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Home My WebLink About0161 WHITE MOSS DRIVE - Health 1 u3h ti-e, Mcc-s �n Q e� 63 ( - O CA --CO`7 - m M i 1\s ASSESSORS.MAP NO: No........................ PARCEL Fmills. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. .......OF.........61rl? ------------------------------ AVpfiration for Bhipasal Works Tottarurtion Prrutif Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: lt6. .......... ...................... cation Add ss or Lot No ..... .............................. ...BOX ........ ne Address ...CL................................. ..JAY ..... ... . ...... ....................................................................... Installer Address Type of Building Size Lo L.0...Sq. feet U Dwelling—No. of Bedrooms.___3..................................Expansion Attic (tlb) 6arKage Grinder (A16) Other—Type of Building ............................ No. of persons.__._.______._______._._.___ Showers Cafeteria P4Other fixtures ...................................................................................................................................................... Design Flow.............6.75............ gallons per person per day. Total daily flow.___._.__.__., ._____________..____gallons. W Septic Tank—Liquid capacity- gallons Length________________ Width__.___._.__.._._ Diameter____.._________. Depth____.__._._.__-- 130" Disposal Trench—No_ .................... Width_._.____..._._______ Total Length.___________._...__. Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter.................... Depth below inlet___.__.____._._._._. Total leaching area____. ...........s , ft* Z Other Distribution box ( ) Dosing tank ( ) 04 Percolation Test Results Performed by....ZZily... 5al-ji6elm...4��!.I.v...C/:�'Iate......F 1.4 ........... ................... 04 Test Pit No. I.Je.5.5..minutes Per inch De of Test Pit_____ ---/---- Depth to ground water.. Test Pit No. ;r-k-,dminutes per inch Depth of Test Pit. __3......... Depth to ground water........ ._. P1 .................................... . ...... . ......I........ C, ---- --------------------------------------------------------------------------------- 0 Description of Soil.-_0,7.& c,lq A,ev, .:5 0 --------------------------***......--------*.................. ................................................................................ .......C U ............................................................................................................ ............... ............... .............................. U Nature of Repairs or Alterations—Answer when applicab, .............. .......................... , I ........................................................................................................ ----------------------------------Ar-O....... -- -------------------------- 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 i,,.,ued by the board of'health. g Ah �-, '-'L.e'g1w Si- - --------- ...... -------- ...................... ........ D I ApplicationApproved By..................................................................... ....... ........... ... �'2� _. .. Date Application Disapproved for the following reasons:............................................................................................................... ........................................................................................................................................................................................................ Date PermitNo..--- . -------------------------- IssuedL....................................................... Date -------------------- No.. ......... . .._ C}Pr � R THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiun for Diupu,sal Works 041notrurtion Permit Application is hereby made for a Permit to Construct ( Vor Repair ( ) an Individual Sewage Disposal System at Location Qddrp :1 or Lot No Oviner Address... c`.. .--•.....................•---....._ . ......_. 7I (, •---..............._.: . -............... Installer Address Type of Building Size Lot__.._..7.. � Sq. feet U Dwelling—No. of Bedrooms..._..-r............:....................Expansion Attic (YO) Garbage Grinder (A,) Other—Type of Building No. of persons......................... Showers YP g •--••----•-•---------------- P --- ( ) — Cafeteria ( ) a Other fixtures -------••--•-•--•--------------•---.._...-------•-----...--------•-•._•--- W Design Flow.................�:`:............._ gallons per person per day. Total daily flow.......... . gallons W Septic Tank—Liquid capacity.. gallons Length................ Width................ Diameter................ Depth.._............ x 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 tank ( a Percolation Test Results Performed by.... _�y.... }.Cl ...6111i e"r ( 2k �..- E r� ate._.. Test Pit No. 1 � _minutes per inch Dei of Test Pit_._._ �__: Depth to ground water... �+.. 44. Test Pit No. 2_ .t��.Olniinutes per inch Depth of Test Pit.................... Depth to ground water.................. P4 .................................... ......... .. ............. D Description of Soil. ccn ,j C�, 5 C C.._......_:_ .......................................... ._....... _ j . ..j 't �:�� '. __ r1 % ......_ --_-.------••------••-•- � ---.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 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 is ued by the board of llealth. Si ned.. t--� r.� .A : - :t .. D Application Approved By................. _: --° '! _— ate � Application Disapproved for the following reasons------------------•--•---.._......--•-----•-•-----------....._..----....-----.....................____.......__ ----•--•-•----•-----•----•---•-•----------•--._....�..............••----•----------------.........---•--..............------------...---------•-------••-------.._....----•-------••-••....._•--- .....Date Permit No.-------3_1_._::_I11-•-----•--------------_ Issued............................................ .... Date THE COMMONWEALTH OF MASSACHUSETTS ABOARD OF ,HEALTH ............... 4' 1 !....OF.............. '. .................... Tntifutttr of Tompliana THIS IS T.Q. CERTIF,Y�, That the Individual Sewage Disposal System constructed ( �or Repaired ( ) by--.. ' ...... A.,P 7.C< �� ----------------- --- ............................................................................ --..... ES i �{ Installer �1 } ` crypt �� " rllo.S t r 6� � /(� �r 6 (41,1< at.......................... ....�.a.......� 'r E..:. •----........=-•..... ..��!.L� �'-�= � � �t -.... .... has been installed in accordance with the provisions of TIT LP, SAof The State Sanitary Cod a( de gibed in the application for Disposal Works Construction Permit No....... r___._ ..'._�....... dated--------------,__..`_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.------••---�i ............................ Inspector.... .�1.... ........................ .............••---••-•••-•- THE COMMONWEALTH OF MASSACHUSETT BOARD OF' HEALTH ,, t r � .. .._ 4�No F$$..- -.. .: Disposal Varku Tonotnutiort Permit Permission is hereby granted............. )_ -"": --- 0' --•-•----•.....................................................__ to Constru ( 4 or R air ( ) an Individual Sewage Disposal System at N t w >--...........-•sheet �.. -------------- as shown on the application for Disposal Works Construction Permit No..•.Z~_: ,__t_`�bated...=......._? .1� 1�.`......•----- Board of Health DATE..--•-•-••---------��i�.--.....-•t---.l.��.�...�--------=---=------- -.,- FORM 1255 A. M. SULKIN, INC., BOSTON - �. - •-,, ; •j ,$my'}g r rep r s i- i o r tax r�' f l ♦ .. `^ '< K�a'f,1Kg� `tc�'$1'�'�,r,r ,s` qr'n� .,� � t` ?tSk «r%£ .. �V '';jk� 4 Sylr .$i ' �{./L/ 9S ! - - - � \ . . � : r �;.��.�#��x'`��n.'f�34 r.::.: '�s r-: E£� ��';- F a xx�-:gw w«i",., '�.�•. NO- Lu �a,.,. #,At v�A�hy '/7 �Oi 4. CAL Z 7 A44 \ ttA T \ @SC ZONE �F o �N , \ � 3 \; E'tl LaT P RaT"rLTt D � t L°R T®;uM Ike,d, tom' 4 S �4,,L(Cs �. Av �< 00 LEGEND o EXISTING SPOT ELEVATION 0 Mqs PROPOSED SPOT ELEVATION EXISTING CONTOUR ___0—— � may.; � o� ROBIN : ti PROPOSED CONTOUR - 0---,-- h© AoAVID''P S h9ARIANf) N ry WIL N '' 4 ' NOTE: THE LOCATION OF ANY UNDERGROUND c ' cIVI t" = t ' No.31 t ty SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON ,p No.31115 THIS PLAN IS APPROXIMATE ONLY AS DETERMINED �+ FROM RECORDS AND/OR VERBAL INFORMATION. � .T ' " � '. � °y THE CONTRACTOR IS RESPONSIBLE FOR THE VE,jR�''IFIC�.'ATnION OF THE EXISTING..4gCATIgpj$.IN ^S TtY'1dLI.Et,.Oe 5 4 >, t PR n ENRIt .EE�R.S LANDSCAPE ARCHITECTS sDQw,IVwl , / w PLANNERS �- l,ANO SURYEYO. S D� sY.= i � ,. E #.3rnsf4�F,Atµtif •,S` 5 a$ :r.7fl,$89, ST CENTERY11. E A MOP. � , Q �QTX a� TOWN OF BARNSTABLE ✓ LOCATION I OT ; AAV�5 �.iV SEWAGE # i�� RVILLAGE 1 9'a f S l dh S ASSESSOR'S MAP & LO INSTALLER'S NAME & PHONE NO. �� ' s L 1 7 )1-31:4 L SEPTIC TANK CAPACITY__w",<) LEACHING FACILITY:(type) ) tk i (size) 1,/ C NO. OF BEDROOMS PRIVATE WELL OR_ UBLIC WATE BUILDER OR OWNE -✓ ce2 r I, DATE PERMIT ISSUED: T, DATE .COZIPLIANCE ISSUED: VARIANCE GRANTED: Yes No. ' 4 F� ,� �. i ' �70 ® 9� �. � � .� :+:f�� ., �O FT. M/N• IV07E /I- THeSEPT/C TANK OR Ile LEACK//VG .P/T ARE IJORE 7-T!f1/V 1Z"BEL0JV 4u01,9. 6RAGEAA 24"27/AME7.ER CONG'�FET.eF COYEAP " }E ScyEot/[E#0 SWALL BE QROUGHT TO 4IOTA N:tCX7*11leA, COA/CRETE /pVC. P/PE 1`/E.4Vy .Co97'/RON COiiER` 5'/H.4LL 13E USED P/TCH COVERS M/N• e'• �B p PEiP FT. /F/N bR/VEJ�VA y tat c: a .�oE CO!✓ER CLEAN SANG .rid. :-. • _ 2"LAYER ••' C. P/PE i 0O 'b MIN.P/TcN ��-- G'4L. .0 1 • • • • • • • e „ , WA5HFD SMNE pox.I'r. SCP7/C 7".�4/VK BOX D/sT. � • • . . . •e a i p 1 •EFFECT%VE • • � o ° • OFPTN ' • 1 ' v o WASHEO STONE /s/ X 2..5-= :3 7 7 S�PD s a � • . • • • • • . p O � PRECAS.T SEEl�AGE lNIi�R'T ELFY.�47"/ONS. //3 x /. O ' //,3, pGp� a r n° � . • • s . . . . eo`o P/T OR �U/V. • e E L 8�. O w 7 CgMC 7 y 9 0. S C/p� INXERT AT BL/ILD/NG 9.�• O FT. INLET 3E'PT/C Ts4NX . 9-?•8 FT. FT. O/AJ►9. C SEE TABUL a1TtQA/, OUTLET SEPTIC TANK FT /NLET D/STRT/3I/T/ON BOX 9—.FT. GROUND H�TER'.T.aBLE. 0d7LE7-D/57-,R1BUT101Y®OX 922 FT SECT/ON OF /NLET.LLwACHIIVG Ja-'T 92, o fT. SEJ�JAGa� .�/.SPO�SA.L .SY.��'EM 7A- j41L.A'Tl0IV LEACHI/V G /a/T DIMENS/ON A S FT. SCALE �4" _ /=O~ DRS/GJV Ciz/7'EM//4 �I�JrENS/oN . B T=T. NVAf8ER OF EEVRvoms D/MENS/ON C FT. 47A.gaA6,E®/5,POsgL uNlr o SD/L. `BOG .SD./Z .VEST fi TaT.4L ESsTIMATEG T='LOFt/33DAv -SOIL TEST / So/L T.ESTl0�2 NUMBER OF 40ACr/l)V6 P/TS .EL Y OATE.QF SOIL S/DE LEACHING PLR PIT• /S/ SQ, FT. p�-?' TaP.Soi� RESUd.TS h//TNESSED BY.Z� C BOTTO/W t�gCHTIVG PE1R PIT zz SO. FT. SU�c3S��G PERCOLAT/ON JeATE jO 2 / lhliNt TOTAL'lEACH//YG. AREA •2Ca SQ FT. PJFI�COL47/ON RATE fk2 t+'fll►► /N RESERVE LE�iCHlNG AREA sQ. FT. �z OF i., �' �� SAND �✓r}iTE�%1GS=s� 3, f DAVID P. r' •� ,L07- - ' MARIANO t . clv,>_ y LEVY& ELDREDGE ASSC�GiATES. . No..31115 . user oae EL. MAIN STREET Ff 2. .0 889 WEST T CENTERVILLE MASSAChI GRO W,, ulVp 4 Tt°R AWCDUNTERED G L I.ENr: /�EFiJB/Q/ER+b•I i� x "I l Y, Q Gilt OUA/D Lt/ATEi� ✓08 J6Id 7. ..w .:�. ,.. . `..+.ten; �, •.::,,.- »,,.+� _ .