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HomeMy WebLinkAbout0050 LARCH LANE - Health SO 1,oxc-4 L N ci^to r vcr 1t :�jiGNING ENGINEER MUST SUPERVISE r ASTALLATION AND CERTIFY IN WRITING i t ff q, THE SYSTEM WAS INSTALLED IN STRICT '^ No... ACCORDANCE TO PLAN. Fiz$ •�.............,� THE COK,MONWEALTH OF MASSACHUSETTS BOAR® OF. HEALTH --77.0.vV'N...----.....OF......�3AiZi✓sT ........................................... Allp irFa#iun for DiupuuFal Workii Tuni#rnrtiun Famit Application is hereby made for a Permit to Construct ( Y'or Repair ( ) an Individual Sewage Disposal System at: ....................... Location-Address or Lot No. .... ............... Bp�L s v L ....tz',zr �✓i, -•--•............................•-•- ....._______......_._._..__.______. ................................ ...... _ Owner_:„ ress W .G 1.r,?�..._G n/cS 7........_. S.l._`!2_✓'/ L L,E.Od ........... ................ Installer Address Type of Building Size Lot.... 9.`f 7...Sq. feet �--� Dwelling—No. of Bedrooms................. .____................__Expansion Attic"' Garbage Grinder—(--)-- `4 Other—Type T e of Building p-, yp g _1 ,..... No. of persons.......!;�................. Showers �= Cafeteria-f"-7 dOther fixtures .------.t -----...----•-•--------------------------•---------------------------------------------------------...------------••---•-------- W Design Flow...............v` .................gallons per person per day. Total daily flow....... .............gallons. WSeptic Tank—Liquid capacity/P�Pgallons Length.!..__G._. Width.Q.._10... Diameter________________ Depth_. �_8 x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.................... ft. Seepage Pit No........I........... Diameter....../_*#..... Depth below inlet....3._S.... Total leaching area...3�".sq. ft. Z Other Distribution box (✓f Dosing tank Percolation Test Results Performed by.....9_!�...__.......__S_. fL.!� _________________• Date...... a Test Pit No. 1---. _ '.minutes per inch Depth of Test Pit...../.2........ Depth to ground water_____--CK''t'....4.2.. ' Test Pit No. 2....4.`E....minutes per inch Depth of Test Pit._.._.�t3_..._.. Depth to ground water._._ •8f-----____ o � w' •--------------------------------- ---------...-• ----- Description of Soil F 1 ..e_..........��...... �e( .---'S a---------- ---- t�v�e. - --._._....-- Of x .................................-------------'--..'-e----------- Q '... a/s Ct a- -c v.vn L.�.✓' 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 TITIZ- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been �ued the board of health. Signed XC �.�``S „- --------------------- ---- ---------_....._.. c� �at � Application Approved By.......... . .. .....-• ..._ •--------------------------• / $ ---- Date Application Disapproved for the following reds s-----------------------•-----•-------------------------•-----------------------------------..Date----•-•------- ....................•------------------------------...------.......----------••---------_....------........--------------------------------------------------------------------------------•--------••--- Date PermitNo............................. �••••------------•••-• Issued_....................................................... Date THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA No..? tJ y FEs..�.�'...`.s� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 .............OF......K •-� :':.f-5 i ? L_ F Appliration for Disposal 10orkii Tontrnrtion thrutit Application is hereby made for a Permit to Construct ( l/)or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ ---------•-----------••---•-•••-•-....--•--•••--------•-•--•--•-•----------•-•-•.......-----••••-- Location-Address or Lot No. ...................... s 'atL D N 1 3 ! �� /�T� f _3 2 /� s�_ (, ,✓'-s ��� ...................... ••-••.....--•-----•---...................._..._ ......................--....................... -- _ Owner _ _ Address �. L~ ©..\/.S l � i .__ 'f ✓ / ,L..L—/= .............................................. -.--• -•----...._.. Installer Address Type of Building Size Lot-__f_U__`4.2_7'....Sq. feet Dwelling—No. of Bedrooms................_.__.__�_______________•___•___Expansion Attic_(---) Garbage Grinder-(—) Other—Type T e of Building l �^'!_...... No. of persons �.................. Showers � YP g ------------------- P ("-) — Cafeteria-() dOther fixtures -----------•-------------------------------------------•----•-•-•--••.••--••••---••-•-...-•-••--•---••-•-•-------•----------•-----•-----•-•.....---•-• W Design Flow......................s`?...................gallons per person per day. Total daily flow____-_____.._---'._?_.0....._..........gallons. W Septic Tank—Liquid capacity-'..:?22.gallons Length• .._-- _'__ Width.!!_..j__�__• Diameter---------------- Depth--_�.-_�..'3. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area................._..sq. ft. 3 Seepage Pit No........ !--__.-______-- Diameter..... '-�...... Depth below inlet...:?_:_ ...... Total leaching area.......0.�..sq. ft. Z Other Distribution box (✓)' Dosing tank (--)T Percolation Test Results Performed by....`........... ......................................................... Date...... _`I. "?3 Test Pit No. 1....` 4 !_ -.. '..minutes per inch Depth of Test Pit . =_........ Depth to ground water....................... l fTA Test Pit No. 2....:.__.r.....minutes per inch Depth of Test Pit..... ......... Depth to ground water....".. ... ....... . ,CQ .............................r._. ._._____:.______.___.._;_;________...__________........________...... ._.__.._-_------------- --------------------.------. r Description of Soil------.... '. . '._�__:"'.. A -I_ ; . , -/ f� / `� ..-- --..._.......�.._..--•-••......---••..._-•-•� xr / " 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 TITI 4 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. Signed_'X............=.................................................................... ---- ---•---•....:............. Application Approved B rDa G Date Application Disapproved for the following reas ns:....................................................................----......................-•--------------- •.............•------------------••------•.........------••---••--•-------•-•-..........-•-•-------.......................•-••••••---•••-------•---•---•-••-•-••-----•---•-•-••--•---•-••-•---•••--•----. Date .. �Permit No........-•--•--...-...-...... ..................... " Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.....�- 7.?................................ Trr#if iratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( i,,,or Repaired ( ) by.....f//C 1c. Y C� =� /.S — - cDr,7- '," ✓- ` I 'e: ----------•----•--------=-------------------------------------------------------------------•-•-----•--.....-.Installer lj i Z ....:' ..[� I / . ✓c— / ___ iZ/:c-/? V''.. G Lam'=-------------------- at '-....... ....• --• . has been installed in accordance with the provisions of TIT r 5 0The. State Sanitary C de des m the C ILapplication for Disposal Works Construction Permit No----- ...._...� __,__...__. dated------- =� .. _ �............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...........r�� f ......................................... Inspector.......... j ry`... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ( 1 J ................................... .- .--.......................- ..................... FEE........................ 15iopoottl Workii Toniirnr$ion rrmi# Permission is hereby granted... .. ... . �_ y C- 0' V T- ----- -- -------------------------------------------------------------------•--•-------.....•--_.. to Construct (� or Repair ( ) an Individual Sewage Disposal System at No �— c`a % ` / Z G .-�,Z C fs � ,-���.1=" �� .I=' , ✓ i '= LC� .._....-----•--------•----------•-•---•-•-------------------------------•--•--.••--=-......-----•---•-••-••-•-------------•-----•-•-•--- ........ Street (� �4J L% as shown on the application for Disposal Works Construction PM No.J<X__d_.......__J..:_ Dated.............� .-:. ............. nr ............... ....... •-----.�i L------------------------......-•----...... j4 1,./ .......... Board of Health DATE- ----�-,-�--------------------•------•--..._..�----,--- FORM 1255 A. M. SULKIN, INC., BOSTON AWq u December 11, 1986 John Kelly Health Department Director Barnstable Town Hall Hyannis, MA 02601 Re: Lot 12, Larch Lane, Centerville File #1-521 D.E.Q.E. S.E.-3-1443 Dear John: This is to certify that I have inspected the installation of the septic system at the above site. Initially the waterline had been placed in the proposed leach area and the pit had been shifted closer to the wetland. However, upon my instructions the leach pit and waterline have been relocated to conform to my approved plans. Although the septic tank is slightly closer to the dwelling than planned the system now meets the intent of my design and complies with the Title V and BarnstablevHe.alth regulations. Sincerely, �`�� CRAIG y� SNORT tp, CIVIL y tJa. Cra' R. Short ,o 27493 Professional Engineer o� G/STEL���`��`� SS/aNAt 4N� cat/CRS cc: Conservation Commission i WN OF BARNSTABLE LOTION°°l;p L SEWAGE # VILLAGE Ce f\1,0-�t \\ e ASSESSOR'S MAP & LOTS2 , - INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 1000 4aQ LEACHING FACILITY:(type) P (size) Cho NO. OF BEDROOMS 3 PRIVATE WELL OR LIE WATE BUILDER OR OWNER eb e\ S o\,\ aw5 DATE PERMIT ISSUED: g I DATE . COMPLIANCE ISSUED: -110(o VARIANCE GRANTED: Yes No 7 6� O � LA �J � SOI L LOG p ' - 3 �- � od. .a sr2za�F DATE 2f20/ =`_ ?a N L� T-/ T-'J C O N T/Z.�0 C_r Q WITNESSED B Y /�R^- - PFF J ._ 77,=) fcE"D y J R`,� t H % L S"'L L• T i f 1- © 7—H L 2 4. C Z P �" 2 , Al A D/✓i+-r s A,v D Z Z 7/ .S f W�tr 7-�y/VL� s(i'' Sr3vL7 t 6:W?A✓ r' G L J`'. l �r%2a✓E 3ll L 12.� 9.00 � --'` / /" -- _ !.S is• �L �� (, / - �'- E TOP OF UANHOLES AND COVER TO BE BUILT wIrHIN ~\ �� F d 2 OF FIN ! 5 H E D GRADE . ,- AA I N. 2 SLOPE o FOUNDATION ' 1 5 H E D G R A D E 4''CAST I RO — ram _ / 0R 4" PVC Sc 40 IST � . �+ _.. `� 1`. t f �� :p.� PYC SCH. 40 P ITCH t FT. � 2' LEVEL% ` UIN. 2" LAYER 10 _ - �,.1�`` 3V f p P I T C H i .w �+�'' � 1/2„ P E A S TO N E ? SU INVERT DIST. -' D t- a INVERT _.__ � G A L L J N 1 N V E R T'.. , N D. ,� / „ /� sr fNvE F2 't �_t � �. a0X cG 34 - t ( 2 D ! A A ...� ,�' SE PT IC TANK Z H 1 17 3,15 Q " ! ^„�,OJ' p�G1 "' , ' '• e'... ;..•r.-,;•: •. : I N V E R T — •'.D U U C�. W A S H E D STONE i '`. i , •T ", ` p P .a:: .:/ r/ '• ,r r a , � INVERT u. d00! ALL AROUND y NJi > � � .� ... , _ ...�. .J .� Fir , a .. j .+ � o� O� GARBAGE .'�" ---�-�•-� �•'•tD t1 ..3 0� E L E V. B 0 T T O AA -d M D✓/E .� i ./o _ _ IN . 6RINDE R -•�--- OF P IT = - 4 2 0' AA I N -e-- / 4 A-4 ¢ - -N` ELEY ` w%1 O 4 ��• ' �` y �\\ r � '/' �" ;:,:+ / C7 f'� !_ i �'-"� '$ © V r0 ___ _.._ — _ O. �•+y fir-4 C r- l!r'• > ;' H , 3 ? t �J '�.' � � PROF 4 ! E 0 F rROUND WATER TABLE lk / s+ /c'q�'•' / = \ t jam/ 7 W r T':' , +^..tom _� PZ. ..5 � �- i f ° `o 3 t_ _- SANITARY DISPOSAL SYSTEM E�r� �-- ,axe q r .. ©' NCT T sc .aL DES6IGN DATA t BEDROOM S • CONSTRUCTION OF SANITARY D I S POSAL DESIGN FLOW 33 y — GAL DAY IQ SYSTEM SHALL CONFORM TO MASS . ,y , 1 LEACH RATE '�' 4MIN./INCH ^ - . ` . ENVIRONMENTAL CODE TITLE Y._ (REVISED 7- 1 -- 17) 4 j AND THE TOWN OF C3 =� r� =- CH CAPACITY : ` PROPOSED LEA P ' HEALTH REGULATIONS . 4 SEPTIC TANK DISTRIBUTION BOX AND LEACHING I � � � • , I X � T- PITTO BE OF REINFORCED CONCRETE : 4' �-� GAL/DAY MIN CONCRETE STRENGTH 3000 PSI s 3 � 1 RENGTH 2O0OCPSiM ! N . STEEL ST s L © _>�— ?" f v 2 H ?() DESIGN LOADING'8 / • DRIVEWAYS NOTTO BE LOCATED OVER SYSTEM 3OZ3 / 5_0 - � 7 , UNLESS H - 20 DESIGN LEADING 13 USED . _ • ALL PI PES AN D FITT I NGS TO BE WATERTIGHT ANC � `` �' / 7' �! TO BE OF CAST IRON OR SCHED 40 P.V. C. S l T E P L A N S HOWING PROPOSED CONSTRUCTION SH . f OF - SHS X 7- f-= 1-Z 4 kY 'X�--- LEGEND L 0 C A T 1 O N A rz,v ( ENT-.: ,� � l FOR ; G_ �' - ~ ' ,. , .f� �. APPROVED -- -- . ---- 19 - _------ SCALE : ! _ © D ATE ___-_._ 4Z/ ��� BOARD OF HEALTH BUILDING SETBACK REGULATIONS PER EXISTING CONTOUR - - -16- ---- REFERENCE : oT / 2 !- � ✓✓ ✓ ��'./ BUILDING INSPECTOR OR 6UILDPNG PROPOSED CONTOUR 16`- - `/ �= � 4 -38 DATE AGENT COMMISSIONER . rv' I N FRONT SETBACK EX STI NG SPOT ELEVATION 17 6 �A��H OF M MIN , SIDE SETBACK PROPOSED WATER SERVICE W �� o CRA TEST HOLE LOCATIO N . sH MIN REAR SETBACK IL 27483 • �- A _ C . R . SHORT, INC . T _tt- �. PROFESSIONAL LAND SURVEYORS L ENGINEERS ss�o�vALE�G�� �✓ ` d l 4-4- 1586 MAIN STREET (RTE. 6A) EAST DENN15, MASS. 02641