HomeMy WebLinkAbout0093 HILLSIDE DRIVE - Health 93 HILLSIDE DRIVE, CENTERVILLE
A=193-084
No. 42101/3 ORA
ESSELTE
10�
a o 0 0
/ 4
TOWN OF BARNSTABLE
N - / Y
LOCATION f_�!'T� / �' SEWAGE #
17-ILLAGE %i_/,�/G� �F /�C ASSESSOR'S MAP&LOT ` Y, -" ? '
INSTALLER'S NAME&PHONE NO. G1/Sd! je ' /1�2 6,6 111YTO rl —,-77 e 77C
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER &2.,T
PERMITDATE: 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
�o v�'c
� � � �
�� � � f ,�l
� f./
�`� �`
� � �
� �
/Y. - OS?
No. �� 7
e. THE COMMONWEALTH OF MASSACHUSETTS {
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pphCatton for Oizponr bpmem Com5trurtton VCrmtt
Application is hereby made for a Permit to Construct( )or Repair(.�<an On-site Sewage Disposal System at:
Location Address or Lot No. Owner's Name,Address and Tel.No.
q.3 171-
/- /�
Installer's Name,Address,and Tel.No. 77 7 7 rP Designer's Name,Address and Tel.No.
C7 K"e w /�
Type of Building:
Dwelling No.of Bedrooms 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
Description of Soil —2 ' 17eq
Nature of Repairs or Alterations(Answer when a licab e)y9.r0/tiorrl�l zary c/�/ <S'76-1te,���C2rJ
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 jkoaroobf Health.01
Signed _ [/� Date' f/,/~,q
Application Approved by
Application Disapproved for the following reasons
Permit No. Date Issued
No. / .� Fe d.6W
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,MASSACHUSETTS
2pprication for. Migool *raem Congtruction-permcit
Application is hereby made for a Permit to Construct or Re air an On-site Sewa e,Dts osal System at:
Location Address or Lot No., Owner's Name,Address and Tel.No.
Installer's Name,Address,and Tel.No. 77 5"6-7-7 1p Designer's Name,Address and Tel.No.
c>J �
Type of Building:
Dwelling No.of Bedrooms Garbage Grinder0 s
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 F
Description of Soil �f7�
Nature of Repairs or Alterations(Answer when ap lica le) Oi1/9� O�
Date last inspected:
Agreement: t
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 ar f Health. '
Signed Date
Application Approved by,
Application Disapproved for the following reasons
Permit No. Date Issued 7
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Certificate of Compliance -
THIS IS TO CERTIFY,�tiat the On-site Sewage Disposal System installed( )or repaired/replaced(A115 on
by!,r/ /7n E'Jirl, ✓/�t;�K. .�2/!� for A
-as l e has been constructed/in cco;rVgce
with the provisions of Title 5 and the for Disposal System Construction Permit No. X& /Z dated
Use of this system is conditioned on compliance with the provisions set fo_qb below:
IF
No. qC0 /•7 Fee 70
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
lwigoar &VOtem Construction Vermit
Permission is hereby granted to P /icer
to construct( )repair( an On-site Sewage System located at
L. andscribed in:the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
ith Title 5 and the following local provisions or special conditions.
uction mustbe completed within two years of the date below.Approved by `id�
.Si 7-
LACATION rC�?!TE7?✓/C �`�� h�
30'. . , DATE .?DG ,'4
PLAN REFERENCE ,!- c? ':F . .LoT,B a
t:Zw, 7DP OF
Cave. &0vvv .s /
La 7-
8
b
0
Pi r
/ `0 O
A eo y , 7;V.z
•� /op
/zES E vc i -
/ 1177,00*
D l Ple/✓4: 4o WODE
/ l
Joe 67
/DO
JARD y�•
d t
E.
KELLEY 4
No. 26100 �o
Lf$L
Pe71-T/0 N�J2
_ 1SMSORS FLAP NO:
No "- ---- FEB... .............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
........... wni........OF........ ......
Appliratiou for Dispasal Works Tonstrurfivit Prrmit
Application is hereb made for a Permit to Construct (✓) or Repair ( } an Individual Sewage Disposal
System at: 4u�e_ 9-7
-------------------------------------------------•... ••.
�� Location-Address or Lot No.
- ....�i,�G�--•......................... ...........................................
"-•--•-------------------------------•-•--
Owner
.S'�jZC.E77 U.✓ Address
� _/. --••--- ---•- ------••'-•-------------------•---•--'_......_.- --•---....---•-------•--------•_._..•._-_...Address
Installer
UType of Building Size --------Sq. feet f
Dwelling—No. of Bedrooms..........3..............................Expansion Attic ( ) Garbage Grinder ( )
�a Other—Type e
YP of Building --------•-------------•-•_.. No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures ---•-•----------•------------•------•--:...-----
W Design Flow_.•........_..5.�r._
--------- ---------gallons per person per day. Total dailyflow.............3-�.... __............gallons.
WSeptic Tank—Liquid capacity_I A.gallons Length-A X Width._!?:.'6_".. Diameter-_------_____-. Depth.s'8'�
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area_--_____-_..__------sq. ft.
Seepage Pit No......./----------- Diameter........ Depth below inlet....�::5--- Total leaching area....��..sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
`-' Percolation Test Results Performed by.....�'�W��.__.4r. ................ Date..S�P7_ Z3 /F8K
Test Pit No. 1__�_./-_--.minutes per inch Depth of Test Pit.................... Depth to ground water.._____
(� Test Pit No. 2....L_�----minutes per inch Depth of Test Pit-----1-�.'.--.. Depth to ground water________________________
-----------------•-------•-•-••-----•--•---••---....---------------'--•------•------------------------------------------------••-••-----.•...
O Description of Soil...... �._ .� waaD4o/4-7-7-...............................................®>G "_/¢¢` !'D, S.g-,vim
x
V -----------•--------------•----•------••---•--•----••--------•-•-------•------....--••------------•-----...-•--------------•-••----.._.._-----
W
V Nature of Repairs or Alterations—Answer when applicable...............................................................................................
...........................................••----------•-----------••-•---------------------------------------•--••--------------------•--•---•---•--.....------•-••------------------.......----•-----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of L-t;.;•,. ; of the State Sanitary Code— The undersigned further agrees not to piace the system in
operation until a Certificate of Compliance has been issued Y the b r . f health.
Signed.
�r Da
` ••--
Application Approved BY �" �:. ------------------------ ..----
-.
Date
Application Disapproved for the following reasons---------------------------------••-------•-•------------------•--•---------------•-----------
..................................................-----•-----•------...•-----••---....----•-------•----•..--------...-•---------•--------•------•••---•----•------------•---•----------•-----------••...
Date
Permit No.. - I__ I__�............. Issued.
Date
s 8 --
1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
7 1,i^/ (3�iz�vSTsi c�C.0
_ _._. ....................OF..........I...............................................................................
Applirtttinn for Biquosal Works (flingtrnrtinn Prrmit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at:
.............•----...---•------.....---._...------•-------•----••---....-•-•-----................. ..................................................................................................
.. Xe,4� Location-Address or Lot No.
.....................__ ----------------
------------------------- ....
-.......
•--------------------
.:..-------------------------------------
.._.........------------
Address
Instal er Address
d Type of Building Size -------Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
a4l Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures ......--•--•--•-------------------------- --- -•. .•-
W Design Flow.......................................:....gallons per person per day. Total daily flow...........-3 0.......................
WSeptic Tank—Liquid capacitv�s'p..gallons Length .......... Width4......._. Diameter---------------- Depth°f.A"
x Disposal Trench—NTo. .................... Width.................... Total Length.................... Total leaching area_.___....._....._.__sq. ft.
Seepage Pit No.....�............. Diameter_•____ 2.__..... Depth below inlet.. _S..__... Total leaching area..�`'.._ ......sq..ft..
Z Other Distribution box.( ) Dosing tank )
�+ .�w��.� G... /mac-�� SG-�T �3
Percolation Test Results Performed b •,e! ... Date--------------•.-_-
a Test Pit No. 1..4.. -minutes per inch Depth of Test Pit................... Depth to ground water-__...._........._.
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
........... ..................... ..............--................-•----..-•--
O 4.. ......--»......ioo�Ge 5.
Description of Soil -•---------------------------------------•------------------------------------------------•••-•-•-------•---.
x
W
VNature of Repairs or Alterations—Answer when applicable.______.........................................................................................
.•••...--•-•-.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of 1?71
p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue -by the board of health.
_._
fie -----------
Application Approved By..................... -----------------------•--------•--•-•--...........----••---•-•-•--•-.... - / C�
.........
Da ---ate
Application Disapproved for the following reasons------------------•---------...•....---------•-------------------------------•--•---------------......---•-----•-
--•-•••••-••-•-••---••••••....•--•---•••••......---•-----•••••••••-•--•••--•-----•-•......-•-••••---...•.-•••••••••--•••••--••••••••----•••-------••--------•--•---•>-----------------------------------
<- .} Date
Permit No.....r ��� �'' t ..._.. Issued-----•-•-----------------------------------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T�•ti Al 1ays Ti°L3G
............... .........................OF...........................................I........................................
fir�ertifirtttp laf f�u�t�fittnrp .
T iS_IS.TO CERTIFY, That the Individual Sewage Disposal System constructed 4�,') or Repaired ( )
V '{ -l'-1
Y r....
-------- -
.� l 1 i Install
at
has been installed in accordance with the provisions of i. 1Z 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit Noel_. ....... !..�......... dated-_- ______________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUA�ANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................ /v ......u --•--------•-- Inspector
I / 'f THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-1"1 B Gtis�.9�3/Gr' .
...................................OF................................
No......................... FEE...................
�i��r.tt ttl nrk� �un,�tr�rtilan rrbtit
Permission is hereby granted... _ .............
to Construeb or Repair (j ) an Individu4l',Sewage Di" STtem
at No----------=f ..........._ .f-t-%�i s•
......................___._..................__....__._.____....._...... -
•_____ Street �--^. ;
as shown on the application for Disposal `Forks.Construction Permit N�a` 1 _1.`4--- Dated_.f �
.--.-- Board of Health
DATE------- ..................-•••••-•---....---•..••...
FORM 1255. .HOBBS & WARREN, INC_ PUBLISHERS
,l TOWN O/F' BARNSTABLE
LOCATION A�� SEWAGE # � 134�
VILLAGE r'�=` � L�% ASSESSOR'S MAPS: LOT /9
r _
INSTALLER'S NAME & PHONE NO. �.,
SEPTIC TANK CAPACITY /)—c2 e>
�LEACHING FACILITY:(type)6e ac N A,% (size) & f2 a
NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER_ZZ�. �
BUILDER OR OWNER / Af7
DATE PERMIT ISSUED:
DATE .COMPLIANCE ISSUED:
'VARIANCE GRANTED: Yes No
..
F
s
17 ��
� �
�b `._
,r-•
l�
LOCATIOfy '� ?�% -�E; CC�?!TE2t/il.GE� hl `"
SCALE DATE E .
PLAN REFERENCE LoT 8 D
„ Sal.✓.v o/v . �PL.oB/�. /8Z
.aG. z.6-
�Z -' //34%
�! 7-U/ .
Lam 8b
� aZ
Pr T —
;ev be
i Sic �•�, 1
ze
`lF
Joe D 6 .1:>2/V4
r"3 ,
roo
'Si
I � r
E�JARD
_t �! E.
KELLEY N
No. 26100
`rF 9FGI ER��
RG7-1 T/oN
/3-67
TOP OF FOUNDATION
CONCRETE COVER
CONCRETE COVERS
S,o$r e o 4"CAST IRON 12"MAX.
OR SCHEDULE 40 12"MAX.
e ' P•V-C. PIPE 4"SCHEDULE 40 PVC.(ONLY)
r� PITCH 1/4"PER.FT. PIPE- MIN. LEACH
PITCH I/4�PER.FT PIT
PRECAST
o' INVER� C LEACHING
° EL..!?. • :` ?" INVERT INVERT p . 6.4 PIT OR
SEPTIC TANK EL 7 >_ EQUIV.
DI ST.
INVERT EL'io7.'S BOX �� °B '
/08 Zo �S"o•• •• GAL. INVERT �:; 3s a o: ..
o; EL......c..... INVERT .:►, 3/4 T011/2
EL�°7:ZS. � , . ww a
EL!eG,8o LL WASHED
o w STONE
, r
•, /Zr DIA. eNcuvrc/zGn
o,
PROR LE OF GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
NO SCALE
SOIL LOG WITNESSED BY :
DATE SeP7'.2-3./98f TIME.I�-O"' N�ANe� GG��-i`'�� BOARD OF HEALTH
TEST HOLE I TEST HOLE 2 {�/ �Q �- /«u�y ENGINEER
ELEV. . . .�//: .30. . . . .
"y '0 DESIGN DATA :
�� WouDLoq-rtij
NUMBER OF BEDROOMS �. . . . . . ,
��• /bL.GU �✓Q
TOTAL ESTIMATED FLOW . . . . . . . . GALLONS/DAY
Ham• BOTTOM LEACHING AREA SO.FT. /PIT/G,RD,
S�-+urn /`�GD. •
SIDE LEACHING AREA . . . . . . SQ.FT./PIT/3Zq,
GARBAGE DISPOSAL .NaN4�. ,(50% AREA INCREASE)
TOTAL LEACHING AREA . .Z¢�. SQ.FT
/4�F Lam• 91 ro /zo' �z /co./o PERCOLATION RATE js. / .�'^!�• MIN/INCH
�o WATER ENCOUNTERED LEACHING AREA PER PERCOLATION RATE .'�/4�. SQ.FT/C.PD,
..... .
NUMBER OF LEACHING PITS
APPROVED BOARD OF HEALTH. .. . . .
. . . . . . . . . . . . . . . . . . . .
DATE . . . . . .
AGENT OR INSPECTOR
OF
]� 2> EC' it, ��s '� STETSON
�L. , v .HA
% /�ELLEY o- No.5
• �/�Gsir�L� �2/I/�s I / No. aGioo Az o
9fClSTER`�� h. Y TE /
• CG-�/T�Tz i/i LG E- Snfl�A� �B3i1 SANffAH�O�
PETITIONER