HomeMy WebLinkAbout0098 CONNERS ROAD - Health L-71 CONNORS RD., CENTERVILLE
A=251.020
10
UPC 12534
No.2_ORS
HASTINGS,MN
TOWN OF BARNSTABLE p�
LOCATION y9 Cohncrs SEWAGE #
VILLAGE /_ rvt 7Prd-'Ilf ASSESSOR'S MAP & LOT 1-G 2A
INSTALLER'S NAME&PHONE NO. To/,, Au lt0 ya?S- qJr `�
SEPTIC TANK CAPACITY /SOO ti
LEACHING FACII.TTY: (type) (size) aOff' %O `laL
NO.OF BEDROOMS y /
BUILDER OR OWNER ,S^hr v le-e
PERMTTDATE: 7/3 " 16 COMPLIANCE DATE: =L/ -9�;2 _
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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 feet of leaching facility) 1 Feet
Furnished by ''y
s
07 3 ? ,�
D 000 A !3
A .21/
yap' �y� �
C 'gyp
y
h f1/10
�p� /5 voS Z. Ir
r. /p�wX5i0 L Xo2 �!J w
J �
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in compute
Yes
r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppricatiou for Mi5 gaY *pgteuY Construction Permit
Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Clkfn. ON wnneer's Name,Address and Tel.No.
Assessor's Map/Parcel [�G
Installer's N e,Addr s ,and Tel.Nt�. Designer's Name,Address and el.N
��/Y1V S A L10 �� �
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building 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 Type of S.A.S.
Description of Soil
Opp
Nature of Repairs or Alterations(A er when applicab
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 7b this Board qqealt
Signed Date
0
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
No. i- Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
/ PUBLIC HEALTH DIVISION -.TOWN OF BARNSTABLE., MASSACHUSETTS
ZIpprication for 30 5 gar° pztem (fongtruction Permit
Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System O Individual Components
Location Address or Lot No. �,r51A( AI Owner's Name,Address and Tel.No.
Assessor's Map/Parcel ��
„ Ls•/r V
--D -
Installer's Name,Address.and Tel.No. Designer's Name,Address and 1.N F+ F
Type of Building: y
f Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building 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 ! Type of S.A.S.
Description of Soil
. t
f __J
Nature of Repairs or Alterations(A er when applicab
t
Date�last inspected:
- Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system %r
in accordance with the provisions of Title 5 of the Environm ntal Code and not io place the system in operation until a Certifi-
,�"Cate of Compliance has been issued b this Board q lealt �d
Signed ` A A A Date"
Application Approved by _ ... �s _ Date
Application Disapproved for the following reasons
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
,4. certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded X
Abandoned( )by
w
at has.beed constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer Designer.
The issuance of this r—t-4
shall otbe construed as a guarantee that the system will function as designed.
Date ' `' Inspector ~ Y
— -----;;---------.-----------
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Migool *pttem (Construction Permit
Permission is hereby nte�c} ,to Construct )Re air( U a ( )Ab ndon �
System located at '� (�
and as described in the above Application for Disposal System Construction Permit. The applicant recog izes his/h r duty to
comply with Title 5 and the''following local provisions or special conditions.
Provided: Cons c 'o must eted within.three years of the date of t ' e t'
Date: f Approved by
i
n > `
c TOWN OF BARN STABLE p�
LOCATION �� 4-041h0rs SEWAGE #
VILLAGE lPH7rrd.��� ASSESSOR'S MAP & LOT 1S1-GaA
INSTALLER'S NAME&PHONE NO. //0 yak- 9;s
SEPTIC TANK CAPACITY /5-00 y o`l S to /oA
LEACHING FACILITY: (type) T- 60O'S (size) OF Ok /O
NO.OF BEDROOMS y /
BUILDER OR OWNER �S^h v �Z� •/�y S
PERMITDATE: 7/3 r �� COMPLIANCE DATE:/
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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 feet of leaching facility) Feet
Furnished by
�` t
�P
O ono 13
Sa' a 7
" aq'
3 ySG' 3a N
71
G� �a
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I i � 1. ALL, ,WORKMANSHIP AND MATERIALS SHALL. CONFORM TO D.E.P. TITLE 5 1 , I � � -,11 41 � 'f .,% ,� -
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" . ;. 11� I li, " WHITHIN SIX,INCHES OF FINISH GRADE WITH ANY REMAINING ACCESS 7� - _� I . � I .,
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I . .: . 3.' ALL,COMPONENTS OF 'THE SANITARY SYSTEM SHALL BE CAPABLE OF I I EL-Ii-AD . ^ I t_% % I I I I 17-,-.. � 11 11�� I , I ,, -
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I I I� � . . . WITHSTANDING H-10 LOADING ,UNLESS THEY ARE UNDER OR WITH.IN , . � � . I U__=====0 I I i r I � .1- -FLOW LINE I I . . I I '� I I . I I -4 F'C�12_5jtA _� . I I � I , , , .
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. . .1"",, ,' ' , .I- -�OF DRIVES OR PARKI,NG. H-20 LOADING SHALL BE USED UNDER OR WITHIN I - I . . � ,�� . 24" C.1, .,�� ". I , (PRESSURE TESTED) . I I J, . . � ,,
, � _ ,� : : ' 11 11 � . . � - I � .. I I 6_t) �IAuLk�V�0� ,'r ,, 2' MIN. - 1/8' TO 1/2' WASHED STONE , . v, � , ,
. , � 11 10', �GF: ,DRIVES OR' PARKING UNLESS NOTED. � + , I - -- � () 1 . I FRAME & C04R � I � I � I I I , . I . I �.
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I I �� w . 1 4., THE , ACTOR SHALL VERIFY THE LOCATION OF ALL . I . --'-'I t�l V T--:,-',',k<. t>L17 Llaj S . � . j, � I INV. EL. ,4n�I � OF FIN. GRADE , i r-2" GATE VALVE 5-1, � I --- - t I� . I I I �, I .11 I
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11 I SITE UTILITIES PRIOR TO ANY EXCAVATION. I . 6 I
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1� I I � � ,� I I 'A LINE OR RECONSTRUCTING THE LINES UNTIL ALL NVETS AREOF � �,` 1� .
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. I 11 .I . . � I 11>1 /� 1 1471 1 / . /", pump and fill existln esspools .. � � . . I � I I I I I . I � . � � .. EQUAL ELEVATION. , I I I � . I. 1 _i __ �, � 1,1.
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MINIMUM CONSTRUC11ON MATERIALS PER 310CMR ,15.226(2) � " , , , "
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� I V�. , TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND I I 1�1 I I/ I ---I" I , I I '74c, . � , I i U I . , . I I . . , SET AT THE INTERVALS SHOWN ON THE PLAN. ALARM I � . I i � I . I . � I .I �.1 , 1. '.., ,!, .�. I 11 I.1.1
I � . i� � t / � 1. "'.., % . I I 1. LIGHT SHALL BE LOCATED IN A CONSPICUOUS LACATION . .1 I I. . . � I . . I I � I . I I � I 1 I
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I SHALL EXTEND A MINIMUM OF.6' ABOVE THE FLOW UNE I TP // % ..'. I--, Z_qz� -A I I � WITHIN THE HOUSE AND SHALL BE POWERED BY A CIRCUIT , I . � � r
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! �, 11 , SEPTIC TANK !LOCATED,DIRECTLY UNDER THE CLEAN *GUT I I / .,/150 1 ... [ I . I . . . � . . I . I I I I I � . I I I 11 ) . . . �
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