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Home My WebLink About0441 OLD MILL ROAD - Health -- - �`�3/00� \ - - � `� TOWN OF !RNSTABLE LOCATION � � .S®G�yl9L�G R�_SEWAGE # - VILLAGE_Q57.eU1LZ,—S:' ASSESSOR'S MAP & LOT 1,3 INSTALLER'S NAME & PHONE NO.,&'G�'c�`&Q77 CGAJs% SEPTIC TANK CAPACITY LEACHING FACI.LITY:(type) /fdlJDi%zll i7 (size) �X NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER j =T— BUILDER OR OWNER �✓l/F/�f�a �i �CLS� DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED VARIANCE GRANTED: Yes No C priC. T4t4IC, 1,000 L-�1 p IT- \J 1 N N THE COMMONWEALTH,OF MASSACHUSETTS BOARD OF-HEALTH TC)w N ................0F...CZ �VVS ..` ".: .-................. Appliratiun for Disposal Works (boa-stritMon Frrm t -Application is hereby made for a Permit to Construct O or Repair ( ). an In•ividual Sewage Disposal System at O L I L L --»R 1�19 ...........:.......»... - LC' - ........... ._...... -` •----..... .... »•-» Location ddress _______ __ •»-or Lot No. »•»-- -»»- ..»».._....» co ' .1�9;R QSf . .. ....... ............•-----•---- ---... ....-- -• -------...._.....:. . .»........ - - ..---- Owner Address W Installer Address --A/ A- _ Type of Building Size Lot.... ....................13q-eer aDwelling—No. of Bedrooms_____ ��..:......................Expansion Attic (--) Garbage Grinder (NC a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures _..__.....•. ----------------- ----------------- -•----- Design Flow............ _ ____ __.____--gallons per se per day -Total daily flow:_._ __.. ..____________________gallons( Pam. p Liquid p y gallons Length ..... . Width__,._ -: Diameter________________Depth...8 Septic Tank—Ll uld ca actt .I.Qq . �._._. !�?___ W , x Disposal Trench—No..................... Width....................Total Length.......................Total leaching area.........:---------sq. ft.. 3 Seepage Pit No.......I............ Diameter....../b........ Depth below inlet.....I .......... Total leaching area..16.4Z_.._sq-ftG-PP Z Other Distribution box (+- Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ ,al Test Pit No. I....G_2-____minutes per inch Depth of Test Pit....1.3::....... Depth to ground water... Ott? ....--. Test Pit No. 2................minutes per inch Depth of Test Pit..../..y*__:.......Depth to ground water.:.P`100 ........ a ......------ ...........1.....:....:.................................................................... O Description of Soil...:. p L.....0-a r....?off.t Sci S�' �� i 3 yh tcf r U AA S n: w T�2 0-z,... tsJl� sv( 1 a �v n�►< r��r, ----------------------- ----------•---..__......-------------------•---- ....____. ..----- -- --------------......._-••-.......� :................................... 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 TL ITA IS 5 of the State Sanitary,Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ' s ed by th o of health: Signed.. "- ------------ ----- ---- - ---.................. .................... , ...1........ -.._.... Date Application Approved By.-............ .. --• ----- ......................... --•- + Date Application Disapproved for the following reasons_..............._.........................................................................................._»».. ..................................................................................................................................................................................... •••---------- Q / Date Permit No.---- --- ----------.. � IssuecL...:.......:.:._. ' -- -......_ Date............................. "".'•^�-."^..�....".�.'..-..�....,,i...r''.�,.�+•_..^--.-....-...��'r.-"_^'...;.--�---•--^-'^�..1.-`-�.-_.. —v....--"�i�.i•.�"..+_�..+v-...�-.... .r...�.�-.w..�..-J-_r�-_.rv..el1Sr,..:i,�•:...ru✓ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .T"ot v N.................OF... ace, S ),-e.....------------•-• . Appliration for Disposal Works Tonstrurtion Frrutit Application is hereby made for a Permit to Construct (�) or Repair ( ) an Individual Sewage Disposal System at: ._.._........__0LrLLOw Lr ...!. ... ........ ...5------....----------.......................-••....__•.....�...._._.. Location- ddresQs or Lot No. ............_.. /4 lM�.:_R 1 - !C-J /� �S/�-- ----•.......... ......•----------.......................... --•••-.....................•-•.............--- Owner Address W Installer Address G�G� Type of Building Size Lot......:....................:S -feet- V Dwelling—No. of Bedrooms..... ........::...............Expansion Attic (--) Garbage Grinder (N0 Other—Type of Building ............... No. of ersons....._._....._.............. Showers — Cafeteria P4 YP g ............. p ( ) ( ) Other fixtures ................................... ....... d ro WW Design Flow......................._._......_____..gallons per-per-so-n.per,day. Total daily flow.--........-.__...d....................gallons'G P WSeptic Tank—Liquid capacity.!pg9.gallons Length.F-.?,5;!' Width..t/..'! Diameter................ Depth. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No--------I............ Diameter......Z Ct.._..... Depth below inlet.....r ....... Total leaching area_:92�y...:.sq-ft,;PP Z Other Distribution box (✓j Dosing tank ( ) Percolation Test Results Performed by•••••-•--••--•-•---....•-•-•-......---•••--•--•--•--.........••--•.••... Date-•----------------------------- ,aa Test Pit No. 1....G z....minutes per inch Depth of Test Pit.... ....... Depth to ground water...N G4 Test Pit No. 2................minutes per inch Depth of Test Pit---1 y.�.__..... Depth to ground water....QONC....._... x --------------------------- .............•------------- ...._..... O Description of Soil-.... c.(� ....C?.-a�. rof'f S�..So, `...... - r 3 P?-ed r 0^n S 14-Ad j� ._...... ..........................-................0...........•......... W .............._........................•--------------•---------------------------------- ....._......••.••. =---••.......•-•••--••-•-•...-----STP2 o-Z' �� ts� c) roeolor, SA _....-•----_-•-----•--••--••------• ------••-• --• ---••--- -•--•-----•-•• --- •-- •--- 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 bee s ed by th oW of health. Signed.:.. D ate Application Approved By............. --.-1D. ---- ....---.........-..........-- ......../4FL' &•t..&.e-. Date Application Disapproved for the f ollozu:ng reasons-..................-..................-.................-............................ ................._.._ ••-------•--------------------•......-----•----------....---------•----.....--------•---------------...•...---------------........--.................................................................. - Date Permit No.....$ ...... ,1.......... .._.... Issued---..................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -`r0.�../�...............OF........1� .r.�^.S'! .� P................................. Trrtif utttr of Tontpliam M THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ,r)' or Repaired ( ) by................---------------------------------------•------------------------•------- ...............................................-..........................................-........- Installer at.......................................................................-L•�••---�..1..1.1—..f�-----------------......-----------------.........----.........: has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._ S'r.::..7.cL/.............. dated_............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL F UNCTION SATISFACTORY. `1 V I DATE..................Y.... ..... ._.r:. • ; ----------•-------- Inspector----------....................---------•-•---------------•----•------...--------.. -------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......:�.��...........OF.....-� = _ . l s -� Disposal Works Tontrurtion f rrutit Permissionis hereby granted...........................................-------------------------------------------------------------------------..................__.... to Construct ('X ) or Repair ) an Individualwage Disposal System at No.........Z[4..._..zL._:__...a L. M � :L_.... ..e------ ,.�, _ / G.Street 77�� as shown on the application for Disposal Works Construction Permit No.9KI".1._. Dated.......................................... { r ----•---------------------- f e� �BoarTof Health DATE........................ ..` -••= •• --------------- /555.6887 1 830./342 � 53.50 1429./762 //140:00 rOP OF FOUWA7M 770./794 � /VO TES: COA RE rE covEs COACR TE COVER /.p, r 1. AL L WORKMANSHIP AND MA TER/AL S SHAL L 4" •dWcr.r 40 PVC -- - (fnd) CONFORM TO D.E.Q.E. TITLE 5 AND THE TOWN OF Prf--UK BARNSTABLE RULES AND REGULA TONS FOR THE _ _ - -- py• sra+ - SUBSURFACE DISPOSAL OF SEWAGE. NVERT Nv ?r N�Rr fWCAsr 2. 4LL COVERS TO SANITARY UNITS SHALL BE EL. &76 50"YX rAW EL 5/.25 � � 4;: �p p7 000 GAL '•• r f' .�/�" to (/?"/ BROUGHT TO W/TI4VN /2" OF FINISHED GRADE. _ __ NVs oo ovvERr .:; O o WASHM 3. EXISTING AND FINAL GRADES SHALL REMAIN _ _� Q. 50.50 - - sram � ASS M%P 14 3 ESSENTIALLY THE SAME. io _ 20I _ 6 - -� 4. ALL COMPONENTS OF THE SANI TART SYSTE — /0 4 57 LOT Jc SHALL BE CAPABLE OF WITHSTAND/NG H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN /0 F PROFIL E OF MO GROUW WATER TABLE 14 0.50 OF DRIVES OR PARKING. SEPTIC SYSTEM 4 REQ 1. 4 4+ 4 ORES 5..AIRY AfAS0M4R.Y�TS-USBD- TO-BRING COVER 1 FO GRADE SHA/.L BE MORTARED IN PLACE. SOIL L OG 6. NO DETERma rxw HAS BEEN MADE AS TO COW L/ANOE WITH DEEDED OR ZOA MG DATE O C r.5, 1988 AMMER GENERAL NOTES ' REGULA TIOVS OWNER/ APPL/CANT IS TO � rEsr/tx£ -EST HOLE 2 OB TA#V SUCH DETERMAW TION FAVM r APPROPR/ATE AUTHOR/TY. � 54.50 �4.50 I MT=f TOP & SUB i SO/L DESIGN DA TA / 2' 52.50 52.50 2' ANU�t1 ' \ � ` � _ 9ER OF BEAROO�IS 4 � 64ED11JM i TOTAL FLOW 40 vY0 SAND BOTTOM LEAamw AREA � D 56 .. / SINE LEAC*W AREA O GARBA6E AtrO [. iV0 50% xxcf.asm TOTAL LEA C"W AREA 0 3' 4.50 r ` 4 y0 Li 40.5 PERCG[.A TIA+V RA TE / T S T t ___ _ WATE1, 0eCc:-cBNTLW,0 55 Wx s x io x 2 5 74 x 6 Jr 7 = P.o. YyY r ES ZONE' 'PC' FLOOD ZONE "C PLAN REF 262162 DA TE 1215188 TEST PLO T OF LAND 5 i PITS /N 2 _ a _ - , _ 54), BARNSTABLE N n " PREPARED FOR 53 N. 0 30 60 90 \ 52 , 42 - AM- E- RICO BARBOSA IV F.F. 5 ` 5 " 1 Ale SCALE.' I" = 30' / 40so A tu ' Lj ow � ; � oL"i ', ► 9 9 53 YA NKEE SUR VE Y C ONSUL TA N TS AA. 68 140 ' 143 ROUTE 149 o�Fo rN T MA RS TONS MIL L S, MA 02648 OLD MILL ROAD . 1709