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Home My WebLink About0101 INDIAN HILL ROAD - Health 10_ I Indian Dill Road Barnstable -- A= 318 - 036 4v�� 01 31v - 3 6 a LO CAT ION s Est WE 6 Q. 4 or YS � LAGE INSTALLIR'S NAM£ A ADDRESS Z. 8UIL0ER DR OWNER Tim DATE PERMIT ISSUED --%!� - "" I O— 11 — ?-.9 GAS o qit i 3`� 0 D THE COMMONWEALTH OF MASSACHUSETTS f BOAR® OF HEALTH 3 oc ...................OF.... Appliratiun for Disposal Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...l�.f. 4iAx?... . . .._._..... ?................ ............................... ..--•---------------------.......-•----•-----......•--- L ation-Address o Lot No. s112. --•---•----•------•------------------ Owner Addr s ............ .............. �.'.-------- 3 ............................................ Installer Address Type of Building ? Size Lot-AVY510._.-..Sq. feet Dwelling—No. of Bedrooms........d..............................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building No. of persons............................ Showers t� YP g ---------------------•------ P ( ) — Cafeteria ( ) 04 Other fixtures ...................------------•----•• - W Design Flow...........+...................gallons per person per day. Total daily flow_--_.3J0.........................gallons. WSeptic Tank—Liquid capacity��O__gallons Length___-&....... Width.....d....... Diameter................ Depth..j<.......... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..3s3C).....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ as Test Pit No. 1_75�_C_._minutes per inch Depth of Test Pit-./4C1........ Depth to ground.water........................ t? Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ----•--------•-•••-•••-•--•--•--•--------•------------•----•••--••-•---••........................•-----.....-•-•-----------•--------•------------------------ O Description of Soil....Q-.-Z6........< s2 tSUQ��S��..-•----..--••e 80••------ -=°•r�'�- 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 TITHE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i ued by the board of health. Si ned ----- ------------------ 10 � Y Date Application Approved By-•••••••. ----1 � y Date Application Disapproved for the following reason .-----•-----••••----•--•-------••...•--•---•-•-••---••--••••••••-----•••-----••••----••-----•.................... L. --•-----------••----•-••---.......--•----...----••-•---•-------•-•--•----------------------•--••-----•---'-----•--•------------------•-•-----•---------•--•--•-----•--------------•-- ...--•--...--- Date PermitNo......................................................... Issued........................................................ Date 11� u THE COMMONWEALTH OF MASSACHUSETTS �~ BOARD OF HEALTH :. (may OF..- r7 .................. 4Apliliratiou for Dispas al Workli Tonutru,tPon famit Application is.-hereby made for a Permit to Construct .( ) or Repair ( ) an Individual Sewage Disposal System at: ................. � .. L ation Address or Lot No. ..........................•-------•---- y C �.k.-l�� •.�i Owner Address 00e6S,.... ............•••---....._..... '----•_� -I ._........................... Installer Address UType of Building Size Lot_/,V..W. .0-_____Sq. feet �. Dwelling—No. of..Bedrooms_______13-______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -----------------------••------._...------------------••--•---•---•-•••--•------•------------------•-•-•---•--••--•--•-••---• ... W Design Flow........... _._gallons per person:,:per day. Total daily flow_.___ _ gallons. g � L� g P P P Y Y` •J� = WSeptic Tank—Liquid:,capacity,� ,O..gallons Length._.,&........ Width_____.6....... Diameter________________ Depth__e______-_-- x Disposal Trench—No. ________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area__33CJ.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ -_minutes per inch Depth of Test Pit_.,,,1_ Depth to ground water________________________ Test Pit No. 1__S�_.�_ P P �Q0-------- P fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ ................... -••--•---- _.. ..............................................................=--•-----...-•--=-•-------•-...---•------....--•-•----...-----•--••- O Description of Soil _C; :,lam`_.._- 'c'✓ �;�Lr ;S+c�t {� -----••---•---- =� . '° 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 Sanitary Code— The undersigned further agrees not to place the system in operation until MCertificate of Compliance has�been isissued by the and of health. n W Signed - DApplication Approved BY---••--- r U fDate Application Disapproved for thefollowing reasons:- ---•--------------•--•--------------------------_...................._ ......................."--....._....__....-•-•--••--•----•----•--•-•----------•-----••---.._------- ----•-........ Date PermitNo.......................................................- Issued-----------------••-••---------•-•----------•-------- y Date �^ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..,..�,IL�.r l..................OF.. 0, .................:.. Curdifirab ,af Tuutpltattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (V) or Repaired ( ) bY.........�/. l� .ro1C, ........deo's--z................................................ ...------•-••-•------._..__.... Installer Q at.....zli_1__..... .........1CJ1----- 04- ' ` 11�- ,---C'6',tv z__ _!e1-Q------------------------- has been installed in accordance with the provisions of TITLE 5 of The. State Sanitary Code as described in the application for Disposal Works Construction Permit No-__.___,/4.__.._?1___-__ dated________________________________________________ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... . 1 - ........................... Inspector............ "' ---• ............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .................OF.. �� 1 No.......... l FED........................ Disposal Works ��_�_u�tstrttr#iuu rrmft Permission is hereby granted........................... w. t� -w'1✓ to Construct ( ) or\R air ( ) an Individual Sewage Disposal System ..... ...0 ------ �, .�� Street as shown on the application for Disposal Works Construction Permit No______________________ Dated..........._.............................. .' ................ ..... ____ ........................................................ '` Board of Health f k•, DATE.................................... /(> ---•---•---- E � FORM l2S8 A. M. SULKIN, INC., BOSTON of Z Sf/ TS 3q'`I' . o° All '1 /oL,oo I � /7, Est 2 t2'447 L EACH o Vpir I Z3' 0 I lb A i o Ldr 1?1 Af �XisnvG � 0 DwNulw6 � MFvN a GSZr�-y= '4'Z.00 � alb �M La T 3:5- �4 i G 0 n • � � LoT 30'`� I 98 3/ I 4r 32 ' ' IZ.#v,¢-T7oA/s 494; &W oA/ '/qS 6'40/1- 7- /�SScry�D D�1?LM. LOCATION SCALE — !. 30 . . . DATE .o?C PLAN REFERENCE . .45�7 !G LoT•a°`..... . 0 /�5 •s-//oWA o�/ At Mqs . . . . . o EY y 0. 26100 pA . . . . . . . . . . . 9FCIST ER�� I CERTIFY THAT THE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF . . . . . . . . . . WHEN CONSTRUCTED. DATE . . . . . .. . . . . .. WiGG//-rr/ �: SW/FT'— I��77T/DNS REGISTERED LAND SURVEYOR r r r sti�� z of L .SyF�rs 4Z O o TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 3 9,6' e o 4' CAST IRON II2',MAX. r OR SCHEDULE40 12"MAX. • ' P.V.C. PIPE 4��SCHEDULE 40 PVC.(ONLY) 1L PITCH I/4"PER.FT PIPE- MIN. EACH PITCH 1/4 PER.FT. PIT PRECAST o' �INVE T LEACHING o EL 3 .,oZ. INVERT INVERT PIT OR SEPTIC TANK EL..37 6d . . DIST. ELP.-P.. • ; >= EQUIV. ►_►- . . 00 ELN:7.. .. loco GAL. INVERT BOX INVERT '¢ o a :;�: 3/4"TO 11/2 E L 3.7n. WASHED W STONE ez.74,76 ...' . --- /Z i D I A.--d PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE AT Titi,-- o� /NSTRGL H?!O� SOIL LOG WITNESSED BY : DATESe•pT ?-�,!I�BS. TIME.��%30 SAS. . �o' ^!4eme-. BOARD OF HEALTH TEST HOLE I TEST HOLE 27�b✓A?ZD , C, � . ENGINEER ELEV. . . ELEV. .. .. . . . . . . DESIGN DATA : CL NUMBER OF BEDROOMS /08 TOTAL ESTIMATED FLOW 330 GALLONS/DAY t-Z.,3A7D MLA BOTTOM LEACHING AREA .. . SQ.FT. /PIT/C,PD. s � SIDE LEACHING AREA 8 . SQ.FT./ P1T/37767.P,D 4qy GARBAGE DISPOSAL .NP`!''r. .(50% AREP. INCREASE) 547vD TOTAL LEACHI NO AREA SQ.FT Ze4� L� �37v PERCOLATION RATE 'SS.?'. ��1.7?VQ MIN/INCH LEACHING AREA PER PERCOLATION RATE490-�. SQ.FT.�C,P,D, WATER ENCOUNTERED �� T IAI/� NUMBER OF LEACHING PITS . . . . . . . . . . . . . APPROVED . . . . . . . . . . . . . BOARD OF HEALTHY F •r pF S'Tn�/ AA/ DATE . . . . . . . . AGENT OR INSPECTOR 0F Mgff`, s�Fp�tIt OF fir,,s , o`er EDWAP (v 5 ALL H LbT 3S LLEY °^ I 5 . . . . . . . . . . . . . o. 26100 0 t LAP1� SANfTAF1P� PETITIONER Aw 4047411.a An eA lit 6 b VA 4 u, K