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HomeMy WebLinkAbout0428 OLD MILL ROAD - Health 428 OLD MILL RM�d TERVILLE A= s. i ,r z S r A TOWN OF BARNSTABLE !(�(6-0d(-aVAt ` LOCATION e— 0c-6 iw-dl k D SEWAGE # J J!- /-r VILLAGE ® k u ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. B.C.k 70) SEPTIC TANK CAPACITY /6'6 d c,5! — LEACHING FACILITY: (type) pA&- ,,r (size) !�X 33•s�-x 2� - -- NO.OF BEDROOMS lip BUILDER OR OWNER '16A �,.,.)A s- PERMTTDATE: .3 — 9 — Y S'' COMPLIANCE DATE: _5-- Zer Separation Distance Between the: i 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 Wedand and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by roc`' Ll l-o may- 4. No. Fee THE COMMONOVEALTH OF MASSACHUSETTS Entered in computer: 2 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes rtcari�� ott for Mtqogar *pgtent Congtructton Permit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. r' ddress and Tel.No. Assessor's Map/Parcel 6 ? © � "�a fL � Installer's Name,Addre s,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms _ Lot Size i sq.ft. Garbage Grinder Wo_ Other Type of Building (,4jjtj j o.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow o LID gallons per day. Calculated daily flow gallons. Plan Date f" h q 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) C 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 issuedV=—An ard of H alt . Signed l.Cf Date /1�; Application Approved by ® Date Application Disapproved for the following reasons on en em Permit No. Date Issued No. ir Fee THE COMMONWIAA TH OF MASSACHUSETTS 'Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS application for Migoar 6peum Congtructiorl i3ermit 1 Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ❑Complete System ❑Individual Components Location Address or Lot No. f�d5 r' ddress and Teel.No. Assessor's Map/Parcel © ROSLA/t/ 7ltl� �-� l C fo l� o Installer's Name,Addre s,and Tel.No. Designer's Name,Address and Tel.No. �7 �. � « Type of Building: Dwelling No.of Bedrooms Lot Size S 6 dsq. ft. Garbage Grinder(Mb Other Type of Building Dt)�� �+�+tl`lo. of Persons Showers wers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow / u gallons. ,—Plan Date Eh f`l 9 Number of sheets Revision Date Title Size of Septic Tank,-- i,,Type'of S.A.S. ! Description of Soil Nature of Repairs or Alterations(Answer when applicable),,, Date last inspected: Agreement: g The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system -m 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 is*Board of Halt . Q Signed a Date ! Application Approved by ® 8 ze AX Z Date z . Application.Disapp roved for the following reasons +,.._ Permit No. 1 Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS , d Certificate of (Compliance THIS IS TO CER hat t On s' Sewa ell)ispOsal System Constructed( Repaired( ) Upgraded( ) Abandoned )b " / at s b co tructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. aced Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date u-• - 9 Inspector ——— ———————————————————————— No. r ''- � Feel./ '---- _ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISIOq - BARNSTABLE, MASSACHUSETTS mt'OpOa p5tem Construction Vermit Permission is hereby granted to uct U grade ) b ndo System located at (� V� 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: Approved by TOWN OF BARNSTABLE <::LOCATION o44 ►ui lC D SEWAGE# ::1LLAGE ® sir u�LLc ASSESSOR'S MAP &LOT INSTALLER NAME&PHONE NO. •C• �� $OPTIC TANK CAPACITY ACHING FACILITY: (type) �Ar i.cr wsce�i°L ( 13ar x z' NO:OF BEDROOMS — WELDER ELDER OR OWNER ),rug-1 PERMTTDATE: .3 - 9 f 7 COMPLIANCE DATE: Separation Distance Between the: Iyiazimum 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 I ::Famished by G 174_9 .is — G � -hS �•; s E' h h' �hZ h r s bF • cam,. � IL TEST HOLE LOG 7� DATE: SOIL EVALUATOft:; ., WITNESS: ._ C,r PERC RATE: •C Z��,�,/it.�/�fs� / Z 4 N �_ 8 �s�..v � E'Lo•v� E. Me rZA a L r /3 c�«7- SA.v� SR zSy 2/3 7,sy 'l3 4. / {/e o _ DESIGN DATA w _ DAILY FLOW:(y)BDRMS.z 110 GPD- WO GPD SEPTIC TANK: Wo GPD x 200%=B8 d GPD i �� / USE:/Soa GALLON PRECAST SEPTIC TA NK LEACHING FACILITY: r i USE:=<3)_S x_8._s-�rZ.. sca _a.PyGJ�cS CAPACITY: _ L SIDEWALL:__��37!"..Z..x_a..� BOTTOM:-- TOTAL: �►� ���" �`'�ivs A0,voe � s a � r NOTES: 1. ALL PIPE TO BE 4"DIA.SCH 40 PVC. `? J / 2..PIPE TO BE LAID LEVEL FOR 2.OUT OF DISTRIBUTION r. BOX. '\ 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN w r GDtu'S J / 6"OF FINISH GRADE. ell R� 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A . N GARBAGE DISPOSAL S. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED SURYEl�� J ON A 6"LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEL 2•LAYER OF 34•PEASTONE OVER . Y4*.:UP WASHED STONE ALL AROUND �p 0 TOP OF FOUND. J �. EEL. 6Z.00/ 10• u• 57.2o ' S�•8S S].6a ` SEPTIC SYSTEM PROFILE } SITE SEWAGE PLAN GENERAL NOTES FOR I. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR — 0 $ >c'o 4-1/G C JZfJ, D57&Z//L 6 4 r TO ANY EXCAVATION OR CONSTRUCTION. i 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH } PREPARED FOR 310 CM 1L 00:TITLE V. 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE ' DETERMINATION. DATE: /LJ/�,P/J� l f g SCALE: 4. ALL DISTURBED AREAS TO LOANED AND SEEDED. S. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY REQUIRED INSPECTIONS. ` e j.: a WELLER & ASSOCIATES F - :_ 1645 FALMOUTH ROAD CENTERVILLE, MA. 02632 TEL: (508)775-0735 FAX: (508)7754754 ; APPROVED BY: _ _ . TEST HOLE LOG DATE: SOIL EVALUATOA-. ._ A-f,4.5- J cs� Y WITNESS: .. Cr PERC RATE: •C Z�cliitJ,/it t/ci� 7 Op 1 C3w Cov�+Y � Goq..T SAtia �.a•+o ,�j,• yy4 �.5ye s/B 57p yt. Z 5y 2/3 7.Sy Y3 w Z • o - ss o° N xZ\ w DESIGN DATA DAILY FLOW:(y)BDRMS.z 110 GPD= 4"7'D GPD SEPTIC TANK. f� o GPD z 200%=88 c=l GPD USE:/Soo GALLON PRECAST SEPTIC TANK. LEACHING FACILITY: USE: 3� /nIt CAPACITY: SIDEWALL:__��37�".Z"X 77� BOTTOM:_-. - / / TOTAL: -- _::w_ Vs /01011 .NOTES: � 1B« 1. ALL PIPE TO BE 4"DIA.SCH 40PVC. ' 2..PIPE TO BE LAID LEVEL FOR 2'OUT OF DISTRIBUTION v r v BOX. 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN w L / 6"OF FINISH GRADE C 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A N GARBAGE DISPOSAL l�4�SOAVE S SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED J ON A 6"LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEL PLAYER OFYP PEASTONE OVER . YP'-1 111'WASHED STONE ALL LL \9 p AROUND 1 n TOP OF FOUND. Q @ EL. to Z,o0/ 10• 14• " ,.�: 57.7 o o, 58i Zo ' S 3O S2.00} SEPTIC SYSTEM PROFILE SITE SEWAGE PLAN GENERAL NOTES { FOR 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION .j OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR O 4-0 TO ANY EXCAVATION OR CONSTRUCTION. i 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH PREPARED.FOR 310 CMR 1&00:TITLE V. 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY WIVE G ",A J AJ6 O0/ DETERMINATION. a 4. ALL DISTURBED AREAS TO LOAMED AND SEEDED. DATE: ._/t-J�:/v, /j SCALE:,/,.. ___--_- S. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY .. f REQUIRED INSPECTIONS. WELLER & ASSOCIATES S �' yi 1645 FALMOUTH ROAD CENTERVILLE, MA. 02632 TEL: (508)775-0735 FAX: (508)775-0754 APPROVED BY: