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Home My WebLink About0105 WHITE MOSS DRIVE - Health IDS wk �{e— [Y)DSS I YA v-e._ 031 - 004 -0�(� - �n . m l l� i TOWN OF BARNSTABLE LOCATION "t t QS� I�JLyc SEWAGE # VILLAGE Me MOQZS ASSESSOR'S MAP & LOTAI il� INSTALLER'S NAME & PHONE NO. � S 7 e e SEPTIC TANK CAPACITY �,b�� Cii LLaf Al s LEACHING FACILITY:(type) —(size) 600 ONO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATE Q 0 BUILDER OR OWNE ob -"l C-oep. DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: � — � 3 " C�7 VARIANCE GRANTED: Yes No s .. � i �� LL ` �' �.. k, �". t �� iSSESSORS MAP NO: 4- �4 '3ARCEL NO. � No... :^_�..� ' Fes$. `.............THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .-...._....�o.).........0F............. .............................. ApPration for Bi_qpooal Work Tooitrnrtfon ranfit f Permit on ru r Repair an Individual Sewage Application is hereby made or a Pe t to C st ct ( ) o p ( ) S ge Disposal System at: �T.3(_ cu14 rrl� v �5d �---� GI�S--------------------------------------- :------------------- -. ...._ L ca n-Address or Lot No. o ner Address ......T&v��......v mi c��.c ... --------•------------------------------ Installer Address Q� QType of Building Size Lot.... _.rl ..Sq. feet U Dwelling—No. of Bedrooms___...,„?_ _____________________________Expansion Attic (0) Garbage Grinder (� aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .................................. W Design Flow............_!�5 .....................gallons per person per day. Total daily flow.................... ...___._......gallons. 14 Septic Tank—Liquid capacity._)IJ66..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 Sank ( ) `` '-' Percolation Test Results Performed b Le1/___ �._. 1 �_._ !./.!leQ�l__... Date...._r_�..f �_ b� p a Test Pit No. 1____.... __.minutes per inch Dept of Test Pit....... Depth to ground water______1KJ ... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .I• ' • - - . ---------•--------•-------------------........................................................ O s Description of Soil--�-=-�--�--- -�D��.----�---�1�.!�5d1- ---•---•----------------------------------------•----------------------------------------------- Wx ......•----•-•--•--•-••1 12------. ------------------------------------------------------------------------------------------------------------------------- Ia..'12� �: - �.. .-`-',y------------------------------------------------------------------------------------------------------------------------ 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 i T i LE 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. Sig d...... ��' � ' 334- ate Application Approved By•••--•-•-- ..-. ..................•..... ......... 3 1 Date Application Disapproved for the f ollowi g easons:-----•••--•--------------•-•--•----••---••••-----•••----•-••••-•••-••-...-•••--••-•----•--•-••--•------•-----. ---------•-----------------•-•---•-----...-----------•-----------••-------....._......----...-------------••--•-•---------•---•--•-•--------••-•--•••••••.....••--•-•--••------•-•-•••-•--•-•-••-......_ Date Permit No...... .: l .-/--•-------._---- Issued....................:. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _....._: �1` '...........OF........... . ..'. :•.! >L • tl� Appliration for Disposal Works Tonstrnrtion Prrmit Application is hereby made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal System at: d---�c� ' `.l... 1 ....`---•f�-�u. .__. d :.(. � :......... ....#J}�ir � �� f '. .J�'�1t s ,~ oc ion Addres or Lot No. - . 1. carer Address.. ......... ..... ......--•-----------•............. t ------ --............----.-. ...----- .....----------------- installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-------�...................................Expansion Attic 01 ) Garbage Grinder '4 Other—Type of Building ............................ No. of persons........................ Showers — Cafeteria G 1 Other fixtures .._... - ---- - •--------------------•------------- -emu.. ------•-•---------- - W Design Flow............ . ......................gallons per person per day. Total daily flow................! =::..................gallons. 9 Septic Tank—Liquid capacity. C_r ___gallons Length.................Width.............:. Diameter................ Depth................ Disposal Trench—No..................... Width..................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No-_--------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing ttank ( )� r Percolation Test Results Performed by.... :F.f..'.. .: !3 f`s! �..... �"f!� ''r_' _. Date________________________________________ aTest Pit No. 1................minutes per inch Depth,of Test Pit................._._ Depth to ground water........................ fX4 Test Pit No. 2................minutes per inch Depth of Test Pit..............._.... Depth to ground water........................ ........................-................................................................................................................................. ODescription of Soil........................................................................................................................................................................ x - U ----•-•----------•-•--••---------•-•-------••--....................................................................................................................................................... x --------------------------------------------------- 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'TT' ` 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 ,' r, ,, s . ---- ;Date Application Approved BY-------•---••---•-•---•-- --•--..................... {Date J_> Application Disapproved for the f ollowing Vreasons:................................---••---•---•-............................................................. �r. ..•-----------•------------•-•---•------•----------------------------•----------.•..--......-------•••--•••---••.........--------•---••----••--•-•-•-••-••-•--•--••-•-•-----••----•-----------.......-- Date PermitNo.----- --•-------------— Issued-........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH A ...... .........O .................... Tntifiratr of Tontplaanre THIS IS TO CERTIFY That the Individual Sewage Disposal System.constructed (:1/1) or Repaired ( } bY............4:1 �� ....... _�:�.�. ��:�:-.........................----..................................................................................... 1 1Installertl" 1 at fS ---•-.' .� ----i f ;, / (�3�` J ��r ----------- has been installed in accordance with the provisions of T T T tE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated-.---------------------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... ...-._.�. Inspector '"--------------------------•--.-_- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �Yoj J °T ..... ........OF..... . .Pla . ., .f�. t . 'i................... FEE r 4 , Disposal Works Tom ton r rmit Permission i hereby granted........ ........ .. g .�F to Construct f ) orepar an Individual Sewage Disposal System treet � ¢ .�, U I as shown on the application for Disposal- r orks Construction Permit No.................fi;Dated------j___._ ....... .•- ...._..... i -- -= Board;of Health DATE----------------------........................................ -- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS V ` 5 : w'4 , c s, c- x '''Sodra /� 09 x l0 t�(/• .yam �,.. �� "w^ a L I') S Al a e To-rAL r. 3' op O�1aR3 s u dp k MV A s `G TANX y 2 . ,. .- °'� • �( i,°, %` �:•� ran _ 9 '`. � Sr EEO kcf .}. (. � 1.y ' 1'OV dj: f { - ,`"•t't�}�� r k'-4't ��M r� ar Rykk c N/gQ �� D� xis ( d i (v3_ = ; OSS I 1 s � s c .E CERTIFY THAT THE' PROPOSED' BUI LDING � �§t� ,:�!"F SHOWN ON THIS PLAN CONFORMS TO 'THE rsh� ZONING LAWS ...�..,'MA LEGEND DATE= �y _ A ra a E EXISTING SPOT ELEVATION 0 qh )� PROPOSED SPOT ELEVATION `.r: EXISTING CONTOUR ---0— —— g PROPOSEDW CONTOUR. :O � �� .. DAVIp P 4ya t < NOTE T.HE°'LOCATION OF ANY UNDERGROUND: `SEWERAGE WELLS OR OTHER UTILITIES SHOWN ON �' clvlif THIS'PLAN'IS APPROXIMATE ONLY AS DETERMINED No.31115 FROM RECORDS AND/OR VERBAL INFORMATION. �or��yYE~10� ,THE-CONTRACTOR IS RESPONSIBLE FOR THE VERIFICATION OF THE,EXISTING LOCATIONS IN a THE FIELD. 8.` Y' bAt'i N IN - R t r h .t Ek ELDREDGE ASSOCIATES,INC. 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MARIAN , T� j No.311 15 ANLET SEPTIC TANK /o , 2 FT, �T.�I�i��/T OIITCET S'EPTJC TANiti �43, OFT, . �Fs q �� /AILET p/STR/BUT/ON pox Imo•0�� LEVY & ELDREDGE ASSOCIATES, INC. OUTLETOJSTR/BfJTJO�lL3oX /AFT. 7/2NJA/N ST., NYA/V/1//S MASS. . INLeTFLOWd/FFLJSO'R ' /Ul,% . FT. C.C/ENT� F_N R/E�' DATE : / JQB NO, � � SHEET 2,• QF 2 `