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Home My WebLink About0062 BAYBERRY LANE - Health 62 Bayberry,Lane Barnstable A=335 - 062 i No. 4210 1/3 BLU i IT010 UI& ® O 0 O .. = Fizz/Y..v.. .......... �� 93,1 APPROVED THE COMMONWEALTH OF MASSACHUSETTS t'rial),gCogmlvatio.o*omOntBOARD OF HEALTH -ST WN OF BARNSTABLE 33S-Do 1trativit for Diiivwial Wi orkq Ton.5trurtiun Vamit ftfj&-�Pplication is hereby made for a Permit to Construct ( ) or Repair (Lr-a—n Individual Sewage Disposal System at .............. ----------- ..bo, ......--------------- J ttion-Address or Lot No ......................................... ...1...._--.....N....cc(oNI.ILJ......--.......... ......•-----... `J N �1�L .. owner fires Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling— No. of Bedrooms.----.- ..-................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures --------------------------------- - W Design Flow.. .... ' --...................gallons per person per day. Total d y flow.... -..�U......................gallons. WSeptic Tank �—I_iquiTd ca acityISNgallons Length---W....... Width_.- --.--- Diameter--.............. Depth................ x Disposal Trench--N 05 �. Width..9.............. Total Length...-3 ....... Total leaching area----------..........sq. ft. 3 Seepage Pit No ............... Diameter-.------------.--.-- Depth below inlet.--................. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.--..................... fZ Test Pit No. 2................minutes per inch Depth of Test Pit...--............... Depth to ground water...........:......I...... P4 -----------------------------------•-------------------•-----•----------------------••-•-.................................................................... ODescription of Soil........................................................................................................................................................................ x w ------------------------------- ........................................................................................................................................................ UNature of Repairs o Alterations—Answer w en applicable � `r.4B....L__;.. 5'� j F. ..... . �....12..41 ............ . ----------------------------------------------•-•--....--•--------............---. 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 een issu d by d of h Ith. Signed ........................... . .. .......... .. ` /r j�'/�� Dare Application Approved B ................... ...�.- --------------- .................. .... ..... .. ................. ........... ..- Dace......... ...... Application Disapproved for the following reasons: . ................................. ....... . .................................................................... ............................ ..... ..................:. ......................................... ........................................................- �------. ---.. Issued Permit No. � �.1..�. ----- -._..---- ..: .�t ..�� ... Dace �tiW',h...�+.��..i...+^...�,�w--:......r �.•,.....�ti.«.�w...r--.....,:, .,a�;ar,.$,a.:.......«}�'w.:,.:f3'L.Li.+'a.F'�'�=a..;*t:.,,r......r:..... ti..+L..-%'+ �.-•�w��'G�«...•i`t'r`:,�..�..+1^'d.l;it�r..�'i�:�'+a.i..sYt+»��''.��..'a.,y� 1 C f 3 2/ THE COMMONWEALTH OF MASSACHUSETTS - f BOAR® OF HEALTH � ,'—$T9WN OF BARNSTABLE NVp iratiutt fur Diripmial Wnrk,i Towitrnrtiun 11amit �e N i,'rkmoppplication is hereby made for a Permit to Construct ( ) or Repair (L—)an Individual Sewage Disposal System at r, fl d� ( E / Locstion-Address or Lot No. �: . .. r! .r-../ c .w ( �r t?n ;IL J .` Qwner I Address W r' c � ...-- ►Avg ,—c = r ci`r r<� .:....40 Installer Address UType of Building Size Lot............................Sq. feet ,., Dwelling— No. of Bedrooms........................................_._Expansion Attic ( ) Garbage Grinder ( ) aOther—Type/of Building ____ ____________________ No. of persons..................._.......... Showers ( ) — Cafeteria ( ) a' Other fixtures ---------------------------- w Design Flow.. ...`.`?^.....................gallons per person per day. Total daily flow.._.y :_�........_................gallons. WSeptic Tank A-Liquid capacity 5(Dgallons Length---t(2_...... Width--__f"._--_--- Diameter................ Depth............... x Disposal Trench--No.�'��.. Width..9.........._. Fotal Length.-_ � .r---- 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..................:.................................................... T aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------------•-•-----------------------•---•------•-••-•---•-••--•------......................................................... W ' x Description of Soil......................................... W UNature of Repairs or Alterations—Answer when applicable.-7T__)C:_ j_A_t k..... �..<_......... ." x l ..Z. VLFG:1�.�...... jl, r = {•,!1----'---------------------------------------------------------------------------------- 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 Comphance_has been issued by the board of health. Signed.------ "- :..........1 r Ir_ --- ... .... .4 �....... I?ace Application Approved :/"...... ........., ,/r............................. ..... .....-,/ Dace Application Disapproved for the following reasons: ................................................. .r. ............................--------............................................. �1F !J '.f�- _ . Dare 7 /... .. Permit No. ... .................... ........................ Issued ... /.........�.......: ^�.... ...........1 Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tez#ifirate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired --n.r'T�� c.__, ....._................_....... . ...................... by ... .e 7- ... ------ ..:_ r � lo..i;�ii�. at _........... Vh �'.�v° -- 1.<,: �............. .�..... r�"..�..± i.. .c. ram.... ,.4-...... - ----P, a I has been installed in accordance with the provisions of TITLE 5 of ThhState Environmental de as escrfbed in the application for Disposal Works Construction Permit No. �Z' . d,ted � _ _:.- ..... . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT-BE CONSTRU& AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ........................ ........�y.�... �...�.. ---------------- Inspector ._...._.... ...�t .............................................. ........... V THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE J FEE/. ._ ...�. ..� Difyofial Work,5 Taantrutinn annit Permission is hereby granted ------ .------*----------------- �----=s`.-=�---'------------------------------------------•------------ to Construct ( ) or Repair ( L) an Individual Sewage Disposal System r atNo.............................. K rstree �/ �/ � as shown on the application for Disposal Works Construction Permit 9To- ;L Y: Dated--7.77/ ---------------------------•---------- q >`v Bbaad of Health GDATE------------------------------------------ ..................................... FORM 36508 HOBBS&WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE � > „ r LOCATION t.6�� Cpc�Q SEWAGE # qiU' Lf VILLAGE �t,111 tM`Gi ti�� . ASSESSOR'S MAP st LOT3S i, INSTALLER'S NAME & PHONE NO. dam&,-U g[a SEPTIC TANK CAPACITY__LjlE;;-e? LEACHING FACILITY:(type) (size) y NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED:_ 7 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No `— '" r j �� a �¢ � W Wti x f i../ � . � = I J� c� � . . r - . al r' r '� r J // � TOWN OF BAAR�NSTABLE �— LOCATION (O �,�P/'/y 1 --� SEWAGE # r� VtL-AGE !��/ /�, ASSESSOR'S MAP & LOT 3 •06Z __ INSTALLER'S NAME&PHONE NO. ' SEPTIC TANK CAPACITY LEACHING-FACILITY: (type) �leG� (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: �� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 fee of leac g facility) Feet Furnished by vl� k 111�ftiti SEPTIC SYSTEM HOUSE "TIES" A B DESC. 1) 27'-9" ;;35-4" TANK LID 2) 33'-6" 36'-0" TANK LID 3), � - COVER A174 yS'o " SOIL 3 ABSORPTION Fo SYSTEM 1 ,000 GAL. 2 SEPTIC TANK o � B #6 2