------------------.._...... VNature 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 ----------------- --------------------- .--- " — — to---- Date ApplicationApproved BY --- --- ------------'--..... .. ----- -...-- ----...-.......--- -- -- ...-..._.....--Date..........----.... Application Disapproved for the following reasons- --------------------------------------------------------------------------------.... ..................__-------------------------- ------------------------------ - --------- .--- ------- Dare Permit No. ...... ....'"-' " Issued " , to THE COMMONWEALTH OF MASSACHUSETTS / BOA� OF HEALTH �/- UV-AJ.. ... OF ... ----------------------------&r#tfi a e of Tomplizxxt e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( �/` ) or Repaired ( ) by ........................................................................... ------------------. In .....--------............--------.-------------------- ..................--... ............-...... J _ ...... ....... / staller ��y,� at ---.ems f ' --...... )G�------� �rf 1 U!{.15-..L�,t .._ ....... ' ' �* has been installed in accordance with the provisions of TITLE f he St E vi e s described in the application for Disposal Works Construction Permit No. ted ...........................I------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT E CONS E A A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------------------------------------------------------------------------------- Inspector -------------------------------------------------------......------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �•, ......... .......OF....... .f E�............................... 10C) No...... FEE........................ Disposal Workv T11notr i an rrnait Permissionis hereby granted---------------------------------------------.------------------------------........_..--•-------................---•----•---................ to Construct (9) 9r Repair ( n Individual Sewage Disposal System at No......................./ `fi r --i ... .-..�..ODated t� - _. . -• . -• ............... Street as shown on the application for Disposal Works Construction Permit N . .._ .......................................... ----•••••--------•---------•-•----------------------------------------------------------••-•---•---...._ Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS J No.----•-.` -) -�/ -,?, ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /. . c.�►,c O F... :...........' . ....................•-•--•......•...•---- ApplirFation for Bhgpoii al Works Tomtrnrtion Vvernat Application is hereby made for a Permit to Construct N or Repair ( ) an Individual Sewage Disposal System at: `y Z:... -. 1�f ---- �-- = .�.�� .. � : r�'±�%` ....� /...................................... Location- ress or Lot o. Owner Address W Installer Address d /Type of Building Size Lot.. � .....Sq. fe t Dwelling No. of Bedrooms___________________J-___-._-___--..____-___-Expansion Attic � Garbage Grinder (��.5 a Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria Q' Other fixtures -------------------------------- . W Design Flow.................................5.S-_gallons per person perodV. Total�'jy,gow..__...._.__._._..._je. ........gallon.,. WSeptic Tank—Liquid capacity-'ok- '>_gallons Length---¢.fJ`__ Width.F_.:7?5P...___ Diameter----""-------- Depth ..- .... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------s2........ Diameter......._/.�/.. Depth below inlet.....C:e?........ Total leaching area..._.��_.sq. ft. Z Other Distribution box ( ) Dosing�tank ( ) r.. a Percolation Test Results Performed by..f21` _ _.. /u _;./!L? ................ Date.. ------------------- ,-a Test Pit No. 1_24:-.........minutes per inch Depth of Test Pit.__10--________- Depth to ground water?' 1 . . Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4t --1.........I...... ---- ---•••••-•••--••...............•--•-•--------- O Description of Soil--0._..�........��t7 '------...... 1/0------�4 E iLJ-- �-��` S r x 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 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. /�SJigne�d ...�.... .... : / �- j .... ........ Application Approved By ,A /`-_-/------?i.:__... L:: ! '"./</:..!....., - »ate----------------- L/ l Date Application Disapproved for the following reafon.r: .....................................................!... .----................................. .............................------------------------------------= ........................ .......... . ............................ ---------- f,I , r, r-�....,.:w �.. " °'=`............................... ............. Permit No. ----------�L...._..>..� ;� ..9.. -� Issued .............f-.� .+a..�, � r .-.. -. j THE COMMONWEALTH OF MASSACHUSETTS BOARP OF HEALTH A::?C J-1Q OF ....JIT12 I - .................................. Teztifira#e of Complia <ee THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ------------------------------------------------------------------------------------ ----------------------------------------------------------- - Installer at ...- o. ....3.------��.l�.l ------- t=L�� ..- � r�-/'���5..... -5 --------------------- has been installed in accordance with the provisions of TITLE of The State Envi o s described in the application for Disposal Works Construction Permit No. � ...... =.....t._-jtiy_ .-.. �......................------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOiiii ONSW&6 AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---------------- ----------------------------------------..................... Inspector ------.....:.....---------------------------•............................................... r THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF HEALTH No...� ....)... . FEE .................... t Utop i ial Work.5 Tomitrnrtion amit Permissionis hereby granted............................••--•-----.....----•••-•--•-----•-•---•--•••-------•----•••--•-••--•--•---•-••----------•-••....------•... to Construct (x ) 99r���Repa* ( 81y, Individ 1 ey,age Dispg�al System,, at No.......................`-0.7............_.. ..� Pam..:!.... /-/'7l/- ;t ... ....... Street /1 � a�+''°� �� as shown on the application for Disposal Works Construction Permit No.....� __ll_. D ted......................................... -------------------------------------------------------------------------------------------------------_ Board of Health DATE................................................................................ FORM 1255 HOSES & WARREN. INC.. PUBLISHERS -757 No. .... Fis............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH o---14.................OF.....` Jfk .N1.. ................................ Appliratiun for Disposal Warkii Tomitrnrtiun ramit Application is hereby made for a Permit to Construct (Y,) or Repair ( ) an Individual Sewage Disposal System at: G� Locati -Address -q-wsv g v�t�� o 1 G•✓ C:219'3 - - _.._.._C. .... -r ........................... ..................................r�,�._.. - . .................. Owner Address W Installer Address Type of Building Size Lot_/3J_9 -----Sq. f et U Dwelling—No. of Bedrooms------------•____---------------------------Expansion Attic Garbage Grinder ] a Other—T e of Building No. of persons___________________________• Showers — Cafeteria Q' Other fixtures ____________________ _ _ W Design Flow............... __gallons per person per day. Total daily flow.-------8.�5'......................gallons WSeptic Tank—Liquid capacity?gallons Lengthy_"�_1..... Width-4.� Diameter_ Depth... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........ ----------- Diameter......14v-------- Depth below inlet.....(0.......... Total leaching area.JB...sq. ft. Z Other Distribution box (YQ5 Dosin tank �Lo aPercolation Test Results Performed by._- �T&-C j._!.!�.G.....�:�.................. Date...'-. .'. __...._.... a Test Pit No. 1...L2....minutes per inch Depth of Test Pit-----10......... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------------------------------ ---------------•-•-------------------......-- ----._... ---------- ---------... ------------------ 0 Description of Soil_ 2 aa` 1 �7c!c35c91 �. 2.'- !® l. rAs M C!Q.- ft. '(? x U -'------------------- --•--•------------................................................................................................................................................................ 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 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 ----------------------------- -------------------------------------------------- ..........- -------..... Dale Application Approved fi _ - - - Dare Application Disapproved for the following reasons: ----_------------- ------------------------------------------------------------------- ---...................................- ---------------------------------------- PermitQ Dare No. ...-7.-[---10® Issued 2O c-� --------------------------- Dace THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ---- i`' n�,---------------- of -- .A - 5 - 4 ,---------------------------------------- CfertYfYrtt#E of C11untialianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( V ) or Repaired ( ) by -----------...................... . ... ...................._...----------------------------------------------- - �l, 3 m Kl --N t -- Installer at -------------------------- ,, 1 +� - `�" 4Q ----- ........ ....................................... ----5 has been installed in accordance with the provisions of TITLE of;he State Environmental Code as described in the application for Disposal Works Construction Permit No. .. ..'._....--(..J..(.. ................... dated -3--'zo--'- --'............. 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�-t. 1...................OF..��...A2t .a`�.. .V> --.............................. ©� Disposal Works Tunntr iun rrntit Permissionis hereby granted.........................................................•-••--------------........._...----•-...••-•--------------...............•----_..... to Construct (K) or Repair ( ) an, (Individual gage Dispos System A/ at No.........................'OAK ..�I,��s�ru s------,c.c._s st t as shown on the application for Disposal `forks Construction Permit Noi'tOO_... Dated_._----. _.__ ..1............ --------------------•------..._------•-------•------------------•----•----------•--•-----.....-----...... Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS -7 57 `_ . CEO LO( 7- 3 �100 .ao No.. ...... _....... Fx$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD��OF HEALTH _ Q Nl.. - OF.....--lc.-✓A '.-•t J 6T7--\ ............................. Appliration for Disposal Works Tonotrnrtion jhrmit Application is hereby made for a Permit to Construct ( ?C) or Repair ( ) an Individual Sewage Disposal System at: .. _ - .... i2T-4.G.t:................................................ .... .....--------........... ... •-••-•--•-------- -••-•-•.......... _ Lo_cation Address p _ t' • �J or•�I.ot No. �] - l to c( ..._ f{,r_ ��_ :r`I '"Lt?4J ��3't2S4GL+ I*y _1� `�i7`la 1 ... � 3....,Z1` 7 Owner Address W Installer Address g ti Q Type of Building Size Lot.:_.__..!...................Sq. feet Dwelling—No. of Bedro ..............................................Expansion Attic (l C Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria al Other fixtures ________________ ___________ _ W Design Flow............... ....`_ . ` .__gallons per person per day. Total daily flow........a?.�.......-----------------gallons. WSeptic Tank—Liquid capacity gallons Length±A.' �.._.. Width.G.::�..._ Diameter__" =. Depth..-.....'. x Disposal Trench—No. .................... Width........,........... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------Z.......... Diameter....... nl........ Depth below inlet............... Total leaching area...�--.sq. ft. z Other Distribution box (�Qb Dosing tank (4t.) _ d Percolation Test Results Performed by.._ _t' ................................................+ �-` `..� `-� 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........................ 04 •-•--------------------- - . ....... O Q ? l,c;ct,.r� `�cJ<3 .t c r ,- ► Q C.�Lc:A�►.S �"I L l .......... Descriptionof Soil .....'--------------- - ------------------------------------•-•-------•--------•--------------------------•-------•-------------- --------....----••--- x V .....••••-•-----•--------••--•••-•-.._...•••••-•••••-••-•-•-•..................•----••••••--•---•------...----•-••••••••-•-••-----•-------•••-------••-•--••-•--•--•--••--•--•-••-•-----•-•-•-.......... UNature of Repairs or Alterations—Answer when applica.ble............................................................................................... 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 .. ------------ ---------- ------ ------------------ Date Application Approved B - '-'-`�` �!J ' -----------------------------------------------------------------,.................................... .......... - Dale Application Disapproved for the following reasons: ...................................................... . ....................................... ................... .... . .................................. ............ . --... ...........-- ..................-- -- . -----......................................... ---------------------- I_ � Date Permit No. .--U-`.�................................. Issued ..-I..'2�-1......-..--------------- ------------ Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH 7 r»U t'i - .-. OF ... A>2,..t5�((_Z -----------------------------------------------•------------------- -- C9elrtifirate of C11antplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( >, ) or Repaired ( ) y •----- ------------------------ .............-.----.-..---------------------- - -- ....... Installer - .t . C ...kZo AC 0 ( .. ..:- � tC�ll,� . ...E�. ......... at . - - . has been installed in accordance with the provisions of TITLES�f�? J to Environmental 3Code bdes�ri�ed 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 - -- --------------------- ------ ---- - -- ------------------------- -- ----- Inspector ....----..........--------------.....--......----------------. ------................ . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �0�`_.. ..................... .. .OF �ta. ..A� � e C .. ' i No......................... FEE!....................... Disposal Morks Tonstrudion Vantit Permission is hereby granted.............................................................................................................................................. to Construct ( Y\) or-.Repair ( ) an Individual Sewage Disposal System ,,� ry �, at No......................... 1 c x ti, �� �.G....(Ig_ ---W�-- �I i 5 ....5-------.-..=L�..........-- Street as shown on the application for Disposal Works Construction Permit No...J__....UQ... Dated.._..Z�. ��._�............ .....................•--•-•---------------------•--------------------------------••••--.._.........-••-- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ----------------_.......................OF..............................-._....... % Appliration for Dispuiittl Works C> onstrur#iurt thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 2 ..- _ ..................... .. .............................................. ......••••----...._...•-•-••••.......•--....•••••••--.....-•••••••••••............-•-.........---- ation-Address or Lot No. � ? y2 i r •.........................•.........._..... Owner Address W Installer Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms..............3 Ex Expansion Attic a g— ---------------------- p ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons.............3............ Showers ( ) — Cafeteria ( ) P4Other fixtures --------------------------------------------------------•----------------------------------------•---------------------------.....---...........----- W Design Flow............................................gallons per person per day. Total daily flow.......... . .` ------..............gallons. WSeptic Tank—Liquid ca.pacity_���.gallons Length................ Width................ Diameter................ Depth........_....__. x Disposal Trench—No. ..._............._... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 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........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ w --------•-•------------------------------•------•....._____..._....____.........._............---___......••----•-•---••••......__......•••------------------ 0 Description of Soil....................................................................................................................................................--.................. V ---------------------------------------•-----------••--•-------•-----....---------•----------••-------....--------------------------------------...-----•-------------------------•••---••-•------------ 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 oVhe State Sanitary Code— The undersigned furthe agrees not to place the syste in operation until a Certificate Complianc as been is ed y th oardea t� igned _ �.-----••----------------- ---- ------- ---- -- . I App cation Approve By----- ------- --------------- -------------- �f-...... ------.(....... ate Application Disapproved the olio wing reasons:------------------------------------•-----------------•------------------------•-------------------......--•_.. ----------------------------------------------------------------------•----------------------------------------------------- Date Permit No................3 4 ---� •........................ Issued.------..�...�-----•--K-------------._...--- Date - ----------- ---- - - No ...I.... .. Fs ..._.... ._...._ THE COMMONWEALTH OF MASSACHUSETTS BOARD 'tOF HEALTH ..........................................O F..................... Applira Linn for Ui�.Vps al Works Tnntrnrtiun ramit Application is hereby made for a Permit to Construct. ( ) or Repair ( ) an Individual Sewage Disposal System at .............. !......lf lY7 ._. ...� ... ........... - �C.-�� ... - .... - L ation-Address or Lot No. Owner Address & Installer Address Type of Building Size Lot----------------------------Sq. feet Dwelling—Yo. of Bedrooms........................................Expansion Attic ( ) Garbage Grinder ( - aOther—Type of Building ____________________________ No. of persons...........,�x............. Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow............................................gallons per person per day. Total daily flow.........Z_4_.....................gallons. WSeptic Tank—Liquid capacity/_$VV.ga]lons 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' ' ... •... •-------------------------- •---------------- •------------------------ *--------------- •------- --- _----------------------------------- •-•---- •------ •••- 0 Description of Soil........................................................................................................................................................................ x U .•----------------------------•---•----•-------.......-•••-------------------••-•-"---.....--•--•----•---•-------•------.._...-.-------•---•--------•-----------...__..._..•-""---•---•••-"•"-------•--•- W x -----"--------------..................................................-"-----------------------------------------------------"---•----"-------"---•---------------•------------"""---•"-•-•"------••"" U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...---""•-----------•-------------------•-------•-•------:-•---."-..--------•---••••-•-.......---"---•........_•"-""-------""•"---"-"--"•--•-"""""•--"•""-""•"""-"•"-•-•-"•---•--"•""-"........--••-"-• Agreement: `A The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T LE 5 of the State Sanitary Code— The undersigned furth agr es not to place the syste in operation until a Certificate of Complianc has been Is eZth oard o h igned ... _" ..._. ..... t- .........----------- :""- .. .... a f Application Approved By_... ................ et ... ....,........................................................ .... .............. Date Application Disapproved r th ollowing reasons----------------•----•-------------------------------•--------------------------•--------------==------•--.._._. ....-•-•--••--•----------------------------4_... •-•---� � � --------•----------•--------...-•-••---...-------..._..---•-•----------------••------ ---------•"•-- _----.......................... Date PermitNo.......(!.____---_._3.._..-S------------------------- Issued.............................. ................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... �'" Tatif iratr of TuntpliFatta �- THIS 1 4b CERTIFY, That the Individual Sewage Disposal System constructed (�r, Repaired ( ) by-••-- -ate'•'•�� '' Z - -- -- . sc er---•----•----------•---•---------------------------------------------------------------------- at ............................ has been installed in accor nce with the provisions of TITLE 5 of The State Sanitary Co as ibed in the application for Disposal Works Construction Permit No----, �j�c. ! ............ __ dated __... -_._...__________. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........a.` a-...-a ,�. Inspector.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF_ L Nam' / 3 ,•71 - i raor� v 1 rkii Cnnn#ration amit i Permission reby grant "' .... -==---•---•- ---•-•------------•----------------•-----------___._-------•------_._-._____-•--- to Constru or epalr ) a Indivi 1 Se age osal System U Street as shown on the application for Disposal Works Construction Perini _____________________ Dated.......................................... ..................................................................................................... - DATE................................................................................ Board of Health ,f FORM 1255 A. M. SULKIN, INC., BOSTON . . :�- w�Ti4 eea�r.� Gee _. ota t Low . t t o �c �L traD�=GGo6.P�t Itr vt S PoSAt_ PIT V;E :2- t Cxzo ,1 Ntrt _.. _ w , BOTTOM ArzaA'a , ;7$ �F _ . . .. . .. ._.. . I'... :..�i, , r o8 ( GO iX2 = �ealo� �. I , . ; ' :...." 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Yf:IS}co GAL o• 4/,Z 60 35*1 �► � AAZWA IA- 4z.81,� 3q ILI \ 88 � i s A3? 6a.� S4 0 p3•d ��1r0. zi. o, E4zEV, Z5,0 PERCOLATION -Tls$ LOAM - -CI. OAD� 1 SU 501L CLASS I MATL-RIAL. - A� � CR N� , 4 � � Z4 A/L3 DE.PTN - N8'I r. j �_.a 1 QJ LESS THAN PERC T&s'T' Z MIN/INCH I I y8•• NO WATE%ENCOL�NTEp ' : 'i c MEDIUM DATE, 03 zyl,ee I SAN NO. P-6878 ' - WITNESS' 1, DLINNIN� V40 WATM R ENGOu N Tc.D TEST 13Y' ?•Sri LLIVAfv I I ? d M LV/ y l/< A ..-UL 3 "� - •sue . ,� �'i � � � •1 � � . ` � � ot opo( to. ` •J :_3�. y pJu O12AroSEQ — e OF PETER L CIVIL `� 't'i. �L PLAN VIEW e ° /I MI Lc I I �r T I I r I Scale: 40 I. L- ~��� SITE PLAN PROPOSED • ' y_.._...- ' .... . .�.�.:. .�= • • . SEPTIC SYSTEM' AT �� A,.'4 �A.►J" a, d'+,a. rl--� `J- '"'- ,,,,,,,(ar � :`.: - LOT 3; HOUSE NO. 359 BAXTER NECK ROAD MARSTO L MA 6, µ0- ._S�f-r-:,_._ -- NS MILLS, FOR -.-.-� ' i"•' s■-�`--_- - - PRINCE COVE REALTY TRUST a _.Ir M`�LS F���IEtZ J. R. J BURKE, TRUSTEE SwP&,y • .. ..- ;� ". 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