HomeMy WebLinkAbout0024 SEA MARSH ROAD - Health <St-maw a
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S M E A D
No.2-153LY
UPC 12934
amead.com • Made In USA
AcY-o-ib
SUSTAINAW
FORESTRY
INITIATIVE
fortified FHwSomino
wuw.dinopramnrm
TOWN OF BARNSTABLE
LOCATION 44 s C A ni wm k P.d. SEWAGE #
VILLAGE Cr'r4r-t2 ur 11 r- Ma ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO. 'S 3 ea4. Coast.
SEPTIC TANK CAPACITY b QU G lG0 ti
LEACHING FACILITY: (type) (size) f Y 8
NO.OF BEDROOMS Lt
BUILDER OR OWNER 0 W N i2
PERMPTDATE: COMPLIANCE DATE: �-1-
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
0� '
•
/2Arts 711 i
septic.tank, leaching facility and
Sketch house,
Ali
show distances from septic tank cover to nearest
house corners.
No. ...... o Fx ......�?..� .............
s ir •�
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
SSION
AIM
Allp iration for Dispasal loarks T11maurtion Errant
Application is hereby made for a Permit to Construct (&-�r`or Repair ( ) an Individual Sewage Disposal
System at:
.......... 4.. 1Y�l1 SS'N..---- ..A ........................ t!t. ........................
�1 - was Location-Address or Lot No.
._ �j
�i/�a ,F•i.� .... � .._.. - sr�6d-._ N.�C Slal6r_....��f�..._.6+r M /X.
Address
caner .-
-----......_ ------------------------FrOG !��,r '.e!i ......................................
Installer Address
d Type of Building Size Lot_.._.r2,1 .97-1_..'.�Sq. feet
U Dwelling—No. of Bedrooms................1Y•--_-------------__------Expansion Attic ( ) Garbage Grinder ( )
a`4 Other—T e of Building No. of persons............................ Showers
—Type g ---------------------------• P ( )--- Cafeteria ( )
Otherfixtures .----•--•----------------------•--•-------------...-----•-----------------------•-•------•--•-••-••--•-•----------. ------•...
W Design Flow.................. ....--..........gallons per person per day. Total daily flow........ -4Q_........................gallons.
WSeptic Tank—LI uid capacity/,5QDgallons Length._/ �`. Width..6"�... Diameter________________ Depth-.,4!tv^'�
x Disposal =—:moo_____________________ Width..,il�-•......... Total Length.,��.......... Total leaching area....................sq. ft.
Seepeg o..................... Diameter.................... Depth below inlet.................... Total leaching area W_&' . ft.
Z Other Distribution box (p Dosing tank ( )
'-' Percolation Test Results Performed by._-..A.IW S-___.--_,jx�rV.&X.!� 4-- Date_._.F,�,�d�e
Test Pit No. 1...,;?,....minutes per inch Depth of Test ... Depth to ground water---------pA_........
(z, Test Pit No. 2....al. .....minutes per inch Depth of Test Pit-__tom'!. Depth to ground water..., a.A10..
•-••---•-•--•-----------•-••..........................................•-------------............•...-•-••-...-----•-•--•-------•--•-•-••-----••--------....--
Descraption of Soil •-- �4 • .at...J�0 wz------------ ----------•-------------•-------------------------------------
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 TITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has b issued by the board of.health.
Bi .... ._........ ----- ...................�-
Dt
ApplicationApproved By........_ ..-' .?. ._.................`--.......................................... ......... -- ----.-
Date
Application Disapproved for the following reasons:--------••-•----••-•------------•------••--•-------•-----••---••---------•------•--------•-•-• _---•---------
••------------•----•......--•------•-•-•-••--•--••----•-----------------•....••-•--------------.......-•-I----------------•--••--••--------------••-------------•--------•-•----••-••------------........
Date
Permit No.----- - Issued------•-••---•--------------------••.. ate
Date
t
s
No.L 1
THE,COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.......... :...---...OF..................
Appliration for DhipsFal t n trnrtion rrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
....... _.H ......... ..., ........................ '.yeC,�'_.. `��- ...................•--
Location-Address or
...... .�.1.�.___. �.......: .r�.r'ric '.. ....t_�.'_i:c�+`.!.....�.. .............� ........... G.�_..a ..✓.5 Lot
ytt�.S......t'� ._. ....w...
"owner Address1.4
'y
PQ Installer Address
14
d Type of Building Size Lot.....9_: _�✓'�'--_-LSq. feet
Dwelling—No. of Bedrooms................1 ---------------------Expansion Attic ( ) Garbage Grinder ( )
WOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures -----•----------
W Design Flow..................a ................gallons per person per day. Total daily flow--------<- .......gallons.
WSeptic Tank Liquid capacityl. Jgallons L�ngth._.��?: Width._ :.®__- Diameter................ Depth..Y.g.e"1
o..................... Width... !_.._...... Total Len th...r"'?!�......._. Total leaching area-__--_------------_-s ft.
Disposal �w g g q•
S@@peger1ait-1T0--------------------- Diameter.................... Depth below inlet.................... Total leaching area.,7l�4: ft.
z Other Distribution box ( Dosing tank
'-' Percolation Test Results Performed by......zf... ^' ...... � Date....
lI.Z. '' ..
W
Test Pit No. I....�,,,-----minutes per inch Depth of Test Depth to ground water.........2.11........
(T4 Test Pit No. 1__. .....minutes per inch Depth of Test Pit----Z:�✓ _ --- Depth to ground water.-_ .
a Description of Soil-------- ..._.._ - :
-----.... / `.x 't,�. _ -- -- - - - -
.�
D ...:.
O p .
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 be ssued by the board of health.
... ....................V. ...It........ ................................
Application Approved By......... `"_s- .--•---.Q-f-!../ .......................................... .........
Date
Application Disapproved for the following reasons:-----•--------------•---------------•------------------•-----------------------•-----------•-•----•••-•---------
-----------------------•-•---- ....-•-•••-----------•-•---------••----------•---------------------- --------_._..
y Date
Permit No..--- �' .. ---•-•----• Issued........................................................
Date
ti. THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
a '............OF..........
�r.` :fi........................
Tntifirair of Tontpliatta
THIS IS FY Th t Individu Sewage Disposal System constructed ( ) or Repaired ( )
by ----- -�� - ti
_ Installer
---.--• --- ---•------• ...................
has been in�talled in accordance with the provisions of TI L, 5 of The State Sanitary Code des d in the
application for Disposal Works Construction Permit No.._. .�-�....._f �..n__�... dated-_---_1_�: f.............................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL N TION SATISFACTORY.
DATE... ..1�� ------------------------•--......_.._--•-.. Inspector.......r...........................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.....OF......1" � - . ' ram.: .......................
No..5 `I FEE � ?............
..
tort • (gon tr l ' nYrrutit
Permission is hereby granted . ---------- .
to Constru t (� )) or Repair--(----a) an Individual Sewage Djspo Sys
at No........ `---.`2 :t...•--- � � ....('V6_=�`-`- -V�----------------�^n---i_U ----------•---------•-----------------------------------
Street
as shown on the application for Disposal Works Construction Permit ... Dated-------E �r?1 ............
� v ....... �.
p Board of Health
DATE.......... ... — D. .....
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
L0CAT10N41- Y3 SEWAGE PERMIT NO.
.s6q m&x /f '
VILLAGE
N INSTA LLER'S NAME i ADDRESS
IN-
S U I L D E R OR OWNER
DATE PERMIT ISSUED
I�
i
r
DATE COMPLIANCE ISSUE D go�:
/ 1
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9
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At L- GENERA 1,, NOTES
t •.
PLAN V/EfN /. 44k EI,EYAT/ON6 SNOkYN ARE
,/�•R: r ,�,Qr/ 9 A Sr'J G Al �9 E.��✓ ..SE`.�
B C,GEAN OUT INSPECT/ON COVER �F
.2. PITCH A,�,4, .L/NES A ,�L//N/MUM OF 18'IFT
A UNLESS OTHERWISE SPECIFIED.
,•� n_ j z ' t� _i 1 _i 1 �- -_ _ _ _ _ _ 3. A P/PES TO AND /N THE S YSTEM SHA4,
SAN 17 , \ \ J ►- S J —� BE CAST IRON OR SCHEDULE 40 PVC.
, 4 A�,�, SEPTIC TANKS, O/STR/BUT/ON BOXES,
S SNAL d, BE DESIGNED
4N0 �.E14CN/NG P/T,
Wow cd �a -�- AL(^�-L - a h � .�� - - r. B ,J - -- �� fOR . 1-Z0 tVNEE�C, .COAIP/NGS WHEN
�- c ,'T •, ,�? L 4y 8 O /OE V/E U/YOER PAVING.
Q k - -- FRONT_
Fla-- 3��' b" ,9 - ;. o� r ,5 REMOVE 44 �, UNSU/TAB�,E MA TER/A4,
+ .r _�__ _y BENEATh' TLIE //VVEA T EEC,El/,4TONS
bru. lq N►TCQ► ! Irnpzzg J r
_ : T 2� _ . , 'O " o � �� M OF THE O/FFUSORS FOR A OAS TANC E OF
,2 c ,r--. �. . + Z `-C 5A V1 .4RY TEE , 9"=* -� (3O)Z-S%z"OPENINGS KNOCKOUTS FOR
.Z - 9 i6 ANO BAC/YF/I,4, WITH C,(.A Y-FREE
� —� �/B S.COTS, BEO/NSTA,C�(..4T/ON
I~3"4:�" e" Z/z" r Z' SAND 4NP GRAVE V,4V11V6 A PERC01,.47'/0N
T YP/CAS, 015Ti�s'. B(/TION BOX � � t � c�, RATE OF Z M/NOTES PER //VCH OR 1,ESS.
NOT TO SC-+x E o 0 4 6 6. THE � �✓- BOARD OF HEAL,TH MUST
,'VOTE D/ST1?/B6/?10N BOX .4ND �t,4,, z-y4:j 4 3" 4 4
OBSEf�Y�JT/ON PITS REINFORCED SEPTIC T.4lYK BY J SECT/ON B-B BE' NOT/F/E!� �YHEN THE SYSTEit�f/S NEAR
T YP/C.4,�. �.� GAS(, SEPTIC TANK
_SECT/ON 4 A //�F�off C/NE COMP,L ET/ON ANO PR/OR TO BACiS'F/�„C/NG
R,ERCO4A 'r,0,'l, RATE AMER/G'AN /-RE,--,4S7- OR F00A.L PRECAST 4EACHING CNA�f 9ER 7 UN4,CSS 0THERWISE NOTED,A4,1, SYSTEM
OB SEfr'Yr4 T/DNS B Y -9 -J d V t',S VOT TO SCA.;,E
�3oL�. r;<.r.�'XtA,y' BCAR'P OF HEA,C,TN -NOTE ,ANKS REINFORCED TNROUGNO�/T FD 4 xf3 -- D F�,OWO/FFUSER R, COMPONENTS BE /NSTA.L..C.EO /N
1VOT TO 5C.4i-E � ACC0v?,P4NCE- W I Tf1 T/T4.,E JT OF THE ST,4 TE
ENG/VEER ,dam xr�'.+� �- ,,f��.{
hV/TN EGECTi4/C WE/ CEO /9'/PE N'/TN •�i¢ %z S4N/TARY CODE ANO ,4NY k0CA1, RULES
E NBEOVEO STEEL RODS /N TOP cx BO T TOM.
jNH/C/� BHA Y A PPS,Y.
CONCRETE /S 4,000 P. S./ TES T
MEAKOUT CA lok.)
F/N/SH GRADE O/'ER ,C.EACH/NG
-Z'4,C =/f�,Sp AREA ;
F/N/SH GRADEzo
-INI,5H GRAPE OVER TANK F/N/SH Glf4PE RRf'C,4Sr 1,EAC)q/N4G CHAMBERS
4rE1of "D" BOX (FL OIY 0/FFUSE/�S�
Pt2 vi REV
�f��4AYJL _ I�Jn X �•Z/2� , ,, r. .c _ -�^�,,. r , ..i,/_y; r. rr �rr ,S /� /• .Gx�Bx �4'i
�- �PEASTONE
= 1�• �G�vt��� 2� P tZr�tJ t>3r� � /Ni!= 1150 /Nf!=15, a
114 F,CO3W UNE
IN
,. - /N ,: 6 4�o/ST BOX ..
_-- REINFORCED �TO BE,CEiEti 3/�=!% SNEI �; ��. �'�314 x 1%2yN'ASHEO
CONCRETE STABLE) STONE'' STONE
SEf'*/'TANK
(r0 BE .C,E!/EG STAB,Cr WILD ► -U'
� j v
a TYPICAL SEW,46F' 6YS7"EA4 PROF144F
NOT TO 5"4,67
tK ID
cr
.4,t4l
�v f
_ t , ✓ 1 'o �.� / WAR SEC -ION P4RCE.(, �,O T ADDRESS
�- ���'J"/\ t,,.C::, •t •1c l� .COT � ( 2 Z-7 ---- —1— �-- - - -- —
o.
7p, ✓. i ,,� yr ✓8`` j .ZONING O/STR/CT F4 000 H,4,ZAR0 .ZONE
--- -1.ate
_T'�'� PEd l N CR17TRIA ,G EGE/V� PROPOSED ,LOC,4 T/ON OF O,C�f�E,C�GING
� G {""� AILIMBER OF BEDROOMS 4__ EXIST CONTOUR - -- - -- -8 S'�!/t/ O�
T .qNS PERSONS PER BEDR00141 -Z _ PROPOSEP CONTOUR 9� - QGE SPOS,4.4 SYSTEM
d ` .G a T 33
qo GAA,4,ONS ;PER PERSON PERp4Y 5_ EXIST SPOTECEVAT/ON BtO
1 d Q H. I-EAC,N/NG REQU/RE,49 _6-420 G.wr,F'�POPO.SED SPOT Ck FVAT/ON 8 t0 G€AI7"�"/Q- V,�� �� � M"j SS'
�,EACN/NG PROV/oEl"l PERCOLAT/ON TEST m
€ i
ELfY. //•Z JrSPOSA,C OBSERVAT/ON P/T APP4IC,4NT : ,ENGINEER :
rl
6 x � `3�- r' � S = %' � rJ :a�v ,�� f 1` ,r's'7 IViti/S M A
Si GE WA4,1- _ � GAOS //-
BOTTOM - i 4 x ���; x � � = 4��� r F'� +� ;��
SC,44,6,/ - 4d' DATE SHEE T
I TO TAB, = AS NOTED OC7--
-7 fK-
?y +1T ``T i OR,4WN BY CNECAIEP 45Y APPP B Y: Pk 4N NO.
P ✓i,J n/ di
... . . f'�,�.-✓ ,�r�c- � $ .3 0 5 yam. 4 b .._,.�_..,...,_....,._.....1� •J G