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Home My WebLink About0395 LAKE ELIZABETH DRIVE - Health 395 Lake Elizabeth Drive A = 227-019 Centerville 1 P -.0 a� No.._.. .. s$........... ®o...... c ��_ THE COMMONWEALTH OF MASSACHUSETTS O�� BOARD OF HEALTH ...........................................•- �� AVpfiration for Bi_ viial Works Tonstrnr#iun Frrnti# 11 Application is hereby made for a Permit to Construct (,,-) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot ......................,No.. .--- Owner Address W • •.........................•----•.........•....................... ---..............---------•--.......-•-------••---.......................•---••--•---•-------••-•. 14 Installer Address t� Type of Building Y Size Lot_Z¢ f� S feet d YP g -- -•-•----- q•aDwelling—No. of Bedrooms......_.... ••--------------Expansion Attic ( ) Garbage Grinder (�) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) aOther fixtures ----------------•-----.....--------------••--------......--------------•-----------------•---•--------•------•--------•---------.....---.............. d W Design Flow..................-5 ................_gallons per person per day. Total daily flow.........6 ........................gallons. WSeptic Tank—Liquid capacityA! ..gallons Length.._'*'C_/:... Width..±._'_-- Diameter-.______-____- Depth..�`�.".. x Disposal Trench—No- -----------------•-- Width............._._._.. Total Length_................... Total leaching area....................sq. ft. Seepage Pit No.........�:........ Diameter...../a......... Depth below inlet.......d.......... Total leaching area.....S.� .sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..._ �r^f ?'t'!�.... :..��u �1, -._._._._. Date._T�"'`._..f c� G___... 04 Test Pit No. 1...!L-.....minutes per inch Depth of Test Pit..... .�_.. Depth to ground water-___- "-------------- (14 Test Pit No. 2...L. ....minutes per inch Depth of Test Pit----Z� ..... Depth to ground water........................ a -•-•---•----••-•-•------------•---.......•-••--•-----•---•••-•..................................••----..............------•----•-•-•-•-••••-•----•-----••.... O o"-�o" . ,9"04e-4 ..`rv3zso.� 3a7z" G-� �'a�a-r�scs s Description of Soil............. ------•--- ----- ,1-----------•----•-•._........... V .. '__9.. .......G'?! 1.�----- ----------ti6-" .. .....---r-e'-�'-`•sue-- ��-- .c W ........................ .................................... -----•--------•-----•-•--••--•----•---•-•-•-•-•-•-------•-•••••-••••------••--•-•------------•----....................................... 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 TITL% 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in ope ation until a Certificate of Compliance has been issued by the board of h e�_ 2 7_0j/ / Signed... ��' �� --•- •-•--- ------ --------•-•--••-- a pplication Approved By...........A`..... ... ..! ...._ _ d 6 ------------- ate Application Disapproved for the 11owing reasons:................................................................................................................ -----------------------------•----•--•-•--...._.....-----•--....-•--••-----•----•-.....----•--------•---•........---.........----••--------••----...---------------------•--------------••--•---••--••... ADate Permit No. �j ---� .j�.............. Issued_------•-----...............-----•-•----------.......... J Date �� 3o"Z. -* � No................_....... Fss.................. ._...._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --. .. ...........oF..... 13 Appliratiun for Disposal Works Tons#.rurtion Permit Application is hereby made for a Permit to Construct (c-� or Repair ( ) an Individual Sewage Disposal System at: -. ��..... • ....._•....•••....••.•..•.••••...._. Location-Address or Lot No W • ..... ...................«........ Owner Address a .......................................................... - ...................... ._ G. ...._...... ....... Installer Address Type of Building Size Lot......z 1.......::...........Sq.feet aDwelling—No. of Bedrooms.............:....................Expansion Attic ( ) Garbage Grinder (vj a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures . W Design Flow.................. ...................gallons per person per day. Total daily flow......... ` ..._......._............gallons. WSeptic Tank—Liquid capacity_it��..gallons Length...-_��_�__. Width-_.4.��__.._ Diameter................ Depth_.s.f' x Disposal Trench—No..................... Width.................... Total Length...................... Total leaching area...................sq. ft. Seepage Pit No..........Z........ Diameter....../.a-........ Depth below inlet........G........ Total leaching area......S:3.-j`_.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '"' Percolation Test Results Performed by.....67-1 1114 71e?? L �Gi z-«`�--.-•-••. Date...`..............4 / �V L a �...... Test Pit No. I... _........minutes per inch Depth of Test Pit..... ' ..._. Depth to ground water,................... 4.1 Test Pit No. 2....:.`....minutes per inch Depth of Test Pit.....!4..... Depth to ground water.................... 9 -•-•--••-----•-•---------------•-----•----•--••--••--•---•--.......'---.....--'•---•------•.........-•....--••---------- D Description of Soil.........�............................................'- o,. hiot,,a ec✓i.� g/ J3 zSo i 4.- 30 _72" �� Cam✓s.__f...��j ......-•------...---....---•------•-•---•--------•--.........----•-...... -- x -7 2 '5�6 i. ri^l L z............. L "- /3 C,,�7-5 C- S� > /r�}'VL"Z.� ......-"------ U --------•.......................•-•-•------.....................--_.... _ .............------................................. 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 TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operationissued by the board of t 9_2 7. until a Certificate of Compliance has been •-gf Signed .�. . = ��=- ...---•- ........_.... Application Approved By............ .. ... . .. . . . ............ ate..... ---------- Application Disapproved for the lowing reasons:................•-••--•-••-•-•-----.......------.....-•-••-•-----....-----....--•'-•--•---... .___ C� ...................----------....-----•---------'--.............•-•-•--'•--.._...._._...... ....._.... �G_ _ Permit No........... `_�0. :.... - ._.... Issued....-------••-•-- -----•----•--•-------Date------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................70- �.l O F...........,--'..'6 Kh%STi�i�3G�� .... ..................................... fITrr#if irate of Tompliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (may or Repaired ( ) by.............................. 11 •••'--••...---•--......---'-•-•-•--•---•................... ..... .............•-----••--•-............-----..........................------....... ......_ Installer at.. - .... -...._. - has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated..............r.................................. THE ISSUANCE F T IS CERTIFICATE SMALL NOT BE CO TRUED AkGUARJANTEE THAT THE SYSTEM WILL FU� 10 A ISFACTORY. DATE.................... - . . --------•.. ............................... Inspector......... ............ . _ --------'-'---••-•----.......... THE COMMONWEALTH OF MASSACH us. S BOARD OF HEALTH ....O ./-1�✓n,.5�"�1�L ....................No..... .................. No..... E?.... .9` OF..... Fim........................ Disposal arks Tonsfrurtion Permit Permission is hereby granted.................�. �-,�. ir`: ---------------- '.PP.-•.....•--•••---•-•--....-----.........•••----•...._......----....................._.. to Construct (✓) or Repair ( ) an Individual Sewa�e Disposal System at No.......... ��•---......112....:': I--1._........_L-_�.��. ._...... :_C!.Z�1 (3�.l t.-� �Y Y. <- �1 � j �. Street ......................................... ............. as shown on the application for Disposal Works Construction Permit No...............�...... Dated......... ....... ....... ............ ...... .................... Boa4 He�tL�•'\; I... DATE....................�:-��--�.��.......... ... .:.. .... of FORM 1255 A. M. SULKIN, INC.. BOSTON / f . / 2Z) 281 / T W/o 4e S / �4 �?Zo / Lo� T LoT 07 � a&v lop o ,J fl�v�s�v i �i 2 s� 14) .53 PST/ LE�iul i� 1 � �1 Pir �o J4 v.., ... A111 11J l "/ LZiZ �ee pa . Al AL LOCATION SCALE . . PLAN REFERENCE ..B�7!v,G. .. . ... ..... .5'/4/owiv OA/ EDWAR . . . . . . . . 6. . No. 26100 "`fr I$iE4�`Q 1 CERTIFY THAT THE ... ...... . . LRk�S SHOWN ON THIS PLAN 19 LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF . . . . WHEN CONSTRUCTED. DATE � . . . . . . . . . .. . yAA:�oV �Ti�/S — /�fT/T/�� REGISTERED LAND SURVEYOR • - LL Sfl��`T "Z L. TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS Z g5 ,•'; 4 CAST IRON II2"MAX.ir 12"MAX. OR SCHEDULE 40 4"SCHEDULE 40 PV.C.(ONLY) P.V.C. PIPE PIPE- MIN. LEACH PITCH 1/4"PER. PITCH 1/4"PER.FT. PIT PRECAST ' t -� LEACHING •• EL v?R .��.. INVERT INVERT w t. PIT OR SEPTIC TANK z DIST. �¢o , .• ;.; EQUIV. �,i INVERT EL....�6. BOX EL........ . .!-��a..... GAL. INVERT S: �� 0 3/4"TOIVZ� EL Z/.,r7 INVERT w W o. 0p o �: WASHED � � EL........ '': STONE �s--•}�-6 o1A I NONE PROFI LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE f�- 5G8g SOIL LOG WITNESSED BY : DATE `T! ,.'7 1184 TIME.!?:PP.AM , , !'�%1,5, ,/YG.eG•vn/ . . BOARD OF HEALTH TEST HOLE 1 TEST HOLE 2 ENGINEER ELEV.. .23: ?P. . . ELEV. . z 3:/O. , , WooDLo woov�olarl �zt _ S�gso,� . . . . . . . . . . . DESIGN DATA 30' 1, SvB"5o:C. &Z.ZZ./o en.Z/.4o elv-Ax sE -' rsen/cosr,ZSE- NUMBER OF BEDROOMS .. . . . . . . . . . . . . . . 7i' TOTAL ESTIMATED FLOW . . �� GALLONS/DAY —EZ,IB./v Via. �n G,.eAVEZ BOTTOM LEACHING AREA . . S0.FT./PIT/C,R D. /88. 96„ SA�o SIDE LEACHING AREA . . . . . SO.FT./ PIT/47/ C.Rv 1-2 GARBAGE DISPOSAL . Y.�' . ..(50% AREA INCREASE) 4>Axsc SAr//� TOTAL LEACHING AREA .`'`3¢7. SO.FT G��vez PERCOLATION RATE Zl s.7�. 7Wo . MIN/INCH L2 Z 13Z /4� L'Z.//./o ./ , q� .� � e 1. LEACHING AREA PER PERCOLATION RATE ZO.??.. SO.FT.�G.RD. .^� .WATER ENCOUNTERED 7'L✓o �//--s NUMBER OF LEACHING PITS . . . . . . . . . . . . . . . . Tl�Q ��T o F .S'7nNC-: oni /�1 ZG •s/DE5 APPROVED . .. . . . . . . . . . . BOARD OF HEALTH DATE. . . . . . . . . . AGENT OR INSPECTOR OF 0i p� yG T sTET50N �IC� �/ x I°. VE.- R.HALL o ✓KELLEY N 41 1-771 2 VC No. 26100 CG�/T-G�zl/iLLG-' Jib a�fs�/ofcigTEK``S Anrt�a�a� . . . . . . . . . . . . . . . . . . . . / aAl LAMS � PETITIONER ; A-lCoV Z /s 66tr Y Tl� . . . . . . . . . . . . . . . . . . . . . TVP OF l /L /3.5'u7) 2Z � a Ec lc I I t- 2L'--� / ToP y¢� / pp-pos / 2�� Ml Z g GQ h .361I �. •fiMr'-) xr--t• J I�:� II� � opgt 4° P _ i /V 0 - EZL�/6177aN5 B sE D b N / T 7�/ /spar,/ SEA G�vc2 . LOCATION . .C !..z ? SCALE . ./ . . . DATE .�� PLAN REFERENCE ,v7vD LoT EDN�3D�A, { v LEY 26,100 r Jam. AF�►ST��`�^a�L -` I CERTIFY THAT THE R�LttO SHOWN ON THIS PLAN IS LOCATED ON THE GROUND "Q�. AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED. DATE . . . . . . . . . . .. . REGISTERED LAND SURVEYOR ;y, -° 3PfE�-T Z of Z -SNE�TS L. . .Z8,oo. . ... . TOP OF FOUNDATION CONCRETE COVER. CONCRETE COVERS ZCAST IRON 12 MAX. 12"MAX. ' OR SCHEDULE 40 4"SCHEDULE 40 P.V.C.(ONLY) P.V.C. PIPE PIPE- MIN. -T k PITCH 1/4"PER.FT PITCH I/4 PER.FT. o o EL. $RSA... INVERT INVERT p w 3 Q•' SEPTIC TANK EL..!7,9•¢. . BIOX' EUZ� . ' ; >x n INVERT /,Spo . ., GAL. INVERT ;: /,o,�a M '� a' EL.�8.�.�.. EL!.7 �.? INVERT w w� :i, 3/4��TO I I/2 WASHED STONE PROFI LE OF GROUND_ WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE p- Sb 8 S SOIL LOG WITNESSED BY : DATE "A .?�986 TIME. �`� AH r/AS• ,/7C� � BOARD OF HEALTH TEST HOLE I TEST HOLE 2 G'`7�/i�/6?12/� .495•• kCuC-V. ENGINEER ELEV. . . ELEV.11/17, M. . . . . . . . . . . . . . . . . . . . . . W0e01aAH ZZ. /o DESIGN DATA �'Z/"� Cbn25E NUMBER OF BEDROOMS 440 HC-'D/CoAR3t SM�D . . . ii TOTAL ESTIMATED FLOW . . . . . . . . . GALLONS/DAY Et./7.�ja BOTTOM LEACHING AREA r�oo•o. . SQ.FT. /PIT/ p/mi G�i►VEL /`/ED. 9c,r SAD SIDE LEACHING AREA . . . 80, o SQ.FT./ PIT/cZ/7 a, C A Ego GARBAGE DISPOSAL . . .(50 % AREA INCREASE) TOTAL LEACHING AREA . . . . .. . . . . SQ.FT a r, �C3S 77/A� -TWO MIN/INCH G,a�/fVEi. Ft.//,/o PERCOLATION RATE . . . . . . LEACHING AREA PER PERCOLATION RATE .��5�. SQ.FT-1C,,0p /Vo ,WATER ENCOUNTERED NUMBER OF LEACHING T2ENCN5, 71vo• , • • LL�1G/�//vG T a/ctls wlrh' 7Wootz APPROVED . . . . . . . . . . . BOARD OF HEALTH /tvL�!- /Ic/r/SolzS /1�0 77hO6Zr . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . DATE . . . . . . . . . . G/= STb../� O n/ /=YLL 6,/D t-s . AGENT OR INSPECTOR Ott! Of E /2�98ETh/D�2/✓E `I _LLEY �AK. . . . . . . . . . . . . . . . � � 10. 26100 c 1` `l a' P C wre-1Z✓/LL ! iER�� PETITIONER ygitpV .ZTAGS / e 3 as TOWN OF BARNSTABLE I.00ATIONZo-t- la SEWAGE # W-30v? VILLAGE 4�f- 11.'1Cf ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. J"A III SEPTIC TANK CAPACITY 0�9 LEACHING FACILITY:(type) F',il (i-fA,,40,1) (size) . J)aX/ NO. OF BEDROOMS' PRIVATE WELL OR PUBLIC WATER vbl c" � Ut`LDER R OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: to d' f VARIANCE GRANTED: Yes No ..__"��. o� j � / � / / \ry � i t�,_ t�� 4 � � i i � r_.. ,I . '�Si ` �� a, t � ./ � . �'� re �' � ,�+V � 9 i � y _