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Home My WebLink About0134 EVERGREEN DRIVE - Health C ..� ro ,7 341Evergreen Drive �Marstons Mills .� �. "S 8 ty,- Y �` y�,gr" 4 � ��ti_ 1�6Y��070 ? r � w'9�^:..0�' dr d �' �'�+•sti'at'k'�"a ^.�-�k" � %^9 •�+-*��Y� ;d�r`,�,�, k+'� �'� ,�a�;'«t*� �� s` �$e�',� •tom ,�''` ; �Lb� 4�, ` AsBuilt Page 1 of 2 (i7 TOWN OF BARNSTABLE LOCATION /. 4P-'ei(� SEWAGE # VILLAGE / ��s ASSESSOR'S MAP & LOTL�G^�C9�: INSTALLER'S NAME & PHONE NO. ,T SEPTIC TANK CAPACITY LEACHING FACILITY:(type) I �v�a �,� 1 (size) l l( � NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR O"ER T;d 1 A rIL4 *e DATE.PERMIT ISSUED: DATE COMPLIANCE ISSUED; g VARIANCE GRANTED: Yes .,No r i ...C7 . J i3 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=126090&seq=1. 11/29/2016 TOWN OF BARNSTABLE ��/�� LOCATION rd SEWAGE # VILLAGE / ///S ASSESSOR'S MAP & LOT/"-" INSTALLER'S NAME & PHONE NO. p12 SEPTIC TANK CAPACITY T,'U ® LEACHING FACILITY:(type) lvva ± ) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE - COMPLIANCE ISSUED: "/ �' VARIANCE GRANTED: Yes No SeZAJ . A � �^ - �31 � r ASSESSORS MAP NO;,"j_2� _ f ;' PARCEL (� 1 NO A No.... --••-•••-•--------- �. Fps.... ............ ..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE ApplirFativaa for Diirviiii al Wor1w Tomitrurtivaa Vamit Application is hereby made for a Permit to Construct (w"J"or Repair ( ) an Individual Sewage Disposal System at: .13.4-.. v.. 2- aR. M, Mf �� Lar ...............•-•----- , ...................... ........................... Location-Address or Lot No. I�PFYV i EV� GoP-Qg�-��H................................ .....................................P.O, �X 'Z046 CE►-1�Y1 L- .......................... Address a ww/ AN-i_T- (�,4-�i�c v�c� Sowf4i.>ccr, sr. M_o_M_ Lis o2�4 8 Installer Address Q Type of Building Size Lot._.___1-.A:c.__......Sq. feet Dwelling— No. of Bedrooms---------------------------------------.----Expansion Attic ( V�r' Garbage Grinder (Y ) Other—Type of Building ----?: I�................ No. of persons-------trl_A------------- Showers (v-,�) —.Cafeteria (hA) a Other fixtures ...-...±4 ---------------------- ............................. Design Flow..........1.►..a..... ...................gallons per person per day. Total daily flow..............-'�._3a............_.......gallons. WSeptic Tank—Liquid capacityTl OP...gallons Length Width.-s:. Diameter..t!4'k--_--- Depth.3.` x Disposal Trench—No. . ......... Width.....i-:Q.A------- Total Length....t-./.^:_..... Total leaching area...-.--x-�A_......sq. ft. Seepage Pit No.................. . Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box Dosing tank (NA) `-' Percolation Test Results Performed b Date-----5�3.:J _ .5........... Test Pit No. J.L. . ---- minutes per inch Depth of Test Pit...i3,5'------ Depth to ground water..Ndl`P ._... . Gi, Test Pit No. 2.....`--.......minutes per inch Depth of Test Pit...��.'.......... Depth to ground water..."��'^�-------- a -------------------------------------------------------- -------- ........................................................................................... 0 Description of Soil... l3 14 r i.4. �.SfY�-1�4 V f_ +•. iZe4v ..... i.tb G en e-i.0 - ...................................ia.L- 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 of the State Envi on tal Code—The undersigned further agrees not to place the system in operation until a Certificate of Co fiance as b en is d by t and of health. Signed ----------- D ------- ------------------ace...........:. -a ..... Application.Approved BY ---- -- --- ----..- . ........_..._.. . T--------------- ----- ---------.------- Application Disapproved for the following rea on • ........._......................_.........................._..._........ ------------ ....... ... ----------- ---- .... ...._---------------------......-..-------------------------- ---- �Permit No. --r- - - Issued --------- --- -------.... ------. t 2 Co 90 No..............._....... R FEs. ...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apphratiuu for Diti-putial lVurk,i Tontitrurtiun Funfit Application is hereby made for a Permit to Construct (v'�_or Repair ( ) an Individual Sewage Disposal, System at: ,134_.Ey6Ee F <Z._.4.._.M_, M► L-!_5 LcT 4(0 �'c �L...l 2o34_p--.(s f-► 3 F-.G) . Location-Address or Lot No. (�A/VIE ......------..... ..................... ............------•--• •-----------•---- Owner Address a �c> -I, A IC-s 1SowAL�,v1- ST'. M . aAlt�s o264-b .-•- ••..................•-----••••-••--••----•-...-••-••-•••--••-••--••-•---- •••••------- ----------.......•--•------ Installer Address Q Type of Building Size Lot__ ..........Sq. feet Dwelling= No. of Bedrooms---------------- ----------------------------Expansion Attic ( V1, Garbage Grinder (y) 04 Other—Type of Building --.- ________________ No. of persons.......N Jf............. Showers (MA,) — Cafeteria (HA) 114 Other fixtures .......t`_/A................. . W Design Flow........... .o.........................gallons per person per day. Total daily flow------------- ....................gallons. WSeptic Tank—Liquid capacity.1599_-gallons Length--1.5?'�n"___ Width__S'. ..... Diameter._!-�t1.tk----- Depth_ 5'7. .... x Disposal Trench—No. ......... Width----- ------ Total Length-----�ft J.A__---_- Total leaching area.....w.�.A.......sq. ft. Seepage Pit No._-_--_..-_---.-.-_ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( Dosing tank (WA) Percolation Test Results Performed by..... ....................... Date----- ............ Wa Test Pit No. I_�:T.'7'_._minutes per inch Depth of Test Pit.-.13:5---.___ Depth to ground water.._Nd�+ ____... (i, Test Pit No. 2.....--..._._minutes per inch Depth of Test Pit._.1A. Depth to ground water.. ' ^ra..._... --------------------------- ------------------------------------•-----------------------------_..._.................................. ..... . O Description of Soil-- ...... �,-. �z S`'�ix�1�_. ._2'�z- 13 ........................... x AA Ef-+v&A-S/he 1 v �F �¢c4v E� / MO ��=v�+�..c�c?i-j�¢ _._G't�te,-¢..--............................... U ..... --•-•-•...... •--•-•••- W UNature of Repairs or Alterations—Answer when applicable......_.1A................................................................................. 1 ....-•----...._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Envfironme, tal Code —The undersigned further agrees not to place the system in operation until a Certificate of Corp liance has b en is d by t�e bard of health. Signed -------------- --- G"'.. . _...:...!i. ............ ................. ------------------ 49;[�1 / 4 Dare Application.Approved B f%.-f..r/l. o �. PP PP y :--- ----- _.._............... -� .............. � ------------- ----------------- Dare Application Disapproved for the following reason • ..........................................s�./.........-......------------- ............. ----,-- --......:_................. ........ ... - --------------------------�----'�-' --- _.....Dace...... Y Permit No. ---- .... ...-. .�2 - Issued .............. !/7- ...1:.�. ............................ Dare �..Y_._.._.�.-�.�.1-----o----------------sue. :------I-- ,--------m--m—.-..�.�..��.�-..:��.�mv THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE V ertifi ate of (1:11ompli? are THIS IS TO CERTIFY, That-the Indiv' a Sewage Dispo .Fsy ern c nstructeo ( ) or Repaired ( ) by ..- - — ----..--- / ; ;-" --- -- ------ ,-._�---- _�.�..._. /...:----/'l.�/? i�.............................. h��au. ate , , ..--------------------------------------------------------- been installed in accordance with the provisions of TI I I.E e S to Environmental Code as described in has the application for Disposal Works Construction Permit No. .......t-.... ...""....... ........... dated _...._...._........................... .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B CONS UED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTO ., � .. `T -- DATE ..... - ............. ....._ .. - ------- Inspect r-�... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No....... ... FEE................. iu�rnu 1, urk �ncn tr inn e_r�ttit Z) Permission is hereby granted.--_------— v...... -- --••-•••-• . ....................... ................... to Construe �°r Re air ( Ind'vi ual Sewe,Disposal Syst at No..••-•••.� � 1 :.�... --!J._ �..---- . � ---------------------------------------- Street as shown on the application for Disposal Works Constr.ctio ee mrt No__ _ _______ ___ e ._..__.__.__._..............._._.._. - -------- -- - ----- -------- ------ ------ -- - --- "�..J /l�S�..7 . Board of Health DATE-----••-------................./ -a-�•-------•--- •------ --..... FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS r 1JESI6 tJ -PATA -51146LZ FAMIL`( 3 $EIPP-wM4' ��T ► �� 2 -PA I L,-( SEPTIC 741v. 53c+ u iso�o 4clrj GPb lX 1500 U-A L_ ; w r,I �,�as�.E L o-r- 4 (, DlSFMA L PIT 51DEWALL:, 61 S GPO B.oTTOM A¢b4 : 113 s F 115 45'L&PD MA 2s��s 1 I elm, M A I'L Co Pit Q��L �r o TOML `TOTAL DAILY rtoy,/,_ 33a �PD cK PEP-e-'aLAT1 o14 VA7E t0OF � 4r`� ' Ea�lN OF Af �y PETER H yes SULUIVAIR Zr No. 29733 � 74 0 �AX7t-� � f•-I�IL LI-lL.. �' L�•NG.IhiE�a. c [.�r °�; J-' L �'► 01 1 ti A A 0-6 9 r= 1 o Awt 1I7M5r P a4o-7 rtOLC FLU= Ioo >`v�Ial 1:F 1 03.5 5v3sai�. it CC, PuQ. INv. ICO.S `�►,s — 6AL I Nv 100 $� gqK aez 99 8 Sepric GAL oils T NL 55,5 _ Y Peep 4,�s' LF G Ap(3 1 MI=DILJ" WIT'( WA49Eu Alt, Aw- 5rzvmzc-) sr-T 9 u _T04E MME T44W 4!"DEEP SHALL me A-zo n ELz 91.5 0 Y Re1" Pld N OG +(10l1 : MflQSTr�I.r AA ��.�, AAA. go scQ L� =4,=. DATE, /i T+IdT T.}I�{E .��L PLAN PZL E IC.m SNoWry LIGLW Nh/ ({JMTC. S WI TA UE L-ANU LGau�T PL,tt 1/� I Lo�j LI-D ' != 7r4" c; TlfG7 IDA OF. Re 15Tfl l�c� SI I£ET 3 o F Cc A+t� IS Noy 7:5E 115 >J (S N oI.1 AN p 551aJdL Ld�hDY Sula/Eyo¢S 6urz,/ey , A/JD rHe �Fr=Sers 4�00LX �1Q M-J�4tZ3E o rw,L E4J61 N EEIZ5 u521:) T'D ESTAIN-KN Rz°•rezTy I..I NL.5 fzvll.c.E MASS. dPPLICAN�'; �a-QaRA�+.��, xf � L.—T 4 b �v�QGQ�� DQ�v/E MA QSTe�ar'76 M I c_�5 S iµ o3 �6•�15 \ — --1o2 O / Of AJ - �. PMR � 'No. 29133. P � � ;: v -- -- - - - - _ �'�'�•'�i$AL L\`�� 102 ' IOC + � A It h •o• ' }�1 g 0 TJ4441 T>�M.e 98 49.9 1 \ . 'Y Zi 1 , 30 ��a� ` � . 3'•� 96.3 3i Q APPLICATION FOR PERCOLZ1TEON TEST AND OBSERVATION PITS LOCATION L caT 4f. Ey�2�.2 E�tit Daoyc JILLAGE Al A-0-S TcpN:% ,AA i L�t.g _ DATE 1PPLICANT f��y�i Ewi cc2 PoR,t-'no,.r FEE - \DDRESS (3oX FIC-QViL« TELEPHONE NO. -)-t5 . ��,�1 (Non-refugdable :NG INEER uT=ve tiyE W L _TELEP NE N )ATE SCHEDULED (,'', > T (Applicant' s signature) • . 0 0 0 O O O . OS• O L O O O O,O oO . . . . . . O . . . O . . O S103 ASSESO R IviAP OT NO: 11t, qo SOIL LOG 3UB-DIVISION NAME DATE TIME "XPANSION AREA: YES NO A�►-T�2 �+`a G i*+c. ENGINEER 'OWN WATER vr• PRIVATE WELL 6=0 ) . Du Nba 1UvBOARD OF HEALTH )OHS &A1.-TD EXCAVATOR ;KETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) NOTES : 53 JD IZ °% ��tia 5Z� a N 5� AA�( t. S • to (SEE u 6) � . Nsei�o�W2BB.27d�i � Ga'�1 1��ItIC I Dt 4o' W j° N � ry0 and P, .]L 46 K � � 46 g47_1 vm OP.'S N i F cv O� I s .Ts.�'yic•. ,i h ' 30 SEE SNEET ♦/ 29 Wi f)D fo-r V" 'ERCOLATION RATE: AA 'EST HOLE NO: ELEVATION: TEST HOLE NO: ��- ELEVATION: 1 2 �'�/— I / 1 s w5 2 I 3 3 4 114 - 5 5 L r ? MMD,t yl7) 6 3 ' Pry 8 Z'30 - I3'�1 V4 1T4 8 9 9 10 `Qw mil_ 10 (i 11 ( 1N�i 12 12 Al x 13 13 14 14 L 15 Kry 155'EtZ f 16 16 /� ;UITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PI`IS ✓ { LEACHING TRENCHES 1NSUITAB.LE FOR SUB=SURFACE SEWAGE . REASONS: ► TOTE : ENGINEEIRING 'PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION r )RIGINAL: COMPLETED IN ENTIRETY BY P E AND RETURNED TO BOARD OF HEALTH :OPY: RETAINED BY APPLICANT