HomeMy WebLinkAbout0114 BAY STREET - Health 1ti14 BAY STREET
Osterville
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THE COMMONWEALTH OF MASSACHUSETTS-
BOARD OF F H ALTH
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ovaxl le*
ApplirFatiou for Di-4pas al Works Tnntitrnrtinn rnmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
,System at:
1�.G? 'A'_..._ • ...... -- --------•--••......... .......•--------------...........----....-- ------._......-------......-----------
Location-A res or Lot No.
-•-- --•- •• - . •-_..
..........7---------- . ..=�---------------=----------•-------
wn Address
a -• ............... --
..•---•--••---�.=
� nstalle Address q -�-'
Ty�of Building Size Lot_____!(0_.a, Sq—feet
Dwelling—No. of Bedrooms.......... ..............................
__________ _______________Expansion Attic ( ) Garbage Grinder ( }
aOther—Type of Building ____________________________ No. of persons...... !................ Showers ( ) — Cafeteria ( )
Otherfixtures . ------------•----------------•---------------------------------------------------------------------------------------•--••--------
W Design Flow............ r- �_____________________gallons per person per day. Total daily flow...3�_(_ .........................gal ons.
W Septic Tank—Liquid capacit} {_OnOgallons Length_T_Lo" hD 1
.___. Widt '_ -. Diameter________________ Depth_ _ u-
x Disposal Trench—No. ..................... Width..................... Total Length.................... Total leaching area....................sq. ft.
Diameter__..___�__':_. Depth below inlet__��__�_ ". Total chin area._ ft.
Seepage Pit No �,d�`�,.u xe
� ------------- P •-• .1e�a g �------.._.sq.
Z Other Distribution box ( ✓) Dosing tank ( ) J 1 =_�075
'-' Percolation Test Results Performed,4141 --- � -!fit -- ----- ----- DateL.Q f:`��.-��- -______--
W ._
Test Pit No. l.__. _..____minutes per ineli.w�epth of Test Pit__ ".______ Dept to ground water...U3Z.
44 Test Pit No. 2................minutes per inch Depth of Test Pit...................... Depth to ground water_____-__________________
P4 _ ............ -
Description of Soil = - u----- �L_:_4__�u—bao .-l•-----------------------------------•-------------•------------------------------------.......---
------------...........----- • ------
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 iITL 1E 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.
Signed...................................................................................... ..........................--....
Application Approved By------------- --•----. _�__ ':-__�Z. _.
--------------------------------- Date
Application Disapproved for the following reasons:------•-------••---------------------------------------•------•---------------------...----------•---...._-•--•-
'10 Date
PermitNo......................................................... Issued_.......................................................
Date
�
THE
/ COMMONWEALTH -'---'--- '- |
BOAR OF HfEALTH |
' }
�
liration for
asal Works
amit
~/ - ' ' Tonstrurtion
~
~
« / is hereby made for u Pero/it to Construct (°~) or Repair ( ) an Individual Sewage Disposal
System at*
dre orLot� U Or
tllr
No
WInsa- ex A""r " -ize
[)welling--No of Bedrooms---'-�=!............................ ( ) Garbage Grinder ( )
04 Other—Typeof Building ------------- No. of persons--'�c2................. Showers ( ) _- Cafeteria ( )
~� Other -__---_-_------_-'-__'_- -' '
* Septic Tank—Liquid-capacity.k.O.VQgallons Length.S.10 Width'.'!.*.'1..Q.'�.. Diameter................
Disposal Trench--YJo..................... ---' Iotal LeoQth- Total leaching area....................sq. b. |
Seepage Pb Nu-''�_-.---. Dianocter)."3'JX-.-' Depth below Z-\-1....sq. ft.
z Other Distribution box (v') D r - /o /��
~+ ` ' - ". .
Percolation Test Results Performed b,(.'K c 0' � i\C_ JOIN
14
Test Pit�,I�"o. I....�12........minutes per inch tepth of Test Rit..IA4......... D
�
0 .
-_--_-----_-__-_----_'----_-_---_-'--'------------------_--'-----_-'------------------_'___ �
''g'-_'_-'.
The undersigned agrees to install the uforedeocribe6 Individual Sewage Disposal System ioaccordance with
|
the provisions of TAITlE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in �
operation until u Certificate of Compliance has been issued bv the board ofhealth.
Signed...................................................................................... ________________
Date
nApproved 8y'----' -�.�' ----------------'- --'9-c'����=.��'�c--
- Date
Application Disapproved for the following reasons:...............................................................................................................
_
------------'-----------------'-----'---'----'-----------------------------------------'----------
W 3 _ -��/� DatePeroitNo.--���--'-��-° ~
.... �suedL.........................
{
\ THE oomwomvvsALrH OF MAss*o*ussrrs Date
`
' BOARD OF HEALTH
-�� -----'OF......
� ~��
` Tntifiratr �� Tompliattre
'.RT Y Th- he Ind,*vidual Sewage Disposal System constructed or Repaired>�'
Installer
has been instilled in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the
THE ISSUANCE OF THIS.CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL Fwnnv°xuOxn SAom»Fx«CoOmx.
DATE...........................1����1��-�'�-------------_ ......................................................
_ \J
.�
THE oowMomvvsAcrH or mASsAcxussrrs
�
BOARD OF HEALTH
[�0 ' c��/� --�/���/�t�------��F-� -'---_-___--
m � "~ . . �
� to ---_--_' ` ' or Repair
Street
uo shown oothe application for Disposal Works
Board of Health
' `
� FORM /ums xoeas * WARREN, INC.. puBuoxEnS
�
P—TT32LJHDA22AM --',0 I+T—IA7JVkIMONANIO:D 3HT
HTJA3H 90 091A081
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........................... ba-Isk I ....... ........oz firri-it)CI rlol;j-)tro,fTOD 1p,G-oqaiCl -iol noilnilqqr, -xli ric, fiwode as
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@RIfia3-IEU9 ,JDW 143R'AAW A i3r.]ROH FEISI MRO-i
t - r TOWN OF BARNSTABLE
LOCATION � SEWAGE #98 -'O
o/
VILLAGE O��'' /Q(J j �� ASSESSOR'S MAP 6t LOT 07 OZ
INSTALLER'S NAME & PHONE NO. cs�
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size) 3
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER �0
DATE PERMIT ISSUED:��`��� '
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No ��
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TOWN OF BARNST --ABLE
LOCATION nj. f SEWAGE #98 `._ 00(
VILLAGE ASSESSOR'S MAP-& LOT ) )7 02
INSTALLER'S NAME &.PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type)I f/, ;. , (sue) 3
` NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATERS,�l,
BUILDER OR OWNER �� �� � �
DATE PERMIT ISSUED:�� � "
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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LfYA'n^iY'Ans:.e.riwwEsv+'•ro.•:rewwmea*v-u•.....s,r'.w.s.na.+cm..�,-._.bm+n+ _.. ..__........_.....� .,.._.....,_
i S YS TEM PROFILE
NOT TO SCALE
TOP FDN. / 4 FINISH GRADE OVER
FINISH GRADE
EL . .o:.ee,.a: FINISH GRADE OVER DIST. BOX 2, , " FINISH GRADE OVER
�. SEPTIC TANK �,2 .S' LEACHING PIT
D.'
MAX.
3" OF 1/8" — 1/2" 12" MAX
b'°.e.�,e .e:`;'o.:p :e. d:e:•�.:e: d•s�l:e °O
o:a: PRECAST CONC. OR
SHED PEA STONE
. Q=j ~a'•
BRICK & MORTAR
TO 12" BELOW GRADE
3" e _ OUTLET PIPE LEVEL
t
FOR 2 FT. MIN.
� e:.o.,'0 . . • 4 Oe..O:O���jt' .o..O: .e ••o O Q;p• 2�
i `•�:• 'd. /o,OC7 :0 :o �• /...,7•�' q�. •O::i!,:e.3„•p..,i •pO 008..0 p:0: .o N w • by •�• Q.e p0.p
;.00 :o C. I. OR PVC TEES
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o: D• :.o
e•
GALLON
o..o•'.•. � o 0 0_ ON '
a -: DIS TRIBU TION BOX
INSTALL ON LEVEL BASE
3/4 TO 1-1/2
o PRECA S T CONCRETE a WASHED PRECA S T
Q,•a,.0•,'0•:0'•'•• A f ice_/ o REINFORCED o
CRUSHED CONCRETE y .�
a:
.0 :O' •o' 0 Q:o::: « e•.p•b;p•,•Q•:�•..p.'A. ...::.j:'6 'O.•b o•:o: STONE
H--2 4 REINF. _ }
T NK
A
I
.-SEPTIC
INSTALL ON LEVEL BASE NOTE: EXCA VA TE TO ELEV. ?a OR
LOWER TO REMOVE ALL IMPERVIOUS
MA TERIA L BENEA TH THE L EA CHING AREA
REPLACE EXCA VA TED MA TERIAL WI TH
CLEAN, CLAY FREE SAND -!
s si'
GENERAL NOTES
LEACHING. A � /- ,C- Y
1. A L L EL EVA TIONS SHOWN: ARE BASED ON 14 .55 U M f
INSTALL ON LEVEL BASE _
2. AL L PIPES IN THE SYSTEM MUST BE CAST IRON
OR SCHEDULE 40 PVC. OBSER VA TION PIT ;.
THE -BO"RD�.OF ".�lL TH,. MUS '.BE NO TIFIED
WHEN: CONSTRUCTION IS COMPLETE ETE PRIOR
TO BACKFIL L ING PERCOLA TICN RATE:
4.- ANY CHANGES IN THIS PLAN MUST BE APPROVED
2 MIN./IN.
B Y THE BOARD OF HEAL TH AND CAPE 6 ISL ANDS Ni TNESSED B Y.'" "
SURVEYING CO., INC.
5. MA TERIAL S AND �'NSTAL LA TION SHALL BE IN �•, BRD. OF HEALTH DESIGN DA TA
COMPL IANCE WI T14. THE STA TE SA NI TARY
CODE TITLE V�- AND LOCAL APPLICABLE DATE.'
RULES AND REGUi.4 TIONS
NUMBER OF BEDROOMS
6. NORTH ARROW IS FROM RECORD PLANS AND
0 9� g r�s_'` IS NOT TO BE �USEO FOR SOLAR PURPOSES T° " r GA RBA GE DISPOSAL N
7. FL DOD HAZARD zhlVE .ram s b d , DA IL Y FLOW . c� GAL .
8. WA TER SUPPLY ! -T'o,�„ ���g �6 SEPTIC TA NK REO D. o 0 o GAL .
SEPTIC TANK PROVIDED io o c� GAL .
Mid
LEACHING REG�UIRED GPD.
SIOEWAL L AREA
S. F.
S.F:X 2, s" G/S. F.' 3a.�'GPD
BOTTOM AREA = ''� S. F.
i a - LEGEND �� S.F.X a G/S.F. = 8f GPD
i�2� __ __ z a LEACHING PROVIDED 'tea 9 GPD
o— ,
PROPOSED ELEVA TION 'yy"
i000 GALLON EXISTING CONTOUR'
—PRECAST CONCRETE
SYSTEM UPGRADE
° SEPTIC TANK OBSERVd TION PIT ;
h r
O DS TRIBUTION BOX
ZO
rm
�� PROPOSED SEW GE DISPOSAL � S YS TEM �
-7 OOO LEACHING PIT �i
llo. 2"ss^A» PREPARED FOR
o -o SEPTIC TANK F�SfoNAL ��G DA VID di PHYL L IS COL E
ti
LOT A BAY S TREE T
(RP) RESERVE
i
S TA BL E—MA SS
� •_� OS TER VIL L E—BA
1 G' _c
moo,c o PIPE INVERT EL EVA TION �'�� �
U SANICKI
28085 DA TE: .S�,-f 19, /94fe
CAPE G ISLANDS SURVEYING, INC.
STEa�`�
PLOT PLAN / SCALE AS NOTED P. O. BOX 334
SCALE* 1 ''a
MAP SEC PCL LOT HSE " ?, PLAN NO. s l e e& TEA TICKET, MASS.
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