HomeMy WebLinkAbout0935 BUMPS RIVER ROAD - Health �- /� ZC�
7 0/�-�/
0
,
No. Z1 r Fee i
THE COMMONWEALTH OF MASSACHUSETTS
Entered in com ter:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftphtation for Mispo$al 6pstem Construttion plermit
Application for a Permit to Construct( ) Repair X
Upgrade Abandon( ) ❑Comp to System Individual Components
Location Address or Lot No. i�per � d ress, d Tel.No. n Q�,�
Assessor's Map/Parcel �j �p ��l �� j'�� )2iV Z �-�(�
Installer'am , ddre,� �ttd Te. �-7 Designer's N e,Address,and Tel.No.
(�
Type of Building: n
Dwelling No.of Bedrooms /1/ Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil A at
Nature of Rep irs or Alterations(Answer when applicable)
60Y !.�/ 2c�
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the is m in operation until a Ce iflcate f
Compliance has been issued by this Rd
a t .
Si e8 Date
Application Approved by Date p Z
Application Disapproved by Date
for the following reasons
Permit No. � � `j Date Issued �/AD Z
zo
No. . i.•. t> _. _Fee J
THE COMMONWEALTH OF MASSACHUSETTS Entered in computei:
PUBLIC HEALTH DIVISION - TOWN OF,-BARNSTABLE, MASSACHUSETTS
,* 4ftplItatiou for Misposal *pstem Construction Permit
Application for a Permit to Construct( ) Repair <Upgrades( Abandon( ) ❑Comp,11te System ®'Individual Components
Location Address or Lot No.(I w Owwnels Name,Address,/d Tel.No. `
Assessor's Map/Parcel IE7 ,2� ��yqlps lN/Elz ant>
Installer's sNName,Address an Tel Ns u�Tf ] Designer's Nar$el-Address,and Tel.No.
Type of Building: y� '
Dwelling No.of Bedrooms / 1/ Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures', /A� p,�
Design Flow(min."required)' /1/ gpd Design flow provided d" gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil A lrl—t
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
4'The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in 1 ;
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
r, Compliance has been issued by this Board Hea t1. 7
SignelA / d_i ) Date
Application Approved by g/ Date / p
Application Disapproved liy ,� �--'� Date
i for the following reasons
Permit No. / J Ca j . Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compiiante
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( )
f'
Abandoned( )by _
at '4!�XU I tY f,'V_ < has been constructed in accordance<t_ t5GY lr✓N U
with the provisions of Title 5 and the for Disposal System Construction Permit No,7A�, dated
Installer (i `V ,,� � �,� -ICLII Designer
#bedrooms h Approved design flow gpd
The issuance of this permit shall not be construed as a guarantee that the system wiTfupon s designe,(d�
Date �U��( Inspector • J,
-._-_'"---- -- _ _ _ _ _ - -- ------....... . -- ---------
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
30isposat 6pstem Construction Permit
Permission is hereby granted to Construct,( ) Repair L) Upgrade( ) Abandon(
System located at V� ,_ ^e rat —) )f' 71)
r/^a
and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 this permit.
' N
Date Approved by , -''
No...8.2.:.y -• Fic ..., �.....��....s .......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 0 I-1 HEALTH
-y /..l.e O F.............
✓,� Applirativat for Disposal Works Tuaautrurtiuu rantit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
PP Y
System at:
2� v I2 .4.1 Gti C
................__ .. ...............-• 1..._... .f llf..._ .......... �. . - 9 ............... ....
Location_Address or Lot No.
-.
---••----------------__ ./ ..bra - -- � � ----.�:-�-:--.. -
Owner Address
W Sa --------------- ......................................... dds s -�
reInstaller --al
UType of Building Size Lot__2f�)_ -......Sq. feet
,� Dwelling—No. of Bedrooms............... --------------------------Expansion Attic (4�0 Garbage Grinder (�
Other—T e of Building ............................ No. of persons............................ Showers — Cafeteria
a' Other fixtures ^
W Design Flow......................1�.___S____s__....._.gallons per person per day. Total daily flow..................._._�_�_.�._...........gallons.
WSeptic Tank—Liquid"ca.pacity.`(�.0#11lons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No. ..................''.''.. Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No--------------------- Diameter-___..__-___-_______ Depth below inlet.................... Total leaching area..................sq. ft.
Other Distribution box ( ./j Dosing tank ( )
Percolation Test Results Performed by................. �C ------!e'/..- ... Date....... �.�_l��Z
,aa Test Pit No. 1....4 Kf -minutes per inch Depth of Test Pit...._. ,7....... Depth to ground water.._ ....::... -
Lt, Test Pit No. 2-----A:6+-minutes per, inch Depth of Test Pit_____ ____________ Depth to ground water..-(4-. '
Z"i- ---------------•.......... . -p ---------------•-•-•--•- ......••-•----...................................-•-•----•----•---•
ODescription of Soil-------------------------•••-•0'._ ...�.......f._....5� 1� .."t---fi 1 O.J.�' =--------------------•--•----•-----
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 iIT1! 5 of the State Sanitary Code— The undersigned further agrees not to place t tem in
operation until a Certificate of Compliance has been issued by the board of health.
Signed...................... ---.---•- ---•----.. ............ . ................................
D to
Application Approved BY--------------- � � ._._...... 2' d�'
Date
Application Disapproved for the following reasons:................................................................................................................
--------------------•---------------•-----•-•-------.._...----------------------.........------------------•••••--••--•--••----•--•-•--------•---------•--•••----•----•--------------•-------------_..:_
Date
PermitNo..............................................----------- Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
c
.;---- BOARD OF HEALTH
Allp iration for Ditipmal Works Tonitrurtion Prrutif
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: _..-•""""_ .
............. .........
Location Address or Lot No.- f '
'. Owner �� Address
a .Js� ... "..................•.i ,S C •----•...............................f _4 ,....e.- �._ ..-.._ .......
M Installer Address
U Type of Building Size Lot_"F4 .....Sq. feet
-117
Dwelling—No. of Bedrooms............y-...........................Expansion Attic (A '0 Garbage Grinder ("'t-,)�
'4 Other—Type T e of Building .._......._. No. of persons............................ Showers
P-1 YP g ---------------- P ( ) — Cafeteria ( )
Q' Other fixtures .._
e- ----------------•-----•--- -------------------................
W Design Flow...................... ..........gallons per person per day. Total daily flow.............�-;`'.-�?.............gallons.
� Septic Tank—Liquid capacity t.6.?.. allons Length................ Width................ Diameter................. Depth................
Disposal Trench—1vTo. ................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No..... ............... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution;box (--) Dosing tank ( ) f /
~' Percolation Test Results Performed by.....................( .* !. t ';"'' ...._.�/�'r._. Date__..... /%?K P
Test Pit No. ;l......?�s.�_minutes per inch Depth of Test Pit......1' ....... Depth to ground water.._
(s, Test Pit No. 2.-..:=-j^! .minutes per inch Depth of Test Pit.... .. ...:..... Depth to ground water.�''°�-. °"•� /'
O Description of Soil--•--•--------------•--•-•--... ..::: ,3a 1--- -t - /--
w
-------------------------------------------•-----------------------------------------------------•------------------------...------------------------------------------------------....-----•----•---•--
U 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 TI'I•;•
p 5 of the State Sanitary Code— The undersigned further agrees not to place they""stem in
operation until a Certificate of Compliance has been issued by the board of health.
Signed
.............. ----
t'' / to
Application Approved By.............. � f------=�� ---•-•--•-----•--------- ..... f.-z=1.....-----------
X Date
Application Disapproved for the following reasons:-----•-------------------------•----•---•-----------...-------•----------------.......--•----•-------........._
---------------------•----------------•---------------------......--------------------.......----------------------------------•-•••----•---•••••--...••--••--••••--•-----------•-------•---•--....-----
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
j BOARD OF HEALTH
(Inrtifirtttr of Toutplitnre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed-(,---)-r Repaired ( )
Installer l -
at.......................................................... �r-% W. �f �"� t ............. �lr,
v= r
has been installed in accordance with the provisions of TI'i'L: j of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.. ..._` .�.................. dated_-.------.......................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SA ISFACTORY.
DATE. ,11� ----------•--- Inspector._:. ---------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
d.. '`Grp!"'..........OF........................1..... 1' _. _.
... _-..... ~i ,cf
r
No................. ...... FEE........................
sposa1 Works Sono rnr#ion ermi� f
Permission is hereby granted .:* 4, -----------'----r j ......................................
to Construct ( .,or Repair ( ) an Inddiiv�idual Sewage Disposal Syste
.
' . ?at No ' l /♦IJ-"
. r--A---.--�•---•-•••-...--•••-
Street"
�
as shown on the application for Disposal Works Construction Permit No.................. Dated..........................................
....................... r';Board of oard of - -----------------•-•-------------------------
���. /r Health
DATE..................................fJ� ... .......
FORM T255 HOBBS & WARREN, INC., PUBLISHERS
Pv33G/c
,cw
/ec�A�
of
q�,�
94 23. .y o
4e:o
5DT
° a
..� " � 122 m IL7OO WAL K}, Y' �.- • ',l 1 +.
V
.. .. .. --J � •'a ° /j.(! �.ly /Y sn , �� L Jo, m iYN f l fi,:... � ..
_ - .. .. �'[��.fir i�f,,,.'.• *.1tR R a,5 y/„? F'L+ ✓h ,� ' .:r Y t r hx?�Y .'.�_:. _
L aT s 3i,
t 1 '
: ZNOFMgs
.( 29974
x rr' s ` i N SURD
LEGEND m ,,
CERTMED PLOD` PLAN �
... STING SPOT ELEVAI`tON
EXISTING CONTOUR —
FIN-1S14ED SPOT ELEVATION :- � „ •V C /1ITG��' r//L L. —
FINISHED CONTOUR - ® "t"
MARS I N .
es
APPROVED BOARD- OF HEALTA _ No 1.^0951 fir l
A9o�`��is.x��; � A �®1 SIA A La`s ASS4
pg
`��pNAI E� SCALES so ®ATE, 91
MATE AGENT ,✓r,
V.
SEDGE ENGINEERIAIG Gt�tV CL P ITT..; ,. I CERTIFY THAT THE PROPOSED
82 c4 // OUILDING SHOWN ON THIS PLAN
E'ISTERE REGIST�ED �;: Joe`Nd.... .....r.
CIVIL LAND CONFORMS TO THE ZONING LAYS
D I<IEEit RV OF. BARNSTA E, ASS.
712 MAIN S T R E'ET,: ark: Doi,y�.,,�
H YA N N I St, MAS S. '`.' SHEET_L.. OF z DATE G. LAND SURVEYOR .
20 FT. M/N. /�lOT1� /F EITHER THE SEOT/C TANk OR
!EACH/NG P/T ARE MORE TN.q;/ /2"BELOit/
/D FT• M/N. ::TRAOE� A 24 III/AM ETER ['ONG'RETE COVER
Fe-- SNAGL eE 0R0uGH7- TO 4RTA
CONCRETE 4 PYC P/Pr �VeAVY C-AST /-'ON COyiER Sf/ALL pE USEO
COVERS M/wV. P/TCN /F/N DR/V"C'WA Y
/e PE.Q Fr
2 J MiN. CONCRLcTE
A :°o G .40E COVER CL cAN .SANG
&AC,ie�/L L
L/QU/D LEVEL i
1, ' a 2"LAYER
IAOM P/PE G/�L of
= PErc IT. SEPTIC TAAo'X D/ST, o • •. I 1 • . , , � • , � • WASHFO STONE
'•s: BOX v 1 r $ ► • • • • • o!• •
?•�_ • • ► 1 • 0ER74W • • e • e v o WASHED STaXE
400
. e i • • , • • • • I • p . v PRECA5 T SEEPAGE F
78- x / O 7� s y.4 • I • • • • • • • a •o P/7 OR EQU/V, a
lN 7'veR &ARV ITIONS P,rGtP�tcr.i
/NYERT.AT:QU/LD/NG 46 S FT y 6 Fr: D/�M.
r4� GAL f/9ft y
Ir
/NLE'T ,SE'PT/C T-4/VK 46.3 FT /D/� O/AM -_� C SEE TABULATION, '
oU74E7 SEPTIC TANK
INLET D/5TRZ611710M BOX 45 9 9 GiQDUeyD WTE g1t Ti�BLE t
OtITLETD/,gTR/,�11T/ONMX 45. 7 F SECT/ON OF
J! f
/,VLEr LEACH NG oi7' 45. 5 FT SEWAGE OISPO SA 4 5KS r&,"
L E/4CH//VCw P/7'
-rA5 11-A '!ON
SCALE ��`• _ /-a~ L7/MEN.S/ON A 3 FT.
N
DR516 . CRITERIA - ®/M.Elvs/oM 6 FT.
NUMBER OF®EDROOMS
GARBAGE D/SPO5AL UNIT tru SOIL LOG
TOTAL E1T/MATED FLOH/ 3 6AL.1DAY cS0/L TEST 0/ SO/L 7ZFST*2 S®01- 7557'
X.JMBER OF LEACNlNG PITS_ f^ELG�K 475 �`-AMOY, DATE OP- SOIL TEST �/�'7/�� j
q/DE LEACHING PER PIT l IF�S� PT. 0—/ RESUJ-7-5 *V/TMESSED dY`✓RE—
.9oTTOM LZACH/NG PER PIT ZF SO. &T. Lo/�M d� PrRCOLa4T/Dlsr II,�TE / LASS ^.J/N /NCH
TO TAG LEACH//VG .AREA Z 6 6 SQ FT. AERCOL47'/0N R.4yE A
RESERVE 4E 4rN//V6 AREA 2--b 6 SQ. FT. 2-;(�
Zd OF Md S k OF S,x o PvI,/ LD T 7 BU M pS ,� !✓G/2 2 r' .
LPL Miss f 1zf� T�//✓�
v S H X A. rnl
f�.2474 o ORSE y)� ELO RED GE ENGJ)V,&.R/NG Co /NG.
•p No.10951
N�BTfi� pQ` 90 F ELEy 3S,S 712 MAIN Sr HYR�c1�/iS. M.gss
D SURV �FrS/ptrAlE�v NO GROUNt7 YNi4TER ENCOUNTfREO CL/EAl7';G DELI%�^/e' D,�jTE fs�2.
G/LO C/NO Lvsa TER AT ELL<<! - ,JO6, NO. 8"2 O l SHEET?OF
LO CAT IO SEWA E PERMIT NO.
%=� m a
VILLAGE
v
INSTA LE NA i ADDRESS
i U I L D EA R OR OWNER
a
DATE ,PERMIT ISSUED' -- ---1�� ,��
DATE COMPLIANCE ISSUED
L 6T
vi ,�Ck