HomeMy WebLinkAbout0015 MINTON LANE - Health 15 Minton Lane
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No THE COMMONWEALTH OF MASSACHUSETTS_.- .... -FEE S j
BOARD OF HEALTH
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APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for tt to Construct Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components
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Locatioq wner's N e
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bivlC.t�-
Map arcel# Address
Lot# Telephone#
Designer's Na� I �
Address F Addr
Telephone# " Telephone#
Type of Building: % Lot Size a0 0 2U Sq.feet
Dwelling—No.of Bedrooms Garbage Grinder ( )
Other—Type of Building No.of persons Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min.required) gpd Calculated design flow tJ gpd Design flow provided ��J gpd
Plan: Date co 7-f� Number of sheets �_ Revision Date A/ 4
Title '"�(G /% Jf[ ✓ v U m✓ L�f
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 an er agrees not to place the system in o e nh a rtificate of Compliance has been issued by the Board of Health.
Signed. �I L�lot
Inspections
FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
TOWN OF BARNSTABLE
�L
LOCATION 1� N 0 SEWAGE #
VILLAGE
ASSE R'S MAP & LOT 1'7 f 007 D
INSTALLER'S NAME& PHONE NO. ,�i\-
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)S 3—1
' I
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: `ro t COMPLIANCE DATE: 3-S 0
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 facility) Feet
Furnished by
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r No. •�1-�-7J7 THE COMMONWEALTH OF MASSACHUSETTS ' FEE /
iA 9 K)St OQ141BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
Description of Work: ❑ Individual Component(s) ❑Complete System
The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( )
at
has been'installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built
plans relating to application No. Ao 1 - A-7 dated Approved Design Flow (gpd)
Installer /) .j
Designer: Inspector P A A-) . L/�l'..v Date 3 .(5 r 6)The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96
THE 1°wiCOMMONWEALTH OF MASSACHUSETTS FEE ry
m� nn
_'a'�WJQSSAf��U BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby grant d to Construct ( ) Repair ( ) Upgrade ( ) bandon ) an individual sewage
disposal system at � i / .Ii/ 1�/� /�as described
in the application for Disposal System Construction Permit No. dated
Provided: Construction shall be completed within three years of the date oft 's pe t.All local conditions must be m6t:n
Date 1 C��� Board of Health T
FORM 2 - DSCP DEP APPROVED FORM 5/96
FORM 1255 (REV 5/96) H&W HOBBsB WARRENTM PUBLISHERS- BOSTON
�i i ��to Q�� . tii.b-\�•, y ff�tY..t4��
v..__ INO I �`� THE C MMONWEALTH OF MASSACHUSETTS FEE !�0
OARD OF HEALTH
— OF
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application for P t to Construct. Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components
Locatio wner's N e
Map /arcel# Address
;3� 0��-�3
Lot# 1� �'`Telephone#
` \ �/gs �/1{ �n, �� I./`I/�E. �9✓G,'-�.tJ f F/1.lr✓,�, ��V G/�
/ CWS arn� /"-I��'"'_- � ' Designer's Na
•-n-ZZ2� Address rAddr
-+ [•1C� Telephone# 7.4
�—Telephone#
r J Sys -
Type of Building: Lot Size 490 y 21-2 Sq.feet
Dwelling—No.of Bedrooms Garbage Grinder ( )
Other—Type of Building No.of persons Showers ( ), Cafeteria ( )
Other fixtures c`
Design Flow(min.required) T d gpd Calculated design flow gpd Design flow provided�gpd
Plan: Date (.0 Number of sheets Revision Date A/ 4
Title rl a /% . _ /�y�e.I d ✓ �
Description of Soil(s):_
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation ?•(o
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TITLE 5 an er agrees not to place the system in ape on nti a - rtificate of Compliance has been issued by the Board of Health.
Signed to ,
Inspections
i
FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
• I
1 TOWN OF BARNSTABLE �L
LOCATION \� "k SEWAGE #
VILLAGE(2�� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
.
SEPTIC TANK CAPACITY p
LEACHING FACILITY: � W5(size)'
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: t COMPLIANCE DATE: 3--5'-o 7
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the.Bo.ttom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (lf 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
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GB Phone(508)790-6265
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BV75-3344
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k TEST HOLE LOGS
SYSTEM _PROFILE _ --
TOP FNDN = 107.0' -
_ ACCESS COVER TO WITHIN 6" OF FIN. GRADE - NOT TO SCALE) D A, OJALA, SE
ACCESS COVER (WATERTIGHT) TO ENGINEER: _
RrE s
WITHIN 6" OF FIN. GRADE WITNESS: JERRY DUNNING I
�l MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM F '�-SR�CE RD98. -----------------------------------------
F �~-
2" DOUBLE WASHED PEASTONE DATE: 26 98
RUN PIPE LEVEL _ LOCUS
102.0' FOR FIRST 2' 3' MAX. PERC. RATE = C 2 MIN/INCH '11INTON
PROPOSED _1500 IIL- r
98.75' GALLON SEPTIC rBCA
8.5' DTI TEE /// 95.5' CLASS _ SOILS p# 9166
TANK (H- 10 ) AS - p
' FFLE 93.17' 93.0' - _ CO Q 0 O Cl Crl O [� NOTE: THS 1 AND 2 FAILED (SILT LOAM)
MIN c�c o 94.67'� 0 Q E� Q 0 4 -:SOUND
( 2 % SLOPE) � 6" CRUSHED STONE OR MECHANICAL [] [� L� 0 CI CO CO ELEV. ELEV' pQ�
COMPACTION. (15.221 [2]) MIN o Fa 2' CJ El ED C7 CI ED M CJ ED ob 92.67' 0" � 98.5' 0" �_
(
DEPTH OF FLOW - 4 MIN 1 % SLOPE)
TEE SIZES: / 98.5'1 % SLOPE) ( 3 4" TO 1 1/
2" DOUBLE WASHED STONE '
10 2 O
INLET DEPTH = 0 LOCATION MAP No SCALE
14„ 2,.
OUTLET DEPTH = E
£
LEACHING 12 17' LS LS ASSESSORS MAP 174 PARCEL
FOUNDATION- 26' SEPTIC TANK 17' f D' BOX 21' FACILITY 4„ 2.5Y 6/2 4" 2.5Y 6/2 ZONING DISTRICT: RF
B B YARD SETBACKS:
LS LS FRONT = 30'
36„ 2.5Y 6/6 95.5' 36" 2.5Y 6/6 95.5' SIDE = 1q'*
�.� Cl REAR = 15'
HYDRANT 80.5' Cl LS
TAG BOLT {#1799 I>erc � (unsuit.) PLAN REF.
ELEV 111 .03' M/FS 72� 2.5Y 7/4 92.5
FLOOD ZONE: C
_A --- 108" 2.5Y 6/4 89.5' MF SAND *WAIVER GRANTED BY PLANNING
/ BOARD
C2 2.5Y 7/4
M/F SAND 96 C3
of �` 2.5Y 6/6 M/FS
MAN TQ 2.5Y 8/1
a = 138" 80.5' 144 86.5'
_ ,..,� N N \
NO WATER ENCOUNTERED NOTES:
r. T AL O<-VED nyp UM IS ASSUMED
"qEPTIC DEIGN: (GARBAGE DISPOSER is-NO
E crC 103 �- AVAI ABL_E
UTILITY CL T R SDI �' f �� I RtSI(;iV Fi_C;,N: _ BLOKC;JN/6 ( i ivhF'U) _... ,.; , fir' " '2. V'v`I=,TES:
ELEC,TEL,CA E A 440 GPD DESIt3N FLOW 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10
�I~PTIC TANK: 440 GPD !` 2 ) = 880 5, PIPE JOINTS TO BE MADE WATERTIGHT.
� \ / W `� i UTILITY CLUSTER
CATV
J ��r~J^ UTILITY
CLUSTER
I_.SE A !� C GALLON SEPTIC TANK 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
ELEC06 ENVIRONMENTAL CODE TITLE V.
7
of GAR --- ' CACHING: 2(33.5 + 12,83) 2 (.74) . THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
5�� SIDES: --- 1:37
PROP, DWELL. - USED. FOR LOT LINE STAKING. ,
\ 19 33.5 x '12.83 74 3'i 8
°o� \ TOP FNDN = --23.0' q E40TTOM: -- - 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4' PVC.
107.0' �� PROVIDE-FOUNDATION 614 455 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT
DRAINS IF UNSUITABLE SOIL TOTAL: S.F. GPD INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED
ENCOUNTERED IN AREA OF USE (3) 500 GAL ACME OR EQUAL LEACHING FROM BOARD OF HEALTH.
DWELLING CHAMBERS WITH 4' STONE ALL AROUND
10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE
LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR
�6 TH1 TO COMMENCEMENT OF WORK.
ILED TEST OLE QI
~ LEGEND / I/ E I I`L HN
6 TH 2
5' REMOVAL
R D FAROUNDUNSUITABLE 100.0 PROPOSED SPOT ELEVATION OFSOIL LOT 9 M I N TON LANE
Cl' / PERIMETER OF LEACH
100x0 EXISTING SPOT ELEVATION
FACILITY, DOWN TO SUITABLE IN THE TOWN OF:
L0 9 /`T I SOIL LAYER. REPLACE WITH
3' CLEAN MED. SAND. 100
PROPOSED CONTOUR
2 02 s (C E N TE R VI LL E) B A R N S TA B LE
r� H3 66 - 100 EXISTING CONTOUR PREPARED FOR: MAINE POST AND BEAM
O N •00' w SP E 86, 30 q 30 60 gq
A \
L 6- BOARD OF HEALTH
96-- APPROVED DATE MA SCALE: 1" - 301 DATE: JUNE 16, 2001
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off 508-362-4541
fax 508 362-9880
down cape eng�neering, inc. �, ARNF
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939 main st. yarmouth, ma 02675
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