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HomeMy WebLinkAbout1760 SOUTH COUNTY ROAD - Health �A 760 South County., Road Marstons;Mills I I s No. , ;.� Fee 100-6 / • TliE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ,✓/ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., IMASSACHUSETTS Yes ZIppfication for Mtgogal *pgtem Congtructton Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Xcomplete System ❑Individual Components Location Address or Lot No. 1760 South County Road Owner's Name,Address and Tel.No. Tettke Osterville, MA c/o Douglas W. Lebel, 1600 Falmouth Road Assessor'sMap/Parcel Map 98, Parcel 10-2 Centerville, MA 02632 778-4700 Installer's Name,Address,and Tel.No. J Designer's Name,Address and Tel.No. Earl Lantery 5 63 Advanced Technical Solutions, Box 99 Sandwich, MA 02537 508-888-4029 Type of Building: Dwelling No.of Bedrooms _ Lot Size 45,001 sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 110 gallons per day. Calculated daily flow 440 gallons. Plan Date 7-12-99 Number of sheets I Revision Date Title " Sewage Disposal System Design for Mr. Douglas W. Lebel" Size of Septic Tank 1,500 gallons Type of S.A.S. Description of Soil HOLE #1 - 0-10" 0-A, Sandy Loam, 10 YR 6/2; 1.0"-48" Bw, Loamy Sand 10 YR 6/6; 48 -132 C, Med-Coarse Sand, 2 ,5"'Y 6 3. HOLE #2 - 0-9 O-A, Sandy Loam 10 YR 6/2; 9"-44" Bw, Loamy Sand, 10 YR 6/6; 44"-128" C, Med-Coarse Sand 2.5 Y 6/3 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 f the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is by th' oard of Health. Signed .. Date Application Approved by Date P Application Disapproved for the f owin eas s d Permit No. C/ - Date Issued Fee d 4l • +�, , � 5�E COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y PUBLICHEALTH DIVISION - TOWN OF BARNSTABLES 'CHUSETTS y pp'ticatfon for Mi5pogar 6potem Conotructfoo permit Application for a Permit to�onstruct( )Repair( )Upgrade( )Abandon( ) Complete System 'El Individual Components Location Address or Lot No. 1760 South County Road Owner's Name,Address and Tel.No.Te.t tke Osterville, MA c/o Douglas W. Lebel, 1600 Fa&mouth Road Assessor's Map/Parcel Map 98, Parcel 10-2 Centerville, MA 02632 778-4700 Installer's Name,Address,and Tel.No J HO1 e,L &-Sot1— Designer's Name,Address and Tel.No. Earl Kantery 5 Gap�a-fir-I� l �a _S_and�hbhh1,;.-KAr-f12'563 Advanced Technical Solutions, Box 99 548-8-33-03 p Sandwich, MA 02537 508-888-4029 ILL" W666�1 Type of Building: s Dwelling No.of Bedrooms Lot Size 45,001 sq.ft. Garbage Grinder..( ) Other Type ofdBuilding No.of Persons Showers( ) Cafeteria( ) OtherFixtures.. Design Flow Y' 110 gallons per day. Calculated daily flow 440 gallons. Plan Date 7-12-99 Number of sheets 1 Revision Date Title Sewage ,Disposal System Design for Mr. Douglas W. Lebel" Size of Septic Tank 1,500 gallons Type of S.A.S. ' t.< Description of Soil HOLE #1 - 0-10" 0-A, Sandy Loam, 10 YR 6/2; 10"-48" Bw, Loamy Sand 10 YR 6/6; 48' -132' C, Med-Coarse Sand, 205YH 3. HOLE #2 - -9 0-A, Sandy Loam 10 YR 6/2; 9"-44" BV, Loamy Sand, 10YYR 6/6; 44"-128" C, Med-Coarse Sand 2.5YY 6/3 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: j 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 f the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss by t ' Board of Health. Signed Date Application Approved by Date Application Disapproved for the f owin eas s r. Permit No. 9119 - U Date Issued ------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage ispos 1 System CoW-ct ( )Repaired ( )Upgraded( ) Abandoned( )by at *` h I has been constructed in accordance with the provisions of Title 5 and the for Dispos 1 System Construction Permit No. L dated Installer Designer The issuance of this permit s o be o ed as a guarantee that the sy t M�tnc�io s dui ned. � Date Inspector 1/,'WN /1! tJ I --------------------------------------- No. Li6t_ !_t 7. U Fee�� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS - Mf6po0ar *potent Conotruction Permit Permission is hereby granted to Construct Repair( )Upgrade( )Abandon( ) System located at—1 7-A a <' t52 L 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:Cons c ' n must b /completed within three years of the date of this Date: �/ Approved by i 1 ale i t . Town cif Barnstable Department of 11ea111l,S:Ifcly, :In(, Gnvironnlenlal Services `ofIM Public Health Division D:IIe ` 167 Main Street,I lyannis MA 02601 nA nNsrA m,F MAA9. 94'Arcvr—n9r• A Date Schc(luled r' •I-ime hcc 1'd. Soil Suitability Assessment.for Selvage Disposal I'crlilnncd 11y:_ 0 1Vidlcsscd Uy: rn l O All) ON11// --` l ` �/ LOCA'I'WN & GENERAL INFORMATION Location Address 1760 �q" 0O�J� /! /� �--V V/�l / U\vncr'sNanlc �pU(CL(�S L���\� J sTE2V 1 U-E Address , t0 p F A Uy)O- i$v 'Cfl Assessor's Nhil/1'nrcel: 118 / ) C)- Fllgillccr,� G G I kLx- -mQ'Z t31 t 6iQ► p,95oC. NEW CONSTRUCTION REPAIR I'cicphonc ll 4oZ� Land Use —_ S` �'�L ) � -� a( D Surfacc Sloncs Dislrulces from: Open Water Body Il 1'ussiblc N��- 1Vcl Arca k `, It Drinking 1Valcr\Nell it Drainage Way Y _ Il I'ropc.11y Line II Olhcr S 10ETC11: (Street name,dime sIU115(lf lol,mitt loca(iolls of test hoICS pCrC ICSIS.locale\\CIlands III 11(milldly to Ilolcs) ;�V Parent material(geologic) Dcplh to Bedrock 'y `, Ueplll to Groundwnler: Standing Wntcr in Ifole:11 1Vecping from Ili(Pace V�� Estimated Seasonal I ligh Groundwnlcr 'V-M ll1�1'CIt11'YMA\'IONTOR SEASONAL 111GI1 WATER TA11LE Method Use([: Depth Observed standing in obs.Iwlc: in. Depth it)soil 111oHIcs: Dehlll Io weeping from side of obs.hole: in. Cinnnlchvatcr Adjusunclll Index Well H_ RcadinF Dalc: -- —- Index Well Icvcl_ - Adj. I;actnr -- Adj.Groundwater I,c\•cl I'ER .-OLA'I'ION TE,ST wic7- Observafim) I tole ll - Dcpllt of Perc I imc al 6" Slarl l'rc-soak Tin1c ra Tillie(9--6") End Pre-soak (�L�s Rate Min./Inch Site Suitability Assessment: Site l'nSSe(I v Site Pailcd: Additional Testing Nceded(YIN) Original: public Ilcalill Division Observation Ilole D:1(:I To Be Completed on Back j Copy: Applicant 7 A DEEP 0.13SE1 VATION IIOLE:LOG : Hole'# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Struoturc,Stones,Boulderes. i e °/ avel O - 1 O O -A .944py Lopm 10I R Ole j E Oj� ._ORGAN 1 C w LokrAyS► AD )oYR "jC r;)dq-SAND 49"=13Zr' C O Es>-Sh)J 2.5 Y 6/3 DEEP OBSERVATIONIiOLELOG Hole # z Depth from Soil Horizon Soil Texture Soil Color .Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,1loulderes. n i tent %Gravel r F')JJ la S O O-9 O -A SA�,py Lr I o vR ro 2 '1/0>d IF w 1 .-R(N kr kl> S ►v-w 1-090 )b"Mlro/6 F/d6 sghln rI � C MFD- Lb �13 1)0r1E C'1T-3�1h .................._.. . . ... .. ............... . . _ .. .. . DEEP;OBSERVATION:HOLE LOG Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,I)oulderes. Consistency,%Gravel) DEEP'OBSERVATION:HOLE LOGIo1e.# : .. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Uravch I Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No �/ Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv.ouuss material exist in all areas observed throughout the area proposed for the soil absorption system? `Yf If not,what is the depth of naturally occurring pervious material? Certification I certify that on ( (date) I have passed the soil evaluator examination approved by the Departme%'ning, ntal Protection and that the above analysis was performed by me consistent with the require e i nd experience described in 310 CMR 1-5�.01 . 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I b.9'/ut./I••00•Ir OC..'l1•oon ___._.___ jj _______________________ l 52 r.waw]n.wocG w,GmravnG � � E0. ,17-8-,'- 6 w•),cm�ic raBnrrP�Y"'Y I A ca 4— 1� ao ]fi 0 FOUN MON FLM XU yr . N01E PnMOR i0 CORBIRILTO.y OdRnB01OR m - •YUSr VE AFr Nl[WLW510Y5 s4M uWiq � I I o�oa Y tlw Y.rYSBlir e w muBnwl� B,ca• YowY °' o � rrb•a B.oagBw. � Z _ o I I rl � Z X 10 5eC0W FLOOR J0155 16" O.C. F ,Y.3• Ira- - ]:-r � � 17 a• 2X8 LELM-015t5016"OL, g I 2IWf•9 'HWO-W1 P•aoF �: 5�Ya ii 4 . O mxac wa mo• I y4C� Si�$ 3/A]a 4 Him I.- FMI a i5 i I � � iron a, �'���� �•R3 60• x�.�fl; ...�]� i ou�� � fl 559 ov[x y �aR i a t.l+seal� � tea.Y•r ::-o Age E A. � 6 - � Q 5�CONI9 PLOCR M MING PLAN N OOn•Nu auRY NG vR.6 In-f_pr m'rvfua xm.Ox iz mn r.ea.ca Y ..3� ins•n e .'�`6 s'cu.ui .PFN+f)- m v.ais a a�Rw� y'I f n b v�tl U,RM.WMK id WW rti•If'OC �,] -nia mo �pA'cne� rove.f.d. _ vmw f� M.S.,•SOrzn.9n r- � ItOm .I•1.Of. i.ifl.+�c �p ) _ art.J r.Su.W� Y •A�•QK./hx ay.f•x'0f. � y�i ffl•c uan•r n. ,;/- f/Y, •swx coo.my wr.w+ � _ ono- _ •.r ac --------------- --- I L�.-{yAi:w�%sm ..c.a.na•r m. uc nnom xeioa. - � �13 k- 11t___� r wv.ears wr xoai ars•"•oc o rtKi-.nee. ___arms tie ncaaaw maim s•v ax a••Y1°�msw'�� __`VArs wTaiw _ r;may • ' �� xorv:vx-oa c�ca+;rwcmf.canwcrox :I usi vr.uvr a�i o>.Yrfsnxo.mm...mw � ar.rwnm msrufofoai w w r ms>w naw a aw mwcao ixo.�. r.x•ms mwc """"' mi�m�exnef. +e w �' ce h vr-e ' c�2055 5ECilON M FAMILY KM.&M.CI KM, *ffTTflC& aO`55 S IION 11�11 MAIN N01.1`�wuvJ=-roe I - TOWNOF BARNS BLE //�� ' LOCATION l S 41JX,,�6 (JSEWAGE # 9q � k VILLAGE �57�yG� Q .� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. Wes. kl e6 �Z_. �416 ,.SEPTIC TANK CAPACITY LEACHING FACILITY:(type) � lC% (si ) `� X 1� i NO. OF BEDROOMS t ' PRIVATE WELL OR UBLIC WATE BUILDER OR. OWNER .DATE PERMIT ISSUED: A lqq .DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No . a � -Cis a=-- t, i �._ 4 Town cif Barnstable Department of Ilealill,Safely, nd Cnvironmenlal Services '"E''� Public Health :Division Dale a� 367 Main Street,I lyannis MA 02601 9 nnrwstnnl,g y MASS.,b79. �Arto►`u•�c" Bale Scheduled Fee Pd.-- SOU Suitability Assessnneuff' o " Selvage Disposal o � I'crfirrntcd 13y:_ I WitnessedUy: / JIIN Al AOI I /�/ LOCATION & GENERAL AL INI+ORMA'IJON F1,01cations I / O r�/7, eo/)n11 ��Uc 511 / `—l/J 1 V ] � Olvncr's Nantc L� Lt+��.0sTE2V1uIe Address / 6z>0 A(JV)o�,TV-Z0 ssessors Mall/Parcel: Ila J t/\\ 0 V '—" `r I` * -Vq�dZ L31 t_l � A4Soc. NEW CONS fRUC710N RPI'Alli telephonee f ll Land Use �5, �� '1)7JG Slo)cs:("�) eJa \, I _ ( Surface Blanes Distances from: Open Water Body �— A/,�, _ Il I'ussiblc% Wcl Arcs It Drinking Water\Pell It Drail'lagc Way Y It Properly Line Il 011ie[ S KETCI l: (Street name,dime slops of lot,exact locations(11(esl hoses&Pere(CSIS,Imc(IIc wetlands III llr(lxiolit)-10 lIoICSI J 6�� � M) Parent material(geologic) L S�I DcPlh to Bedrock • A Depth to Groundwater: Standing Walcr.in I tole: Weeping from I'il Facc 1 still"ed Seasonal I ligh Groundwater 'V— llI�TCI.INIINA r10N FOIL 8Ei ASONAL II�GII /A`1'I It 'I'AI3LL Method used: Depth Observe(_Slall(llllg ill ohs.1101e: III. Depth to Soil Illoilles: Depth to weeping front side of obs.hole: Index Well N Rnrdirh Daft: imlcx 1VcN Iced Groundwater AdjusUllclll --..—.._ . ._,_-_ Adj. factor — Adj.(iromndwater Level PERCOLATION T.vis,r w a- _Wf iliac // 30 Observation Bole ll it l imc al 9" _ Depth of Pere 5 I intc at 6" Start Pre-soak Time to I inlc(9"-V) e;� 16' G )jJ— F-Ild Pre-soak /—C-3S } z`.-CGbI)j4 Rate Min./hlch Site Suitability Assessment: Sile Passed Site Failed: Additional'I'csling Nccdcd(Y/N) Original: Public►►ealill Division Observation hole Data To I3C Completed on Back Copy: Applicant j V DEEP.OB ERVATION HOLE LOG Hole#< 4 ; Depth from Se l Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Bouldeies. C w i lei °/ Gavel D 1 O t O SWPy L OMB 101+rZ 6�i' r/b}J,e 'OR C'PAN 10- w 1.0�- 48� W LONMISNYD ioYR 6 6 O,IE r'�1J�-SAND °19=13Zr, C rnED- 2.S y 6/3 i✓o�Ji` C LF�4N .. DEEP OBSERVATION HOLE LOG Hole # Z Depth from Soil Horizon Soil Texture Soil Color .Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes. Cons istenc °°Gravel o-9 O -A SAii-PY60A Ia vxro e j4), b a %9 9 ,=4¢' 13w �o3�ry ,o�ZG/6 n�o�yE l=�tJi; s�hln C -Z.5 y `J-3 OWE C LT.3 �J __....._ _....... . __.................._.. .. .... EEP OBSERVATION HOLE LOG :Hole# ...._ __ .11 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel . .... DEEP OBSERVATION HOLE LOG Hole# Depth from i Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistent %Gravel I Flood Insurance Rate Maw Above 500 year flood boundary No `� Yes - _ Within 500 year boundary- No v Yes Within 100 year flood boundary No_ Yes i Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv.ouuss material exist in all areas observed throughout the area proposed for the soil absorption system? `+f Ss If not,what is the depth of naturally occurring pervious material? Certification I certify that on / P7 g (o (date)I have passed the soil evaluator examination approved by the Department Enviro ntal Protection and that the above analysis was performed by me consistent with the requir tr 'ning,e e i and experience described in 310 CMR I-5-2 . 7 Signature Date TOWN OIL BARNSTABLE y �� � � 7-77� LOCATION I Q VILLAGE �� �U ASSESSOR'S MAP & LQT_ ft4STALLER'S NAME & PHONE NO SEPTIC TANK CAPACITY LEACHING FACILITY:(type)o�V- (size) NO. OF BEDROOMS :�5lPRIVATE WELL O1t<g LIE WATE �� . BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE'ISSUED ___ !_ VARIANCE GRANTED; Yes_ NO n r r A= C - 07 � CID i r 5�0 «i�V T D '16 Tsy No.. :.77.. - Fims...7�. ': THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..----..... — .....OF............. ............................... Apliftration for Uhipoli ai Workii Tonstrurtion Famit Application is hereby made for a ermit to Construct ( ) or Repair ( te<an Individual Sewage Disposal System at: ..... =...cm %---------- --------------------- --------------------- ------------------------------------------------- or Lot No. .•--•-•------•--------------•-------••- -----•--------- -Scut• •------....----------------------......_..---- O er Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building .............................No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. G' Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ 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 ( ) PercolationTest Results Performed by.......................................................................... Date---------------------------------------- ,aa 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----------------_....... -----------------------------------------------------------•----•-••------------------------------------------------------ ---------- -........................ 0 Description of Soil........................................................................................................................................................................ ------------------------------------------------------------------------------------------------------------------------------------------•------•--. -----•--------- Nature of Repairs or - t�,ons— e _� _q-�Z en applicable.. .........-..I � Ar._-_ Agreement: a� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 4 i'�11E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has i d by health 1pp Signe . ---- . ........ 1 f• _ 7 t �►e Application Approved By............ ":"`,.e. -- ._........ --=--------- -Date Application Disapproved for the following reasons----------------------------•--------•--------------------------------------------------------------------------- -----------------------------------------------------•---------------------------------------------------•--------•-•-•-•--------•-•--------•-•------•-----••••-------•----•••......................... GG Date PermitNo....... �......................... Issued-....................................................... Date Fim$.Z5.-._:: ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` , z.-�_ OF...........X� ?.-vim.' -<9��fp'................................................. -------- Atiptiration for Dispvii al Works Tomilrurtion Frrmit Application is hereby made for 1a.Permit to Construct ( ) or Repair (d, ) an Individual Sewage Disposal System at:-20 ., \A)...................... ...................A!,..... = .................................................. 1. L tion;Address or Lot No. � ----------------------------------------- -------------.........'�......... ... - --------- caner _ _-.----•Address Installer Address Type of Building Size Lot____--_____•___•-______.___•Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P`' Other fixtures .................................. W Design Flow....................................._-_-_gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth___•-__-____-_-. 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. I................minutes per inch Depth of Test Pit_._.__..........._.. Depth to ground water---__----____-_______--. r= Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ►x •--•-•---•••-•-------------------------------------•----•••........-----------•.....---•----•--•--•-......................................................... 0 Description of Soil....................................................................................................................................................................... x V ---•--•--•------•••-•••••-••••--•---------•••--•-•-•••--•••---•••••-•-•--•--•-••--•....._.....-•--------------------••-•••-•---•••--•--•-----•-•-••••......----------•-••-----•---•----••-------••----- W --------------------------------------------------------------__.._._----•---••----•----•............................................................. el U Nature of Repairs or tjons—_ en applicabl�lQ1a F___........(21_���_c _ }_�.__.. ....E `� �Y2--.........- �------..--=- .. ��... ----•--- ---------------------------------------------------------------------------------•-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 1! 5 o> the State Samtar Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has s ed b tlye-,�o health. T. Date Application Approved By___________ _ D ate Application Disapproved for the following reasons:............................................................................................................... ..-••-•••...---•--•-•---•••-•-----•-------•---------•----•--••----•------------••.............••••.....--I-•--•••-----•-•--•--•-•-•-•---••-••--••---•--------------••••----•......---------•---••-••..... Date PermitNo......0.- ....... 2.2 ....--•-------------•--. Issued_------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............OF........r' <,' ;< :?� Y.:? .... ................................. ... Trrtifiratr of Tompliaurr THIS IS TO CERTIFYStt, That the Individual Sewage Disposal System constructed ( ) or Repaired �) Installer ---------------- ---------------------------------------- has been installed in accordance with the provisions of i i i j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..___ ___�___7�.-_-___._.._.. d:�ted________________________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................L`_k_--. $Y................... Inspector............ ....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r- (j C"�'2c.1-............,OF.....f ,5 d=^:✓t...... .......c , NO. _.1_`..�_ FEE. ........ Disposal Works 0.1,11nstrudion un ii Permission is hereby granted------ ...................................•................................................... to Construct ( ry ) or Repair (,k) an Individual Sewage Disposal System a.t NO..•-•-•-•--/---`�'•-- --�cL�-......-•�.-•�-.._:'=:_v R .._...__"'_`'!�'{`�.'=-== _-T-----���3 41-------------- ---------------•------•---------------------------------------- ....- - - - - - - Str eet - _ t? as shown on the application for Disposal Works Construction Permit No . Z �-... Dated....._.,'_ G " --- / Board of Health DATE-------------- --/--- •--Q� = ................................ FORM 1255 HOBBS. & WARREN. INC.. PUBLISHERS TOWN OF BARNS BLE LOCATION 1740 SEWAGE # VILLAGE ASSESSOR'S MAP 6� LOT r t i INSTALLER'S NAME & PHONE NO. WO-, k/ �(�l� ( r� )..SEPTIC TANK CAPACITY. vG l l LEACHING FACILITY:(type) �' (si NO. OF BEDROOMS PRIVATE WELL OR U LIC WATE - BUILDER OR,OWNER., 6-:- 4-0 DATE PERMIT ISSUED: 14. LATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No CJ C 14 q3Z0 ZK j YJ LJ So 273 i N� 4b \� b _TDW WATER , ' Tay �� e a \ 1 7 Co I �., 00 i M M y4 +`'r l \\ •,4;` V) P \H OF 1 �' - 94 c9 HARRY L 'G 'b� ALLAN yG EARL LANTERY, JR. KIIVGSBURY H No.26575 p p #26101 RV E (k cis C/SrE�` AWE A ) G o o r- x\u\A ov TP Ro AC� E NTER V L L� M A C)71(�3,71 R \$G \ o>3 7 GO SOUTH COUtJi`/ r�,D_ 0��1�U1LLE � 1�F\ 02 �55 I ��DV IA�J CE.D T E C M SOLUT I D N CONSULT ENG' P.. E . SWDJiMN D'(a�E : 7- IZ - 99 D�JJG, 71?9� - I I -- '10 fff` L L.4s.o EX�s;11�G GR•tL,4 6. o x xx n ACCESS W.,/ V. ro 4N o VE : Pic vE .Ht_L f t�at�2v�6Js G P.. 14P TE -4 f Fl/.0 _o r , �45.� u Mh. �3� x Cov . r-R tN1/, 45 3y G.AL_ Cc-LL1>RF�ooJZ to NiN 1',CCoNC EL, 4 1,0 S Ell G y'N, .7 le., LEAldy, TC A C 1-LE) 20�M,rl. c�-1�0 4 ELoW SCAL>= CL . 3G.o DRLPLE of DISP0SAL SYSTI=M ' o ES'1,p0-PoSAL. SYSTEK To Ba Cot,157-1:ZUCTED 1N Siram\CT CcoapruNc.E of CorsM. or As S. ENvI CpoE-T1-r , �. -RE N1WE ALL IMPERVIOUS MATE- IALS S' AROUNM S (STEM. � q� � r 3, NSSESSOR'S 1tilAP 98, P� 1C-�; zZ�NlNG` RC :' ZHOF qss `�. B ENZ," TDP/M_H.6 ELV. 53,0 C G.Z. 5, 3 a 5. U SE . 3- 5 ' x8'x Z ' LEANCMAWM E.R5 w ,Tl.\ � ' of 314 " ,To I '/2" WASHED TEST Pi rs 1%=Rc 7-Est HARRY yam, EARL m STOME w r» Z " ap FEASTONT- cis TAP LANTERY, 1R. N NCs— �n_ SURVEY Fx o rv\" P LA N or, LAND >N B ARN S T ABU-" A/\) A .N. R . 0 R�bLNo. 6575 � P LA1J 1'rZ�41\RCD FoR MR . STf� MLEY TE TT K E of SDU T 1-) 47.0 — `— —47.o ss�o n► COUNTY RaAE�s C�ST ER7UI\..L L _ 4� �_ S✓�NDY LOAM LoNMY Sly PLAN DE.S 1 SNI sc A L E. 1" .=30' SINGLE FA M1 12. DWELLING W/+ C3 DR oo M S -j 76 c R?),iC o "L3AGE Q1SpCS - P,�, 9-1- 64 /�A1L`( FL aW = / ► a X /+ = 4-4o G: P, f�. SEW�B� DISPOSAL SYSTEM QE51G� SF PT I C. TAN I< N a-. R GQ-L�� 440 U. P. 1�. �c 2 _p = 8g0 GALS. ' M � . T1) 0 U GLAS LE>3E L o 1� 500 GAL. A -IK — o. K. I C, s��p CE VTE�ZVI tE� �`�l)a OZ63z LtAGNING C11 �M8ER S a1y cJ S >= 3 -S 'k 8 ' x 2' P. 0- _ CON C L. C _ + STONE J 7 6 c� Sc)U ti t-1 COU A37y R D. E Ft= ECTIVE O>=Qr11 _ 2,O A5�E5SOR 'S MAP 9�, 14-� cAP/T\ o E , 0 CG4 fiZ63 ), 0.74 = 133 c) 3T71ZVI L_LE� 1 3 x 3Z k 0"7q = 30'a _ 1J ,� _ AQVAUCF� TECH. -S OLU TiONs -r 'DTP\L CAP>Ac TY�= 4}-4 1 GALS. 36:o- �TEzSn=ram: A . 3. 1\oLLCR So ^F � 7- I Z�99 DyWCr• .Z IZn--L la' v I � I z4, 50 --------------- TDW WATER ^� Tad ° QA . ! _m 1\P 38 PC )O-217 Q ICD I T E PS G S 10 co 0, Ott 07 N OF NO 9 U t11 II f5� MARRY yN ���tFl �� �NA�,9 q a. c9 O EARL �y f ALLA LANTERY, JR. y i C. . No.265 KINGSBURY „ •p #26101 I —=f/RESE Rv E \ Z 4, 5 ' r�3 E "N� ss s 9 7 60 SOOT H COU K)T`/ t�D_ N SS r5 ( rR 'S M X 98, 7C -2 O Cs, RV1l.LE I "DVlA)JCEO TECh SOLUTION CONSULT ENG'P.. E- . E"DjlIMN DACE : 7- IZ - 99 DW6 -71Z99 - I i ,.. Ft N_ F-Ld �L. 50. ` ToPoV,WAU— Fi�,/.GR CL 4$.L E>_.4s.o a xxxx ACCESS W.Jw.. 6" N c7- MPE1w160-S GP,. l- OTtgr% rt-P'i ILL s S IH]Z�vrJOSyS�E,�. Mt�. CoVtp, CEO-.LAR F400� lD►y+� 1'�C C �5 ;~ �� EL. 41,o N• r SEE /ETC J1C1=I�,:..D S E"c y,N .i t?' LE�C IN/Y, I 5 r^ y SC,AL E-. 1`l• c-I-1�0 d E L W L E of D 13 P O SAL S Y S T 9-M O ES�I•(D 1S�OSA� SYST'TEK To SS CohIST-'2UCTED IN Sl.t�\cj A ccoaAAN C.E of C oM M, or lv` Ass- EN V iRot' - Coo6--TTiT i F:- RF- N1OVE ALL IMPERVIOUS MATERIALS S' AR.CU1M S\rSTEM. OF qs 1 3, NSSc5SL)R'S MAC HARRY GU, `�. S ENC1-1 )\/tARI-,/ - TDP/M_}-1:LS ELV. 53,0 C G-I. S. '� EARL 4 5_ USE 3- 5 'x8'x Z' LE-IACN CNAM`3C.RS w ,TlA 4 ' o 3l4 ";o I '/z" WASHED TEST Pi rs P=Rr- TtsI- LANTERY. IR. - 6 STONE w )T�-I Z " op iPCASTIDNE, oN TAP, —Ex ►�TINCs— oFscsT fin. SURVDN D�Tk ►�RoM� t�LAN or LAND >N BARN5 TAaL.1 Aij A .N. R. ;?AbL C' LATJ fiR� 1\TZCD Fob M}� . ST MLL- Y TE TrKC oT 5OU T 1-) 47.0 _ S✓��.rDY LOAM COU)�TY RaA� , DST ERUIIrL_ L_ `}� z— Lo(\MY SI -FE PLAN DES I SNI 43 .0_ s����� sc A L E: 1" -30' St NGLE FAI�tt VY DWELLIPI G W/ 13�DR oo M S � 2 .21rc ' Z 9464 Nc (3, R AL A -13AGE DNSPCS I = < 2MNl►v 1�AlL`Y FL aW / ) a X 4 = U-4o G: P, D. SEW�6E 0)SPOSAL SYSTEM QES1�� S E IFT I C 7A N K (J CL-. R=CQ 440 G, P. �. X 2.D - Sg0 GALS. _ ' M SR , D O U GLAS LELit L 11500 GAL. r A-1`1K — O, K- c CEIVTCRVI1LtE� M1'. 0z6 Z LEAG1i) NG C1-1 �\M8ER S 6)y 03 3 -S 'k 8 ' x 2' P. C _ L ON C 'L. Cl _ + y--" STONE J 7 6� SVU T�I-1 COU A3TV E F t= E GT I V E �'E Pr�.l = 2.0 �� S M A I� 9�,�. I� CAP/7f 0 2 , OCC4 t -a6-1 0,74 I33= OST�.>ZV1LE, 1v1}� 3 x 32. x 0.7C+ _ 30'8 i✓ol�zJ �VAIJCED 7-ECH. `S 0 L U TIOh1S `rOTr\ CAP'AC 1TK= �4 I GALS. 36.C} TESTED: 7/��99 —36,3 CaN3VLT. "CAP- P :P't14 . LATE- 7- 1 Z- 99 11MG, -f iZn--L