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Home My WebLink About0558 MAIN STREET (CENT.) - Health it 558 MAIN ST Centerville i A= 201-041 I IN I SMEAD KEEPING YOU ORGANIZED No. 12534 2-153LOR n SUSTAINABLE FORESTRY MIN.RECYCLED TT INITIATIVE CONTENT 10% Certified Fiber Sourcing POST-CONSUMER 19 SFI012M MADE IN USA !SET ORGANIZED AT SMEAMOM s No.. Fiz$..... ' ..'........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH bYOF...............................................-----.................................... Appliration for Disposal Works Tomitrnrtion Vamit Application is hereby made for a Permit to Construct ()K or Repair ( ) an Individual Sewage Disposal System at: s ---------------------- ------------•--------•-...--------•••-----•-•-•----------•--•------•......----•-............•.--.. Location-Address or Lot No. .... ............................................. -....--------------------------- ..----------- . OwrTer ) ! Address Ins er Address UType of Building / /' Size Lot...........................Sq. feet �--� Dwelling—No. of Bedrooms___ C4?...Aelt�.f�` &...Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow ................... .......gallons per person per day. Total daily flow gal g g P P P Y Y Ions. WSeptic Tank—Liquid capacityl -gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.-.;...... c_._... Total Length........... .. Total leaching area....................sq. ft. Seepage Pit No.."�_...----___. Diameter....... , _.�. Depth below inlet....... ...... Total leaching area..................sq. ft. Z Other Distribution box (V Dosing tank ( ) aPercolation Test Results Performed by--- ........................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water______._-..--"-"-_-_____ a ......••-•••••••••-----••••---•...•-••-•-•••••......--•••-......••.... ODescription of Soil......m:d_•.-Sowd""----""""--""••--•"""---"-•...................................................................................................... x U •••-••••••••••••-•••-••••••••---•••••••....••-••••--•._..--•-•-...•-•••-•••-••••-•-•..__..-•-••••••••-••••-•-••••-•••---•--•-----••••-•••••----•-•-•---••-•-....•-•-•-••••-•......--•-••..........•..... w x ••-•••••-------------------------•--------•••-•••••••-•--------••-•••---•••-••-•••.....•••••--•••-••----•-----••-------'-----------------------•--•-•-------•••-••••-•--••-•-•-••............••-•--..... U Nature of Repairs or Alterations—Answer when applicable._-_ ~04.,e�4191J__1 a' + •................................... ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL1� 5 of the State Sanitary Code— The undersigned W s not to place the system in operation until a Certificate of Compliance has been ' ed by the board of li Sig - --- --- - ----"---�- -----•- ..•••... ------ Application Approved BY-•-• -•••••......••• ---- - ----------•--•------------•------•----•---.--•--•--------------- •--•-••--�1_ia '... le Application Disapproved for the following reasons-----------------------------•-----------------------------------------...----------...__----------•---•--------- ....•-••••-•••....••-•-••••-••••.....••••••-••-•-••••••........-••••-•••-••--•-•.............•-•••......-•••••--•-•-......•••------------------------------------------I'll------ Q� ��`� Date Permit No..A:�;.�---------------------------------- Issued...........................................Dat Date TOWN OF BARNSTABLE LOCATION -637F A(WI J (S7-- SEWAGE # ` VILLAGE ASSESSORS MAP & LOT �7- INSTALLER'S NAME & PHONE NO. Zy4-',j7Y60 / CgA)-S,I 771-3Z391 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) / (size) 6 0O�� j NO. OF BEDROOMS PRIVATE WELL O UBLIC WATER BUILDER OR OWNER A64FZ ,,61/-JE /<L- DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes C40!s ��+�� Z No.AY-252. FEz U......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF............... Appliration for Elispvaal Workii Tomitrurtion romit Application is hereby made for a Permit to Construct N4 or Repair an Individual Sewage Disposal System at: ........ ...St....(�x.Mn),Lfflk........................ .................................................................................................. Location-Address or Lot No. ........................................ ...A+;...... ............................................................................................. Owner Address .................................... ... .................. Insta e Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms... AM....Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons._..__...................__. Showers Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow.....1/0..............................gallons per person per day. Total daily flow-,66-0...........................gallons. 1:4 Septic Tank—Liquid capacitA00-gallons Length................ Width......._.._._... Diameter..__.___........ Depth..._............ Disposal Trench No..................... Width............I;....... Total Length......... ... Total leaching area.....................sq. ft. Seepage Pit NO. 6% Diameter.......�2__.A Depth below inlet..... ......... Total leaching area..................sq. f t. Z Other Distribution box...('i) Dosing tank 14 Percolation Test Results Performed by--- �4 ........................... Date._..__._. �4 Test Pit No. I................minutes per inch Depth of Test Pit..........___......_ Depth to ground water_._._................._. frq Test Pit No. 2................minutes per inch Depth of Test Pit__.............___..•.Depth to ground water._...____._............. P4 .............................................................. ...................... I .......................................................................... 0 Description of Soil......M-4d....s d...........................................................................................................I....................... W U .................................................................................................................T...................................................................................... ......................................................................................................................................................-................................................ U Nature of Repairs or Alterations—Answer when ......4.&�le !:7 ---------------------------------- ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T LE 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 by the board of health-<_7 4,7 ...................(_1......... .... at Sig .................... . . .. .......... ............................ ......... Application Approved By.... /ate Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo..,k ................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................OF..................................................................................... Terfifirab of Tompliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (><I or Repaired by...... ................................................................................................................................. Installer at....... ................. .... ...t.........e. .................................................................................................................................. has been installed in accordance with the provisions of T_17T 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..4.*/nl��................... dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE._.. ............................. Inspector-------------------- .)3............................................. ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH g .................... .......OF..........94_1 ................................... O N X. FEE.... ........... Dispnoat Permission is hereby granted.......k�� ......1/............................................................................................... to Con§truct 11S or Repair-(— ) an Individual Sewage Disposal System at No..:�a.!j3....1!;.T L=_ ... . ............. . ....... L.r Street as shown on the application for Disposal Works Constru No&Y_',�_ _ ..........I------ ctt9jj-Termit_' .. Dated-_ ................ ........................................................................................................ < Board of Health DATE....... .. ... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS WA TOP of FOUND. 20 FT. MIN. SOIL TEST EL. _ �` `� 10 FT MIN. DATE OF SOIL TEST FF ICONCRETE 4" CLEAN SAND WITNESSED BY PI 'r tavi+i/� ra COVERS SC 40 P,yC PIPE PERCOLATION RATE L MIN. PITCH I/8 PER FT. �_ MINJ INCH CONCRETE OBSERVATION HOLE I OBSERVATION HOLE 2 k�ASFJ'r �r 4CAST IRN PIPE 12 COVERS 2 LAYER OF ELEV. ELEV.= , Jc I ! (OR EQUAL,j MIN. I/8 1/2" WASHED PITCH I/4 PER FT STONE , ray * �. FLOW LINE t g 0*410 1 SWJ6 10 EL = J MIN. :r,t•r.r N �QAi) .Cj EL.= �3 20" EL = 1 LEVEL = EL= �- EL. _ w D I S T. EL. = 91...f BOXoo a o '. Lillti WATER AT `� EL.= 33.t WATER AT EL.= >_ 3/4 I I/2" ° fo° I v o GALLON WASHED STONE • o° ° u- o 0 ° DESIGN CALCULATIONS SEPTIC TANK �' ° l `'c o 6'° v EL.= PRECAST LEACHING - _ NUMBER OF BEDROOMS c BASIN OR EQUIV. (6 GARBAGE DISPOSAL UNIT AOU f DIAM. TOTAL ESTIMATED FLOW SEWAGE DISPOSAL SYSTEM PROFILE c /fv GAL./BR./DAY x r BR.) % �`J GAL./DAY NOT TO SCALE REQUIRED SEPTIC TANK CAPACITY r�1�i GAL. �e _/;� ,•. i� � -' °'" � -';_�i'%� ',�. � `� � J''>�' ACTUAL SIZE OF SEPTIC TANK ' �Z GAL. BOTTOM OF TEST HOLE OR US63-fROB tE--WAfiER-TA- tE- E L = �`�.1, LEACHING AREA REQUIREMENTS ;VER—T@tf --i— -EL = SIDEWALL AREA GAL./S.F. BOTTOM AREA GAL./S.F LEACHING CAP C TY BOTTOM SIDE LL) ��' GAL. LEGEND I +yX S xsx .83 7!t3 14,31,7 X 7 IJ/mot 4i(; r�T�) r. . / SERVE LEACHING CAPACITY fix' GAL. EXISTING SPOT ELEVATION OOXO EXISTING CONTOUR - -- - 00- --- FINAL SPOT ELEVATION 00. NOTES FINAL CONTOUR w I. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.Q.E. SOIL TEST LOCATION TITLE 5 AND THE TOWN OF ir, !?` o RULES AND UTILITY POLE -0' REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. TOWN WATER W �`=W CATCH BASIN 2. ALL COVERTS TO SANITARY UNITS SHALL BE BROUGHT TO i WITHIN 12 OF FINISHED GRADE . 3. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME. T 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H- 10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT OF DRIVES OR PARKING AREAS. H-20 LOADING MIN FRONT SETBACK SHALL BE USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING. MIN. REAR SETBACK 5. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE MIN. SIDE SETBACK SHALL BE MORTARED IN PLACE. 6. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER /APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. t — y ► ''� ,� � �� ` __ .___ 71 APPROVED : BOARD OF HEALTH AIIATICI" DAT I '� E AGENT �� +, `w J - PROJECT LOCATION, 7c 3 { / APPLICANT: lz --- ..' _` _'" `.-. *-- .� 39 � � ,�, t `�� 1 �L,_kq�•�t'../'I r k � -/`��U.��"}'_ i� rf �' gliq �-� ROBIN w. WILCOX PROFESSIONAL LAND SURVEYOR 203 SETUCKET ROAD 385-6478 SOUTH DENNIS, MASS. 02660 SCALE: DATEt l REV. REV. LOCATION MAP JOB NO. SHEET ► OF