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HomeMy WebLinkAbout0034 MELBOURNE ROAD - Health 34 Melbourne Rd � 268-235 Hyannis i ASSESSORS MAP NO. �- No.....1J...Y166 PARCEL NO:�� �� F�$.. �C ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Mupouttl Ourkii Towitrinrtion f rrunit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: e ...3Y---1+!lf4 c�.,lnl. '..1G'�.�4 =............................... Location-Address or Loot No. Ftt1N_ -•------------------------- tJl d?_L'tJhsr.d /Soo Owner 4 Addre W I alter Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.............. ..........--...--.......Expansion Attic ( ) Garbage Grinder (jVn) Other—Type of Building ------------ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) G4 Other fixtures ................ ............. gallons per person per day. Total daily flow....------- ..................... tons. W Design Flow--------•--ll.�-.........................g P P P Y• Y - � WSeptic Tank—Liquid capacity. Vv_Qgallons Length---------------- 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 ( ) aPercolation Test Results Performed bY........................................................................... Date........................................ a Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.-_------.--------- Depth to ground water........................ 9 •--••-•------••-------------•---•---............--•-•----•-•----.................................---......................................................... 0 Description of Soil....................................................................................................................................................................... W U -•-•••••-------------------••---------....-••-•-......-•••-•--••-•-•••-•• ••-••••••-----------------------------------•-•-......--•--••--•-----•-•••--••••••---- ...................................... ..............................................--.........---------••--•------•--------------••--••----•......------------------...--------•---..........-•--•---..... f U Nature of Repairs or Alterations—Answer when ap ilicable..... a1S101(.L-----P-gU4s1.C.......0 --------------- 1 p tp. ,a4... �.,� vaka.....;02.%1 ..80x....................................... ...................... 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 board of health.,. Signed ........�� C g ... ................ ... B `� /--------_� q _ Application Approved BY ------- -- ...... ----- ..` G..S Application Disapproved for the following reasons: . .............................. ..... . ......... . .................... ......................-- ........................................ PermitNo. �...6 .... Ll------------------- Issued ............................---------------------------D�-------- Dace TOWN OF BARNSTABLE � e LOCATION y �1�� Q nrl ct�tsE /�oA SEWAGE # 9S �G6 VILLAGE �3 —!T ,• l r/�c�7' ASSESSOR'S MAP & LOTZ-6'PLY INSTALLER'S NAME&PHONE NO. C ��t s s�r�l r� 'jrl b'—O VW GKr at.JC' SEPTIC TANK CAPACITY 2 SjrS LEACHING FACILITY: (type) ,AST' (size) /o o o G C..o NO.OF BEDROOMS 3 BUILDER OR OWNER KFo-) 0, 5 ` PERMTTDATE: 410 !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 e YJss oao/ �i► 4 z op �Zz a-x q I THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH \- TOWN OF BARNSTABLE ,���lirtt#i�an �nr 3�i��n�tt1 Arlt� Cna�$t�#rnr#iun �CPrnti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...: `! ►Ul _ nsl� .t...1E� s,_3 sT_;J,/ A........... __. .... Location- \ddress / or Loot No./ / r .......'iCl_A-�1�-8- �-4-•--•---------------------- ?i y Y n h_L k 7 n.1.Q^I Lw ..1�rr A c 7 ht�!,A MA* a � 1 Owner Address ........'.........'..-'..'.............. .c .. —^ ' AJ� ... ...._..... .. JA� Z.X Jt........ ................ �I�staller Address yam, d Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms---------------- .----Expansion Attic ( ) Garbage Grinder (K/G) PL, Other—T e of Building n No. of persons---------------------------- Showers — Cafeteria at Other fixtures ---------------- -------------- - - W Design Flow....-�,.._/./o..........................gallons per person per day. Total daily flow............Z..1...................--gallons. WSeptic Tank—Liquid capacity-_ho_12-gallons Length----.--..--_-- 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 ( ) aPercolation Test Results Performed bY-------_.................................................... ........... Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit--.................. Depth to ground water........................ 94 ----------------------------------------------------------- •-------------------- ...... ......-------•-------------------------------------- . ........... ..... 0 Description of Soil.....................------•--•-•-'••"---•"•-•-•--•---------•-•-----•---'--------------------------------•-------'--------------•--"•.--•...........•-----------'--- x V W UNature of Repairs or Alterations—Answer when applicable.---T _)_->7A�_/___.•___Q ,•SA_,1 _-- ,� �__4_______________ k�, 2....r LEA_C ("6 ... __VC7.V—C.. �t....AI&I'~t... � ,5(-8'_c. ......... 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 the board of health. ,.3 0 Signed ........ C-_�_,,� .�� - .�.::,�,._..a�.:... ............................ 9 Dac- � Application Approved BY .:.. ' - - ---------------------------------------------------------------�--- ....3'-" "` ��� v Dale Application Disapproved for the following rearon.r: -----------------------................................................................................................................. --------------------------------------------------------------------------------------------------------------------------. ......----------------------------------------------- ........................................ Da. PermitNo. --------------- Issued .................:...................................... ....... Daze --------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ` Tertifi ate of CTlumplia lace ti THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired e by ------------------------------------------------__---------- -------------- ----------.( ..C',.. t. ,�I1;�1- -.... Instiller f at ...- .�j�.....h<1.. . .. r) t1�� _4-------------..g':5?"-------�;��!,,.I t.t., .. -- - " ''..... has 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. "'_R� .............. dated ......................................... .... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ' -------------------------------------------------- I ' 'DATE ......................................................; �; -v � .�Inspeaor .... -- _l. ' C7 ------------------------------------------------- ----------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Uispnittl Worbi Tnni#rnr#inn rami# Permission is hereby granted--------------------------------B`"-C= S[�:,:1. -----------------_------- ------------------•------------------•-•--- to Construct ( ) or Repair (V) an Individual Sewage Disposal System at No................................................. . .a C rsL r A�.1F_..-.; o �L------------1.A_I4�ST Street p as shown on the application for Disposal Works Construction Permit Dated---.._��-, ...... — ------------------------------------------------------------- - �a DATE---------.�.--....�.�!.!�....----•------------------------------•- .-- Board of Health FORM 3650a HOBBS 6 WARREN,INC.,PUBLISHERS TOWN OF BARNSTABLE LWATION � 1L149'Z ,6 a Q,,AJJE ik 0 4 d SEWAGE # VILLAGE IA)E:= ASSESSOR'S MAP& LOTSY-23 INSTALLER'S NAME&PHONE NO. C . t 1-51-i:dC rjrl E D Cxi wlzo SEPTIC TANK CAPACITY LEACHING FACILITY: (type) JM&r,,-*5r (size) do®o IC44 NO.OF BEDROOMS BUILDER OR OWNER IM"sLIA PERMITDATE: 430-%� COMPLIANCE DATE: 3 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 4AID 1-11, % .\3 \4 cn C � � o tj cli 1 �° N ��� g ac V"dNk c y N � IM c � c t W W at a ' W. W. r` IQi _, h me z O w dG /)2��� ;. `� � - a - � �$ 1 . �. z,' . — >> '�: � � � � o � � ' � �- � � `� -' . � � �� p _ � s�.- �:_ .�. . .. - '�3k. t �:. � 4' L THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH /..� � . .....-•-------.OF......��u "S 7_4-bl- . ppliration for Disposal Works Tons rn.rtiun rnmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: � ._. -• �... • --.. �. �...,a!!/'cc........Z�.... ...�j��`/7�� ............................ ........ ..' ' '� _ ......... ............ Lo ation-Address or Lot No. .1. .._. ....----•-----•................... G� ¢l rr. /Z.n.....r��.....�.........�t.:"j.r� f Address W Installer Address Type of Building Size Lot../!�__�_c 42---____-Sq. feet Dwelling—No. of Bedrooms........... ............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria Pa Other fixtures --------•---------•---•-••--••-• - w Design Flow..•.._....�6.........................gallons per person per day. Total daily flow---------- ......................gallons. W Septic Tank—Liquid capacity/.(�E14,Lgallons Length._ _ _,�.__ Width___tl`,�..._ Diameter________________ Depth.._V x Disposal Trench—N . .................... Width.................... Total Length........ _ Total leaching area....................sq. ft. Seepage Pit No........ ......... Diameter....___���__..._. Depth below inlet_.___._ ........ Total leaching area..90.�_..sq. ft. '—' PercolaZ Other tion Distribution Results ) Performed bsintank ( --PAC, = Y ._.fit._ Pra't_ _._.... /rr 7' a ----------- Date-- ,� Test Pit No. 1------/--------minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-•-------••-------•------•-•----...--•-•--••---....---•-----••-.......--•--••-----...._--•--•......-•-•--------••.............•----•••.............------•-- ODescription of Soil.------- t yf= k t.4 . .---......-•-----••--------------------------------------------------------------------------------•----------. x 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 TITLF, 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ------............................................................................... -•-- --------- --------------- ApplicationApproved By... ------ --•-•-••--•••••••._....------•-----....--•--•---......-•---•-•--•-•----•--• �. Y� D e Application Disapproved for f wing reasons:................................................................................................................ ..--------•------------•-----•------•---•-•-•.......•-----•..----••••-•--....-----•--- Date PermitNo.......................................................... Issued_..................- ..----•--•---.......---•-•-•-•- Date � -� -- - - Iti :...... .. Fx$.............. ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _7;�WA.....................OF.... �::E S. 7'a-�!/ Appliration for Disposal Works Tonstrnrtinn jhrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -- - . _....... ... 7.------..Vr/ !t&....... ... % 71.. ........../.' IfjS......................................... L cation-Address or Lot No a _° - � . " . d y,rSTr A/ ---•--•-•------••----------------------- • _... - • • --. ..... .-- Owne Address a ...................................... Installer Address UType of Building 0 Size ---------Sq. feet Dwelling—No. of Bedrooms..........0`.'.'-----•_-----------•--•-----.-Expansion Attic ( ) Garbage Grinder ( ) 9k Other—Type of Building ...._ No. of ersons......................... Showers a YP g ---------------•------- P --- ( ) — Cafeteria ( ) d Other fixtures ------•--- W Design Flow......... •_ .i�`�............. .._--gallons per person per day. Total d i1 fl . gallons WSeptic Tank—Liquid capacit Q -•-gallons Length. „j.... Width--.. --- Diameter-------------_ Depth.-!�--- x Disposal Trench—No..................... Width.................... Total Length........,f_�. ___..._ Total.leaching area...._._..._._: _.__sq. ft. Seepage Pit No........�.......... Diameter......&....... Depth below inlet........ Total leaching area-'40 .___sq. ft. Z Other Distribution box ( ) Dosinjtank� ) - '-' Percolation Test Results Performed b .- . ! •? � a Y -------- -�-�J`-� !--��--•--------------------------- Date--P� ----- .....-7..-----•----- a Test Pit No. 1.....)--------minutes per inch Depth of Test.Pit.................... Depth to ground water:-:--..----------------. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' -----•.---- --•---••------ ----- ------ ------ • -----. -... -. --. D Description of Soil........C�-e lr............9 --------------••-•--------•-•-•-•-•• - .-----•---- ---•----------- 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. id --•--------------•--•--..............--------.--- A . �. Application Approved By.. . ...... --------------------•-----••-••----•-•-----------••-••-..._.....------ _?, ••-------- Date Application Disapproved for he owing reasons----------------------------•---•----•------------------------•------------------•-----•---------.... - ------------------------------------------•-----•--•---------...----------------•-----........-------••-----------.........---------------------•----------------------------------------------...--•-•- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.............................................*. .............................. �ntifiratr of Toutplitrr THh �Tj CERTIFY, That the Individual Sewage D' osal System constructed or Repaired ( ) // Y ----- ------------------ b s 1A 1 has been installed in accordance with the provisions of T m 5 he State Sanitary Code as described in the application for Disposal Works Construction Permit No. ". ......._... dated..............:................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU AS A GUARANTEE THAT THE SYSTEM WII.JilCT10N SATISFACTORY. DATE..... 1111Z4.......................................------------- Inspector--• •. --•-•--••-•••••••-••--------•---•---•----•-------••-..---••------......•. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L ....................OF............................... ' . No .... /.. FEE. 11.. ............. �rk� ��an,��rttr�ilan rrnti� Permission pis-b'eby granted ` . to Constru _r� it ( ")f n I *ndual Sewage Disposal Sysidn atNo. f� ------------------------------ ----•--- ,.,.�,,.—Street re as shown on the application for Disposal Works Construction Permit No.-_-. __ ,...�..__ Dated.......................................... ..................... .� �.1- f DATE..- Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON pM i r7 4. 4_:..• ,. }> _ . .. - �, • -i•• F.., - .. . '�.• r � ,t� 'Y �,,,'; .,,�t' 2• c: �. t It _y .ow e�. ,. t• } ON 2 r 'SEWAGE ,- I ��' � � .v•j — L©+ I/ ' PIT' S C TANK. 'D BOX - - LEACH - � TOP o� c � .,2"OF:lsTo,h.. WASHED STONE r f IN- OUT 1N. �TIN- 0 ��• A� JL (OO O.{---u T—�. - �G$:OO 2 SEPTICG ELEV. Z7 5 TANK Z'?.O ZCo,'30 ELEV. ELEV. G} Q r { ELEV. ' 22.3� Q � ' ELEV. ELEV. �' Jti. ELEV. Z-- --ro/— *F-^►�� Otic p OF 314 .-142" nth / .1- WASHED STONE df(a 24 Y x, rr,i r, J �k,�t Peo P, TEST HOLE-LOG �fn 2 BED 2�O TEST BYfop fed, -a TEST T ^`- :I p $ WITNESS u ? ' Q " ^L1I �+.. 3f3.0 v s OA E Z. BEDROOM HOUSE Z '' 0 IN DESIGN TA. # 1 29 3 T.H 0 2 \ h. ELEV. ELEV. NO Z� S PERC RATE '� MIN/IN. DISPOSER DISPOSER Q Y�� ` A� S 10 FLOW RATE (GAL./DAY) 2Zo — SEPTIC TQADK2o A IS - ocoa -'LLI h � / SEPTC TANK SIZE �--"` t�• �' LEACH FACILITY /Yv� fi�,a Y SIDE WALL lo��{) = 125. (2.5► 314.3 G/D. �a BOTTOM 102 - 8.' ( 1,©) '78.5 G/D. A ' I f` I / t--OT6. 3r7.�' TOTAL 2_s 1 Ifa � 15.3 USE: oNE LEACHING PIT s 3 tl' ,Lg n O ,WATER ENCOUNTERED , #'•'�;� � � r =r (/ _4 2 NOTES: (UNLESS OTHERWISE NOTED) 0 Lo+ 3G� 1. DATUM (MSLJ+TAKEN FROM .__HYR!•`?�1§i_.•._....QVADRANGLE MAP , / I �.� 2.MUNICIPAL WATER � __•_•______ -__AVAILABLE 3. PIPE PITCH: �l+"QER f00T O - .tts�.�� �,�n _. ��N Of B.M. -hcp of � r] 4. DESIGN LOADYNG FOR A.LL PRE-CAST UNITS: AASHO- { -44 •tt� �* .� '9�' oM surmP'0,j Gl.=,qO.QO 5. MIM.GRIaUND COVER OVER ALL SEWAGE FACIL.lTii S: (1) FT, ' mob. ARNE N. G 0 ARNE �,! -� DISTANCE ASCERTIFIEQ 6. PIPE JOINTS SHALL BE MADE WATER TIGHT r flJALA `� 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. cO.a CIVIL a OJALA I HEREBY CERTIFY THAT THE BUILDING SITE PLAN STATE ENVIRONMENTAL CODE TITLE 5 No.30792 #2f 4 SHOWN ON THIS PLAN IS LOCATED ON THE , 111 Q GROUND AS SHOWN HEREON&THAT.IT. - LOCUS: Q� CONFORM TO THEZONING BY t AWS.OF'THE REG. y -- TOWN OF HYR , GINEER WHEN CONSTRUCTED. -DATE REF: .c>�" down ctlpe enginring . ,10 PREPARED FOR: '1�1 CIVIL ENGINEERS L BOARD OF HEALTH AND SURVEYOR'S • CONTOURS (Ex,ST,NG):----•-----•- REG. LAND SURVEYOR' _ . -(PROPOSED)—O—O---O—O--� APPROVED• DATE� MA � Yarmouth&1 WAALE { 20 • SC DATE 84 fit{'