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HomeMy WebLinkAbout0353 SKUNKNET ROAD - Health 353 SKUNKNET RD. CENTERVILLE / A = 170 114 648 TOWN OF BARNSTABLE LOCATION 5��,��/G� �� SEWAGE #a�®dl— t 87 lltq VILLAGE i, '.e%Cf a lx r.- ASSESSOR'S UM' & LOT I _ INSTALLER'S-NAME&PHONE NO. 611 oa/'A10 SEPTIC TANK CAPACITY LEACHING FACILITY typel li.� 1 �L`�_(size) e-2- Qi® NO. OF BEDROOMS -BUILDER OR OWNER PERMITDATE: 6 Z 14,1'.OZ COMPLIANCE DATE: Separation Distance Between the: c Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility ,(Y any wells exist �dn site or within 200 feet of leaching facility) > Feet Edge of Wetland and_Leaching Facility(If any wetlands exist. : c � ' within 300 feet leaching facility) Feet Furnished by . �2'7! 3 �.27 •G , Y o -4/ c36, 1 y No. �v ►e 0/1 /- 7 Fee -✓ cis THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppYicatiou for Zioogaf *r5tem Com5tructiou 3permtt Application for a Permit to Construct )Repair( )Upgrade( )Abandon( ) O Complete System El Individual Components Location Address or�Lot o. Owner's Name,Address and Tel.No. Assessor's Map az/ir cel Installer's Name,Address,and Tel.No. 410,7 Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms _ 7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ,�//S gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Osi /iYG Zd e c' __Ty pe of S.A.S,? G J cc-P _,Z-A6 .7 XZ-re Description of Soil e- / Nature/o3 Repairs or Alterations(Answer when applicable) C i�XrG G !Lr4 7CC 1' a Gu' ✓ s 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 byk s and of Health._ Signed DatecZ,Z 2A Application Approved by ' Date Application Disapproved for the following reasons Permit No. Date Issued " � ��� 1'f TO VN OF BARNSTABLE LOCATION _ : J \,l ��CVI/,[/G�` �� SEWAGE # 7 VILLAGE �. ,�%c� ri�,� ASSESSOR'S MAP-& LOT J INSTALLER'S NAME&PHONE NO. 611Ale h/y t I SEPTIC TANK CAPACITY i ! C�J i LEACHING FACILITY"(iypel l,.Z / C (size) Y'A fJ�4 j NO. OF BEDROOMS I i BUILDER OR OWNER ��CJC a.0 PERMITDATE:_, ©/ COMPLIANCE DATE: i Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Welland 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 I within 300 f eetA leaching facility) Feet Furnished by �� �,�1� �L� Z J7 r C i I g31 q i J No. Fee 0J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZppYication for Migogal *pgtem Congtruction Permit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel N` Installer's Name,Address,and Tel.No. a<s�'.�' *,Pt� Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 7 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank X i,1'i i.vc /d a°' Type of S.A.S.—� G 4./ 4- /eC5' ;�_76 Descriptifon of Soil Y f ✓ - Nature of Repairs or Alterations(Answer when applicable) P _ /- � G �� Gu CCf a Gvii � ' c � u, s, Dafe las�spected: 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 by this and of Health.,'_ U i c✓ Signed Date, ?IZ 71zs/ Application Approved by ,.► Date 7-?-2�4-7- 2!e / Application Disapproved for the following reasons Permit No. 'a /-v / ice Date Issued 2— e/ ,Z r ----------------------------------------- THE COMMONWEALTH OF MASSACHUSET797 BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY-,;that_the On-site See�w ge Disposal System Constructed(k")R?paired�( Ypgraded l ( ) Abandoned( )by jiV at t l' 1`�..1 �' C/ H {', .T" lae�q. / 2,v2t% ,U/.G E' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No; L'1 ✓dated . JP,/ Installer Designer The issuance of this Mt shad not be construed as a guarantee that the system '•11 fu tien-Ah esigned! Date �f �l 2-�"�/ Inspector r -------------------------- No. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpogaf *pgtem Congtruction 3permit Permission is hereby granted to Construct( )Repair( )Upgrade(_ ),Abandon System located at .'�� � ' �° �.�i" ,/ _.,� "l _,.w•/i,Y 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 of this permit. Date: Approved by '.. -a � ; / If /A►1 L� 1/6/99 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 I, &ewr ,974<-hereby certify that the application for disposal works construction permit signed by me dated , concerning the property located at �"3�' U y�.�r� i /1® meets all of the following criteria: dK This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. N� dr 14"' There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed There are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] v4' If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed, leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation+the MAX.High G.W.Adjustment Z DIFFERENCE BETWEEN A and B SIGNED : DATE: /=; [Please Sketch proposed plan of system on back]. NOTICE Based upon the above information,a repair permit will be issued for J—bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert * Q o d,CJ�c 47 No ..... Fins. . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...----. ...._....._.... --..._.......OF...... .L'�:.:k�..ti...S.fi a -L -------- Apptiratiou for Dispniitt1 Warkli Tumarnrtion Errant Application is hereby made for a Permit to Construct ( /or Repair ( ) an Individual Sewage Disposal S stem at: - t�?........ ...... ....... .. ^ ... An p-.. ........_... Location-Address or Lot -o. re ............ ..: =''----------------------- --------�s�'. .1 P 'f `r.-;T- � .......... Installer Address Type of Building Size Lot..... .......Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ,PVV Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtur .... W Design Flow................ .........................gallons per person per day. Total daily flow------------- .................gallons. WSeptic Tank—Liquid capacitytlwagallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area...____��ii___........sq. ft. z Other Pit Distribution boL ( Diameter tank (th)below inlet 1____.. Total leaching area_ZZ4T D...s ft. � SeepageP g q• '—' Percolation Test Results Performed by �?�_ ._ .-�'.� c--•_--__-__ Date....I.C.P.J. aTest Pit No. 1......:.........minutes per inch Depth of Test Pit-----I.:L__....... Depth to ground water-------.....____........ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__-________--__--...___- �+ -----------------•--•---•---•-•• . ............. ------- ......r O Description of Soil................�'n.7i-- _.. ?�.1 'v ll,-' /�Ar :D._ ._ _ .' M�1?/Gc7!a4S ----------- - - x Via _ -� . s_ O>J o W ..•-••••-•----------------••---••-•••••-----•----•--••••-•-------•-------------------...•-••••-•••---••-------••---•-------------••----•----------•---------------•-••-•-••-......-•-••--•--------•••- UNature of Repairs or Alterations—Answer when applicable............................................................................................... ---------------------------------------------------------------------------------------------••-•--•---•-•--•----------.......--•--••••----•-••----•-••-••--•-•-------------••............-•-•-----••-. g Agreement: The undersigned agrees to install the aforedescribed Indiv lual Sewage Disposal System in accordance with the provisions of iIT? 5 of the State Sanitary Code—The dersigned further agrees not to place the system i operation until a Certificate of Compliance has be M_e of health. ed•••••. •--•. ... ..................•-- ......Wa tApplication Approved BY •-••--. = -•-•••....._...._ � Date Application Disapproved for the following reasons--------------------------•-•--------•-----------....----------•-------------------------•--••---••••......------ -••-------•---------•---•.....--•----••---•--•••••.....•••-•-...-•......................................... Date PermitNo......................................................... Issued......._.. kA�e— 3 ' a �� VILLACE I N S 7 A LI.. E R'S NA ME I A 0 D R E 5 S "Na u I-LD E R C-R 10IN 0 E N D A 7 E PERMIT ISSY E D S l6 $�_ •------ DA'T E C 0 M P L I A H C E 1 S S U E 0 27 3 Y�. i No ..... Fus.............................. THE COMMONWEALTH OF MASSACHUSETTS ) BOARD OF HEALTH ..........................................OF...... .l...�"'.. ! t ..._... Applirntiou for Disposal Works Tonstrur#inn rumit Application is hereby made for a Permit to Construct ( �)r or Repair ( ) an Individual Sewage Disposal System at: t ................ . C� 4i' .74.� 1.---►J L.`� '.�-`......��..-•-•-- f -.-��'_ ........................................................ ................__................................................ Location-Address or Lot No. Owner '"" 1 es ..... Installer� Address U Type of Building _ Size Lot----- feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder kt1t aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------•-----•-- •------•-•---------•----•----•-•-••----•-•---•-••--------------------- -------------•----•--------•-•••--•-......---•-•......•------ W Design Flow...............i%1--------------------gallons per person per day. Total daily flow............ ................gallons. WSeptic Tank—Liquid capacity)!Z<Q.gallons Length................ Width................ Diameter..-_-_...___-___ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No_________ ___________ Diameter.....1�........ Depth below inlet.._`:�5:'....... Total leaching area•l.4D....sq. ft. Z Other Distribution box ( �' Dosing tank ( ) Percolation Test Results Performed by_�+?j` ......::� ...�..?...._�'M.... 11J�- U� (Z 9� t', a Date ,a Test Pit No. I...t__. '_minutes per inch Depth of Test Pit.....__.::..`..... Depth to ground water----------...... _._.. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --•-------------------------•-------..1...--••------------........-----------......----.----- ------•._...•----------------•---.....-----------...---...--- D Description of Soil c ? 1?7)? .-.'..�?.I3_.... itM.__' 1a i-i� `I C-C / _` --- -� '���Lv6,PS F: x /-----•------- 1 r r W --------------------------------------------------------------------------- ----------------•--------•-•-•-------------------------•-•----•--•-----•••----•----------------•-------•--•-•-------------- U Nature of Repairs or Alterations—Answer when applicable___________________________•_-___________-_----- .............................................. ..----------•----------------•----•----------•-••-----------•-•----------------------•-•-------------------••-•-•••------•---•----•---•-------------•-•----•--------•••--------------•-•---------------- Agreement: The undersigned agrees to install the aforedescribed In Sewage Disposal System in accordance with the provisions of TI T I,: 5 of the State Sanitary Code— The dersigned further agrees not to place the system in operation until a Certificate of Compli4no has be s d��' e d of health. Signed---- f `. - G '_�` 5......- _ � / .. ^D Application Approved By..`... ..... � r� � ....................................... Date Application Disapproved for the following reasons---------------••----•--•---••-•--•----------•---------------•-•-•-------------------....__...---•---------••---. ................................•--•----......--•----••-------------•----•-•-••---------•----•------------•-•----•--•-•-•---•-••----•-••-------•---•--------------•--••--•-----------•--•------••-•----- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD,OF HEALTH ....................................OF........•, `.. .. �.. .. �.� .................. Tntif iratr Of TwOntpliatirr THIS IS TO �PRTIFY, Tb4t the Individual Sewage Disposal System constructed or Repaired ( ) by....... ,>q , f......... .....UL ---••---- .......................... ............................................ f rw' Installer -•^ j 1 at----------r 12.... �`'f . ... ,Nht.... -- -•----..... ....i�?�� ..I f� j.f� -------------- •. has been installed in accordance with the provisions of TITL ��-of,T ef1St Sanitary Co tole cn e ,.cn he "'e M� application for Disposal Works Construction Permit No------__.�... ` ........._ dated..............:.----------...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSFETTS S A GU ANTEE THAT THE SYSTEM WILL UNCTION SATISFACTORY. DATE.....--•-•-......( ... ...••---- Inspector............. ------••-.- ------------ THE COMMONWEALTH OF MASSACHU BOARD HEALTH iz ...........................:. ....OF........ ... _....._....�................. _ No......................... ;t FEE........................ Disposal Ork -Tvn�strnrtiOn rrntit Permission is hereby granted....................... f --��'.�. ..... - • -- --. to Con r ct (--) or Repair, ) an Individual ew e Disposal Systg**m�..,_.r..--- at No.. �_ l :..-•-1` Cam - ., --- ---------- - -- -- - ........ . Street �-�t{"?nop � •.... as shown on the application for Disposal Works t.Construction Permit No" .___ .D'a y.�_. «�.............. ' fir#r am . /V� '. *� . ........................................................................................................ Board of Health DATE-------- �' ".-� '' FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �K SITE PLAN sHEEr I of 2 SCAL E: I 1ap,lo2 I " i 1 C GOO Cam? L, w- 'AG-{. rst r ti �u�,•�l 3' 7To�v� At�vutiJC i t? I S�JKoQY- iUO� Y�'1 + t j"oa St�ItTtL TAa.1K o IA 9 3 rA tqz 14 z� 1d i >7'1�74oP � �•-� 53�® W 4 � i 1(.-, 1.7 z SI OF Mgsfgy . c WILLIAM M. WARWICK N s, No. 197.71 d REGISTERED LAND SURVEYOR FOR 5 K-v�_j (L.t'J mac"' 1� , ZONE , PLAN REF. DATE 5 1 BENCH. MARK DATUM � . L�17 �yfi���Y WM. M. WARWICK B ASSOC., INC. i DOMESTIC WATER SOURCE '1 w�-r fig-. BOX 801 - NORTH FA L MOUTH FLOOD ZONE- Nn -)- �_A c �r- MASS. 02556 - (617) 563 -2638 LEAGHING QASIN SECTION NOT TO SCALE sheep 24 C.I.MN COVER EARTH F/L L BRICK AND MORTAR COURSES AS REO D• TO BRING COVER TO GRADE INLET �B FLOW LINE `-,��.� 2"_y"TO% WASHED PEASTONE FREE OF/RONS, PIPE FINES AND OUST /N PLACE OPENING WITH 4%8 44 TO I%2 WASHED CRUSHED STONE FREE OF CJ7J� OUTER DIAMETER IRONS, FINES AND DUST /N PLACE AND 1314 INS/DE DIAMETER I. CONCRETE TO BE 4000 PSI 26 DAYS 2. REINFORCED WITH 65%6° NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS 4'0" 6'0 • . I '1�—� 4. NUMBER OF PITS REQUIRED dNl;- MIN. I IZ NOTE; EXCAVATE TO ELEVATION I•o OR 1 EFFECTIVE DIAMETER (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL WATER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. 5�0 1811ST0. LT. WGT. C./.MH COVER 4 C./.PIPE 4"81r FIBER PIPE OUTLET LEVEL DWELLING FLOW_LINf TIGHT JOINT „ O TO FIRST JOINT O O 11 0 O 0 1 1 — C.I. TEE 3 �-�- q$,7g 1 I 0 1 00 if 4&'y STO• PRECAST CONC. �I$.�J \ " if 000 00 1 1 t t ' Jr D/ST. BOX TO BE 1000GAL.SEPTIC TANK•. I I 1 100 00 0 1 .t 1 INSTALLED ON LEVEL, t i 1 0 00 O 0 0,1 t t STABLE BASE ttltoo 001I � t \sFPT/C TANK To BE t if 0 0 0 00 1 1 t INSTALLED ON LEVEL t it (00 I O 0 I I ' � STABLE BASE. t If 000 0 0 1 1 i t � 11000 0011tt LEACHING BASIN o10 , BASE TO BE L EVEL i I 0 O O 0 • 't5•o SOIL AND PERC. DATA 2. 0�� TEST PIT N0.-r��(03 0�� TEST PIT NO. 2 PERC. RATE � MIN. /IN. Z� - l'�9J95o1L• . TEST BY : _ R2c.� �4EL-•P SA+uD (.�I�Av 4 WITNESSED. BY P►o N &X���12-D M�plco,AV_ sAtip �3_0 7, TEST PIT GR. EL. 1:Le_A/J nA�blun� DATE: sn.►,JD 12 — 1� W o.-1-C"�Z �•I.a DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. . DISPOSAL SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL.22—OGPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK o0o GAL ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE SIDEWALL AREAz'SGAL./SQ.FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY 1 , 1977. LEACHING REQUIRED Zoo SQ.FT.. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. Z"42 Q.FT. AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE c'b.7`A4�,L-t-r 45:z A-L. BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL ,SEWER LINES 1/4� / FT. UNLESS INDICATED OTHERWISE. . A�.,Il1tA °r SEWAGE DISPOSAL SYSTEM wo MARTIN 'a1 4 E. FOR L'0 ca M 23 17 >g23417�Q � M A S S�1116vil,41 SCALE AS INDICATED DATE- S t I ob S • WM. M. WARWICK Q ASSOC., INC. 8OX 801 - NORTH FAL MOUTH ` MASS. 02556 - (6/7) 563 -2638 PROFESSIONAL ENGINEER