Loading...
HomeMy WebLinkAbout0645 MISTIC DRIVE - Health ry)K s�l L beu1- �`"1 --b L04 CY1ftlkLAO �1A I" i i N SMEA KEEPING YOU ORGANIZED No. 12134 2-153LGN FOREST MIN.RECYCLED INITIATIVE CONTENT 10% Cartfeed Fl6er sourcing POST-CONSUMER w ® ww.sfipropram.orp SFW1290 MADE IN USA CET ORGANIZED AT SMEAD.COM 6 1WA1,iVtTOWN OF BARNSTABLE (� NCATION L� I 6Z SEWAGE 'i ter, GE � VILLAGE ffll"CS�oj ASSESSOR'S MAP 6i LO Y INSTALLER'S NAME & PHONE NO. 3.J- 0y�XAI 771— Ioy 0 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) Z V3f (size) i J,Il6i4S lwc.` NO. OF BEDROOMS PRIVATE WELL O PUBLIC WAT�ER BUILDER OR OWNER {�c�.�5 �� ����� CD, 771pa DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �' . -� VARIANCE GRANTED: Yes No �/ t7 l No.- ...... Fizz...... ._. ........... ... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE \WU Allp iration for Di�ipniul Works C�vastrnrtion umit Application is hereby made for a Permit to Construct ( V�or Repair ( ) an Individual Sewage Disposal sys a nn oC. c Address t No. ...._.. .... L................ . ........ . .. .................... ------- --._._.-_-----•----._._.._........ ......... a !��- r .� �.Address -----------------------•------------------------ ----r_1__......--------•-•----•-- ----•------•---•----_______---_.-.___--.._. Installer Address L� `' Q Type of Building Size Lot_.-. :5,__�J�_S�_..Sq. feet V Dwelling— No. of Bedrooms _-_._._.__ Expansion Attic ( ) Garbage Grinder (�t/�j � _.�' S•R.-No. of ersons____________________________ Showers — Cafeteria p`4 Other—Type of Building _.__:_.... p ( ) ( ) Q+ Other fixtures -------------------------------- -------------- W Design Flow..................J/0................gallons per .___y per day. Total daily flow............. 1:4 Septic Tank—Liquid capacity/zallons 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 nk ~' Percolation Test Results t Performed by... .... ............ .. ..... .. ..........�_...._.__.__.._____._ Date........................................ ,tea Test Pit No. 1..-2- .._minutes per inch Depth of Test Pi __._ Z._._..__ Depth to ground water........................ fZ Test Pit No. 2...f?`__'�_.minutes per inch Depth of Test pit------._Z_!____. Depth to ground water........................ a _.. -- 0 Description of Soil........_. V ............................................. --... .................-------•....._......------------- ----•-------------•------------------------------------•---•---_._......_-•---- W .....................................................-.................................................................................................................................................. UNature 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 Environ ntal Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp an e has issued y the board of health. ISigned ..... ................. .. ................................... .................�--- -........... ApplicationApproved By . ... . - -- --------- --- ---v----- ............... ....... ...... ..................--------- .... ..... .. ...... .... re Application Disapproved for the following rea n : ....................:..................... .......................................................................................... ......- .................... � Dace Permit No. ............................... ...... .. ...... . Issued -------�....... j..Dace No.... FEs.... .... ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di►ipwial Worlto Towitrnrfton Permit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal Sys................k,a..................-: :: _�1,-.�----------- --�. /...------?.�4z - ---- ----------- ------------------------- IZocat n lddress o`T of No. j� ..................... .......................................... .. r�}Er Address Installer Address UType of Building Size Lot.... 5, ...Sq. feet DwellingNo. of Bedrooms ____..!___ �_______________ _— ._-_Expansion Attic ( ) Garbage Grinder Other—Type of BuildingL�-U '-�. _No. of persons............................ Showers ( ) — Cafeteria ( ) 4 ¢ Other fixtures ......................................- •-••-••--•-••.................. Desi n Flow = ga P / P Y Y Y ..0....................gallons. i W g -/���... ............ lions er ers ti per day. Total daily flow....._..._..._... .. G Gd Septic Tank—Liquid capacity- _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---L-f...1 �. .._.... . .. -Q................................. Date........................................ Test Pit No. I..Z _-_-minutes per inch Depth of Test Pie-. ........ Depth to ground water........................ Test Pit No. 2._a`..<__minutes per inch Depth of Test Pit------ ..... Depth to ground water........................ a Description of Soil �Q- -P /� �ir�----------------..................................................• ----------------.----......------•----- I V ------•---••------------------------•---------------------------------------•-••-••----------------------------------...._........... --------•- UW •---•-•....••------•---------------•--..........•-•....•••••-•-•---•••-•••••....-------••••-----•••-----••-••---•---••--------•------••-••--•-•-•---••--••••••--•--•••=••-..........-----------......... 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 Environ ntal Code—The undersigned further agrees not to place the system in operation until a Certificate of Comp<ian a has e issued 1the board of health. Signed ... . ............ ..- r ................. ................................-.. ..............� .~........:...1 / Application Approved By ...... ../�Y//,: � ?' ........................ Application Disapproved for the following rea ... ....--..`.................... .. ..... ...................._..... . ................................................... ...... ........ .... ---------- --. .......... ...........................".....................................................--........ ............ .n ate Permit No. .......""(..........�.-.. ... - - ...-...-... Issued ........<-�..p�� . •- �. D Dale ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE i Certificate of Tomplia ce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) j'" D rZ.I U-LL .... --------- -------------------........--..... ... ............. ..................... . ..--...._.. ............... by .............. ............ . ....... Insr,Jlcr at .......... .7-.-.... .. /4_l.5 7./c------.�E2_l VF_ iYL �l.._I..L I S............................. . .............. has been installed in accordance with the provisions of TITLIA of he State vironmental Code as described in the application for Disposal Works Construction Permit No. .....-�- dated ............._.... ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT E ONST�U A AS A GUARANTEE THAT THE i SYSTEM WILL FUNCTION SATISFACTORY. '_' . ........... Inspector-'" .. ... ... ...... L-. - DATE.-. ���. .` _......-... -..-._...... �t-- ___,__-_,.-____-_.____,_ _ ___,._-y__,_,___ a_-_,_,_______---__,._,_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Noq _..— l TOWN OF BARNSTABLE.__. FEE._/Z).O. DisVoottl Workv Tomotr ion ermtt Permission i hereby granted...VAT_,Uln_-..�CQ��-------•---•--------•-----•--•---••-•-•-••------•---•-••-•-•--••....--••....---•............ to Construct (V) or Repair ( ) an Individual Sewage Disposal System at No. Ld /)!..._../(.. .---em u' Street a as shown on the application for Disposal Works Construction Permit No.1_________ ____y_�ated........ �.�-.' ...................................... -Y.:9. ................................................. B DATE..........)..a.... .-2 3; -- %-/•-•••......••-•••--------------- oard of Health i FORM 36508 HOBBS h WARREN.INC..PUBLISHERS -PATA FAMILY .4 _ $EDQr�Mir tiF 2 v 6ATZ5AC.E GRIIJ�Ert AILS( FC-o1c/ 4-�ll Iq=44v Art:- 51mlc TANS. D: lXp �L � r�l o1J 1�Q05A L P I T 2 iwo GAL/Z sti r 51DEWQLL AREA -3-77 5F .: : . 37� SF x 2•v "..��� BOTTOM A2CA = I s7 sF ls1 IV Kan M15T C, VZIVS ToML 16tJ = 86,f- 6w• AlQT4STDI8 1t/IILL,S 'T•OrAL. VA I L rLa1N =4d0 Gf'D PE¢cac.ATtoN Q _ ��►►J 4-MI+� �5 -I ' / M 4? �L RECHARD N PETERBAXTER �CyG 1d0.24049 '� SULLIVAN �-8307 1-L5 T: I��i aa1N s cz'f l&2 TO ,k/— 60 roe L " PV.c ANv 4 Ay 2 bKT ��y �vr. &Ai 3 5 rI L¢dvsL i oo� w� -7 5�9 1 'A L 4 '6AL 55 A69EP Imo: A4.t._ 5rzvcru9Es sr--T MOU T44SA 4' -DEEP Q4ALL. BE 4-zo Z• Z y�yOr ELOPED 'P201-I Ls-- LoC.�cTi©t i MAZ6TZw5 Mlu f ►�o scp.L.� .. SGA LE Flo ►�la 1= DATc—; IZ , 1�,q4 PLAN Pei ROJC.E cazn�-Y I*T TEE rww-"�C. d%QwN HEawt4 <:omfuy5 wrrµ iuf. 5(VEuj4E far a+•� Is Ibr G-ocA� w r�l� � man �A��t. ., T�� �3�. �o� ?�•. � �A XY�11 NYE f(L pP4[�'`rSli�.l,d.L�d�J•D SuPal�yarz5 K FLAW (5 NcT' ?A5© oN hN l�1ST�c�GtE+J'T z��i L E+.►Gi�1 EEizs 6LJWvy MT) TNe oFFSEli 4I.4m)L.D ►.Icr T3E oSTEr-vIL-a MASS , u50 ro ESTaB�-.(SN APFLIC-A NT s�� t w ` y! )M)6 UlL;b►al6 Co. (►.,- S�ks 1t50 12� � q .. No �o S I• I I i- ao ti0�am�' Prr 4k. � G r Tw� ` Z- o 7- a � 9 P-832a ����-, �•�►tt1 OF R CH RD `'i °� PETER aax ER N�� SULLIVAN rvo.z< oaa Pao. 29733 ca �w