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Home My WebLink About0731 MISTIC DRIVE - Health 5 TOWN OF BARNSTABLE �� ® ,9- �� . LOCATION ?3/ A�T sT'/G �VP—SEWAGE p # C5S-3Y,? VILLAGE- Q� �S�N,g� ��J.�-S ASSESSOR'S MAP &(O INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ZD00 LEACHING FACILITY: (type) / (size) /000 NO.OF BEDROOMS BUILDER OR OWNER s f D PERMIT DATE: COMPLIANCE DATE: 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) A.1 , Feet- Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet eaching facility) Feet Furnished by 5��Q 74 A/Yl 1 tfI- 3g i f on 2, 21 5'0i!r �{ �� fjD S TOWN OF BARN TABLE M f O 7 9- O t39l . . �pCATION SEWAGE # ` .3 V�LAGE /Y 14a,51-9N.g IVt 6+.5 ASSESSOR'S MAP&(0 .::':;'INSTALLER'S NAME&PHONE NO. :'SFM- C TANK CAPACITY /DO� TEACHING FACILITY: (type) /J' (size) /000 >NO.OF BEDROOMS' >13UILDER OR OWNER :P1~RMTTDATE: 7 COMPLIANCE DATE: w -1 b ,. paration Distance Between the: , M urn Adjusted Groundwater Table and Bottom of Leaching Facility N .-Feet :;Private Water Supply Well and Leaching Facility (If any wells exist site or within 200 feet of leaching facility) /l! Feet ;.VO:of Wetland and Leaching Facility(If any wetlands exist :; :within 300 feetof4eaching facility) Feet :?Furnished by %gl-IiirIQ Jw- �'. 1 � A� o p 2 Z q a�s . ....... . .. , ASSESSORS MAP 140: 7 q t_ No.... PARCEL NO- 5 9 FEB ?v....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for UirjVu!3a1 Wurlui Towitrurtiun Prrutit Application is hereby made for a Permit to Construct (V'or Repair ( ) an Individual Sewage Disposal System 73 / 7 -----------------------•-----•-------•---•-----....._.....--------•-----------•-•-•.... - -......_oc Address iw -Addr ss ------......or Lot No. WW1 ......... '... ............................... �lt K..�- �lJG— f f7-p�.'.�.Kr`e``i Installer Address Type of Building Size Lot_.: ...�.... 7✓......Sq. feet .� Dwelling— No. of Bedrooms _ _________ ______S__.___-_---_-Expansion Attic ( ) Garbage Grinder (; ,,q a ..... Other—Type of Building l ......... . No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ....................................... . . -•-------------------------- W Design Flow.................... /0.............gallons person per day. Total daily flow..._._. ._. .__gallons. WSeptic Tank—Liquid capacityls�.dUgallons Length__............. Width._.-_.-_-_----._ Diameter._-_..__.___.__ Depth................ x 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 to ~" Percolation Test Results Performed by `----!-- ''e------•---- Date---- Test Pit No. 1__.�____.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---------------- ......................................................... 0 Description of Soil.... j_.. ... V ......_...-•-•-------••------••--------------•--------------------•••--••----•••-••--------------•--------------••--•--------•-••. W -- -----------------------------------------------------------------------------------------------------------------------------•--------------------..._...-----------------------------------•------. Z. 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by t board of health. Signed --- ----- . ........ ..P............................... ...................... .... ......7s.'...�,07 Application Approved By .----------- `1 (J - Application Disapproved for the following reafons: .......................................................................................... ... ................... --------------------------------------------- - ---- ------------- -------- ---- ----....------------.....-----------------------------------........---....- ------ --- C� Dace Permit No. / ' -- -----67- /-7------------ Issued ------------------3 ` ...:.�,�----------- ................ Date cl No.... �? - ..� S'cj Fxs......... /C�v....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH „ TOWN OF BARNSTABLE Ap,phratilan for Di-nVa!3al Vork,6 C outitrnrtinn mini# Application is hereby made for a Permit to Construct (1/)�or Repair ( ) an Individual Sewage Disposal System at: -73 ....:.... l ................................................................... Localioi -Address or Lot No. Ir Address Installer Address Type of Building -7 Size Lot....V dT2......Sq. feet U Dwelling—No. of Bedrooms___________________ __� .--_--_-----.__Expansion Attic ( ) Garbage Grinder (4-v) a . Other—Type of Building C __.cA�No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ------- ilk ------------== W Design Flow..................../--�_(�---------------gallons per-per-son per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity].5_�galIons Length---------------- Width---------------- Diameter--___-.--___.-- Depth................ x 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 /0"14� .............�... ......----------------- Date......//... .. ct. .... W 1.4 Test Pit No. 1...!�..Z=.minutes per inch Depth of Test Pit------------------ Depth to ground water....................... fX Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ ------------------- -------- -------------------------•---------------•--------------..-•---- ------------------------ ------•---------------- x Description of Soil....0a-�-�--Z--- - 441 ------------------------------------------------------------------------------ U.. .------------------------------------------------•---•----------•---•--------------------......---------------------------------------------•- 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by t e"board of health. Signed --- ---- iti c ..................... " .-.. "..".". -------------------- ------- Application Approved By ............. -..----- -" ... .... Dare Application Disapproved for the following reasons: -"-----"--------------------------------------------------------"-"----......-..........-.......-----"--------------------..------------ . ................. . ......................... ..... .................................................--.....".................................... . ---------------------------------------- Da, PermitNo. ........... .�� ... J�. �7".."-7"...."".... . Issued ..................: ...'...................`................... Dace -------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tertifirate of lJ((..��II1 ayliance THIS IS TO CERTIFY, That the Individual Se age.Disposal System constructed ( Ll or Repaired ( ) ...."..-.. 0---------"------"-----" Installer �bl at . """ ..-- - ... ....................................................""------........---.....-..----------------------"---------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..__"--/c/.. 3.-"""---7----- dated L _. .% -�..__.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION(SATISFACTORY. (`� DATE.........................................``f- F �� ............. -- Inspector .... - .... -.-. ;a-�-..--`.:_\._------...--------""------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No.....r..-...."_........� FEE....... .Z?_.<-a, �i�p,a�tt1 �rk� �un.�tr�rtuan �rrnt�t Permission is hereby granted-----fit _.,?_4.:. .�............. .__. , _� i ��........................ to Construct ( V) or Repair ( ) an Individual Sewage Disposal System . e ----------------•-----•-------. ---------------------------------........ as shown on the application for Di'posal Works Construction (ermit tNo-5--_- 7.�jD,ated_-l- _3,Y.......................�. P' � Boar -of rHealth DATE................. ------------- U t / ' FORM 36508 HOBBS R WARREN.INC.,PUBLISHERS La 7 -547 L o 7� s , . . SD AOI sty nc: - - . . __ � �- ,-• °max �,� � �� .,� G� . zo 7- 1 G Z o 7 6 4 j -��gr Gvv ID w�M lu t of �Fiui�H GRrcp(: �� v r ►�a = � ,U �... �aii n i. • �O�G :.Y lure 17 5jt j �u bSW c. 4'Pp� alsr.• tw G,s,.. A 1►�V. 4 No.29;33 CLAN. . IJo" Ace �c1vP�'� •.j �"-+sTt�°� �4 w rN Mo(zE >Nei J 4 �ssior`qG�� C WAS+1 ED /a L,4_ I T20- Tz' M C O p STo�tE 5z- PVc, f . �kCl�. — -,� uo ScA.L • i)�wP-t� L'ae'� L Z..fit'i}u.S J1 N C.4 _I, I • ! Design Data Single Family - 5 bedroom ' No disposal, Daily Flow = 3 Xllo=g_'b GPD. Septic tank = 33Ox1.5=660'gal. Use /oon gallon i septic tank. Disposal Use /-6x6 leach pit. N _ w/1' of stone. Bottoms. sf ".1.0 GIs.f. = 5v G/D. Sides = 1,5o s.f. @ 2.5 G/s.f = 325G/D. pr 6• P/(...� T �C AA, WILLIAM y�,'• �t ,, I�c�� ` '< A� I certify the proposed dwelling . C. �,` /vl AK. 570/vJ IV ILL S /"`A conforms to the sideline and setback jp N rE y. requirements of the Town of Barnstable%- P No. 19334�0 .��.. and iw not located in the.floodplain. 4�" t2 s z ,iB S ��• Z, 2dStS ' rofessiona `_.Land Sure yor Date r4w. 2.7.a97 BQxr2FZ f Al yE, /Nc G-LEV 76k)5 OA569 6N 7-014)XJ 0/:'7 .fir—Ess�ti�. c�w�sc.�orZvc=yc�t-s eA PNsTAr3l�' 6, rS, MARS �' U! C. EVi G/NC ..TES 6S /LGt`