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Home My WebLink About0045 MOCKINGBIRD LANE - Health 45aMOCKINGBIR6-LANE MARSTONS MILLS A = 013 - off { V V TOWN OF BARNSTABLE LOCATION n�� I°o(1-C6CLW /8e 46r SEWAGE # q S r V rLAGE A SO S PJ'dGLL ASSESSOR'S MAP & LOT (/�J INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) G �a cII1`/'"k ) 1 3 NO.OF BEDROOMS BUILDER OR OWNER PERMIrDATE: COMPLIANCE DATE: Separation Distance Bztween the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Weil 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 r s� G4"dfU i TOWN OF BARNSTABLE LOCATION 4Ei` MaUrz�e Am z&-r SEWAGE # - VILLAGE-'1.A07ZVYS In6LL 'n/ ASSESSOR'S MAP & LOT-0O`J INSTALLER'S NAME&PHONE NO. AAbgtV��l l<% 92o::: SEPTIC TANK CAPACITY LEACHING FACILTTY: (type) ;t�lbc NO. OF BEDROOMS BUILDER OR OWNER Lam'/'z f 71-1Ye< � PERMTTDATE: '*7 -`Zq COMPLIANCE DATE: 7`0-9q 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 a s � No. v may, / `� L V FeeG� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Rpplication for Moo.5ar *p!tem Construction permit Application for a Permit to Construct( )Repair(94 Upgrade( )Abandon( ) O Complete System El Individual Components at Ad mswdr Lot No. OCkr f�61PO IN. Owner's Name,Address and Tel.No. V� e Pyl-ed4 (bier TIH4AT/S/ Assessor's Map/Parceb D f4a Installer's Name,Address,and Tel.No. 21gk q,,qY T14- Designer's Name,Address and Tel.No. ,0`kD 7 Type of Building: Dwelling No.of Bedrooms Lot Size,�sq.ft. Garbage Grinder( ) Other Type of Building , No. of Persons Showers( ) Cafeteria( ) Other Fixtures JJ�� Design Flow T!�Q gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 000 Type of S.A.S. 33W C/%4061 'J/70/9L5 Description of Soil Nature of Repairs or Alterations(Answer when applicable) lySTfru 7 4400 OlUo"/ CA S ,rrf$ 4° Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the E ironme l Code and not to place the system in operation until a Certifi- cate.of Compliance has been issued by s Bo ea Signed Date Application Approved b ` Date Application Disapproved for the following reasons Permit No. Date Issued v n> r No. ��" �/ a 1 Fee �f ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipprication for bigpogal *p.5tem Con!6truction Permit Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Lpcati n Address or Lot No.�M(jL kjAlO & p,, ks/�, Owner's Name,Address and Tel.No. Assessor's Map/Parce .--�� t#1.d f &PT �A11,"T11 �f MCC Installer`s Name,Address,and Tel.No. 0A ON Ayo77Z Designer's Name,Address and Tel.No. ao TCdF1TuP clrz. Type of Building: Dwelling No.of Bedrooms Lot Size_4?__!r6o sq.ft. Garbage Grinder( ) Other -,Type of Building No.of Per_slons Showers( ) Cafeteria( ) Other Fixtures Design Flows gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1600 Type of S.A.S. _32 04 MiZO,`/60i 11,60 4 **5706"d< Desdription of Soil Q , ZoAM i j;69�ial'/ �,�, /,,) ,�/ 4Q&_C_0Z4 AZaZKQ A Nature of Repairs or Alterations(Answer when applicable)1& TALL zLoa "- i of/ i rall;/tt&3E 5 4 ayl 4.f rc�� ' N Date)ast inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site,sewage disposal system in accordance with the provisions of Title 5 of the E, ironmen al Code and not to place the sysfem in operation until a Certifi- cate of Compliance has been issued by is Board�f Hea Signed Date Application Approved byj Date Application Disapproved for the following reasons Permit No. ss Date Issued -------------- ------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(4,")Upgraded( ) Abandoned( )by&//)N (10TIi4 at _ U[ z ha5 been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No 4P dated 9-A 5;9 Installer &0y (10(TL 6a-67. Designer h The issuance of this permit shall not be�bns_ . ed as a guarantee that the system-will function as desig "ed. Date (- t�/' Inspector V_ kMh Al, � F �wi v f I 1117 —— d —.,fir. NO. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS &Opo5al *p5tem Con!gtruction Permit Permission is hereby granted to Construct( . )Repair(U Upgrade( ) a don System located at 4S m G1 IN( Igo 4A/ and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of t, 'sa) PP Y ' Date: ® / "` Approved Z �. 6it:�� 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, IM a`OTM , hereby certify that the application for disposal works construction permit signed by me dated 9-7 Qq , concerning the property located at 18- Moc uy aw LA/ meets all of the following criteria: The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. �• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. "Is There are no wetlands within 100 feet of the proposed septic system �• There are no private wells within 150 feet of the proposed septic system �• There is no increase in flow and/or change in use proposed �• There are no variances requested or needed. 1• The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation +the MAX.High G.W. Adjustment. DIFFERENCE BETWEEN A and B SIGNED . DATE: �,Q9 [Sketch proposed plan of system on back]. q:health folder:cert r, AG o .. o c� � aA-w,, rvnaP ; /3 - JS LOCATION S SEWAGE PERMIT NO.� $� �3 — VILLAGE INSTALLER'S NAME&ADDRESS n` BUITMER OR OWNER »d `1 DATE PERMIT ISSUED 4? to R5 DATE COMPLIANCE ISSUED �3 CL 3 e Y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF...... ....................... Appliration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a P nut to Construct or Repair an IndIvIdu4I, ewago Disposal SysteM2 at: ........... ....... ........ .../ .....0. ....... 2 ....... ..... .....9 goo, ---------..... L i7oca�ioA dress or No-.,,. 0 er IX ------ ...... ................ ............. ..../.................. 1.40*/ ----tVzi . .. ....... Installer Address Type of Building Size Lot...2A..0V.-.4.ISq. feet U .......Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( ) 44 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) Otherfixtures .............27.0t-VOT....................................................................................................................... Design Flow.............. ......... gallons per person per day. Total daily flow......J..3.10,..................._gallons. ... ....... W Septic Tank—Liquid*capacityA.-"*'Pgallons Length________________ Width...___.._._._... Diameter________-__:--_ Depth.............._. Disposal Trench—No. .................... Width................._.. Total Length.................... Total.leaching area____-_-.___ ....sq. f t. Seepage Pit No.--_____-__.---__---- Diameter........../4... Depth below inlet.._...?........... Total leaching area..f.. .. .....sq. f t. Z Other Distribution box ( ) Dosing tank,( ) Z: Percolation Test Results Performed by Date.... Test Pit No. I...........:....minutes per inch Depth of Testground water.__..................._. T ... ... ..�ept�to gr Test Pit No. 2................minutes per inch Depth of Test Pit.._.....___....__._. Depth to ground water...e2a.w.4- P4 --------------------- ................................. 4I.A.*9............ ........ ..... ........................ . -------- - 0 Description of Soil......... .......:.�� - a----------- ---------------- W ...........................................2_=ZZ........Y#I.- I............................................................................................................ U W t� ...................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................. ....................................................................................................................................................................................................... A ement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with th ro ions of TIT E 5 of the State Sanitary Code—The and ed further agrees not to place the system in era u i er to of Complia has n * ed by the b5s iea Signed---- .. ............... ......................................... ....... ... ..... e dv ication Approved By.... .... ..................................................................... . .. . ........ .( F�. .0.- ...Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date Permit No......... IssuedL................................................... Date ———------------- ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. ... .................OF..... ..........................._........... . ........................... Applirat.tilin, for Disposal Works Tomitrartion Prrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ............. ............................ Location<Address No .. 4 .. ................. . .............. ............ ........... . i Owner . ✓ Address ...................................................!.............................................. .........✓............ ................................................................... Installer f Address VTe of Building Size Lot__....................:Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons------------------:--.---_-- Showers Cafeteria Otherfixtures .............'Z.e'"_/........................................................................................................................ Design Flow-------------...............................gallons per person per day. Total daily flow----- ......................gallons. ............*.... Septic Tank—Liquid capacity _f?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.Y.6�.� sq. ft. Z Other Distribution box Dosing tank.,( ) 04 " #,�- '- " -/ ................ Percolation Test Results Performed by...... .......................r.................................. ... Date___ -)....... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_____................__. r%4 Test Pit No. 2................minutes per inch Depth of Test Pit__-..........._._... Depth to ground water.. .................. ...............................f... ............................................................................................................................ 0 Description of Soil........r�.. 'e'7 --7 "4"V 0;1 .....) /(_/� ) t; '�.... ....................................... ----------------------------*------------------- -------*--------------- V/? A1109 U ......................................................................................................................................................................................................... .................... .............................................................................................................................................................................. U Nature of Repairs or Alterations—Answer when applicable......................................... ....................................................... ............................................w.......................................................................................................................................................... A ement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with t pr sion of TIT 5 of the State Sanitary Code— The=6r'igned further agrees not to place the system in per on U to of Complianee has Nen issued by the board of hea h. C SiPY _ gne(...,,.................................................................................. a- �e ication Approved By.... e' ................................................................................. .......... Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date Permit No......... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (Intifiratr of Toutphatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by................... .L4 ...;.................. V�A................................................................................................................................................... Installer 6t ry at................................................2-----------�ill_�k .......................................I............................................................................................... has been installed in accordance with the provisions ofjI_TLE 5 of The State Sanitary , ode as described in the application for Disposal Works Construction Permit N'k- - G :�'�_' �J"" ", - ................................. (r.L1___._,>--,,, -. ........................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM -WILL FUNCTION SATISFACTORY. DAT E.....:`....... ............................................. inspector.......... ---a - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................I ..OF... Z............. ................ Rapoind Workii Tonstrwtion "pmnfit Permission is hereby granted...._I;.I i e�-A_;.. ............................................................................................................. to Construct ors Repair an Individual Sewage Disposal System atNo ' .�-------------------------------1� : --A-A----------S-t--r-e-e-t--------------------------------------------------------------------------------- as shown on the application for Disposal Works Construction Permit No&. ...... Dated/.1.6....ai'J5�.............. .............................. ........... ................................................. Board of Health DATE.............0 )1"RT............................................. FORM 1255 A. M. SULKIN, INC., BOSTON T LOT 7� - 'xt L 67 78 . OWr Gdirt'�L W o o v. 4 t.. a� ,r -• , 10,000 5r titi \ .:�/or�8 I �o0 7 �Na�s . Y�ts ' O ' ^ if V1d. OF2 1 13 �04 01 N yo1 .o tij \?� / t ---'- Z osvc A' F a�u p No.10951 441 �s , N OF M II ?IXuN Zp�/lr%!v ldYtS e y�FA� Asti /ao• 7 U f o� '•ROBERT . �� , .I Iz - 5. oq S 37 D6'3 CATcH BflSin( I I 1 C,9rct/ , - E 9T•9.. , " �oc� —o� 98U�f nA✓��-�"��"r' 9g, 3 s . �f•G'}S7!'�k� "✓ .a .. - .. °!Gigs/N } /HOC K 1 Cc 1l�17 LANC � S yp, w r D rX I VA r� wp y NHS 7a,.,�1 t xr LEGEND ` - ;* 1-EX1*TIN® ,SPOT ELEVATION Ox0 ' "IX.t:STINB CONTOUR --- 0 --- CAT1FIED PLOT PLAN *,. IFJN,JSH�EQ SPOT ELEVATION ,[ . (,o-r•r�/.: l.�-zc� ' `IFINtSHIED-• CONTOU,R O J L oT 85Mock�NP. fa:i G Li'iN� y /ass in of i, �2e"i -rQ/YS /'A ( L L . � �IhJT'E The -aocat.i.on of any existing under l ound sewerage, I N wweils, or other utilities 'shown on this plan is approx- } mate -on l as .d„termined from records and/or verbal 4lnformation.. The contractor is responsible for the Verification of the.existing`locations .in the field. gCALEu- v ' DATE l7/8s t,►ORiEDGE ENG/NEER/N6 CO. IN CLIENT. Hal_ I .CERTLFY THAT THE PROPOSED ; *Y E019TERE REGISTERED Sds s BUILDING SHOWN ON THIS PLAN' J08 NO. f xy `<`CIVIL LAND CONFORMS TO THE ZONING LAWS �� d x_ E 0 NEER � RV R DR.BY' ,,... OF 9ARNSTABL E , MA 01 STREET CH. BY �----- E , HYANN_1 S MAgS. � �}`` s ' 9HEETj_ OF 'DATE REG. LAND SURVEYOR j 2_1"N 4 ov 7 qz"r rA, Ac 0/7 ,Rrlc Ov0 PIT'ARAF 110R& 'OP& 'k�7 ' CANER A� JP4 AM 7W-e CONCRETE RAP.S.. 7 SJ,rALL 'BA1006RT• 770 4R, �AV EXTRA wc VY; CA 57 IRON coVER SHALL BE 'USEO VE WA)I' % Mew. CONCRL�TE CLEANSAIV-0 A 5A CAe,=1 J/'g IF • 't (SA ;r/C TANK o. & •V_ •f •Or •f •f •# •POO fl & •0 •0 & 0 , . " 41 A9DY -FC7IVff AP,.E.4prAF 0 WA5N.=P STONE 0 f o -70 % x 2S • a VO PRECAST SEEPl4GE v Fir �lz/o^y P/7 OR ZVZ// y Iyv&A r )6 - 6.wr. PIA 7 Ar 7 (SEE 7. aVJ_A .1do It-) FT. APIAM- .�C 7.14,VK_ Fr� k I,v -va74,ETSZRlTJC TANK -ex 7A' j4E I I ,�. ..., . aRoov)vo pz47, r4FC7 ION OFo R/AtWrYON BOX 10- 'IF7 Jf EWA 0 A 4 .5X5'r&,M. 021177 r., .PIS~ -rA4l1.AT1401V 4 LEACHING J=/T zp.,MArN-Tl 0 At A J JCA j%E510A( C dj?TA!�RIA. 3 lolAfs '3 3 9 a, SOIL TEST,� musr*2 SO[A.,TEST A/ $OIL. V(A"",e OF 4wlACMl1Va PITS 3 1!Z ELfY, PArE'0.v' SOIL TEST Frr— s47. 4or;r Fell co Ar CHI MC, OPZ-a.P1 7 VESSZAP 49. RESULTS PVI'r, -7 4 0,T-row Lw4cH1lA4, >j R P tr�-_7 r 0 1 & ocLA C0L A 710W A-rJr Z_ AW 707A _44ACH AR15A - Z fT.. 350 f __ ill C JF -Al :7 5L�po7 ack-lv.ag I;' efA, z_o r- -4 ti n, -,"ROBERT,-'- ALBtR U- U, 461E A9WWAIAMMIM 13 4 WOR &A.PREAP r RYA') l4o4 WV:a