HomeMy WebLinkAbout0022 OXFORD DRIVE - Health 22 OXFORD DRIVE, COTUIT
A=021-061
TOWN OF BARNSTABLE .
LOCATION ��Yj� � SEWAGE #
VgLykGE 40 ASSESSOR'S MAP& LOT
I R STALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER O COVWN3E .
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
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
f � �
r
/k aY 7 6 " �-
g-- o� b
a
D _.
No. — Fee 1n i C
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for Migaar *p5tem Construction Vermit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No br, Owner's Name,Address el.No., ! 1�11fte�
Assessor's Map/Parcel
CL> rrA- mw,-55 4243--Cvl too
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
�S c�C' d Cis �� te.�'�•..a �� e.
a-t 1 YV1 Ar oZo-t$ C39 ZJO �5`�vv b��e YK k 'kZ8-q �
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size Z42,500 sq. ft. Garbage Grinder(A
Other Type of Building rer.id2 S`V*�CAk No.of Persons t Showers(3) Cafeteria/)
Other Fixtures
Design Flow 350 gallons per day. Calculated daily flow 3 x �\Q - 3W gallons.
Plan Date u.st 2-2- C&-1 Number of sheets Z Revision Date
Title r
r Size of Septic Tank 660go.-Ito, Type of S.A.S.
Description of Soil 50 a� C.C�_SS a,
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by t ' Boavd of Health.
Signed Date
Application Approved by Date �-
Application Disapproved for the ljollowi`4 reasons
Permit No. Date Issued
TOWN OF BARNSTABLE
LOCATION Z e az Af SEWAGE # 7—Z
VILLAGE f�l ASSESSOR'S MAP & LOT. ®�
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUMDERO WNE
PERMTTDATE: 9"�O --¢7 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
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
�AaZ e►� a-/ot�QSt � �`
!k mz7 6 " d-
t V
,f,?p j
No._/ 0 Q ti Fee I
f
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
r. Yes
PUBLIC HEALTH DIVISION,.TOWN OF BARNSTABLES MASSACHUSETTS
ZIppl cation for Cottgtructton Veriutt
{
Application for a Permit to Construct.( )Repair( )Upgrade(£ )Abandon( ) ❑Complete System ❑Individual Components
is
Location Address or Lot No. U ?r'6� �tr. Owner's Name,Address an el.No.t ('�cIft—e-4
rAssessor's Map%Parcel Z�. e`�_"
Installer's Name,Address,and Tel.No. t Designer's Name,Address and Tel.No.
Mc�-a #. 1 its mAr avx>-tB tagw, nsAYv -e wn+q- 1Z8-�t3 t
"Type of Building:
Dwelling�r No.of Bedrooms 3 Lot Size ZIP,J 00 sq. ft. Garbage Grinder(A
Other Type of Building I`eStd2v11'�k No. of Persons L{ Showers(3) Cafeteria(�)
Other Fixtures '
Design Flow 33� g` f'-al1'ons per day. Calculated daily flow 3 K �\V =' gallons.
Plan Date U.S Z.Z 1 Numb`e of sheets 2 Revision Date
Title. /
Size of Septic Tank Wo Type of S.A.S.
Description of Soil 56-1 Gr_5°6 �.
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described or-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been is Bo d of Health,, /� 7 sued by t
! Signed / Date
Application Approved by Date ,
Application Disapproved for the Vllowi4 reasons
Permit No. 7 y:7— Tx Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS'-
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( �)
Abando ed( )b ,z
at zn constructed in accordance
e
with the provisions of Tile Tan' the f r Disposal S stem Construction Permit No "' dated
Installer Designer 1 ? A
The issuance oft ' p sy not be construed as a guarantee that the y' e wil fuy�ctii as/�esig
rie /
Date U Inspector I 1 i� 11� f" P .
---------------------------------------
No. 7 �� � � Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
30t.5pogar *pgtem Conttructton Vermtt
Permission is hereby granted to Construct( )Repair( )Upgrade )Abandon( )
System located at
ram.
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes 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: ?-7 Approved by �_
f
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itiAltTt A WILSON
Flu 8/0W No.30216/Q
Fizz
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........... ....... ....................OF........ra� C.....................
.
Appliration for Uhiposal Works Tonstrurtion "pamit
Application is hereby made for a Permit to Construct (V or Repair an Individual Sewage Disposal
System at:
L2T..9!>0 ........... ...... ..............................................................
Location-Address -7
or Lot No.
< >
. ......................... ...El..r. .....
Owner Address
............................. ....... ............... ...............................................................................
Installer Address
Type of Building Size Lot. 'f.5�Eesq. feet
U ...........
Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder
aOther—Type of Building ............................ No. of persons............................ Showers Cafeteria
Otherfixtures ....................................................................................................................................................
Design Flow..... ............................gallons per person per day. Total daily flow..._... 4F ................gallons.
...........
04 Septic Tank—Liquid capacity.IC.Z*;�.. lons Length.�_rP... Width................ Diameter._._.___........ Depth................
Disposal Trench—No. .................... Width.................... Total Length ... Total leaching area....................sq. f t.
Seepage Pit No....._..___'______ Diameter.......I?A- ..... Depth below inlet...... ........ Total leaching area...0+ sq. ft.
Other Distribution box
Z Dosing tank
-7
Percolation Test Results Performed by .........e7�.!!�!p.......... /65
4 9— 1—-----------------. Date.__ ......... ------
0.4 Test Pit No. I................minutes per inch Depth of Test Pit---------U........ Depth to ground water.........................
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.._.........._...... Depth to ground water.___._.............____.
9 -------------------------I IT--------------__ ------------------------- ..............0.................w....
0 Description of Soil............... ....... .
U ........................................................................................................................................................................................................
............................................................................................................................................................................................ ...........
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 TIT!- 5 of the State Sanitary Code— The undersigned further agrees not to place,
the system in
operation until a Certificate of Compliance has beensued by�the),oand p;4@Eft----_—\
Signed.......-.-=-
..... .................................
Date
ApplicationApproved By.......... -------------------------------------- ..........................................
Date
Application Disapproved for the following reasons:................................................................................................................
............................................................................................................................................................................................. ..........
Date
Permit No------1? a-&/..................... Issued..................................................
Date
A , I I
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...T......rviJ---------------OF......... .!�. >.T 1�C. ................
Appliratilan for Disposal Works Tons#rnrtiun Permit
Application is hereby made for a Permit to Construct ( V) or Repair ( ) an Individual Sewage Disposal
System at:
...........................� ...... �-T. '....r..............................................................
Location-Address _ or Lot No.
Owner Address
W '
Installer Address
d Type of Building Size Lot...::�''�_ Sq. feet
Dwelling—No. of Bedrooms......... ...............................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
PI Other fixtures .----•--•-----------------------------------------•--..---•••--..... ..------•-------- ..............................................................
W Design Flow.....15_5...........................gallons per person per day. Total daily flow........._._......_........._.........._....gallons.
c
WSeptic Tank—Liquid*capacity.1 0-��allons Length-��_T'P... Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
,- P g .. ... ".8.sq. ft.
Seepage Pit No._._....__..� _...,. Diameter._.._._._��.-..__._. Depth below >nlet._.... .�__._. Total leaching area.
Z Other Distribution box Dosing "
tank ( )
,-
aPercolation Test Results Performed by..... zK.......f �_'..._... . .. Date....` � ..-�1 =�-_-_.
Test Pit No. I....._•..-------minutes per inch Depth of Test Pit..........1........ Depth to ground water------_..............
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 --------••--------------- -----------------------------------------------Description of Soil------------------------•.J. --•--- ! v Svi-�%-------........� . & P=1�t►- t.l� ._� "�1�
x
U ....•-••••••-•--••••-•••-••--•--••--•••----------•---------•-----------------------••----------••••••.........---------------•------••--•---•-------•---•...
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 TITL' 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been i ued by the and off,
Signed..., ........
Date
Application Approved By........ �1.
'-*-• •-
Date
Application Disapproved for the following reasons:................................................... ..........................................................
--------------------•----.........................-•---------...........----------•--•--........-•-•-•----•••---•-•----•----•--•-••••-••--•-•-••....---•---------••--•---•----•----•--•••••.......--•---
Date
Permit No.....&.£5...:..._ -la 1-------------------•-- Issued-.......................................................
Date
i
E COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
3l.n,.........OF............ ..............................
Trrtif iratr of Tnmpliattrr
THIS IS TO CE TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
. ............ ---•-------•---------•----------............................---•-•-------•-•-----•-•-----......------.....------......
Installer
at---------- ---L-C�- 0'r......zo......r..� ------ -...........
has been installed in accordance witl�'the provisions of TIT 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit 1� ........ dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FLWCTION SATISFACTORY.
DATE...... ........................................... Inspector.............. G
t
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�j
a...........OF............. '•'��t'�+.:�.:ri c 1�� 1.('° ................................
No...a..'u f/. FEE........ ......--:.
Disposal o ks Tons#rnr�ion rrmi#
Permission is hereby granted..............0 ._._ �?�------ « __.
to Construct ( or Re air ( ) an Individual Sewage D' posal System
at No... G 6• Q..... r�'l �. G��.t: .........................
}-• . ,
Street
as shown on the application for Disposal Works Construction Permit No.... ._;._-_ Dated..........................................
DATE. Board of Health
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
TOWN OF r3AR STABLE 1�
LOCATION L® -D. rid WAGE #-� '��^
VILLAGE `"-` -F- ASSESSOR'S MAP & LOT _
•
INSTALLER'S NAME& PHONE NO.--f,- az
SEPTIC TANK CAPACITY 00 —
LEACHING FACILITY:(type) � (si:.e) —
NO. OF BEDROOMS _PRIVATE WELL OR BLI.0 milt
BUILDER OR OWNER �
9
DATE PERMIT ISSUED:
DATE,NCOuP-6A.NC:F, ISSU41):
---
VARIANCE GRANTED: Yes
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of ;
� L ittilt t fil'I ��/� k R� -[t z �'ti• r,.
REGISTERED LAND SURVEYOR FOR �'� I--�
Lo7- .'
ZONE-
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j• y' /�P�N w 'z
PLAN .REF. ,��,�� ��t �5 MAr� zI Lc.�-fi- .�) DATE .I U � de�2 eQj
BENCH MARK DATUM t��
WA RW I CK 8 A
DOMESTIC WATER SOURCE T4'`�� � � r' f�
BOX 80/ - NOR TH FA /NOUTHzst
FLOOD ZONE. a/ ,
1 1 c 1. .1 - ICI ,•� �Wit,�,•t, ,.
N h... # •. i Z Y pd +c:
A MASS. 02556 - (6/7) 563' 26.:38��.
•b 1�?;4F-ifrsy'ps{��•i r�� t c�� � '�,�'r�C
TYPICAL SYSTEM '
YSTEM PROFILE 'iY�SHEET �2�OFAA2 ���z
"CONC. 4ANHOLE COVER WATERT7Gt1T
1 J T FL.. i7CR C.I. FRAMr&GOVER IF PAVED F.G.
CY IANA RISER(S) OR BRICK&MORTAR
3z,o A)UR"C4 AS ROD. !0 BRING TO GRADE.
4 VC
37S - FINISH GRADE r r
10
re _ a
IQ low �IN'E IMF-1 D 4�Vc
I
%r.0. II 7Lc ja sc6.40 4'aVC 73 44�ery� t
✓JJ LOADING_ Ftow uNE i,_ '"';
I• I a i
�� I o� U—BOX ��� �,�7 ,�.
.... ...........
GAL... z8.(o�j Z8• .•.... r �,{.3y; �r� .......•..
SEPTIC TANK
.......• h ;LOADING: .•.•••.••�•.q T
NOTE: fOUNDA 110N 70 PF ......
•• - er.} a{ t" 5 , • •••••..♦ +!d
CESIGN£D BY 0171£R. :;rpTIC ANK &D-BOY M DE _ - ••••••••••• `'
qc
14Si ALLED ON A LE M, SIAQI.E QASr •••���•••� 6} r w ••�••••••••
24"CCNC. MANHOLE COVER WATERTIGHT F S
....we.... LEACHrB�AS! ••••••,... r
OR C. lRAME &COVER IFPAVE'D FG •.••..•. 5 � � ••••••.••••y j
••.••• , t - P ••.•••••••ta
r]�l� rr Jp� '1 BY TANK RISER(S) OR BRICK &MORTAR •�•��• �f .c •��•••.••�•�,at Y�'?`Lr
L-�IAA r" BASI1 I SL CTION COURSES sr POD. 7C RRINCADF h 7p GRADE.
NO)rr MJS!RE 70 GRAOF- IF DESIGN • �- •.••.•,•• •�r�
EFlLUENi!S > THAN Z000 C.P.D. �� •���••��•
IIN+Sh GRADE �" • .< +r 2N 9- F + 5{rd
..- I
TO 112
WA SHED PEA S TONE, iaY • ; •. . ...• FREE OF IRONS, FINES, &u DUST IN PLACE.
"SPECIAL NOTES
3/¢•• TO , I/2" CLEAN 4;t {
'. :. ••; WASHED CRUSHED STONE, a'•••• . FREE OF IRONS FINES, &
— -- — '•' LEVF_Z EASE OUST /N PLACE If:° .:e •
G
l2 FT EI'fECBV£ OIAMrin, '
GENERAL CONSTRUCTION NOTE7S
SEPTIC TANK, DISTRIBUTION BOX, d LEACH BASIN TO BE 'ACME" STD. PRECAST REINFORCED CONCRETE,LUNITS.,
OR EQUAL. C'ONr RF_ Tf- 5000 P.I.S. 28 UA Y_S, STEEL: ASTM—A-615-68 GRADE 60. H-10 LOADING UNLESS'NO,TED 4 ALL SEWER LINES TO h'F 4" P. V.C. .SCI-l. 40 PIPES. GLUED JOINTS, INVERTS TO CONCRETE TO•:CBE PARGEQ & �.
WA TER TIGHT. MINIMUM PIPE PITCH TO LEACHING UNIT: 1/4"/FT. UNLESS INDICATED OTHERWISE. ` t1r��b:,• .
AL_L. SYSTEM (:'C>MT'ONFNTrD .SHALL. BE INSTALLED IN ACCORDANCE TO THE STATE ENVIRONMENTAL CODE,��TI,TLE
THE MINIMUM REOUIRF_MFN r_> FOR THE SUPSURFA CE DISPOSAL OF SANITARY SEWAGE EFFECTIVE ON
AT COMPLE7ION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL .BE ,NOTIF/ED�WWR�AN
INSPECTION. ( WM. M. W,ARWICK &• ASSOC. INC. TO BE NOTIFIED IN SOME TOWNS.) r '•. �`k���51<� �
��
ANY CHANCES To Tl1/S PLAN MUST BE APPROVED BY THE.BOAR,D OF HEAL TH & WM. M., WAR WICK; & ASSOC°,INC}
y�� ? �.� t.may: ?'d 4'�I�i
SOIL � - I�ERCOLA TON D_A TA Tyr .: a F �I.
.I.
TEST PIT # 1 TEST PIT; ;{,2„ Y
- -{-
3�
Uti
EL 0,
PERC. RA TC: z w 7
MIN./IN. To(��,i l_ Sc,£�.�t�. :• , , �3i+'�y,��h �
/ 3 �o )
TEST PIT EL.EI PERC. UEPTH.
0A lE. 4/-10 /e57 M . ,
1 i1} ii
i 7..J I L)Y.- ✓ t`J C"'lI./�'�F / n� j`it r !'tsi/+,rn��.y` S7,Bf'
WITI•VFSSED E'r. DyrJIJtrJC-1
HEA L TH A GEN T R.0,
DESIGN DA. TA
GROUND WA TER WAS !JQrENCOUNTERED.A T A; D.EP,aTH; O
NUMBER OF BEDROOMS:
GARQAGE DISPOSAL: NO 5 �}'•,� � � . �,
t
.• u fir.?s + c� ttijSs>t��}• d I �
EST. TO7AL. DAIL Y EFFL LIEN T ��� GPD. » J�E•
SITE & SE DER PLEA. .
SEPTIC TANK RF.OUIRED l�� GAL. _ "5 Mks >
FOR 7 w ai4ty}
SEPTIC IANk PROVIDED:
SIDEWALL AREA Z S
SAL../sr�.rT.
BOTTOM AREA o
.�� i i 3 F 5 t• �Ssll!
17, Scale:1 e: As Shown
,A � Date.`,-:
OF
o� BRUCE yG 4
7 �1 Wm. M. Warwick & ASSOcn
6,
I' HELD
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N°. 961 �! 213 Old Main Road Box,' 801� h
I Pouf 'tCrSiEREo`�F�� ,
��Slorinl sat'=� North Falmouth, .MaSS,`�,�:02555� g
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:v ROrLSSIO (617) 563 2638 ��
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