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HomeMy WebLinkAbout0200 PINE RIDGE ROAD - Health 200 Pine Ridge Road Cotuit A = 019 183 j I i i S' j :I TOWN OF SARI STABLE z LOCA1110& ZdV 9i SEWAGE " VILLAGE '/ a Lam' ASSESSOR'S MAP,& LOT If 3 LNSTALLER'S NAME&PHONE NO. -�� ,JIG> l� '7 SEPTIC TANK CAPACITY Ti &0/ LEACHING FACILITY: (type) f/ i P 'VL0ee— (size) NO. OF BEDROOMS BUILDER OR OWNER � /'� � PERMIT DATE: ^/g'' COMPLIANCE DATE: S l U Separation Distance Between the: Maximum Adjusted Groundwater Table to the 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 Fuinished by f � 1 3 p y _� lw No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Ap pitcatton for Mtgooal bp6tem Conotructton Permit Application for a Permit to Construct o<)Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No. �iQ Owner's Name,Address and yTel.No. Assessor's Map/Parcel 763 Installer's Name,Addres§,andTel.No. -5" —�j 9—SW/ Designer's Name,Address and Tel.No. $ A.9#5—bjq O� 'Pl C/1#.AJfO �l Z V1✓1 l4'/K-S1 i fo C—'c.®lzgvd6er Maw Type of Building: ��pp Dwelling No.of Bedrooms Lot Size ✓q,®/0 sq.ft. Garbage Grinder( ) Other Type of Building P�F14- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -300 cl FD gallons per day. Calculated daily flow gallons. Plan Date Z i Number of sheets Revision Date 1 Z 1 P31ZC0 Title � L a Size of Septic Tank a4 Type of S.A.S. �C. L Description of Soil e�0 v Ai,,-7 T-d 1 q 4" ►,j C) \, tAl m-� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the aforq de cubed on-site sewage disposal system in accordance with the provisions of Title 5 of the En,' tal We an n c he system in operation until a Certifi- cate of Compliance has been issued h Bo of eal l Signed Date Application Approved by Date 9 Application Disapproved for the following reasons Permit No. Date Issued No. . i ' (JID 1 wA ti.. Fee ��J THE COMMONWEALTH OF MASSACHUSETTS h Entered in computer: PUBLIC HEALTH DIVISION TOWNjOF,.BARNSTAB.LE, MASSACHUSETTSa Yes ZfppYfcatio,ri for 0igo.9aI *pgtem �Con!6truction Permit . . JtZ . , .{ (j. -% Application for a Permit to Construct 0<)Repair( )Upgrade( )Abandon( ) tg Complete System ❑Individual Components Location Address or Lot No.07Qd��Cf� ;9 jX �"� { 'Owner,s Name,Address and Tel.No. = Assessor's Map/Parcel 1^ /LA Fa' A 6_Z, EL .U.1' ze Az -y77 7f3�o Installer's Name,Addres ,and.Tel.No. �g— "9—� � Designer's Name,Address and Tel.No. g. �bb,00, � �� - 0);, t Z Y1��19-'11G.j% alUlJ ETAIt�� ,- ate''Type of Building: Dwelling No.of Bedrooms Lot Size ,J /0 sq.ft. Garbage Grinder( ) Other Type of Building '7F14- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3�� gallons per day. Calculated daily flo �'� gallons. Plan Date 124 10 17,cX / Number of sheets Revision Date I-Z-1 1 TA X9 Title •?a: LI� t.� L &-Rl !! � Size of Septic Tank 1602 04 Type of S.A.S. Description of Soil e=0L LL1� r ���r D�-F-e_,dl � rvT7 Tt:;, 144" 1,3 o C:AJ Nature of Repairs or Alterations(Answer when applicable) y , 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 EnYiromne tal Code and not to place the system in operation until a Certiff- _ cate of Compliance has been issued H'Board of ' eal Signed Date , Application Approved by `' Q k c Date Application Disapproved for the following reasons Permit No. 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( ) Abandoned( )by at `DC» Ptsvt a_o,-�6C. Ocd has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 1l-C10 dated If 9 Installer Designer �k The issuance of thfrxs ermi shall not be construed as a guarantee that the sys e ,wld1 nction as d si ed. Date '�» t i�h InspectorlZor 0 No. �� GJ �¢ ' Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mf6poar *p,5tem Cougtruction Permit Permission is hereby granted to Construct.(,4Repair( )Upgrade( )Abandon( ) System located at h C U 1.,l 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 e t� Date: `r7 / ll Approved b I TOWN OF BARNSTABLE /L LOCATION ZdV �X J 1jf E lel, • SEWAGE # '� ' Q/i� f' VILLAGE �TV 17' ASSESSOR'S MAP.�&LOT ©l�?- I r 3 INSTALLER'S NAME&PHONE NO. -1 � /�1C�•� J� ' � � SEPTIC TANK CAPACITY Cd9 L' LEACHING FACILITY: (type) CV1-%�'e- (size) /22 4`2 NO. OF BEDROOMS BUILDER OR OWNER PERMTi DATE: ^/ COMPLIANCE DATE: 5 l U Separation Distance Between the: �J Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility. (If any wells exist ` kFeet 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 facility) —/ Furnished by -Lyoc l nv 1 2 3 4 6 9 A8 A8 AB A8 AB s 6 6 ro'-lo• e'-4• ro' p aS-r DECK (1•4 MAHOGANY) A '� }T •Ta O$ ON WAL N. L6O E(RE RAT E7 DOR ' ° 14 �ua lili a sV Er ae TT E N 1 LAYR Or1T�eD.ME•x`G -®-- DINING_O ROOM _ Ir I1� M. ®A°IN ISLAND � jI1IiIII 1VldA�LK-6IINM AiI1IiIII � STER BEDROOM GARAG:LI• ITYx Y:0D. p •CLG. ® AewE ------------ row GAD GIRErLACt etwuL LIVING ROOM �� .. VAULTED CEILING 1 OCOVERED PORCH (lw nANowNY) MUD ROOM e 4 § a-a• 9-O• a'-a• a'e• 7-4' 6'-1' a'-e• 4'-il` as-o• as-0• N O• r 4 5 AB A6 V-e. 14'-7 19'4• e'er' __-___-__ _- • I I s © elite ERA 7, BATH _ I - I ® ® BEDROOM # � I BEDROOM � CL �. 2-26" ATTIC .� ? Y 1-26" RA ING M. p e I • I �-�S OP I \\ ' AGCC •DOOR \ I I ___ ` VAULTED CeILIN6 iO'1 TO DQLW1 a a I i IC---AlTORAG! I / I \ / --------- ----- a I • - I e1CYLIGW I (01TI0NAL) 1 I I I 1 I � I 1' 91-r eta• 41d SCALE, 1/4'� No.__...ce 3 Fss.... : THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ......... .... .....................OF...... Appliratiun for jBiupusttl Works Toustrurtiun frratit Application is hereby made for a Permit to Construct (V/) or Repair ( ) an Individual Sewage Disposal Syst at: _.!....Location' --ress •- ».. Owner Address W Installer Address Type of Building -� Size Lot.... -----Sq. feet U Dwelling—No. of Bedrooms............ ............................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Building .............• No. of ersons.......__........•.......... Showers Other—Type g ----------•--- P ( ) — Cafeteria ( ) � Other fixtures ------------------------------------------------•-••--........................................................ ••-•--- W Design Flow........... .......................gallons per person per day. Total daily flow.........���J ........................gallons. WSeptic Tank—Liquid capacitOaO.gallons Lengthh''r[?... Width................ Diameter................ Depth................ x Disposal Trench—No...................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------I_-_-__-__. Diameter.......I.a....... Depth below inlet._(?............. Total leaching area.z7 . ft. Z Other Distribution box (�) Dosing tank ( ) / '-' Percolation Test Result Performed b .0-..-�_ W'li�...A. G.:... Date_7l_ Test Pit No. 1................minutes per inch Depth of Test Pit.....1Q........... Depth to ground water.......-:.............. fi Test Pit No. 2........7/..minutes per inch Depth of Test Pit......121........ Depth to ground water...................... Ix ............................... •-.---•fir-------i................ ----....-•-•....... O Description of Soil.......... n --.' -..ram �1? b �/-Z M �' � C� �� •�D.----...... x ' W VNature of Repairs or Alterations—Answer when applicable................................____.........._..•_._........._........................_........ Agreement: lop, The undersigned agrees to install the aforedescribe dividua wage Disposal System in accordance with the provisions of iITLi: 5 of the State Sanitar e e snot to place the syste in operation until a Certificate of Com liance has ee t oa o health. C� Date ` ApplicationApproved By........... .................................................................................. ........................................ Date Application Disapproved for the 11owing reasons:.............................................------------------•------------------•....._........._.......... .. .. ......•••--•----•-----•--••-••-----------•---•-•---..... ....--•---••- Date PermitNo......................................................... Issued....................................................... Date vylq No.......--............... Fmc......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............................---..._.....OF...... ................................ Allpfiration for Uhiposal Works Tonstrurtiou' ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal S t vs t em a " .. .. -- . . t.................. . ..................... ..............................................( qT -. . ... Location• re ............................................. . .. ... .... .................... Owner Address Installer Address .2 Type of Building Size Lot....21.9,1.0.....Sq. feet Dwelling—No. of Bedrooms___..._....oms............. ............................Expansion Attic Garbage Grinder ( ) PL4 Other—Type of Building ............................ No. of persons....._.._............._.__.. Showers Cafeteria ( ) P14 Other fixtures ............................................................................................................ <� ---------------- Design Flow..........C25.......................gallons per person per day. Total daily flow......... .........................gallons. 1:4 Septic Tank—Liquid capacitj gallons Length.61P.-_ Width................ Diameter............_... Depth----------------- Disposal Trench—No. .................... Width............._....._ Total Length_........ ......... Total leaching area....................sq. ft. Seepage Pit No.........I........ ' Diameter.......J.a...... Depth below inlet-_-(P............. Total leaching areaZ� ------sq. ft. Z Other Distribution box Dosin tank 7 Performed at Percolation Test Result ..................... D ............ ..Test Pit No. I................minutes per inch Depth of Test Pit....1C.).......... Depth to ground water.......-..........._.. Test Pit No. 2-------len..niinutes per inch Depth of Test Pit......1-2-1......... Depth to ground water..........._.......... ................................. ........................ ...............i..................................................................... 0 Description of Soil......... --------....... ------------------*--------------------------------------------------------------------------------- ------------------------------------------------------*-----------------------I----"""-------- ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable................................ .............................................................. ............................................................................................................................... .................................................................. Agreement: The undersigned agrees to install the aforedescribed ividual , w e i osal-System in accord nce W/!11 the provisions of'I'IZ 5 of the State Sanitary C6Je _ i urther agrees not to place the syste L L operation until a Certificate of Compliance har�s__b�e�e ,issued b the'boaid of health. IC2 .............. ........................................................................... ...... Date ..... ............................................................................ ..................................Application Approved By..- ..... Date Application Disapproved for the .ollowing reasons:.............................................................................................................. ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD Of HEALTH ......................................... OF.... ............... Tntifiratr of Tompliattv THIS IS TOeC constructed (\/O �RTIFY, That the Individual Sewage Disposal System constru r Repaired,.( by_.(:�A/ZVV........... .......................... ............................ VInstalaer at................................................................................................... --------------------------------------------------------------------*------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code described'in the application for Disposal Works Construction Permit No.. . ...... dated_.. ----Q . j.... ;>1----------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................... 241:� ...... Inspector--.- .............................................................. 17---­------------------------- THE COMMONWEALTH OF MASSACHUSETTS e 1,pj VA VS 4 rj V S4 _,HE T-eAAA 0-_cl 0 VX d.;J- B? OF LIT I..............OF.................................................................................... No.... ................ FEE........................ . Ot-Sposal 10qthii f qqKVt!ott- firrmit Pern-Assion is hereby granted........................................................................................................................................ to Construct ( ) or Repaii an Individua Swage DisrVsal System 'I C.. , � I% jj ��, at No......................................... . ........................... Street as shown on the application for Disposal Works Construction Permit No..... .... Datede=L.. .......... ....................... DATE.................... Yyo � f Health ............................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS SITE PLAN SHEET I of 2 SCALE I"- Zv N l o � 6TV. Z -ne oT��t4z/ (,, ZZ, 17X5 A j VJA -- 4a SrelIzYIGP- i \ G►i1L � �Ooa SAL, riT \ - �x I Oh1C--A 1Jl — \\loox�I c� Ie2y- o ----- ------------------ -- b�G ar- Pllz-Tr-ai-D �- � n (of ion WARWICK y No. 19771 '�fCISiER�� FOR ice ` CJ T ` REGISTERED LAND SURVEYOR L oT Z I 6 D I'c (ZoCs.p ZONE PLAN..REF. /S.yh�9, MAP Iel 1-vT33 DATE JUL-Y 10, BENCH MARK DATUM rPyM Uhey Tod`' WM. M. WARWICK 8 ASSOC., INC. ` DOMEC WATER SOURCE Ty�STI BOX 801 - NORTH FALMOUTH FLOOD ZONE. �oti.1' (-� ��Q �- D �IGr MASS. 02556 - (617) 563 -2638 a t 1 . T LEACHING QASIN SECTION NOT TO SCALE shcc l 2 'I 24C.I.MH COVER EARTH FILL BRICK AND MORTAR COURSES AS REO'D• TO BRING z 4 _4•�_ COVER TO GRADE B FLOW LINE _ INLET 1_ _ :� i 2'- 46'"TO�"WASHED PEA STONE FREE OF/RONS, PIPE FINES AND OUST /N PLACE , ''• OPEN/NG WITH 4%g" 314 " TO I%2"WASHED CRUSHED STONE FREE OF OUTER DIAMETER IRONS, FINES AND DUST IN PLACE AND 1314„ INS/DE DIAMETER 1. CONCRETE-TO BE 4000 PSI 28 DAYS •.• . . L>;Q�. ��.�• 2. REINFORCED WITH 6%6" NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR I" GREATER DEPTH REQUIREMENTS 40" r---ZI —} s'o" 2�.—� 4. NUMBER OF PITS REQUIRED Pt J� ? MIN. I Io, ;EFFECTIVE DIAMETER NOTE: EXCAVATE TO ELEVATION OR t � ' (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL WATER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. Z' lB"STD. LT. WGT. C.I.MH COVER 4"8/T FIBER PIPE 4"C./.PIPE TIGHT JOINT OUTLET LEVEL OWELLING � FLOW_LIN£ _ p TO FIRST JOIN -- -�r . ,,-; -• 00 0� IIU �001 � C./. TEE I� �1 IL) 1 11 000100 1 1 1 1 1�-o (°j•`�� 'STD, PRECAST CONC. : I�•Z�j 1 1 1 0 00 00 1 1 1 1 . DIST. BOX TO BE IOOIIGAL.SEPTIC TANK INSTALLED ON LEVEL 1 1 1 000 0 0 0 1 I I g_•'•. ..,.•':. ,: . :.. ' 1 I 1 goo 00 100 0 0 1 1 STABLE BASE 1 1 •• . . III 1 1 1 1 �SEPT/C TANK To BE i 11 000 0 1 1 INSTALLED ON L£VtL, 1 f 10 0 0 1 1 1 ; STABLE BASE. 1 1 1 0 0 010 O 1 1 1 I I1Igo 1001111 LEACHING BASIN 1111Q0 1 00 D 1 „ i BASE TO BE LEVEL 1 i 1 1 0 00 1 1 j SOIL AND PERC. DATA �✓8�2 j PERC. RATE 2 MIN. /IN. 011 TEST PIT N0. I 011 TEST PIT N0. 2 II 1'op/h��hodV ZI o T E S T.BY- tP f=yc4 �� -Z U D 'f ��hvl�hol L. WITNESSED. BY ToM M� �A1.1 --1 Mr,,PIuM/Pl J 4A0D McPWA4#iI.p_, A,A P TEST PIT GR. EL. Zoe i, 7/� S j DATE: / No a�o�►JoIaJA t NO &FwL)WPWATtff j DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EF•FL:�:2OGPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK 000. GAL, ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, SIDEWALL AREAz'�GAL./SQ.FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA �-f GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY I , 1977. LEACHING REQUIRED �12 SQ.FT.. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. 2�7SQ.FT. AT. COMPLETION OF CONSTRUCTION, PRIOR TO BACKFIL LING, THE f BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 1/41 / FT. UNLESS INDICATED OTHERWISE. SEWAGE DISPOSAL SYSTEM o� MARTIN I E. FOR'MORAN f223417 H L,O'r l PG D t • Qa� SCALE AS INDICATED DATE JULY Lcf 19'0�6 n WM. M. WARWICK 8 ASSOC.I INC. ' 8OX 801 - -NORTH FAL MOUTH MASS. 02556 - (617) 563 -2638 PROFESSIONAL ENGINEER i • 00 TOWN OF BARNSTABLE LOCATION 4✓, t :226 A A e , , SEWAGE # d "' VILLAGE ( � v a ASSESSOR'S MAP & LOT .' s� INSTALLER'S NAME 6z PHONE NO. �1 .S S�E -6 SEPTIC TANK CAPACITY to m o LEACHING FACILITY:(type) (size) ie oo i NO. OF BEDROOMS PRIVATE WELL OR PUB�WATE BUILDER OR OWNER DATE PERMIT ISSUED: DATE . COMPLIANCE ISSUED: ink r. VARIANCE GRANTED: Yes No �� ,, ,r` �� �� a� ._. sr • � ''b �`a� etoGE Qs Locus Fx isri l.1G I I�ur1.t.+gC. Q — . to .ti 1n 7 � N OrA m T*. -SL-opE �' I E QS MAP 18 L !S 3 15 LKs T4Afj 25'f� tAA I LAZ. I �ti zt i 1 1 p- A-8 4(1 }. l 10 1- t r i 01 \ �. t o 7� P a i 1 � 3' � \ � I � . 3 � 1 g•� •7 � ° � 0 1 �_L �G C� 3 E i I ► �.i A.s £ �od -roP OF el•13 � , LDT 6 — �24. � ) 59, D 10 SF T•frA L Pi qa 71 13&- DEs1&4-L VATA Si We.1_E FAML`{ 3 M aCa wl F a'Pvc Pipes NOTE: .4 spt I T R Kt/L F•r�IGE SNAi . BE' do aAIZ A&Q (.Zlt l05it. SET AT Tf/,C J.Ii?/r OF /VOX K A Fr" VAaLY FLOW 3 -4 Ito = 33o GPp f f'L F/CoS/OA1 CONTROL I't!�'J;I S�1R�.5 A/<'e- SrrtG 6Go RFD 114x R6'mOt/E.D FIND PRIOR TV X 5SUTA14 A uSa: 15m Esd L� CIF4er/Ci4rE Oc- c0M0PZ1AA4Ce. 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Sq•M L. 1} DN Cg pL j,5 to iTIA Ta -UDEL W6 AMP �� •Ztt OF Mgssgo Sas'TSAGiG. mWvmSMGQT IDF TUG ID VAJ OF , VAC),5TAW,E AQV is or LvrATam wtr'utN A h,% P ti Baxter, Nye & Holmgren, Inc. �pcuai Fts� 4iI►z�lrs� zaNE. its 812 Main Street No. �$ �Q 4sterville, Massachusetts 02655 SS�CIVAL Ems` al--I✓-$� f oM BV WO10" 4VDLXD tJ r b br. vsta '�. 6Sn►sc.isa.t PRep�ry L�Nerf. /zip p/ Registered Engineers Land Surveyors