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HomeMy WebLinkAbout0005 SAVINELLI ROAD - Health �Sa L/ .SAN Tu►�'—�lE ial7'�tMN tZC�� ! `��� r ��_ i W R ST- TION SEWAGE PERMIT M E 0. L 0 C .� Fe 'mod-r tJ'x-.� J?d0. try''s3 VILLAGE `- �I G-•�a�C.c-C aiI TA LLER'S NAME & ADDRESS' a e U L D E R OR OWN ER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 0' 7 � i L ` � P ' ' ��v..Y ����� _ f g J I TOWN OF BARNSTABLE LOCATION IfP l &Je44,2w,1J RJ SEWAGE # ggG;Oe /3 $ v11AGE Colo 4 ASSESSOR'S MAP & LOT aZ V-11 " INSTALLER'S NAME&PHONE NO. /g,,4/0/6' 6w51 dloar S/1�S $9itto SEPTIC TANK CAPACITY /,o d0 G"4 L LEACHING FACII.ITY: (type) (size) Id"I yo'�� NO.OF BEDROOMS y BUILDER O O R „fru << PERMITDA : Od COMPLIANCE DATES�Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility t 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 bg Feet within 300 feet of leaching facility) Furnished by /5�� �ipra N Mar �j � . • .. n as �s` y3 O G�` ., ��, 1lrsOC� Oi y0. /O -►- Ao z t- No................ F>cs....r ! .............. TF' COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................,r-�.✓..................OF........... �., Appliratinn for Disposal Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct (pQ or Repair ( ) an Individual Sewage Disposal System at: No --- M g�5 M .�i. .............................................. Location Add ss or Lot No. aR.�_b ®W.r w rC_� . .......SG eJ k l� Addye�s O ......� .. � . Installer Address d Type of Building Size .....Sq. feet Dwelling—No. of Bedrooms____r ________________Expansion Attic ( Garbage Grinder ( ) per, Other—Type of Building .r-F�_Q -_...... No. of persons._.F-i Y_ ...._.__.. Showers ( 1 ) — Cafeteria ( ) Q' Other fixtures ...................................................... w Design Flow...........55.........................gallons per person per day. Total daily flow......... 0..__........._.._..•....gallons. WSeptic Tank—Liquid capacity.104*..gallons Length_5'_.(=.... Width.W.t.Q__ Diameter______________- Depth..S.�..S11 x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area------------._._____sq. ft. Seepage Pit No--------------------- Diameter.....10........ Depth below inlet_....?.......... Total leaching area..ZtW?.....sq. ft. Z Other Distribution box (>Q Dosing tank0-4 ( ) I Percolation Test Results Performed by... .`._ -_...At!�n.......... Date... .��J I.g-�'_.•..•_.._-. Test Pit No. ......minutes per inch Depth of Test Pit---A7....._..... Depth to ground water___ e.! --- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil.... -----�.Pr!M...:t...5 ��!-.--f---3---.----.--Z------M "•�-J�=-"-�A W ---•--------•----•••••-------•---•---•-------•------•-•----------------------------••----•-••---•-------------••---••-••---••-•......---•---•-•-----•••------•• ' w UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: e undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with JA visions of iITI.L 5 f the State Sanitary Code— The undersigned further agrees not to place the system in n fi of Compliance has been issued by the board �oftlhealth. Sign �..... �.. � b.�... .. ......`t ._ n Approved By----•------_-----•------- ...-- ..� -------• � ••-••--- y � e �cation Disapproved for the following reasons---------------------------------•"---"------•---•---------------------------•--•"--------------------...._•----- .............•-•••••--......--•--•-•---------••-----............••---•------.......-•--------_...- Date PermitNo..................................................._.... Issued....................................................... Date .- - Ar L�+ No..... `f::.. �: ' F zs.. .................... TH£.COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH w.n.................OF.......... ,.. .r'. .1r�.s .,, R ........................... Ap' Pliratiou for Disposal Works Tonotrurtiuu rnmit Application is hereby made for a Permit to Construct (1/Q or Repair ( ) an Individual Sewage Disposal System at: _(', t: s? ............�-.......►�C. Uu l_r1 { �%Y...... �= ............. ....._............... ... --------------•. ------ �/� Location-Add ess _ �'15'_(v 00 or Lot No. w.erl� 1. f:..e. t� ._A�"S .._.. •.. _i _lQ,C„'.'k- Installer Address UType of Building Size Lot_2_4t_p.` '._.._..Sq. feet ,-, Dwelling—No. of Bedrooms.._:: :....•.............Expansion Attic (-,YJ Garbage Grinder ( ) Other—Type of Building :F !.1�� --.._...._ No. of persons.E i.4_K' ........... Showers (1 -) — Cafeteria ( ) aI Other fixtures ........................... W Design Flow............ .........................gallons per person per day. Total daily flow....... .........................gallons. W Septic Tank—Liquid ca acit .iP Q__gallons . Len th. '.6.._.. Width.4`..!_Q_.. Diameter................ De th:�`.'Z '-!-- x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area---------------------sq. ft. Seepage Pit No........ ----------- Diameter.....b.0f....... Depth below inlet.... ... Total leaching,area.?.-.�e......sq. ft. Z Other Distribution box (}C) Dosing tank ( _ Percolation Test Results Performed by...-:7ry �:--C)' > -./'/ �.` •.......... Date...` _ . .- - =..•.._....... Test Pit No. L.` __.___.minutes per inch Depth of Test Pit...!Z_............ Depth to ground water.. !' P4 Test Pit No. 2................minutes per inch Depth of Test Pit...................... Depth to ground water........................ . .. a --------------r_.:...- n -------- O Description of Soil....r?s�� .� `' ` ! 2'_ (�E 4 �� W -----------------------------------------------------------------------------------------•--------------•---A....------------------------------------................................................. U r Nature of Repairs-or Alterations—Answer when applicable............................................................................................... -------------------------------•--••--------------•----•--•---•--••-----------••-------•-•--•----••--------------------------------------------------------::.-----------------------•••-•......--•--- Agreement: e undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with h pr visions of TITLE 5, f the State, Sanitary Code— The undersigned further agrees not to place the system in er taon a ifi of Compliance has been issued by the board of health. Sign c=4 414 Appl n Approved By.......................... �� r._ •- ......--•------• at�.�-------- Date Arrp ication Disapproved for the following reasons:.............................................................................................................. .! .........................................................._...........--•-••••.........•••-•-•-••----•--•-•-•--•--••--•-•-•--•••---•--•-----••-•-•••----------•---••-•----•--......----•-------•---- Date Permit No.............................. ........................... Issued-...................................................... Date Y. THE COMMONWEALTH OF MASSACHUSETTS 80ARD OF HEALTH 4!, ..`•11..............OF:.:........ ......................................... ............................. �rrtifirttte -nf f�uut�li�aurr • "•. THI IS TQ CERTIFY, That the In vidual Sewage Disposal System constructed ( .) or Repaired ( ) by.... .......O a C"......CO---- ^mac - staller has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..........2_f''._-�i.9..... dated................................................ THE ISSUA CE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM LL NCTION SATISFACTORY. DATE... ..•..• �� ------- Inspector --- ----------------•--..J------....................................... THE COMMONWEALTH OF'MASSACHUSETTS BOARD OF HEALTH ...�,,.... I.......OF.c� ...... - .,' Ic- . No.11..: FEE;:..�2 f�............. Disposal arks Tuns �trtiun: rrutit Permission is hereby granted..........0.� r........... 3 ..:. ......................................... •- to Construct OK,) or,,Repair wage( ) an Individual e age Disposal System � at No....Lo.�.- --- ( �'W -- � . --• Street as shown on the application for Disposal Works Construction Permit No..................... Dated..................................... Q (/ B of Hea lth DATE..............B..'_j ........... FORM 1255 A. M. SULKIN, INC., BOSTON of pRr v�-r�' ` `Fa' y•'o �_, s' s rtc PW a; a ww 1, i Ps t y • � t t t 'r t 1• ��N pF MqS , 76 �� 1 /ZZ92a L /V! g 26 c(a o ORSE' <n: ! j , L i j OA K44G/ e i0���. f Q �� 4i..r 0 rY S37NAt� ,�s LEGEND X 4 _ h �t>z .!. p aiLo X. EXISTING 9POT ELEVATION Ox0 �t�of M�sS CERTIFIED PLOT k PLAN} EXISTING CONTOUR -- 0 qr k s4M7�i� ROBEFi yG L;O T 6 ; FINISHED SPOT .. ELEVATION ( FINISHED .CONTOUR. 0_-- BRU ;ELDRE APPROVED 18OARD •OF HEALTH ls � o4VAAL ;; 5 DATE':. 'AGENT - h t4 ryw•9CALE. / "*. ,gyp' DATIE� •9 /. � DREDGE;ENGINEERING (, /N ,. C'LIENT.�r #. 1 CERTIFY AT TiE EOISTE.RE REAISTVIED ? �. d3bt y JOS Nl�. OUILDINO SF40WN: ON TMIJ,; <�L.A1i _ CIVIL LAND CONRORM$ M:TO TWE ZONING 11Nl� z r= y ,. OR DIY.. � y «� E�OOINEER 9URYEYO � 11'1 OF 9ARNSTASLE, 712 MAIN S.TREfT CH BYs�: � ���;%/ --- --� HYANN'I S,;. MAS8 f. SHEE"f,L F DA E'. _. `REO•: LAND SURVEYOR, '` /VOTF /F E/TNG°R THE SEPT/C TANK OR .,. 20 LEACN/iYG .P/T ARE MORE TN q,,V- /2"dEJ.0$V fRAOE, R4"PIA A4 ETER CONCR�FT,E COi�E.P SWALL 9E ,@RO&4NT TO G/TAGE.�i4N EX7R/� L ,i'PVC CONCRtTL h�EAvy C�1 ST /RON GOi/ER SHALL DE uS46' M/N. P/TCN { C= 14 Z,?. COYERS �' /F/N GR1 vz—WA r a P% M/N. lo, G"O/VCRL�TE E A _ *MADE Cc� I�ER CG EAN .SANG BAC.+C�/LL F � o LEYEL 4. F 4 CAST - - AY 9 /RON.P/PE :: f DO Dt G.4L. . • . •• • '• o q�L i MIN,o/TtN ': e • • s e WASHED,SMNE % Poo, SEPTIC TANK B X. o �' ' e • . • .° o:' , aa o�e • e DEFT: ,° /o o n WASNE0 STONE 0 0 P aAl : • • • • • • ° • • b p RECAST SEEfMGE TY � a, o PIT DR EQU/V.p/NiCRT LLE✓AT/GNS PIT ceP� G_C . 4 4., `T/,o '. MIJAZ T AT.Ol//L.DIVE. C( FT. G fT D/AM. a-//1FLET f�T O/�4JN.• SFETr10lJLAT10N� dUTLET SEPTIC TiiNK;.:.. FT..: D/$TR/B//T/ON BOX 91 )IT` GROuNO N�fiTER TAa1LE SECT/CN 4F, 'S TD/STR/Omr.10N oar Fl.' �. 1:EACN/M4. Q/T g S:a Fr SEwi4GE OISPO�TA t SYSTEM LEACH//VG /T 'T/� W�TIDN P DJMEN DES/6N. SCALE S/ON A 3 l�T 1 . CAI TER/A' ° D♦�/�Hvs/oN • 45, 4 NIJMOER OF SE'DROQ/yS. 3 D/MENS/ON . G F7' lam►i14. sGARaAGEO/SOOSAL elV,)- 14'14E SOIL .GOC T07AL E?7//r%4rEO F'LOK/-3 3 y G.�L DA.Y SOIL TEST'If♦/ : SOIL 7FST 2.' SD/L TEST. V NUMBER OF 4rACNI/VS EL!•Y, 0.4 TE OF SOIL TEST S/.DE LG'ACH/NG PER P/T / S! 55 a PT, r _ RESULTS H//TNESSED 49oTTOM LE�IG'N/NG.PER P/T I i S4- P7`� AERCOLAT/ON RAT&,t/ L c ss /y/wS//IVCN TOTAL LZACH/NG.A qRA b `F'SQ. FT. PWiYCOIAT/O RATE AZ - .Svi3.5 c N r.L RESERVE 4EACN/N6 AREA Zb`j SQ.' FT. 3 r ! Zvii 7_a57' 3l9S m /T p 7 S<F/✓7"tJ _ 'g:h'z s��nJ , t� DF M,�s Sii n/f� sic S�4 /✓Tt1/ 7- At OR, , EL DREDGEAFAI&INACRING CCv/NC. f No.10951•<O Q pF 74t MAIN .3T:,.., 'H,ANNl9. MASS. Sti' `�' 9aF LL FSSIO.NA1:�a� ®; NO GR0V V,*. ;4ri4TER:ENCOC/NTlcRL�O ?'M�f�Eo A( D.ITE c !.3 B • GA v[!Na' L✓aTE�i•'RT�L E1/. z 1 • ,Y JOB /V1D= .85�0 3 SHEE'T it t • No. Fee set THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Ziopool *patent Con.5truction Vermit Application for a Permit to Construct( )Repair(Y✓)Upgrade( )Abandon( ) El Complete System C�Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel � !iv Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ©�fdZ4�1 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( � Other Type of Building !41_ No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Cry gallons per day. Calculated daily flow ® gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 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 t 's and 4 Health. / Signed Date ! ®� Application Approved by Date ' "TsOrO Application Disapproved for the following reasons Permit No. /3 T Date Issued �� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppfication for �Di000l &patent Construction Permit T Application for a Permit to Construct( )Repair(1/)Upgrade( )Abandon( ) ❑Complete System 21 dividual Components Location Address or Lot No. �vfD�a Owner's Name,Address and Tel.No. /s y td Assessor'sMap/Pazcel e Installer's Name,Address,and Tel.No. •/"L Designer's Name,Address and Tel.No. /157 > ?/ d Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( d Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank `;�� �'/S�/�✓� Type of S.A.S. f aiYz 6/S�iy�i fD Description of Soil G N r�J`✓OJalS> 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 t 's and Health. � Signed Date ®0 Application Approved by Date ?ice Application Disapproved for the following reasons Permit No. TF Date Issued 3 '?47" ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CER ,that the On-site Sewage Disposal System Constructed( )Repaired( ✓)Upgraded( ) Abandoned( )by Or d LO CO S at .1�e A/ ac ll9 d 11 el*d 746,11 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2AVId -f dated 317 7 Installer Designer __ A_ 'A The issuance of pent s j of be construed as a guarantee that th��sy�� ywk11 fpu ct on as de`g�}rey.� L 3n, pv Date Inspector / i�! � V l,Pll I "�L��Ifi, �{ --]-�y-��----------------------------------- No. -Z6rl ^ / V­ 1!,21-1 `/J{-Si Fee SaI THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ]Di!5po5ar &p5tent Congtructton Permit Permission is hereby granted to Construct( )Repair(✓)�IJpgrade( )Abandon System located at 13—Z y /-Ve%k1 `®U_111 CD Z 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 thi t. Date: 1-1 p Approved by _ li�i • llb'99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH.-UND APPLICATION FOR A DISPOSAL WORKS CONSTRUCON PEPN[iT (WTrHOL"T DE TI SIGNED PLLNS) L ©��r�''� !/ /��/� �l�iereov cerriiv that the aDphcation `or disposal wor.{s construction permit sinned by me dated '1,01`®e cane--=2 the property located at ✓`Z ✓l'/e�rJ � `✓ Wit. M,"'meets ail of the fcllowing criteria: L/ :he failed system is connected to a:esidenuai swe:ling oniv. :here are ao cemmerc.ai or business es asscciated with the dwelling. • ,he soil is classified as CiASS :and the cercciation rate:s less Shan or equal :o :: minutes Ter mcn. " �" re aere are no wetlands within 100 feet of the c oti rot:esed sec'srsXem fief „ - are no private we.ls within 1:0 feet of:fie propose..set is system �,/7here is ao increase in low and/or chance in-ise:roresed •" i.ter a are no variances r uested or needed �/7he bottom of the proposed leaching facility will tot be located less than Eve feet aboverhe maodmum adjusted groundwater table eievaticn. "Adjust:he 7cundwater able Isin$the Fnmrter ethod when applicable] . • if the S.A.S. will be located with 250 =eet of any vegetated we lands. :he bottom of the prcposec leaching facility will not be located less than fourteen(14) feet above the maxtimurn adiusted groundwater table elL-vadon.- Please complete the following: Aj Top of Ground Surface Elevation(using GIS information) C B)l G.W. Elevation 3 Z =the VAX high G.W. Adjustment. D1FFERE�ICE BETWEEN A and B �, o I SIGNED : DATE: e'�e (Sketch proposed plan of system on back]. q-heal@t folder.nett c I� `. D Q�U t� ovup, W I TOWN OF BARNSTABLE LOCATION SEWAGE # _jgGOd- /3 $ VILLAGE Ca AO i ASSESSOR'S MAP&LOT �� J" INSTALLER'S NAME&PHONE NO. /gs,-�rJr�/i Cows�rwr o•a• y1°$ 8 7,2(o SEPTIC TANK CAPACITY LEACHING FACILITY: (type) Z,4 f rG 1pri 66) (size) NO.OF BEDROOMS y BUILDER 0 0 R .,fva tC PERMITDA : Od COMPLIANCE DATE: S 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 I within 300 feet of leaching facility) _ Feet Furnished by /�C - I _ •off ,,o I O £h