HomeMy WebLinkAbout0020 STANLEY PLACE - Health aa s-Fan /c1 fl4(A
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TOWN OF�BARNSTABLE ;
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LOCATION fVWe-� / E SEWAGE #
VILLAGC gip/ - oc)_>
ASSESSORS MAP 6t LOT
INSTAL 4ER'S NAME & PHONE NO. OCC070lAW Gam-f- -';P
SLPTIC TANK CAPACITY 0 �...
LEACHING FACILITY:(type) (size) e % xv
'.NO. OF BEDROOMS PRIVATE WELL OR, PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
a^
DATE COUPLIANCE ISSUED:r'
F. •VARIANCE GRANNTED: Yes_ -No .
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4; ASSESSORS MAP NO: 32-,5' t. .:_......_:.-
gg PARCEL NO: -4 ]
No.. -.�.1._� Fis......r�( '_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..............�W N..---. ..OF......... /Z/�/ST,q-,�G
AVp iratiuu for Bhqpuu1 Works Tuustrurtiuu Prrmit
Application is hereby made for a Permit to Construct (v) or Repair ( ) an Individual Sewage Disposal
System at:
._-ST..hvL.. __ P�� �.v'vi s------------ ------------•-----....--------•--L-" � ...--------•---------.......----•-••----
__ x....- .....- ,,-...�t . ........
��L>ocation-Address or Lot No.
.ST✓a'JNLG .....--..!:X-........�vo/Z�'-.......... ............. ...............� NHS I .......................................
W Owner } Address .
---•--••----....--•-----•.........................................••..... _______ _
Installer
Address
d Type of Building Size Lot....
� --------Sq. feet
aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage;,Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Ch-feteria ( )
elOther fixtures .._....-•------•-----•--------•-----•--...-•-------•-------•------•----------•------•.
W Design Flow..............-`'r....................gallons per person per day. Total daily flow._._........ ..._-................gallons.
Ix Septic Tank—Liquid capacity.!Sa.gallons Length.A!.A Width..:!!!!!� Diameter................ Depth_. .��
Disposal Trench—No. .......�'......... Width.....��`...___.. Total Length......' ..... Total leaching area-----7zo_..._sq. ft.
3 Seepage Pit No_____________________ Diameter.........._......... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by__. W ._._... :_-- ---_-••••- Date_T!!E._
Test Pit Pit No. 1__ __ .._._minutes per inch Depth of Test Pit... �........ Depth to ground water____--------_----_-
G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Ix --------••-•--------•-----•-•-•------•--....•---------------------------------•-•--------...._............
0 Description of Soil �-�Z�! INoo�Lo `7 S�f3 Sa/G /2 '* 7 2" Ca/�� S,q-�vp
x p .•• . ------••-----------•--••--•- ------....--•---•-•--•---------...•--- ---•-•-•--•--------------------
W
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 I"11 1E rj of the State Sanitary Code— The undersigned further agrees not to place the system in
operatio ntil a C ifi of Com fiance has be issue b aid of health.
Signe � --- -� ---�-7
Application A proved By----.----- --. �,�'°'�`� - -----------•---------•-- -------•----------.Da e-------•------
{/ J Date
Application Disapproved for the following reasons,:................................................................................................................
-----•-••-•---------••-----------------------------•--------•------------------------------•--•-----...-------•-•------------------------•--•-•....-••--•------•------•-------•-----•--•--•---•••-----•-
Date
Permit No--------- --- -::.. .0.71----••----------•-- Issued--•-----..............................................
Date
I � ,
•
No.--F7'._ & Fxs......7-5
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
--------------------- ----------......OF...........................-----......._.------.........----....-------•------------------
Appliration for Uiopooal Works C ianstr trtion Prratit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
..................---_...............................................•-...........•------•--•--- ---...------•---•-•...........---••----••----•••-•••-•----..._..............••---......---------•-
Location-Address or Lot No.
....................................................................•....._._..._...._............ ..........7...........•.....................•....•••..._............_............__.._._.........
Owner Address
W
Installer Address
dType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( )
►�
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures -------------------------------- -
w Design Flow............. ..................•._......._gallons per person per day. Total daily flow............................................gallons.
9 Septic Tank—Liquid*capacity............gallons Length................ Width.......--------- Diameter---------------- Depth................
Disposal Trench—NTo. .................... 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 ( )
aPercolation Test Results Performed bY.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-_-___---___-__-..____-
914 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
C4 ...--••-••-•--------•----•--------------•••---•---•-•-••-••...............----------••-•-•--•-•••••..........................................................
0 Description of Soil.................
x
w
VNature 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'TT'TTLE of the State Sanitary Code— The undersigned further agrees not to place the system in
operatio until a C in e of Com liance has been issued by the board of health.
i� Signed...---------.................................... '
\ � ±�- . Date
Application Approved BY f -�-��'�� ..�. -- .............. ........................................
V: U J Date
Application Disapproved for the following reasons:_...---•----------------------------•--•----------------------•----------------•-----------•-•-•--._..........
--•-••••••----••-•--•-----•---•-•-•--••----•------------••-•••••-•••-•-••--•----------••-----•-•-----•-----••-•--------------------------•---------------•-------•-------------•-----------•--.........
Date
PermitNo........3_2......2.'?.-z------------------ Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF....................................................................................
Trr#ifiratr of Tomplionrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( }
by........................:...........••-•-••.._.........---......---•----.......---------•-•---•--•---------.....--------•-••----•--••-•--••••-•-----•----•--•--•------..._....--•--••--•........----
` r� /Installer
at
��
has been installed in accordance w the provisions of �'i'�i ,. j of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No---- �-____J.`.�_._..__.. dated---------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Q .........
.................................OF................................................................
.....................
Biopoiial Mirkii Tonotruction unfit.
Permission is hereby granted......................................................................................................................................-........
to Construct ( or Repair ( ) an Individual Sewage Disposal System
at No......1_ ?. -----9--••--•••...•. =t[I~: . ........ ... .....•--.... -'-�------------------------------------------------------.......------.
-- ---------
eet r�
as shown on the application for Disposal 1t orks Construction Permit N _7 r�...__ Dated..........................................
�( •...............................••--•- . --• ...............................................-
DATE �.T 11......................................• Board of Health
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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TOP OF FOUNDATION
\\ O' CONCRETE COVERS
4 ,
Zrlz�� ; 4 CAST IRON Z'1. v,. �..v.sN Cc.•DE
PIPE (OR 12 MAX. " scNED�tE a
*� \\ \� ° EQUIV.)- MIN. 4 (OR EQG1V.) 12 MIN.
o �► PITCH 1/4"PER PI PE- M I N. C2
PITCH 1/4"PER.FT. LEACHING F1=L0 (.,...REQUIRED)
1
t/8' I/2" WASHED STONE' z
INVERT
') / ,, "" ` � �` ____ :•� EL..L!:—S.. INVERT -INV WASHED STONE
8 't A ;
INVERT SEPTIC TANK EL DISX `L.. z4''
/o To /.
BOX
-• •. --. . . . . . GAL. INVERT
q X :Vic_ _ a, EL../o,7S, EL..!o,./Z iNVERT INVERT
a �z � PROFI LE OF
���' _�IL —___ �' •''�' 3 3 GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
SOIL LOG TYPICAL CROSS SECTION
NO SCALE LEACHING A ELD
i f i DATE18l TI M E . !/. .'"'?.�.�?. NO SCALE
�`ll,,y •i�/r ��s. ' 'f / / _ 1;;�_ _ _ TEST HOLE I TEST HOLE 2 1
= �l ELEV. . . !h',s �.. . . ELEV. . . . . . . . . . . DESIGN DATA . -
G" r .y. i r - .� N _ - �,vE WASHED
�iy O .3.�•-. 4 � 12'MIN. ,
7 O / 46 r -
UMBER OF BEDROOMS
3yAric4Y �' >ew/cG `yr .'r 1, _ —.—.
\fc I
o�,4,.' - � STONE i
�Tgni�E'y t�•tcc • --- ' ` ✓ A �(' /zII Sug-So�� TOTAL ESTIMATED FLOW! . . . `.. .. . . . . GALLONS/DAY
SZ. /3,SI3 4 R FO R E D
r BOTTOM LEACHING An EA ??.?. . . .. SQ.-7./TRENCH PLASTIC PIPE '4'
Sqs�� SIDE LEACHING AREA SOFT./TRENCH
I GARBAGE DISPOSAL . ^!�^!`� ..(50% AREA INCREASE) WASHED
STONE
► GZ. 8.-S "B TOTAL LEACHING AREA . .7zo. . . . ... SQ.FT.�`;/?D, " 3 4
16
Q 7 DQ II, 111 ! ' 60 3 4" 3 4 ' e' I CEO ii
LEY T-p� � �on+C. Yi a k ?�-, / � `• ,
, i I k /y�D/ PERCOLATION RATE SN. SEz: PER. INCH
+ LEACHING AREA PER PE!=LATION RATE .749... SOFT
S40 AN S z �h
/ GROUND TABLE
���l�1J I / _ !l�� c.� ,..,�, c2� T _ — — — APPROVED . . . . . . . . BOARD OF HEALTH
WATER ENCOUNTERED DATE . . . . . . . . . . . . !
AGENT OR INSPECTOR i . \ •,�" a r WITNESSED BY :
BOARD OF HEALTH Lo T. 10S
f ��/ ' r ` �l'r _ C� ! 7i fi✓Aa21� � / ENGINEER - K.1 i.I_Ey
.� 7,A/�/
. . . '40.
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