The URL can be used to link to this page

Home My WebLink About0428 OLD STAGE ROAD - Health 428 Old Stage Road Centerville A= 190— 114 ! t .. S M E A D No.2.153LOR UPC 12534 amead.com - Made in USA ,ocm e% J ti No.........?� .1.. F1cs....� ."'... THE COMMONWEALTH OF MASSACHUSETTS BOARD O F F-I E A.LT Appliration for Disposal Works Tonstrnrtinn frrmit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: ••' 'Z Ad. .................................................. ... .... Location-Add lor Lot ............................................................... ------� 5 ! ....- ...... i Address Installer Address Type of Building Size Lot. .......Sq. feet U Dwelling - No. of Bedrooms...........�.......................-----Expansion�Attic (+�d) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........ :.._............. Showers ( ) — Cafeteria ( ) dOther fixtures .........---•-------•..................................-----•----------•----...--•-•-•--........-----------•---•-•--......-----•-'•-'-------••-•.-•-... w Design Flow......... ._d...................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity/,.l6.0ftgallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area..R.'._9Y.._..sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z . Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.....C Q_....... ............................. Test Pit No. 1....<.Z---minutes per inch Depth of Test Pit..... . ....... Depth to ground water........................ LT, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ M --------------------------- C. L ". ..-_./.Sf:_//_... O N }/ �'OZ�-�5 L ..---- w -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable............................................................................................... .....................•••---------------------•----------------------------------------------------------••-...... Agreement: The undersigned agrees tor 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 operation until a Certificate of Compliance has been ' sue y the board of h Signed-- �d... .....--- -- .. . . •--•- ................................ Date Application Approved BYE.., ✓ ! _::.. 7 ---?......... Date-------------- Application Disapproved for the following reasons--------------------------------•----•-------------------------------------------------------------......._._... --------------•---..............--'--.....---------•-------------•--•---------....------......------•-----------------••----•----------------------•-----------------------------------...-----•-----•-- Date PermitNo..........................................--------- Date XI �/ No........�....I.L..- F.Ric THE COMMONWEALTH OF MASSACHUSETTS - BOA RD E ...----- .�.......:OF........ .. ........................... Apli ration fur ispos al arks Ton trnrtion Permit Application is -hereby made for a Permit to Construct X) or Repair an Individual S Disposal a Dis ( P ( ) g P System at: ------------- ............. Lc n Ad ................ , ` I •t li�i f 11 ...................................................... dress a0 . ! _ . .................--........ 7 ....... ... ....... Installer• Address Type of Building Size Lot..4�d�!:0.....Sq. feet `.Dwelling ✓No. of Bedrooms._:_ ________............... .. '_Expansion Attic (+�4) Garbage Grinder ( ) PA Other=Type of Building ............................... No of>'persons............................ Showers ( ) — Cafeteria ( ) Othfrfixtures ------------------------ ---------------------------------------------------- ............................................................. Design Flow..•......4r., ...4 4................... per person•per;;day. Total daily flow.................................... WSeptic Tank—Liquid capacity_ 04ftallons Length_;__:: Width................ Diameter................ Deith___.__.--_----- 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 ) '"' Percolation Test Results Performed by....:�':... ._..___$I P. .. + '� �� '"_......... ---•••..•-••------------- 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........................ 04 ..................................................... ----•-•------- ......................................................... O Description of Soil 1� yr 6e E 04 V 1,/ x/� ri l�'O�(!��•-- ��..�...••• f............................ w UNature 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 TITIE 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. Sign ................................................................ ........................... ",. D� 7APPlication Approved BY ....... Date Application Disapproved for the following reasons:......................... ------------------------------------------------------------------------------ Date PermitNo......................................................... Issued-..................... ............................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............OF.......... : :::�%�............................................. (Irdifiratr of Toniplitanrr T S S TO TIF That the Individu Sew, Disposal System_constructed ( ) or Repaired ( ) b.y .� -- ...._--- .........--••---••--•....... --------------••-•------.._.__......_ In at -A- has been installed.in accordance with the provisions of 5*ff The State Sanitary Code s described in the application for Disposal Works Construction Permit N r�' ;-......... dated- ---7w� : ............... THE ISSUANCE OF THO CERTIFICATE SHALL NOT BE.CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.-............................................................................... THE COMMONWEALTH OF MASSACHUSETTS 7" BOARD O HEALT a ........OF..:......- .......... • .. ... No. ---• FEE._. .............. ,k .,. i000 1 ork on ; ' iiimrn rr .� , Permission,1 ,hereby granted.. ...... r... -------- ...................................... to Construct iR a Repair idual Srix, sal tem at No...`".. .... ----•• ;Sr ...•...... ....... "W -------•----•......... Street as shown on the application for Disposal Works Construction P it No ':' Dated "' '" Board-of:Health DATE::...-- • - �... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS TOWN OF BARNSTABLE LOCATIONo? R SEWAGE # V"LLAGE Jfekrc-L/I( ASSESSOR'S MAP & LOT D INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY I, d Of7 LEACHING FACILITY:(type) (size) NO. OF BEDROOMS .3 PRIVATE WELL O PUBLIC WATER BUILDER OR OVY DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No a y L=OCA ION SEWAGE PERMIT NO. g7 2— . VaLLAGE INSTALLER'S NAME & ADDRESS G�-C B U I*L D E R OR OWN R i DATE PERMIT. ISSUED 2 DATE COMPLIANCE ISSUED —/yam 77 '- �.-, 3y � !?�' 1�. vJ r `4 TYPICAL SYSTEM PROFILE A R E A PLAN FDN TOP / FINISH GRADE= ___ NOT TO SCALE FINISH SCALE : I FINISH GRADE OVER TANK- GRADE OVER PIT-_1 ,_ RESIDENCE j q O e . e C. 1 . TEES -- • • . . �/ • • ° • r O ',. 8 S M'T T 7-o FLR GAL. 4 • • r r • • • • • e r r REINFORCED „ DIST. BOX CONCRETE _8 TO BE INSTALLED ON ° ' ' r • • • • • ' • ° A LEVEL STABLE BASE • e r e • • • o • e e S. m SEPTIC TANK C, B• Kk,r, • r • • . • • • e • e e TQt`•' .d`-i�.U�l2.l� )`L `f TO BE INSTALLED ON A • e • • • • ° . e ° ,. + � � r_� LEVEL STABLE BASE e • • • • • e e Y f. -- 2"-1/8'L 1/2 "WASHED PEASTONE ALL ' ' ' ' • • ' ' ' ' BRICK Bi MORTAR COURSES AS AROUND FREE OF IRONS, FINES ° • e • • e r e e ij REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE <� 24 " �,C.I . MANHOLE COVER 8i -- 3/4 TO 1 -1/2 WASHED CRUSHED LEACHING PIT .�. FRAME ' SEE DETAIL 1 STONE ALL AROUND FREE OF BASE TO BE LEVEL 1I<. -.SILT TOE IRONS, FINES AND DUST IN 49. E PLACE ' j ; �y�e!` -- FOR FIN. GRADE SEE SYSTEM PROFILE i — SOIL AND PERCOLATION - 4" DATA TTt7 ` _ 8" - - - _. -- PERC. RATE : MINA IN. + 3kt, /4` �, FOR INV. ELEV SEE oil ' ',';L ° SYSTEM PROFILE C. D. SPOHR INLET _LLi6„ TAKEN BY : p ^Ar L'NE 0 0 OPENINGS Wi4-I:'8�� WITNESSED BY . rf- �'' o D OUTER DIA. 81 1 -3/4 D ° DATE , 7' ' ; o INSIDE DIA. 0 o T-I TEST PIT -GND ELEV, DfST"Kt13UTIC7N COX .,,F5 PliZ^P+,_ 0 .-- �_ E 1 .tia't+►1L .P�► /�•f�: `n: �CRC • . o ' o D 0 D D " ;� `j,� — �.L 0 0 0 0 ,�; ' 1'x J' I 1� EFFECTIVE DIA. `s' b E D(BOOM ---- +�� '� I �O� SE I F � ' �'' LEACHING PIT - SECTION �` r�E0 �` c v�t?rt�. !ti' Bs►�'; I NO SCALE -2 DESIGN DATA NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM N0. OF BEDROOMS L7 — DISPOSAL LEACHING PIT NOTES: —' EST. TOTAL DAILY EFFLUENT GALS I . CONC. TO BE 4000 P.S.I a 28 DAYS . SEPTIC TANK GAL. ^? 2 . REINF W 6 x 6 '6 GA. W W. M. LEACHING AREA SOFT/GAL. __ SQ.FT. + 3. 2 SAND 4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES GREATER DEPTH REQUIREMENTS I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ( NOTE . ACCORDANCE WITH ART. XI OF THE STATE SANITARY CODE EXCAVATE TO ELEV. OR LOWER AS DATED AUG. 15, 1966 81ANY LOCAL RULES APPLICABLE. REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR'D. BY THE MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL BD- OF HEALTH. WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED PRIOR TO BACK FILLING, NOTIFY BD. OF HEALTH FOR INSPECTION. 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED. 4' - )•4" �',� ^� 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT BOARD OF HEALTH APPROVAL. ----- -~�----�-�--- -- - - --r- LEGEND 6. BOARD OF HEALTH INSPECTION REQD. WHEN EXCAVATED. 5 0.0 EXIST GROUND ELEV. 50.0' FINISH GROUND ELEV."UNDERLINED" y ` R E v DATE DESCRIPTION Ilk 4 47 50 PIPE INVERT. ELEV. STAGS .. O TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM o o SEPTIC TANK F.0 R Mlk. THOMA hA� T _l 0 DISTRIBUTION BOX _ 4 C I . PIPE u` aSSAc\ LOT ! OLD �TA� E /vz.� A f�'1 ��f. � �� ; O..... 'harles D. C�NT 7 t'` V I L L E, �J if1 C` J. ~ ttttt+tti— 4��BIT. FIBER PIPE -TIGHT JOINTS gpp S Est DESIGNED. C.D.SPOHR DATE:C DRAWING N0. - -- �— PROPERTY LINE . ` �/ DRAWN. SCALE:ASSHOWN MIN . CODE DISTANCE \ _� v - I CHECKED: C. D. S . l