HomeMy WebLinkAbout0042 MARYALICE LANE - Health rIN
421VI�IAI�Y�A°LICE' LANE F
y ►Hyannis
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' T(.)A"iy Ur. ARNSTABLE -
�i�CA OIL, �Wc- �T�e t o �•�+�aC ;i SEWAGE # 93„ I�3
ViLLAGE- !ASSESSOR'S MAP & LOT O-31-67b
INSTALLER'S NAME & PHONE NO. �p
SEPTIC TANK CAPACITY le0a
LEACHING FACILITY:(type) /�oo L (Size) « ' X
NO. OF BEDROOMS -3 PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: - j 3
VARIANCE GRANTED: Yes No
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070
THE COMMONWEALTH OF MASSACHUSETTS
7
TL
BOAR® OF HEALTH 7
Appliratiun for Bispoii al Works Tonstrnrtiun ramit
Application is hereby made for a Permit to Construct (,Y) or Repair ( ) an Individual Sewage Disposal
System at:
��'f -�e--- i
......E-r....--............... ._ ----------------------_.... _ ..... ..---•-----•--••---------......-......-_-- -----------------.--..._....----------_•.
Locati n-Ad s or Lot o.
sic, --�E�l�..... l... �� x _..�. -��.':,_.... ......... +n ..L �� .__.. � ....... ...r,"Ns.s__..._. . c�abol
wn Address
................................................... ---...--•--------•-•-------......._.......------•----_---•--
Installer Address Type of Building ,a Size Lot_.__ _
:S Sq. feet
U Dwelling—No. of Bedrooms..........
..................................Expansion Attic (eZ) Garbage Grinder
pa, Other—Type of Building ____________________________ No. of persons........_................... Showers ( ) — Cafeteria ( )
aOther fixtures -------------------------------•----------------------------•-----•-•--•-•-•----•-•------------•-----._.._..------- ::-------------...---------
d
W Design Flow............ _______________________gallons per person per day. Total it ow____Z-3A.�6b- .........gallons.
don 42%
WSeptic Tank—Liquid capacity gallons Lengthfg.__la_..... Width_._ Diameter-------'-..___ Depth_S___6_-.
x Disposal Trench—No.____________________ Width.................... Total Length.................... Total leaching area............._......sq. ft.
Seepage Pit No........./_________ Diameter...Z�._......... Depth below inlet.......e_........ Total leaching area...1 ...sq. ft.
Z Other Distribution box Dosing tank ( )
%Y / - ---••• Date__ _`�k, 93
a
Percolation Test Results Performed by--- d _._______...........
Test Pit No. 1................minutes per inch Depth of Test Pit___ Depth to ground water...A-.-)__ ___-_.
Gt, Test Pit No. 2__4-. ...minutes per inch Depth of Test Pit-----/__�_`______ Depth to ground water___PI.A______-_.
--------------------- --------•------------•. -----------•-•-•-•----•-----•--------•---._..._._...---._..........----------------•--.........._.
O Description of Soil_______________________�'---�' '' � `'�'.L
x 0
U .� �Z-..._....__��c`� - �c _� v
W A-!,.- 4-r-A--�p—
x -
-----•••••-•-------------•-------------••---••----------•••-----•--••---•••----•---•---.....••--••------•••--••-----------------------••--------•-•---------•----------------•-••-•••-•--•-----•--------
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 iITx LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been isstxd by the board of health.
t. ;
1 3
Signed ..................................... -•---•----._......
D
Application Approved By.... _--• • •. -----Y1d=. . --- ------- ----•----`�``V,
Date
Application Disapproved for the following reasons____________________________________________________________________________________________•----------•----___--
--------------------••--------•-•-----••--•---•---•--------••---•-------•!.....•-••-----•--•-•-••-•--------••-••••---••----•--•••---•-••••--------------••--••--•--•---...-----•--•-- ------•-•-•-•---
f� Date
Permit No..-<_.__��_--�_...<...F..�-----------------_ Issued..--
1 Date
a
+� . .
No.................-....... Fmc............._............_.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-•�• —
.._....--.../.®-�.�-�.........OF........
ApplirFa#ion for Disposal Works Tonstrnrtiun rumit
Application is hereby made for a Permit to Construct (,Y) or Repair (� ) an Individual Sewage Disposal
System at:
• .r� i _ ......::i ,...... ...c—_ .............._.__.'.-....
�. ocah n-Ad ess aor Lot No.
J V
... .�` ,. ... - -----�Ew....t�?§
/ Owner Add ess
a .......................VSra
..__.� ... ..Q.................................................... ..�...._________...____.._..___.___C_• _........_._.__.______.....__..._._.__.._.............
Installer Address U Type of Building Size Lot....l - ' ?_-E.-Sq. feet
- Dwelling—No. of Bedrooms.......... .............................Expansion Attic (e73) Garbage Grinder (/I)
aa Other—T e of Building No. of persons....................... Showers
—Type g --------•.................•• P ----- ( ) — Cafeteria ( )
Otherfixtures ------------•------------------------------------•...••-•---•--••-•••••----••-••----------••--._.....-••-•-........•••. -_._..
Design Flow.._._....-_Z:-________________________gallons per person per day. Total it flow...3_"./'6':- .........gallons.
WSeptic Tank—Liquid'capacity a.gallons Length'`_��__.... Width_.. .0 Diameter------------- Depth_.J_..'e._.
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--_---.---__.___----sq. ft.
Seepage Pit No........Z--------- Diameter...f�.......... Depth below inlet.......e�......... Total leachingarea..G .Z...sq. ft.
Z Other Distribution box (y ) Dosing tank ( )
~' Percolation Test Results Performed ------------------------------
Pit..s�?:_5...._. Depth to ground water-__ ?l�'.._...__..
fs, Test Pit No. 2•.4nZn....minutes per inch Depth of Test Pit-----Z...... Depth to ground water.._
9 •---•-••-------------------------- --••-• .................. -----------------------------------•-----------------------•-•--------..----
Descriptionof Soil .--• • . .........-•----------•----------------------••--••---••-• ........................ ......................
V .................................................... ...../t......_......=...t_ • ... _. .��:......3.�J
--•--------------------••-•------•••-•---------•-••---•---•-----------•..........._..-••---•-•.....----•----•-••-------•----------•-•••......-•--••...............•--••----•--............-•-•--.......
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 TIT LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be is ed by the board of Iealth.
//�� -3— c/3
Signed.. Cam... ....••---•-•----•-••---------------••-•••••--•--
Date
ApplicationApproved By.................................................................................................. ........................................
Date
Application Disapproved for the following reasons:............•------------------•----•-------•---------------------------------------...........................
Date
Permit No............D_--IN3
--- ------------•--- Issued.......................................................
Date
THE COMMONWEALTH O L F MASSACHUSETTS
BOARD
OF HEALTH
............/� .' `.............OF.../�G,v� 541-/. ....................................
.....
Tnrtifiratr of Toutpliatta
THIS IS TO CERTIFY That`t e Individual Sewage Disposal System constructed or Repairedp
hh P.
by D..N.....R. e
g P �' ( ) �
��� I staller
at..........l•o lJ'fler/i f_.._/T-�/C ..... ........ 170i
has been installed in accordance with the provisions of TITIE The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated-...............................................
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE. 4.':�'...-1.................................. Inspector..........
�.�_1..-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF -HEALTH
No...,l 3.-...1.�3 ................. .....................OF......... FEE.....Ano
Elisp o s Works Tnn#rndinn "rrrntit
Permissionis hereby granted............ ........••--•--•---•• ------------------------------------•------•---....------....•-••....................
to Construct ( h)-or Repair (' ) an Individual Sewage Disposal System
Street qq
as shown on the application for Disposal Works Construction Permit Nof,.b 33..._ Dated..........................................
t - ------------••---------•----••------•--•
DATE. Board of Health
-------•----------•----
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
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BEDROOM
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DES I GN CR I TER IA : INVERT ELEVA T I ONS :
GENERAL NOTES DESIGN FLOW: INVERT AT 'BUILDING:
//6 G. p. L). PER /a 0.2 f"
BEDROOMS A T INVERT IN SEPTIC TANK:
I THIS PLAN IS FOR THE DESIGN AND
ACCESS COVERS MUST BE W1 THIN BEDROOM EQUALS 3-30 G. P. D. INVERT OUT SEPTIC TANK: _ 401"r'
CONSTRUCTION OF THE SEWAGE DISPOSAL FIRST 2' TO
12* OF FINISH GRADE
BE LEVEL INVERT IN DIST. BOX: 7
SYSTEM ONLY. 7 GARBAGE GRINDER
INVERT OUT DIST. BOX: 9
4 PVC MIN. 2* OF
�_P:: I I "I-- INVERT IN LEACH PIT: 2
PEASTONE
2. ALL CONSTRUCTION METHODS AND SCHEDULE 0 ? — — " ,
SEPTIC TANK REQUIRED:
BOTTOM OF LEACH PIT:
MATERIALS FOR THE SEPTIC SYSTEM
��9 Z 314' - 1 112. a�7 G.P. D. X I 50V - GAL
D IA.
SHALL. CONFORM TO MASS. D. E. P. ADJUSTED GROUND WATER:
:3 OUTLE q3 Z WASHED STONE SEPTIC TANK PROVIDED: GAL ,
TITLE 5 AND LOCAL BOARD OF HEALTH /0' MIN. -'�46'2' GAL D-BOX OBSERVED GROUND WA TER:
REGULATIONS.
SEPTIC TANK
LEACH PIT SIZE OF LEACHING FACILITY REQUIRED:
PROFILE : NOT TO SCAL
3. ALL SEPTIC SYSTEM COMPONENTS LOCATED
DESIGN PERC RATE `52 MINIINCH REVISIONS :
UNDER AREAS SUBJECT TO VEHICULAR TRAFFIC I C
No. DA TE REVISION
OR GREATER THAN 3 ' IN DEPTH SHALL BE
PROVIDED: 'P I T(S) W1 S TN.
CAPABLE OF WITHSTANDING H-20 WHEEL LOADS.
SIDEWALL le�3 S. F.X 0-S_ - "7170 GPD
7 9 GPD
BOTTOM. 77 S.F.X
4. ALL SEWER PIPE SHALL BE SCHEDULE 40
TOTAL Z6-7 S. F. GPD
OR APPROVED EQUAL .
TEST PIT DATAs
5. BEFORE CONSTRUCTION CALL "DIG-SAFE'. SOIL
1 -'800-322-4844 FOR LOCATION OF
INDICATES INDICATES
PERCOLATION OBSERVED
UNDERGROUND UTILITIES.
TEST `GROUNDWATER
9 9
6. VERTICAL DATUM IS: ASSUMED ZONE : RB TPA TPO
GRND EL._Ze, z
GRND EL.
SETBACKS: FRONT - 20 '
*4q.
G. W.EL. 6.W.EL. -
7. FOR BENCH MARKS SET. SEE SITE PLAN. SIDE - /0 '
REAR - /0•
9,2-
z
8 . M. TOP CBIDH
EL . - 101 . 74
102.0+
81'34-,10
//0. 00.
pJ
L 0 T 4
13, 200± S.F.
40
TP
461
01.6
101.8 DA TE: /:&-a It- 579-5
TEST BY., 257z-DA,' rS
0/.8
WITNESSED BY:
052 PERCRA T . z-2 A41NIINCH
PR
OPOSED 78R&F
DIY L/No. BED)?
ROOM
ror
E4. Oy
. 0
E_P T 5 YS TE-M D E Is (a
49
/000 GA cv
SEPTIC TANK 102.2 0 1.7 ;.3 -ijol.6 N
+ /0/ 2
CIV
00.9
YA /V/V S , "A SS
RESERVE
6' PIT
D-BOX
W12 STONE
• 10 Q
,. ... W
102.0 A 1\10 R E KA 5 K
101.4
N .00. SCALE" "A R CI-1
00.57
ce7z_ _slz/ljT -,E--,V C7 z Z./v(5! drlv4cl7
t
311 _5
RA R YA '
x J5:v er"2.r2 t v ewer . cr 0 .7
CE
LAIVE
0 /0 20
SCHEDULE LC 0
T
-208T F1ELD:CFW/ CHECK: CFW DRN: SAH
IJOB NO: 93 SAH CALC: CFW
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