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HomeMy WebLinkAbout0018 BLOSSOM STREET (CENT) - Health - 2-I(L) f p ff P l u b i, �� � TOWN OF BARNSTABLE LOCATION zy- �® � �'�, SEWAGE # ® � VILLAGE t . ASSESSOR'S MAP & LOT06-0/-5-- ny/ INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY � e � LEACHING FACILITY:(type) ZI:5�17 (size)_�� > NO. OF BEDROOMS _PRIVATE WELL OR PUBLIC WATERS.AP BUILDER OR OWNER DATE PERMIT ISSUED: � ,�.- Q DATE COMPLIANCE ISSUED.: ^- :;z VARIANCE,GRANTED: Yes No °' A �+ to n e O � � V 3A S ' I No- __� Z 2 e•K- Fmc..........................C.� r a 0 THE COMMONWEALTH OF MASSACHUSETTS DI �I �u ,,- :;:�: BOAR® OF HEALTH " 'L4(01 TOWN OF BARNSTABLE Appliratiun for Uiupuual Works Tonstrn.rtiun amit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: AV/8 f3LO5.<e" ST �2A/l, diLGF.ty' #1 /5 ................-__,_ . .......- ..... -------------- -- - ......._.._.. Location Address or Lot No. 4Q.,� ! 7��.11 T .... crud �E� vcv�� -w, .Uis,�v�2T =... t ,� ._... Owner Address aInstaller Address Type of Buildin ,, / Size Lot._�dx_9Q ----.--Sq. fe aDwellingNo. of Bedrooms_____. b✓V_________________________Expansion At (lo) Garbage Grinder p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -----•-------------------------------- W Design Flow...................... ..5 ..........gallons per person per day. Total daily flow______2.Z 0.....................gallo s. WSeptic Tank—Liquid capacity./YM9gallons Length._....:./'Width......••... Diameter________________ Depth...`✓__._.. x Disposal Trench—No..................... Width...................:Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........../------- Diameter.......K./_..._ Depth below inlet-_'./.._._._. Total leaching area..-¢!. � Z Other Distribution box ( � Dosing tank ( ) 3 5 7 6i W A-GL',ft0c 43 ~' Percolation Test Results Performed by.......................................................................... Date................... � Test Pit No. I......../.....minutes per inch Depth of Test Pit....�U_ ..... Depth to ground water/ __.... Test Pit No. 2.:..............minutes per inch Depth of Test Pit__-_1U_1_.... Depth to ground water� 4t�E.1e �_.. O Description of Soil el �� Sa.!__ ..- ----/v - � �� 4- - x j U ••••--•••••-•-•-•------••-••••-••-•--•-•--••-•------•--•-- (dQ T W ----------------------------------------------------------------------------------------•-------------•----•••----........---•-----•••......•---••.--•-------•-••--••••. .......... V , 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 b n issued by the board f h t. A/ Signed ------------------------- Application A roved B � Q ....: ........ -------- ------------- --- `�`.11_ /.`�1�----- PP Y -- ------- e Application Disapproved for the following reasons- --------------------------------------------------------------------------------......................................------------ ------------------------------------------ ------------------------------------------------------------------------------.............................................................................. ---............................ Date Permit No. - 2 Issued �� j� ` v.------------------ Mte No.._...!.t ✓.._....... Z� Fss.................. ....... THE COMMONWEALTH OF MASSACHUSETTS it S .`��' � BOARD OF HEALTH P t r , TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstr ion rrmit Application is hereby made for a Permit to Construct (X)�or Repair ( ) an Individual Sewage Disposal System at: `4( _ ---.........�/8 f3�ossc� ST CrZ✓a/, d�L�E , �>fLft-fU�Ga _# .._............. .. -•---•••--•--•--•-••--••--...-•-...... .......-•-••••--- -----l - - Location-Address or Lot No. r ..................v 2 .-1. ? ._.7/ _1� l--------------------------- C� ivc r��� Z/v 2w x -W, / s ,vis.... Ag7 W Owner Address Installer Address U. Type of Building Size Lot..�Ui.U�d....... feet Dwelling x No. of Bedrooms....2 W.v..•......................Expansion Attic elo) Garbage Grinder (,(4 �,,�� Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ----------------------------------------- • -- -----.---- Design Flow............................................gallons per person per day. Total daily flow---_-_�_Z ......................W � WSeptic Tank—Liquidicfapacity_/MD gallons Length.......� Width.... ___.... Diameter_______---------- Depth....5......... Disposal Trench—No..................... Width.......------------- Total Length..................... Total.leaching area--------------------sq. ft. Seepage Pit No box Diameter....... Dosin/--tank Depth below 5 et__.-� �eT��lleacching area.- �y z ( g ( ) T!/n!t Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I........Z.....minutes per inch Depth of Test Pit.... ..... Depth to ground water((�---k<Z45/2 G (Tq Test Pit No. 2................minutes per inch Depth of Test Pit....Z_4?.... Depth to ground water./_"...A�x/,!En ev C a' ------------------------••-.......-•••-••----.-•--- - ---- D Description of Soil GV U.•---j.P�_ ..... � ,�rJ t ----- - /U �f �` x -------------------------------=----................................... 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 TITLE 5 of the State Environmental Code—The undersigned further.agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of h a rh 0_1 Signed / a .�-- ..--- -------------------------------- ` ................................. flare 'Application Approved BY - �- - -� �� .- --- ---- ---------------- --------- ------- -- -- � CD Application Disapproved for the following reasons- ........................................---------------------------------------------------------------------...----------------------- ----------------------- - -------------------------------------- -------------------------------------------------------------------------------------------............................................................-- --------------------- - • _..� 5:--- Date Permit No. . ...... Q... -a ->.... Issued /�i--�9��.................._ Date ! e � ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C9.elr#tfira e of Compliance e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( k ) or Repaired ( ) b ........-... Y --------- ---- �� ?.- ' Installer at - - ... .........- -c7.................... -------... -(1 tC.V--[._�-.. ..... 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. .'-. -2 dated .......51/zl5j v............ : THE ISSUANCE OF THIS CERTIFICATE SHALL'NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. --- Inspector ..-..... " THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -2 2. TOWN OF BARNSTABLE r FEE....�. No......................... . ..... Disposal Works -1V11unstrnr;iun ermi# Permission is hereby granted....................................................................... ... to Construct (x) r�Repair ( ) an Individual Sewage Disposal ystem 3 J as shown on(the application for Disposal Works Construction Permit N....'��....�ated�!_.��� .....:.:............... q DATE....................ly ........................... Board of Health FORM 36508 HOBBS B WARREN,INC..PUBLISHERS ' F, SOIL LOG NO.- 1 NO. 2 SITE PLAN <'5 2 J� - 7 3 C© TOP OF FOUNDATION EL.: D MEN 4 $ 9z • . 4 ;� I� E-rC 'Zl"(n r L s 10 • I N.E L. )R `T,-1 - j L �rrrr:" - ::• IN.EL.LLL IN.EL. `�;�. � C , ` 7a?-t,.� ,,,, /� 2 IN E� ' �� a``, 13 4 LIQUID LEVEL O/B W/ 6 SUMP -` �' �t� .�14 ,o Y ad � �?r• � , , r � ALL 10 • 14 ��3,� M�4°� .o 1 _- -- ---- ��. t'� ���_�, PERC TEST RESULTS PRECAST SEPTIC T NK WITH ld' ' - � PER6 RATE: CAST AV ACE INSET AND i -- 12 ._ _,� ', � t WHITE D lY __..____._ _..._... N SSE OUTLET T "S PER TITLE Y BOARD OF HEALTH SIZE : � ► ) '= 'ra.� r,�,l L � �, � � t � , � := - DATE: w. PROFILE OF PROPO.SED SEWAGE SYSTEM ��`�;� _. °' Pia raj° SYSTEM DESIGNED BY THE TOWN OF �� REGULATIONS AND STATE TITLE V FOR SUBSURFACE DISPOSAL OF SEWAGE . SCALE : 1/4 -- 1 0 i is N . B . , 1. ALL PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPE t p 2. All PIPES SHALL BE SLOPED 1/4"' PER FOOT EXCEPT FOR '` y. THE FIRST 2 FEET OUT OF THE O / B WHICH SHALL BE LEVEL — 3. DESIGN FLOW - - BEDROOMS AT 110 GALDAY PER BR. sue- GAL/DAY SEPTIC TANK SIZE . , X " GAL. '' ` tL ►+ �.... ; USE ' � "'° GAL. W/ � GARBAGE DISPOSAL LEACHING SYSTEM. USE 1r 1( t EFFECTIVE AREA: SIDE _ • ;,, .- �- � � `� � � ' " r � BOTTOM r c ; 4 xj, N �-' i qt ' n = t ��--- - F oa s l/x o i TOTAL FLOW ° TOTAL RE "DoF To of �► ,rAoz_t Q D FLOW = .� X �' — _ W/ GARBAGE DISPOSAL �� /.�A�n � � RESERVE FLOW tt GAI/DAY i —_.�.- —-------- 7 C A L c • I - Z O mot'a'l E � EA. E 2 J G A �1. EA �ra e i REFERENCE PLANS 1'� c,�► = �.; _ Z3o �AL � 1� 5 - -- ELLIu(A CA-00o-r "t36 F r'► �r> T� Mr�r2 E TN Iry 3 �5 �ti �.ao�,t , f ° l't.1 E� t. f "e,L JV!N G, 0 Tff YL i _.ter.`;�_l f �'_ "� APPROVED BY : _ ° v�5 A � e.v zao r - BOARD OF NEALTi� DATE : { PROPERTY OWNER : ----- ►-._ ��, M A' u_ __ __ SITS AND SEVVAGEPLAN �N 0� �I LGW_ I p3MA2. GrJS rkLIST MUM � FOfi'. L�r ► A�z < :> j -r ,� � �LPL lt� f! c 0 ©ATE- S- 15 23.5 l 1r►nD*'2. LAME - tk� .','��, ..., ,' .. '.. .- _. ._.• ._.__:.. __. ', __ .. ,._ .- - _. - - .. . . n. . . + .ram.. + f , -