HomeMy WebLinkAbout0168 WHITE MOSS DRIVE - Health 68 White Moss Drive
Marstons-Mills
A= 046 141 �-
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i
"�wJOWN OF BARNSTABLE
LOCATION t o t i y w-ti r re— a SEWAGE # �
,VILLAGEA,a.F3 41 f I'll i l l f ASSESSOR'S MAP & LOT f o °,f-06y oll
INSTALLER'S NAME & PHONE NO. l{(5,co0 co.
[, .SEPTIC TANK CAPACITY
Q . f / G►
� EACHING FACILITY:(type)(-f- 26 (-r (size) 6 6b Via!
NO. OF BEDROOMS 3 PRIVATE WELL OR UBLIC W�A�TE
BUILDER OR OWNER 6feedv co P.
DATE PERMIT ISSUED: .�
DATE .COMPLIANCE ISSUED: t-j
VARIANCE GRANTED: Yes No
Zvi NAr
ASSESSORS POP NO: o�/=06,
PARCEL NO.. —
No.2�. FFz.....7%: ...""
THE COMMONWEALTH OF MASSACHUSETTS
I �.P BOAR® Off" H, gEALdTH
jq)
.._.........L.�� ..........OF.....--.-.j,�� 0 �7 � .
`� A Iiration for Uio ooai Work Tont.rnrtion Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
_�.... lac � -----------------------
o lion-A dress or Lot No. �' 7
Owner Address
0 .
a J _� ............................ ....... ...........................................
Installer Address
d Type of Building Size Lot...... Q !7i Sq. feet
Dwelling—No. of Bedrooms___..._..5..............................Expansion Attic 414 Garbage Grinder
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures -------------------------------------------------------•--•-••---•--------•-•-----------•-----------••----------....................................
W Design Flow.............. gallons per person per day. Total dailyflow___....._...a O...•......_......_...gallons.
04 Septic Tank—Liquid ca acit _�- --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 Results Performed by. �' _. �F��l. i�._ 9!' 1^(r _ Date_.....l.....� _._ .........
,aa Test Pit No. -------minutes per inch Depth of Test Pit____________________ Depth to ground water___----_-__.
Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O f
Description of Soil------L�._--_---Z.._` ._ __` f __________________ __
P .
W
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 i sUi, 51 of the State Sanitary Code—The undersigned further agrees not to place the system in
o_oeration until a Certificate of Compliance has been issued by the board of health.
Signed.....-�j�_ 1�/ --•--
Date
Application Approved BY '^" ...................................... --• f 7 ' r� .......
Date
Application Disapproved for the following reasons---------------••--........_.........--------•---------------------------------------------------------•--•••---
..•--•-•...---------••----....•-••-•.............•••---------•-------••••-----••••-••---•-••--•••------•--•-•••--•--••-•-•-•------••••••----•-•••-•------•----•-•-•••--- ...............................
Date
Permit No..... -----------------------. Issued........... "...J -" -'..........
Date
V
No....................... FEic............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ ..... ��t 1�6(45�....................
......OF....... 7A Appliratiou for Dispmal Workii Tomitrurtiou Prrutit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
_m .....Ail -4,15 .1019-------------------------
Lgca .t�52 -----------7
tion e or Lot, No.
?
. .......................
...................
. .................... ......... -------------
Owner Address
.............................. ....... ...............................................
........................
Installer Address
Type of Building Size Lot....--_ feet
U
Dwelling—No. of Bedrooms.......—'>...............................Expansion Attic Garbage Grinder
Other—Type of Building ............................ No. of persons...._................._.__.. Showers Cafeteria
Otherfixtures ......................................................................................................................................................
Design Flow...........41,-1; flow_.........:Z419
-................................gallons per person per day. Total daily ..................................gallons.
1:4 Septic Tank—Liquid capacitylAW---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. f t.
Z Other Distribution box Dosing tank
r hdfw�...............
...Ze --- Date...__
Percolation Test Results Performed b) ---- ......r.....j,
Test Pit No. I....!2ee------minutes per inch Depth of Test Pit.................... Depth to ground water-
----------I----------
(% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_________._..._......._.
.........................................................................
----------- -------- --------i7............ .........
0 Description of Soil......61.— , 1)(5 ........ _0D
............ ................. .....AD.......................................................................
............1" ^11 1A
............................ .......4............
U ..... ..................................................................................
W
...............-----------------......................................................................................................................................................................
U Nature of Repairs or Alterations—Answer when applicable---------------------------------------------------2.............. ............................
.......................................................................................................................................................................................................
Agreement:
The undersigned agrees to install the afo-,edescribed 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 ligalth.
Signed.....4.QA0� -------------- -_------_-------------
Date
ApplicationApproved By.................................................................................................. ........................................
Date
Application Disapproved for the following reasons:................................................................................................................
.................I....................................I..................................................................................................................................................
Date
PermitNo......................................................... IssuedL.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..:..RAAU...........OF........ ..........
VIEntifiratr lif TompliztUrr
THIS IS TO at t Sewage Disposal constructed
CERTIFY, Individual S Dil System I �'/) or Repaired
.riol.4....................................................................................................................
kv--------J1.Ial")1c'?5.........at nsta!�.........../ _t ......
.................. ................../
VL'
has been installed in accordance with the provisions Of TLITIE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit 'NTo----------------------------------------- dated-...._-_..-------------------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................. .................................. Inspector........ ........ ......................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No......................... ...... ........OF.... ..................... FEE........................
Disposal Works Tianstrurtion ramit
...................................................................Permission 1 s
hereby granted........:t �'a........P.41'. r J.44
to Construct or Repair an Individual Sewage Disposal System
M..at No.... /S.....................................
Street
as shown on the application for Disposal Works Construction P rmit No....... Dated
...........( ..... ..
Board of Health
DATE........... ..........1.4........677..........................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
!VOTE /F E'/THEM? 7Nff SEPTIC TANfC OR
to LEACAIU/VG P/T ARE MORE THA/V /Z"SELOJ4v }
24"DJAM ET,ER CO/VCR.�TE .CO;i Ail
a, - SciyEoci��40 SNALL BE BROUGHT TO 4,TAOE.�AN FXTRA �
GO/VCRC`TE P.V.C. P/PE NAF-4VY CAST /RON COVER S//ALL 8-6 41SE.0
� COVERS �9�pFiQ FT. /F/N DR/VE1t/.4 Y
'- 2 J MiN. COAICRFTE
CLEAN .SANG
BACK/=/[.L
_ � „ � -�,,_. Ul�t//D LEVEL - •.• '�'
SCNEOOL6 'T'n'T'�" _ .. 2 LAYER
PKf P/PE i O d o 0 0.
GAL. s • • • • • • b o„
SEPTIC TANK DIsT. . s • • • • . • • , p a + 1NASNFO STt�NE
BQX Y • � $ • ° • • •of .°° •
i P • • •EFFECT/VE • ` . y 314
- • ° r • • DEPTH • • • • o o yV.95tlED STONE •
:: v • r • • • s •• t Ao o ,
L/ x /•CJ = • ►'�, .a r • • • • • • • • p n PRECAST SEF-PAGE'
iA!{/i�'r EL EVA774OINS 3 °o r • • +. • • . • r e o P/T OR EQ /✓.
1'1TC<tPAC.(Ty = 49a;S c7�r� a a ,E,c, 79
/w/Y.ENY AT BUILDI/VG 90,d o cr BIG 6 F-r. D/AM.
'LLZINLET .WPT/C 7 4AW 8 1.6z FT, FT O//�]J►'!. C(SEE TA�IJL AT)ON�
Dt/7Le7r SEPTIC TANK f7-6oFT.
IJVGET DJ5Y/�/BUT/ON BOX ��`7O FT GROUND W,47 R Ti4BLE
_. SECT/ON oI�
OtlTZETD/�'TR/BlITJON BQX �S St�4M!
!INLET.tEACN/IVG PIT 3so FT. .5�1�/AGE Ol.�®OSA 1. SYSTEM
L EACH/NG P/T WA�lll,.ATIDN-
��S/6!v CRIT��/�4 JCA�E : %s" = I=o" o/MEN-TION A XT.
DlM.ENSI a N $ —f'T.
IVA'AfUER OF 0EDsR00AfS .3 D/MENSIGN C FT.
�®AaEv/SPo L4�l/N/Y SO/4 LOG
TOTAL EJ7I/44"TEO FLOW 33d G.4L�pA�' SOIL TEST#J SO/L 7rST.#2 SDLL ?'EST
IVfJMBER OF /.4`ACKINt P/73 I 'fEtEY. R�LS ELFY, PATE OF`SOJL TEST 9
V/!3E4&ACHlA16 ?ER PIT /S/ Sq PT. a —2 Ta/� RESULTS W!T/VESSED 8Y /�G°f�.E
®OTYOM LEygCH/NG PER P/T / _sq, FT. Sv�So1�— PER COLATl0J9/ DATE=*! .Z t1JA1 11V
TOTAL T EACH/NG AR,--A Z� _ i 3, Pf/rCOL/4Tl DN RA7,E j*Z Ml1V,f/NCJY
RON—FRXELEACNING:AREA SQ. FT.
MEDIUM
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N OF Mass, SA-fJ p
PA U L �`hs LOT /4 — KlkrE" MASS DRAJ
C E V LEVY.& ELDREDGE ASSOCIATES..INC.
No.10050 O Q
75,S 889 WEST MAIN STREET CENTERVILLE,MASSACHUSETTS 02f;.
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LEGEND
EXISTING SPOT ELEVATION 0
PROPOSED SPOT ELEVATION
EXISTING CONTOUR .---0——— �A of Mass � �w of
PROPOSED CONTOUR 0— gOti o� R0Bi -
o � P•AUL � � •
NOTE: THE LOCATION OF ANY UNDERGROUND A. '^ vVlLwo
SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON c v Y
THIS PLAN IS APPROXIMATE ONLY AS DETERMINED No.10050
o
O
FROM RECORDS AND/OR VERBAL INFORMATION. A AF "� 01STE�`�°
' THE CONTRACTOR IS RESPONSIBLE FOR THE �0�Fss�s `` �o�aL �A%
E. VERIFICATION OF THE EXISTING LOCATIONS IN
THE:FIELD.
N I
LEVY & ELDREDGE ASSOCIATES,INC. PROPOSED PLOT- PLAN
CLIENTclMaldetia
ENGINEERS — LANDSCAPE ARCHITECTS JOB NO,10 r9- 14141 MD S IUD
PLANNERS — LAND SURVEYORS DR. �{_ :,. !"'� --*-'*---�'
889 WEST MAIN STREET CHKD. MA a
CENTERVILLE, MA. 02632 SHEET.,.,l,. O Z* SCALE=.,, .. 4 DATE= 2 146 87