HomeMy WebLinkAbout0835 OLD POST ROAD (CT & MM) - Health �'-s-3-5OLD POST RD4� COTULT _I
-- A= 073-oo6 — - — —J
i
No....�, .-7 � FiRciBc ..lc):12........
>_ THE COMMONWEALTH OF MASSACHUSETTS
-BOARD OF HEALTH
TOWN OF BARNSTABLE
Appl ration for Diripwml Work6 Towitrnrtion 11amit
Application is hereby made for a Permit to Construct ( V�_or Repair ( ) an Individual Sewage Disposal
System at:
. ........ .................................................................................... . :•-- .............. ..............................................
Loci io- t-: /�
----•-•-- • - ---------- -------- ------ ... •-•--••-••-------•-• ......-------•--- � --
-?If
-•-•--•----Address
W _•••• -•••..........•-•---..._...•• -- •..•�l. ---•-•------ •----.....`.I..--- ---• t�, --- .-- .....
a r j�
Installer Address J✓r !U-�� % .
d Type of Building Size Lot__AAd.d.0.........Sq. feet
U Dwelling— No. of Bedrooms-----__---� --------------- -___---..---Expansion Attic ( ) Garbage Grinder ( )
Type of Building Wf', fT✓ -No. of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures ------------------------------- .-•-
WDesignr _____________________gallons per 4=rsen per day. Total daily flow.........7..........._....................gallons.
WSeptic Tank—Liquid capacity�w__galIons Length---------t---__ 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..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) 02
`"' Percolation Test Results Performed by ' Date ............................
a ----_--------_
Test Pit No. I----�_c_..minutes per inch Depth of Test Pit-----------------_ Depth to ground water__- �..
fZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.--_-_-_.-.-.__--___--.
t� - .-- - ----•-•••---•--••-••-•••-•-••----•-•--•-•--•-•--•-----••.................•--•---•--•---•••-•.....-•--•-......-------•--•-•--.--•--
0 Description of Soil...... ............ ..
U ---------•----------------•-------------------------•------------------------------------------------------------------------------------------•--------•--------------------------•---••---•---.......
W
--------------- -----------------------------------------------------------------------•------••••------••....------------------....--------••-•---•••--•-•-•-•---•-••-•--•-••.........................
V 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 TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has
hass been i y th and of health.
ied ........v!�ar....... ........_............ .................... �-1 ..:......
Dace
Application,Approved By ........... .... .. ..... ............. .......----- ---------.............._...........--------.................... ---------...._Dare..........--------
Application Disapproved for he ollowing reasons- ---------------- --------------------------------------------------------------------------------------------------------------
--- ----------------------------------------------------------------------------
q y Dace
----75 ------77X Issued ----------3.......-a�...��' -..� -- -------
Permit No. -- ...........
Dace
....
'THE COMMONWEALTH OF MASSACHUSETTS
f BOARD OFF HEALTH
TOWN;OF BARNSTABLE
. ,���tltrtt�i�ait fnx ��i��tit��I 3�nrli,� C�l�ttt,��r�r�tnri rxutt# f - ,
Application is hereby made for a Permit to Construct (, )or Repair ( ) an Individual Sewage Disposal
System at,
✓ led
Location-t\ddr�ss- or Lot No.�i
� - l ✓ /mot G c✓� -i`�sa -. r . v J; ,c
--------------_.................... ------ ---- -------:------------------- ---Address
y: - ---g.---- - --------- ------------------------------------------ ------------------------------------....... '------....... ` Sq. feet
.✓ J` Installer
Address
d Type of Building Size Lot..1�_!Z4 AC___-__-_-
Dwelling— No. of Bedrooms_____ __________________________._--_.".Expansion Attic ( ) Garbage Grinder ( )
pa,,, Other—Type of Building/W( I/ No. of persons............................ Showers ( ) — Cafeteria ( )
A' Other fixtures --------------- --------------- ---------
d - ---------------------------------------- ---------------•---.........................................
W Design Flow.................I.f O...................gallons per-p.erson per day. Total daily flow.".-.-"_- .� ---_ ----------------........gallons.
WSeptic Tank—Liquid ?capacityZ ..gallons Length---------------- Width---------------- Diameter---------------- Depth................
x Disposal Trench—No. _...._"_-"-_--_____- Width.................... Total Length-------------------- Total leaching area....................sq. ft.
3 Seepage Pit No---------............. Diameter"-"-_._"---_-- Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank, ( )
W Percolation Test Results Performed by--------.--✓ 4i----- ---....-----------�--------•---------------- Date------------............................
,-4 Test Pit No. L"-_ _ __.minutes per inch Depth of Test Pit-------------------- Depth to ground water... AA_EE
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
D Description of Soil-----!_.h `/. .y/1- ft✓a
---------------------------------------------------------------------------•.----
x
W
UNature of Repairs or Alterations—Answer when applicable.-__-_---...___:--------""_f-''"�
.t . ,>
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 agrees not to place the
system in operation until a Certificate of Compliance has-been issued`by th Qard of health.
i ned -..... ........... - _........ ........... -
t g ;
Dace
' �...... ...._... .^.......
....._._-------------------------------------------..... --------------------------
--------------
A, placation.Approved By .......� ✓J..........
Dare
Application Disapproved for the following reaj- --- -------f----..
------------------
' v
....................................................p.......... ...................................._...............w..----------------------------------------------------------------------------- -----------------
Dare........._......
Permit No. .......1..t7.....' 7.�f------------------------ Issued .......... `?....-...a�..� .�... . - ....
Dace
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
CErttfirate of Compliance
THIS IS TO CERTIFY, That the Indiv<idual Sewage Disposal System constructed ( �/ ) or Repaired ( )
b ..--------------------------......-----......----------..
/f �/�� ,, �1 / , Inv aIIZ7 .,,,.
at .... ..a... ��C .1....`` ""(.. -�-Cl_ ---------------------------.----------------------------.--------------------------------------------
...............been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. --------75 ......7.7H-------- dated ------;j.-."�----7-.--1S7---
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
r r _.
DATE............. . � .... ... ,-> -' - Inspector ...............
.......- ; " ".`,'-„ .........
........ .... ... ----
----------------- -----_,____ ___ - --------_._.__. __..---CIL-_ __.-_�-.�-_-_-_.__-_-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE 3
No.!?: FEE........ .
Permissionis;,hereby granted....--`------------- ----------------------'--L�--•------lJ .............................................
to Construct or Repair ( ) an Individual Sewage Disposal System
atNo. + � .......... -��•{ ................................( . ----------- -----------------------•------------------------------------•----------------.-.
Street �j 7
as shown on the applica°ion for Disposal Works Construction Permit No- ------'-/�--!�Dated:/��__._-".��.'_��P ..
�j
[�
Board"-
of'Health—
DATE..............._0�III ---- -- f` ----------------------------------
FORM 36508 HOBBS 6 WA REN.INC.,PUBLISHERS
t �x
r . � TOWN OF B ARNSTABiLE
LOCATION SEWAGE#
VILLAGE. �.� 1 L�,,� ASSESSOR'S MAP&LOT'O7 3 ao&_
INSTALLER'S NAME&PHONE Oa. 32 O's-V o
SEPTIC TANK CAPACITY
LEACHING FAt.II,rrY:(type)~_.y �. (size7� l
NO.OF BEDROOMS � 'i 3 e ST,
lnn�caer e �.i;3�osaL
BUILDER OR OWNER
- � 9
PERMTTDATE:. -3 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Botto ;of Leaching Facility F = s
Private Water Supply Welland.Leaching Facility y wells exist
on site or w1thbi 00 f:et of leaching facility) �. ' Feet
Edge of Wetland and Leaching Facility, (If any wetlands exist
within 300 feet-of leaching facility),. VFeet
Furnished by
M 1
4 +,t
No.---______---------- Fee--------------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Zipplication-for Well Conitructionperrnit
Application is her by made for ermit t on truc�(v), Alter ( ), or Repair ( )an individual Well at:
Location — Address Assessors Map and Parcel
-- ------- --- —_ ___
Owner Address
Installer.— Driller Address
Type of Building ,
Dwelling
Other - Type of Building--=—.--—_.----__-_-_ No. of Persons-----------.- ---— .....
Type of Well
Purpose of Well
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certificate%.off Compliance has been issued by the Board of Health.
—date
Application Approved _
date
Application Disapproved for the following reasons: — ---.------------------______ ____—__�_ _—_
date
PermitNo. -- __-- Issued—---------------------- ----------_ ___—___---
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
C ertif irate Of Compriante
THIS IS TO CERTIFY, That the Individual Well Constructed ( Altered ( ), or Repaired ( )
�by �j� �t/ � /t/Co� /�i'• ___—Installer
at—_ S i
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. ---------------------Dated THE ISSUANCE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE---- - --- Inspector—__-------__ ---------—
No.------------------- �•" ; Fee------ -------------
BOARD OF HEALTH °
TOWN OF BARNSTABLE t
Zipp[itatid"Aw- orIVell Construction"Vermit
1
Application is hereby made for a permit to onstruct (PerAlter ( ), or Repair ( )an individual We 1 at:
Location — Address Assessors Map and Parcel
---- -------------------------- ---^_—_—_-----------
Owner
Address
----------------—---------------------------------— ---- —
v
Installer — Driller Address
Type of Building t
Dwelling — Q—S-�._"!; :=�� /-------------------
Other- Type of Building-----__—______________ No. of Persons------------------------__—__—_
Type of Well— 'V
Purpose of Well---
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.
Si
— date - `•�
Application Approved B}+;— — - --- — —- —— --- ------
r date
Application Disapproved for the following reasons: —------
-- ----------------------------------
date
Permit No. —— — -- -- Issued----- -— - - -- — —— -------------
date
---.------------------------------------------------------------- ------------------------------
BOARD OF HEALTH
. L
TOWN OF BARNSTABLE
C ertif irate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( *<Altered ( ), or Repaired ( )
by-- ---—--------------------------------------------
at —- -- -----_----
Installer
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. ------------------_-_--Dated--------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE--____ — - --- Inspector--- - —-------------- -
----------------------------_---------------------------------------------------------------------------
BOARD OF HEALTH `I p .A
TOWN OF BARNSTABLE
Vell Con5tructionpermit
0/0— �/I Fee- —ry•'--`=---
Permission is hereby granted
to'Construct (/e�; Al er ( ), or Repair ( ) an Individual Well at:
s Z.,
No. G -- - - -- — ---- ----- ---------------------------------------------------
k' Street
as shown on the application for a Well:Construction Permit
No.---- r Dated---
h
.l �7
- --' ---------------. ..------
Al � Board of Health
DATE - — — --
APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS
LOCATION rr_ � !L .POW � NO VI
M VILLAGE__ DATFr"���
APPLICANT FEE..As� G�
tADDRESS 164- 0, WA17j,a,, vJ TELEPHONE NO. (Non-refUndabTc
ENGINEER_ �tLjCt �► � 'f►�- j TELEPHONE NO. 31
DATE, SCHEDULED — �—
MAP -13 PNIr P6L. `] (Applicant's signature)
• . • • • • • e o 0 0 o e • o • o o n e o e • e e • • • e o e • e e e • • • • • • e • • • e • • • • • • • • e e I e • • • • • • • o • e • � • e e • e • • • • .
ASSfiSSOR'S biAP 6!LOT NU: -
SOIL LOG
SUB-DIVISION NAME DATE ,;—y TIME
EXPANSION AREA•. YES NO �t ENGINEER:'?• '
TOWN WATER XZPRIVATE WELL •5-10 BOARD OF HEAL?
1�c=l EXCAVATOR
SKETCH: (Street name,etc. $dimensions of lot, exact location of test holes and
percolation tests, locate wetlands in proximity to test holes)
NOTES:
'T Cif'
43,iq .r "1A,613
!� _ �4
I ,
{
PERCOLATION RATES �v 2�v►I vit cb s
TEST HOLE NO: i ELEVATION: TEST HOLE NO: ELEVATION:
2 2
3 3
4 4 _
5 5
FF=1
9 9
10 10
• 11 11
12 12
13 13
14 14
15is
16 16 /
SUITABLE FOR SUB-SURFACE SEWAGE: . LEACHING FIELD LEAC G PITS �!
LEACHING TREN:CHE§
UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS:
NOTE: ENGINEERING PLANS MUST SHOW NUMBER-ASSIGNED-ON PERC TEST APPLICATION
• ORIGINAL: COMPLETED IN ENTIRETY BY P F AN R TURNED TO BOARD OF HEALTH
COPY: RETAINED BY APPLICANT
BAXTER NECK
0
o
NORTH
- o PT lS BAY N
Locus TEST HOLE
COVERS LOCATED TO WITHIN
FEBRUARY 28,1995 12 OF F.G.
BAXTER & NYE INC. COVERS LOCATED TO WITHIN COVERS LOCATED TO W THIN
#P-8396 12" OF F.G. 12" OF F.G. 49.0
F.G.. 49'f F.G.• 48'f TOP OF
LOCUS MAP PIT #1 ELEV. = 49.1' PIT #2 ELEV. = 49.2' FOUNDATION
LOAM & SUB SOIL LOAM & SUB SOIL
-2 -2 T 4' DIAMETER INV. - 46.2
qO P.V.C. DIST.
SCALE 1 125,000 _ 200o cAL. :
BOX INV. 45.6 INV. a
ASSESSORS -4 PERK TEST -4 PERK TEST 1000 GAL scH��� INV -45.8 SEPTIC TANK 46.0
2 PEASTONE LEACH PIPS
MAP 73 PARCELS 6 & 7 ;z wlhi 3• ' INV. -45.2 IN a 45.4
ZONE ?; 3°/4. I,� 10.00•
>> To MIN.
A.P. CLEAN CLEAN is 11/2' i
WASHED ,
MEDIUM MEDIUM ,
RESIDENCE F SAND SAND 39.2 i STONE
MINIMUMS 12.0'
AREA = 43,560 S.F.
" FRONTAGE = 150'
I
FRONT SETBACK 30'
SIDE SETBACKS = 15' L
REAR SETBACK = 15' M.H.W. = 1.s'
-12 NO WATER -12 NO WATER PROFILE
BUILDING HEIGHT = 30' EL. = 37.1 EL. = 37.2
(OR 2.5 STORIES IF LESS)
NO SCALE
ALL COMPONENTS LOCATED IN POTENTIAL
VEHICLE TRAFFIC AREAS OR BURIED 4 FEET
OR GREATER SHALL BE H-20 LOAD CAPACITY,
f
i
49.0
Lu
O M co
O
tl �N L
49.7
9.o /NEvli:c Ns
k7
co �s e�, LGT 3 ,�
Qh`V �� / 82yc• �84/41 ' t`
T •�. � F G, to
4 ♦ / Z49.7 J
- 1 S �.. °-
.�V �,j�C 49922 47.0 4.
Q #
O LOT 2 UPLAND i=XP �Fp / °` Y
4 .2 54,655 sq. ft. -1 2�O�R/I,� M co
# = 20.75 3
x 49.4 4 06
k�C �� / 41.40.2 V�4 a
WETLAND 0.04 AC. PIT q 47.
TOTAL = 1.29 AC. 6+, k x /
.48.2 x 31.0 �Q
w 49.1.
Q PIT / a' �� / 25.2 ` N
2 / 39 ^� Y
BENCH MARK 4s. / A' . o
.P.= ELEV. 48.91' t7 M/ , x 2� // x 0.71v� 3.1
R
.7 / '�
34 x 2 .6
x 8.9 18
j -IX
7. 0
a x 0.8
CV
F /38'7 / x 1 .8 x( x 26
r T !
L Ol 1 l .2 22. co 00 �t
n 3.1 l ( I O
II )x 5.1
PLAN / Qo �►
GRAPHIC SCALE �x Z. ' C4 3 �'
0 20 40 80 1 2
I N 1
SCALE: 1"_ 40'
O
ELEVATIONS ARE BASED ON N.G.V.D.
100 YEAR FLOOD ELEVATION = 12.0'
i
DESIGN DATA
SINGLE FAMILY 7 BEDROOMS
` WITH GARBAGE GRINDER
k DAILY FLOW = 110 X 7 X 150% = 1155 G.P.D.
SEPTIC TANK = 770 X 200% = 1540 G.P.D.
USE 2000GAL.SEP11C TANK
i
DISPOSAL AREA
PLAN OF LAND
USE 2 1,000 GAL. LEACHING PITS
IN
WITH 3' OF STONE ALL AROUND ( COTUIT )
SIDEWALL AREA = 452 s.f. X 2.5 = 1130 GAL. /DAY p p
BOTTOM AREA = 226 X 1.0 = 226 GAL./DAY B A R N STA p D L E MASS,
TOTAL DESIGN 1357 GAL./DAY
FOR
REQUIRED GAL./DAY = 1155
PERCOLATION RATE: THOMAS DeVESTO
1 INCH IN 2 MINUTES OR LESS.
SCALE: AS NOTE► DATE: FEB.23 ,1995
BREAK OUT CALCULATIONS
NATURAL SLOPE IS 0. -
BAXTER & NYE INC,
REGISTERED LAND SURVEYORS
CIVIL ENGINEEPS
❑STERVILLE, MASS.
i
I
4�Y4t` 'gyp_P,TPR RICHARD
�
CERTIFY THAT THE PROPOSED FOUNDATION SHOWN HEREON y�
�p e cr
K a
A ,y
COMPLYS WITH THE SIDELINE AND SETBACK REQUIREMENTS OF
AXMR
Nu. 2y/33 > 3 is L b
THE TOWN OF BARNSTABLF, AND IS NOT. LOCATED WITHIN THE
I -FLOODPLAIN.DATE:• GPAt
#95031-9