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HomeMy WebLinkAbout0074 HITCHING POST LANE - Health (2) 74 HITCHING POST RD., CENTERVILLE A = UPC 12534 0 �� No.2� 153LOR HASTINGS. UN r TOWN OF BARNSTABLE 0 LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. /4,�h C_,e�a SEPTIC TANK CAPACITY ZOO 62 LEACHING FACILITY: (type) /A/ (size) 121 2 2-S NO,OF BEDROOMS 13 BUILDER OR OWNER PERMITDATE: ml�yCOM-PLIANCE 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 s G � GA o/= i32�- - -133 - - 7 ` � No. [ ©� s� Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Migpogal 6pgtern Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System individual Components Location Address or Lot No.I 1A \ FA Owner's Name,Address and Tel.No. Assessor's Map/Parcel 1*73—0'3 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. vS Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures e Design Flow 73-30 gallons per day. Calculated daily flow 3� ( gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank " c S;� k�CO Type of S.A.S. GYM �3'w i Description of Soil Nature of Repairs or Alterations(Answer when applicable) =0 1[a�� �!�— d� 6�Lg f:7_>,_j(Z- ", L ( Q`(o t2 S C STr_e Si r�� _/�c� [�(t c J in 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 a not to place the system in operation until a Certifi- cate of Compliance has been i is Signed Date & Application Approved by , Date --,rS Application Disapproved for the fo wing reasons Permit No. 00 Date Issued ZO ' ?-S-- No. / / O fr {^ „ i'' Fee THE COMMONWEALTH MASSACHUSETTS Entered in computer: ✓ Ye's PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS Rpplication for Migogal *pgtem Con.5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System [JdDdividual Components Location Address or Lot No. 7 y - � AE� Owner's Name,Address and Tel.No. Assessor's Map/Parcel - I'�-3-0� '" Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. rf 1� P--e-va,ff—S*p--c g: %S �ovts Type of Building: ' DwellingNo.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. C+C' 0 Description of Soil Nature of Repairs or Alterations(Answer when applicable) =CA- U l=C,G)� . `t C._ c 1 I GY1 S C--,Tt� Date last inspected: 7 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 an of to place the system in operation until a Certifi- cate of Compliance has been is Signed Date Application Approved by Date Zo- Application Disapproved for the fol wing reasons Permit No. 10 Date Issued - 0 - Z S-- ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(t.-< Abandoned( )by r= ti at c. - -- rZ t ` tl has been constructed in accordance with the provisions of Title 5 and the for&sYosal System Construction Permit No. 7 Gda-'te�i- Installer Designer /Y _ The issuance of this permit shall noi be construed as a guarantee that the sys�em� it function as desin�ed. Date d (r Inspector � � �; ti:f j, — / / "- — ----------------------------� .,,------ Fee _ (7 �--03 9 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Migpogaf *pgtem Cottgtruction Permit _ Permission is hereby granted to Construct( )Repair( )Upgrade( (,'Abandon( ) System located at Ac_ 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 becompleted within three years of the date of this PC t. Date: Approved by 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated ��—a S— cf concerning the property located at flFfr' fz-p6'S- meets all of the following criteria: ( The failed system is connected to a residential dwelling only. There are no commercial or business Z- The uses associated with the dwelling. soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. `There are no wetlands within 100 feet of the proposed septic system i y There are no private wells within 150 feet of the proposed septic system There is no increase in flow and/or change in use proposed There are no variances requested or needed. bottom of the proposed leaching facility will not be located less than five feet above the ��e maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Fnmptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation 35 oQ +the MAX. High G.W. Adjustment DIFFERENCE BETWEEN A and B SIGNED : DATE: [Sketch proposed plan of system on back]. q:health folder.cert b 6 G 1` Sc06 TOWN OF BARNSTABLE LOCATION SEWAGE # 76d VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 17/A r,4a SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 1.v�1'4EdZZ4a,C S (size) NO. OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: G' 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 I 7 No..- -- -+� f ,r .............. THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH pPA CJ.................... .....OF.......... ................. .............. Applir�ation for Dispati al Mork C�nn��rnr�Wu ramit Application is hereby made for a Permit to Construct ( ;,) or Repair ( ) an Individual Sewage Disposal Systeem- at• ...'go, .�.._.... / ..I .. .... � 1'. �'C ----- ---------------------•-------- ..................... ..... ocation-Ad ress Z or Lot ----------------!---fp �e ........................................... Owner Address W Installer. Address Type of Building Size .Lot............................Sq. feet U Dwelling—No. of Bedrooms_________________________________ __ ____Expansion Attic ( ) Garbage Grinder (� U aOther—Type of Building ____________________________ No. of.persons.............................. Showers Cafeteria ) Pa - Other fixtures .._... _ ----------------•--._...----........................................ W Design Flow............................................gallons per person per day. Total daily flow__._._.__.:_._'3_ .Q-_._:.........gallons. WSeptic Tank—Liquid'capacity_/QQgallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ .................... Width.................... Total Length.................... Total leaching area---SM. ..sq. ft. Seepage Pit No-----------------_-- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test R""ess�u""ltts�s a Performed by.................................. ......... •---------------•------•• Date........................................ ,aa Test Pit No. lA0'f_? 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_..................... 0 Description of Soil...... ` 'k�..f .._......... V ............................. ---•--••••-•-•••--...---•---.._•--------•------••-•-••.._...----•-••-•-•-...-•--•--•••••••-•••••-•---------•----••-------•--•---•••---•-----•----•-...---•••--•-••--•-••- W U. 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'T: 1, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is by the b rd Signed.------ - . ... -- .... * ...�_-------------------- ----- .....�Q` .. Date y Application Approved By............... r-A J ........................ ...... ate Application Disapproved for the following reasons:................................................................................................................ ......-----•---------------------•-•----------------------------•--------•----•----------•-•--------...--••••••••----•-••-•-•-•---•------•-•-•-•-••----------•-••-••---•-•-----•----••••-•••••. Date PermitNo......................................................... Issued................................ Date THE COMMONWEALTH OF MASSACHUSETTS OARD OF EALTH 4 OF........ . 1-2............. --- _. Appliration for Uisp. sal Workii Tnntitrnr#iun Prrniit Application is hereby made for a Permitto Con ct ( ) or Repair ( ) an Individual Sewage Disposal System at ..... ..... . ....r!!�. Location-A ess or Lot Now t :t' _..;11✓.ec !/,��_J.............:.1 J' F:.�!' -�jz--�ac.�a�. ._ •• ............ . • Owner Address Gd 'Installer _: Address Type of Building Size Lot............................Sq. feet aDwelling—No. of Bedrooms________________ _____ _____Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( /S — Cafeteria ( ) Other fixtures ------•••••-•••••----•-••••••- W Design Flow.............................................gallons per person per day. Total daily flow...._.__.:._._ _;Q:.............gallons. WSeptic Tank—L iquid capacity/6.0. eons Length________________ Width_...__...._.._._ Diameter_______..___.._. Depth................ x Disposal Trench—No. .................... Width...................... Total Length.................... Total leaching area_' .'.T- .1 1 -sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing t ) ._ . Percolation Test Results �,}..��P��erformed by �? Date aTest Pit No. �if/,#uriutes per inch Depth of Test it__.f*_______________ Depth to ground water........................ Gi Test Pit No. 2..........._.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ ODescription of Soil- r ...--------•-----•-••-•--••-----•----••-•••-••••-•-•••••-•••••••--••---•••-. x >J 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 2iTLF, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has;be4eni by t o rd of ealth.Signed.__ ._ . `•�. � Date Application Approved By....._ /..- _. Application Disapproved for the following reasons_............. ___________ _e_........._................................................. •................••-•••--•......••--•------•-•••-•-••••-•---••-•-•-•--•-••-•---•-•--•-•................................................................................................................ Date.' PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD ,OF HEALTH ..........................................OF........................:.:. :......_............................................_... (9rdifiratr of Tompliaurr THIS IS TO CE TIFY, That the Individua Sewage Disposal System constructed {,, ) 'or Repaired ( ) / :......4:`•.�''e: _x_S✓ --•-------••-•---•................................................................•---•--._....---- Installer at............... <s -------- ----- has been installed in accordance wit h provisioners of TI LE j o 3"� to Sanitary Code as described in the applicationDisposal Construction CERTIFICATE SHALLO �E CNST dated AS A................................................ THE ISSUANCE OF THIS A GUARANTEE THAT THE SYSTEM WIL�NCTION SATISFACTORY. DATE..... . .. ..............................: ........•--.......... Inspector.... ... ... ? THE COMMONWEALTH OF MASSACHUSETTS s BOARD OF HEALTH ...............OF.... Bis`.Vnsa1 Workg n trudion rr 'i Permission is hereby granted � ., ..............•••-- ` = �/ _ _�._l`Sl .. to Construct ) or Repair ( )) an Individual Sewage iisposad.System at NO. �'.-......_•, "f .....,ffy i' �^�r r as shown on the applicati for Disposal 7orks Construction PermitNo_____________________ Dated........................................... O ' / Board of Health DATE.....�---/�--- • e ............................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS %, - _ is^fi P 3tr"r4^+ fT vet_ f .'t. 5�„sty„}� 'x fiy 'w4 ai"�•S ! • � + >B Yf s�rr !t yxs4,�ti ,d..#iYjzL� ]r f y f y .>s r�r.�!��• ., d ' r C A C '�„'F J Fi. 4.,�•! y ✓ a 7 x'' Y 3 v +'# v hx 5 4.�� i-;t> ti sa...c'�fr,B G a b3t,} r µ S f'i�r,� 1b ,z q:$7 �? .r�i�: i,#� `F e`{•' N F $ +).. x :' O 71,. 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Vl�y3z'cs� X i���` +4�r' ��' } zr- i✓ 5 3Fa �I[�� '� �;y Sh' a 4'` f ' t Ip�!(�y� ,} Kr A's4✓1'c�4 h �r fi) �`3 * a,¢.� .d +t + f tk0. x a ry 1 # ''ty a� £4 JiA. °.# T8•�T f`z �- G ' vv i 4.k ,•'T �( ate' l� �4 ;,j F'�' F2z, I '� u`TW(�r .Mw' `'• y " `s x't`af',+t' 1^ t' .'r /1/ � t �1 ll �.,` ° �'- s -1..r fi' .ae 'ky'�,c�a+ 7�, c 'IC;+'1 Bh'Stf'.•'.m-:}.2q^ v ai 's .s t z fi t > 7*w4 f0 7 e • � �'1' e+s-w ,z T}e� t><''d l•%� r."� �,R��l•t�" �: Q � . � r#� ' �+y� 4 � .� �t„ya'a s ,xic a"���'�. 7w k•C a,. � y., $ GN * - - a .�. yil a ra.ryx i ' � ,�x' a ®� �aa LEGEND �F-yafa ��.� a � .;, _ EXISTING SPOT ELEVATION CERTIFIED- PLOT PLAN EXISTING CONTOUR _r.,,. 0 .. '_ t � �'� = y ,� o �? !-/�'�"cH�RlC posr- 4AA1E FINISHED SPOT ELEVATION �`� r"�� AAtul FINISHED CONTOUR 0 - APPROVED s SOARD OF. -HEAL7'FI = ,,9 F ► -� �` .�� `°,. f ,,, �. , DATE AGENT •3„ § r;y' � ,�3 tq „ rSCALEr , 30, . DATES s/9��3 COREOGE ENGINEERING C0`lN C41 qNr �- .s I CERTtlY THAT THE PROPOSED EGISTERE .REGISTERIR �, ii ��'" ? BUILbaNO SHOWN ON THIS PLAN CIVIL LA Ilia y w � t � a , , ,� ON TO 7NE ZONING LAWS ENGINEER URVEY D,RY -- �OF BgRNTA9 E# �' ' A83. 'I r w, ,J•�e.� �y I` s • $ 712 M A i N S TR:E «�.r�� HYANN I.S,, MA3$. p7 . LAND SURVEYOR /VOTE /d= E/TNEl4 THE SEPTIC TANK OR 20 AT M//Y. ?,1E/4C.441,VG P/T AR4r MORE 7WA:^,/ 12•`6E40W /O rT.M/N 1RAOE/ A 24'D/AMETEK CONCRETE COVER SwALL ®F BROUGHT TO GRA oE. ��+N EXTRA CONCRCTC 9�PYC P/PE ILYeAvy, CA ST /RON COVER SHALL DE USE TCN: F%N O D EL" IOfo;S COVERS MIM. P/ } / R/✓EJrVA Y_ ; 2 q. M/N. CONCRETE a G3t.�oE CUVE:4 CL.EA/V .SAND — _ BA Cx F'/L� L1 0/D LEVEL 2 LAYER vs M/N..P/TCN G/tL t y . s . •• r e •DlST, WASHPO 5,70NE . � R rr:: BOX w � L s♦•D• t t •Ef�FECT/✓L .314 f �2 • • •'�'a DEPTJ� • • ' • . WASHED STaNE I 4 •, 1 • • • ••11 �p o � Y 22�0'.� X 2:a ,s ¢S2.�( 4�D,,.' a� ♦'a s • . a • p v PRECAST SEEPAGE •� t13• � A0.83 ' `�3. 9 .C�lD. o �• r • .• • • • • • • • o P/7OREQL//✓.r tNYCR�' CLEti�T/oNs • a — -L= 89.S; NYE/4T,sly Q!//LDlN6`j 48 5 F� �T cAPr�c�rl s 54Co 3.6/ TANK,:` �8 3: FT 1'�• O/AA7: C SEE TABULATI I ON T SEPT/C Ti�NK T r Y s °�?:9 FT GROVND P.C4MT TABLE lN.L.ET DJSTiR/1�!/TlO/Y.BOX S �T'tON.4 - _o(/TCEroI urIoly - /NLFT CLtACX/NG o�TLFT LEACI'f/N fT Ti�BuLATID/V SCALE: bES/6/v GR/TERl.A. " D/M.ElvS/a AI' 8 FT• D/MElVSlON C '¢ F /YIJMQER.OF BEDROOMS � 3 - ZaitRe4GED/SPO.S1fL UNIT n'or/E' . _ SOIL. LOG ToT.4L r571AIA FL.Ort 3 3�_GAC.1DAY SO/L TEST .*/' SOIL,7L=S7-*Z SOIL TEST: —r l J NC/MBER of 4rACRINa JP/73_ ! f`L-LG�K 97./ of ATPV 9�� DATE OF SO/L, .TEST SIDE 44ACH/N6 PER P/T . 14 y Sa PT. RESULTS *V17"VESSED BY BaTToM LEr•IGN/NG PERT I(3. t SQ. AC PER COLAT/O/v MATE cH, 339.3 TB!'-5 pEjeCo4A7` .0 RATE TOTAL; LEACH/NG •4REA SQ. ,f T RESERI�ELEACN//VCrARE/► 339.3 $Q• FT. Z 1- S ' D F: J-P - p- r 823 P�ZHOFA444 7FaT C 4 t GCT /7 AJ/ 7CJfdN� �O ST C.AA, R u SPcN� 1NIA CIY � t/ jLLE gE '=+ o RSE w $ CA No.1095L 0 j EL DREDGEFNGINEERING co,I/1/GF_ �NII,3931i�C po FGISTE� �Hi' ELClf $S",1. 712 W q/N Sr • HY.�ic/N/S. MASJ, i E,,7 0NA1 NGROUN7 T SI r GRO !/VO yvA JOB No: EEE TS �3 z OIs z._ LOCATION 'Y SEWAGE PERMIT iO. 7" / hZi 7-6,4 IA,,,'- 7,o-c 7-A.t,yla- 83 3179 - - VILLAGE I N S T A LLER'S NAME & ADDRESS -71 S U I l D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ' �7 � // hS h � V �v� ,� � ��� fl