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0017 TIFFANY ROSE LANE - Health
17 Tiffany Rose '(,t he- Marstons Mills A = 031 - 004 - 012 I TOWN OF BARNSTABLE LOCATION OJT �7 &P (h, SEWAGE # VILLAGE PAW- � S UDC CL�ASSESSOR'S- MAP & LOT nf?S �la INSTALLER'S NAME & PHONE NO. tJl COS-- 77 l SEPTIC TANK CAPACITY I000 '5Q( LEACHING FACILITY:(type) to 4 CIL Pig (size) 400 q V NO. OF BEDROOMS _PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER � /�rC e !^' �1�9 d��C h 67 ®if P. DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No [/ ,._ �. ���� � ,� i �7 5� Vo No.- - --- o t� FEx.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...... o .....OF....... ----------...................... I f liration for Bi" viia o � � �� � 1 Work C� tt tx�trtuart r�uttt Application is hereby made for a Permit to Construct ( or,Repair ( ) an Individual Sewage Disposal System at: , .1. .7 ..� ... �1 ,:. ......................................... anon-A dress or Lot No. Own -•-•••--•-•--•---.-Address-:- ...._�K1 Zb.&L................................ •• N1 ------•--•- ---._......... ---------- ---- Installer Address cy�� Type of Building Size Lot...�.(,d_ ._ -----Sq. feet U Dwelling—No. of Bedrooms......... ................................Expansion Attic ) Garbage Grinder etol) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ..................•--•••--...•-• - W Design Flow.......... .............. .....gallons per person per day. Total daily flow.............. �� .................gallons. Septic Tank—Liquid capacity.10'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( a Percolation r-a Test Ro. esults Performed Tes Pi s �.. Per by.... Depth s DPtground It/e r ! r%q Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' -•••-•--- --{ --------------------------------------------------•-- .-•--------------- ----------------- •.------------- ----- -•••-- Descriptionof Soil :' , J6---------------------------------•-------------•-----------------•------------------------- V f 1 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 iT p 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- ' 1 ••--- Date Application Approved By•--•------ . " ------------------ ---- Da4e Application Disapproved for the following re ons:................................................................................................................ --------------------------------------•-......_...------------••--...••---------.........-------•-•-•---....._....._.._..-••--••••-•----••-••-•-•----•----••-••--•-••--••--•----••--•-•---••-•---------. Date PermitNo-----&7=----- .................... Issued_....................................................... Date +: No.... FEs.......................... THE COMMONWEALTH OF MASSACHUSETTS �+ BOARD OF HEALTH •: Appliraffinn for Diipu,i al ark,/&nstrnrtinn thrum# e Application is hereby made for a Permit to Construct ( 'V) or Repair ( ) an Individual Sewage Disposal System at: - � /.r J ; ...a'` ... r/.1... !S{:..� ...i. j_:....:4.-a" .'""t Y+r+=fit. .:j�`"- d. i�✓C{..._ _j.1.4:&::.......................................... ....._.. / r 1 7 Location Address.y > or Lot No. -L7 A - �y:J 1j r � 1 k"'•t_..'.......................... ...' f. I_4._______� 3z ..................•--.........._...............--- Owner Address ._..... ...; .................................. •- Installer Address d Type of Building Size Lot.__ . _, ---Sq. feet Dwelling—No. of Bedrooms.......... ...........................Expansion Attic ) Garbage Grinder (It,) `4 Other—T e of Building No. of persons............................ Showers — Cafeteria dOther fixtures ..............•---•----•--•... -- ;. W Design Flow...........61- .................. ...•gallons per person per day. Total daily flow............... �t.�..........._....gallons. 9 Septic Tank—Liquid capacity..`.-;J.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 Result�� Performed bY.__. _V.1..4_� l_:I ���' � t y+� �" �'60&te........................................ Test Pit No. minutes per inch Depth of Test Pit .................. Depth to ground water--__--_--_________--_.-- GX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ • D Description of Soil---- " �� , .. .. - -- - -- -- - - ---- ---- -------------- `�t�`-�'�f L�����...7 ....C� ..- 5t...-sAXL 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 TTT p 5 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 or health t r q � /p Signed '= -:. ----•• ....-- Da Application Approved B ` .............................•-•-••.PP PP y•••• al Application Disapproved for the following re ons:••-•••••-----••••-•-•••---------•••••-••••-•••••-•-•••••••••-•••••••-•••••••-•-•••--•--•••-••••-•............... ....••••---•-•••-•••••••••---••--•---•-••...-•-•.....------•-•••-•••••••-•-•--•••-••-•---....-••••-••••-•-••.....-••----•••-•••••••-••--••••----••-••--••--••--•-•-••-••-••----•••----•---•----...-•---- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .,l Trrtgfaratr of Tautpltatta THIS IS TO CEIi,,TIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( } b 1rr Installer•...... .- •...... .... ... :-•- -••••-•. i `�� •at................ - 1. jk)q P ` - r has been installed in accordance with the provisions of TT T 5 of The State Sanitary Code as described in the �� _ ._ w. application for Disposal Works Construction Permit No........�_____________�._.1___..__.._ dated_...._.__ :-.�_.�.__.�.�......___._... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE.....................ram'' . . --------------------- Inspector....... _. .. --------------- b (� THE COMMONWEALTH OF MASSACHUSETTS p 12, BOARD OF HEALTH .......... ............OF..... e:.(.: .� ........ NO... ................... FEE........................ Rapos aI nr� ��an #rn Uan rrani� Permission i0ereby granted........... - c_:.:.....: ....._-• ?t_.:�_j. +... ..:: :...........................•- -- to Construct or Repair ( ) an Individual Sewage Disposal S stem at iVo.... ...... `-1-, %:i:'3�.{.......... f...... ......... C..t-.k,�. Street _ n^ V as shown on the application for Disposal Works Construction PeAltNo...Sa_'.�..!._.Dated_.->_____1_.J.......................... .............. ••-__•• 4� ----------------------------------- d of Health DATE--------- " j G " &.2............................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS • v 1 S PAC E \off A4% o !8 2.231 S. �9 ' 9 lo°►' _ \off 2 \o '12� i 1 � f s LEGEND EXISTING SPOT ELEVATION OxQ Of � I 'f PROPOSED SPOT ELEVATION L�H OFMq $�' EXISTING CONTOUR ---0--- ��P ss9� ROB PROPOSED CONTOUR 0—'^— �o� P A U L W. N ; , NOTE: THE LOCATION OF ANY UNDERGROUND 0 A M . tL SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON v Y �o THIS PLAN IS APPROXIMATE ONLY AS DETERMINED o p N .10050�0 � � fCISTt FROM RECORDS AND/OR VERBAL INFORMATION. �o�`���STE ��`�`` ���A1 LO ' THE CONTRACTOR IS RESPONSIBLE FOR THE VERIFICATION OF THE EXISTING LOCATIONS IN THE FIELD. ISIERED EN61—NEWAN R LEVY & ELDREDGE ASSOCIATES,INC. cLIEN PROPOSED PLOT PLAN k x ENGINEERS - LANDSCAPE ARCHITECTS J08 IN0.1o3? /07. 29 PLANNERS - LAND SURVEYORS DR. BYt at, /7 . --- -• - IN 889 WEST MAIN STREET CHKD.BYs '/�/�TR1,�a. CENTERVILLE, MA. 02632 SKEET.I OF? SCALEL.,. ��� DATE �- 9 -.e. 'Y1N-ir ;�'�sr..._ww,:.5.:. ,.:.- ,....... ,.-,,•._-`...:...<..aw.,r.w..r ..�.!...,w,-.........:....«...:.,,, - _ 5 No-re /i EITN�R' TifESFP77G T-4N/1C OR---- - r M "- • . ?O FT. M/IY.' L.E/4C/,l//YG P/T ARE I`9©RL= THAN /2"BELOJ�f/ 4•w.a GRA off, A 24=".PIA M F T,ER CONCP.F7T.E COV4oV /►l�Nf SCl/E4wLAS 40 5NA4L BE ®ROfJGNT TO GRAv.W.(;4/✓EXTRA h°. CONCRETE P KC. PIA W ),►E,4Yy C.�+ST/NON.C D i��IP SHALL B� USEO !04.0 COYERS MIN. P/TCN !F/N CDR/VAWA)rl 2%MIw. CO/VCN—,--T� 4 of COVER CLEAN SAND .. BAGJCF/.L.L ^_ . UQ/J/D LEYEL a a 4� Dip �• //e� GAL: e 0 ,0 t t .. • • . •• • > • WASHED 57ONE � Pe�Ie/"1: 14 BOX SEPTIC TANJiC` • t t s . • • .• e • • • t �• • • •e • .• s• �•� �r�// // • • • t e OBPT.N •.t ° ' t v a WA5NED. STO�YE d =./ /3, d CpP� ► yB • • . e • • • •• ► P ��� PRECAST SEEPAGE /1 0 0,10 • • • •. • of of a a P/7 0R 1JV/�.CJ� PLEYAT/GNS P rT CApA tTy O•S c'P'lD IItIyzjrr AT mv/.LD1"Cr /O .7D FT G I7: VIA". j> O F7; O/i4A9. C SEE TABL/L.�iTJON� !JltLET .S,l+'P'T!C T�4NK / P . OV74La '7'SEPTI C -rANl4FT.. //V.LE>rD/STR/Li//T/ON BOJ� CT/OM TE AL/09-Q A7 OROUA© , RE 3./0 OtITlETD/STRIB!/T/ON BDX —PT. sT AGE s� _O/.SSA !1!/LET.Lt''ACN/NG P/T /�Z. 7d F7: T ULAT/ON LZACHIIVG fa/T AB seALE : y4" = i o" D/MENs/OAt A - 3 f T. DArS/drAf CM7A=,M/A D/PI.ENs/oN FT. vvAfozR oP BEDROOMS ax1 SO/�. LOG �T. GaROAGEDISPOSAI- �/N/r AI V_ SA/J. 'TEST TOTAL JET/MATED F1-O*V 3-30 G.44.jDAV. `SO/1 TEST 0/. SOIL 7WS-r#R N4VMS,ER OP LEACRINL: /D/TS I f`ELEY./07, 7 EL�TY, QATE OF" SOIL TEST O 9 S/DE�LCACH!/VG PER A 7 �� PT. ,_ � c- Q 2 T6P f RL�SC/LTS I�/lTNESSED BY 90T7-0ML.64CN/NG PER P/T / so. PT. --4"coAAT/ON RATE#/ "G ll.'AVINCH TOTAL LEACHING AREA SQ. FT. , , PEVC04A710NRA7-_=AZ . M1N1/NC0y RJrSER1�ELEACNlNG AREA SQ. PT. P�TN OFMgs �� qc l° scAoM o� P A U l �� LaT //FfAitl yGLSE Lf}NE A. m, R.S . e LEVY Sib A p�No.10050�0 0 L 9¢, LEVY& ELDREDGE ASSOCIATES. INC. 889 WEST MAIN STREET `CENTERVILLE,MASSACHUSETTS 02632 '. 9o�FSS YYATEiR EMCO/JNTI�REO EL/ENT row k?f I VO•ITE: 9 $,j GRU lJ/W.dJ yd.4TEr.F' AT SrLE!/. ./O6 NO." 1f�3 SH.E.ET'2 0l= 2. AsBuilt (7—V 1�10J/—Page 1 of 1 TOWN OF BARNSTABLE LOCATION LOr �¢ l 't'l�10-u�BSp Ct�, SEWAGE # n' VILLAGE 1�164 S t bPA A 1 GCS ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. �3 > CO( L. SEPTIC TANK CAPACITY LEACHING PACILITY:(tgpe) C C �C P/�' (size) � U v NO. OF BEDROOMS . _PRIVATE WELL OR PUBLIC WATER () BUILDER OR OWNER 67/'-C C'.r- pCi Ki(* 67 01e P. DATE PERMIT ISSUED: ,5 DATE .COMPLIANCE ISSUED• VARIANCE GRANTED: Yes No, LO 13 77 51 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=031004012&seq=1 1/28/2014