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Home My WebLink About0276 FULLER ROAD - Health 276 FULLER RD.,CENTERVILLE A = �� RECYCiFOCO UPC 12534 No.2-153LOR Y�srcoct HASTINGS. NN No. lo�� THE COMMONWEALTH OF MASSACHUSETTS FEE G BOA = GF HEALTH -W/mBUL APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT PP ) Repair:( ) Upgrade ) �P Y ❑ P Application for a Permit to Construct Re sir• U rade Abandon ( ) om lete System Individual Components J �1( VAC,- OVA40A&AA Location o ncr's Nan e Map/Parcel# Address Lot q v C IIep one# Installer's Name Designer's Name t, Address Add, ss Telephone 9 Telephone# Type of Building: Lot Siz ` -:�->Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.re red) gpd Calculated design flow 7��i gpd Design flow provided d Plan: Date f o 1� Number of sheets Revision Date�'l-CC -1�1 Title ti e a� a==c Description o Soil(s) ��-•, "1 � i-�� JO"- �� Soil Evaluator Form No. Name of Soil Evaluatof , Date of Evaluation - DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 an er agrees not to plyce the system in operation until a Certificate of Compliance has been issued by the Board of Health. i Signed glry Date V #IV FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 (✓ TOWN OF BARNSTABLE LOCATION Z 2 6 Fy d 4A he A,D SEWAGE # `I`! 6'51 VILLAGE C IT A]r.c/t (j,(Lr ASSESSOR'S.MAP & LOT 2- INSTALLER'S NAME&PHONE NO. G (1)-lssLt )c •70Y-o yyy SEPTIC TANK CAPACITY I1"aa r.s% LEACHING FACILITY: (type) pie gc4-rl' 2 NO.OF BEDROOMS -3 BUILDER OR OWNER M o L- G cLAi cE7kY PERMITDATE: O- Y- 9 9 COMPLIANCE DATE: ,1:-Z- 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 Llo � � ww � N A O N 41 No. / / -`(p�I THE COMMONWEALTH OF MASSACHUSETTS FEE B O A R-D_,&F H E A'LnT H OF [ APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT tO Application for a Permit to Construct ( Repair ( ), Upgrade ( ) Abandon ( ) - c4eomplete System ❑.Ihdividual Components026C �. I 1 ,OkAAk ocaurn+; O ncr's Na e J � ,Q U - pot A Map/Parcel# Address Z Lot# Telep one# Q o A, «t,�..60 L4 �� a Installer's Name Designer's Name Q r Addr(Sss Telephone# Telephone It ti Type of Building: Lot Size -jSq.feet i Dwelling—No.of Bedrooms 3 Garbage Grin er ( ) Other—Type of Building No.of persons c Showers ( '); Cafeteria ( ) Other fixtures Design Flow(min. re y ed) rJ`�.'gpd Calculated design flow . gpd Design flow �5 provided pd Plan: Date to Number of sheets Revision Dated 6i- 9 Title t. Ck Description o Soil(s) (3+'- t LvoSC3 Soil Evaluator Form No. Y Name of Soil Evaluators ii�TWDate of Evaluation „--3-RL( DESCRIPTION o-OF REPAIRS OR'ALTERATIONS 1 The undersigned agrees to install'the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and" er agrees iiot to pl the,system in operation until a Certificate of Compliance has been-issued by the Board of Health. ( Signed Date -I�tspe�itc�' A ✓v'ire �'�` � t � -/I- .. s Y I 1061 i ,FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. �G J THE COMMONWEALTH OF MASSACHUSETTS FEE f OYI a �- .r I. wSfo BOARD OF HEALTH ' .. _ CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: at LCJ 2, 2 7 6 FF_- 1GV (� Jam' ~ -4 has been installed in accor'dapce w h t e rovisions of 310 CMR 155 P (Title 5) and°the approved d gan it plans relating to application No.`? dated /0- " / Approved Design Fl Installer Designer: Inspector W'^`\ Date `y- The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE i' DEP APPROVED FORM 5/96 � No. /9!q-6 s-/ THE COMMONWEALTH OF MASSACHUSETTS FEE 1�a• N'�"6 BOARD OF HEALTH DISPOSAL SYSTEM ONSTRUCTION PERMIT Permission is herby granted to Construct ( _Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at L n 1 2 Z 76 f--i_.iz r%� as described in the application for Disposal System Construction Permit No. 72 -6.-1 dated Provided: Construction shall be completed within three years of the date of this permi All local c nd' tons mu be t !' Date ' 7 / / Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255,(REVv5/96) H&W HOBBS&WARREN PUBLISHERS- BOSTON 4 r - I t QD L _ r ' ^I • { Ttt; r r � y r• d i L 1 of t r- I It I ©C•LAJL two JJ' 5:V- A lo'-.� lo-4, ac•o• .............. .............. r LI 'f r O 4 t s�y• E 8 �I[ � c u i L�i 4 TOWN OF BARNSTABLE 1 LOCATION "Z? 6 F U UEU AAA SEWAGE # 17_ 65/ 0 4 V1.L.L.AG ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. i3g LA &SEPTIC TANK CAPACITY /-ro o Gs j LEACHING FACILITY: (type) I©@ LcC,�¢� V �(size) /3°2 X 2-5 +� NO.OF BEDROOMS -3 0 0� BUILDER OR OWNER N o L.4 G c AA/ GEE Y PERMTTDATE: /O-- Y- 9 _COMPLIANCE DATE: - /"9Y 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 Fv o 3� . w �> --' 9 G z � B a To � - 32' 3 2 - /�-6 2 - 3�f. y 3 .- 3�J•� 3 - 23' y - ys- y_ 3 2.y s_ Sp,6 s- z 9' G �' s�' � - 3?' �,�, �: '�� .., ..�m n SYSTEM PROFILE NOT TO SCALE TOP FNDN. FINISH GRADE EL .- 0 1 . 5 FINISH GRADE OVER 0 VER TRENCHES 7 3. 5 — 71 . 5 ••'`� FINISH GRADE FCO.O FINISH GRADE OVER DIS T. BOX 74.0 SEPTIC TANK �4 O 12" MAX. ° c4a• de: t�'• :oa'ao.a� o':O,viDO"'vo/opy4p��f� o .A'tib•'r iQ TO TA L L ENG TH OF TRENCH S` _ a 4c.o•. a o 3,, OUTLET PIPE LEVEL o. FOR 2 FT. MIN. A3 "., b6w 72�28 CAP END f 72.03 . ELC. I. OR PVC TEES b$ 71 .7 8 ® oo $ did. j. 'D• pe• I � :. p _. . A p• oa a° e e 1500 GALLON D,l"S TRI U TION BOX b' BSMT FL . EL . •o °' ° INSTALL ON LEVEL BASE �� ':°o o ,� oa �®0 GALLON OR Yh/EL L S 40 PRECAST CONCRETE ;o 0 4.o a ai,o.;•a4 ob H I0 REINFORCED a: a• ao j��o:aao.oi•o•.c' o•? •'e;:o 'a•6�'Qt• pp�+•o;a• e•••o. _ n• ; .•o,.v`i°•o•od- •vP �•'•�.•o:.a. o.'y P,.o.ob�fc •.q•y.4pX�4: , SEPTIC T�4 NK TRENCH SECTION 72.�A INSTALL ON LEVEL BASE ,�D< NOTE• EXCA VA TE TO EL EV V._ I�/,L1. OR L OWER TO REMO VE AL L IMPEPVIOUS MA TERIA L BENEA TH THE L EA CHING AREA t 2 d" DIAM. 6p REPL A CE EXCA VA TED MA TERIA L WI TH 3". OF ?/B"—?/2" CL EAN, CL A Y FREE SAND ,a.;,Q, .o o: c' b': ;b o,'• '�f anti 04 •:�; - a. b.' A� ®.•Q WASHED PEA STONE t � 3,14 " — 1-1/2„ WASHED a • pOAU �� U I"[/ k CRUSHED STONE FULL _-GAP G��'f'GU SIN _ _ _ --�----- ---- ' r,e / iC 73. s 84•� GENERAL NOTES ,� •- „ ?. ALL EL EVA TIONS SHOWN ARE BASED ON ASSUMED NUMBER OF TRENCHES ? 2. ALL PIPES IN THE S YS TEM MUS T BE CAS T IRON NUMBER OF DRYWEL L S 2 OR SCHEDULE 40 PVC. ,T +�, 3. THE BOARD OF HEAL MU "T >BE NOTIF�'ED — - _. I112) P-343. 1 n WHEN CONSTRUCTION IS COMPLETE PRIOR TO BA CKFIL L ING PERCOL A TION RATE: C2 MIN./IN• 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED WITNESSED BY: BY THE BOARD OF HEAL TH AND CAPE 6 ISLANDS } SURVEYING CO., lt,/C. 5. MA TERIA LS AND INS TALLA TION SMALL' BE IN R.-GIFFORD COMPLIANCE WITH THE S TA SANITARY BA;'7NSTABL49RO. OF HEALTH DESIGN DA TA v JUNE ?3, ?9B4 U J3 r_CODE TITLE V - AND LOCAL APPLICABLE DATE.' / RULES AND REGUL A TIONS tY` _-._- NUMBER OF BEDROOMS 3 O -- X�� 1NG NORTH ARROW IS FROM RECORD PLANS AND ,� UvU � GARBAGE DISPOSAL NO J 6. IS NO T TO BE USED FOR SOL AR PURPOSES W t TOPSOIL 6 ,FL OOD HAZARD ZONE NON—HAZARD � DAILY FL O� 330 GAL . , - _ SUBSOIL B. WATER SUPPLY TOWN WA TER SEP TIC TANK RE® 'D. 1500 GA L 1500 GAL . , 3G SEPTIC TANK PROVIDED LO- 330 GPD m N , W 4, aSacn a m" L EA CHING REQUIRED 11 a, MEDIUM N rwifd _ bOL SAND SIDEWALL AREA .= S.F. e ?525.F.X 0. 7t/S.F. = 112 GPO. r•s `1+ � Way %� to oar °°� 2 L�� y Fo ^ BOTTOM AREA = 329 S.F. He.,v `',• y'Ffrn! � y /,Q a LEGEND 329S. F.X 0. 74GI F. = 243 GPD Ho11V Nil\Q�•` i • LEACHING PRO VIDEO = 355 GPD .• _ 1 a, M.' Church Hi p c R 70 PROPOSED EL E VA TION ?44'•' NO GROUNOWA TER w Y Nd,h ,.. o A a 8t a' C� Rd. Idnd 7O -- EXISTING CONTOUR. .. . 3 Sru �P ` .SINGLE FA MIL Y RESIDENCE G OBSERVA TION PIT _ c 2 3 SF. ❑ DISTRIBUTION BOX as �f` V, OFyAss9c PROPOSED SEPIA GE DISPOSAL S YS TEM �__ =j �ep 1-11c FiD you ,n�,� � PREPARED FOR " 3F,TRA 9 2.1..E • _ .. � �* � 2�"894 �* 4 1'�'OL A GERA c GER ' N 6 Qo.63r O O SEPTIC TANK N f ti��. n�4 �Q 'pp •2 " PO. 4q F GLSlFt \, A x - �5 —:— LOT 2 FULLER ROAD p I I RESERVE AREA BAPNS TABLE — CENTERVILLE — MASS. as � V /• DAVIL� PIP INVERT VAT N _ ' 75.70 E IN E ELE TION _ � cH,�F��s n, �a SANI KI ( a -1 DA TE_JUNE- I1 1�'o� u' r CAPE 6 ISLANDS ENGINEERING PLOT PLAN SCALE.*_S • sip`" SCALE AS NOTED 133 FA L MOU TH ROAD — SUITE 2E 3U I r� �,fl-2 2 2 7 'a��r i _ � w PLAN NO. GO�1 MASHPEE, MASS. MAP SEC PCL LOT HOSE `( _.