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HomeMy WebLinkAbout0019 ROSEMARY LANE - Health (2) 30 Rosemary Lane A= 147—007—002 , Centerville " U/I � UPC 10259 NO.H� 16 OR NA•*�Mq• rN oW F BARNSTABLE e LOCATION -se kn _ SEWAGE # g 7 ' 76 VILLAGE ',gx �,,,1/e_ ASSESSOR'S MAP & LOT _ I INSTALLER'S NAME & PHONE NO.�/ C Lorls�` r. SEPTIC TANK CAPACITY 1000 :LEACHING FACILITY:(type) ftc ccj,A "-A (size) lao 0 611 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER_ BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED_ VARIANCE GRANTED: Yes No �/� _ _ _ a q, 3� � �.b �i �3 � No........ .�.1. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ppliratinn for Disposal Works Tons#rudiun 11trutft Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: ` .�.. .. ...... ��_-�_ ..mo►.En hire t.....4�4: 4��a.�l.!e.�. - f 2Z ......................................... Loc Address -r o .. .:.......�1. �:�.. . �..�- - .=............................. .... � .:..I�' .�w.. Owner Address .... ................ c ........................................................ ....................•--_...........---............----.---............---- Installer Address Type of Building Size Lot.. ...Sq. feet V Dwelling No. of Bedrooms..............2>..........................Ex nsion Attic., g— . pa ( ) Garbage Grinder ( ) Other—Type of Building .........:.................. No. of persons............................ Showers ( ) — Cafeteria ( ) aOther fixtures ..........:......... -•-•----..._.......... ...............................•••....... Design Flow............. ..D....................gallons per er,day. Total daily flow........... gallons. Septic Tank—Liquid ca.pacity.lb.0tk ns Length...1b..b.'.'. Width:...:).Q" .............. D th...V.......j.. x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. 3 Seepage Pit No..-O. .... Diameter.....1.0.'...... Depth below inlet.....(A............ Total leaching area-2-t,c2-7.-.sq. ft. Z Other Distribution box (� Dosing,, ( Z_ a Percolation Test Results Performed by....._... .ln.�.r'. .s,. .. ..*..1.1 ........................... Date......l .-Anit'. _�*............ 14 Test Pit No. 1................minutes per inch Depth of Test Pit...., Depth to ground water.. .QAI.�...--__. 44 Test Pit No. 2................minutes per inch ,Depth of Test Pit...... ��'..-- Depth to ground water..._ .- ot4a' .. .. :..s.u .cal.fQ.......---- Description of Soil.............a[J!�)��1.J �.Ica.+! .............................. .......................--•---.. ........... Uw -------------------------- .... .. . . --. .............. ..........------------................---------......---......-----.............................. 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 LI'LZ 5 of the State Sanitary Code—The unde signed further agrees not to place the system in operation until a Certificate of Compliance has been iss by th and health. Signe�d.i..................... ............................. ............................... Date ..........Application Approved By...... ................ 3W ........... Date Application Disapproved for the following reasons:.............................................................................................................. ........................................••---...................---.....--••--••-•---•---•----..............._.................--• ..............._� --•........................•----•-----........_.. Date Permit No................. _...1... _q D.:..__ Issued.............................. ........ Date ......... r Fss....... .. �.00 p THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �r Appliration for Disposal Works Tonstrudiutt Frrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal j�Syst—e-s-n�at: ` 1 .. '� o f �2 ---... ... _.. .Loca�u�n•Address..................................... "or Lot No 1.FT Owner Address .._... .r. ........ a . ..:.. .......................................... •......•-•--•--•---••••••---••-•••••••--•...------••-•••-•---••....._............................. ` Installer Address � q' Type of Building Size Lot....�_..........6..............S feet V Dwelling—No. of Bedrooms..............? .....Expansion Attic ( ) Garbage Grinder ( ) a aOther—Type of Building .... ....................... No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ........"............................. :......:........ Desi Flow............. ..................... Ions r er=sonF er da Total dail flow----.....` ..:z. �----- . WW > per P P Y Y gallons. WSeptic Tank—Liquid capacity...C'.nT'gallons Length_-- :' '... Width:..�..1 a" Diameter--....-:..--..... Depth- .--.. x Disposal Trench—No. .................... Width....................Total Length.................... Total leaching area.......------_--_---sq. ft. 3 Seepage Pit No.........�-.... Diameter......Q........ Depth below inlet..... ?............ Total leaching area. �,J��sq. ft. Z Other Distribution box (i/) Dosing tank ( ) -7 _ `v' . <" ''" Percolation Test Results Performed by...! :. ��: '"ha ..... �C: ......... Date.....+t:..zq ` ........_... a ..........- ..... Test Pit No. 1................minutes per inch Depth of Test Pit....j. l o.`.�.... Depth to ground water.... .t: r..... f� Test Pit No. 2................minutes per inch Depth of Test Depth to ground water.. ...... /k'. 41 1 (a" L-g"r... i ....._.. O Description of Soil...............n� C� � _ �.-v. 1:.......... ......................... .................... ...... --••-•....---•---- .............. � C- .....................+ 1• l7 ' . -�.... �• �..,a'-�Sc ` ....... . Ca..A`i . .... t .............................: ' s,�`�'e_.. ..�;Y� P,C te_.J�1.�....`�?h r�C� ........_......... . U 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.TITLZ 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. Da te ate Application Approved By...... ('-t *� 3 ��............................................................... / I ..1............ Date Application Disapproved for the following reasons:•............:...•---.....----...........---•--....---------........----------•--:...---.... . ........ .................•-----•--•----•••---..........•. ...----•-...................---•----•.........----..............-----•-•-•--...............--._...................................... Date PermitNo........--••-•--..-- --`-----•--........ .._ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` ! t ........ �l Jn}.........OF... (Irrfif irate of faomphaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...............,�-•-•--.......-��--..•----..- ••-`�......................................Installer/.-� �---�--••-------------•--•--.........--•---.......................-•----•-- at.................................................. ....�E�rn r N .l_ .stale ` `"1n a• •-- ..............•••---••-••--•------................................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No 2.7.'.��_O................. dated...... ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--•••--•--........ .r:•f.........�.......-•............................... Inspector.... C ...:1 ......................•. THE COMMONWEALTH OF MASSACHUSETTS ~FFFJ BOARD OF HEALTH °t:<?!� 3..........oF .c-11. �f�l.. ....... oO No.�: �f Fn....... ...... Disposal Works Tonstrudiort rrrmd Permissionis hereby granted.... 1 ..................................._...................................................................................... to Construct ( ) or Repair ( _) an Individual Sewage Disposal System at No.............!-.rf.....2--_z...........(r' 'Dsc'maQ, L-�----� �n�� . ....................•- -- ....... ........... ...•-------------- ..........-------------------------------- ...... Street as shown on the application for Disposal Works Construction Permit No..................... Dated............/............................. DATE. aura of Health •••-••............_...---•---•. ..._......--• ...._.....-•----•.........................................'.... -r SECTION - SEWAGE MOTE.: S E Q CH M HP•K: Et_.42.S4 'TOP of G.B. S. E. GOPhJE� LOT l = I G&t SouT H o f 1rJTEP. ®F �ossmA2Y LA- SEPTIC TANK - s - "D"BOX - p - LEACH �( TOP OF FON t (MSL)# (^-�"2"OF 1/8TO:/2" 1 WASHED STONE A �� IN• OUT• IN- O OUT- �000 G o e (] 3Z STANK IN' T 4,( 1 .O I /1,cJ,('�."� ELEV. ELEV. ELEV. ELEV. LoT Z2 1 ti ELEV. ELEV. 8 ELEV. Z` 2t! { I Y C0 42 5 y 1 L_ G T - 2 WASHEOSTONE HOLE LOG -A Zy �030 TEST fi�y j. p ,i. M���AIJ, 2-8' � �'.Fai r�oirti k•��i�2:-.�-.���s, iJ•LE►T►•.�El�, i 1- Z'i-SAC• x \ sp�• TEST BY WITNESS TEST DATE J ' DESIGN BEDROOM HOUSE T.H. # 1 T.H. —Y4 ELEV. ELEV.Ll7l,� NO DISPOSER DISPOSER Su y 24 I 1 �F r; !� PERC RATE G MIN/IN. 4g'S FLOW RATE 33C)(GAL./DAY) 33U L.o-r � �� �a� SEPTIC TANK ���C7 x (tS)= �95 (,! Al REQ'D SEPTIC TANK SIZE /0005AND ��� LEACH FACILITY S•�. A� 1 \ �("�,/`� j) SIDE WALL 1olY G/D. BOTTOM 1�ZTr' 4 = 73P2 ( I,C>) _ '18• G/D. t� l TOTAL O S.- = S Gfp a ` � • USE: t l "... LEACHING 11 11 nn I O` EFL. +fa:, r; Cc; (-7 11 E'F--F t ,-� Nl/ WATER ENCOUNTERED � � •�� NOTES: (UNLESS OTHERWISE NOTED) 1.DATUM(MSL)+TAKEN FROM __._ _`"_ -'__._______QUADRANGLE MAP - V 2.MUNICIPAL WATER......_fs...........__...............AVAILABLE Ott 0f 3.PIPE PITCH:1/4"PER FOOT 4.DESI'GN LOADING FOR ALL PRE-CAST UNITS: AASHO , •44 0� 'SG � 5.MI COVER OVER ALL SEWAGE FACILITIES: (1) FT. r� ARNE H. --Q—DISTANCE AS CERTIFIED CjL-I/+���� 6.PIPE JOINTS SHALL BE MADE WATER TIGHT OJALA 7.C DETAILS TO BE ACCORDANCE WITH COMM. F M ca i w CONSTRUCTION D O ASS. CIVIL y p STATE ENVIRONMENTAL CODE TITLE 5 O. oa. SITE PLAN 3 tp Locus: Z Q 7 eKa 7r7 M-Y - �' T GI , � q� f 'o�' ARNE I REG. ENGINEER I CDH• - OJALA REF: 407 G a- , #26348 a� \ I down cape eligineering F0 5 PREPARED FOR: ( CIVIL ENGINEERS A 1 LAND SURVEYORS ---- — BOARD OF HEALTH matn REG:LAND SUR YOR SL DATE 6- 2-,S � CONTOURS (EXISTING)----------- GATE W J I (PROPOSED)-O-O--O-O- APPROVED �NSTAB�•-E,�MA CALE A Y��� i f , s L`07-1VO, 22 8 J42 s• a y � d L Lvo9 . 7-1©1l /3•/' /3.2" i Z s-z. z' rjrj EX/s 7'1/� N s" (u 3�•2 • t _ i. i W r E. L9 , . p t f ' .Z R,E51WSy CEO Th=Y 7-1�A 7" 7'HE -X/�5.T//V G Q T NO, Z Z ARE 5h;0~1 W 7 -11/ 5 01 A1/ ,4 S Y Ae 4 L a C4 TE,D ON 7HE 6RO1-1 1,b 6A,5Eb oN AN AC7-61A4 11V 57'R4W,51V7- SURVEY. 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