HomeMy WebLinkAbout0086 BETH LANE - Health 86-6ETHl LAVE, HYANNIS'
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i
r TOWN OF BARNSTABLE
LOCATION �l� �� h. SEWAGE #
VILLAGE Is ASSESSOR'S MAP & LOT 2
INSTALLER'S NAME&PHONE NO. 1141. 6— L, P-a rV 90
SEPTIC TANK CAPACITY ,,���►4/ J L,
LEACHING FACILITY: (type) QCize) zz Z
NO.OF BEDROOMS
BUILDER OR OWNER Co � e
PERMTTDATE: ! I" fl / COMPLIANCE DATE:
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 leaching facility) Feet
Furnished by '
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„!A THE COMMONWEALTH OF MASSACHUSETTS Entered in compter:
Yes
PUBLIC HEALTH DIVISION -TOWN-OF BARNSTABLE, MASSACHUSETTS .
01ppCication for 33tgool *pgtem Conotruction 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
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size -' trf® O sq.ft. Garbage Grinder( )
Other Type of Building A4-,eo4 -o"+54 No.of Persons 4' Showers( ) Cafeteria( )
Other Fixtures
Design Flow 9 gallons per day. Calculated daily flow 5 re ® gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank /®�� �'Y��T''S Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
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,iss ed by t Board ealth.
Signed Date 1 C`
Application Approved by 4 Date I/ /_-E fe
Application Disapproved for the olio g reasons
Permit No. Date Issued
/ J TOWN OF BARNSTABLE , L.
LOCATION (A. ►J SEWAGE # _ H2O
VnI AGE H ya4 f"S ASSESSOR'S MAP& LOT!2 —,�
r INSTALLER'S NAME&PHONE NO.A 1 ICE
SEPTIC TANK CAPACITY (5��0 6
LEACHING FACILITY: (type) S 11-ci v WI q h0lt ize)
NO.OF BEDROOMS
BUILDER OR OWNER ( � / �! eti
PERMTTDATE: I I— �l 9 COMPLIANCE DATE:
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 leaching facility) Feet
Furnished by
2? 2 '/
No. " '" Fee
, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Apptication for Digooal *pgtem Cottgtruction Permit
Application for a Permit to Construct(Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
cation Address or Lot No. Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
e of Building:
Typ
Dwelling No.of Bedrooms ;!P� — Lot Size r�oo o sq.ft. Garbage Grinder( )
Other Type of Building ts*o,&O o",4Ao.of Persons e' Showers( ) Cafeteria( )
Other Fixtures
Design Flow -9 gallons per day. Calculated daily flow �� gallons.
Plan Date Number of sheets Revision Date
Size of Septic Tank /�"moo �%Y/f'T''''� Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable')'
Date last inspected: `
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system I
in accordance with the provisions of Title of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been 'ss led by thig Board ealth.
Signed Date 4 —U
Application Approved by Date
Application Disapproved for the ollow g reasons
Permit No. 77 aL6 Date Issued
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
at has been constructed in accordance
with the provisions of Title 5 and the for Dispos(A System Construction Permit No. _ �71 e-_ dated
Installer Designer,'
The issuance of this permit shall not be construed as a guarantee that tthe system will function as designed.
Date Inspector :�,
---------------------------------------
No. �?— 73-o Fee
r
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
D gpogal *Pgtem Congtruction Permit
Permission is hereby granted to Construct( )Repair(*)Upgrade( )Abandon( )
System located at L.0
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
j 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.
3 Date: 1 I �� Approved by
124
&3 69 32 yW10
10
1O Bath
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Bedrooth
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Clow,
` * a 8tin8co
•e
e 4
LIVING REA
760 s�ft
133
Fes----
Stairs leadao
Dining Room NOTE 2:upstairs
bedrooms with unfinished Future
Bath
Dw0 0
0
Kitchen ):�;kTH-
OO
T.10xS1
Landing.
LOS
. P6xr4
Bedroom
-Living-Room ENTRY
11.'8-x.3'6
UP.
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F201
4...
LIVING AREA
1120.sg ft
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1/6199
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only. -
CER=CATION OF SKETCH A1ND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)
I, hereby certify that the application for disposal works
construction permit signed by me dated / Y� concerning the
property located at $ JqCn meets all of the
following criteria:
• The 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.
• 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]
• 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 . _
DIFFERENCE BETWEEN A and B -I L
SIGNED : DATE: I '
[Sketch proposed plan of system on back].
q:health folder.cert
L, �' a 6S)
LOCATION SEWAGE PERMIT NO.
VILLAGE
INSTA LLER'S NAME ADDRESS
/ /� , g /a�L
Me 5 B RN �YA6l e,
® U It D E R OR OWN ER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED -,Z.�_7�
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No. � . .: ... Fus........................
�✓�� THE COMMONWEALTH OF MASSACHUSETTS
BOAR® HEALTH
--.:...OF............ .... .�(7�l!✓�... -----------------------------------------------
Apptiration for Btipusal Worka Tnmitrurti,an Prruat
Application is hereby,made for a Permit to Construct (Y) or Repair ( ) an Individual Sewage isposal
System at: Q. ' `
.... ............. -----W 7.........................................................
a ✓o N..... B----------------------------------------- ---------�1lr��l,
Installer Address
d Type of Building Size Lot../3t004--------Sq. feet
Dwelling—No. of Bedrooms....:_......................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q, Other fixtures .......-------------------------------------------•--••-------
W Design Flow...............55.....................gall,Qns�per person pe�day. Total dail�flow________.._.._.... . . ............gallon'
�' ...
� Septic Tank—Liquid capacity.)gW.gallons Length................ Width_1/._l._._._. Diameter..-_............ Depth-..l7�._.
Disposal Trench—No..................... Width.................. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..._...._I.......... Diameter...f.._.._6___--- Depth below inlet......_.._._..-_. Total leaching area...46S..sq. ft.
Z Other Distribution box ( Pr Dosing tank ( )
aPercolation Test Results Performed by.... '! ..:. R A'AR................................ Date.....$.P: 8........
Test Pit No. 1....'<._......minutes per inch Depth of Test Pit..../2. Depth to ground water..-__�o...
fz, Test Pit No. 2.._S.`Z__._minutes per inch Depth of Test Pit----- Depth to ground water--_____--
O Description of Soil-•A`' ----n 'c,� /
V --------------------- ------
•--------------------------------------------------
------------------------------•--•---------------------------- ----------
-•---------------------•----
...............................=-------------------------------------------------------•----•-------...---------------------------•--------------------------•--------------••-----•----•-••--------•-•.
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 iIT .;:., 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been iss ed by the board of ith
,,// /
-• ....
igne �1- / 7
/l Date
Application Approved By... .. ' �✓�_ _ ...9............----• = �' -
Date
Application Disapproved for the following reasons--------------------------------------------------------------=------•-------------------•-.....................
Date
PermitNo......................................................... 7------- Issued-...,;��:'�•-----...............................................
Pate
No ..... �`, .. Fizz.............................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® HEALTH
F,
4 T^'^ '�:.:�...............OF.........
ApplfrFation for Di_qvaiial Work.5 Tontitratrtinat Famit
Application is hereby made°for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at•
......; -- ................- .� .� ............ ........ � `_.. ...............................................................
....lY.elV .6.A .._. ...L [�!._ress.e`! z... ..dv0_i..�7 .. '�!..�..........•..
T .... ----------- ---
a .." ......................................• ...... .......
ar`.
Installer Address
QType of Building Size Lot../,Kj0j0.Q.....Sq. feet
Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons------------------------------ Showers ( ) — Cafeteria ( )
Q' Other fixtures ._._.._..-•----------------------------- ---
----•--...--•---•----•-•...................................•---------------•. --------------
W Design Flow.....7.....................................gallons per person per day. Total daily flow-------_....................................gallons.
Lei Septic Tank Liquid c' pacity............gallons Length................ Width_............. Diameter---------------- Depth................
Disposal Trench—No.......F............ 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.........................................
Test Pit No. 1.................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................riiinutes per inch Depth of Test Pit.................... Depth to ground water............._..........
a .•-----•-•---•••-•---•--------•--•-•..........................•------•-----..._.......------.....-----................................................................
0 Description of Soil........................................................................................................................................................................
W ------------------------------•--
Nature ----...................................................................................................................................................
U ----t - e 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 TiTLr,
p 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 b the board of health
Signe 3V/W.�. _
. ` f Z ..
A licatiori=A roved B _
PP PP,, Y ............................................... ......................... ----•--------•--•--------•-------••--•--
r r r r+' Date
ri A lication Disa roved dr`the'ollowin reasons---------------------------•------------.....------------------------....................._..-
PPPP f f 9
,�
--------•----••--•--•-•---------------------------------------------------•------•-----•=--•---.....-----•-•----•------------•---•-------...._._..-•--------------•----•--.............................
Date
PermitNo...--••--•-•......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
B0I4RD O LHEAL�.......OF {.: . . .:. ...... i............
rr#ffirFa#r of Tontpfi as rr Ael�
THI 1 CE 7F3 t Elie Individual Sewage Disposal System constructed ( or Repaired ( )
by .
at•-•-------•---- ... .... ......st er •..........................•..
ir��!�rr I
has been installed in accordance with the provis ons of T State Sanitary Cod . as descrikecjn the
/ /." h
application for,Disposal Works Construction No.Permit __._ ;__ _____ _____ _____•. da.ted_...._.___....._.._.._. ................
THVISSUANCE OF-THIS CERTIFICATE.SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WIL�FUNNC ION SATISFACTORY'
.,.
DATE-- . ....•..---•- Inspector __ _ 1 ----------------------•--------
k THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALTH
7 � ..... .. ..........OF......... :.....................•••.................. d-
el
No................... ..' FEE....................
Per"mission is hereby granted = -- -----------------•••........--••--•--
to Construct (;',) or Repair ° f) a In 'uidual/ a posal System
(JJ��
at No - --------------------------------
•--
.as sho ap i r�ispoSaL rsonrry"�tiop -
/-----� wealt
-a h
DATE................. ----------•-•--------'--------__.........
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS,,-
f F. TYPICAL SYSTEM PROFILE
AREA PLAN e FINISH GRADE=-=
FDN TOP NOT TO SCALE ;
= 42.U4 , FINISH i .
SCALE : I „ qd I FINISH GRADE OVER TANK= '51 .0o_
s _5d��
GRADE OVER PI,T-__
LOT .6 27 BE T H S LANE
I A
P V C OR - p p . • •
O F► C. I. TEESBSMT
�$ 3
il � t ,
FLRQ� GAL. 4" ��, �° • • • e • a • • o' e e o
REINFORCED DIST. BOX r
CONCRETE 8�• T0 INSTALLED BE IN TA D ON n • • • • • s • • o "'
•.
'
A LEVEL STABLE BASE • e a • • ' e o lot
>o .
SEPTIC TANK
TO BE INSTALLED ON A .�. • . • • • • • • o
LEVEL STABLE BASE 4 01 0 f 0 4 1 1c
2i_1/8"- 1/2 ..WASHED PEASTONE ALL • i • • • • • e • • • • !'
I BRICK avMORTAR COURSES AS AROUND FREE OF- IRONS - FINES
• • • • • • • 0 1 ,o e
j REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE
f LEACHING PIT
� 24 ��C.I. MANHOLE COVER a 3/4 ��TO I—I/2 "WASHED CRUSHED
FRAME- SEE DETAIL ' STONE ALL AROUND FREE OF BASE TO BE LEVEL
IRONS, FINES AND DUST IN
► P,D)
PLACE
FOR FIN. GRADE
I SEE SYSTEM PROFILE
SOIL AND PERCOLATION
. _ � DATA
8,, T' PERC. RATE : < 2 MIN./IN.
- ,
OR INV. SEE
Z4
C. D. SPOHR
° INLET SYSTEM PROFILE
:, „ . TAKEN BY
,
6
' 40 I LINE - ° „ WITNESSED BY:eAP_\. srAaLE BD.-Or- HEAl-TT-1
LANE
: . _ , _ ° ° OPENINGS W/4-i/8 0 ; -��. ', , � ,� 5 DECr , l t3��3
B E TH S ..- j p OUTER DIA. a I —3/4" °
DATE '
0 25° J$" I INSIDE DIA. { �
N 1 3 7 - , TEST PIT-GND ELEV.
,6 °_ _ TOTAL
12 �.t�c3 " W o o AREA o
0 0 ° 0 0 3
3 N WA-Sr ;_' ,�d`- ° o NQ BUST LEDGE
_ LOT 26 a, �_
LOT 28 � o o 0 0 285 � - _
4ca # ° ° ° °
gut Y�l fl _ `- ; o 0 0 ° o o °, _ A OR W � ��
N LOT 2 o
.
Gat �,, ° � 00 o c o
:
= o ° PAVE L
o o ° o a__o 0 °
` 0 15 0oo 5.F I
Q 2- 1
32,
1000 CTAL, PRECAST CO Io ,o aa'i � a ICE` �` ' EFFECTIVE D I A. BOT. PERC. HOLE
SEPTIC TANK.-S. EE PROFILE N 3I � Q `0 DOWN
i g, N LEACHING PIT - SECTION
I PE(:�D. 12!
PRECAST CONCRETE
•
u-��ohl >3�x ,$' � No SCALE DESIGN DATA : �
D� ST12B (WAR) NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM No. of BEDROOMS
�Z H,
_ DISPOSAL
?p_FCAGj oo ►c � _ 1 � � I �5.00' LEACHING PIT NOTES:
pl-F I RF_QT)_ SEE Pf?-OF1LI ° � °, fST. TOTAL DAILY EFFLUENT_�_GALS.
p� 1k 5 -- 1 3 2 `a $ I . CONC. TO BE 4000 P.S.I a 28 DAYS . SEPTIC TANK 1 000 GAL.
2 . REINF, W 6 „ X 6 ,, 6 GA. W. W. M.
3. 2 SAND 4 SECTIONS ARE AVAILABLE FOR
GREATER DEPTH REQUIREMENTS GENERAL NOTES
I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN
NOTE. ACCORDANCE WITH TITLE OF THE STATE SANITARY CODE
EXCAVATE TO ELEV.A0,00'OR LOWER AS
j DATED.JULY 11977 a ANY LOCAL RULES APPLICABLE. --
REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING
'! 2. ANY CHANGE TO THIS PLAN. MUST BE APPRD. BY THE
OWNERS 4 BU I LU E R : MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL
BD- OF HEALTH, AND CHARLES D. SPOHR.
WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING,
COMPACTED PLACE.
CLARK 4 FLY W,W UI LDE NOTIFY THE ENGINEER FOR INSPECTION.
A Rid,q t2�. ,C� SIDE AREA = I S S.F�A S.F/GAL -4 95 GALS
ON EA 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED.
F7A L-'MC�UTI:--1 M A� , BOTTOM.AREA 87 S.F,@ a' S..F./GAL GALS
TOTAL'A EA F. 5�3 � GA 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN
- R S TOTAL GALS APPROVAL BY CHARLES D. SPOHR.
SR T LEGEND 6. FOUNDATION INSPECTION REQD. WHEN EXCAVATED.
50.0° EXIST. GROUND ELEV. t
LOT � A5S L)t E T_-.)- �Y, -i-
50.0� FINISH GROUND ELEV.2'UNDERLINED"
4750 PIPE INVERT. ELEV. REV. DATE DESCRIPTION
AREA ;PLAN • SEWAGE DISPOSAL SYSTEM
- � TEST PIT LOCATION
� AR'EDD FROM SurzvEY PC,et w
FOR
Es ..,
o SEPTIC, TANK
F~Uk' C SCAL-E 1 - 40
OCT.
//����((//��••� /��• }��}�..'•�j��� J. ��.,,•/y .,Aj,�'�(J!/ yam.. P C L A R K FLYNN , BUILDERS'.
. .
❑ DISTRIBUTION, BOX
„ QV wn c
LOT 27 BET H S LAND. {
: 4 C. 1 . PI P E ;
w
TOWN . WATER � AY)TO _ o c�.a�ha �;;� . , �P I T� HERS WAY), I-�YAI�N � S
11tt-I I I I I- 4 BIT. FIBER PIPE TIGHT JOINTS (� .. SPGHF
o No:7tf8 w'! DESIGNED: C.D.SPOHR DATE: Dry 7 ° DRAWING .NO.
- - PROPERTY LINE �c $
A��FESSiNA�EV; DRAWN: C,J. SCALE:AS SHOWN
MIN. CODE DISTANCE `.�� � 5 : 1 2 8 C
MAP SEC PCL LOT CHECKED: C. D. S .