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HomeMy WebLinkAbout0688 MAIN STREET (COTUIT) - Health co VNCAj-.h I i I i I �Z Y �'►4 �S �. � �� � ck TOWN OF BAR STTAAP E LOCATION>5 - i iliit VT" PS SEWAGE # VILLAGE GV L � � � ASSESSOR'S MAP & LOT��v INSTALLER'S NAME 6z PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITYAtype) (size)�d NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATE �. BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No4ir �-� �, - . �... :' R 4 � r .� � Q � ��� .Y,� � � - � �' v ;�� y i'`1 _��; . . � � J _.. I k 5 �� � I,� THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ------------- �Appliratiun for Disposal Works Tonstrnr#iun rrrmit Application is hereby made for a Permit to Construct ( � or Repair ( ) an Individual Sewage Disposal System at: � �� .�_ a �.:Q..1. •- fi .......... ..-•••-...---•--...-•----•-----•....-------•-•-•---••-•-•-••-•--•-•-•=------•--•-•.... • --Location•Ad s or Lot No l toC �5 � -t-�z� N ... luS..J�OI� •. Owner Address Installer Address y�! h t Type of Building Size Lot..C_-.•. -...`...............Sq. feet U Dwelling—No. of Bedrooms.................................. .Expansion Attic ( ) Garbage Grinder ( ) �-+ aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fi res -----•--•----------------------• ... W Design Flow.............'��i _-.--_--_._....•_--gallons per person per day. Total daily flow__........7� ...................gallons. WSeptic Tank—Liquid capacity_.. gallons Length................ Width................ Diameter................ Depth................. x Disposal Trench—No .................... Width..... _._....___-_-- Total Length.................... Total'leaching area....................sq. ft.. Seepage Pit No------------- Diameter.............. Depth below inlet.............. Total leaching area 7......sq. ft. Z Other Distribution box (V Dosin tank ( ) p aPercolation Test Results Performed by. u�.... ..j.,5 ......•........... Date�� ;. 81-0.E.5_.._._.... a Test Pit No. 1...,��.....minutes per inch Depth of Test Pit.......A .... Depth to ground water-___--_____________ (i, Test Pit No. 2....�......minutes per inch Depth of Test Pit-------�..Z_...... Depth to ground water________ ____________ � ----f fi------------------- t C./ - - ....•----•--------. ........................................... ............................... O Description of Soil � �0 ��- -• ----------------•- --- ----------------•------------_------------ ---•-- 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 TITI- 5 of the State Sanitary Code—Tl^ndersigned further agrees not to place the system in operation until a Certificate of Compliance has b e issued rd of health. p fi Signed .................. � 00 ....... Date Application Approved By - �-- ---- ---•.�c.�� �-------------------• Date Application Disapproved for the following reasons:-•---•--------•---•---•---•------•-------•--•-•---•............................•---------------------•-••------• -•--------•---•-----------•--•-•----•---------•-------•--------------------••--------...........----------------•----•-------_•---•--•-_-•------..._--•---__•--_-••-•_•-•_•-••_•------------•---•_-_-_-- / Date ` Permit No..........5 e- 1� ----•--------------- Issued ----------- --•------•---•-•-- ----•...................... Date Fss.....7 . 'THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T `U ........... .......oF...r� ..��.. 1 STD.�1 ....... Appliration for Disposal Works Toustrur#ion Pumit Application is hereby made for a Permit to Construct ( r ) or Repair ( ) an Individual Sewage Disposal System at: i t Sfi: C t-U,. --- - �... . ........... ...............................................---------...._...-•--------..-•-••---•-_-•--- G AdIF / j� n j A u ti 1 UCJV� V I �Q �Li 1�C� C..., � K- + o��J� �1"�j CU S �I IISI�/'t ... .... ---------�.. ----------------- --•------ ------------ ------ -------- --........._._....._.....__. ......... Owner Address W ' Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other ��res ---------•--•------------------------------•----------.....--------•---------------------•-•------.--- --------------•---- Desi n Flow.---•------1,15-------•--- 1 � O W g ____..gallons per personle,.r-�day. Total daily flow............................................gallons. WSeptic Tank—Liquid ca.pacityf�Qgallons LengthS_l._! _.. Width................ Diameter................ Depth................ Disposal Trench—N .................... Width.................... Total Length......... Total leaching area __.... sq. ft. Seepage Pit No................... Diameter.....-...___........ Depth below inlet.-______._........_ Total leaching area._..._. .......sq. ft. Z Other Distribution box (V Dosing tank ( ) p Percolation Test Results Performed by._ _.Z�C_f_... 4 .. _L: ..___•......... Date�� a 2, r Test Pit No. I................minutes per inch Depth of Test Pit.......I.�..__.__ Depth to ground water-----................... (i, Test Pit No. 2._._2.__._..minutes per inch Depth of Test Pit.......1_:�....... Depth to ground water........— --. --___. -------------t-------------------^----------••......----_.......----.....••••------•-•----._._..._.._........---------•----•............................O Description of Soil-----••.! --.... Z�. v� LC S c� 5� V ------------------------------------------ ------ 4(..---C-��� . T = S f 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 TITLE 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. Signed...................................................................................... ..................... Date Application Approved B Date Application Disapproved for the following reasons--------------------------------------------------------------•-----------------•---------------••------•-•-•.. ........................................................----•-•--•-•--....------•--•--...-•-••-------.....-------------.....----...----------•-------...••-------------...-•----•-----•--------••---•--- Q'��jj Date PermitNo.--•---... - --/za------------•----•--- Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......�7xr ..kx:.j.............OF.......�..1 �,N-.s e l....................................... QwrtifirFa#r of TompliFaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) bY------------•-------•-------•---------------------------------------------••---------------------- -------•-------------------•-•-----•---------------•------------------------------------------- kInstaller has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... fF•_-_,1 ....... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................... ; ..-. ....................... Inspector............... .......................... I THE COMMONWEALTH OF`MASSACHUSETTS BOARD OF� HEALTH // Z,&:l�L..........OF..............1... tc:.v.:_t�:.4Y1� �-'�... NO... .1.�---11�..� FEE...��..:.:.... Disposal Works TwOnstrmtion Frrmit Permissionis hereby granted.............................................................................................................................................. to Construct (�` or Repair ( ) an Individual Sewage Disposal ystem at No. -o� T f 11't 1_.`s k,�.... 5T-------------- t Street / as shown on the application for Disposal Works Construction Permit No.... ...._ ated.......................................... ---------------------------------------------• ----r ------------------------------------- a of Heait DATE..................................... .......................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS r n' S/lE PLANw SHEET / OF ? SCALE. l rj::max;. �o: �rh [� tt pph •f�r3A-: Y T - }{tA d w, ;4 v x {1µ l..oT I q„�Itit _ I _ kkY o I62 A L ,5 1�5, TA rJ k �l OOTE r Kbe-P TA09 -- 4 �'. .. _... 1 to FFFoM }3vLKHEAD, - P IT _.P�,0L.K.I-4 SAD {[ WAY og j ft s Pit). 113771 P T- � R R � FOR � `/'f ) REGISTERED LAND SURVEYOR ZONEco I..' ! .L. PLAN .REF.' �� `.r: �, F,;, _? DATE BENCH MARK DATUM '� ' ' %-3 c `;a WM. M. WARW/CK B ASSOC. , INC. wyh DOMESTIC WATER SOURCE ` " ' wrtr BOX 80/ - NOR TH FA MOUTH : �5[ '`�' FLOOD ZONE. �`� " `� �`ut11 MASS. 02556 - (6/7) 563 -2638 ma's 3 a�w i LCfrvn//VV DHJ//V JC (i / I L11V NOT TO SCALE .Shecy� 2 f 2 _;�--24"C.I.MH COVER ;, ,4" < EARTH F/LL BRICK AND MORTAR COURSES AS REOD• TO BRING' — ., _ ,�• COVER TO GRADE \\L �.R•YSf 1 B„ FLOW L IN E `' `-- INLET. _ - 2�� A' TO WASHED PEA 5TONE FREE OF IRONS, z�F PIPE DUST IN PLACE- - _ _ •' FINES AND T= ' OPENING wires 4/e 4 TD I%2 WASHED CRUSHED STONE FREE OF - - IRONS FINES AND DUST /N PLACE Y =` , OUTER O/Ail/ETER : •,�, ' ANO /3/4„ INSIDE �.• 1 ' DIAMETER • I . CONCRETE TO BE 4000 PSI 2- I«x� U � • 3: 8 DAYS • - 1, E—AC44 1',-r- r:- 2. REINFORCED WITH 6% 6" N0. 6 GA. W.W.M. - 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS 4101, 6 O , z --I 4. NUMBER OF PITS REQUIRED o,c ;:',`'• i MIN. NOTE: EXCAVATE TO ELEVATION �OR' l:FFECT/VE DIAMETER (NUT 1"O EXCEED 3 TIMES EFFECT/VE UEPTHI LOWER AS REQUIRED TO REMOVE ALL 1VAIER TABLE LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL P80FIL E GRAVEL TO DESIGNED GRADE. 5. •c� /B"STo. LT. WGT. C.I. MH COVER 53c �Z•v 5Z_ 4"C.I.PIPE 4"B/T. FIBER PIPE PLOY' LINE TIGHT ✓0/Nr OUTLET LEVEL. OWEL L/NG TO FIRST off•'1,� l4 i 1 I 0 op I I C. I. TEE 4 1 1 0 1 00 1 1 � y� 1 11 0o0 00 1 1 1 1 STO, PRECAST CONC. --p7 p/ST. BOX TO BE It 000 00 1 1 I I 10(/0 GAL. SEPTIC 1ANA- �• I I 1 0 0 0 00 0 1 1 INSrALLED ON LEVEL, i r 0 0o 00 I ,I I STABLE BASE SEP T lC' TANK TO BE t O 1 r INSTALLED ON LEV1'L I I 1 100 ) O 0 1 STABLE BASE. 1 1 1. 000 0 0 1 1 t � 11100 100. 11 , , L ACHIN BA IN 1 1 0 O O 0 1 ! elPl/ BASE TO BE L EVEL 1 s- SOIL AND PERC. DATA PERC. RATE MIN. /IN. TEST PIT N0. I TEST PIT NO. 2 0 0 zf- Tv�xo1L�/SU ✓So�L� '1�op�ot�/ LSa�IL. TEST BY : � v 31 WITNESSED. BY : J. L)UOOI�JC, ►-Aeb1uM 5.4,uD ct,1�►J Nk�bIum. TEST PIT GR. EL 5 DATE ' 14 tfflev. _36. 5 IZ, DESIGN DATA GENERA L NO TES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL � c) SEPTIC TANK , DIST. BOX AN LEACHING BASINS TO BE STANDARD EST, TOTAL DAILY EFFL.�LEGPD. PRECAST REINFORCED CONCRETE UNITS: ' SEPTIC TANK GAL. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE SIDEWALL AREA GAL./SQ.FT. ,MINIMUM REQUIREMENTS FOR'THE SUBSURFACE DISPOSAL OF BOTTOM AREA GAL./SQ.FT, SANITARY SEWAGE EFFECTIVE ON JULY 11 1977. LEACHING REQUIRED 1_72 SQ.FT. . ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL'LEACHING AREA OF HEALTH. .SQ.FT. AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES FT. UNLESS INDICATED OTHERWISE, SEWA GE DISPOSAL SYS T'EM o MARTIN I E. t,; FOR.- KJ -ro©�.1 •p� 23417�q �-� I 1>c.L. 2 &&A r l J ST" Z f-.V--' MA ss . s`•QIiPL �-�� ,ti1t - _ �� •lid /zg SCALE AS INDICATED DATE r a s ! WU. M. ICARWICK 8 ASS 8OX 80/ - 'NORTH FAL MOUTH- -- NA SS.' 02556 - 1 6171 d 6J ~26J8