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HomeMy WebLinkAbout0028 QUISSET ROAD - Health (2) 28 Quisset Road Centerville A= 250- 127 —TOO 5 M E A D� No.2-153LOR UPC 12M smnd wn • Us&In USA P��,I � 1�1�I�NIOILTtY SFI OF M 0 wrws�oawraoci No. Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitation for Disposal 6pstem (Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) ❑Complete System Individual Components Location Address or Lot No. O s Name,Ad ass,and 1.No. Assessor's Map/Parcel Z Installer's Name,Address,an Tel.No w Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision ate Title Size of Septic Tank Type of S.A.S. Description of Soil Nature�of�Repair s o Alterations;jAnswer when applicable) �JLJv G�� l�zc� Date last inspected: Agreement: The undersigned agrees to ensure the construction and aintenance of the afore described on-site sewage disposal system in accordance with the provisions of T' e En ironmental C and not o plac the system' eration until a Certificate of Compliance has been issued by th Bo rd of alt . Q SiA Date UG Application Approved by Date p 16 P— Application Disapproved by Date for the following reasons Permit No._O 2-4 — jb Date Issued 6 " 1 _366 9 o� No. ! Fee ) ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Zieposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ;Abandon( ) ❑Complete System M Individual Components Location Address or,Lot;No. Ul, ,ip I L O er's Name,Address,and Tel No Assessor's Map/Parcel ` u` �rI 2 _ a Installer's Name,Address,anhel.No � Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 1/ ' Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Qe Title l Size of Septic Tank Type of S.A.S. Description of SoilCi/ �ll' i Nature of Repairs or Answer when applicable) � �..,PKE 4 QP� � ,,�&_I L: Date last inspected: Agreement: { 1� The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposalj'system in i ` accordance with the provisions of Title 5xof.th Environmental Cod1 and not.tlo plat the system ifllo°peration until a Certificate of Compliance has been issued by this.Board of Healt . ` W, S. ADate Application Approved by:_ Date WWI .L Application Disapproved by Date for the following reasons Permit No. A j6 Date Issued _I>6 -2' -------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS QPrtificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired pgraded( ) Abando ed )by ►fit...+..- ��11 t�l� at has been constructed in accordance with the provisions of Titjl�e,�5 and the for Disposal System Construction Permit Non t- �0 dated ` d 6 It L Installer ( � 40W v t L � ,_ n Designer ' / #bedrooms N Approved desiign-flow, A ^ gpd The issuance of this permit s all not be construed as a guarantee that the sys'et�m-'-Vi'll nction as d s�i ed. �-----F--- Date }C, c Inspector �'" _ -----------------­--------------- -- ---•------ - - - -- - - - - - No. .�O f..r 3)S Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARN STABLE,MASSACHUSETTS misposal &pstem,"(/DnStruttion Permit _ 1 Permission is hereby granted to Construct'( ) Repair(��' Upg�raa�de( ) Abandon System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to 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. Date Approved by x� LOCATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME i ADDRESS ® U I L D E R OR OWNER DATE PERMIT ISSUED /C wlox DATE COMPLIANCE ISSUED !l � � 3 9` Fms..-..•�..�..................... THE COMMONWEALTIj OF MASSACHUSETTS -BOAR® OF HEALTH r.40 ..................oF......../ �, : ..,�/�... ApplirFation for Uhipoii al Workii Tnnitrurtion Prrafit Application is hereby made for a Permit to Construct (✓f or Repair ( ) an Individual Sewage Disposal System at: Locations Add ass / //ff o Lot No. �,L.c1jJ� —�s lam..... I ✓LEI ..... L .....f..l s •---•-•..._........-•-•-- .ray<.�� r.. .. Owner Address' s a ! ��r--G® _ r �o �'= nr_ ....i 2 .................................... Installer Address Type of Building Size Lot._ZZ: 7....Sq. feet Dwelling—No. of Bedrooms..............-.3.................___-__--Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ....... No. of persons............................ Showers — Cafeteria Design Flow.Other fixtures ._.- -- -__gallons per person per d . Total daily flow__......... ............... to ..... W .g g P P P �3' Y gallons. WSeptic Tank—Liquid capacity/.40l�.gallons Length___5_'_.__t Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------/.......... Diameter-_-fo`: .".. Depth below inlet.......:F Total leaching areaZ5�4',4!.sq. ft. Z Other Distribution box ( V5 Dosing tank ( ) `-' Percolation Test Results Performed by- /.��✓� .1✓ ��/ v r .?., . a�_42)Date__..._S1/c?/A-K------------- a /*/y¢®Test Pit No. 1....fl n....minutes per inch Depth of Test Pit-------6Z_....... Depth to ground water....AL-lev_7 e _. fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ------------------------------•-----......-----------------•......-•------Y............------------..................................... -•---... ---..........---- O Description of Soil--------------� . �t�G��------ 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 iITLZ 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. gned.....---••---...--•------------------•-----.............-----•......-------------- •--••- i ApplicationApproved BY---.._.._ ...........................•-------.......................... - -------- Date Application Disapproved for h following reasons-................................................................................................................ ---------------------------------------------------------•---------------------........------------........---------•----•--------------------------------------•--•--------------------................ Date PermitNo......................................................... Issued....................................................... Date No � F ..0..................... .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 , Appliration for Uiiipogal Workii Tomitru.rtion "anti# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at ...............!.....:....................................� 4...C...s�.......�.. ..... .............................................���f ..... .��:. ............ Location--Address ! I or Lot No. J s / ' / - -/ /"- / / j -!y'./ !7 T'- /_~ /_. r/-:CG /'J i i .c;- � ......................»...................... .........___._._............................... .........._.._ ..._........_...._..... __ ..................._». ............ / Owner / / ' Address' .... ns ... .. ..........�f r�......__.! '_.......6 .f:.S........................................... / Installer Address Type of Building ., Size Lot.. . :. . ... ....Sq. feet U Dwelling—No. of Bedrooms................ ...._......_.............Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers � YP g ---------•---------------•-- P ( -•-)--- Cafeteria ( ) dOther fixtures -------------------.-----•-----------------------------•-••-------••--•-- W Design Flow.................... '.?__..............__gallons per person er da . Total daily flow............................................ g g P P P Y Ygallons. WSeptic Tank—Liquid capacity`�<.gallons Length...."r�"�. Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... ----------- Diameter... Depth below inlet....... Total leaching ft. Z Other Distribution box (I) Dosing tank ( ) _ '-' Percolation Test Results Performed by..''=� .:! s:-. ='f ! 1jf_ •'_�"`��'�'tDate....."' !�' .............. P1740Test Pit No. 1_..��-_._.minutes per inch Depth of Test Pit......«......... Depth to ground water....�f�e? (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .............................................................-- - ---------•-......._•-•---•------..................... Descriptionof Soil ----•••........... .:...:.......•.-----...................--=-• -=.................................. f / / W 1r� 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'T'llaE, 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. -­Si ne e----------------------------------•-•----........ ----...------•----•------------. ... ='- Application Approved BY ... •••-- .. ...... ---- Application Disapproved foItfollowing reasons:............................................ 1 s. Date ..........................................•................•..................._....................•.....................--......•..._..._...__..•......_------•-----••--•----......._.................. Date PermitNo......................................................... Issued-....................................................... Date.r THE COMMONWEALTH OF MASSACHUSETTS 34F BOARD OF HEALTH f ......................................OF..................................................................................... �rrfifiratr of T�antpliattrr TH S II CERTIFY, That the Individual Sewage Disposal System constructed 0 1 or Repaired ( ) f- by #` ' '. / -------------------------------------------------------------------•--......_._....---- Instal ler at.......... ... . ----- ----------------------------------------------------------- ,�. has been installed in accordance with the provisions of T cr` f The State Sanitary ,prod as "s ibed in the application for Disposal Works Construction Permit No. } f!'__ ................ dated_fi�-_ -__. ... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS D AS A GUARANTEE THAT THE SYSTEM WIL FU TION SATISFACTORY. DATE..... .. �?•-.. Inspector..: ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... No ...._....••---- FEE........................ Permission e eby granted... ••---•--- .--•---•--- to Construct . or ndl. 1S'�r Ta Disposal System atNo.._ .._ . ...... --- . .............. Street lJ ......... as shown on the ppli tion for Disposal Worlcs Construction Permit No _ ...... Dateda''/ /r Board of Health s' DATE.:.------- • .................................................. "FORM 1255 HOBBS & WARREN. INC., PUBLISHERS SITE PLAN T YPICAL PROFIL E SCALE — / + - NOT TO SCALE z^ ' t i s s�t. , -' 18"STD_LT. WGT C. MH COVER ' 4BIT. FIBER PIPE TIGHT ✓DINTS 4"C I. PIPE _—_ _ :, --------- ck1TL E T LEVEL FLOW L/NE TO FIRST ✓DINT DWELLING L1 EE l4' 0 o - 1 C.I. T C./. TEE STANDARD PRECAST 1 - i CONCRETE : GAL LON lip , OOJ SEPTIC TANK B TO BE INSTALLED ON i_EVEL , STABLE_ BASE I I r SEPTIC TANK !. I . _ TO BE INS TA L L EC ON ,r LEVEL , STABLE_ BASE ( ' i. C75, O ^.�•j u»A c- rs) A .6 2 - //8" TO 1/2" WASHED PEAS TONE L EACHING PI T r�sxogl - ALL AROUND FREE OF IRONS FINES r � BASE TO BE L EVFL AND DUST IN PLACE ( ` a BRICK 8 MORTAR COURES �' 3/4" TO I-1/2" WASHED CRUSHED AS REOU/RED TO BRING STONE ALL AROUND FREE OF T- u- COVER TO GRADE 24 C. /. MH COVER IRONS, FINES AND DUST /N PLACE_ �vao G,Ac. - �� 0 T �; 10" AND FRAME TA kJ K V 4LEACHING PIT SECTION--- 1INL E'T- --__ FLOW L lNE - - - Q r P/PE _ {-�-- - ^• -- --- - I CONCRETE TO BE 4000 PSI 28 DAYS �,. 2. REINFORCED WITH G" x 6" NO. 6 GA- W.W M 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER w ' " DEPTH REQUIREMENTS- # w OPENING W/TH 4-//9" � 4. NUMBER OF PITS REQUIRED OUTER DIAMETER 8 NOTE EXCAVATE TO ELEVATION OR LOWER AS x 1-3/4' lNS/DE DIAMETER 3„ REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH lPIT REPLACE EXCAVATED MATERIAL WITH CLEAN GRAVEL TO DESIGNED GRADE 2 ;C7 -f ''�) MIN EFFECTIVE DIAMETER (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) WATER TABLE I F, r SOi� ND 'E;C. DA T�; GENE L NO TES N — P PERC. RATE [~.� MIN ;'IN t=' f �) 4C3 NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. \r , y SEPTIC TANK, DISTRIBUTION BOX LEACHING PITS TO BE STANDARD rES � BY - - - -- _ J,�+ 1,u'd.r�tiu ✓ � 0.h�O► PRECAST REINFORCED CONCRETE UNITS 1 WITNESSED BY _____`,__ "j JQCOt�jt ! 13, M , A , ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE , TEST PIT GR. EL.: DATE : MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL OF . Icy- TEST PIT NO. TEST PIT NO. SANITARY SEWAGE EFFECTIVE I JULY 1977 14 . Gri __ 0" 0 _ ANY CHANGES TO THIS Pi_ AN MUST BE APPROVED BY THE v � �Lj �3�t>✓ BOARD OF HEALTH. AT COMPLETION OF CONSTRUCTION , PRIOR TO BACKFILLING, THE `* �J�' G`szA '''aL__ BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED OTHERWISE. �JO \AlA - DESIGN DATA -- BEDROOMS __ DISPOSAL _ '' EST. TOTAL DAILY EFF. � ____GALS. } } F LEGEND - SEPTIC TANK _ 1 vaG' GAL i5JU - ( � 7 � 0i' Gv SIDEWALL AREA z' GAL./SO FT BOTTOM AREA _ t' G' GAL./SQ. FT ,--. Oxoo EXISTING GRADE LEACHING REQUIRED * '? SQ.FT ������ DISPOSAL SYSTEM ZONE' G " _i____— ;o- o© FINISHED GRADE ACTUAL LEACHING AREA _^'�"`' SQ.FT. J FOR O o01 INVERT ELEVATION jam!-�v'r✓ �7 ,-G•�� !'�...� ,,'� `Tl` . . i,� '� L. .� � � U � T DOMESTIC WATER SOURCE : T y u/ ki w 'a T L- oT -P2 _ PROPERTr LINE - tr.; G : Tim >ctylLLr-- r7 jhTlaP5L. k-- 5 PLAN REFERENCE 4 " `'f) Z` ---- - ---- MEAN HIGH WATFF ?� SCALE: AS INDICATED DATE ' 4- ' BENCH MARK DATUM F t2o r,n �. � �_- i �" !- •` «_ +_ �.. MARSH WM M WARW/CKa A550CIA7 Go z . �_: F - ►�; G n. r o. 6'L)X 80/ - NL)RTH FALA400TH MASSAL'HUSETTS 02556 S/TE PL A N TYPICAL PROFIL E SCALE -- / NOT TO SCALE /B"STD_L T. WGT C.l_ MH COVER 4"C.I. PIPE 4"BIT FIBER PIPE TIGHT JOINTS ` xx FLOW L/NE OUTLET LEVEL 0 TOFIRST ✓O/NTDWELLING /O" /4 _ O.` _ r = - i c.I. rEE 1 3v .. C.I. TEE STANDARD PRECAST f 4 I 5 CONCRETE ; GALLON li a , a v j J I SEPTIC TANK ., 0/5 TRIBU TION BOX B TO BE INSTALLED ON LEVEL , STABLE BASE. SEPTIC TANK TO BE INSTAL L EC ON LEVEL , STABLE BASE { L.0 c A h ►J i} 2"- l/B" TO I/2 " WASHED PEASTONF. y LEACH/NG PlT ALL AROUND FREE OF IRONS FINES AND DUST /N PLACE a _— BASF_ TO BE L EVFL 1 BR/CKQ MORTAR COURES ` 3,/4" TO I-I/2" WASHED CRUSHED �, avx AS REQUIRED TO BRING < STONE ALL AROUND FREE OF �' -5 P D, p a ► A.S,T 20 COVER TO GRADE 24"C.1. MH COVER �_ _____,—_��!___ IRONS, FINES AND DUST IN PLACE a,A L l. T f —� AND FRAME — 'rips a , �( q" _.. -�- / p �L. 3 ET 8' F_ - - - - LEACH/NG PIT SECT ON - FLOW L IM 0� /NL 1. CONCRETE TO BE 4000 PSI 28 DAYS 2. REINFORCED WITH 6 x 6" NO. 6 GA. W.W.M 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER s } DEPTH REQUIREMENTS. OPENING WITH 4'//8" i 4. NUMBER OF PITS REQUIRED _ t ' u OUTER DIAMETER S ! a /-3/4"INSIDE DIAMETER NOTE EXCAVATE TO ELEVATION OR LOWER AS REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH [ ^M PIT. REPLACE EXCAVATED MATERIAL WITH CLEANGRAVEL TO DESIGNED GRADE j. 3� ! v. t 6 -6" - MIN. ' EFFECTIVE DIAMETER (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) — �- WATER TABLE L v T '> ( ( ti c".! 1': C l: c: 4' c.? ti.f T r- tx- E.D ) s SOIL A ND PEERC. DA TA GENERAL NOTES PERC. RATE MIN. /IN . F' I el) 40 NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. SEPTIC TANK, DISTRIBUTION BOX , LEACHING PITS TO BE STANDARD TEST BY _`� `` �°�-� � '-U-`� w'AW+u •= K l.hhAG. ) PRECAST REINFORCED CONCRETE UNITS. WITNESSED BY _- •��'`� JAB �r� t ( t3, � . 14 ,) ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISEC TITLE 5 OF THE STATE ENVIRONMENTAL CODE , TEST PIT GR EL.: U'`} - DATE �j ' j O "' '�' '-� MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL OF _Z ;3 "AS ;6c—u! SANITARY SEWAGE EFFECTIVE I JULY 1977. TEST PIT N0. I TEST PIT N0. 2 rot 0 T_"-`" 0" ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH , t-A � AT COMPLETION OF CONSTRUCTION , PRIOR TO BACKFILLING, THE �fC> G,gAxv L. BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. ` �,ts,; PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED — ------- - OTHERWISE. - E-. -;- r DESIGN DATA - 4<.J A y BEDROOMS _. DISPOSAL \�l E� EST. TOTAL DAILY EFF. L ''4= GALS. L EGEND -- SEPTIC TANK 1 v a o GAL. SIDEWALL AREA Z' '2 GAL./SO. FT. BOTTOM. AREA 1' �' GAL./SQ. FT SEWAGE DISPOSAL SYSTEM Oxpp EXISTING GRADE LEACHING REQUIRED ���' `�`� SO FT ZONE- cl I o. oo FINISHED GRADE ACTUAL LEACHING AREA ZEr" '�' SQ.FT. . --- l?R DOMESTIC WATER SOURCE' i_o oo� INVERT ELEVATION %�jJ -2 Gc.�% - . 1< ra T "T tz v A p PROPERTY LINE i'=r - G is► t-.i*T Ot y I L._Lr P- D� t� r.l h T A P5 L 1 1 &A A.g`5 , ' -'�; PLAN REFERENCE ' -1 MEAN HIGH WATER t T SCALE AS INDICATED DATE � ' 1'4' f BENCH MARK DATUM F M ,' &A 3 — ----,J h :.t %� r� 1, ••'r -w = MARSH WM. M WARWICK B ASSOCIATES -J' o f v F' p© L;� Z_„�J E � ,,; -� �� BOX 801 - NORTH FALMOUTH MA SSA CHUSET T." 02556