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HomeMy WebLinkAbout0129 LOOMIS LANE - Health (2)�A9 Lron�t UI., (A� a91 / Oai 0 n (19H M 02t? 'ON WWOD + v' ASSESSORS MAP NO: THE COMMONWEALTH MANAfSiIH£ETT6 G� BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Di-tipuuttl lVurku Tunutrnr#iun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......................f........%................................................... -- ----•---------------...---------------------------•--------------------•-- Location-Acjdress or Lot No. =[- ..... ................................................ ---•----........-----............................... O r Add c s a ------•--G..t4 -- Q -�-(.------------------------- O . d. . c, ... .. Installer Address �� Type of BuildingSize Lot__-�._. 7 Sq. feet Dwelling— No. of Bedrooms--------- Expansion Attic ( ) Garbage Grinder ( ) a4 Other—Type T e of Building _��,_ ���r No. of `ersons____________________________ Showers p, yp g 0--__ _..---:_- p ( ) — Cafeteria ( ) a' Other fixtures ------------------------------ -- W Design Flow........�t -�----•_________________gallons per person per day. Total daily flow..__._. W Septic Tank—Liquid capacityx �gallons Length-, ...... Width_/_.. f _ .?__. ameter__,.6.. ___ De Depth. i x Disposal Trench—No. ________-_----___- Width.................... Total Length.................... Total leaching area....................sq. ft. > Seepage Pit No---------------------- Diameter_..._._-__._-_.____. Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. I................minutes per inch Depth of Test Pit_____________.._.._. Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit________-.._____--.- Depth to ground water........................ a •...---• ---------- -------- - ---- ------------ . - --..... -- il Descriptionoo ._... - -- -- ... .3-......--.... k` U .............L- ..Le_. .............................-.................................................................................................................................. W V Nature of Repairs or Alterations—Answer when applicable._.__.�/� ._____ /..5. .._.f .l� ............................... -------•-----------------------------••----------•-•--------------------•---------------------------------.--•--------------------------------•--------�--------.--------------------------------- 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 he undersigned further agrees not to place the system in operation until a Certificate of Com li ued b the d of health. Signe ------ -- ------- ------------ ..... v D­ ApplicationApproved By .l........ --------- --------- ----- ------------------------------ ------:-------.---------. -- .......... ----- ��.: Dare Application Disapproved for the following reasons: .......................... .. -- ....--................................................ . -- . . . ............... ...._........ .. ............._....... .................... . . . ................................. ---------------------------------------- PermitNo. .. ?..�--------- ........ ---------------------------- Issued -------- ....D. le.. ..................---------to are THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of C ontlatianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (Ntl,,))or Repaired ( ) by -- ---------------------- ------------------------------ --------------------....------------------------------------- ---- at ...... .._......../ . . /w �1 /t�tv. � � � (/�L .. has been installed in accordance with the provisions of TI- I.E , of The State Environmental Code as described in the application for Disposal Works Construction Permit No. �_�1�' '..` .ZD ....... dated t- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR AS A GUARANTEE THAT T SYSTEM WILL FUNCTION SATISFACTORY. DATE..... .. ...... ........_.. ................. - - - .. ..... Inspector --------------------------------------------------------------------------------- No. . .. -• THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH TOWN OF BARNSTABLE d Appliratiun for Uhnipuuttl Murk,i Tomitrnrtiun 11rrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: / ......................•. -••-•---•----_-•--- -•-----------••---•-•-•--••--••---•---- o ---•--•-----•--•-•----......---------............_..•----•-•••--•-••--•--••----•-- ' Location•Address •_--or Lot No. .... _.CD w E'/c..J --- ON tier Addse,s( a y i Installer Address 2U ©7v _.Type of Building Size Lot._--___��__________________Sq. feet', Dwelling— No. of Bedrooms..._._..7......Y ......_-.._-.---.._.Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building _lyre ?.( p00"No. of persons---------------------------- Showers ( ) — Cafeteria ( ) _ Other fixtures -.--..... •---•--••----------------------------------- --------------------------5 W{ Design Flow--------_�z • Aq______________________gallons per person per day. Total daily flow.......Z1.9-V.----------_----------gallons. WSeptic Tank_-Liquid capacity 14 "-gallons Length,$- ------ Width../.2_......-- Diameter., C1-. Depth_�Q_f�. x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area--------____.___.___sq. ft. Seepage Pit No--------------------- Diameter......-------------- Depth below inlet.................... Total leaching area..................sq. ft. r Z Other Distribution box ( ) Dosing tank ( ) Il Percolation Test Results Performed b ------------------------- _.. Date..................................... j Test Pit No. I................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......................... = := ............... ------------------•----------------------------------------......................... xDescription of Soil.................�•/ ...._. � / i_x�l �v"•---c �' = � 'fir'' ...........f --•--------------------------------•--•--••------- W x . Nature of Repairs or Alterations=Answer when applicable_:__: /���- # ` ---------------------......... U P .. ----��_ f - - 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 —iThe undersigned further agrees not to place-'the system in operation until a Certificate of Compliance-has-been-issued by the board of health. Sign`e/d ' ` .............. ........ ------------------------------------- 3Due Application Approved By ...:...... .� �=' is ce Application Disapproved for the following reasons- ---------------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------------------------------------�.., ...----------------------------------- --------------------------- --- - r _ Permit No. � `"..�� ' c� Issued ........ ...................... ----9�....�....... Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE GPrtifirate of CIImplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (NCb))or Repaired ( ) by ---------------------------------------------------------------- ------------------------------ ----------------------------------------------------------------------------------------------------------------------------------------- at --------------------- ' ...Z00) �.1. .. ,, ..._..... / t:.---------------------------------------- has been installed in accordance with the provisions of TITLE of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _ �'..` . ........ dated .. r''. .--. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THK SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------- ----......-------....------_---..._--------------.._-------------- Inspector -------------...._.... ........... -----...---......------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE IW5r No. .�.... FEE........................ �i��uuttl urk� �unu#riun �lerutit Permissionis hereby granted.................................................................... ----------•------•••----.....--..-----------------•------•._...--•-..._.. to Construct (Pp" Repair ( ) an Individual Sewage Disposal System at No...... ••r•= •-- =; -•---•--- -- ....ZZ.-9-----O ars•rr�1.5.....St.'1/ /_ - _ G`���% Z-hIddLL-�----••-•----•-• reet as shown on the application for Disposal Works Construction Fer, it Np�'.._AY��_ Dated..-.-_.1-..�_ �...'..�� --- - - / r � .•_-.•_________________ Board�f Health DATE................. ................................ FORM 36508 HOBBS&WARREN,INC..PUBLISHERS b� a" Puc(Soti 4'0)TyP TI Pelyc+-4tylcNc /.— � /y 3 I Lcac h IitcJ Z. I C.h it m bcr Ll9afI1cA I(`► ( 5.1-e n c.. I' ------4 q' . .__. Effcc�rs ,(c'17fh PLAN E ff cchm LcaLkIKI Amcc. Sd' A I Z� = 6.00 SF J � J bco sF x 0,753p�/s1F . 45o gPd 2" P Lot*t At ILA min Govtr 9�"—1��2•was h c� b iO�1 G �,_ (T"'�1 —"�:� 6' PRoF/L.E Pv e- h 46, .6 L ca r-h.,or _ a u lAlushcAG Ll�iaiubar 6�v d a.lan� 4214 1,75 I • s' Mrn. 5cc-rioN A- 1q STcPI-464 �' ! ALLYN ... j WII_SO^1 37, �- 0. 3 ^ ;�h �.� U5G5 Add, W��h Groundwai-tr L r4GhII/V6 /cf1 C/L I TY ,DE'TfI/,L -Too c c TOP OF FOUND 20 FT. MINIMUM won kipMom� SOIL TEST (P-s1 z7) FOUNDATION 10 FT. MINIMUM CLEAN SAND DATE OF SOIL TEST Oc•+-eta er ELEV, s4 x A WITNESSED BY Trr.rm CONCRETE PERCOLATION RATE 'i-•••,6 MIN./INCH. COVERS 4" SCHEDULE 40 PVC PIPE 2" LAYER OF OBSERVATION HOLE 1 OBSERVATION HOLE 2 47•o MIN. PITCH 1/8" PER FT. 1/8- TO 1/2- �V= q�g �V.=� • zo.o CONCRETE 2 MA WASHED STONE COVERS 0 TOP AND . 4" CAST IRON PIPE f2„ SUBSOIL (OR EQUAL MINIMUM PITCH 1/4 PER FT. FLOW LINE 84 % f*wwot C/carr 3ww.r FLEW - 45_.2 10" ylS,«4// LeL4ku MIN. 1 9-L ELEV. 45. 2 2.o. 0 C ELEV. m .'��_ LEVEL p :� o u 15�� No �/o v,.) ELEV. 4 4.Z► EL 137. 4 a ELEV. 0 0 o G CPO*" Sfiun" Bose0 o WATER AT EL.- WATER AT EL= DISTRIBUTION ELEV 3/4" TO 1 1/ u� DESIGN CALCULATIONS B 0 X WASHED STONE_ NUMBER OF BEDROOMS .,,, 1 500 GALLON TO BE WATER TESTED / W 0 - GARBAGE DISPOSAL UNIT nn IF MORE THAN ONE OUTLET TOTAL ESTIMATED FLOW SEPTIC TANK (.�GAL./BR./DAY X _*� BR.) 4 GAL/DAY WELL REQUIRED SEPTIC TANK CAPACITY �� GAL ZE ACTUAL SIZE OF SEPTIC TANK �.QQ GAL. INDEX LEACHING AREA REQUIREMENTS SEWAGE DISPOSAL SYSTEM PROFILE ADJUST BOTTOM AREA GAL./S.F. NOT TO SCALE ER "R5 ft1 rAC tAED DF--r L LEACHING CAPACITY (BOTTOM ) 45e GAL/DAY LrVcsvat,,vet Lakt BOTTOM OF TEST HOLE ELEV. = 37,4- RESERVE LEACHING CAPACITY A50 GAL./DAY OBSERVED WATER TABLE ( / / ) ELEV. = -/— Ex►++,� NOTES: 3 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. i LEGEND: TITLE 5 AND THE TOWN OF J9A,1#afTok1b6E RULES AND EXISTING SPOT ELEVATION OOxO REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. I 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO •-�: -��w�+ EXISTING CONTOUR ----00---- WITHIN 12" OF FINISHED GRADE. --- •�f Prop. L•.•d.t a•4 Oorhr_ FINAL. SPOT ELEVATION t •� �' r w �'Iti �`""`� FINAL CONTOUR 3. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME. �tias �Kt 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPAI LE OF SOIL TEST LOCATION �aK fug UTILITY POLE V#17HS('ANDING H-10 LOADING UNLESS THEY ARE U`r'DER OR WS.T'i�: P -J- �' 9V4tjf J TOWN WATER —W-- 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE / '\ USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. _ -36 �_ _ _ _ CATCH BASIN �In 5. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL vs't °53 go BE MORTARED IN PLACE. Am& fkot< -ftP4+ 6. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH 90 — �� e — �� 4a 12 Z�i 'sF- DEEDED OR ZONING REGULATIONS. OWtlNER / APPLICANT IS 'fl0 r CA/ r rod / OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. EuaI'm . M'oaoz rk '" J.' i 7. 44—. ...I ERl Y/A' Gcsa,��e/ 0 / '� " /fv`r STEIHEN 6c ��.a�..�, ALL °N L - APPROVED: BOARD OF HEALTH /..✓ are..../ar.i.d � 46, .� � ��kd w.,c4 .snNgG � ,r Na 302i..�; IS _ \• /,. *e� V O / C .Gas r �Jafta- st�uj"s *-. " �� olow DATE AGENT a stole. m� t-op 600se //to(4f <.,,,4 f. � N PROPOSED PLOT PLAN r FOR �._. RZC fW,14 R o COYeV All m.f alr9wells W t �,'•V PRO&= L=7= �. �.eu... arty.! S/.•/� bC �S7bi`t� Ltin� {tf<uC�'. �.,«1es. _ . / ! ;r •"'`-� • IZQ l..aorv��s L.ahc � a)n aa. s/,a// be use, 3 d/o so .J A..// Ac :r4 r vr. fi// ,A-C bp.,t'a/ &-ac e%�• GC h ttcr'0;1 1 C rru m s . l p ji0'r Am-A werk r/6-Afc� o1.eV fWP/'ev'CCo by .'§dc • >j, ZI)107D� '�' �Ow.fCrw +4.n o4•�ea� grSMALDLANOD111; YPR SUR Tt N 50� BOX 307 - 36 PUTTER 'y• .�, v 771 7217 WEST HYANNISPORT, MASS. 0�672 • t SrI1LE DAM ,r//4/93 ICEVIG' 'D . // Zee •_ Ira' �•ti�'�S�ar •,.;i» `."'lieu'. � � / / i � L IL •.•`; ..K Srv+ahnl.rlc -Pic s.t•,.h ALP .F;44 No. sE 3— LOCATION MAP ��/�3 ''� Nm SHEET I OF j F im"'6*v% +' EI cal 4 1.40 NI V P r r .�—..�r