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HomeMy WebLinkAbout0030 SEAN'S CIRCLE - Health (2) 30 Sean's Circle, Centerville - A= 170-057-009 — No. 42101/3 ORA ESSELTE � 10% 0 0 a 0 �I i TOWN OF BARNSTABLE / LOCF.TION rid J� /I 5 /GMde SEWAGE# b `� VILLAGE �i�l�1 I�G/IL�� ASSESSOR'S MAP & LOT 2 --D21�4 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ©�© L LEACHING FACILITY: (type) ���/ (size) t' NO.OF BEDROOMS 3 BUILDER OR� p PERMIT DATE: ``` �� COMPLIANCE DATE: / Z Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 9 k � 33 O Fee No. �°' , THE COMMONWE LTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Mi!5paal 6pgtern Construction Permit Application for a Permit to Construct( )Repair( ✓Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ?O el&, a Owner's Name,Address and Tel.No. Assessor's Map/Parcel 661,enln /lr )Oda/ `51-w,4 v 5 eaor of J'c. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(.�D Other Type of Building 2—�e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /l a gallons per day. Calculated daily flow JO gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /ADD 9A Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �J�!/�� Date last inspected: _ Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued thi and f alth. _ /�� Signed Date Application Approved by Date 2 --/ Application Disapproved for the following reasons Permit No. Date Issued TOWN OF BARNSTABLE / LOCATION 3� S �S Gl��� SEWAGE # b VILLAGE �iP::.'�i�L��``� ASSESSOR'S MAP & LOTnD—a�c:2� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ©�© LEACHING FACILITY: (type) ���/ (size) NO.OF BEDROOMS 3 BUILDER OR(� �1,Y4 PERMITDATE: 2- - /y COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility •S � Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within.300 feet of leaching facility) Furnished by lbilk* f 9 hf „ q�th L hh At9> v i No. 97' d ��(! J /' D�� Fee THE COMM Entered in computer: ONWE LTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for -Migaal *pztem Congtruction Permit Application for a Permit to Construct( )Repair( 4pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 30 S��rls Gile Assessor'sMap/Parcel L ✓ , Pai / 5*1'1*� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �D r t�C�ffi Gone` 7 3 � Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder(_Iel'D Other Type of Building 16,1151 le No. of Persons Showers( ) Cafeteria( Other Fixtures Design Flow gallons per day. Calculated daily flow ���0 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /we7 7"- Type of S.A.S. �` ��G��.iy�r/ X�����r�✓� Description of Soil Nature of Re airs or Alterations(Answer when applicable) r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued Wthiand f liealth. Signed Date Application Approved by .� Date Application Disapproved for the following reasons Permit No. J0 Date Issued r THE COMMONWEALTH OF MASSACHUSETTS /7D DS`�'_Q179 BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(✓)Upgraded( ) Abandoned( )by 13,11-fel& 11 S/yl/',>-J at 3© � I-el,41111 if has been constructed in accordance with the provi ions of Title 5,ta�nd the fff��rDisposal System Construction Permit No. 7-A<9 dated Z Installer jGl' /"D`fJ// ! (�/�fST Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date '� 1 r^) Inspector � No. � 7— --------------- � 7��J -7 GV� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS xie;po.5ar *pgtem/�ongtruction Permit Permission is hereby granted to Construct( )Repair ")Upgrade( )Abandon( ) System located at 3 J`G��/75 C�rc�� and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date ofrthi�s x t. Date: r"�' Approved by�-'�� NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS. hereby certify that the application for disposal works construction permit signed by me dated 7,y�9 > , concerning the property located at AD lie&,"kj 4-4Ilemeets all of the following criteria: r ere are no wetlands within 300 feet of the proposed septic system There are no.private wells within 150 feet of the proposed septic system 4, he observed groundwater table is 14 feet or greater below the bottom of the leaching facility There is no increase in flow and/or change in use proposed /There are no variances requested or needed. SIGNED : DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert r' /i - 3 17(-o 40T -9 �8) o 4 ' old 1 • 1� P,r , 1 � , Toy �D,�,y7'8 ►oo0 4A`' /ees,l /, t1 sapne. koeaA/ • ` \� I • yo- I f I ^.E,C'T/Fy T�//1J' THE . iaVr:: aT1"s 3 i3�:J��`� ,1;; 1/;•, crn�(4ri i tiE?!n ilia k. ; tic) G.O. 0 bl k . .5,✓owN .vlcAb''�N wFs ft o ,-, f o� 1 f/i.`. .,>Y-s r'1 av Ne;41'r. 3), i979 oc�./)L. rS , 6 ;.� r, �: /.Sf - .a 70 C,O,N^0. 47 'TD TN a2�',w' j �r.. j.. 77 .S / v r•r:, .;;it/sf = 73 /t,D. /?),9 S S '4 tj ili i i913 L.A- 1 n rNl S or, JAIAF S -. � ;� RrriWICN �;r,. p. I .A I" ' f ! ,• lU I.HAPMAN ! . ATION SC H E D U L E '��.�.,, .... < per• ,:�` PROPOSED SIT PLAN UNDAT10N SEWAGE SYSTEM DESIGN EPTIC TANK (oZ IN = SEPTIC TANK = �� ,D.4,2,us �r��s I.-. �C�"/1/-]F�? 1•'f L.�.�,�,,/►'�/'9 g.S• LOCATION 44 SEWAGE PERMIT NO. O 7,6, o :5,coti G/leGZ-4E VILLAGE INSTALLER'S NAME i ADDRESS dlA-5r09%��= S U I L D E R OR OWNER S All 1" DATE PERMIT ISSUED DATE COMPLIANCE ISSUED //-aU-,�' r f �?N 3� 3' �17 No......... .2::,.. FEB............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...----....Tmm. ..............OF........BarMt.01.0..------------.................................. Appliration for Disposal Works Tnnstrnrtinn rrmit Application is hereby made for a Permit to Coristru(b ( X) or Repair ( ) an Individual Sewage Disposal System at: LQt-...9..Z.•.Aae'.s...Ur.`�e-;---C.entervulA-------------n-------------------o-r-�--L--o-t---N--o-.------------------------------------------ Cc -AVs ........... s .........................................o.... nsc \ ' A dress 14 1.4 Installer AddressPQ �� Ql4 Type of Building Size Lot.-..-._:..................Sq. feet Dwelling—No. of Bedrooms....................3.....................Expansion Attic ( ) Garbage Grinder (n9 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -----------------------------------------------------------------------------------------------------------•-•----------------......_•---.._......••-• d Design Flow.................55.....................gallons per person W pre day. Total daily-_fl--o_w---_---_330_..........._____..._._..._g?ll-o-n- s. rr WSeptic Tank—Liquid ca acit .100O allons Len th $........... Width.....4.f.10�iameter................ llepth. +_.O.tr- Disposal Trench—No..................... Width._..........._._.... Total Length._.._._.._ _____.... Total leaching area.... _______....sq. ft. Seepage Pit No......................._.. Diameter-___-10_t_______ Depth below inle ..-..._61 Total leaching area..2b?•______sq. ft. Z Other Distribution box (X ) Dosing tank ( ) - Percolation Test Results Performed bf apa__-Gad___Suruey...Cons-ultant-s Date------7/16/79.............. Test Pit No. 1.....2--------minutes per inch Depth of Test Pit.._1,2•_.......... Depth to ground water-none_____-__--. Gz, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ •----------------------------------•---- -••------•-•---------------•-----••--•---•.....----••••-------•---•---••....•-•......_......... ------ o Description of suhso11_,...2..G-_5..Q...mad.___sand._ x -and-- raue.l 5.Q-1.2..D---med.---sand.--------------------------------•-• ------_.. �`_` s9. GVra T �� RENWICK �G •. ----•--•---------•------•----- -------•----••--•................•-•...............................--------------- ............................. -- V Nature of Repairs or Alterations—Answer when applicable._________ ____________�__ ___ _ _.___.__.__.___.__ A ...._ B. CHAPMRN---_. � ` Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in '�Eg sTE the provisions of liTLE 5 of the State Sanitary Code—The undersigned further agrees not to place t n operation until a Certificate of Compliance has been issued by the board of health. Sigd-----•• •......................................................................... ................................ 6 Application Approved By. �:.� L!/1!1 - .....................•- / 7 ` -----•..............................•----••......---•-----•--......-_-•-..Date----•-....._._ Application Disapproved for the following reasons__________________ -••---------------------------------------•--•-••••••-=-•••-------•-----•------•-------------•-•..•_...---••---•-----------•----•-----------•---•---------------------------------•......-•--•---------- Date PermitNo......................................................... Issued_....................................................... Date No.........4�.!2 Fin$,,..3!>................. THE COMMONWEALTH OF MASSACHUSETTS ,r ,-� BOARD OF HEALTH , ..........T0wn....................OF... Barnstable................................................ Aptirtttiou for Di-qVuottl Works Tvatitrurfivia ramit S � Application is hereby made for a Permit to Constru(b ( X) or Repair ( ) an Individual Sewage Disposal System at: ................_..L01...9...30Mk!*a...UX.C1a.F...C enterv�.2la.....-----•--.....--.....-----------•......--•-----•--------..........................--- "'� �p Location-Address - `o_r Lot No. MCA.( ...... ......� ......---� �. Y7�rr�a._..... ............... A dress a .2. a�:� .a? C -----.----• ........_ .................•...-----.................--- Installer Address d Type of Building Size Lot_ $.#01..4._..._....Sq. feet U Dwelling—No. of Bedrooms...................3......................Expansion Attic ( ) Garbage Grinder (n() Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) Cafeteria ( ) Q' Other fixtures ................................... W Design Flow.................33_.....................gallons per person e day. Total daily flow-------33Q.............................gallons. WSeptic Tank—Liquid capacityx004gallons Length_$........_ Width....1 3-91)iameter---------------- Depth-4 t_Q ._.. x Disposal Trench—No. .................... Width.................... Total Length........ ....... Total leaching area------- ...........sq. ft. Seepage Pit No............ --•__-- Diameter-_-_1fl ....... Depth below inlet �,, Total leaching area.2 ??_.___...sq. ft. Z Other Distribution box (K Dosing tank ( ) i ✓firr Percolation Test Results Performed 14,ape... ..SUr.V.4y... AnS7AJ.•an:t v Date.....7/16/79--------------- aTest Pit No. 1.....?w--------minutes per inch Depth of Test Pit--12 t.......... Depth to ground water Z14a............ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....... Ri ._.•.... •....-- ..... --•---•---•-....-• •...... ...... _---•- ••-•............... _.._.... S D Description of Soil.p..Q,,,fl.S Q ta...�. ;?�A � ib C .7 .� }. 3 mod. 1d ��.... . �90 o ti x -•---•8]K3d_ "e s��.�. � -- G�y -r........................................ ..... ' RENWICK N U y • I3 ------ VNature of Repairs or Alterations—Answer when applicable......... ... ...........- _. ............... ` . .............................•............ ------- ••...-- ... ••.....•-• Agreement:,� SS�aNAL EN6 '> The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accor the provisions of iI T 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. /id�....-- ---•-•-••-••--•--••------•----•---------•--•--•----••-......--•-••......• -•----......................... De Application Approved By------fir � .4 -- ----------------------------- ... ...�,�...--�( -----•-•--- i Date Application Disapproved for the following reasons:---•-----------------------•-------........................................................................... .....:......................•---------------------------------------------•-----......--------------•-----••-••-•--•---•••••.....................-..................................................... Date PermitNo......................................................._ Issued.-•----.......-------------••-•-.............--•••-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............�..T ..............OF.....PA s.t6b.16...................................................... err ifirtt a ttf Toutplianve THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (x ) or Repaired ( ) by Vetorino Brothers -••••-...........•--•-•..._.......••••••••••••••------••-...---•--...---in......r at............................. ot 9 Sean*s Circi - C �.� has been installed in accordance with the provisions of T r of The State Sanitary Code as described in the application for Disposal Works Construction Permit Noer"` ............. dated__.•_._.`�T� '_f..?_.............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE.THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �� DATE ---— �� .... - -.•------------•----------------- Inspector..-f I--••••• - . 7- ---•-- ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �!f 1'OWtt.......................OF..-•-•----$ll at.aIll..0................................................ �'Q .,.-. (/ FEE................. No. Elisplasttl Work, Tctt�irudilatt nutit Permission is hereby granted Vetorino..Brothers ,..................................................... ............• ---.. .-•••-•--------•. to Construct (it ) or Repair ( ) an Individual Sewage Disposal System at No......Lot #9 Seans Circle; Centeryiile, MASS. • ............... Street as shown on the application for Disposal Works Construction Pe t No.-,,--'_._ �'� g ... 7 Board of Health `, DATE........ - / FORM 1255 HOBBS & WARREN. INC., PUBLISHERS A t • �l SOIL LOG '' • /�X eC.tl�✓/if /AN ,�ry� ".PEA9TONE LOAM S FILL•-• 12";MAX, �Q�M f f °o ti �• rT ° I S I've• � acr►„ V4"C.I. DI S T. �° ° -9A- r . 1000 BOX f°. 1000 GAL. . ° 1 a o lo'MIN. GAL. 1° ° "" PRECAST OR , ° o E` 24" P> � .6tw . SEPTIC I•;::°% , ° • 1 MIN TANK 6, BLOCK , 1, °ee SEEPAGE t+IR h PIT , ' ° ° SANG r/ d i 20' MIN. �L ovom' - - - -- - - - .....•1 _P FOUNDATION z�I 1 + 1 1 /2 WASHED STONE "" • I I ,� ELEVATION SKETCH • 1 10' 1 PERC. RATE: 1,/,, zrn1Au1E.yc1l SCALE I"= 4' '" TEST BY : 4412p.Y 17;;AkS TOWN INSPECTOR: 01, J BACKHOE OPERATOR: RAA IVIR _yrs TEST MADE ON : ___ ti /,/ a 9 00 a q(, d /8t Q/4 4 r t toPSTK ; } �� 1 ERcyIAI¢ . � � • kv ;rod r`$ loos§ 4,+ /ea� 1 ! n uq o{ r � 9 14 L t 1 FG�c+n�oA'7'7 oiy S�/vG✓.v N•�R �H Wi•rs 3 U11'+00015, , it1� Lac�'TE17 �N rH� r/�'c.© ay ,qc.�. .�/, iq�q 7 �m�x ./��c�w�+/3�.� 1,3�1�� X" F't••au� fo,c'_ 7'�J.s .S�s•r'�r� �: k � A.y.Q Jr o�aEs �a.N po�aa 'T'a 7"N,e+ �wl,�+� , si v�w��.is, t 8 f�' �•� � �,�" � �r.fs7� � ?� t�+f. ,S�"T c�AG K ,�'E'¢1/lf�e"NP�N�'"S dF �"•'+f.0 'TOE 54 Cj•4 P r t ,47rq 441,1114.-'°'x3s X o ;WlS 07 9/2�0/7 4F f�RS ZH p f df b •. �ritt�. +5,q�, , ��pL qd+� . RCNwIck P. a B. wi (6 LAPSt_EY v' o. CHAPMAN vj ' No.22597 4 No. 2i 654 T } i E L E VAT ION SCHEDULE r PROPOSED SIT PLAN Y I. INV. AT FOUNDATION ° � a -9 ,4Z SEWAGE SYSTEM DESIGN 2. INV. INTO SEPTIC TANK ,. IN 3' 1 NV. OUT OF SEPTIC TANK = 72`` 7,QAA574 rCe'Al--" 1-1L4-FX,,,M4 )'.5 ,, SCALE: I 4. INV. INTO DISTRIBUTION BOX = " =' ►�.�a,19" t Q 5. INV. OUT OF DISTRIBUTION BOX C ' 7At ! ��` 6. INV. INTO SEEPAGE PIT = �Q-OcS. Cl— CAPE COD SURVEY 'CONSULTANTS ROUTE 132 7. BOTTOM OF PIT = HYANNIS ,MASS. s F t t