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HomeMy WebLinkAbout0140 OST.-W.BARN. RD - Health 140 OST. WEST BARN" T � , OSTERVILLE A = 120 051 002 i A i No... .�. .............. THE COMMONWWEALTV OF MASSACHUSETTS BOARD OF HEALTH iz0 -----......T.W.^1...----.....OF...... ................................. Appliration for Disposal Works Tomit.rurtion Frrntif Application is hereby made for a Permit to Construct (tor Repair ( ) an Individual Sewage Disposal System at: - y ........................... .......__......--------.....-•-•--••••---...........---•---•------• Location-Address or Lot No. Owner Address a •--•-.:� �...... �n�sT--------------------------------•---.-......._ 8,.....-..- ...-..------------------------------.....- ------ --- Installer Address Type of Building Size Lot-_G .7Z...........Sq. feet �. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 44 Other—Type of Building No. of persons._•__.._?-______________ Showers ( ) — Cafeteria ( ) dOther fixtures ... •-•--•--•-•----------•---- W Design Flow-_t�tt__s _F _wNa _gallons per person per day. Total daily flow.................... .................gallons. WSeptic Tank—Liquid capacity./ __gallons Length._ Width_!.K'._. Diameter________________ Depth__S`.8'� x Disposal Trench—No_____________________ Width.................... Total Length_.___._.-_.._•_-_.__ Total leaching area....................sq. ft. ._._. Diameter.___P.._.___._. Depth below inlet...... Total leaching area... _��_....s ft. 3 Seepage Pit No.___._.l__:._ p g q, 4 Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by....f�_/ e---� --•---••---•--•---•-•---------- Date._!t/a V Z/ /%� `�a Test Pit No. 1... _z.____minutes per inch Depth of Test Pit----Z� _•.. Depth to ground water_..._._-............... (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•-----------•----------------------••-•------•-••---...-------------....-._...----------------••-----..._._.................................................................. D Description of Soil-•------D��--�if- -.. su/,3=So�G•-•------Z¢"-! _i`iGs1U_ x _ • - - U Nature of Repairs or Alterations—Answer when applicable. � /V� •____ -LNG 2_.._.___. .....--••••.._..-•••-•..-`- C .Alp C Agreement: 6�=- L C4 �i F 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 t/he board of e l Signe' _...0..--_.--- _•_-_ .... ---•--..•-------------•-• - Date Application Approved BY- ��:_ ....... :�44l[ �'---._...-- Date Application Disapproved for the following reasons----------------•----••------•--•-----------------------•---•----------------•--•------------------......-..._._ L ......................... .........• -------•----------- -------- •--------------------------------------------•---------_-------. -----.---------------------•------------------------------ Date PermitNo......... h... ----•----..._. Issued........................................................ Date 1���f•)������.����������i�����J�������st�Y��if:**a000r00r0840lee#00000004,a00009*0000*6006400000096964*68*6 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............T..t...v..........OF.......... ........................ T rr#if iratr of Tontlilitttta THI$�IS TO CERTIFY, That the Individual Sewage Disposal System constructed (for Repaired by...........---••••• �:�-..............•--...-•--=•-----.....---•--------------•--------•--------•--•-•-----------•---•-•-•----••---........---..............-----•---.......---...-----•--- Installer at-...-••• L-offer ' has been installed in accordance with the provisions of TITLY, of The State Sanitary Code as described in the application for Disposal Works Construction Permit No -E L'__�_`7•...L dated_....2T! � .__.__.____-•--. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCT N SATISFACTORY. r / . DATE.................---...--r.. .............................. - Inspector-•:�1*:�-------------------...--•------•--....--•----------•--...-. -------- -- - - -- - -- - -- ------ -- -- -- -- -- -- ----- - - -- - -- -- -- -- - - No .._.�.`. '.t F$sv THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -G&- c.. lni n/ OF. ..�i'/� . -� Applirtttion for Diopoottl Works Tonotrttrtion Vandt Application is hereby made for a Permit to Construct (I.-ror Repair ( ) an Individual Sewage Disposal System at: ••Location-Address or Lot No. ............ _.....................• -• ...•_ ..•....................... . ...................... -.._........... .._..._.................... ........_..._.... Owner Address a ---- ----•-•nstaller I -•.- ...............•---------------•----•-•-- :_ ------ --= s• Adddresres s........................................... S Type of Building Size Lot...G�.._7 .....Sq. feet U Dwelling—No. of Bedrooms.......................:....................Expansion Attic ( ) Garbage Grinder ( )�+ `4 Other—Type of Building n�aR ^ �C No. of persons ........ Showers tz, YP g .... p ( ) — Cafeteria ( ) C4Other fixtures ..-•--•-•............................._..---...--•---.....--•-••---•-----------•----•--•............................................................... 3L? Sry. - s_ -c lops per person per day. Total daily flow.......................�¢ gallons. W. Design Flow__f._a..._..k..E T_�,��_�E!���'. -gal P P P Y• Y, ............. WSeptic Tank—Liquid capacity.Z gallons Length-__ .�� Width...`.' �..._.. Diameter................ Depth.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No.......J.......... Diameter._....�d.......... Depth below inlet....... Total leaching area.... G ....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by....................................'.� .. yE._..... .................. Date...!t/a!/:/4 /yl� a .. ,.a Test Pit No. 1....4�. :._..minutes per inch Depth of Test Pit..... ... Depth to ground water._.__.^............... (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------••-••----------_.............._.....----••------...-___...._......_..._........._._... ........................................... D Description of Soil.....•--Q............................................;"'/ ' Sc.r�_ .`ail_. 24 /��L " t �[:� /-iz-D• �/��JJ� x ............••--.........-••--..........._•---•-•...._.....--•---...•••-•------_--••- V .................••--------•....._............_.........•--••-•-------------•........._........••••-•-•-•---........._•-----.........---._..... -•-••------••------••---------•-•-•-----••-••-•_.... ----•------••--------•---•••------•--------------------------•---•------•---_....._•-••••-••----•-•-- ------- ••-•--•-•-•--•-- ..... U Nature of Repairs or Alterations—Answer when applicable. �` ( i..a ......_.. .....t�.�-��11!� !t��-•---.l�?�L ..�_�!e r lT:.�'.. ........ t ....•-- `--.....4..r._. _' ............................. Agreement: p V—­ L.C—:OCrl 9P I T 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,--, / Date Application Approved BY 1 ... -- Date Application Disapproved for the following reasons:................................................:.............---------•----•--•---•--.. • ._......___ ---...------•--.....--•--•---•---•-•------•-•-•-•................•-•----------...-----..._..--------.......------------------------......-----._.......--------•-------•---•--...-------...._.........._ Date PermitNo.........< ----------_--- Issued..............................................---•--.... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... ..�...v�................OF.......... ........................ Tatif irttte of Tottt plittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (--ror Repaired ( ) by...........: Gib.......................................•-•-••--•--...__. - __ ....._..-••-••---•-••=••---.....------..................................... ..._..._ L. Installer at.......... :.j;;d._-�.... ........ &A - .. '-�.............................................................._ ----- 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......�E. .'G- _ ... dated.... ft f .................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE`CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector....•--•------�___............................................................. THE COMMONWEALTH OF MASSACHUSETTS K +���'- 0AJ BOARD OF HEALTH ddd-✓✓� `rVC-5` tZ ftx ¢ ............... .... ................ ........ .. ........................... Disposal Works Tottstrudion f rrmit. 1_1-/ tea, Permission hereby granted.... ................. o ' T' -......._.................•-------------.......... •r '.i to Construct or Repair ( ) an Individual Sewage Disposal System atNo.....j,.:.A t'�--�L...... ...... =•----••-------•--•................................•---•-••-•---........ Street as shown on the application for Disposal Works Construction Permit No ::.(" .. Dated. ................. DATE. .C 1 f y(, / Board of eIiealthh FORM 125- A. M. SULKIN, INC., BOSTON t TOWN OF BARNSTABLE . LOCATIONG.4 2 j3�2,j,,, 0s�,,:,21///Z !!?L SEWAGE VILLAGE ' / } . -- _(/5�%� ��� / /� ASSESSOR'S MAP & LOT(Zo-OS%-DOZ INSTALLER'S NAME 6i.PHONE NO— Zzo/ec?,t.-S7' SEPTIC,TANK CAPACITY 0 LEACHING FACILITY:(type) 6�.o c s//'i T (size) G X /o"/,g- NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE .-COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No STD�Cii��P U�►�Z�'r q 0 UCZ '1 i i L Go 'moo TOP OF FOUNDATION . CONCRETE COVER CONCRETE COVERS I 474 ',% 4' CAST IRON 2 12"MAX • OR SCHEDULE 48 4"SCHEDULE 40 PVC (ONLY) PVC. PIPE PIPE - MIN. LEACH N PITCH 1/4-PER PITCH 1/4•PER.FT PIT PRECAST -� LEACHING •• NVERT •.� • EL.. Tr74 INVERT INVERT • ; PIT OR �1. INVERT SEPTIC TANK _38 OIST. To¢ W �;• EQUIV. EL.. BOX EL >_ •�, i EL..-sT�� GAL.. IN INVERT ` W W 0 :is 3/4"TO I V2 EL:. / �a a EL WAS ' I W .' STONE II — _ WDIA PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM s NO SCALE i 4o i J ! / � SOIL LOG WITNESSED BY :BOARD OF HEALTH 1 k DATE TIME . . ,20�� it i�•/zU �• c N�v i4 /"dat q'3� A.y TEST HOLE I TEST HOLE 2 ENGINEER ELEV. =� �'. . . . ELEV. . . . . . . . i 771 x / O '6'z_ r,x ,�. DESIGN DATA ✓, S/ '9G�' S Z-ly ,4 NUMBER OF BEDROOMS 1_ TOTAL ESTIMATED FLOW B4. GALLONS/DAY f 0 _ e_'r:<.aM BOTTOM LEACHING AREA .78 .�°' SO.FT. /PIT/.P,D. SIDE LEACHING AREA SQ.FT/ PIT/471 r . nt A Bo x GARBAGE DISPOSAL .(50% AREA INCREASE) i TOTAL LEACHING AREA . .?G7• �' SO.FT r►..e O P,r �'8• PERCOLATION RATE MIN/INCH LEACHING AREA PER PERCOLATION RATE ��' S0.FT.fC•�Z: WATER ENCOUNTERED NUMBER OF LEACHINGr PITS 0^,E � . . . . . . 1-f L T O/ .0 Oiv APPROVED . . . . BOARD OF HEALTH I! DATE _..7r/►�� �o �� AGENT OR INSPECTOR I gH OF C FT � ,V E 5z . . . . . PCB,s ��' y ©sTC-; Vi4" W. (jl/w.a e Z' � -k Na 231 0 PETITIONER V1,6 ArqU SG • _ l _ �l G-O• - Ate 5B 4 i � I 3 7Ltrs t- I ACF&C, 444ry o S,,,e v-6 yo.e'. 40 ' I /1/c�T� ---- EZ�'v%'a�76a ni'S �J�-:�v 4�.i �}S Sum-s'd� •A4'lt�/`7 I I 39.0 7z1