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HomeMy WebLinkAbout0288 PINE STREET (HY - Health (2) 288 Pine Street Centerville A= 228 -039 - 002 No-. 42101/3 ®RA az � d low �I TO F BARNSTABLE 1,07.JION /2V OZ S7 SEWAGE # VILLAGE C�� %��/G� ASSESSOR'S MAP&LOTg'03��d�a INSTALLER'S NAME&PHONE NO. CORP '57 SEPTIC TANK CAPACITY LEACHING FACILTI'Y: (type)�A� l y/L�,41d2/(size) A/)/ 071c�_ / NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: /7 ~�(® COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility /1/A/Z6eet 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 facciili ) Feet Furnished by �_ . A 3 �a No.... FIms.. ln�........_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uiripwml Wi urkii Tunitrur#inn runfit Application is hereby made for a Permit to Construct ( L_�or Repair ( ) an Individual Sewage Disposal SysG� 7 '��l�� .... 0-----.._.. ...------•-•-- --------------•---......--••-•----..............--•- Lo , n �\i ress -- r Lot No. ....... ..... .. ....._...._..... . . ....... -- /l :...�....}.... ...... • ----------- ... .. a ^' 4/ �sV... .............:(....... -----••- . dress ^_•..._. � Instal er Address �� (�U O UType of Building ��� Size Lot...-__ _¢..............Sq. feet Dwelling— No. of Bedrooms._/"X�n -r� -----_-Expansion Attic (Ala Garbage Grinder WQ) p.,, Other—Type of Building[et/if vr�.__ o. of persons................._-__-_-_- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - --------------------------------------------------- W Design Flow...................11Q................gallons per p en per day. Total daily flow..........3-----------_...__...._..........gallons. WSeptic Tank—Liquid capacity-M.gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench--No. .................... Width.................... Total Length.................•_. Total leaching area....................sq. ft. 3 Seepage Pit No-------------_-_--. Diameter_................. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing ;aanyk�( ) ,�1�1 3 ~' Percolation Test Results Performed by_4--_"--- ---Y.-l6 ".'6Y---------------------------- Date--------_--..--64-6----------- Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......_................. 0 Description of Soil -- -'----------•--•---••-•-...-•--•-... -------•----'--....-•......--'--'- ----------------------------- W -' --------------------------••-•-------------'---.....------------------...---------------'•-••-'----••'-•---------------------••--•----•--'-••-'-•-••••••----••••----••••...........•-----•--._...-' V 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 Enviro /pental Code—The undersigned further agrees not to place he i Sys t i operaQ ion unti a Certificate of C ll n e een issued oard of health. 7_ � •Signe ......... ....... ... .......:...... ' ...................... Dare App,jication Approved By ............. ........ .� Applica ion Disapproved for the following reasons: ...................... ............................................................. ................... .....----......�.......--.---'.................................................................................-----`----............................................................................ ........................................�[e -�ermit No. ..O[V..--.. ���........................... Issued ............. Dare e F � i THE COMMONWEALTH OF MASSACHUSETTS _ s BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Diripuual iVarku Tomitrnrtiun ramit i Application is hereby made for a Permit to Corfstruct ( ✓)/or Repair (. ) an Individual Sewage Disposal System at: ..................... ........ ... ....................................... ....... .-_ .6�....----- ---•--•.------. ...... Lortfibn �.\d rcss t No.or Lo ,.�._._._.. 3 - --------------------------------------------------- Address ----------- � Installer Address U Type of Building Size Lot..�8 .O....Sq. feet _._____..._ Expansion Attic N Garbage Grinder A( ) ., Dwelling—No. of Bedrooms--- --_-.--•.----•-_-__-_- p ( �). g ( v `a l.��i'1/.r _ /!_.�C. No. of persons............................ Showers — Cafeteria �t Other—Type of Building __ � p ( ) ( ) POther fixtures -------------------------------------�3 ------...------------------------------. --------------------------•-------------•-------.:_......__.. ` W Design Flow..................../l_.O...............gallons per persen per day. Total daily flow..........3.�-�_a.......................gallons. W Disposal Trench—No. .................... Width..................... 'Total ���idth..-;------_--_-- Di�Imeter_.-.__.--__-_-. Depth................ � Septic Tank—Liquid capacity.�. .gallons Length___ -----._ I; x Seepage o..................... Diameter._._____......_..._. Depth below leaching area.................... ft. 3' T Pit l� } low inlet................Total leaching area..................sq. ft. �Z Other Distribution box ( ) Dosing.,tank ( )�.�� ,, .k Date...5../01.3/ �b '-' Percolation Test Results Performed by.,_, ..-p. .7._.C.-._.. �P_ .2............. Test Pit No. I..........'�---minutes per inch Depth of Test Pit................... Depth to ground water....................,... �r4 Test Pit No. 2................minutes per inch Depth of Test Pit.______...._....... Depth to ground water........................ .....................••-•--•---•--......--•---•---••......----•-•-•-••......................................................... Description of Soil...... A.__� A.. !'_M::... ..... ...... .-------- •--•----•-------•-•----•-••--------------•--•--......-----••..........----••-------••--.....--•---•--------•----•------------••-----•-•- .....-•-----------•-----------------------------------•------------------------•-•--------•-----••-----••-••••--------------••-•-------••---------------------•--------••......---•-•......-•------•-- 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 Environ-mental Code—The undersigned further agrees not to place the system in operation unti a Certificate of pli� ri e hV een issued =h e-eboard of health. �— `7 �(O�Signed. ..�..~,... ............................................................................. .................Dare...........:...... Application Approved BY ------... ... �. ...-.�/ Application Disapproved for the following reasons: ............................................................................. ... ..................................................... .... ................... ........................................................................................................... ........................................ Date Permit No. .. .y...---`jr. �� ....._.................... Issued ............................. Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C'lerti i a e of Compliance THIS IS TO CERTIFY, That the Individual Sewage Dispos 1, stem constructed ( 1/ ) or Repaired ( ) r- -ram ,��- !1�I1 /� �(/ b .-------------'--rrc�-- .`; '�D....._..._- --_ .._a..-----.-----_...............`................--.._........................................ Y ..... . .................... �.........._........ Installer _ at .. ��.��.. ......... .._..._��,/ �.. � ......................... ...�../........../G.................... .... .... ........................... ... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..._.... 3�� .. dated ...._...............................-------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......../..^..... ^..../....... ................. -------..-- Inspector ... -45W...........- ........�...... --_- ----_, o -.__ ----•-- ---- __- �_--------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..... . 33 FEE---� ?......... Disposal Workii gunu rudiun "amit Permissionis hereby granted•.._---- ------:....-- •••. .. -----------------------------------------•-----------•-------------••---.:.---------- to Construct (V) or Repair ( ) an Individual Sewage Dispos ystem at No...... U 7 a /, .... S T- ... C NTi�.(�✓.�.�-� ......------•----------- ..................................... Street C� / q as shown on the application for Disposal Works Construction r it No.-!.�-33 Date�f V�..-C��."../�..... ����.------��_ Board of Health DATE......-•--.-f--�----------• ----...........------------�.. --_ FORM 36508 HOBBS&WARREN.INC..PUBLISHERS 'Y TEST HOLE LOG DATE: TEST BY: WITNESS: PERC RATE: - 5�3 Z. �y Z r`l ------------- DESIGN DATA - DAILY FLOW: SEPTIC TANK: ?'_+ x 1SU%= GPI o LEACHING FACGI LIT Y' � 3 vim=STacJ�c USE: CAPACITY: / S1DENVALL: GT '� •�� ���` �`?`'_' / V J BOTTOM: �'P Z�' TOTAL: ' /;`e ••��. -yam /-".� .._...�/`/ G`/ C— •' ✓ .0 L Al DI ;..Z OF 31 ".PEAIRT47):1 F Lill '4"-1 j,':" WASRED L7 0 1. "'SL Ov Dl ,!-RJ .U1-(pN)jOx STON.f. LLAR'-'UND TOP OF FOUND. 0.1 1711 z 5 ALL PIPE TO BE 4"D1A.SCH 40 T'-/C jWsE ALL A-PPLICABLE 'vl xNfIOLF CoVyRs 1'0 WITIiIN 6 C11 FlINIS11 GRADE THIS SYSTEM IS NOT DESIGN",'-9 FOR THE USE OF A GARBAGE DISVQ",%1- SEWAGE SYSTEM 13ROFILE SCALE: 1` 10' D A E. L NOTES GENERAL N 1. CONTRACTOR TO BE RESPONSIBLE FOR THE ar ABOVE AND h, LOCATION OF ALL UTILITIES -4 ON A. UNDER GROUND,PRIOR TO ANY CONSTRUCTION SITE7SEWAGE PLAIN EXCAVATION. FOR c OR INSTALLATION OF SEPTIC SYSTEM TO BE IN COMPLIANCE WITH 310 CMR 15.00: TITLE V. PREPARED FOR 3. T '.IS PLAN IS NOT TO BE USED FOR PROPERTY' .It NE DETERMINATION. .43,00l SCALE lVo>�,o DATE: WELLER & ASSOCUMS P. O. jjoX I 1 19 YARMOUTUPORT, NIA. C:� APPF'OVED BY: (508),362-9131 a OCT-25-1G94 17:52 . FROM TO 7750155 P.01 t� low �t i+k18S' z-1 z8 t Z,4'7.gZ i A3aoO± �cQ} 70 �'1 J pE. �C1r�vED Nlu s — � — _ Yc � 7E K Q rA C. O Q 0l05 _ r in E+5 r'_Zo vC �- M LrX�'SFpL Crip) 51 41 eT 10�� C1r�cI-� �.:F.l!Y•�/ �+. LfACQ�U_ �' �+ �� zY � �"SK�µ'� / 0 Z ��o W rO� -PV r L1C- 4���( PAUL A. tea+ �q o A U L c'SG LEVY 3 A. 1 ,Y All Na 10617 " p C E Y Y y 1'\'lam �/Q, ,sy lio,lOdS�rcQ LEGENO - EX18TINS SPOT ELEVATION OAO EXISTINQ CONTOUR ----- O ---- CE IFIED PLOT PLAN FINISHED SPOT ELEVATION ltlNt lNED CONTOUR ---O HOTS: The location of any existing underk-:-ound sewurabu, wells. or other utilities shown on this plin ii approz- IN locate only as determined from records and/or verbal �C-.�T�1�.VILC.� VVA information. llie contractor is responsible for the verification of the existing location9 in the field. SCALE$ V 40' DATE- S-U,-81 r- EW & EU)REDGf_ ASSOCWTES, INC. I CERTIFY THAT THE PROPOSED ENGUKERs-LAIDSCAM ARCHrrEM JOX NO. BUILDING SHOWN ON THIS PLAN OL.AIYIMOtS_LAND wRVE MS yt 5 CONFORMS TO THE' ZONI S LAWS 0� 712 MAIN STREET. CH. aY• �'�,t� MYA IJN I S, AtA93. SHEET t Of ATE G. 9LANSURV£Y N07"E /X Ar/TNER '?'N4 S1�pT/C TA, 1 O,4 ?O J°T. M/N• LF.4CN/IVG P/T AJtd MGRE THAN /I`3E1 Dr'S/ �4•,D/AM /D pr. At-W. �R•'�dE�A rFT.E& CQNCPPFT� CGY'C R 8/41e1Lt �°F jf W0V pq7- TO ciRAOlx. �'r4N ,GXTrF'� R CpNCRty'd '4�PVC PJPC r{E,r}Vy Cif ST IRON COVER S'fr'.4-LL B,E• Us03-02C7 =i - �� � 'O COYFRS M/N• PITCH IP'/IV rbRIVE1NAy •'• +:; P MIN. A ; - OAP& C 0 VIER CL EAN -TAJ1r'O •' f BAC.E'F/d L :i: LQtt/0 LFYE4 • ' ti ' J!Ka P/PE 5 — 6A4. ° s° ► ► • . . • •e r d}0 a 6 WA3Ir'FO$7nNE. MIN.P/TCN D/ST. ' • • • • • ►► e • T 4•Pent P T. 5ffP77C TA/Y/� BOX o ' s i t $ • r • •• � .•+�Q • ' Y�`t • �tD • r r•gPfrFCT"/.� ; : i i � 4 — l f2 tier • OGPTN • � 0 � 1 ° • • ••il 'eve I661%4sX3 , = 14/O At • o. • i • • . • •• � a ••• /N oMor fL.eVAT/CNS '7Bx /,6 X3par�s • Z34 !^raLs • FLW INYERT A7 Ou/LDIN6 l oZ•15 FY z' 6 sT. D/.4M. IN&&T SO?TIIC rA VK 10?.3 FT Fi), GapYi7. _ /(D44 CrPD- IO .47. o%AM. C(SBTa7�IDUL�IT.iGIy> Ot17tET$&PT/C 'rAN,K -FT INLET 0J3TRJBl/Y/ON BOX �° � SECT/DN OF GROUND TER TAOLF avnErarsrx�suria/v 6oiX �°S.� ��`: -- S�'j'�/AQE �3/SPOSA L SYSTe�FM �' /NtE�'st.�c�IN6 PiT ioc. fr. TjIQ�JL..lTIDN . LEACHIlVew PIT DJMFNs/ON A 3•S F7 D/gS/6N CR/TORIA 01AYAWSION S � f`T• AWNSBR Of AWXWd0MS DiAlAwS/ON C_q•U PT. 0 r,AROAGED/.SPasAJ.IINI,- �°'"� SOIL. LOG SOIL. 7-057' TOTAL �T/J►?ATE'D FLOPS/ R G.4G.�LLAY SOIL TEST A / AhJMOER Gf�LCACNlHG P/TS_� �LCY. 104.i e!LrY, lob ,A�4TE Of 30IL 7'L�TT r..(. � 'F TGp'1+�CH/J�I�d PAW OJT -78 I�7 �' Prni' Ar COLAT/ON A4-rarjoIdY 2 MI IMCN d9077VAfAA4CJ'U/VoP61RP/T �g S4. Jd7: �• ,n •'�r ''�' �JtCOlA7'/ONRATIF 2 M/N.r/INCH ,7n711 L Lf.ACN/NO ARAPA 7.$._14) Re1oRN LEACH/N6 ARF^ SO Fr o. p4C14Ur/. tAof�$ thu LoT Z �Jt ''E V Y 9 No. 10617 A NQ.iooso�o ti �s��. �,�'fi a . LEVY & ELDR£DG£ AS-SOCIAt£S. INC. A� t6 � 7tP MAIN .9T ,gyAAl Mf-$, M.,4S-5. 5 P�a� �j,�.s'Y fr. �. I7 r�,�i '`+Z.1 _. _l.�� o cQ_�.,C.—c,.�O1fAt J DATE:. -? �, ® NoGROtINJ kvATeR ZWCOUNTtr�CC'D CLIFNYr r'.1b� C,