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LOCATIONS SEWA ERMIT NO.
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} INSTALLER'S NAME i ADDRESS
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sUIiDER OR OWNER `
DATE PERMIT ISSUED
D A T E COMPLIANCE ISSUED
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® PF HEALTH
Alipliration for Disposal loorks onstrnrtiun ramil
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
..... - ----•----- ...-•-- ----------• O
Locati . dries r t
. .... . .:.... ...... • .. . ........... ... ••....... ........ .... ... ---•--•-----...............--...--•---
y O � Ad ess
11j41�.-•--- ll .............................. ......... ..... ddre _.... .-•-•--••---....
� Installer Address �® �� �+
Type of Building Size Lot_._-___�_. .. -a°S_••Sq. feet
Dwelling—No. of Bedrooms.............. ..............--------Expansion Attic ( Garbage Grinder (/-/0
Other—T e of Building No. of persons............................ Showers
a YP g --------•--...-•--••-----•-• P ( ) — Cafeteria.(....).
Design Flow...../Z0xtures --• -- -"'_gallons per person per day. Total daily flow._&, .Cs...........................gallons.
W �W Septic Tank—Liquid capacity...........gallons 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 ( ) �.
a Percolation Test Results Performed by- --• •--
Pi No. 1 minutes r inch D h f 0-� Test t per ept o Tes Pit.................... Depth to ground water........................
(i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
--•--------•-•---------------
-----------
.-------------
- ................•---------
...
O Description of Soil._0..:a�.....t ���� _..--.
W � :/s ----------- �� U/ — -�1
UNature of Repairs or Alterat ns—An er en applicable...............................................................................................
..---------•-------------------------------•-------------•-•------------•----•----•-----------------------...-------------------------------------------•-•------------------------.....•--............
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITL% 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operatio u it Cer ifi to of C Hance has been issued by the board of ealth.
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Signed........ ........
� Date
A ation Approved B ...•......._ -_..--.� 4'----------
Date
Application Disapproved for the following reasons-------------•---------•-----•-------------------------••-------•--------------------••-••--••--•.........•-----.
AA Date
PermitNo...................................................-.._.. Issued..............-.........................................
Date
No.............•-•........ F:ms.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT
fZc. . .........oF.. c.c e..-----'.
r
, pplirathitt for Disposal Marks Toustrurtiaan Prruti#
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at ,.
r..n.c. -................e .Z/ . ...•. .J'`. L_•'f .................................�
Loc/at/y�n-Addre s�� t .
_ •`! i^v�P ✓ / F✓ ✓, CCr /,. .Or.....--- .. ............................._..... '
af(! .................... _S--`:_=�Gt.`sG........................^..... --_^..!!���!c..��ur!T �...... ....................•..
Installer
Address r
/ < �� �Y
Type of Building Size Lot ...................Sq. feet
U
,.� Dwelling—No. of Bedrooms............. .............................Expansion Attic ,(JD) Garbage Grinder®)
Other—Type of Building No. of persons............................ Showers
a YP g --------•----------•-------- P ( ) — Cafeteria
Otherfixtures ---•---••--•-----------•--------------------------•---.----•.....-•----------------•-•---•---.... ; ..
-- 4
W Design Flow.... r(,)......................:.......gallons per person per day. Total daily flows-Mil
WSeptic Tank—Liquid capacity............gallons 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 ( ) Dosin
Percolation Test Results Performed by. ✓ .__�° - f ����//{{ �.. ....'Date........y... ... .............. ...j
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
04 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
�+ ............................................. ----------=--- •----------------------------•--•-----------------•-•----------------•--•-•----------------
D Description of Soil.O.". _.... !. s. i
U .-----
UNature of Repairs or Alterations—Answver 4en applicable.............................................•............._._......................_._........
--------•------------------------------•--------------------------------•--....----.....--••--•--•-------------•---------------------•------••------.....--------------------------------------.....--_.
Agreement:
The undersigned agrees to install the aforedescribed Individual'Sewage Disposal System in accordance with
the provisions of TITA U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed_._ � ?'��.�� .............. ..."-`..'--•--•--------....__ ....--••-----�--....�...
Date
Application Approved B
e
Application Disapproved for the following reaso
Date
Permit No....-...._. r -•----• Issued.==-••••........... ------•------.........
---
........ ..................... Date
THE COMMONWEALTH,OF MASSACHUSETTS ,
BOARD<,9F HEALTH, ,.
..........................................OF......................... ...................................
Tntifirate of
THIS/IS TO CERTIFY, That the Individual Sewage Disposal,System constructed or Repaired ( )
by ;F.� � w� `� •_~ "�' _ ...........................................................
y / nstaller
at _ -,4V j s�� ye ,. -" = �1?sue .!=-
`mn' �
P p Sanitary Code as scrib in the
--
has for Disposal o alcWorkseConstruction Permit No IT j �e State lated-----------
application ... . ..-,
rvisons r
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FYNI;TI04 SATISFACTORY.
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DATE .......................... v.........._.........------•---..... ` Inspector... ......................
Y.
Ah% e,wsotioq bt r A4lrr,
/ �- HE COMMONWEALTH OF MASSACHUSETTS 1>�ere�rnYrv� '�,•��"�"-
L yEta.$ oT S,t-lt #A 114
1 ow"ovec3 . )C)' 2►V BOARD OF HEALTH ,r Cer-� ► y •f.�,rt Sys4?
.. :,....z^.f -r?:l.'!:..?!1,..,M,..ee'::,�F....`.�,�','.�'✓'. z, �'_ .....................
bra--.z,_�',e�.•-.- . . ...� - 1 FE$.._�.:;�C'J..........--
so� T 6 A�Vts aas�t1 aarka Taaua�#rttar#uan rrutii
Permission is herebyran
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to Construct,(� on Repair ( ) an I dividual Sewage Disposal System
at No....= � �-- :.. �-• -9:� � -�_ '_j, ?............ f
Street v
as shown on the application for Disposal Works Construction Permit Dated....4. .Z,
............................................ `
B�r i of alth
DATE......... .....• --1`-----6.-----•--•------•--•-•--•----------------- r!
FORM 1255 A. M. SULKIN, INC., BOSTON 5
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SULLIVAN ;.
N0. 29733 " r
LL �SS ;
BAXTER & NYE, INC.
Registered Land Surveyors and Civil Engineers
7 Parker Road/Osterville,Massachusetts 02655/,Tel. (617)428-9131
WILLIAM C.NYE,R.L.S.-President
RICHARD A.BAXTER,R.L.S.-Vice President PETER SULLIVAN,P.E.-Vice President-Engineering
April 22 ,. .1986
Town of Barnstable
Board of Health.
P .O. Box 534 '
. Hyannis , MA 02601
Re : Lot 3' - Maushop' Avenue
-Barnstable Village (P-2711 )
Dear Board:
On April 18 , 1986 I conducted additional test holes
and percolation tests to verify the soil conditions and,
the percolation rate for Lot 3 -done by Down :Cape Engineering.
In brief the results agree, however , I . found a clean sand
layer below the silty sand and hardpan layer . The -depth of .
this clean sand layer. ran across the lot from 10 to 15 feet
below ground surface. At the point where the system is located,
approximately 9 feet of dry. suitable material was found. Per
the Cape Cod Planning and Economic Development , Commission Water
Table Contour Map of ' 1982 , maximum -ground water is shown to be
26 to 34 feet below the ground surface ( i . e. 20 NGVD),. , With
this in m.i'nd, the proposed system was. Iocated in the clean sand
layer .
If the Board wishes, we will conduct an additional test
. hole for your - inspection or I will gladly certify the system
at completion.
Very truly yours,
�Q�jt1 06 MgsS
Peter Sullivan, P . E.
Baxter & Nye, Inc . �� Pt:TER
f0 SULLIVAN
P S/f m j No. 29733
AL
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. Enclosure � ION���,,.�
MEMBERS OF
CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING
MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS
BAXTER & NYE, INC.
Registered Land Surveyors and Civil Engineers
7 Parker Road/Osterville,Massachusetts 02655/Tel. (617)428-9131
WILLIAM C.NYE,R.L.S.-President
RICHARD A.BAXTER,R.L.S.-Vice President PETER SULLIVAN,P.E.-Vice President-Engineering
June 1.3 , 1986
Town of Barnstable
Board of Health
P .O. Box 534
Hyannis, MA' 02601
1 .
Re: Lot 3 - Maushop Avenue
Barnstable '
Dear Board:
Per your request, . I have supervised the installation
of the septic system for Lot 3 . The leach pit. has been
installed in the clean sand strata.. Prior to setting the
leach pit , I dug an additional test• hole with, a hand auger
and. verified that 4 feet of dry, .pervious material exists
below the system.
I. trust that this meets your needs . If you have any
questions, please do not hesitate to call .
Very truly yours,
Peter Sullivan, P . E .
Baxter & Nye, Inc.
P.S f m '
J
OF Mqs� •- •
PETER
SULLIVAN
No. 29733
o
�GtsTERf`
�s'rI/ONA L
MEMBERS OF.
CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING
MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS