HomeMy WebLinkAbout0070 STONEY POND CIRCLE - Health - - - - \ f'Y)G`P Tory o kvv:� - - - - - -
TOWN OF BARNSTABLE
LOCATION SEWAGE #
VILLAGE + + ASSESSOR'SM'APf6&'
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITYAtype) R (size) %
NO_-OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER (y 4ZO
DATE PERMIT ISSUED: `
DATE COMPLIANCE ISSUED- 43 st"
VARIANCE GRANTED: Yes t No
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No........................ �/
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.. ................O F.......'.Peq .........................
Dr Dtavuiia1 Works Tantitrustuan Prrutit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at
... .... .. .........................' ----'---------...
,Emcation / r Ipt No.
CMIf.
5rP --.. .. 12 MA,
Owner Address
W
M Installer Address
d Type of Building Size Lot. 0 .._..Sq. feet
a' Dwelling—No. of Bedrooms.......................................Expansion Attic Garbage Grinder (�)
p., Other—Type of Building ............................ No. of persons.....--.................---- Showers ( ) — Cafeteria ( )
a' Other fixtures ............................
W Design Flow........... •- `! .........gallons per person per day. Total daily flow....... ........................gallons.
R: Septic Tank—Liquid capacity.:I allons Length...V Width.-5--a... Diameter................ Depth..4'36_
Disposal Trench—No. .................... Width.... .............. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---------i........... Diameter-----1'3-.--.---. Depth below inlet.................. Total leaching area..Zr!�.G...sq. ft.
Z Other Distribution box VQ5Dosing�nk (�0
W 0-4 Percolation Test Results Performed by.._. A)_XE _...---. ..._� �-_.__ Date..._��1,. 7--_-------
a Test Pit No. I....Gz-----minutes per inch Depth of Test Pit...«.......... Depth to ground water--Vl9:T•Ei W-kTCM
(%, Test Pit No. 2................minutes per inch Depth of Test Pit--.----------------- Depth to ground water..---------.---.-------.
P4 ••-•------ ----------• ................................................
O Description of Soil.....D7 2---- ......
x
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 Complia ha e issugrd by the board of health.
Signed -------- ----
------------------------------
Date
Application Approved B ...........:..:.:..... ------ ------- -- -
Date
Application Disapproved for the following reasons- ---------------------------------
--------------------------------------------------------------------------------------------------- ------------------------------------------- ---- .----- ------.------------.
/, ... +� Date
Permit No. ----?, �`��7� ... Issued r:. � .�- off ..........
Date
1
r �
06'�> L.
No.......::........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
. C v.l ..............OF........ �-le.Ms`t 'CAC.....
Avviir�ation for DiipnaFal larks amitrnrtiun ramit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: tt
- ...... ..._.. ..............••-- •-----...._._.._.... .....------- ............
Location-Address or Lot No.
......................_.......................................................................... ..........-----•----------•--•-••--••-----........•••........----.................................
Owner Address
W
Installer Address y
Type of Building Size .....Sq. feet
V Dwelling—No. of Bedrooms___...`.?..................................Expansion Attic (J�) Garbage Grinder
PL4Other—T e of Building No. of persons............................ Showers — Cafeteria
Pa Other fixtures .........................--••-- .
d Design JZ 1 .50 gallons per person per day. Total daily flow......... �15.......................gallons.
W Desi Flow-------------------•---- -•--•---•-------
WSeptic Tank—Liquid capacity_. �M gallons Length__tU ___ Width__`.k ... Diameter-----._..._.._. Depth-5-1 _.
W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area_______----_------sq. ft.
Seepage Pit No---------_------------ Diameter_____ .__...._ Depth below inlet___.` ............ Total leaching area...4 n...sq. ft.
Z Other Distribution box ( )� Dosingftank (�)) 1
`� --- .................................. -C" Date---- (_��_1 /.�7
Percolation Test Results Performed by.._._ !�.0 _� -
'-� GZ p p K P ground r 1.1 c�i E�y(
Test Pit No. 1................minutes per Depth of Test Pit_________.._......._ Depth to ound water____.._:...._...........
(T., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water______-----_--__----___.
P4 -•-------------------------------•--•----------------•------..,.------------------.....-----------.........................................................
O Description of Soil.....-� LOAt_/k -� Dur��+L_ 2- -' 1 U `5& l�D1�.. .................................
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 { �! --
s.-r�............... -- .....
Application Approved B �. .... G Q•' ;' ... 1 �--..1 -----------j----------------------------------------- y == ......?. ...�
l Dace
Application Disapproved for the following reasons: ----------------------------------------------------------------------------- ---------------------
'----- ------------................................................................. ........................ Dare
Permit No. ....` - -_`-
---------------------- Issued
----------------- ----... r "---------''..��:� .......-- --
Dare
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
f.. �.�................ of ......�-���'.��..`�T�.�t�C= ------------.-------
Trr#ifirate of CI-IImylian e
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by................................ . ...................................... _...... ----- --------------------------------.--------------------------------------------------------------.............
atICU { ... ..J 1Z1 ►..1_ _....-.- ------O.-l------ ........................................................ ..2................. --I`-'- .... 4
has been installed in accordance with the provisions of TITLE of The State Environmental Code as described in
li the application for Disposal Works Construction Permit No. `; ----- --7,:e.... 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
.... ��............. '-- i
No :, FEES.. '!�:�r,U
Disposal Works TwOnstrttrtion .rrntit
Permission is hereby granted......................................................••--------••--•---•-----------------.........----------------....------.......---------
to Construct (X) or Repair ( ) an Individual Sewage Disposal System
at No... I f--'---f-��1 �f�i`_"- N 0 ..6a �__. _. .Cr �..._ /.f :* �?tc11�ti _s ( Li.
.............................----- --------...._.....
J
as shown on the application for Disposal Works Construction Permit Street
ewo... Dated...............'... .i�.............
"s
------------------------•--.....--------•- ............................................................
DATE..........=------------'-----
Board of Health
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
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FIGURE 6: GROUND-WATER CONTOURS
V%O ar,1ss
PETER a�
LEGEND SULLIVAN
® OBSERVATION WELL No. 29733 "
--�52 GROUND-WATER CONTOURS o
a-41. � �GIS7EA� <�
DIRECTION OF GROUND-WATER O FLOW yq\,
SCALE 1:1320 " •' ;;� i)
inc.
-7.Z0 S�-ICET 301r .7