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HomeMy WebLinkAbout0025 PINEY ROAD - Health z tY'V,4 aty�J/ - - 4N I ' r �l f. i II' f L0CA'T.10N SEWAGE PERMIT •1110 VILLAGE INSTAyI ER'S NAME A ADDUE3S '' .' r GUILDER OR 0 NER '004e, � DATE PERMIT ISSUED DATE COMPLIANCE ISSUED_ /1711 � cK s© +C i. ,y. 3� 13- .y r i f � ................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH --.- -----..............OF..........!.��...9A)3. /_&................................ V Appliration for Uhipoii al Works Tnntrnrtion Prrutit Applica n is hereby made for a Permit to CoUstruct ( ) or Repair ( ) an Individual Sewage Disposal System at: p 1 ad —otcty A� , ................. ` .... �-N ................ ..---......--.:------------- ................. i y................................. ....................... . .Location Address p� or Lot N .............. ..1:....1�l �C�!-�T-------------------- --..eL...� Owner address ._� a ----.•......._�1(C�K 1... C eh?5�12 -?L�?!'J................... ..........�L�1�:��U !�.....t l= :............ Installer Address I ` r dType of Building Size Lot.. .._ i.._____S__._._Sq. feet, V Dwelling—No. of Bedro .. .......Expansion Attic (rp Garbage Grinder O) Other—T e of Building No. of persons............................ Showers — Cafeterias QOther fixtures ------------------------•-----------------------..-----------------------------------•---------- W Design Flow........35............./� ___-gallons per person per day. Total daily flow..... ....__._....___..__.._..gallons. WSeptic Tank—Liquid capacit;_•-• -__-.gallons Length................ Width................. Diameter................ Depth................ x Disposal Trench—N , .. --- Width.................... Length area sq. Diameter..... ®..�..:. Depth below inlet......�,.�✓........ Total leaching area...Zk!�!...sq. ft. Z Other Distribution box ( ) Dosing tank ) _ . Percolation Test Resul s Z Performed by..... .. Date----- aTest Pit No. l.. ._.......minutes per inch Depth of Test Pit______ ...... Depth to ground water----2 ........ Test Pit No. 2'._�_Z_._minutes per inch Depth of Test Pit......12........ Depth,to.ground water...n_01. __. -• ----•..............................................................................•----------...-------••-----•--.-•---- ® Description of Soil......0- ,6. ....................................&0i � � �Z/---ty.74 >m a�D. ................... x V ............... 1 -- W -•••--• - - ----------.� ---- -��.-.,�....... - �T------�.....Z...... �.� w UNature of epairs o Alterations=Answer when applicable______-- . ..... --------•----------------------------------------------•---•---•........._......_..--•-----------------------•--------------------...-•----------------------------------------------------.......----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT 2' 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance, as been issued by the board of health. igne -_ i D Application Approved BY ................ .•..... ......... Date Application Disapproved f o th following reasons:.............................................................................................................. ....................•-.......--------.....•-------------•-•-•.....•••--••-----•------•-••---••------•---•-------------••-•------•--•--------•----•------••--••••-••••.....-----------•-----••--......._. Date PermitNo......................................................... Issued....................................................... Date — e - No.fof a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7- ��r�........ oF...........wI3 !J5(7 1 ,�.�..................................... ApphrFatinn for Diipniial Hlorkfi Tnnitrnrtinn Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 44 ................-- ,..................................................... ---•-••••-•-•-•-••••••---••.......-••---•••••-••-•--•••--•--•-•-••---•---•---•-................... Location-Add ress or Lot No. -•----------------•-•-•••-•---.............._.... ...-----------------•'.................................... .. - Owne� Address W �t!Lr"�( C 0N) X 11t�'r�� ----•--•CLL /ILIA a Installer Address Type of Building Size Lot... �. ....Sq. feet U Dwelling—No. of Bedrooms.............. ............................Expansion Attic (nck Garbage Grinder '4 Other—T e of Building No. of persons.................•.......... Showers — Cafeteria Ga Other fLxtures -------------------------------- - W Design Flow.........25...........................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid*capacity.Z X Ugallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter....../.0...... Depth below inlet....... ....... Total leaching area.... ft. Z Other Distribution box ( ) Dosing tank. ( ) Percolation Test Results Performed by LI-0t,:t-_/J6 '7�?/!U� �7G!!t-' Date_.... ".:����_....... -.._. Z..minutes per inch Depth of Test Pit__._...�Z......_. Depth to ground water----ngy2 _.._.... � Test Pit No. 1............. p p p (i Test Pit No. 2...�.n..niinutesper inch Depth of Test Pit.......L_Z...... Depth to ground water.... f..s..p!.................... R' ------------------- -•--•-------.......--•---------.............................•••....._..._..•--•••••................................................ D Description of Soil - YJ .77�P s.............D!L /Z 21.!L........... ..................... U ..................•----•---------•---.....•--•-•----•---------••----------...-------•-•-----------•••-------------•--•--•-•------••-•-•--•--••-•----•••--••-----•---••---•-------•-.........-•-•-.--•--- W ---•••-----•-------------•--------........................_........--•------•-.......------•-------•-------•-••----...----------....---••--•---•--•-•--•-----•-------•--••••-••-----------••-•-•-••----- UNature 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 IL s:r-. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Complia ce,.4as been issued by the board of health. Igne f- ..------ .. � Da A lication A roved B . ......a , ,1. �i��=r�' .------ PP PP By Application Disapproved f o th ,following reasons----------------•------------•----------••-------------•---....---.............................................. ....................••-----...---•----.......------------------.......------------------------------------••-----------••-•------•-----------•--------•-•-••---•-----------------------•---•---••••-•••- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 7 w.............OF....../ �SIL(...................................... Zrrfifirttte of Tomplittnrr THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed or Repaired ( ) by••-•--1 �1Cl / e'c�r r rrZU l"7,90 ------------------------------------------------•-•--•-•---•-------------------------------........--•-•---•-•---------•-•-------•---•---••••..................•.....__ Installer at-•---•--.._.....'7------...%iUt.1/.....•---j�Ui.4.0------=--Cvl Lr--`-------/--t-i'..A--'------------------------------------------------ ...... has been installed in accordance with the provisions of TI^ v of The State Sanitary Code s de gibed in the application for Disposal Works Construction Permit No--------.............. . ............. dated___.:r ....._..._____... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® 'S A GUARANTEE THAT THE SYSTEM WIL FU/DICTION SATISFACTORY. DATE..... .- 31�. .................................................. Inspector.................................................................................. THE COMMONWEALTH OF MASSACHUSETTS Cr BOARD OF HEALTH d ^'1 Tt��'�v OF..........'.......c./v LE Q No................. ...... FEE. .................... Bispwial Vorkg Tonotrnr#ivit rrmi# Permissionis hereby granted.............................................................................................................................................. to Construct (X) or Repair._( ) an Individual Sewage Disposal S�y_stem atNo.................................................�,l............----•-............ :... =------........ E Street r_ `! �`fi' �! as shown on the application for Disposal Works Construction Permit No ............. t ..._ .._. .............................................. -•--- ---------...................................... and He It DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 20 jar MIN. NOTE. /F E/TNER THE T/C TANK ORS 1 EACH1-,VG -P/T ARE MORE TH A:"/ /2"BELOW IO PT• MIN :JR,�OE, A 24'O/AMETER CONCRETE COVER° ' SJ,�ALL . .F BROUGHT To G AOE. c B R X 4 PYC P/P 1/ A R /Y C O{/ER L L O CONCRtTE J"I EA y G' S T / O SNA 3E U S E MIN. P/TCN EL=.99.c COVERS �B�Ol?iQ.FT. /F/IV DRIVE WA Y 9G MAN. CONCRETE ::aC ���_ p .•oE Cd 1�ER J CL EA/V SANG == . eA:KF/LL L/QL//D LEVEL 4.. �� Z'L. RON P/PE I oOC� o v o • � MJJV.PIMV GAL. • • • . . . . . • • > •'s %q'PeR r'T. SEPTIC TANK D/sT , s •.• • •. s • • • • s • WASHED. S7Y7NE == BOX o • � Qe • • • • r .•• • . +� e • r •EFFECT/✓C • • • •0• 13�.45tJE0/STaNE► r • • DZP .H • e • r • v • o PRECAST SE.E.�AGE 168.5 x �.•5 4*71 �/D e .• • • • • o . . • • a •o P/T OR EQL//V. lNYE�ST ELEYAT/0�1IS -18. 5 x 1.0 -78 GID ► a — EL= INVERT.AT BU/LDImer q�•6 FT. G FT: D/AM. vt P,T CAPAc�7--( S49 v( D. 1 O O/�q Jy C SEE TABUL.dT10N, /NLET .WPT/IC TANK 95.8 FT, Ot/TLET SEPTIC TANKS FT. INLET 0/5TR/BUTJON sox 95,4 FT, SECTION 4F GROuNt7 J�iTEirc TABLE 0u7L.E7DJ3TR/etrr10N LAX 9 5.2 FT SP.yyAGE O/SPO�SA L SYSTEM INLET LEACNJNG PIT �14. FT. TABUL�ATIDIV 4 EACH!/YG P/T DES/GX CRITER/A ,TABLE D/MENS/O/V A 3 FT. DI�f.ElVS/oN $ Fr• NL/MaER OF BEDRGOMS D/MENS/ON C 4- FT. M jJ GARaAGED/SPOswL UN/r "caw SOIL LOG TOTAL E-1TNtlA'TED FLAW �30 G.44.14AY SO J L TEST #/ SOIL 7L=ST#2 •��/L TEST i{(UMBER C3F L.E,4cN/wG PITS 1_ f^Fc�✓. 9(0•8 .r.trtFY.� pATE OF .SOIL TEST i S/DE L�AGH/NG PER P/T 18� Sa FT. s LoAM RESULTS idJTNESSED dY "7Ei o- i88ra�so�1. LAT/®Iv MATE,*/ 1�S t-IIAIIINCH BOTTOM L.Er�ICN/NG PER P/T $Q. Fr. PCRCO e,��,� = TOTAL LEACH/iYG AREA .SQ. FT. -Pep,-- PEVC0, AT/®N RATE�2 :��J MI N.f/NCH RESERVE 44E4C'HIN6 AREA 2(0� SQ. FT. ( 7e57 2' �� 3•0" 16-1 a �PVT H OF,grq r McDivM SAt1D AIL_ T ' T jt P- IS4S �N OF o�� I B t iL cAN LA w D or_i Pi LtE`/ P ,A-4). 1 T PHIL)P 1 ftSSE ySoPS MAP 34 PAP-.EL 19 U. WEINP IF.1✓ L/ CCSTU Cr - P�,AIZ-IS'TA&>L-E—: f0o:2M?4 a ° TER �`, ELOREDGE =IVG/NEE):?/IVG CO,INC. NAL EN�'� F—L� 8 .8 LJ 7/2 MAIN ST. • I�i�YANN/S. N1ASJ. * �'O SUR�� Q�NO GigOUNv YNi4TER CL/ENT: j\ Q GROUND wATER A.r FLEV. _ • N TEo `/� JOB Mo.,�r zwz SHEET�OF. Z_ TOWN OF BARNSTABLE LOCATION'( 2 V t'��� (moo er SEWAGE # ?'6 VILLAGE ®'1"U ! ASSESSOR'S MAP & LO ® " I INSTALLER'S NAME & PHONE NO. S SEPTIC TANK CAPACITY 1000 LEACHING FACILITY:(type) 4 (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 6AAA N� Owe Ems a 0� r f I ► �.Icsr F-'i i..Ic:�r Qa� ...�-� A �2-r ' bE (3ACNS. FD14&,IIdE Lwib. UEpT A Dann rsE R Is, 19 e2 j; 14- to TkV ZZ Ll 10 9 G I' y � r S ck iy 'S'Q N V l/J 3oi E-40-r -n( fSFf�% Pew rev- 273,66,7t _ • .. AS EKPSTPNG-. nor u�� ,�6•d.v/�-2: PEr2 TZEG, An.T. Z1T,'G/rf9/✓r',��.:�J� - SruGt.�" bWN�SM t P _ i F126A" ugRT3 aF3pGr"l� T� T f f1?7tJl i io/� A z3��r, 23.r& F2on, UND�`Fr� n LEGEND *. CERTIFIED PLOT PLAN EXISTING SPOT ELEVATION OAO EXISTING CONTOUR — QLI ; f155�5SoRs MAP3y) PAQrz< /y FINISHED SPOT ELEVATION o EINBERG P//v�Y /TOAD }._COru/7- {CII�tj SHED CONTOURO .p No. 366 a . , IN APPROVED , BOARD OF HEALTH O�FSSU ALE�'�� � �.l�.r�l�J �`1�.���.� ,�.'�.�• `.' P�vID �1,3i 6s i. DATE AGENT of SCALE, i"= � DATE# I-11-g3 M ys . GE- ENGlNLi: 71WG CD.IN CLIENTI;JA a� `� I CERTIFY THAT THE PROPOSED EGl;,TERED Rt0lSTERED `BZ �%z' -4 BUILDING SHOWN ON THIS PLAN CIVIL LAND JOB IdO. ,.�..._...__ CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR.BY$: � ---- a doe OF BARNSTA LE MASS,4-a u TI=p CH;9Ys ^ o sum 712 M Al N S T R E ET H YA N N I S, MASS. SHEET,;.L OF Z DATE ( REQ_ LAND gvRvFy6i �_