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HomeMy WebLinkAbout0287 FULLER ROAD - Health 287 Fuller Road Centerville A = 189 084 Ompford, NO. 152 1/3 ORA ,;'. 10% 9 • e • J.E. KENI>fEDY & SON TRUCKING AND EXCAVATING 575 WIL:..OW STREET WEST BARN4:;TABLE, MA 02668 Tel. 362-3005 SHIP TO _ Ll (��/ w - w DATE DATE REQUIRED CUST.ORD':":R NO. TAX EXEMFT NO. TERMS F.O.B. SALESPERSON SHIP VIA x o ; QUANTITY DESCRIPTION PRICE AMOUNT .j t f/� I , rp Ao- TOTAL THIS SLIP MUST ACCOMPANY „7 ALL CLAIMS AND RETURNED GOODS THANK YOU TOWN OF BARNS�TABLE LOCA:'.ICN �7 F v/'le 2 OZ l%J SEWAGE #Zeloa VILLAGE C c i t 2 vt � ASSESSOR'S MAP & LOT 1Sq ` $ c/ INSTALLER'S NAME&PHONE NO. q l c%/ T Co s o 7 s- f 3 6 SEPTIC TANK CAPACITY LEACHING FACILITY: (type S CAA^Se 2f (size) 3 3 ,SAX!� NO. OF BEDROOMS BUILDER OR OWNER 41s,9-s Sn, Y C, & �e PERMITDATE: COMPLIANCE DATE: O 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) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by :. ,. e 3����aCA i3�L� 03 � � d TOWN OF BARNSTABLE LOCATION ,/ y�� � SEWAGE # VILLAGE � � ASSESSOR'S MAP & LOT "Ov INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY I' �� LEACHING FACILITY:(type) f size) NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VAR-IANC 5TE Yes No c °d ' � �� C�+��- r No. ,owgj � � _ Fee L a ! THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Miopoga[ *pgtem Con5truction 3permit Application for a Permit to Construct( )Repair( )Upgrade( Abandon El Complete System ❑Individual Components Location Adss or tot No. Owner's ame, ddress and Tel.No. Assessor's Map/Parcel / Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. pfLc r! Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building Z S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow `� G� gallons per day. Calculated daily flow gallons. Plan Date `� / 0 d Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S.(_)? Description of Soil Cat' Nature of Repairs or Alterations(Answer en applicable) l r 2 t9c& Td 2�?&' k C-30 s pv 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 is d by this Board of He Signe e Date 7 Application Approved by Date Application Disapproved lor the following reasons Permit No. Date Issued No. f Fee THE COMMONWEALTH OF MASSACHUSETTS t Entered in computer: Yes PUBLIC HEALTH DIVISION,:-TOWN OF BARNSTABLES MASSACHUSETTS application for Mi5poml *pztem Conotruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( Abandon( ) ❑Complete System ❑Individual Components Location Adss I�ot No. 7 �Pf' Owner's Name,/fAjd�dress and Tel.No. ( E'� Assessor's Map/Parcel / S Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. — ecr� Go�vsi Go �/��� �•r/ ��y�2 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 5;4 5 9 / gallons. Plan Date -7�/ 0 Number of sheets Revision Date Title Size of Septic Tank / �� Type of S.A.S.(_V yy Description of Soil �►�- ` Nature of Repairs or Alterations(Answer hen applicable) ���� f1 c "k^ 7 , d % 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 is ed by this Board of He / Signe - _' -Date �/ C Application Approved by 7 1— _ Date Application Disapproved or the following reasons Permit No. Date Issued r THE COMMONWEALTH OF MASSACHUSETTS } BARNSTABLE, MASSACHUSETTS', Certificate of Compliance �- THIS IS TO CERTIFY,that the Og-site Sewage Disposal System Constructed( )'Repaired ( )Upgraded( Abandoned( )by f� (�'v 5"?` C at o2 � 7 /���� 2 �'ti 2 / -rm .has be n,constructed in accordance with the provisions of Title 5 and the for Disposal S stem Construction Permit No. ` ,led P P Y - Installer '� + Designer The issuance of this pe ` 't shall rdot be construed as a guarantee that the s stein will faun tion as des ned. (� Date :Z�` 1/N Inspectors 7�0 A Q, t No. (� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS xi5po5al *pgtem Con!5truction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(-1 Abandon^( ) System located at I:)- 7 U � 2 /2i, C L- v% /-:^2y/ 7 -P /"� o cJ/-( d Li S i9 S 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 a comp ted within three years of the date of this peiwl Date: / Approved by r � rs i TOWN OF BARNSTA:BLE LOCATION 02 le-2 (� SEWAGE. # VELLAGE_. C C TE 2 Ile ASSESSOR'S MAP & LOT/?q ` $ INSTALLER'S NAME&PHONE NO.AA cH 7 Co So SEPTIC TANK CAPACITY �.S o b G-ig ��e •�.S LEACHING FACILITY: (typeC3�S'�v ✓kSr4C (size) 3 ,S'aC/3 '�'a NO. OF BEDROOMS BUILDER OR OWNER Z PERMITDATE: COMPLIANCE DATE: O I` Separation Distance Between the: 2 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) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by B -0 ��, � jT Sa.► _.......... - SL14eA, QC a� ASSESSORS MAP : I09 TEST HOLE LOGS NOTES: �v PARCEL : %� 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH ' � S FLOOD ZONE: BOARD SOIL EVALUATOR: �f2-�-E<� � � +vl��l� ,�THIlS PLAN, 1995M TOWN OF RD OF HEALTH REGULATIONS. [ WITNESS :. tom' REFERENCE: -t DATE: JUrlc- 'I� 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, \ s. 2p2 PERCOLATION RACE: -2^^�� �� } SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO ( (21,A55 ` i LTA ' 0. Y �Pd INSTALLATION. TH- I << .d? ` TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION O CL -, — ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE LUS �I L-L_ DETERMINATION. L� p 4� 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS 103,44-t A SA-/Jv IbY�3/2, SPECIFIED OTHERWISE) LOCATION MAP QQ Lop my ( 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A 5 `� (l( GARBAGE DISPOSAL. MEDIUM p 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON r SfEd�l 2� c- r U,7 A BASE OF 6"OF CRUSHED STONE. 1 if l+�a vA/-ovv76 �. � r��� vNs�� t. Sots _.' !✓ . e �N __. I SEf.,T I C: ��YSTEM DESIGN o I _ w �'c Meo�sA-tQD. N Wf171�n 1,l/ve I I ` BE DROOMS AT I 10 GAL/DAY/BEDROOM - 440 GAL/DAY /©y nig- PPj J SEPT I': TANK st vA'L , 44U GAL/DAY x 2 DAYS - GAL /Z. �C�__ Lm 4nN�1_'____I_�3 14ZO �{jtrDl/`� - -- W 1 / USE I GALLON SEPTIC TANK /3� /lb I/g-,+21.9�h/GS �6 �117, rZ/+/SjI F GF , 4� L� o z 7`b p C/ LAYe(Z- ' / I SOIL .kE'SORPTION SYSTEM --�40 4A7L t o J N Z0 LOAcPeO FrzcCA-S rT- .-,-I s^-4AM3�EY, lal/Air =„ in;: ,-„ / c: ���� C / t, vI�rv��x7ID 1 8 j SIDE AREA: 3. 2 13 2 2. X 64- - ' VN PAVE o a L N BOTTOM ARE A: 33,5 x I3 k O, ?`f 322 .2 7 p2rVE �,,, ..� 5Z - `�-- �� SEPTIC SYSTEM SECTION64 - - 51 0 — -- _... IN toll i 14 � . Z11 1.� �a lam"�5 ✓te se ? CES�� � �h �vj 13' L .___.J GAL , D�-G B OX �Z `� �b��" ��' •(�d �� ,���C'��� ?LV►AaitJ � PEs2 .� {( f SEPTIC TANK O 1 CIO ugt l N , , lUN'I o T�sTl¢yLE, &L z 31,0 7 or 5� ) SITE AND SEWAGE PLAN LOCATION : Sp,oo ` 01 40 - sA � s PREPARED FOR : ; H :V A) 7—e- IVC,I ICE C / SCALE : / zU. Coe DARREN M. MEYER, R.S. 43 VINE STREET DATE: 7_/0_ 02— DUXBURY, MA 02332 DATE HEALTH AGENT (781) 585-0293 3 z