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HomeMy WebLinkAbout0006 HAYES ROAD - Health Lyes Road , h ville F/R 10 103 v i Omrford, NO. 1521/3 ORA 10% f No. / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for Oi!5paal *pgtem Construction Verna Application for a Permit to Construct( )Repair( )Upgrade(Abandon( ) El Complete System El Individual Components Location Address or Lot No. 6 Owner's Name,Address and Tel.No. �( , LIL Assessor's Map/Parcel 2 i o _ i tAfQj.".Installer's Name,Address,and Tel.No. t 'Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building o.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 13a gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1000 Type of S.A.S. as )i a Description of Soil Sul o Nature of Repairs or Alterations(Answer when applicable) lb"�Q°anti ,ntiq�t2_Q_ AM", 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 Hea th. Signed ` Date 9 ®off. Application Approved by Date Application Disapproved for the following reasons Permit No. 2Co2 Aq Date Issued — _O 2 Fee v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppltration for Miopooal*pgtem Conotruction Permit Application for a Permit to Construct( )Repair( )Upgrade(/Abandon( ) ❑Complete System ❑Individual Components �d L( Owner's Name,Address and Tel.No. Location Address or Lot No. 6 � R- Assessor's Map/Parcel 21a ►t�3 Installer's Name,Address,and Tel.No. t Designer's Name,Address and Tel.No. � a 1F1oV1�04,� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building oi oNo.of Persons Showers( ) Cafeteria( ) ` Other Fixtures Design Flow \ 7 gallons per day. Calculated daily flow ,© gallons. Plan Date 91 L4 OD- Number of sheets ` Revision Date Title Size of Septic Tank n �� . 1000 Type of S.A.S. 13 Y X5 Description of Soil a1, l//ulft'Ad- , i Nature of Repairs or Alterations(Answer when applicable) - �?��` 0 i Date last inspected: Agreement: "1 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. ` Signed bs� A tw,.,1 Date Application Approved by O t' Date 'Application Disapproved for the following reasons i Permit No. ZGY>Z 39 6 Date Issued * THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance f THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( �) Abandoned( )by at VLIU 0 Rkm IVY11.9 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2002-�!�dated 4-L'O Z- Installer ' Designer VJ,0 %1yn t QLAA-0C/- The issuanee of this permit shQ1l not be construed as a guarantee that the sy fem>will function a/g d signed. Date - 11 - 0 ? Inspector /41-0 4a• --------------------------------------- No. 2 no I--?J/"t Fee ' ,. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS i5ogaYp5tetn Congtru Lionertnit Permission is hereby granted to Construct( ) epair( )U rade( Abandon( ) System located at _ �Q � b 0 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:C s io 1mpleted within three years of the date of this pe Date: 2 Approved by i TOWN OF BARNSTABLE LOCATIbN �1+9 AYES SEWAGE # d 39q VILLAGE CP.�,�e�v.�C l,� kSSESSOR'S MAP.& LOT 210 —/03 INSTALLER'S NAME&PHONE NO. .7�2 `i 1 2, SEPTIC TANK CAPACITY LEACHING FACILITY:-(type) (size) 13J25 NO.OF BEDROOMS 1 BUILDER OR OWNER1 1 XIS PERMITDATE: -6'U COMPLIANCE DATE: -1 `0 Separation Distance Between the: f 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 leac ft cility) Feet Furnished by r � 2 �3 .XZS ` —�� .L do3� is �.� C_Z AN • ✓wI V • I tv Al e _.J A TOWN OF BARNSTABLE LOCATION �++ Y�S SEWAGE # VILLAGE l,P� Rv ll,�� -�^ ;ASSESSOR'S MAP & LOT 0/0 -103 ME INSTALLER'S NA &PHONE NO.V Dke%)M 1., lwr c, -7r 2 `,rt q q Z SEPTIC TANK CAPACITY LEACHING FACILITY: (type) L4(size) «�2� . h NO. OF BEDROOMS ¢� BUILDER OR OWNERC��> PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: I 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 2001eet of leaching facility), Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300°feet of leac rn� cility) Feet Furnished by o � 2 13 X2 5 -� _4T s' .J FEE E O THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............1aW�----.....OF.....l� , , ,�,6 - ............................. Appliration for Uhip aal Marks Tomitriirfivit Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ban Individual Sewage Disposal System at: r Location-AdIress _....-•..................................... Lot No. �lcZ. ,, 41 K .............. w er � ................................Address ......... L . ----....._.. ------------ Installer Address UType of Building Size Lot............................Sq. feet U ` ,� Dwelling�✓tv o. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons................_........... Showers ( ) — Cafeteria ( ) Q' Other fixtures ---------------------------••-•- W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity............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. s Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................•-••••---••-•••--- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water----------.-_-__-_--___. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------- O Description of Soil......•--s �� W U ............-•-- U Nature of Refpp rs or Alterations—Answer when applicable....../7rT,/®04...... - -------- .1/ ...........•.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLi, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health /� ApplicationApproved B •------ • •• •--••--•••••-••••-••...........••------••-••-•-••-•----•----•-•-------------•--- = ................... Date Application Disapproved f th f ollowing reasons-----------------------------•--------•-----------------•--------------•...................................... w Date PermitNo......................................................... Issued_...................................................... Date LOCATION SEWAGE PERMIT NO• VILLAGE INSTA LLER'S NAME i ADDRESS it 3UILDEIII OR OWNER r DATE PERMIT ISSUED DATE COMPLIANCE ISSUED S- 2-3 �',` � _ 4� _ t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��V! --�elo-17-:4- le.............................. Appliration for Di"asaal Vurkg Tonstrnr#ion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( -_)-'an Individual Sewage Disposal System at: d,�j yy� ,.y// .. ...�Y- '�!- L.�.�...... -AAA* ___......�uG.a:K-•�GC�C zz� ... ...................................... .. .........._...--....-.-...........--..._. .... ............. Location-Ad ress or Lot No. .:.iL sUc•.^ ti�y` ........................................ ............................................... ..........._......._..._..-'- ......_._ owner Address 1--A). ...........g44_:- ... .................................................................................................. Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling To. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) aI Other fixtures ..................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity-------_....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. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil........ U Nature of Rep irs or Alterations—Answer when applicable,-____d.. //j1'0._..._. -....... ................ "" ,. "► ----- '...........` --e----------------------•---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of heal � �D>1 e Application Approved B ---------------- Date Application Disapproved f th ollowing reasons-------------------------------------•---•-..._._.....---------•--------------------....••.......-----•......---- ••---•-•-•---•--•-•-•--•--•-•----•-----•-••-•---....-•---••----------•-----••-•••-•-•-•---•--••••---...----•------•----•-•-----•--•••-----•-•---•-•------------•--•••---•-•--•------•-••--•----•--...--- Date PermitNo......................................................... Issued....................................................... Date 3'• `k# THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH s ..... ........................ (urrfifirate of Tomphaanrr THIS IS TAD CERTIFY,That the Individ al Sewage Disposal System constructed ( ) or Repaired by------------- ••-- l'� r 6. C!s ....-----•-•----•-----------......-----•-•---------...------------- Installer at........ -•-•--�` 'k`` ----- ---•---•--•--- O'hz4.r�..r�1 has been installe in accordance with the provisions of TITLE 5 of The State Sanitar Cod escribed in the application for Disposal Works Construction`Permit _��_.�:7._.__...... dated ... ...................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE �9.._.... �..........�.... Inspector. - ----------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........,� r .�......OF..:....... ;, o e.-------- Dis aasatl arkai Tomitrnr#io rrutii , :1.. Permission is hereby granted ' .• A 1 ...:?`' .. . , . ....... . ._B ................ to Construct ( ) rRepair ( T Indiyidual ... . ge Disposal Syst em at No.--- -------- ------ ................................................................. Street as shown on the applicat•on for Disposal Works Construction Permit No.._._ ------ Dated.......................................... � ._ Board of Health DATE........'Zt! ..................................... yam/J FORM 1255 A. M. SULKIN, INC., BOSTON 1;.--.- PfzOT NOT TO SCALE 2""LAYER OF 9/8"PEASTONE WEgJAq,ET LAKE Fy='41�.0 _ FIRST PIPE LENOTh OVER 3/4"-IV2"DOUpLE PATE: AUeLIST30 2002 P-0-3,p TOP FOUJCrTION GONERS TO WITHIN TO M 5ET LE1'EL WAS1EP5TONE G" OF FIN19-U GRADE. FOR MIN. 2" TEST pY: M.O'LOU6HLN,OSE EL= 42D _ FIN16H 6PADE W IFNE65: L.M cOONNIELL,SOH q-=43af PERO RATE: <2 MN/N ` 4". PVG � .A„ PVG TOP 0 EL. 38.3 q 1 V d �- 5Gt1 4a sr z 500 elAL+��sr vRvwe�s A0.0 FILL 12" '@ -jj i��r�� r bOf'fGM ® EL. '�5G,0 /I A=LOAMY SAND DIST. DO1( � 3 25Y5 SEPARATION 13 W=LOAMY SAND RD+a os'P� 1000 GALLON SEPTIC TAW I 25Y5/4 (EXISTING) {"' STONE r)ASE + >3o Tom Cr TEST m6LE 0 ELEv. v,6 150170M OF PEfRG GI=LOAMY SAND TEST®54" 2.5Y8 f 2 L.OGATION MAP f DE5 ION DATA i �0 M DAILY FLOW: (3)15EPROOMS x I P OPP=330 OPP 25Y-7/6 5EPT6 TANK: 330 C�PP xl.00%=G6O ePP USE. EXISTNO 000&AL.5EPT1O TANK LEA(�N500 GAL PREOM5T PRYWELLS LINEP WITH 4'OF NO WATER ENGOUNT�RED + USE POUP>LE WASHI=P ST:°NE ON 51 PES&ENP5 OAPAOITY-. 4(a SIPEWAU 7G x 2 x 0.74 = (12.5 BOTTOM: 13' x 25 x 0.74 = 240.5 GAT g / WATER E / 48 TOTAL: 353.p 0PP GENERAL NOTEe CONTRACTOR TO pE RESPONSpLE FOR THE LOOATIONOF ALL UTLIFES, �1 ABOVE AND UNPER6ROUND,PRIOR TO ANY EXCAVATION OR OONSTRWTION. 2. SEPT L 5YSTEM TO PE N5 T ALLED N GOMPL IANGE W ITH 312 GMR 00:T fi'LE V I i r:)r LNN u::f 1=OtZ r'RG-'ER i Y L t VE i LRl,Ao A ON / / + ---�4 / -4. ALL P15TUR FP AREAS TO 15E LOAMEP AND SEEDED 5. OONTRAOTOR TO PROVPE 74 HOUR NOTCE FOR ANY REgUREP NSPEOTIONS. EXISTNC7 LEAOH PIT,ALONG WITH ANY OONTAMNATEP SOILS,TO f5E REMOVED. c �ouNDAT�N - I ExOrNG ELEV. 43.0 I LEACH PF 45.0 Ex�rNr� m \ \/ SEPr6 TANK it � \ \ \ \ 1I O40 N \ TE �5EVVAaE FLAN LOCATION: (O MAYE5 RP., OENTERVILLE, MA PREPAREP FOR: J. O LOUO IL I N, I N O. SCALE: PRAWN f5Y. ■R Add P ° J0 , MW ER: PATE: SHEr-T: \ \ \ '^•'i .-', Ur11iB.A. m DAWL 1. ~ BRAMAN G - (.//'—IO8 ✓ ✓�0'"1—�OV/� �P—I WELLER & A�5�506 I AT -�5 ffn \ �(ss'aHA�E"G• IT ENTERVIL.LE MA 02(O3a \ . � -S_�Z I�� FALMOUTh RP N SU E G G , \ '. 7-, 0 TEL (508) ��5-0�35 N FAX: (505) T 15--0754 \ PROCESSIONAL ENGINEERS & LAND SURVEYORS