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HomeMy WebLinkAbout0048 RICHARDSON ROAD - Health 48 RICHARDSON RD, CENTERVILLE A= 210-134-002 No. 42101/3 ORA ESSELTE 10% O O 0 O i i TOWN OF BARNSTABLE �r LOCATION /3-D 0 SEWAGE # VILLAGE ,—,,7 ,—,i //P ASSESSOR'S MAP INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY )-uy /ll � LEACHING FACILITY: (type)�rJ�R�J�kc 4 4,j 175J (size) NO.O ROOMS QUILDE OWNER PERMU DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility !0 'f 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) �l� Feet Furnished by �- '7- L� t�o2' q q w Ire,+ ' V/ 3 � a D, 16 , 13 No... ZFizic...........fa, ... THE COMMONWEALTH OF MASSACHUSETTS 6 BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Uiopooal Workii Tonotrnrtion Permit Applications eby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: �,] �( -/4 �it� ,$'�� ...............% ...?-.`............ :.`. `' wth o..-c r j-- -•-------- C...... ►......................................................... .Csc� Location-Addr or Lot No. - 1Ti Gr7T!�-----�t�0 1n 5----- ------------------ ----------------------------- Owner M '� Address a .............................. �o.,rsc-rz. rT�------------------------- ------------1' l Installer Address U Type of Building Size Lot___ ..Sq. feet Dwelling—No. of Bedroom s.---------- ------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons-------------------_-------- Showers ( ) — Cafeteria ( ) f->a Other fixtures ------------------------------------•----_------------ W Design Flow----------------S._.. .....................gallons per person per day. Total daily flow------------------ n-_-_--gallons. WSeptic Tank quid capacity.�.4. allons ' Le ngth_�e:S Width__5'!8�_. Diameter---------------- De th.-JV---`..5.f z Disposal T ei- i—No. .................... Width...... _.-._-_-_ Total Length-----�.....__. Total leaching area__ ".�z_sq. ft. 3 Seepage Pit No...................... Diameter...........--------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Iz— Performed --�jP�.._�?. 6.............. Date........'1_-_. Test Pit No. I..... _minutes per inch Depth of Test Pit..... 3 2,__. Depth to ground water......___._. f4 Test Pit No. 2................minutes per inch Depth of Test Pit-----0- -_- Depth to ground water.----_-.��4... 9 ...................................... ...........................................................................-.......................................... .+ Description of Soil C��-D'x`t = 5 -a...�. --___'} `,,i1 ` �' i 3' �.....................................` W ............... ...........('G. ....3`�...... �>........ ...------. -- --•---. ------......-••---..........• r� �} ----- 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli e as be th. Signed ---- Date Application Approved By .........�' ... --- -�----�-`� 5 Application Disapproved for the following reasons- ----------------------------------- ------------........................... ----------------------- --------------------------------- ----------------------------------------- ------------------------------------------------------------------------------------------------------------------- ---------------------------------------- G� .� Date Permit No. /t�� & ........... Issued .--------� " Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ClTPrfifirate of Coraylianre y IS RT FY, That the Individual Sewage Disposal System constructed O or Repaired ( ) b THIS. 0 � -..... --- ------------------------------------------------------------------------------------------------- .. - ...--. Installer 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. it"--- :7...G,--------- dated . ...^..-?.-...y..y_..._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......_./. '"`... ../ r...y� --- - - Inspector- /�,� K� �a---i --- THE COM MONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c� - ] ' TOWN OF BARNSTABLE ; No.... ...'.. .(��.1!��i FEE..... Disposal Works Tons#ru#inn Wrmit Permission is hereby granted.......... .:..: _+ - ? c . ....... i to Construct (\,.-) or Repair ( ) an Individual Sewage Disposal System atNo..........1.,..... ..T.... :--•-•-•....0... �*-s- = �. - ...----- C r Street as shown on the application for Disposal Works Constructio Permit No.� r.� 2 • Dated........................................... ✓ Board o DATE----- -,�-J�„�-•---•-------�---�--•------- �ea FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS No... J�.-..f� /_ - - FFs........... .r .b... THE COMMONWEALTH OF MASSACHUSETTS �• 3 C BOARD OF HEALTH TOWN OF BARNSTABLE - Ap.plirtttion for Dinpinial Workii Tontrnrtion Vvermit Application erteby made for a Permit to Construct (Y- or Rcpair ( ) an Individual Sewage Disposal System at: 7, , P 4 A,A 1__ '1 2 til�i n , C,/ly �t � : tT�(2UIc-C_ _ .......................................................... ...•.... ......................... ........ �./.............._....... ......................................... Location- . Lot No. ........................ ................ -- ......................................................... Owner 4 r Address Installer Address Q Type of Building Size Lot.....- �.,.1.�_12.7�...Sq. feet Dwelling—No. of Bedrooms------------__2---------------------.--Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ___________________________ No. of persons______-_____--------._._.-- Showers ( ) — Cafeteria Qt_ Other fixtures -----------------•------•-- ---------....•-•---------.._....---......-"---•--•-----•---..._.............------•--------•-'-•---....-----•-••---.---'•- W Design Flow................(----5..___________---__-__gallons per person per day. Total daily flow.................. - :12------gallons. WSeptic Tank—Liquid capacity_�..`�_.�'gallons Length_ Q:_`--'___�__. Width__-`>�- ___ Diameter________________ Depth_:"..... x Disposal Treiac-la—No. .................... Width------1_0__._.____. 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...����_.. A.,2 _f ?� .C.0.............. Date........................................ Test Pit No. I---------- minutes per inch Depth of Test Pit----- ...... Depth to ground water-------!'!/A...... f� Test Pit No. 2..__. .':.minutes per inch Depth of Test Pit._..�.�1?_.... Depth to ground water............. ---_.. 04 ----------------------------•------•......-•----. •---- •.........--••••---•---•--•-•-------....-•.........---•--•---•-••-----••-•-•-- -------------•--•--- O Description(of So il,22.r.2=• q = � y }. , c-) r�is.Lj -{0 xW la . �... „ . .....-.•-••Q ................... ......... .......... J_ 'V y J.... •. -•--•............................................ ...................... ......---• ----------••----------------------•-------------------------------_------- --_---------------------- - « 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beenNssued by the board of health. Signed ------I......:................... .............. ......... Date AppliPP pp Y cation Approved B f( ...� --------------------------------------------------------------...... -------- - ------�'--�-1 Date Application Disapproved for the following rearons: ...... ......................................................... . ............. . ........... .............. -------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------- ........................................ Permit No. ............./.,,�1�...-....�fv.( .(,----------- Issued ....._..... � _.-...j........ .�- ----Date . Date TEST_ HOLE LOGS ; ---" .. s rr E.N GIN EER.!"�.�,��'`�_''� _ r. L.e1c J< --�► �,, -r � �-�' M WITNESS: - c ! , DACE: PERC. RATE r i PERC. TEST # P_-- '"� 471 LOCATION MAP ( ) 1 NOT TO SCALE) J ���, ..:. �. / 1 - { <% r/ i ✓ !/ O�ir�' C S S RS .1_. PARCEL � ,� A SE SO 1 , _ _. FLOOD ZONEM r f �' • . /(/J(//•/ '.11 t".. . :1a�-S NC" f K ,•�"i f-_ ' A ro NUDES 1 DATUM IS __ -- `� 4-1 LL ; 2 MUNICIPAL WATER IS z1A `7 _ J `< `�'` 3 MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. -- - '" ,yy� 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO-H!©. # t No wl �*r"z rz„ 5. PIPE JOINTS TO BE MADE WATERTIGHT. 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. ` - ENVIRONMENTAL CODE TITLE V. 7. PROPOSED WORK SHOWN MUST BE STAKED IN FIELD BY THE DESIGN PROFESSIONAL RESPONSIBLE FOR THIS PLAN TO ASSURE s \ COMPLIANCE WITH APPLICABLE LAWS. i- 1� , i, i TT �1' IC PROFILE 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. SEPTIC I � -!. - _. - ;x 1 C7t-t�'�h-4F:,t.:""�.� j..':�'", ji;� �,�. t� � ,itr��' G'iL K%�c:.C-L '"�,,K'� ir►','�,"I�'yt'� (NOT TO SCALE) t7 { 4 t,•�,!:H-' C`�.$ \ T.O.F. AT EL.45'-o A-5 o 14IMMUM 1' OF COVER OVER PRECAST RUN PIPE LEVEL FOR FIRST 2' 1- 0 ,4 z o t PROPOSED '`` �11 u�- — _ _ I S4,, d,i. .� GALLON SEPTIC f�� _ / �' TANK 1t S� 4 _ U ,r a DEPTH OF FLOW 4� - a' �'y1o•r+L.! ,: ff� ! SET DERI-!, TEE Hi 51GNf� iA -�' ,�" _ 2 � �• � �X SPE) OUTt..k UFP?'N (� StrUPEj . .�.� .. s '4j t 1 FOUNDATION. ._._ - --- SEPT!(' rt •TANK _ -_ D• 'OX w _ _ p SAC N.ING 3 "_ vv r_.. .�. ..•.ate,_,,.,._... ------r----+• ..._.._ ` `� � , �� '� �'� __..__ -_:_,� fir. 1�= �..+� ••,wt ,: . _. SITE_ AND SEWAGE PLAN y i 1 `'` .lt.'r.'" }.'_ Ott+'. _. \.?. _. .J _ 3t ..��._ L.,/ -._...,. ` `_'•i v,l I`'�' \ i SEPTIC DESIGN._ (GARHA� E DI �c�SFR DESIGN FLOW: BEDROOMS (.}10 GPD) = � 2 GPD _ 1 "N'T ON ; / �,� USE A 1���C� GPD !1E:SI(G"� F'' OW C� I . N r I ► SkP 1L TAN GPD GALLONS PREPARED �'Oh: USE A !r`- :- GALLON SEPTIC TANK Io Feel y _ - _ _._.. -_ _. _ - - -- -- ._ _ _.... GPD t. t' ,uz) f'RE»i�N EL. r TBO,AL: 4�' __ S.F. ;3 � taF'D C�. .. ' I _ `i• _ ?'ATr 9 -- ' s ,�L C ,. SYSTEM IS IROM I:t "�— Leh y� 1✓te' 3- cc3;� 7r N Of urn Cape r'Il�c(;11 ! '�"'1119, 1I1C. �+ _'. !� �� --- f _` _r.� .'" I'_!a .�..._� '_4 -� :Z00r E Af�NE y AgN�s K H. G� ? OJALA I • i HOAKD OF li"LTH t�Jo � It I X ,W.' ' Im, ko 7'Imr, -. I'ItU�",i! ,yUf9„:582 4htl _P) f}� :ita1 mbxlU MA O .L.S. DATE ;���:� n��� irl ��t . y�Y•�_zzu �� 1 f�, 1rIt� APPROVED DATA: H. OJALA, , - w •1.