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Home My WebLink About0094 TROTTERS LANE - Health 94 TROTTERS LANE, MARSTON MILLS TOWN OF B NSTABLE G' LOCATION �� f rd?7-Pf�S � � SEWAGE # VILL +GE ��LL S' ASSESSOR'S MAP & LOT 0 INSTALLER'S NAME&PHONE NO. t n CA�lJ to C-''P AQ'11 e ��rPPUG SEPTIC TANK CAPACITY Z°°' c LEACHING FACILITY: (ty (size) 'Y 11 X -Z S NO.OF BEDROOMS - -- BUILDER OR OWNER PERMITDATE:� COMPLIANCE DATE: Separation Distance Between the: ' Maximum Adjusted Groundwater Table and 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 leaching facility) Feet Furnished by i cr 0 v . A TOWN OF B STABLE LOCATION ? f SEWAGE # J VILLAGE ^11/�VfGL S' ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. .11 t)0 CA 0 AC SEPTIC TANK CAPACITY LEACHING FACILITY: (ty ) -v 17-t.4T6/1 S (size) Y A .2 NO.OF BEDROOMS BUILDER OR OWNER n i PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 leaching facility) Feet �. Furnished by 1p 0 Ier f7 No. ��" � � � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS 0[pprication for Migpogal *pgtem Construction Vertnit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ;Irtdividual Components Location Address or Lot No. — `V`j nn/K Owner's Name,Address and Tel. (el.No. C l Assessor'sMap/Parcel &r�,_I�� G C��`Y�1T 4%-d Installer's Name,Address and Tel.No. Designer's Name,Address and Tel.No. v%S Sty Type of Building: Dwelling No.of Bedrooms_3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3-310 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Fo Sr Type of Description of Soil Nature of Repairs or Alterations(Answer when applicable) k2CX A-( Q'< �V 21�t( k4 / 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 'ss ed by t is Signed Date `ly Application Approved by Date f;% _j y- 9 Application Disapproved for the ollowing reasons Permit No. 9_ v $ Date Issued No. // ' ( t/ Fee 4—'!�5 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Migoml *p5tem Cow5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System Individual Components Location Addressor Lot No. Owner's Name,Address and Tel.No. Assessor'sMap/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. GrAf-49 -Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �� gallons per day. Calculated daily flow ^31-Et gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Ka et (C?c i Type of S.A.S. t ,r' � s 6/ G' .Description of Soil _d -e ;;kg7A Nature of Repairs or Alterations(Answer when applicable):TA,t S2 Q L < i C w SC e' l/ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system 3 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 h een.i` ed�th_h-is-B-q Signed Date `y Application Approved by Date j3 _► w 45 q Application Disapproved for the Following reasons I ,,1 . . Permit No. 11�` y Date Issued 4 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( < ,«)'Repaired( )Upgraded((yf Abandoned( )by lA i 0—CA pg t at [� v- C I At"L-4f r� .' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. `11�- $ dated Installer Designer The issuance of this h 1 ® e on trued as a guarantee that the s s efn will un�s o s designed. e t Date y l Inspector ��' --------------------------------------- No. -t Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi5po5ar *patent Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade e' )Ab don( ) System located at c� � le,_eAl, r 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: Construction must be completed within three years of the date of this permit. Date: I a - 1 `/ - / Approved by �� 6 � 1/669 NOTICE: This Form Is To Be Used For the Repair Septic Svstems Only, p r Of Failed 1l GlCcv�Y�\V rt� CERTIFICATION OF SI--aTCH AND -,pPLICATIOY FOR � DISPOSAL WORKS CONSTRUCTION PERMIT 1W7MnTU1 DESIGNED PLANS) I TIC herebv ce-tify that the application for disposal works construction permit signed by me dated concerning the property located at p-V-k�; --�. meets all of the following criteria: (� The failed system is connected to a residential dwelling only. There are no commercial orb i uses associated with the dwelling. us ness �• The soil is classified as CLASS l and the percolation rate is less than or equal to 5 minutes per inch. '�• There are no wetlands within 100 feet of the orocosed septic system There are no private wells within 1;0 feet of the proposed septic system There is no increase in low and/or charge in use proposed There are no variances reguesed or needed. CI�"�•/ The bottom of the proposed leaching facility,mli not be located less than five feet above the maximum adjusted grcundwater table e!nadon. [Adjust the groundwater table using the Frimotor method when applicable] • If the S.A.S. Will be located with '_50 feet of any vegetated wetlands, the bottom of the proposed leaching facility',vill not ce !ocated less than fourteen (1=) fee; above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation (using GIS iru�rmation) l� t i B) G.W. Elevation ,)G•D . the NL-�-K Piigh G.W. Adjustment _ DJT—tRENCE BETIWEBN A and B SIGNED : DeITE: [Sketch proposed plan of system on bac!<]. T health folder.cart ,��.,� v 4 LOCATION SEWAGE PERMIT NO. j' o rL,0'6 Tom® IrT-6<s ,��o�� 7'- 4iU ✓ VILLAGE OA17 - /;17 slaNe IfflI ' I N S T A LLER'S NAME & ADDRESS A'cl� ��%` Ts' /-/xo 'W/ctl. B U I'L D E R OR OWNER DATE PERMIT ISSUED 7r� - a7 DATE COMPLIANCE ' ISSUED LET L i .B 4cj< Qr N . ...:.....e.l. FEx......,l.v................ ............ J! ,> THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... .........................OF....................................... Appliratiun for Dispas al Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an jndividual Sewage Disposal System at: /�?. /4�. ..... 7�0aP-s.Z ,............................... - ................ ... - .......- lion dress or Lot No. Y u. ... .r.� r. ............................... .... .. Owner Address Installer Address d Type of Buildin f� C}d g Size Lot._ . .Sq. feet U Dwelling—No. of Bedrooms_._..3. . .. ........................... .. . Expansion Attic ( ) Garbage Grinder (iVd) 1 -. aOther—Type of Building ............................ No. of persons............................ Showers (JUgl — Cafeteria dOther fixtures ---------:-• -- ------•---•----•--•------•--------•---•---•--•--•--•-•--••-••-----•--------•--••--------• ------------------ W Design Flow.... ............................gallons per person per day. Total daily flow---- ......._.........__.......gallons. WSeptic Tank Liquid capacity./400dgallons Length................ Width................ Diameter................ Depth................. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------------------ Diameter.................... Depth below let.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) B 7 7— 7-- -77 '_q Percolation Test Results Performed by......._.................................................................. Date........................................ W Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..................... fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... x � -O Description of Soil---------•--------� •------•-•---- ` --=---------- l----- - - t U -•................•-----•----•............---•--•---•-•--•---------------••--......•-----•------•-•-••--•-•-•-•--....•--•---•-•------•---•-•---•----•--••----.........---.....----•------•......._..-•-- W UNature of Repairs or Alterations—Answer when applicable...................................................................................0.........._. --------•-----------------•-•---.....------•-----------......-------•-•------...._....----------.......----....••-----•-----•--------•------••----••----••----------• .................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 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 of health. Signed...... , �¢ --- ........ ---------------------- ---- ................. "Date -_ Application Approved BY ... ---- k---�-7--7 Date Application Disapproved for the following reasons---------------•--•------.......---•--------•--- ..-•............................•-•--•--..........-----•-----...........------......................---------........_......---•--•--.._....._----•-•-••---••--•---------•--•---..._••---•••-------•---- Date PermitNo......................................................... Issued---. - .._.._1�. ...................... Date I �7. Fps, f..S! N... ..... �.. . ..._............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................................OF............................................... ........ Appliration for Bii#oii al Works Tontrnrtion Vamit Application is hereby made for a Permit,to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: _ 7 ........_. ... ..... ............................................................. ..•--•------....--------•--------•------------...---------------•----........•----................ ` ��F --tiow ddress or Lot No. -- f/.vUa�T✓G to .�+'. ..........................-..... ----�55 -� - Owner Address a �-a..k!i...�:A1-.(..o....................................................... .....lh.�:Zq 4..M..l_ll s .......I................................... Installer Address 1 � T d Type of Building Size Lot_2-0 00 0...._..Sq. feet Dwelling—No. of Bedrooms.....�..................................Expansion Attic ( ) Garbage Grinder (ud) p, Other—Type of Building ............................ No. of persons............................ Showers (No) — Cafeteria (IVU) QI Other fixtures -----------------------------------------•.... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity//.gallons 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 ( ) d l 7— I 77 Percolation Test Results Performed by................................................................••-----•... Date........................................ aTest 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........................ a ` �------------------••----_-------.-............. - Description of Soil.. - � �... --------• =.........;--•-_. F...................... V ..-•---•-••-•---•••-•.......••••.........---•---•-•------•...................•-•-•-•--•--•---------•-•---••-•-•••---••------•-------•-------•-•---............................................... 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 TITI E 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 of health. Signed--. ��"" ` �d�''� ," ' --------------------------------- ................................ �J"�C��-? i... .�.� _ Date Application Approved By...... ------------.:,r.:f:;..._�.............................. - Application Disapproved for the following reasons:.................................................................................... ...................•........----•-----•-••---••-•------•-----...............----------.......------.........----•--------------•-------•--•---•-•------------•-•-•-••••--••------... ••---•-••----- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF `HEALTH ...............................OF.........(� „... .: ................':.................................. �rrfifirtt#r of f�ont�rli�anrr THIS IS'TO CERTIFY That the Individual Sewage Disposal System constructed or Repaired ( ) by....... /.._Ir_A1.1:..:k.- .a.......:................: --•------•-•--.................--•-----••-••-----•-•-•--•---•-••---.. �/ ✓' �! � Installer �{ at...... '`- _/.-_•-- .-:.....-- �'w ` -(��''' r ..................................--------------------------------------------------- has been installed in accordance with the provisions of/TITLE 5 of'The State Sanitary Code as described,in_the application for Disposal Works Construction Permit Now` _ _c'. .:f................ dated___._.-c7.'.!'__k...... �_._�_...._ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 11 &71 DATE........ ( 7 •--•--------. Inspector �� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 6 X ....................OF..... ............ FEE....................... Permission •s reb ranted,...__ _..' Mork ion ton �erutt� Ito 00 /�� Y g --•--••-•---••••• �. ..... .....---............................-•-••-----••-•.....---•••................•-.•-- to Constru "") o Repo� � ) Individual S age Disp S sit at No.�y ,` bG v .. _ ......... r ...- - �c--- ( ' ------------------------ as shown on the application for Disposal Works Construction Per _.. ed.�_' .1. .-. .......... �X = �!1. - -------------•-•. � DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 71 Moil i3g fist -`k" LA j— k I'tI . A*jr ti, IC lt All rrr,YI is Is. . . it or! 4t iv I s, sP, 0, 2- 'tp 10 r f) 34 is m too o, OAL s4 tv it. 100 .ih PF ":'Y 7. nosi tr P.q. Ot-1: oil is, V1 nr L EGEND, E10 I-M RTIFIE T,, I "SOOT ., E,L E" VAT N AX ci 07 071 r-79 Isi-HEb SPOT, 1LCVAT4O'f(.-,,Fl o IV 1z Lt Ftk V ft� COUTOV "V. EjDl' 'BOARD r tip A'A m 8, 11" iju 'VENT-,--A ENS jio IrY TMAIr 8 , �77Z r a Plskst� A44 i;-; Af. - GGMCRC'7�E $•'"Pvc,Pl 'LBAN D . p MJN. P/TCV• b -4 r r GovE�rslip _ -,1, x cdNCRE'rx_ 4. 4~CA Z44AYE_R /RON PlPL� �i:� • e o p v �� aF � --.s - :'d AM/N.P/TCN -_ GAL. p/ST, o} • • • • . •• # d os': WASHED 570)Ve $E'PrIC TANK BDX e ° ► • i o •'�.• e a v :C p.. / 1 � Y • • •'j1 0•0 s ONE a too ► • E � e d.. a • / • ® • • •/ • p p PRECAS T SEP_.92AGE /Niii A—r 4MRVAT/ONS O :oo • • • • • • • • �e� o rr P/7 DR LVU/V. e INYERT AT. ¢UILDIIVG _ i�7 0 FT. -- = 6 OIAM. " , SEE 77gB� "J'?O/V> INLET SEPTIC 'T.4A/K _i 6 8 FT• 1_ - - FT EyIA *� C OUTGET SEPT/C TANK /NL.ET D/53'/g1�3!/T/DN BOX 9L�•4 FT GRDuiyo 1��4TER TA6LE SECTION 4F' - OTL,ETD/STAQ/BtIT'/ON BQX.��6 .3. A . U N[ETSEEPAGE �iT 9'�•5 Fz SACFNlAGE APASAOSA 4 SV,-74ffA9_ L Cf�//V�s =�/.T TA8IILAT/QN StAL E fs•• : /= O" O/MEN.S/ON A FT. DES1G/�! CR/TER/A v/pr. a/a a 8-fir FT. aua>'ec�R of eED�OohJs D MENSlON G `.GAR6A6ED/SPOSAL UN/T= • _ _ � _ � - .� -TOTAL E57//rtA•'TED Fl.OkV ~GA4.1,OAY S�lL TE�7" NUMAER QF.Sj&-_ A&Z P/Ts :. 0 _ -} ,DATE OF SOIL TEST 7.,. 7 Z7 T : - SIGZ 4&ACHinr6 P&IQ j?/T 199 s4. PT L O�r TEST��/T_ / : TEST P:<T o0�2 RESULTS I iVITNESSED- BY X:P. B v.✓i/<i s BG7'TO^f 4A4CN/NO PER P/T .�(,�, A'T. - PERV A.rS T/O/V IAA �°•7 Iy! I NGN TOTAL LEi4CHIA"G AMOA '- So. FT. RE?�RI�ELEACN/N6A.QEA_'-G b SQ:. FT. , ¢" t7�a� • _ �y . 3 � T 6 7'rZ0�77�PS 4^NE.. _ o'r ROBERT �� 9 5GRdR✓�L /v} BUNIKIS 5e}.dn P. 0 2Z162 ' 7 G�ST�. M11>IY.ST NAfA 5;0 ti � i '� a - - KYANMI.4�- 4�?�S� �l.�iQ�,M..t7+J' T/►1�l�A�..Tt.' _