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HomeMy WebLinkAbout0045 CENTERBROOK LANE - Health 45 Centerbrook Lane Centerville A = 172 241 No. 4210 1/3 ORA flex' 100 No.�3 '�?.� Fee © �_ r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for Miopooar *potem Construction Permit Application for a Permit to Construct( )Repair Upgrade,("-5 )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. lam, GC'�,✓P ®A-e f t�.C,Q s�r P`/� Assessor'sMap/Pazcel A-- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �77 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building grCf'- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow ��� gallons. Plan Date Number of sheets / Revision Date Title Size of Septic Tank Z'X/J'7�1,w& /00® E7Ae, Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Sig Date Application Approved by Date Application Disapproved for the following reasons Permit No. 6 -I S 3 q G Date Issued S�A_-_-s --------------------------------------- No.0©U Fee 50 k THE COMMONWEALTH OF MASSACHUSETTStteredinsamputer: A B BARNSTABLE.,.x. PU LIC HEALTH DIVISION -TOWN OF BARNS A ., Yes 2pplication for Migozar *p6tem Con6truction i3ermit Application for a Permit to Construct( )Repair.(k Upgrade )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 4,w. Owner's Name,Address and Tel.No., SP Assessor'"§Map/Parcel /,� I $0 3 G&40.-,P aa8406a,. Z ,�_ GG6�✓T Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. op 517r0,7417 a/» Type of Building: Dwelling No.of Bedrooms-, Lot Size sq.ft. Garbage Grinder( ) Other Type of Building apE--P. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow y 91, gallons per day. Calculated daily flow yam' .gallons. Plan Date 3 0- 3 Number of sheets / Revision Date Title Size of Septic Tank 7Ae• Type of S.A.S. _;�'S X l X4 Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signe • Z- Date - Application Approved by__ Date 2 YY Application Disapproved for•the following reasons Permit No. Vic' 3 -3 4 6 Date Issued' — -------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(�')Upgraded 1) Abandoned( )by lF/Ah` L�'•BOc�"�F at G has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.7-00 3-3<« dated I- 28-y 3 Installer d"i,00* -e Designer 6-4L/O go. The issuance of this permit shall not be construed as a guarantee that the syst n u do 5�eaig�ed. Date n - �^d Inspector' �- o ------------------------- '.�' 3 _3� 4 No. Fee 60THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS QiOpoOaf *pgtem Con0truction 3dermit Permission is hereby granted to Construct( )Repair(�o Upgrade )Abandon( ) System located at YS G L°�"e .6'i�+o•.�' +� . G E'•✓T 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 QthisDate: Approved b j TOWN OF BARNSTABLE LOCATION �C`" B•�oo�E �� SEWAGE # VILLAGE -�2r�'` ASSESSOR'S MAP & LOT/;�; . INSTALLER'S NAME&PHONE NO. LT1,09 L��o oJoJ SEPTIC TANK CAPACITY /oo o��{t• %1�'' LEACHING FACILITY: (type) f/EL.O (size) Z ' NO.OF BEDROOMS SL BUILDER OR OWNER PERMITDATE: _`� COMPLIANCE DATE: Separation Distance Between the:. , jMaximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist / Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility (If any wetlands exist Feet within 300 feet of leaching facility) Furnished by i ex se LF I A # 46l f TOWN OF BARNSTABLE LCCA'FION SEWAGE # Vel—AGE �` ��'`�'��� ASSESSOR'S MAP & LOT/�ZZ INSTALLER'S NAME&PHONE NO. _L:7�/� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS Sc BUILDER OR OWNER PERMITDATE: �'� COMPLIANCE DATE: --� 0-1� 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) f / Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �� ,��C k GGff -- No... �.._.t.4 IFmc....... .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE L .................OF... . .Q[ 57 .715- -.` S /- Appliration for Disposal Works Tonstrnrtinn ramit / Application is hereby made for a Permit to Construct ( Z'�'or Repair ( ) an Individual Sewage Disposal System at: ...... _. _. -. ....Q_Cn_ .................en .........._ _ ....... / Locution-Addr s1 t No. l --- Ower Address '------------------------- ------------------------------� C---.------------------------------.-----_-- Installer Address d Type of Building Size ��.. _ Sq. feet U Dwelling—No. of Bedrooms.......... .............................Expansion Attic ( ) Gar�iage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures W Design Flow.............. ... ................gallons per person per day. Total daily flow............ 1 __.._...____.__....gallons. WSeptic Tank—Liquid capacit6Q`�Q.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. Other Distribution box ( ) Dosinglc Percolation Test Results Performed by. ......�. 14a Test Pit No. 1 S._..minutes per inch Depth of '�st Pit.... Z.... Depthground water___________________ Test Pit No. ...minutes per inch Depth of Test Pit.................... Depth to ground water. �.. o ......--•• r ........... f--------------------••......................................................... Description of Soil...... . - �?_ ...... GC ss,�_�{ x -- ---- ---- �, �. � J e �. nn ;54=- ---_------------- ---- ---- ----------------------------- --------- -- - -- 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 iITL% 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by th o�rd of hea '' ' '---'----Signed.. -' --'- - - ---'----'---•--•--•--'--•- �.. .......... Datp ApplicationApproved By........ �` ---- ..-'---------- ------ --- ----- -------------------------- ----'D..'.t-"_ . ........ Date Application Disapproved for t ollowing reasons:-----•---------'----'•----------'•--"'•-------------•---•----•-----------'-'-----------•----••................. .................'----'-•.....-'-----'•....--•--•'-•-----••-•'----•-'---'-"•-•"•--------'--'-----......•---...•---'--'-------....'------'---•---•----------------'-•-'--------------------•-....-'---- Date Permit No........... s. Issued -®2'�i gS Date No......................... Fxs............................_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H ALTH OF. ' .'. .., .................................. Apli iration for Disposal Works Tonstrur#tun ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: �/ / .....4 -- ..4,.I`' .�., � ? 1........---•-- �-ez�e 10i/_ '- 4 .5.. Logation-Add s ,.or Lot No. t H)6drier Address .......................... --.....----------------...---�' --------------------------------•------------- Installer Address UType of Building Size Lot., --- 0_t'�&_Sq. feet Dwelling—No. of Bedrooms.......... .............................Expansion Attic ( ) Garage Grinder.r( 4 Other—T e of Building No. of persons..,.......................... Showers — Cafeteria 04 Other fixture W Design Flow.............. .....................gallons per person per day. -Total daily flow----------- ....................gallons. WSeptic Tank—Liquid capacitt)f OP _.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..._._._._____.___s ft. Z Other Distribution box ( ) Dosing > )- ,� Percolation Test Results Performed by�� � Date -f--- 1 Test Pit No. 1____.minutes per inch Depth of"I st Pit___ __ ..._.._ Deptl4b ground water_____________ Test Pit No. h ...n...minutes per inch Depth of Test Pit.................... Depth to ground water �.. .. .'... a --•- --- ---•------------......................................................... Description of Soil _ � fir—_ z 1' , f x 7i„� •. x ---------------------------------- --. -! ate. 44 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 TITU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate if Compliance has begt� issued by tbAboard of health. *yd ......................... '74 G Date.. ApplicationApproved By.. -------------------------------••-•---........---------.......--•--...-•-...........__ Date Application Disapproved for the following reasons____________________________________________________________^________.___________------.....-----------...._..._ V `E' Date PermitNo............................................•------_..... Issued-....................................................... Date r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAIA�TH IV ................oF.. ::. ...:: �%.' .. .. .............................. dw Tntif irate of Tontphattrr T.4W, IS TO RTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by - �. . .: _ ------------------ ------.....----- - • _--_. _.....------•----•--•---•- •----------------•.....---------- .........7...... le��13__apo e has been installed in accordance with the provisions of TITIF 5 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 CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FU [10 �SATISFACTORY. DATE_:.....................�..1..._QI.. .. .............................. Inspector...........• ------- .---•- ------------------------------------------------ )THE COMMONWEALTH OF MASSACHUSETTS b.,.. BOARD OF HE* LTH �� y ��'� ....°" ........ o F. 1' /� _ .. { No.....................� FEE... ... `. . Owposal Works onotr ton antic p Permission is re by granted..._ ....__..tT !� f _ }_ to Cons ct ors epair ) an Individual Sewa e Disp sal yst atNo. t-J -------------------------------- Stre as shown on the application for Disposal Works Construction Perini INo.__Je:-I&__ Dated---------- ........... ----------------------------------------- ..................................-----------------.-------- Board of Health DATE....... 5--------------••----------------- FORM 1255 A. M. SULKIN, INC., BOSTON S n .r � i. G--0 J _15.0 0 0 L17ill N 10 tu /Q3 Q y Q 4 �XPfINS/vNl J _�.. Wn) n� o G✓A i`E7t. s 39 9 vo ,r a V ` z0 /Ve w. 11 _UQV SE' v, No.10951{ O IONA1 A LEGEND EXISTING SPOT ELEVATION 0x0 EXISTING CONTOUR ——— 0 — } " 4°✓" CERTIFIED PLOT PLAN FINISHED SPOT ELEVATION (� FINISHED .CONTOUR 0 GUT 7 NOTE: The location of any existing underground sewerage, wells., or .other utilities shown on this plan is approx- IN imate only as determined from' records and/or. verbal information. The contractor is responsible for the J J41 verification of the existing locations in the field. SCALES � = 3vr DATES _- �DREDOE ENGINEERING CO. 'NOCLIENT. �N3��E� I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JOB NO. 91076 BUILDING SHOWN ON THIS PLAN CIVIL LAND A: CONFORMS TO THE ZONING LAWS ENGINEE -.§.VRVIKYQR DR.BY /'L OF BARNSTABLE , MAS 712 MAIN STREET CH. BY' h./3•E f �� �. HYANN I S, MASS. SHEET .L OF Z-- A E IREG. LAND SURVEYOR 20 FT.' 2M/N. /VOTE /F E/TMER THE SEPTIC 7 OR LE�l CfI/NG P/T ARE lyORP TNA.IV /2"SAW lON/ %Li FT• M!N 6;RADE.,A R4'D/AM ET.ER CoNCRE'T.E COVER ". SHALL 8.F ,SRO&6.NT TO <i•I�AGE.�AN F.X>Ri'4 , y CONCRErE 9�oVC P/Pa t/E,4YY CAS T IRON COVER SOYA I- 49E Z/S05'40 MIN. P/TCN /F/N OR/✓EH/A Y CL.74.0 COVERS .0T CO. a pE CO NEI� CLEAN SANO. A — BACJ�F/LL 9.. _ C14PU10 LEVEL - h «DMA. M�/� �' �•.. Z*L.AYER PIPE 1p.pO . G/tt 4' ' e t• . • e • • • �• .�� WA"ED S?ONE a: Psi f D/s r SEPTIC TANK �T. • r . •, '� r t. n zrs'�2 ;, r�, .�:3i', '! ?s` xk t i.�,��. ?'£ a -} c .`s 4" .7. '`v,' �.'r t • ���ECT/✓f. 1 R : ..�1. � %�.., i .a • ° . •• DEPT1/ • • t • • «• WASIl.ED STO/YE ~ - 4 e • • •fit ( o • `; • o �� x.f2, = 470 . • '7 . • • • • • • b PRECAT SEE GE • 7�x /� 0 $. s• 1 • ••r S P/T OR LVIJiV F, �-his}-G!�`�1� v�4� / •r 1 • • •. • • e s • 6 'r I/VYCR'T,-EL EY�4T/OJV S PIT . = (.PT. prVk /NYEf�T AT 4UILPlNG` 7 t o `FT F7. PIAM. C(.SF� au�.ar7ow� jr 7,YLET SEPTIC Ti4NK FT p�/7LET SEPTIC T�4/1/K o f, fT. GROu/VO PATEN TABLE t, /NL+ET D/STRIA!/TID/V BMX 7a FT. SECTION OF 00TZ&TD/37R49tlTION DOX Z O.S FT 0 0 .S�J�1/AGE O/JiP'G�SA L �YST'L�/a? - �' lIYLET L A*C,41NG PiT `T' f`T 7"ilQtll-AT/ON �: L ACf�flNG P : o,MEN.floAt' A DES/6/V CRLTER/A SCALE '4 o DlrtEaitsto�I . .: F' N[lM6fER OF eEDeROO�S . , 3 4 - G4i4OAG.ED/SP05A4 U/V/T NOwE... SD/G LOG. := SOIL TgST TOTAL E9YlNJ64TEl� FL0I4/ SOIL TEST / SOIL TL�STlIFP M r -7z,o / ELEY. ELEY, DATE OF SOIL TEST" g' 8�` /Yf/MBER Q L,E�4CXlNG'PITS • S/DE LGACHING PER P/T J* FT. p Z 7— RESUtTS IV/TNESSOD dY✓vim ��2�'� BOTTOM LE40VIA4 PER P/T 7 SQ.' P&W COLAT/ON A.WrO j/ �-' '� AIJWI NCH d `. sv/.�s o / TOTAL lEAChf/NG AREA F_ S , �°1�`JeCOI.�►TyON RAy'E2 M/N�INCH_ RESERIiELEACNIN6AREA SQ: FT._ � v S�/� T r P-3SK3 1,,A OF M� s O T �n/TE2�R E ROBERT �� � a � I L.)Al G�/1/Tc1z BR.UCE Al/�'Z E�DR�*J v SE.. H 140 10951 O p Q � / d�► ?' 'f /� . o ' Fc[v�` ! `4 7/�,$ M,�!/V 97� Kf.!y AlAitf MA 19,' : - r"E"�::51,4 ri y ,*,� � .-, SlONA4 ,., ..,. /4l'6►�` �iM' , �°I� EA✓CO�tI/il�'1CA'�' _ rµ�.G�Q�//� , e e M':y"l a'a.....+ �i s,_tiV;•"Y 3!. '�'.a � fi2i,'y.., �t�,.t L�. �..:0.�)5T ..:'C .{... T P.rM. f'i•�': .. ... 3 'fi C.'Y -.y 4 :'yCe. 3 a:a �:.•' 'i "} 3 i� �'t Fn t 3n a-. .!+! ,r+.:.. .�., Y.k `t-Yda..i.--L>'. .,.-�- �:!{'. 'N. v.:t'�1' ...1'1... 's....�, �. .a a. -- i. - .•' a T.; '{ :".'tom y'C,(•.� - ..,,.....• �.. ;� _.a.:*.� i.. _ .",.. ....kca�' .t, S ,.�.- 4 vc ,..;:a �}ii ��' k 3. J�'�' :x .v.,h' 'w' �:t..�'S,r,":'u�-�.,ti'.,.;�,,,,,,,•, . � � .. � - 4 ....-;':AZrr� .e „__.,.:r+ F ! ��, �^�_'.��. �....:'S �+ ................'�..�.--•"""x^c--^.e'..••-...-..» nr . --R. *.- .. ^_ ..�.,..,.�:. .... ... �. ,,e '.mom 4:.'v'•X:"� _••r: a t,?.....- I LOCATION S E W A G PERMIT NO. q r =q vilLAG er�Il INSTALLER'S NAME f ADDRESS BUILDER OR O NER �T DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �. orho o.-5e, i e! Y ASSESSORS MAP : � 17� .:. . � _�- / _ _ - ----"- - __ TEST HOLE LOGS 7 It PARCEL f _ FLOOD ZONE: , f"' �.. SOIL EVALUATOR:. C.S ., - _ WITNESS.:.:. - 'r - REFERENCE: DATE: 61.1 � �2 ZC NOTES:PERCOLATION RATE: . 21 \,Aal TH- 1 TH-2 1) The installation shall comply with Title V and Town of Barnstable Board of Lo Health Regulations. 2) The installer shall verify the location of utilities, sewer inverts and septic /J�h�f components prior to installation. u1 Lv 3) All septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. Existing leach pits to be pumped and backfilled per Title V abandonment LOCAT ION MAP ;� C O ��__ procedures. --- 5) This plan is not to be utilized for property line determination nor any other p I f purpose other than the proposed system installation. V `la 6) All septic components must meet Title V specifications. 7) Parking shall not be constructed over H10 septic components. 8 The property is bounded b roe corners and property lines as depicted. P P Y YP PrtY P P Y p �"" ✓ ��,, 9) The property owner shall review design considerations to approve of total number of bedrooms to be considered for design. SEPT I C SYSTEM DESIGN so a FLOW ESTIMATE t W 00 �, `� BEDROOMS AT CI GAL/DAY/BEDROOM 4GAL/DAY SEPTIC, TANK CAL/DAY x 2 DAYS GAL / USE �()DD GALLON SEPTIC TANK i7Cl i�1(f{ f` q�tL. I�1W — _ ION SYSTEM o x x ,-� SIDE AREA: 3Z� 4- ! �C \� \ 'BOTTOM AREA:, r _ SEPTIC SYSTEM SECTION I O 4Z � u Dior w n I pr GAL _ SEPTJ C T K T W ftA// �l t\/, W 1 I SITE AND SEWAGE PLAN LOCATION : C •_.. �.� C 0. l VA PREPARED FOR : SCALE: 1 DAV I D B . MASON196 DATE: Z DBC ENVIRONMENTAL DESIGNS W DATE HEALTH AGENT EAST SANDWICH . MA 3 ( 508 ) 833-2177, W Z