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HomeMy WebLinkAbout0160 THISTLE DRIVE - Health 160 Thistle Drive Centerville y A = 149 130019 Owrford, NO. 1521/3 ORA 10% 9 • e r 'No. U 0 a'11 7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppfication for Mi5pozar 6potem Construction Permit Application for a Permit to Construct(pair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.1,61 to Owner's Name,Address and Tel.No. r IJ:^�1//= jiyI/A!e' ;�!✓l 'T, vYI>f/i,�=�" Assessor's Map/Parcel 6,- �1///�/� Installer's Name, //Address,and Tel.No.f'D8-'/2©^9 a/3g-' Designer's Name,Address and Tel.No. W14 v, ��/C��S -rI/ Type of Building: Dwelling No.of Bedrooms 3 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 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer whe applicable) k,:ez ' 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 by this Board of Health. Signed Date Application Approved by �• Date w u Application Disapproved for the following reasons Permit No. 0d;IL--Vf7 Date Issued to ———————————————————————————— •M —��S 7 +""«+ — ',4 Fee , hod THE COMMONWEALTH OF MASS'ACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MA` Entered a. 01pprication for Migpogal *pgtem Cougtruction Permit Application for a Permit to Construct(6,)-eepair( )Upgrade( ,)Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. sT/r Or 1/i= t 1191g1�'/;�liJ T, rylii/,�r Assessor's Map/Parcel CrH�r'�I�/I�/= s''" Installer's Name,Address,and Tel.No.f 0$—y?U—917 3$ Designer's Name,Address and Tel.No. ✓asc pti Q� .C3r�r�s / ` Type of Building: Dwelling No.of Bedrooms 3 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 Type of S.A.S. Description of Soil / x Nature of Repairs or Alterations(Answer whe applicable) 2�s'T�a/ dU a"a r a� 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 by this Board of Health. Signed Date Application Approved by ` . �. l �. Date /O o 2 Application Disapproved for the following reasons } Permit No. 2 Od�t f 7 Date Issued /u --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( )Repaired ( )Upgraded( ) Abandoned( )by i�oJ,c �)� /6it4l�l/ S , at .16a �Li i.S T/f= �w t- �.�ti � 1&i has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2ao�-c��7 dated o/ u2 Installer ; .y_s ►&!,, l2, Designer lye'Ag- z The issuance of thi perm.t shall not be construed as a guarantee that the syste rl func ion as desii dd. Date (d�2 S10), Inspector AV ——————————————————————————————————————— No. aaoa-y 7— /y9- /3O-/9 Fee S� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migogal *pgtem Congtruction Permit Permission is hereby granted to Construct( G-)-R—ep�ir( )Upgrade( )Abandon( ) System located at 16 O 7'Z i 5 rA/= Oe)i//_ 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 770 Date:_ o /U Approved by �, - r SARI Notice: This Form Is To Be Used For the Repair.Of Failed ' ' Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION ExE11+pTION FORM I, 141,4 Id td M 59A hereby certify that the engineered plan signed by me dated h Z Z ,ooneerning the property 1 anted at (9C) ( S �r. � meets all of the following criteria • 'This failed system is connected to a residential dwelliug,only. There are no commercial or business uses associated with the dwelling. ` • The soil is olassified as CLASS I and the percolation rate is less than or equal to 5 minutes por lncl�' The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present, • There is no increase in flow and/or change mi use proposed • 'There are no variances requested or needed, The bottom of the proposed-leaching facility will be loeeted no loss than five feet above the maximum adjusted groundwater table elevation,[Adjust the groundwater table using the Frimptor method when.applicablo] Please complete the following. ' o A) Top of Ground Surface Elevation(using PIS information) r2Z B) G.W.Elevation +adjustment for high G.W. 3 � DIPMEMB BETWEEN A and B ZZ/SIGNED s DATE: NOTICE Based-upon the above information,a repair permit will be issued for bedroom maximum. No additional bedroom axe authorized in the flxtura without engineered septic system plans. q,health folder;Veraexmp a , { TOWN OF BARNSTABLE LOCATION SEWAGE # 02- `i 5`7 VII,LAGEV1 ; ASSESSOR'S MAP & LOT/5J9 -/.30—/7 INSTALLER'S NAME& PHONE NO. e/2D- 9 7 5? J*S c lob® J. SEPTIC,TANK CAPA9,-M 1000 LEACHING FACILITY: (type) 601 j9isa® 6 1- Slsize) �Z__r_ 1,3 NO.'OF BEDROOMS _ BUILDER OR OWNER A10P104 PERMITDAT& le -8- D`� COMPLIANCE DATE:_10-25^ 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 leachin ffaaci ' ) Feet Furnished by �J 4 _ -rI415rle Z­�q"-l"- - 70P OF MUNDATION EL Co3. ► GROUND SURFACE -6 2 '0 STAYDARD NOTE' GROUND SURFACE EL_. Cs C7 1) THIS PLAN IS 1roR THE INSTALLATION OF A SEPTIC SYSTEM OUTLET PIPE LEVEL 2) ALL INSTALLATION PROCEDURES' AND MAITRIALS' SHALL CONFnRV 7V 310 CA(R 15.000, THE STATE ENVIROIVIlENTAL CODE r FIRST T�Yo FEET 3 No VENT RLVUIRLD �ci ?OP Az T777.E 5, AND THE 7`O WN OF ,a ARN 5 7"�4-�3 C.�_- SUBSURFACE DISPOSAL REGULATIOTVS. LI UID LEVEL ' +- MIN 21 LAYER DOUBLE WASHED 3) NO DETERIlINAIlaN HAS BEEN MADE AS 7V COMPLIANCE OF AVAff,4S E PROPERTY IMVRVATION 117TH RECORDED DEEDS In b�? - D-50X 1/9' 1/2' STONE y It OR ZONING RLIGULATIONS.10" " INVERT EL 14 .1 I� ,� r� �•(• T-Z) rJ I� ram► EI'FECTIVE' 4) Tt71Y1V A'ATER SERVICES THIS PROPETY. GAS BAFF7.E AT OU77.ET/ INYL'RT EL 58 s �� F' Cl �� L '� SIDE1lALL 5 ?7YERE ARE NO KNO11'N P$IVATE HELLS ON l 5CATHIS PROPERTY OR A;ITHIN 10I1' OF THE PROPOSED SOIL ABSORPTION SYSTE1l. VE 19 PERT EL ! 8) ALL COVERS OF SYS7 M COMPONENTS SHALL BE BROUGHT 7O A777IIN 12" 0I�'.INVERT EL , ,� FIMSHED GRADE 1/ITH ONE COVER OF THE . e/ X S X Z`f n� SEPTIC TANK BROUGHT A7TXIN 6" OF GRADE. 's �/4 1 1/2 DOUBLE t /NvEQr Cst-,. CE,ct ST� t,t�NL2� �c CIIA- cl_v 2�j G✓�714 � , ) r WASHED STONE 7 ALL SYSTEM COMPONENTS SMALL RE]L4IN ACCESSIBLE Ft�R INSPECTION. NO STRUCTURES SHALL BE LOCATED DIRECTLY Gel Septic Tank C�/E fL1 Y �t�^v f N r l t � s f���= o,v o%`�' A (p S� UPON OR ABOVE TRF COXPONE'NT ACCESS LOCA77ONS, NHZCH #VULO RVT�RE T11'PX THE PERFURMAMM ACCESS, INSPECTION OP 1-NC rN�S �D��� PUMPING OR REPAIR I � o� .{- • ez (Typicel)C x Us`r') � 5 { 3 I EL B) NO DRIVEI/AY, PARKING OR ?LrRNING AREA, OR OTHER ':IMPERVIOUS AR A SHALL BE LOCATTD ABOVE A SOIL ABSORPTION 030f m or Sf o-C SYSTEM EXCEPT 11HW VENTING HAS BEEN PROVIDED. Z 9) • SEPTIC TANKS, GREASE MPS, DOSING •CHAMBERS AND DISTRIBU770N BOXES' SHALL BE PLACED ON A 8" MUNE BASE I TO ENSURE STABILITY AND PREVENT SET7MVG. C 10) OVT7.ET DISn:WTIO.,Y Ll� 5 SHALL mmu.W LEM MR A AWAnjuN b,r ?W YJW IWO FaT OF t�9lElle ILWTH 11) ALL SYSTEM GOMPONEMS SHALL HE CAFABLF. OF I MESIANDING B-10 LOADING' UNI&S , THEY ARM' U11DER OX /f7lXIN 10, l OF DRIVE)FAYS OR PARAOVG OR TURWG AREAS. IN MUCH CASE N RO COMPOArNVTS'SfIAZL W USED. S 40 °4 6 '06 E 1U 0. 00 12) ALL BUILDING S"M LINES SHALL HAVE AN,INNER DIAMETER OP 4" AND SHALL BE CAST-IRON OR SCHEDULE 40 PVC /.3) 77VE DlsP771 OF 7F_' TOP O,r ,4U S STEM COMPWAr75 S*,IL' BOT 47CE£D 38 UNLESS' VEvWG HAS BEEN PROVIDED, 11) ITV THE AREAS OF EICAVA770N, eX6f NG 'GRADES S94LC RE REESTABLISHED C.nVL,E'SS NOW AS PROPOSED CONTOCM, ' 15) IF SO" ARE ENCO D DURING TxE .EXCA VAHiON OF THE SOIL ABSORPTION SYS?EX THAT DIFFER NOTABLY EOM T71E DEEP OBYERVA77ON HOLE LOG, CONTACT 771E ENGINEER B&VRE PROCEEDING. "�ACwR ➢�'i VEjQ1FY' �TION OF'ALL UNDERGROUND U7H 77ES: 1 E Wood Deck 0 - o DESIGN- DA TA DEEP OBSERVATION { t Number of 3 ! (82.2) I Bedrooms: HOLE LOG , O i Garbage Grinder: NO Test Hole > 0 Design Flow: (v/- 9 f) (110 Gal/BR/Day z Number of BR) ` and gal ( � Septic Tank: / o0 0 0 (o (v/•y A loP M� 10 Z Ex. Gas Line �. Z�Ir 59 5� V ) 160 _ _ _ _ . (Minimum - DeIign Flog x 2WWO E Bldg -g - - - - - - - - - - - -g COX ► S ,^ �,Syp `� FS �d -- c3 Bedroom House � Leaching Area: 2�t - i�t~f 4q � C s TOF EL — 631 sidewalL• ' • 2 2k Q (4 3idewalls a _ z —Ft) + , 1 l Deep Obe Hole Data E 1. + �/✓ — ----9oi1 } a r Pam Rate: _ 2 M iN '� �" Bottom: SIL sou sue., D..or>ptioa curvrie l 2 0"W&Hater OUMASx ' ! V (2 Wenches z __�'t z _Ft) �{ '� staaaint Water. ArA Depth to lfottmy(Colwy NA Depth to weeptn� water. 1v.1 - - , a Ong Term Acceptance Rate (LTAR): 0. 74 Est Season Hyh aw sa k , , Leetchin Area Design Capacity t w.n: �,� '^ i 0 g g P Y 3` 5 wv J { , I �' A (� • Com�aen}a e M — — — — — I —,c �e ! (� I; �T (Side�ll Area + Bottom. Area) z LTAR (�'P"D '� o G rA'i"�--� f ,`y j a`chin Fa cili t Area �s Ex. Water � e I . Line Three 4�x 8�x 24" Deep or similar , � i Concrete Chambers ( , ) ti with 4' stone on sides and 1 on ends f - '- c Total Dimensions 28 x 12 I r 1 ` \ �O .Ja____._•-- Existing ' 1000 Gal Septic Tank 1 26 i� i , _ (81 g) 45 IBM I 1. iG D (6Z 5) ! 25 Existing PitfJRAL ' to be filled as i1e ulmd 8L Existing o q 1 1 I Test Pit Location ( . ) D-Box U I / { I Z. 1 d` �s% " 1 ! ' / \ cvjl PB0.1 'CT LOCATION I G v ' s ��1 MAP _14 y) LOT j A 40 46 06 W 155. 00 1 ) � t f (81.05) TBM EL = 62. 5 ��a �o �t-G,, y -t 'Dr _ - -• - - - - - - - - - - - - - - - - - - - -- - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - o� - Iv'� (60.1) (sa e2> (s1.4) Concrete Bo un d o CP� r✓J / -� M Tk�SIe D PREPARED BY. TY-ISYL-IF DRIVE 71 , L/ A & M Land SerTices 15 Sunset Drive `a G South., Yarmouth, MA 02864 Q c c (508) 394-2723 SCALE' =10 DATE.• `1 1 1•z/u Z LOCUS' SNAP REV. ` DWG. NO. 3 of ( SHEET 1 OF / I� a