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Home My WebLink About0383 OLD MILL ROAD - Health .-yh-� , TOWN OF BARNSTABLE lor LOCATION Hof �j 383 Q la '►�I L�1 K.j SEWAGE # Pil ^ �I ILLAGE_0�'�,JZVj lIF_ ASSESSOR'S MAP LOT STALLER'S NAME PHONE NO. 1�En�S T, cell bq- SEPTIC TANK CAPACITY ISO O LEACHING FACILITY:(type) LE#Ck p °� (�, (size) i (�® QAl 0, NO. OF BEDROOMS- P L OR PUBLIC WATER �I o Bi4i� OR OWNER Coi b4 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ` VARIANCE GRANTED: Yes No 1 w.� F ` / p.F ASSESSORS MAP NO: j `' ' PARCEL NO: THE COMMONWEALTH OF MASSACHUSETTS ' BOAR® OF HEALTH Appliration for Dispao al Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct (V5 or Repair ( ) an Individual Sewage Disposal System at: .... --:.._ ............... /, r�ocation ddr's t o. �/ 'h�t p-= a.l �.C?._.._..__ i ---- fit..` r��o " riez ` A ss Installer Address Type of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms______________ ________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other. fixtures --------------------------------------•--•--•-•-•=......................................................................... W Design Flow.............................................gallons per person per day. Total daily flow.............................................gallons. 9 Septic Tank—Liquid'capacity)_�2Z)Ogallons Length.................Width................ Diameter__-____._______- Depth_:.:__:_........ , Disposal Trench—No. ____ `Width____._.._._.__._._._ Total Length.................... Total leaching area.....................sq. ft. :!` �OO�. Diameter::__.._?.____.___ Depth below inlet_.__.._......._. Total leaching area__________________sq. ft.Seepage Pit Nof�_ z Other Distribution box (tom' Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................... aTest Pit No. 1________________minutes per inch Depth of Test Pit-.................. Depth to ground water...............:........ Test Pit No. 2................minutes per inch Depth of Test Pit.....................Depth to ground water........................ .............................................................._. O Description of Soil-=---5,4•n D------ �-!••------ ( 1� ..............................................................................................- , x V = ....--•-- ••......................:......••-•••-- - ----••- o'l-�l� U Nature of Repairs or Alterations—Answer when applicable_ _____________�.__.-_____-_--_______-______--_______:___a-______:_____________-_______- .......................---=•---•-------------------•------•---•------------------------..._._.....----•---.._..---------------------------------------•-------------------------------- ......... ,Agreement: ` The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of ii i 1E 5 of the.-,State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h een issued by t boa�hrh. r: L Signed--- - 7 r„ Date , .._ Applicat-ion Approved By..........0*-�----.a - -----•-------------------------•------- Date Application Disapproved for the following reasons: =-----•-......:---- ----••----•-----------------••---•--------•..------••------------•-----•--...-------------•--------------.._....__....--•---------------------•--------------------------------------•-•---••-------•-•- Date r PermitNo......$_?..:....K--1-5---------•--------._.. Issued-........................................ ----------- Date No.. FEs.7.. ..�... " ... THE COMMONWEALTH OF MASSACHUSETTS SOAR® OF I-I AL,T .—.�--------------OF...�.QYI .!A.......a-�7---r............................. Applirtttiou for Uioposal Works Towitrurtiou ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal S stem at. ,Y t p 1 _ _....... � .... 1 1_.._ _4.�.1. M..�:.�,.� lJt,� JI r Locatmif Add ss or �O A �L W y t 1 d erf �7. J ' . ....1. �v• V .e. --------te a Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......... .r�---------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............... No. of ersons._....:_.................... Showers — Cafeteria QI YP g ------------- P (. ) ( ) ¢• Other fixtures ---------------------------- W Design Flow...................... .......................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacityl..--gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No...... .............. Width.................... Total Length.................... Total leaching area_...................sq. ft. Seepage Pit NoAo—_C".O'L Diameter.._...._.__..... Depth below inlet............... Total leaching area..............4...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........................ rXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------ 7. O Description of Soil-----Sir/t_o-------• � ---------�� `f ....................................................•-............ ................................................................................_.. V ------------------------ ----------- --- -- ---------------•----- V Nature of Repairs or Alterations—Answer when applicable._________________________...................................................................... •--------------------------------------•---------.•-------------------------------------------------------------------------------------------------------------------------------------------.....•---- Agreement: The undersigned agrees to install the aforedescribed Individuai Sewage Disposal System in accordance with the provisions of T : p 5 of the State Sanitary Code—The undersigned furtl er agrees not to place the system in operation until a Certificate of Compliance has0 issued by the oard of ealth - . .7 Signed---•=�- ........ --------•---- -----•------•------•- . Date ` Application Approved By........ �, `,^- Date Application Disapproved for the following reasons:--•-------------•--•-------------•--------•------••-------•---•--•--•-•-----------------------------••---------- .......................................------------------------•---------•-•----..._........-------•---•. ............................................................. ---------------- .............. Date PermitNo.....`L2-------- -------------------- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT L . ................OF.......`!J.. 1�� .1. ........................................ i Trr ifirab of Tompliattrr IS IS TO QERTI ',ghat t Inaividual Sewage Disposal System constructed (L4r Repaired ( } b CF cn`�S Y --------------- ---. .... Installer at--- _ ---------L.R. - ' �..1... - 4c has been installed in accordance with the provisions of T i T tE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No...... ........... dated..---------------------------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A UARANTEE THAT YHE SYSTEM iAIIL w�i;.T/.7 10 ATISFACTORY. DATE .. ................:....... Inspector _ --- THE COMMONWEALTH OF MASSACHUSETTS -- —" BOARD OF HEALT7 :.............OF.. ��v.l.:._S ...:... ...�t�.. FEE./,:;Ilez ............. Diopr n1 Work T rt rrixti# Permission is hereby granted----�/.�d�-tr...... ....... ........................................................ to Construct ( or R pair ( a Indi ua Sewage Dis os System atNo. -®� ..............� .� - 11........................................................... Street as shown on the application for isposal �t'orks Construction P t No 7=_y!.a..__ ated_______ _____________________________ -- • --.. 4.5 �� oard of He✓ATE-------------------- ...................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS P,: n - 40 / 4 0 7- Z. �G, y39 rr 30---. � y I Q JOHN JACOBI / „1 No..814 co �WEAL�N ------" - K RAF: 9y q 1v.74 �iie /1/3 SCALE 6-1V61NEEi2/.vq ree 41,o. n P.d. O G/ / ?• 6RP fr�1 DAT,E.. sH,E�T of (� ra TOP OF.FOUNDATION . CONCRETE COVER CONCRETE COVERS 4"CAS IRON 12 MAX. •; OR SCH EDULE 40 12"MAX �� , . P.V.C. PIPE •'4 SCHEDULE 4.0 P.V,C.(ONLY) . PITCH I/4"PER,FT PIPE- MIN, LEACH PITCH 1/4 P.ER.FT. PIT.. Pt- RECAST �e \—INVERT io ' iy : 1 PETCOR G EL.Y„2'„�,,, INVERT INVERT % . �'� SEPTIC TANK y DIST. w EQUIV. INVERT EL.Y�..A . .. BOX EL•AX.`L. • : >x •i' ?-x '`� E ..:�6Y:.!�?� • 4.1....... GAL. INVEf}T 0 I I/ fj • ELab�:4�a INVERT ' w w :i; 3/4��T EL.y,�x. . �� WASHED i�% / I •� ys></ ;� W :;'' STONE W DIA. T • r, DIAr—d PROF LE OF ATa6R0UN0 WATER TABLE - SEWAGE DISPOSAL SYSTEM NO SCALE S 11_ LOG' WITNESSED BY : DATE .�A TIME..... .. ...• BOARD OF HEALTH j TEST HOLE i `TEST'HO(.E 2 ' : T/�4o$,. , , , , • , • ENGINEER EL-V..Yl eq .. . . . ELEV..Y.S X v.. . o� L7Oy < DESIGN DATA : NUMBER OF BEDROOMS . .. � . . . . TOTAL ESTIMATED FLOW , :yYQ. . . GALLONS/DAY 5/�/Tt • BOTTOM LEACHING AREA SQ.FT. /PIT I SIDE LEACHING AREA . SO.FT./ PIT 1 GARBAGE DISPOSAL . .�:�� . ..(50% AREA INCREASE) TOTAL LEACHING AREA 3.Z:.5 SQ.FT EC. 37. f PERCOLATION RATE %<,4AA. 'MIN/INCH LEACHING AREA PER PERCOLATION RATE .. SQ.FT. .:WATER ENCOUNTERED NUMBER OF LEACHING PITS . . 77 P. . . . . . . . . . APPROVED. . . . . . . . BOARD OF HEALTH •T•R• Z A"/�•`• Y Y- •So•Sf• : • Sao p��• • ' ' DATE: . . . . . . . . . . . . . . . . . . . . . . . To7-.9.0 r S-3 6P/' AGENT.OR INSPECTOR OF AQ r f� J e JACOBI yG��• J. ; �r '•• '�a T' 1 • ••°gyp• ��'� • �D• UPPERCAPL"ENGINEERING F 814 P.O. BOX 616 � ,p E: SANDWICH, MA 02537 . 1. �. . . . . . . . . 362-6281 AN PETITIONER:: /S. . ./. . 17,/9,5,� • , ��t?G �� .4e7- Z. tT . EL i M rI X 3It y I IS 801. � NAL SqN/T /s'- a JOHN � JACOBI / No.814 / lA a°°nr0 -- RFF Ao 6 SCALE : Uf'PE/eGOP,E eNVNZV 6.QINq ,Tde /Vo. ��-�•� ..ATE.•. 7/4 44 L.y sX, .. ...... TOP OF.FOUNDATION CONCRETE COVER CONCRETE COVERS 4"CAST IRON 12 MAX. ,. , •; OR SCHEDULE 40 12"MAX. ' P,V,C, PIPE • 41.SCHEDULE 4.0 P.V.C.(ONLY) . • � PITCH 1/4"PER.FT. PIPE- MIN. LEACH e.� PITCH 1/4"P.ER,FT. PIT.. PRECAST o' `—INVERT io ' �y' a LEACHING '•� EL.`/A X.U.•• �INVERT INVERT % . �•;' PIT OR •'. SEPTIC TANK y zG DIST. w EQUIV. EL.Y�.Y A 6 .. EL:r�y•�. ' >x INVERT ffjj BOX �.. ��. � . li.? ..... GAL. IEL:EIb�!4!. INVERT ' ww ::�� 3/4"TO I1A .•� EL.y42 �� WASHED � � ysxl W STONE I zo --s, —6 DIA, .• I .. •,.., g DIA, �•�'•�. _.__ _ _ 1 El 37XS PROFI LE OF AiO R6UNY WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE Sit a� S I L LOG' WITNESSED BY : DATE TIME..... .11cflE?-i/, . . , ,.. . . BOARD OF HEALTH j TEST HOLE I 'TEST HOLE 2 . . . . . ENGINEER EL•EV,.YIP .. . . . ELEV..Y.Sx�... ��;r,- n� . . . . . . . . . . . . i7,0z, Z40 Aq DESIGN DATA : F NUMBER OF BEDROOMS . .. :y . . . . . . . . . . j TOTAL ESTIMATED FLOW GALLONS/DAY BOTTOM LEACHING AREA . . . . SQ.FT./PIT SIDE LEACHING AREA . . .� 7 c Z . . . . SO.FT./PIT GARBAGE DISPOSAL . .�� . ..(50% AREA INCREASE) c0 SAn/0 TOTAL LEACHING AREA . SQ.FT 37. f PERCOLATION RATE . . . .r: 'MIN/INCH LEACHING AREA PER PERCOLATION RATE .. SQ.FT. w:WATER ENCOUNTERED NUMBER OF LEACHING PITS . . T. Y.✓�. . . . . . . . . . / y APPROVED- . . . . . . . BOARD OF HEALTH Z ' •"f (, y• /- •'� •`Sr • a P is � ZTT;R,.r/. .�..�:z.�:�/.�lJ:�:.�.9�F I?•:�.•2/.9. _.-�Pi.�; DATE. . . ' . . . To 7-.9.0 r S3 9 a-P0 • AGENT'OR INSPECTOR• ► i°�� OF M4f fq`y OB 1 G`•^! • J. JAC o �. .�a TAv UPPERCaPENGINEERING "• �3 T� P.O, BOX 616 A 9F 814 E. SANDWICH, MA 02537 �, �, 0isTE1`� PETITIONER;: 362-6281 AN �pR.'?•�.•.'�