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Home My WebLink About4790 FALMOUTH ROAD/RTE 28 - Health 4790 Falmouth Rd. , Cotuit A= 009-001-011 i P I NO. THE COMMONWEALTH (fj= CHU ---- FEE BOARD OF HEAL-1 ApVtiratinn for Dispn,ial 9.�Y,itrm Tnnitrnrtinn ramit pplication is hereby m e for a Permit to Install (�)/or Repair/Replace ( ) an Individual Sewage Disposal System at: W LocationAddress V Q �— orPlot�Nr'u�. r_ i..I.(_� Sf` �h C � I' 10�+1►f �w��ii [�+C? �� + 1Yl Qi r a owner Address Designer or Inslaller Address Type of Building Size Lot S Sq.feet Dwelling—No.of Bedrooms Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( )—Cafeteria ( ) Other fixtures Design Flow 6< gallons per person per day.Calculated daily flow . 7('1 gallons. Septic Tank—Liquid capacity )S bC gallons Length LI �° Width �' ��' Diameter � Depth ±->t 7" Disposal Trench—No. I _Width 31�Total Length Total leaching area 4�; ) sq.ft. Seepage Pit No. i Diameter Depth below inlet Total leaching area sq.ft. Other Distribution bo� Dosing tank -( .) - 1 �" Percolation Test Results Performed by(�e—'.1,2�4�� •f l�� ,f /ram Date 1/'� /�` �p f7 Test Pit No. I minutes per inch ell ptl of Test Pit Depth to ground water Test Pit No.2 rt minutes per inch Depth/of Test Pit Depth to ground water Description of Soil Nature of Repairs or Alterations—Answer when applicable Date Last Inspected Agreement:—The undersigned agrees to install the aforedescribed Individual Sewage isposal System in accordance with the provisions of TITLE 5 of the State Environmental Code.T undersigned further s not to place the system in operation until a Certificate of Compliance has been issued by the Bo d of Health. Signed Date Application Approved - _ ate Application Disapproved for the following reasons: .a Date Permit No, Issued � �� No,..f THE COMMONWEALTH OF MASSACHU EaT$ FEE /✓O` 40 BOARD OF HEAL / Appliration for. 1.3ispo Tali f 1n;TAnstrprtion Pat nit i..,) tti Application is hereby made for a Permit to Install (`v) or Repair/Replace ( ) an Individual Sewage Disposal System at: M q 1 f-It , 1„t,- 17 Lu"itiun-Addlew.�W + ur l z t ()\qlicr S s Rddres e' Designer m Installer Type of Building z • Size Lot Sq.feet Dwelling—No.of Bedrooms Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ) Cafeteria ( ) Other fixtures Design Flow _ r_i gallotis'rper person per day.Calculated daily flow _� gallons.{ Septic Tank—Liquid capacity-)S"U`6 gallons Length;+Width . ' h Diameter Depth 5 " Disposal Trench—No. 1 ti' Width Total Length s� „Ibfal/leaching area _sq.ft. Seepage Pit No: Diameter Depth below inlet '1*otal leaching area sq.ft. ` Other Distribution box ( ) Dosing tank, Percolation Test Results f Performed by ` `'"'' + {, Date L 3'�l0 ! ' Test Pit No. I Z,, mitiutes'per inch ept of Test Pit Depth to ground water Test Pit No.2 minutes per indh; Depth of,Test Pit ..+•Depth to ground water ; . r: y1 � _ Description of Soil 1 6C" N Nature of Repairs or Alterations—Answer when applicable t ,-,Date Last Inspected Agreement:—The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions.of TITLE 5 of the State Environmental Code.The undersigned further ag f s not to place the system in operation until a Certificate of Compliance has been issued by the Bo •d of Health. A - t , Signed •-j�,.''Li � Date Application Approved Bg'_' t �, Ua t ,ry Application Disapproyed for the following reasons: :t w Date Permit No. ,G ��` �� Issued ""i�- �� l~� ' Date 0" r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Cnrrtifiratr of Tomplianrr THIS IS TO CERTIFY, That the On-Sits S'ewa e.Disposal System installed ( �/) or Repaired/Replaced ( ) On 4V ie 04L,." by for at has been constructed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal System Construction Permit No. �� — }J dated 4Ve -' � � o Use of this system.is conditioned on compliance with the provisions set forth below: THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION AS DESIGNED. This Certificate expires on Date DATE (I / h Inspector 79 NO. f ¢ THE COMMONWEALTH OF MASSACHUSETTS FEE /G1(1. ~ BOARD OF Vl-EALTH 430pimal it�ystrm Tonstrnrtion rrrmit Permission is'hereby granted to to Construct ( 'or Repair/Re 1 ce ( ) an On-Site Sew ge Disp,Qsal System located at �— — slrr Lct as described on the application for Disposal System Construction Permit.The Applicant recognizes his/her duty to comply with Title 5 and the following local' rovisions or special conditions. All construction must be completed within three years of the date below. s '^ �,_w�Board ottlealtfi'-"y DATE _ FORM 1255 (REV.4/95) H&W HOBBS&WARREN TM PUBLISHERS - BOSTON THIS FORM APPROVED BY THE MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION TOWN OF BARNSTABLE LOCATION '1790 At 2 f4 ZFS SEWAGE # VILLAGE l TU/ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �FC� �X C,0✓A7 A16 SEPTIC TANK CAPACITY /c24 9!!;Al- c , LEACHING FACILITY: (type) f/riGH' (size) Z NO.OF BEDROOMS BUILDER OR OWNERfI�SO/y PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: , ! Maximum Adjusted Groundwater Table and Bottom of Leaching Facility /" Feet Private.Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facili ) Furnished by SYSTEM FL NOT 7.7 'CALE TOP FNDN. rr FINISH GRADE OVER FINISH GRADE EL . ��' �' FINISH GRADE �'"�, � FINISH GRADE OVER DIST. BOX ��-�'A OVER TRENCHES SEPTIC TANKc� --. 4✓e, , s' C a p•.. ` .oBOAA `� 12" MAX. o:o"o � Tr a o•4 4' °.11....p::� �,' •Q,O:.p�•A.ts�%0'::Q•e. DFy,,9'�•O�A.'®+dq®`r, a,.6'�•0.7.•..; �0 r,? I-C:SS ' .p TOTAL L ENGTH OF TRENCH OUTLET PIPE LEVEL a3 FOR 2 FT. MIN. " " 0 -0 :e '• 0 ti:3 s ao p. , .. . : ::A: .: °v `? ;'� CAP END C. I OR PVC TEESA 'f •c. by y2 F,y"•• •y/ Poo..e .�.�"!V0 °: 1 GA L L ON b" DIS TRIBU 770N EL INSTALL ON LEVEL BASE "500 GALLON DR YWEL L S " ra•: • PRECAST CONCRETE ' •,0... `p,.•,.: ,Cb ....H 0.. I /Ei NFOPCED p; •Oica'o. Uv,:bq•.Ga'G'b 'b.��?•b::Ct•A:A•Qy� Dvp:p;D•,Fc4•o ° ° a• w: e/.a•.'v s .p•o .�:? .D. o..n. .q•P,.®.®b, .':4''k'4,b,�4: TRENCH �' /�J/"'°� /'°� /''� �7�P T�(.r �A NT1 INS TALL ON LEVEL BASE NO TE:• EXCA VA TE TO EL EV V. OR o LOWER TO REMOVE ALL IMPERVrOUS Sri h MATERIAL BENEATH THE LEACHING AREA 4" DIAH. $ REPLACE EXCA VA TED MA TERIAL WI TH 3" OF 1/8"-1/2" ,y �: «`'a: �::a.' �: ?p b'�,a:D;+ °:►�: ',�CL EAN, CLAY FREE Sr4/VD °:" WA SHED PEA S TONE ,o 314" _ I—J/2 WASHED Ocl / CRUSHED STONE GENERAL NOTES TRENCH WrDTH � dq 1. ALL ELEVA TION S SHOWN ARE BASED ON ASSUMED NUMBER_ OF TRENCHES 1 _- f .-, 3 3 ' 2. ALL PIPES IN THE SYSTEM MUST BE CAST IRON NUMBER OF DRYWEL L S 2 •_5�,�- OR SCHEDULE" 0"" so' '.^,: . S.�.._..., .. .., �ER. •. V PIT -, / 3. THE BOARD OF HEAL TH MUST BE NOTIFIED P-5559 a WHEN CONSTRUCTION IS COMPLETE PRIOR \ 2 Pi-RCOLA TION RATE' TO BA CfCFIL L INS /r \� �°Savineua 4. ANY CHANGES IN THIS PLAN MUS T BE APPROVED <2 MIN./IN. BOARD pry pH p D �n ISLANDS WI TNESSED BY' Cr• BY THE &>LJA�d•,f OF HEALTH AND CAPE JtSLANOJ �' SURVEYING CO., INC. TOM MOfCEAN n• fond �� °� \c 5. HATERIALS ANC? .INSTALLATION SHALL BE IN COMPLIANCE WITH THE STATE SANITARY ASN BARD. OF HEALTH DESIGN DA T ca DATE: �. L N- 3 19I3rw'i N v � CODE — TITLE V — AND LOCAL APPLICABLE i — — RT' &,q pan flefd [. RULES AND REGULATIONS NUMBER CIF BEDROOMS -3 S. NORTH ARROW IS FROM RECORD PLANS AND 0 '" GARBAGE DISPOSAL NO IS NOT TO BE USED FOR SOLAR PURPOSESTOPSOIL c�ir 7. FLOOD HA ,BONE C DA.1'L Y �'�.0 -�.�D GAL . -HAZARD) o I p nCD �I ore � b+ I 4 SUBSOIL Rd a� �m� a. WATER SUPPLY, r-�u,,� ✓ SEPT.I'C TANK REG 'D. 15®® GAL . /o z� `' � "� J` SEPTIC TANK PROVIDED 1500 GAL . LEA CHINb REQUIRED 330 GPD. MEDIUM SAND SIDEWALL AREA = 152 S.F. 152 S.F.X O. 74 G%S.F. _ 112 GPD. BO T TOM AREA 329 S.F. LEGEND 329 S.F.X CJ. 74 G/S.F.... 243 GP® LEACHING PROVIDED = 355 GPD PROPOSED EL EVA TION 156-1 NO GROUNDWATER --�-a -- EXISTING CONTOUR SINGLE FAMILY PESIDENCE G OBSERVA TION PIT — _ DISTRIBUTION BOX �ss PROPOSED SEWAGE DISPOSAL S YS TEM PREPARED FOR .v ' �' -e _ S TIc TANK UA SON ROSSI ..... � I !.J• V G / Y y A T�J � •H C r� wir�. bd�s LOT 27 'HOUSE 4790) ROUTE 28 ERVE AREA BA RNS TA 8L E -- CO TUI T — MA SS. I__,•_B R P E INVERT ELEVA TION t cr�xARLA&:S L s N + 4 fi . DA TE.• CA PE & ISL A ND�.i ENGINEERING s� PLOT PLAN , ��u�' . �,� �1srF � �� SCALE.• 1 -vo �_ �, , tiU ' .t �'�! �`vr � % SOAL AS NOTED ?, 3 FALMOUTH A0�4D -- SUITE 2E 2� 7,,,� MASHPEE M s� ASS. �-p �f tro PLAN N4J.