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HomeMy WebLinkAbout0057 GLENEAGLE DRIVE - Health 57 GLEN EAGLE DRV, CENTERVILLE A — { UPC 12534 No.2.153L R . MAKIN00.Vol No. FEE COMMONWEALTH Of MASSACHUSETTS Board of Health,&le io,i-cJo Ve ,MA. Q APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application fora ermit to Construct(tKRepairO Upgra eO Aban on ) - ❑Complete System ❑Individual Components Location Owner's Name '� Ev f -r) Map/Parcel# L p c� 1 q _ 3�, Address Lot# `. Telephone# Sob- LA "- , `kZo Installer's Name M$h Designer's Name �- h s • /T a ��- ,-) Address P, D a X G Address �� ,1!L �3 ���� L-0,, Telephone#S6 -3 S' OAS Telephone# Type of Building ��\�1 SZ~ � Q�����a �(.1.%t? � ��. C Lot Size } C - sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures s� � � Design Flow (min.required) gpd Calculated de _ �isign flow Design flow provided 3� GQ gpd Plan:-Date - L Number of sheets -1 Revisi Date Title (� 1� Description of So`Cl(s) � ' POIA Soil Evaluator Form No. r - l ' Name of Soil Evaluator 0�&i,I4!.LC/rO 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 and further ajenes to not tc lace�e system in operation until a Certificate of CTpr--C�0. e has been issued by a Bo d of Health. Signed /I"4 d !J /r 1ol A ti.FJFfi- Date q v— Inspectiow,:s 9 ... I ro i y .No. �>-�., �j _ J• 4 � FEE n Board of Health; 'V) :e � MA: �'\ APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application fora ermit to Construct(i-yRepair( ) Upgra e( ) Abandon( - ❑Complete System ❑Individual Components � 6o/d/a �vG-�+ Location �.��(''// t �C,�+J0 Owner's Name 1 ill�ow t ?,v f) Map/Parcel# - } = !� i ,9 4 3�o Address rJ �3 L - Mmmt1► k Lot# Telephone# Qb-*,L-n- I Installer's Name a h w,s Designer's Name - , p d Address D r Address aX Ic �s t �--++ Telephone#S'0 5 tL-19f, - 3�!S 1 D ZS 4 Telephone# Type of Building 9-- `-Qr .�,a �,1.�P�� ',1 Cs;�- Lot Size (jj sq.ft. Dwelling-No.of Bedrooms _ Garbage grinder ( ) Other-Type of Building No.of pelsons Showers ( ),Cafeteria ( ) Other Fixtures _ Design Flow (min.required 0 3 1 gpd Calculated dejsign flow Design flow provided h s2r,gpd Plan: Date Number of sheets 1 Revis' n Datey� Title �IJ.Q S t1 � I Description of Sol (s) tt -- Soil Evaluator Form No. i � 'W Name of Soil Evaluator -CkDate 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 and further agees to n- - -ot to lace�e system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed A'► -1,�l�i ,d t i Date ( ,�a. �`7 ov Inspectitis�1 r • No. � FEE /4OV, COMMONWEALTH Of MASSACHUSETTS Board of Health, C "Q4.. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) r Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed,4, ,Repaired ( ),Upgraded ( ),Abandoned ( ) le has been installed in acc rdance wit the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. �d'a"ted x ''� `` Approved Design Flow (gpd) Installer A 1 r - Designer: Inspector: !!%? . _ /.�; i Date: / The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. C i'.kY3 �l` FEE f C®MMONWEALTH OF MASSACHUSETTS r t\ h��l ` , F Board of HeaCCli` �� MA. y Ar DISPOSAL SY'�N'[(ONSTR CTION PERMIT Permission is here�y nted to; Construct( Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at 't- -� �� �'I as described in the application for Disposal System Construction Permit No. 4sated '� 4y � Provided: Construction shall be completed within three years of the date of.this permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health TOWN OF BARN STABLE ®��;�/�� LOCATION �/Ieh EaO4 SEWAGE # _'2a VILLAGE (.�n,��2u��f CO ASSESSOR'S MAP & LOT IG7 INSTALLER'S NAME&PHONE NO. �(T(!U 9 �a(��®fu S SEPTIC TANK CAPACITY i w6 LEACHING FACILITY: (type) Icn h ita NS (size) iJ NO.OF BEDROOMS BUILDER OR OWNE U PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A Feet Private Water Supply Well and Leaching Facility (If any wells exist ei on site or within 200 feet of leaching facility) hF Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ,� Feet Furnished by TNA"v-d. ° T. 0 W- N of 4 5 Tali 'e- d LOCAT16N �Ch �—T VILLAGE •SEPTIC PERMIT NUMBER -1-1 DATE ISSUED ENGINEER APPROVED DISAPPROVED SIGNATURE DATE ' DATE COMPLIANCE SENT a $ah4h HARK 3.3 Gvtk4a V �I�,fi y',o" Fo�,►�atioa Near _ � O.Tl tD tot �t •�" x f,l va{ors � -FP, L A. PLC TOWN OF BA RNSTABLE LOCATION e SEWAGE # VILLAGE CD,011`¢.ul 19 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. T rl aF1�e IDS Cal SEPTIC TANK CAPACITY LEACHING FACILITY: (type) : to 3�i J j hata 1'S (size) [J NO.OF BEDROOMS 3 BUILDER OR OWNE ^Ua PERMTTDATE: qoLcl COMPLIANCE DATE: Separation Distance Between the: 1i 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�Ma n 0 d a E 4.>Q1 S � �► b ly 01 �- Zl T•1- 491`1 '0 �;� 4�- vel S �'t. 11T4oH $'9'4 tTvpo, 01. 1774)MOD E C WIN 4'wag '7 7' 7 7 �7 c 7,7 AREA YS TEM !" POFI '30 CALE: 1­7 ' N0T.:,,7O-"SCAE 6 A el 6 Y X 04 T-XPM yol �Fliv rADE 60V�OWA Mr0AAAVl TOW OF'BARNSTABLE. UHA VE MARCH 30. 1999 0, .30 0, OVER TOP,FA(D NO TES; 6r�, rRON I EES CAST A -7 14 .54�' 49sm 'T FL J.� ELEVA TIONS,'BASED, OlV..ASSM'D 0 150 -, AL TE�TOW EGUA L _ 2 IV,WA TER i�* 4 FORCED,FL 000 ZONE "VC Ar' DIS T'-WX CONCRETE A �BAAFL 0 BE rl INSTAL E VEL rA BL E'��S 4 SEP TrC,�'TA NK OR TO. BE.,rNSTALLED :ON A 92 VEL STABLE�,,�?ASE',LE' L '.�`AQUAFrP PR0TECTX0Af,0VERLAY:DlSTRXCT A BO VE�'OBSER VD EgUrPMEIV 0 VE , A10 TE.-,DO WO T 'RUN HE4 V Y TEM XA ER -SECT-10 L EA CHI NG -'INFIL TPA TOP PER COLI NO �' AN T, TO,�,,SCA L E P,�6FL FOP 9PA DE SEE S YS TEM lot m IV 2 ­ 1/8" 12_�, RC `RA E, WA SPED $tOl4e -A KE "B rA/ 7 Ir rNESSED BY 41TOAA 'I rle Avo ,-.D4 T E A -4 'DIA PIPE TEs r,P, EL Ev r EFFECTIVE IVA TUPA L S011- '47 40YR AVY�iaw LOT 13EP LOT 16 , L 3 4 �il, 112 4� WA SOV L OAk 10 y �4A 10 SHED 5 TOINE EFFECTIVE WIDTH y TED IDEWA EXCA VA LL 13-05'12-E -4v Ica 100.04 -------------- AV Z'Sy 616 D8 Se TEIVCHES.`­�l NUHBER�VF, c �aan th�robbjv�, d id &and mi th Cobb!_00Z r�ve NUMBER F INFIL TRA 5 LOT �5 0�74.t �20 PROPMED LEACHNO QESIGN­"DA XAFrL MA MRS MX TH TREWOV VIM f4) 41 MW ALL AA m f7.f ,,, S.''F. SIDENALL ', AREA 74,-'&A L.�91S,��, OALS� ` NO.�OF� x -10' 2' 01 10 DrSPOSA L, GA �346 'SF, A90TTOM ARF_Ar � s sp L S TO rA I-"'DAIL Yzkh�uE '256 Iser PnaM IV /` 74:,,GAL 'i�S T4 &A L RESERVE sEpTrcl,,7-A AEA 'GALS F. TOTAL, (GALS/S�r 4t _-GENEPA L 00 NOTE., LOT '6 'AL:L�,-,SY.15;rEM-�COMPOIV,��'t.�; �:sjqA L-, AL BE IN, 0 L LOT,�4 S E :A CORDA WI TH TITLE'.5--OF.,,'.'4,��7-HE-"',�,��tA'7',�� -SAN. AP SEP rp 2 EXCA VA 7E TO EL V­41.C) �OR L O)vtR' �qeaurRED TED NA I 'A 'AN it'OCA PUL E.5�,,APPLIeABLE: �A 0 REMOVE� LL �LoAk�A CLA CON AIING T, ' ANY CHANGE ;IN THIS,.'PLA mA 7,6,qrA L,:BENEA TH, rw L EA cHrAts �A 4EA.REPL A N-. T7 Y EXCAVA TED HA ��IAL P.7 TH Ct_'EAN,� A K REE`GRA VEL, _TWAND`I-FEPPEIP,� ',ASSOC."! PA0P0SrD'(%j C4 F THE, 8 OA RD, "OF 'HEA L �amnoa,4 House BA G /vG CONS T UC ION',:IS �'COMPL E TED'�)HECHA NICA L L Y COMPA C TED INPLACE' 34,; WHEN _BOA PD 0j:" "H AID.'EL V MUS T'.r E,:CHECKE, E COMPL P6 Y rp I �167 EA L TH'FOR "INSPEC ON:, r TeD 5.� TPESE ,ELE V.:MUS T� NO T� 88,'�CHA N LEGEND' ' T HE BGo T" -0F, I 'D' 'WHEIV VA PD E H A L H -NSPECTON,,-RE0 6, BOA EXIS T.GROUND ELEV. 50. 01PA INISH GROUND ELEV. EL. 50.0 ASSMID FA '7V SPO "PLA SEW AGE 'DI SA,L' ��`SYSTEM,, PIPE:.rAf VER 7' ELEV. '100 00 PREPA RED. 'rop, PrT L OCA TION S 11 *31 40 IN TEST. SEP EV F_0_0� TIC, TA EL� TRIBUTrON BO, -78L ENEA DIS LO 4 PVC OR SCH 40 4*Br T.FrBER PIPE-TrGH DA A 7��EPEIRA', ��OCXA TES::�,� AROPER T L .wf, w1v CK 'AS S 19A DS 4AICE �,SPP. NG; A 5, .6 63 AP SEC PCL M *ED TH,�:.,, 4A SS N- '7 7 t % %: 7 APEA PLAN, PP6FIL�- SYSTEM LE* 30 ,' SCA �A )VOT ' TO SCA L E'Z' ',FINISH GRADE —P- 7iE TXQ -flQ1 WORAMI 'INISH�,GRA DONNA TOW OF BAWSTABLE GRADE FINISH j�LA 1999 RCH 30, 'OVER TRENCHES 0 VER TANK 0! WY, F171k�7/11 TOP:FN0 lip NO TES;, SCH 40 PVC'� OR CA S r IRON I EES, 47.9 it SED ON A SSM*D 4- I.' -EL EVA TIONS BA BSM*r FLR v . 4. SAL EQUALIZERS. 2. TOWN .WA TER ON SITE 44-.o REINFORCED GA S DIST.80X 3. FL 000 ZONE "C �A CONCRETE I 1� I P., A:F:��:E: INS r ro"BE ALLED A' LEVEL-,,STABLE BASE 'T ' SEP TrC TAW L RENCH� ENG TO BE INS TA L L ED ON LEVEL 'STABLE'-BASE "A GUA FIR PROM0710H OVERLAY DISTRICT APR . ' NOTE.' DO NO 'H 5'MIN. FIGH T f uN HEA vy EourpmENT o vER Z YS TEM A BO VE OBSER�Eb GROUND WATER.- LEA CHING ' INFIL TPA TOP SEC TION ............. Nor To SCALE. SOIL .; AND "PEPCOLATION -DA TA ., FOP FINISH GRA DE -9376 PMArraV AV. P SEE S YS TEM 'PROFIL E mi/v �P 115 -J 11' WASNED S TONE PEC.:RA TE oo TA KEN 8 MI MESSED BY MIAMAN21 DA fE PEROD-A r 68 4!'D-tA.PIPE TEs r ess rmv 5 NJ PIT ELEV.�:, e too TEST WE I NA TUPAL SOIL EFFEC 77 VE TEST AX DEP *0 Or 16 TH, L LOT 15 S. AAvyLa4N,,-J0YR512- :.,i Amylaw '.fom 314"1-1 -112", WASHED S TONE SANDY La4M YOYR'518 SAAM EFFECTIVE WIDTH ', LOAN''JOYR 5 8 FO SIDE:WA L L EXCA VA 7 0 1-10 1 32, _J3*05 8JR IVE 4'-0' 160.04 --------------- NUMBER OF TRENCHES SAND 2,15Y 6/6, ffledJUR - coarse medim— coarse sand with cobbles sand with cobb�as stones 9 PDX oravel 202'of-evel TRA TORS NU ton" 9 SE :Or' 41�IL LOT 5 18, 074.tSF AV 19ROLMMA MR PROM Acww rprAcH rm mi -QATA DE IGN ' F SIDEWA 171 S -' 126:&ALS. 4' STONE ALL AROVAV L L' AOEA 74 GA L SISF NO.OF BED�?OoAis, 32' x 101-10,x 2' 346 . S F. BO T TOM AREA" . �G ' ISF , I �' '. DISPOSA ALS 256 ,GALS- ''EST. TOTAL 'DAILr,,EFFLUENT�-MO "SEP -'TA W Q-Q-� GAL, -382 GA L SISF 517 : S. F. TOTAL AREA GALS' NERAL OE "OX 00 NOTE., 'LOT 6 -� BE' IN TALLEDA LOT 4 - ALL S YS TEM, COMPONEIV TS SHA L L es IA f5oo SAL 9EPTic I I I I I I .I I - I I . I ,,, I, .1 ., 4 --lITLE 5, A Tt'-SAN TA R Y6�L OD A CCODA Alet ,XI 7H ' T' E YAW EXCA VA TE, TO EL EV. 41 6-OR LOWER A S REdurRED OF H ST I E' TO REMOVE.ALL. tOAM AND CL A Y CON t4 11VIAtG DA TED, MARCH UL ES APPL IC, 19P5 �,ANY LDC AL ' P - 26 t-- HA TEPIAL BENEA TH.,THE L EA CHING A REA.REPL A CE 2.. ANY CHA NGE IN THIS L A IV MUS 7. BE- .A PPRO VED EXCA VA TED -HA TERIA L W1 TH CL EA N,CL A Y FRtE pnopasm 0) GRA VEL B Y: THE. BOA RO ' 6F, HEAL TH AND .)�:E� SS Aamwav msE FUL ASK HEN,,CONS'MUCTION "I .COMPLErED,�PPIOR. TO`HECHANICALL Y,compAcTEorA1(, PLACE 8A CKFIL L OF-'HEA L TH FOR 'INSPECTI 06 4 COMPLETED FAO,., 8L E V f 5. THESE, ELEV. MUST,-NOT-SE:"CHANGED WITHOUT. L EGEND PPR AL:� ' . RO -HE' 7 A OV RE01 H 'D WHE ECA VA MD, 6, BOA RD OF,-HEA L T TION EXIS T.GROUND EL E V. -50................... 50 DEqCH NAW W&60FPAV*T. a. 50.0 ASSN'D -GRou ,7,ELEv. FrlvrsH 5POSA L SYS TEM �'-PL A SEP A GE -LEV. PIPE.,IAIVERT r- '100.00 PREPARED S 11 '31 140 NA/ rEs r Pr 4 oai Tim CHA EVEN.". 'SEP TIC TANK EL DIS uTrolv aox ENEA GLE"',DRI,�'.GL EN V& 13 rRrb 4 ffC..t.OR:SCH 40 PVd ABLE,'.� WASS ii�- 4 0Br r.FER i;,.rpE-rrGH T ODI TS -AP PROPERTI LINE DESGkED: S DATE RU. 4 199-9 ER IRA�.,-ASSOCZ4'SET BACK DISTANCE :SCALE. AS-,SH0 I SPqIiVG 63 L U MO n1 in E NO TjE%5 71 00�,- CHECKED MAP SEC�� Pa'� Lqr- IHSE DRA WING N,