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HomeMy WebLinkAbout0559 HUCKINS NECK ROAD - Health 559 Huckins Neck Road Centerville A=234 040 E 0 N SMEAD No. H163OR UPC 10259 smead.com • Made in USA J�,�cvct� 4Q m No. b Fee zo 6 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: —1-1000 Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for aigpo5a1 *p5tem CCongtructiou permit Application for a Permit to Construct('Repair(Z,?t�pgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 6^,S9 #v41<1ffJ f 11ack Owner's Name,Address and Tel.No. Assessor's Map/Parcel D O Installer's Name,Address}and Tel No. SOB—4120-11759 Designer's Name,Address and Tel.No._r,0, -.f 2- 2 f 22 . 00,//s 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 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 'Zo ff&1Z a-0a �Al:Zr-4 r16 7'Ato C y .2►F.%Tra1'er�,7a S4 rils�i7.1 Gy.TLi y'S'Tes�.c' !�I?�ytia� 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 Health. Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. "— Date Issued J i b '`T 3 77 a`.: Fee Entered in computer: +� THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS kt, 01pplirationkfor nigool *pztem Congtrurtion Permit Application for a Permit to Construct(-Repair( :�,)kJpgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. 5's HUGI</r1/j /c Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. s62 -Zl269- Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms I/ 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 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) f-,,s'7!a/ /S�O) �f t2��T✓,a T,id< iJ 5'% ;�l t�i 2�C 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 Health. h� Signed r� Date Application Approved by ' Date G o Application Disapproved for the following reasons Permit No Date Issued D --------------------------------------- - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certif irate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( �)-Repaired ( ca.-l-Jpgraded( ) 4 Abandoned( )by / 5 at _c's"9 f,E ii;/; ram,4 14,J �i=/i76✓�i;//i,has been constructed in accordance 4 with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer ��iTs r>/ d, ��t�rs-��S Designer -- 'v/_� The issuance of this ermit sha not Vconstrued as a uarantee that the tem w' lion as designed. Date p g Inspector g ,_LJ � ---------------- ��,--- No. � -------Fee 00 _ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpooal *pgtem Conotrurtion Permit Permission is hereby granted to Construct( c,.)-Repair( G)-pgrade( )Abandon( / ) System located at ,�1 ,�i r!i %i/r_ 4 122 / 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 b completed within three years of the dal 'of this pe r ; Date:_ 2 Approved`by.� eQQ�Qf-m �, �0 Nam: t� Town of Barnstable o � Regulatory Services Thomas F.Geiler,Director �►xvstAs�e, q " a Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Installer:Designer: AL Address: . d 1JC�C ��� Address: Ak On_ & - 6 , as-el,4 iz IffmNAr,-,5r was issued a permit to install a (date) (installer) septic system at 7 G' 6/kj kq� AlQGk A0 based on a design drawn by Y N --4 �l�✓`2�1 dated /G-/.5-o ff a � (designer) _ a 7-1 1-certify that the septic system referenced above was installed substan _ily accooding,,to the design, which may include minor approved changes such as lateral elocatiFn of e distribution box and/or septic tank. , m i co I certify that the septic system referenced above was installed with maj r chaffs greater-than 10' lateral relocation of the SAS or any vertical relocation of y component of the.septic system)but in accordance with State&Local Re . lations. Ian revision or certified as-built by designer to follow. - N OF Ms SS A. F G� '0 r ' (In ialler's Signature) N 14 �GfSTE�� I (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COM1>LIANCE MIU NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY T] UBLIC HEALTH DIVISIOI�T. THANK YOU. Q:Health/Septic/Designer Certification Form t _ TOWN OF BARNSTABLE LOCATION SEWAGE # _,1DO6— fY7 VILLAGE �ENY/'y✓/��/' ASSESSOR'S MAP & LOT�� -�` 'INSTALLER'S NAME&PHONE NO. SOB".?SD'M Z' asw de arv�S SEPTIC TANK CAPACITY /500 LEACHING FACILITY: (type) `1-3d S O�/1/r/�raTvrS (size) NO.OF BEDROOMS e/ BUILDER OR OWNER _ 4m g S PERMIT DATE: /O— 6-(Ole COMPLIANCE DATE: 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 f ciliv Feet Furnished by {�Uc�r1�1S �/;c� �� u ��k .2 y, �.� 0 � �PZ�S� s 6� ' $30.00 No..l..:%- .......................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiuu for Dispas al Works Tomitrur#ivat lirrmit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: ....... ...I1T.eGk._.13.9.a Centerville, MA ..----•-------------------------- ... ......... .... Location-Address or Lot No. James H. Spencer Same ... --.. ........--•------•-------•. ......................................••--•--------••--....----•---•--••---.............--- Owner A dress W W.E. Robinson Septic Service P.O. Box 1089, 6enterville, MA ....... ........ - Installer Address d Type of Building Size Lot............................Sq. feet g— ......................Expansion Attic ( ) Garbage Grinder ( ) Dwelling No. of Bedrooms..____...3._.-__.___ aa Other—T e of Building No. of persons............................ Showers YP g -------------•-•-------------•------------•P--- ( )--- Cafeteria (...>. dOther 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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................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........................ W ----------•---------------------------------------•------------•------•----••--••-------------------.......................................................m. 0 Description of Soil........Sand and g rave`l W x ..........................-............................................................................................................................................................................. U Nature of Repairs or Alterations—Answer when applicable._--Installing 2 stone—packed infiltrators . ... ---•---------------------------------------------------------------------•...--•--•------.......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beF issu,0 b e b d of health. of Signed -G � -.. ...... -------- l--------- — Date Application Approved By ................. . �`�;�...,t ►�s�, ---/0..... 1�� ..g Date Application Disapproved for the following reasons- --------- -- -------------------------------------- --------- --- -- ------------------- -------------- -------- ........................ .. ................... .-----. .....-------------------------.......---------------------------------------------------------------- ............ ---..........------ :.:. Permit No. -------Y Dat -�----"-- -//------------- ----------- Issued ---------------------------------------------------. e ---- Date 1 0 L/O LIZ FBx $30,00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Apliliration for Uispoiial Works C oustrnrtiun raermit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 5 5 9-_H'a Ck i_n Mack--T Raacl.-.-...... -- -- -- - Centerville,..MA .-_..------_...__..r. .--. Location-Address or Lot No. James H. Spencer $ame ---------------------___....._�......... ----•------•---------------------------------- ......................................................-..............__........_...-..�.. W W.E. Robinson entic Service P.O. Box 1089, ACenterville, MA ,-� ------------------------•. --------------------------------------•--- Installer Address Type of Building Size Lot---------------------------Sq. feet Dwelling—No. of Bedrooms------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aa Other—T e of Building No. of persons............................ Showers YP g ---------------------------• P ( ) — Cafeteria ( ) Otherfixtures ---------------------------------------------------------------------------------------------------------------------------------------------------- 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 ( ) aPercolation Test Results Performed bY-----------------•-------- --------------•------ Date---------------------------------------- $--j 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------------------------ P4 --------------------------•------------------------------•---------------------------------------------------------------------------------------------...... O Description of Soil.........Sand and--gravek -__ - _____ _ V ..............................-------------------------------------------------------------------------------------------•---------------------------------------------------------------•-------------- W UNature of Repairs or Alterations—Answer when applicable`_..I n s t aA-1 i_I4 2 s t o n e-p a c k e d infiltrators . / �-r�d� ' ''. /. �1 .- .._.. .. - ----------�------- -----f:�---------- Agreement: U"� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issueii byte board of health. t_ Signed.G � '- , / �b` � ----- -J Application Approved BY A. - h ' Dare Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------- ----------------------------------------------------------------------------------------- Dale Permit No. ------J---------------------------- ----------------- ...--------.c� 5 f Issued Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Telr#iftrate of Tantylianre THIS IS TO CERTIFY, That the Individual Sewage Dis osal System constructed ( ) or Repaired ( X ) by W. E. Robin©on Septic Service, Centerville, MA ----------------------------------------------------------------------------------------------------------------------------__---------------___---_---------------------------__----------------_-_---- s[alter 559 Huckins Neck Road, CentervInille, MA at ----- --------------------------------------------------------------.........._----__..................................---------------------------------_-------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .57&............ dated -------------_...........................------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-----------------------------------M `-- ) � - ✓.. - Inspector . u ------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH TOWN OF BARNSTABLE No......................... FX..3.....0..... Disposal Vorko Tlanstrurtiaan writtit W E Robinson Septic Service Permissionis hereby granted--- ........................................................----------------•-----------------------------•-••--------...-•--------___.. to Construct ( ) or Repair (X) an Individual Sewagle Dis osal .System 55'9 Huckins Neck Load, entery 11 , MA atNo----------------•-------------------------------------------•--------•----------------------------------------------------------------------------•--•--------------------------------•------ Street as shown on the application for Disposal Works Construction Permit No. Dated.......................................... ----------------------------- ,y--.......---------------....---------........------•-------- October 15, 1992 Board of Health DATE................................................................................ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE LOCATION _5 �d=�- l� L� SEWAGE #� // PILLAGE ASSESSOR'S MAP LOT o�.�y_ b INSTALLER'S NAME PHONE NO. Iwo SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ;�,��, (size) NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER n !, BUILDER OR OWNER DATE PERMIT ISSUED: i(j - 'l DATE COMPLIANCE ISSUED: f 0-1 y `i 2- VARIANCE GRANTED: Yes No `� ,i f J \[r/ K ' `7 //I / f N �,.. �i"� .�- ..�, //j/,/ ., _,_ l y ^�\ )� �-�'� �. ^4a_. ti � � �' .. � � �,v .. .,� ASSESSORS MAP a3 TEST HOLE LOGS NOTES: PARCEL D 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH soil EVALUATOR: D. RS GSA ~�- �1\L� THIS PLAN 1"5 MASSACHUSETTS TITLE V Sc TOWN OF ,>` FLOOD ZONE: LION �LGtleif / '` WITNESS:DoNtl y e5�5 W�tS g�a-1"� _ � BOARD OF HEALTH REGULATIONS. z REFERENCE: lby, DATE:036PMAAp 6 2) THE INSTALLER SHALL'VERIFY THE LOCATION OF UTILITIES, ! C� PERCOLATION RATE: 2-M f� INo SEWER INVERTS` AND SEPTIC COMPONENTS PRIOR TO q 0�a 52 C[. j 0. INSTALLATION. AS1C1+t PINES ? �� v '? sup-VH O11 TH- I eL: 58,3o �d TH-2 U- 513NI 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE 8t i1E A LbA,MN 10 �� LoA�t 3l DETERMINATION. Wes- ` �1," DF l,J740 ..- _ C) - ---- - _- _R.I..S. 5 Y� toYK v ,P p PCT�� SEPT_ - 11(p �j 4) ALL PIPING TO BE 4" SCHEDULE 40 1/8 "/ FOOT. (UNLESS 5VNKl. ow LDS' S�n Ioyg,41 S 1 JDyf_ �, SPECIFIED OTHERWISE) o 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A LOCATION MAP (N•T5) 27 S�.oS Zit sG 33 GARBAGE DISPOSAL. ► EDIUM � FINC-M EDI VM � 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) 5A-417 C 3"-0 C MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON 5�.�3 oyR�1� Iby� A BASE OF 6"OF CRUSHED STONE. I 5y.�17 � �� 7. � � -C�P�or'S'Tb t3� PuN►1P�fl �_ .�___ rn t - N �jo �vJ 0 6Sa Na C w oeScav_Le� i> �t U Ct P&R-TI rt 1.�c,AEA,J Mn 4IVM_ 1F rl y a �t ) ,Fyq r wit w)rnl I�jb �-T= ©F Q� iJ 105.00 ---- I SEPT C SYSTEM DESIGN ! N1). 00-we i&o_vy _wj)N_i5o_rT 12. L wq— FLOW ESTIMATE lob-40 o1Z. v\ttl --- I 1 BEDROOMS AT GAL/DAY/BEDROOM - 440 GAL/DAY �IkR�yLO y7 F3�.� _R� fCYa--- I � ��-l- � � ' AS SEPTIC TANK GAL/DAY x 2 DAYS O GAL 1a f �, N I � I USE ! '>-bb GALLON SEPT i C TANK E�rs7: I IPA SOIL ABSORPTION SYSTEM i/ !1q' 3 v��I • -� \ Sct�E�S 2•I r-'r gyros �1-IL 12.tr.1Wx 2'0 �I SIDE AREA:"2-441L1612.�X 2 x0#7q to rn I i TH-z i e BOTTOM AREA: 3y x 12.I to X 0=7Y = 305 _1 Li \ rn SEPTIC. SYSTEM SECTION EXISTING ING___-_ DWELL �cp _ f3YtN COVOP5 TO rN I TOP OF FNDNln5 ;Par#'wf in 8.531-- EL = 5 n 9 �. 36MhX 5�.5" MsfA K 14 D-BOX ss�Pj IO I \ i ;5'oC� GAL �s• hkr �s q3 A503 ! O r SEPTIC TANK �� fud ics5 v r z 34 Z x .tb xZ 1D J rn fig- 3 '2 W + ,13 -trb M o F- TEST�foCZ- E L ; 49.30 -- - -- -- --------'� 41.73 FL Dovbte SITE AND SEWAGE PLAN EDGE OF PAVEMENT Siwe w o L 0 C A T ION sS � t`I/C-k-lAiS _ . 24 � [RDANS �� o. DA E 2KI . C � �, NHU E ER N 4� j�ou h PREPARED FOR . 5 Sp anlr��. :. was No. 1140 � o �j SCALE: I - o �FarszFa� t2•t�T h fT' BENCH MARK S�aNirAa�* 14� DARREN M. MEYER, R.S. W TOP OF FOUNDATION P.O. BOX 981 DATE: o s ELEVATION = 58.53 z BARNSTAB�E cis DATUM EAST SANDWICH, MA 02537 DATE HEALTH AGENT Ph: (508) 362-2922 W