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Home My WebLink About0369 BUMPS RIVER ROAD - Health 369 BUMPS RIVER_A*p,,OSTERVILLE A = 120 141 / � J D a 0 TOWN OF BARNSTABLE LOCATIONI�q l�s .r � SEWAGE # VILLAGE �'<V 1�1`�. _ASSESSOR'S MAP &-LOT l INSTALLER'S NAME&PHONE NO. � .M �' FC SEPTIC TANK CAPACITY ts>< 6 '' Iii LEACHING'FACILITY: (type) � c `"t v�L(size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE:" COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted GroundwatefT.able to the Bottom of Leaching Facility Feet Private-Water Supply Welland 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 W within 300;feet of leaching facility:)' T Feet Furnished by f OAck 6)�'- • fir , a f No. Va Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Migoar *pgtem Cow5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System Individual Components Location Address or Lot No. w_'3( \R — Owner's Name,Address and Tel.No. Assessor's Map/Parcel ��Q — [ 4 dCA0 Gis-,-k Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms :7!1 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 20 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank OKI S XA-) Type of S.A.S. t _X cl—C Description of Soil Nature of Repairs or Alterations(Answer when applicable) L -5-1 pt-I 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 beers issu his Signed'-'- Date 6 Application Approved by Date Application Disapproved for the fo lowin reasons Permit No. Date Issued 3 33- Fee_ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION —TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppYication for �Migpoof *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System �4 ,Individual Components Location Address or Lot No.�3(ac� �Je Owner's:Name,Address and Tel.No. Assessor's Map/Parcel 0 — ' (' G uZ ( 2 1 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) «� ",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 ��K��l]]S_( -A, X)D OA4 k�v V-J Type of S.A.S. Description of Soil cc, Nature of Repairs or Alterations(Answer when applicable) t Date last inspected: Agreement: The undersigned agrees to ensure the cons'truciion 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 ' u d this Signed Application Approved by 1, Date Application Disapproved for the followin reasons f 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(VI� Abandoned( )by I Ank,, D-CiAa:g_,_ at W 4 c1 o has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.Y-__'�33dated- Installer Designer The issuance'of this permit hall nort�be"onstrued as a guarantee that the sys em`will function as des��11'ed. Date �t � Inspector , �;��1.fA .t, �' � r r � + i p v ;�' _ r t 1 —————————————————————— ——————————————-— No. I3 Fee S,�n" THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po5ar *p5tem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade((_)_4kzandon( ) System located at _ v VA _S 4 u � 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 permit. Date: l� - (� - �� Approved by 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I oc� Lei � hereby certify tha t the application for disposal works construction permit signed by me dated to concerning the property located at :I J T(2/e 0 e5. 1, meets all of the following criteria: "• The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system /ZThere are no private wells within 150 feet of the proposed septic system / There is no increase in flow and/or change in use proposed There are no variances requested or needed. clzThe bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable] /•/ If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: /� A) Top of Ground Surface Elevation(using GIS information) of—� B) G.W. Elevation �(� +the MAX. High G.W. Adjustment`�r� _ —7 t DIFFERENCE BETWEEN A and B O SIGNED A DATE: (Sketch propos plan of system on back]. q:health folder,cert f O r j TOWN OF BAnRNNSTABLE �3 LOCATION � �'''L '��`r "�` SEWAGE # VILLAGE U' ,` - ASSESSOR'S MAP &LOT A0 - 1 I INSTALLER'S NAME&PHONE NO. rSL D p C�'at IC SEPTIC TANK CAPACITY G S'T --� I0Q0 GVA Uu: ) E f LEACHING FACILITY: (type) .0 -T- -(size) �y K((Itl G NO.OF BEDROOMS v ! BUILDER OR OWNER rn & al v v�� PERMITDATE: COMPLIANCE DATE: ! Separation Distance Between the: { Maximum Adjusted Groundwater.Table to the Bottom of Leaching Facility Feet C Private Water Supply Well and Leaching Facility (If any wells exist II 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 �� -JV �� No._ .....�.......� F��............. ............. THE CCa4MONWEALTH OF MASSACHUSETTS l BOARD OF HEALTH o, ...............0F........... . . ..5.. ------ a f�r Appliratiou for Dupe.ial Workii T omitrurtiou rprmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: � Z------0''� �Z U . l..L-S.............................. Location-Address or Lot No. - L- h� -V..`6 _______�d.�---- 1......---..may�C►.,�1�.`� �.-'`'�-¢�--------------------------- C3 Address W _ ) w ,-1 -----------------•---------.....- --------------------------------------- ---•••----••••••-•-•---•••••-•--.................-••••-•--•--....... g U................. Install Address QType of Building Size Lot..j. i___________________Sq. feet U Dwelling—No. of Bedrooms............ .._--_.-_____ _ ._--.Expansion Attic ( ) Garbage Grinder ( ) ~ _______________ No. of ersons____._______................ Showers — Cafeteria p., Other—Type of Building _____________ p ( ) ( ) Q' Other fixtu s -----•-----------------•------ W Design Flow...........................................__gallons per person per day. Total daily flow-.-_.._..__�> .0.................gallons. WSeptic Tank—Liquid capacity.1�gallons Length_A` TV... Width................ Diameter---------------- Depth................ x Disposal Trench—No. -------------------- Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No---------(----------- Diameter......1;;------- Depth below inlet........ ........ Total leaching area z�?7!?..sq. ft. Z Other Distribution box ( V1 Dosing tank ( ) '-' Percolation Test Results Performed by----U1P-9wi.Ly...... `?y_oG l�G Date.._........_.'Z6� �.. aTest Pit No. 1---4..Z--__-Minutes per inch Depth of Test Pit......12________. Depth to ground water_./) 1�. ... ( Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... L� -_-----•-----••---------•----------------------------------•----------•-•-------•-------------------------------•••••-•••••---- - -... ----- 0 Description of Soil.......... -----T�_P,�S $. _...4 lam•------ l.N . 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 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. Signed......................... -• ........................................................ Date Application Approved BY .......................... -•-••1 -�---- --•Z••-- A � Date Application Disapproved for the following reasons ----•----•-•-----•-•------------•-•--------------------•---•------------------------•-.--_------------•---_----- •----•••-•-•-••••---••--•-•-•-•--•-•--•---•-•---.--•---. ••--•••---•••----..._•-••••---.....••--•_...-••-....•--•••--••••••••....•------_•-...._..-•----------•--••--•••---------•--•-•-----......-•-_... Date PermitNo......................................................... Issued_....................................................... Date Li: 7,+ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '- • ............. .�.'n:.c�.. � Allp iratiun for Uh4pog al Workp Tomitrurtion Prrutit Application is hereby made for a Permit to Construct (' ) or Repair ( ) an Individual Sewage Disposal System at: .. .......................................................... •-••••-----•-••--.....__._.._....-..------....------------ VM n Jess C� (— / ^��i ��•�7j �"t�(A ti fU N/ ...._..%............................... ...... .........................---..._.._._.........__••__•__- ----------------------.......... ......... �e, Address W Address Type of Building / Size Lot............................Sq. feet v .-, Dwelling—No. of Bedrooms........... .............________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons____________________________ Showers — Cafeteria Otherfi s .............................................. ......................................................... 3 o W Design Flow................ ____________rr__.._._____gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacityl_ -'Q_gallons Length_5_7__._ Width................ Diameter................ Depth................ Disposal Trench—�To_ .................... Widt�___I__.....___._.___ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter._.....0--_-_____ Depth below inlet__..._ ___,___-_ Total leaching areaZ�7'�.__sq. ft. Z Other Distribution box (✓) Dosing tank ( ) '-' Percolation Test Results Performed by._�pctZwi.LK"____N.yy vL IA�JG Date -2 (�.. ��— ,.a Test Pit No. 1----------------minutes per inch Depth of Test Pit..... Depth to ground water.N U r4 Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water...........:____.__.___. ----••--• ••-•__ _ ...-..._•--- ---------- . D Description of Soil__..__.__�_.�_�:_._. lS LJF�- 10l�-- - �2 M D. fJE`' iA /.. ----�---------------------------------------------- .. W ---------------------- U Nature of Repairs or Alterations—Answer when applicable___________________________________________________________________________'................ _. ---- -------------------------------•----..__._.-----._.--.-----------•-----------•........---------------------_..-----•--•- Agreement: The undersigned agrees to install the afor) the provisions of TT�'` edescribed Individual Sewage Disposal System in accordance with �t- , 5 of the State S3h tary 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. VSigned...................................................................................... ....•......................... Date Application Approved BY -------------------------------- �� mate) qs Application Disapproved for the following reasons. ._--........................................................................................................ ---•-----•------•---•----------•-------------•-•------------------•-----.-- -----------._...-----------'----------------------------•-•---._.___......------............•.....--'Date------------- PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..............................................._.__......................._......... 0-11rdifirtttr of Toutpliattrr THIS IS TORTI�Y That the Individual Sewage Disposal System constructed ( ) or Repaired ( )' by ---------------------••••-----••....... nstalle ' Installer at.................� .,h•-... .. I-----•------ --- ----------------------- has been installed in accordance with the provisi is of TI i off`Fhe StatCode as described in the application for Disposal Works Construction Permit No..... �/ ____ dated_.-..-.--- ______________y..___._..__..___.__.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE COWSTRUED AS A`GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................................� ...�-•...... -•----------tall-- Inspector...--rt-lr THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 6?J ...........................................OF............................................................__....................... No......................... FEE........................ Biipouatl Workii notrurtion Errant Permissi(Vi-is hereby granted........................ . .•••--•--••...................................................................................... to Construct�V J"r��air ( ) an Individual Sewag Disposal System at No. ---••-••--••••--....... ----- - - as shown on the ap li tion for Disposal Works Construction Permit No................ aied.......................................... ............. r�'---s-.�-�----------------------------------f---------.------..•.-----------•-------- Board of Health DATE_ - FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Y. SITE PL A lV SNEEr I of 2 SCALE: I".: 40' ti 7 D. P��GA Go+JG 10 lea r~�h�►Z.y E AP�st � � a a _ 12- 41 N r � -4z r r r r 1 r s ' � _.__.._.._......... ...__.. r Li NILLIAM M. r I � WAR>ft U ` No, 19711 I m r9 • FOR REGISTERED LAND SURVEYOR ZONE PLAN REF. el.4k PWTGW ,M DATE BENCH MARK DATUM LJ&A WM. ,M.. WARW/CK d ASSOC., INC. DOMESTIC WATER -,SOURCE To v-/t-J 1N r V—O a ROX SO/ - ' NOR TN FA MOUTH FLOOD ZONE. 0 o u MASS. 02556 - (6/7) 563 -26 38 L£/)CLING BASIN SECTION NOT TO SCALE ';hecsl 2 mT Z -- _ - �24' - - - 'C.1.MlI COV ER 1� Ah'TN�F/L�' -. BR/CA' AND MORTAR COURSES AS,RE0'0• TO BRING COVER TO GRADE _ R„.ram_, , _.. FLOW LINE \ „ �. / �_ _ __ _ __, 2- F✓�„ WASHED PEA STONE FREE Of IRONS, /NI ET FINES AND DUST /N PLACE 3/4' TD I%"WASHED CRUSHED STONE FREE OF 1 I �! OPENING WITH 4% , � 9 IRONS, FINES AND DUST /N PLACE 7 I OUTER DIAMETER AND l3/q„ INSIDE DIAMETER I. CONCRETE TO BE 4000 PSI 28 DAYS 2. REINFORCED WITH 6"x6" NO. 6 GA. W.W.M. d 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS q,0„ �--- Z' - ----6'0" �—Z�--{ 4. NUMBER OF PITS REQUIRED ^� MIN. I o EFFECT/V£ 0/AMETEK NOTE: EXCAVATE TO ELEVATION Z1. O OR �—E—' (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOV A— LL '�- WATER TABLE LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYP/CAL PROF/LE GRAVEL TO DESIGNED GRADE. f- - -43 y IB"STD. LT. W6T. C.1.MH COVER %/NN66 E 4"B/7 F/B£R P/PEOUTLET LEVELTIGHT JOINTDWELFLOW LINE TO F/RST ✓0/NT : 701 14" 37 5� �� 1 i u Igo 1 10 C.I. TEE 37�� i100g 00111i STD. PRECAST CONC. �J7 QIST�. BOX TO BE OU ' 'f 0 00 O 0 0 1 i i . GAL.SEPTIC TAN INS AT LUD ON LEVEL 11000 O 0 0 1 I I ',. ii1000 OOo,1i � STABLE BASE 1 100 00 I 1 i 1 coo 0 00 1 1 i ASEPTIC TANK TO BE 1 , � INSM470 Ok LEYt4, `. f 100 O 0 e STABLE BASE. 1 0 0 0 0 � i ► 000 O011ii LEACHING BAS/N , Ito 0 O 0 0 0 1 1 , BASE TO BE LEVEL 1 11 80 O 1 I , ELfrV• SOIL AND PERC. DATA PERC. RATE �� MIN. /IN. TEST PIT NO. I TEST PIT NO. 2 � 0 TEST BY WITNESSED. BY °� G� I��f�D �' M I;D1 U►�/� I fv� TEST PIT GR. EL. 21 DATE: ti O. 4$Z W D WA.T 01�- Z7 O DESIGN DATA GENERA NOTES + BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL SEPTIC TANK,DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL'�""'GPD. PRECAST REINFORCED CONCRETE UNITS, SEPTIC TANK Loon GAL. ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, SIDEWALL AREAL2 GAL./SQ.FT. MINIMUM REQUIREMENT$ FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA I•a ' GAL./SQ,FT. SANITARY. SEWAGE EFFECTIVE ON JULY 1 , 1977. LEACHING REQUIRED 172' I SQ..FT.. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING APFA OF HEALTH. Zb .v Q,FT. , AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. 1 PITCH ALL SEWER LINES 1/4� / FT. UNLESS INDICATED OTHERWISE. j"OF T SEWA ' ®l SPOSA L SYSTEM cif MARTIN E. ��`� IrOR� L�I�l'�L.� �o L L•o�5 MORAN i I.or 13 010 m 1p 5 1z 1 y iz rz v A,T7 a, #23417 G "—••— , ' �rG/�„0 v I LL 1 M A SCALE AS lND/GATED DATE WAI, At -MARWICK 8 ASSOC., I NC. ®OX 801 - •NORTM fAd MOUTH ` MASS. MM - <6I11 56,3 -?6.38 PROFESSIONAL ENGINEER