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Home My WebLink About0166 DEBBIES LANE - Health (2) 166 Debbies Lan-Q A= 027 J i . ASSESSOR'S MAP NO. 2(_PARCEL � V L0CAT10N :*/6fp SEWAGE PERMIT MQ. I-b r # / d � � r� 31 � `S L .9 � PILLAGE INSTALLER'S. NAME i ADDRESS O Kn( w C ci Q / d U 1 L D E R OR OWN ER DATE yPERMIT ISSUED DAT E° COMPLIANCE ISSUED 2 Y s� N v�i 1 JJJ Fizz THE�COOMAO�N DU ALOTHCOF,MASSACHU u S BOARD II�� I-�-- - I-1 4 M!1......................OF. ApplutttUan for Disposal Arks vnstrixr#uan ramit Application is hereby made for a Permit to t o Construct or Repair an Individual Sewage Disposal sal Syst /.. :.................. ----------- - ......... .....ocation-Add ------ --ress or Lot .-. ..Gl I.21 �... T` Owne t� ress al st I ller Address <., Type f Building ��Size Lotr :() ..2 _.._..Sq. feet Dwelling—No. of Bedrooms-- ---------------------------------------Expansion Attic 9 Garbage Grinder / 04 Other—Type e of Building ..._...._. No. of persons............................ Showers — Cafeteria a YP g -•----•-------- P ( ) ( ) Q' Other res ............................................................. WDesign Flow......... ...............................gallons per person�er day. Total daily�ow.._.....2 ....._............--.._... Ions. WSeptic Tank—Liquid'capacity�� .gallons Length_ i ..... Width.._�>..._..... Diameter........ ...... Depth_ -----. x Disposal Trench D Npj................... Width .............. Total Length........ Total leaching area.......-_ ._._.sq. ft. Seepage Pit No......_4�._-__--- iameter.. ................ De th below inlet......._..... Total leaching area. . ...._.._. q. ft. Z Other Distribution box ( Dosing ) Percolation Test Results Performed b . ... . 6 Test Pit No. 1________________minutes per in epth o0.4 f Test Pit.................... Depth to ground water......................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1:4 •...... ----------------------- -........ -----...... --------- •.......... -............. ..... ...-------- -•---------------------------------------- •--...--------- oDescription of Soil........................................................................................................................................................................ x �., UW ------------------------------ ----------------------------------------------.......----------- ...---........._............._... Nature of Repairs or Alterations—Answer when applicabl ..._ ��`1_�z .1 .. �/ _ ............ ............ . . ....-........... ---- .... . n� �rLLt6... Agreement: p�CM 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 Zthem ioperation until a Certificate of Compliance hassued by�board of health. �✓Application Approved ... . -- ----- � . ............. , Date Application Disapprov f or the ollowing reasons-.............-................................................................................................ ......••--------------•-----••....-•-- -•----------------••---------•---------••---•-••-----•-•-........---•-----•-•---------------------•-----•--•--•----------------------._..... -••----•-•--. Date Permit No..........s IRO------ i -_.._ Issued....................................... ................. Date C�1 _---_--- -------------------------------------------------- ------------------------------ a f I No. .... r Fz c to THE COMMONWEALTH OF MASSACHUSETTS BOARD,,OF H�F H ...�;1"-*'- :.-- ---•--•-•--•------.OF../.. . !fay -1••�'•' .................................... Appliration for Disposal Works,4onstrurtion Frrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System 1 j!/ ••///�, ............................................ ...._._._.............................._. 1 Location-Address r Lo-t�Tcy , ...._ .......................... ----------- .?l .. U T..".' ..,.f Owner�._ / .. ....... I°st ller Zdr ss Type f Building ��/-Size Lot�x-L)_,._.!` .....Sq./feet U Dwelling—No. of Bedrooms___ ._._a.................................Expansion Attic Oe Garbage Grinder �/� P4 Other—Type of Building ;e ............ No. of persons____________________________ Showers — Cafeteria Other„filrures -••-------•-•-••••---•--•••---•-•-•---•••-•--•-••••-••._...--------••••-••---•-•-•••-••••••••-•---•--._,--------•........---•--._....•••.....••-•...... W Design Flow____._....:_.-___________________________gallons per person per day. Total daily ow.______7 ._Z�___......._______._._____ Ions. 'W Septic Tank—Liquid capacity/l .?.gallons Length_ 1..__. Width____K . Diameter________________ Depth.. x Disposal Trench—No;.................... Width.................... Total Len Total leaching area__.____.....__......sq. ft. � Other Distribution box D� �` g -'��•"••• •• q• ft. Z Seepage Pit No.e..__.. Diameter____. _____g De th),below inlet..... ............. Total leachin ea. ._ aPercolation Test Results Performed b ._' _ *:` ______..•......................................... Date r'____ .._____. ,.� Test Pit No. I................minutes per in �epth of Test Pit.................... Depth to ground water_.___._.__________.__... f4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ n+ -••_.... ••••••-•---•-•-•-•••--•••--•...---•••-••--••••-•..............•••••••-•--------......--•-.......••-•--.....-•-.................--•--...•--_-•_•. 0 Description of Soil......................................................................................................................................................................... x V .....••-••••••••-••••-••--•------------•---...._..-•-•-•-•••••-•--•-••----------------------••-•.....•••••-•---•-•-•---•-------•--•...•••••__....--•-•-•••-•-.....••-•---•-....___-•--•-•---------------- W •---••-----•----••-----••---•••••••••••••--•--•----••-••---•-••••••-•••••••••••••••...............•-•.... U Nature of Repairs or Alterations—Answer when applicable_._...__ [ _!�!� �> i� ..r....... of-00 ................................................. _- f.... Agreement: t S I N.57.14 Ue t S 7 +etc"i 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 pla/thheem in operation until a Certificate of Compliance ha ssued by e board of health. ate Application Approved By__,.___,_`___ _ _ ____ ______ _.... � —- .......................... Date/ Application Disapproved/r the owing reasons:----••------•---------•----•--•-------------------------------•-•-------•-•------------•-••-•-•-••...-•-•_..._« ...........-•-------•-----------=-------•---•---•---•-----------••--------........_._....----------•-•--•._......---•-----------------------•----....._....-•---...--------------------••-•-•---._.....-- _ Date Permit No....... �+'=�:fl------- i1 «.... Issued- - ._...... - -« Date 11 _ I THE COMMONWEALTH OF MASSACHUSETTS BOARYF HEA THE; 4a ................ " .OF.... --'... ...r: l.<-.:.�`. ..................................... i Tertifiratr ,af Toutphaurr I' IS T -C—E 7F e--Ind, 'dual Se a Disposal System constructed (�,,/ or Repaired ( ) r !mac r" Installer � at.... -• •a..------ f` �* •! :.. -------------- ------•-- ----------•-----...._..---- ------.......................................................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as describe in the application for Disposal Works Construction Permit No._____ _: _ .._j__...._. dated----------;:- -�. . THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARA TEE THAT THE SYSTEM WILL FUN SATISF CT Y. __` DATE....................... Inspector._.. .......................................................... . THE COMMONWEALTH OF MASSACHUSETTSnwUS-, .�� 1�`Tyst�ly(flTlO1 BOARD OF HE L. • I�*w0 CC-0'rl� t&. v�i-rIOU& FEE....•+. ....... �.l Permission i ereb anted '...,... .................. '�._.._..� cOL3t.._........ .««.. Y •- to Construc or Repa ) 1 ndivid Sewage isposal System �t{(✓ i at No.. .� :. 11i'�::: .....................Stre--................................................................................. e Street as shown on the application for Disposal Works Construction Permit No. .__'4W ated_____ 4..._....._.. � 4 •.......................................« f— -i Board of Health DATE............................................................................•--- FORM 1255 A. M. SULKIN, INC., BOSTON � 7 A TOP OF FOUNDATION ' o CONCRETE COVER CONCRETE COVERS / fT De/sFe 0 4"CAST IRON Z'�MAX. s OR SCHEDULE 4812"MAX • P.V.C. PIPE 4"SCHEDULE 40 P.V.C.(ONLY) '�' ° PITCH 1/4"PER.FT PIPE- MIN. LEACH e o PITCH II4'PER.FT. PIT PRECAST ®' INVRT �o /y . -� LEACHING `•o EI,S .XR.. ... INVERTINVERT e•a PIT OR °'. SEPTIC TANKDIST. w EQUIV. INVERT EL1$1 .. . . . BOX ELa�?X.1.. :: �x ; ��: EL.9/ yi. .... GAL. INVERT �' INVERT J' ww 3/4"TO iI/; !., ELS�Y.i7. :.' U. o:. WAS xv ° y( w STONE ,, ,�U ----►�-�—6 DIA. DI A�d PROR LE OF n/0 GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE �- s�// SOIL LOG WITNESSED BY : DATE . TIME.. . . ��7, c��EE��, . , . , , BOARD OF HEALTH i TEST HOLE I TEST HOLE 2 ENGINEER 1� . . ECFV. .4 . . ELEV. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . ENGINEER DESIGN DATA : NUMBER OF BEDROOMS . . . . . . . . . . . . . . TOTAL ESTIMATED FLOW GALLONS/DAY BOTTOM LEACHING AREA �/, 3 . SQ.FT /PIT '. SIDE LEACHING AREA . . . �. � . . . . SQ.FT/ PIT i - GARBAGE DISPOSAL . . /L/o. ..(50% AREA INCREASE) #A TOTAL LEACHING AREA , a.�.4 . . . . SQ.FT-LIU /769 �' o . GC - 113,Y PERCOLATION RATE . . �ES S. . .� , , MIN/INCH LEACHING AREA PER PERCOLATION RATE .. . . SQ.FT. .i✓.Q.WATER ENCOUNTERED _ NUMBER OF LEACC ING PITS . . ANC. . . IA . . . . . . l PPROVED . .. . . . . . . . . . . BOARD OF HEALTH R• y-• .3 �`/ 1,6� JDATE . . - �"CZ;RI/ :G:� ��•��y�..�S�tf=S-'-r1 .3,7S,�Gt�/,� . . . AGENT OR INSPECTOR • v��o�� 4�yG : I J JAC0�1' .814 Si E1• �: PETITIONER": �O`''' . - i l -- ---L _ Fee---- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*rVeif Con5truction_permit Application is hereby,made for a permit to Construct ( ), Alter ( ), or Repair )an individual Well at: 4- =---------------- --------------------------------------------------------------------------------------------------- Location - Ajc ess Assessors Map and Parcels /f — �SQlo----- — -- 12 _L1 ��1Rs IL -L✓L��I'/1� Owner - '{ Address Ao / Installer.- Driller ddress Type of Building /1 Dwelling-� e- --------- Other Type of Building----------------------------------- No. of Persons------------------------------------------------------- n "� 1 YP 5 01-1 nA. `�- - e[Ir - �`rtLCapacity- -- -- ------------------- Type of Well---�---- - ------------------ Purpose of Wellx2- - --i�- h-- r?QI�S Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed - - ,.= - ---- - - --- - - -- � date Application Approved By- ------------------------------------ date Application Disapproved for,the following reasons:---------------- ---------------------—_--------------—--------- ------------------------- - - - --- ---- ---------------------------------------------------------------------- date PermitNo.-- ---- --- - _ -__ _____ - Issued------------------------------------------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTAB LE Certificate Of Compliance, THIS IS TO RTIFY, That the In ividua I ell o tructe ( ), Altered ( ), or Repaired ( ) Installer at— - - - ` �` —'�=--_ --- ---------- --- - -`�- - -- ---------------------------------------- has been installed in accordance with the provisions of the Totnm of Barnst le Boa d of Hea rivate Wel Pr tect' n r Regula'tion as described in the application for Well Construction Permit No./ '- ---- -fated----- ----� --- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE - - ----__—- — - - - -- --- Inspector -------------------------------------- 4. No.------ ------------ Fee-- BOARD OF HEALTH TOWN OF BARNSTABLE r" a ior� r�erY �tructiou Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair X)an individual Well at: Location — Address Assessors Map and Parcel Owner r Address n�11 Installer — Driller Address Type of Building Dwelling J — - ,---__' Other - Type of Building------------- No. of Persons------______— Type,of Well—!" R,0l-,1rcc_evt, V_4d WQ t I_?65�LCapacity----- �_— ___--_ ------- Purpose of7 ?,Q=-1 c) h f?PQC�s• Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. %, Signed jw.-� .� 1. ��j"I'l.�X� � date Application Approved By � �'�T -- t �7 V date Application Disapproved for the following`reasons-----. — -� � date Permit No.---W_��Jh�------- Issued-----_—___--- -- —_—_ date BOARD OF HEALTH TOWN OF BARNSTABLE - clCertificate (Of Compliance THIS JS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) --- - - - - ---------------------Installer-- -------------— af /�"(/. .... has been installed in accordance with the provisions of the Town of Barnstable Board of_"}Health Private WeeI Protection Regulation as described in the application for Well Construction Permit No. �h-- Dated M THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. i DATE------------------------— -- -- —- - - — --—- Inspector-—------ ----- — - BOARD OF HEALTH TOWN OF _�.BAIRNSTAB.LE_ . . IV-ell �Congtructiorti3ermft No. ---------------------- a� Fee------------------ Permission is hereby,granted---- = ---A kn� L-�IC .YI' air J 1 to Construct (l )-Alter ( ), or Rep (, ) an Individual Well at:1No Street-/ as shown on the application for a Well Construction Permit r [A ) I ),— l� Dated----- No. ----r-�--- 4-;�------------- ------------------------------------------- --f----,-----,o---- -- -------- Lf 4 +� `Q Board of Health � y DATE - ---- —------� /--- /—/—C—/ ---- r • y L L i t i i a 3 2 t G I d 3 I. t r r, J i y - t 3 2 4 , o EP t 11J.! 1�� P ZOT 0/ ,� o l � J / � Z • b 8= / q F. ,COT /D� • _SOT XOD 5 _ 96 i T 6 B - - r 9 y t } L .� io i • � 3 r Y yg3 y qq I ., o , q 2 O 1✓ _ R. 'Q zo•oo p 1 i Qr (p e Zy Y � 9 Q R� / n d D r a 5 Iy i f t t 1 J J •2 3.S37y 0 � 1 � ti _ 0•06 : 244-7 �iYY y., of. SZ8 .37 S PIAAJ OF COTS /00, /0 /U2 sc �° _ m o r 1 . ST : �A R A/ A 81— ,E /CIA. Px� 4 zFp 8. y Cal P l / F� N • 3o L R C, G ,. 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