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Home My WebLink About0046 HEATHER LANE - Health LfC� f1'1 Q r`-S 1✓Z i L L s -- 1 0 C A T ION SEWAGE PERMIT N6. L l A G E vc- I'�°I w► � 'I 1 INSTA LLER'S NAME i ADDRESS B U I L D E R OR OWNER DAyT`E PERMIT ISSUED DATE COMPLIANCE ISSUED tie- el 3Y r3 � 8 �� TOWN OF BARNSTABLE `ATION Ale A -rllet L A Ale SEWAGE # P 7` LAGE "� L e ASSESSOR'S MAP & LOT `TL d66 ' O� S-TALLER'S NAME&PHONE NO. JT- 0, A4 A C®Alf e4 -t Y-I v SEPTIC TANK CAPACITY 1 C 0 G f f� LEACHING FACIL=: (type).ve v> Re C (size) 3 a 0 5 NO. OF BEDROOMS BUILDER OR OWNER '�Q&Aa PERMTTDATE: !F -17- / 7 COMPLIANCE DATE: 7- 9. 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`r ` ��` a. {.�.. C% � � .- .� t � 7 .y- � a !� 'S� 7 I k LOCATION SEWAGE PERMIT NO. I 's I N S T A LERIS NAME i ADDRESS R U I L D E R OR OWNER O �S DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r, QO Z No.. Fxs...1 :.............. / THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................... Xpli iration for Uhipoott1 Works Tontrnrtion ramit Application is hereby made for a Permit to Construct (4,-)-5i Repair ( ) an Individual Sewage Disposal yst. at: fin^ .........../ Locatio •Address i r Lot o. ......r.... _ ... :........ ................................. Owner / Ad�dd s / a .............................IA.. ........................................................ Installer Address d Type of Building Size Lot. ./,-/;7----Sq. feet V Dwelling- o. of Bedrooms....................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type of Building No. of persons............................ Showers — Cafeteria a' Other fixtures --------------- -•--•-•-•------- - W Design Flow..//42.............................gallons per person per day. Total daily flow.-,3:7k:>.............._............gallons. WSeptic Tank—Liquid capacitv/Piea.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 are0c:;��..sq. ft. Z Other Distribution box (vf Dosing tank ( ) � Percolation Test Results Performed by-C , t! �- ... G.................... Date... � � �r�- ....... aTest Pit No. 1......el----minutes per inch Depth of Test Pit../--.?......... Depth to ground water.11/eA/4�-. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....--..............--- ••-•------•------------................................---------•----------------------=.............................................----•-•--•--.----• •- OP Description of Soil........ ................................ V 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 U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha een a'�tie the4rolth.gned ......... ... ----------------------------- L. Alication Approved BY---- ---- ........... ....................................•----••-------------•--...._..._ =•--�•----------.------ Date Application Disapprov �f o e following reasons----------------------------------------------------------------- -- --------........... -•---.......--•-------------------•-................----------------------------••----•---......---...----------------------------------------•---------------------------------- ---------•------------ Date PermitNo......................•-•...................•---•------. Issued--------------- -----------.------------------•-- / Date L---------------------- -- ------------''`-----------r— THE COMMONWEALTH OFMASSACHUSETTS -�-- BOARD OF HEALTH ....... /.l✓ (/.//....._.....0 F......6�/6�1G-✓�......................... Appliratiun for Disposal Works Corm rnrtiun Prrutit Application is hereby made for a Permit to Construct (6-y'or Repair ( ) an Individual Sewage Disposal System at: .................•------------•----_.. .. ...___...........-••----•••----_---___ ::_..........................� ......................................... / Location AddressA ��}/ 7 fi✓ C.... .. Owner C '' s/ �� ............... Add ��--.G+ Installer Address Q Type of Building Size Lot_ _f ...Sq. feet V Dwelling—t,;< of Bedrooms.__..._.______.....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No: of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ----------------------•----....-•-•----•--•--•-•--•---.............................................. " W Design Flow... /_�.%'............................gallons per person per day. Total daily flow.._ ..__________..___..........gallons. WSeptic Tank—Liquid"capacityl_`��4�?gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area__�____._ sq. ff Seepage Pit No..._.f--- _.._... Diameter._._:f _.�_:.. Depth below inlet__................ Total leaching are - " �sq. ft. Z Other Distribution box ( Dosing tank ( ) 10 _ Percolation Test Results Performed by.. 4 ....... � =r � ------- j Date___ ' Test -� .._... Pit No. 1________ _______minutes per inch Depth of Test Pit__ _______. Depth to ground water.. (lnl/:`_ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fY .................................... - • --------r ------------•-- -'•-••----•---•--••--------•--•-------_... - 0 Description of Soil......... � -•----.- -ca✓ .3 ... .__ 5`-✓;�-5©_/_L,,,- - ................................ �r f� /C V ....................--�f---`-''-!'7r.`.`�!�l`l-~=x`••-•--- �"'��`%'-`-�-'*'.C-- ------/t,�G9...�!'�'i��?f_�_�_�.._�-•-"i'�....•-••----•--�cj.!�/,: L..,'f,� 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha een issued by the board of health. C/O 11.gned --------------- AP/ation Approved By -V _ 7ate� y •----•-•---------------------•--•-••••-••-••-••••-•-••-•-••••-- ........................ � Date Application Disapprov f o following reasons: -•----------- •---••-•••-•--___ ------_••••-•--•----_-•--•_•-_._..._••-•-••-•......................•-•-••_.._..--••-••.......-••••••_..._-••••._....-•••-••-••-•••••-----••-•---•-•••-•-------••-•-••••-••-•--••__...._..._•--•"------. Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trr#if iratr of f omplianre TH�},� TO)CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) at ' � - '_. _.._ - �....................................................................................................... has bee n d in accordance with the provisions of TITLE 5 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 CONSTRUED AS A GUARANTEE THAT THE-- SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................48........................................... Inspector...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF..................................................................................... ..No ..- ` FEE.... ..:.......... Disposal Vorks Tuatutrnrtiun Vvrrmit Permissionis hereby granted.......... r-...................................................................................................................... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo............. -----------•---._...---•--------•--•-•---•------••----.....--•------•-•---••-----•-----------------------------••-------•--------------------------- Street —, e) I � as shown on the application for Disposal Works Construction Permit No.__._„_.___.�..... Dated______.��_.�_. ...................•••---•---•. .............................................. Board-of Health DATE .................................................................... I- FORM 1255 A. M. SULKIN, INC., BOSTON 44 4--,IA7- 1 .sue' T" it QlSOO,�QG �? U.SE /UDU �L• • • C'ie, � `..,' . ---- � �::' 1� �';: lab 79 OE.2Ga�driav .e,4r�' = / " /.v st�iciae ass �G'" s 'V ' Dr-tirgs o WILLIAMZN Of z C. DAVID N C. `U O F No. 29976 �Y L �y0� .o PE, Z)vd- .0 ,Q- 1 1,ir?SIi,�,r a ` SU!,I Pp CISY l;� � F S�ONA G. o I •✓G vvi /o 0 61. ,3G .4 a c OT , -.� z / .CE•e T/�'Y 7-,4/A7- 7-A C-/1 7o� SNOG✓�f,/E.2EO.C/ CGLs-li�L YS W/?'h� SC,q L 6 / sO O.g TE ,_ /9l i ,rzEOU/�E�IE.c/Ts o.� T.y6 �vw�✓cam" �:, ,� O T' /G- I .4 oCA T'.G'Z:> Wl r-,VIV T.S� OA TS: 3.4 XTE,E?� NyE /NC ,/a7- BASSO Ate(/ AEG/STE.2E� L�4�i� SveY6y2�.c� O,�.SSET.S syay✓.s/SfbUL1� it/OT' B� AP:f'G UJE� 7"o pE'TE,2�(ic/E ,L.OT�/NES.