HomeMy WebLinkAbout0015 WATERFIELD ROAD - Health 03"1 -
7
TOWN OF BARNSTABLE
LOCATION U SEWAGE #
VILLAGE � i GsS ASSESSOR'S MAP& LOT
"INSTALLER'S NAME&PHONE NO. a37
SEPTIC TANK CAPACITY Woo j2 0,X
LEACHING FACILITY: (type) i0C?���a�l ��'C' (size)
NO.OF BEDROOMS 3
BUILDER OR OWNER
PERMITDATE: ef COMPLIANCE DATE:
Separation Distance Between the:
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 Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) NI K • Feet
Furnished by
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LOCATION SEWAGE PERMIT NO.
6/S'/ ��C-/S� lam✓ ,t�'� uit-i�/'�i�.Ll� r��
VILLAGE
I N S T A LLER'S NAME 6 ` ADDRESS
BUILDER OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
3 8,
037
No...el._al..f.1. . z .:; FIMs...jq..�/...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE=A. TH
Applirtatinn for Dtspniial Workii Cnnntrnrtuart Prrutit
Application is hereby made for a Permit to Construct X� or Repair ( ) an I-n-dividual Sewage Disposal
-System at;
Loc o --Ad 46, ¢ or Lot N
.� ......r9a�,� o..----•------ .. . �.............
ner Address- -...............
Wy ...... .................:.................
Insta Address
Type of Building Size Lot-4 .3-3. .Sq. feet
U Dwelling—No. of Bedrooms................................ _Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building No. of ersons......6�.__•-•--•-•------•- Showers (� ( )
Pa yP g ----•---•------•--•------... p -�— Cafeteria ,
a' Other fixtures-s-
W Design Flow...................._5..._............_._.gallons per person per day. Total daily flow---------._.............._.z%. __......._.._gallons.
Septic Tank—Liquid'capacity/00,-gallons Length................ Width................ Diameter---------------- Depth................
Disposal Trench—No._._......I......... Width.....j...._._._._ Total Length.................... Total leaching area...................sq. ft.
3 Seepage Pit No......./......... Diameter....... -----_.____ Depth below inlet.................... Total leaching area...,`/k...-"...sq. ft.
Other Distribution box ( ) Dosing ta!* ( )
Percolation Test Results , Performed by.._...__ �................ .. Date___ ....
J
� - �
a Test Pit No. L.. }Vrninutes per inch/ epth of Test Pit......t. ..___. Depth to ground water-----........d.._.._.__.
Test Pit No. 2._.......:7�niinutes per inch Depth of Test Pit____.li ......... Depth to ground water........................
-•----
t .� ........ - -----------
O Description of Soil [ . !' _.. ....... ---•-•------
W .�
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 i:LL
p 5 of the State Sanitary Code— The undersigned further grees not to place the s stem in
operation until a Certificate of Compliance has been ' su the board
Application Approved By......... _._.__ ._:_. .... ......
f
Date
Application Disapproved for the following reasons----------------------••••-••••----•-•--•--•-------••-•--•-----•----------•-•-•-----------•-----•-•--•..-•-•--
--..........•-••.............••••--•---•-•-•--••-•-•--••-.....---------•••••••--•---•---....••------•••-•---------------•--------------------------•---•--•----•--•-----------•------••-----------------
Date
PermitNo.........................=••-••••••--=----................ Issued.......................................................
Date
1 t
4
s# `r
Fizz
THE COMMONWEALTH OF MASSACHUSETTS
y.. zo_t
BOARD OF I--I TH
' '' ?.............OF......'y ' ....:..:.:.. .� � :. .............................
Applirtttion for Disposal Works Tnnitrnrtion rrrmit
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
System at:
... .-. ................................ ..................... -
p Lo rAddre or Lot No.
rner Address
Wk_ �'✓... ✓l1 !... :. '=.....: .................... ..........................................................
`
Inst Address
U Type of Building - Size Lot./ .�'.:x_ 4...Sq. feet ,
Dwelling—No. of Bedrooms..............:____._........._..•...___....Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of ersons.... �----------------- Showers (;Z+— Cafeteria ( )
a Other
fixtures- . . ...._......._..��........_ _.....- ----------------.................................. p _ .....................---
W Design Flow.................. %_.�-....._.-.__ gallons per person per day. Total daily flow............ '.. .............gallons.
G� Septic Tank—Liquid cap acity_06 _gallons Length................ Width................ Diameter---------------- Depth....._..........
Disposal Trench—No. .................... Width.................... Total Length_..-.'..;........... Total leaching area............6-----sq. ft.
3 Seepage Pit No......1`..._..... Diameter...... Depth below inlet................... Total leaching area _,V...........sq. ft.
Z Other Distribution box ( ) Dosin7epth
) Me"
�- c:::fDate_.f _ f .<Percolation Test Results Performed by._. . _ _...._4a.. ,.:.__.__._.
Test Pit No. 1__- --. minutes per inchof Test Pit....
._.rt= Depth to ground water___- ...........
(z, Test Pit No. 2......:. .....minutes per inch Depth of Test Pit..... .......... Depth to ground water........................
x _ ' ............. --------
D Description o Soil =�3 - a 'lk, '. �'-'r f - ''? ' E= °� ''---------••-•----------
Z
W •----•-•--•-••--------••---•-----------•••----••--••--•--------•------••---•------•--•---------•--•-------------••--------------...-------------•--•••--••.....•-•----•---------------•.._...--•---•----
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
..------•----------------------------------------•--•---•---------------------------------•--.-•--•••---........•-•••------••------•--•-----•----•---•---••--•.._....--•-••---••--•--•-----•---.._..----
Agreement: �0
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System iq accordance with
the provisions of:iT p of the State Sanitary Code—The undersigned further agrees not to place the system in r
operation until a Certificate of Compliance has been, .iss y the board
fr'
�._.... ..._. Dat 1
ApplicationApproved By.................................... .............. . ................................•-• / 2_-? ✓
Date
Application Disapproved for the following reasons----------------------------•-••----------------------••---••---------------._...------------......_......-•--
-•...............•----•--------•-•-•---••----•--••--•----•-----...•--•--......._....__.........--•-•--•-•----------•---•--•---------...---------------------------------------------------•••-•-----•---
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT
......................
%%"•-•.�. �pr�g��rtt� laf f1�la�t�rlittnrr _
LC
IS TO GE TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
b 1 f'. _ ' =�' ---------------
y ���L� scatl
• ... ... ......•... ...... 1 J
.............. `.------•----••--•••......-•---•.--...•....... --...........-- ......................................................
has been installed in accordance with the provisions of TITLE j 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 GUARANTEE THAT THEE_—
'SYSTEM WILL FUNCTION SATISFACTORY.
__�l-_d�
DATE......................................................................_..___.... Inspector.........(�S. .......................................................
THE COMMONWEALTH OF MASSACHUSETTS.
.---- r BQARD ,?F HEALTF
ef �.`.,... •i..i. '.n^• (_.-'/�!V'� b/..uwi". �.�..'.^.. _....^.�..................
No......_•-• - t.... FEE.ti�...............
_.....
Dtllpo� l o* Ton n prntt�
Permission is hereby granted....I_ .........................` P.._____._' _..
to Construct or pair n°I i Idual� ewage posal Sy
/ ' ff
-Inc_
= 1 `i l-l ::
Eft No. .. i •. . 1:
Street
as shown on the application for Disposal Works Construction -rgit No..................... Dat d.._.._.______..__..__.....:..._._._.......
�f
* BoPA bt Health
DATE.........................................�`...��...::.�.. ...----
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
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LEGEND) HOFM,�ss9 }
EXISTING SPOT ELEVATION Ox0 �oi� mHN °y CERTIFIED PLOT PLAN t.
EXISTING CONTOUR ——— 0 --- BEFR LAID of Mc�orJ�LD F
FINISHED SPOT ELEVATION E -�ER 2aAD - ��/►cam _
FINISHED. CONTOUR 0
01SrE11st o�' I N
APPROVED , BOARD OF HEALT �Ho SuvtS
DATE AGENT SCALE, 1 ' B,' DATE, Q6,/.4, S 1 :
LDREDGE ENGINEERING CO. IN :CLIENT
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I CERTIFY THAT THE PROPOSED
EGISTERE REGISTERED JOB NO:'.�11_ ..,_ BUILDING SHOWN ON THIS PLAN
CIVIL LAND CONFORMS T THE ONING L4 I
ENGINEER SURVEYOR DR.BYs OF BARNSTA LE, M SS.
712 MAIN S CH. BY,
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HYANNIS, MASS. SHEET I OF 2 GATE G.. LAND .SURVEYOR I'
_ /YOTEEITHER THE S- /C TANK OR
,E,gCNliYG P/T ARE MORE THAN /2"BELOyt/.
/D PT• M/N �RAOE� f� 24+,0/AM ETER CONCRETE COiiER
j1 SNALL eF aA,0UGNT TO 4JTAOE.C'4,V .EXTRA
CONCRCTE 4"PYC P/Pr JYE.4Yy CASTR /Y/ O COYER SgAZ:L SAF USE10
h .. MIN. P/TCN
- 105-5 COiiERS a /F
EL //V OR/VEN/A Y
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s • • • • • • e •: a
60X . ` o • t $ • • • • • r . a .
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•EF/�ECT/✓C • l✓ASXED/STa�YE .
• t e �• DEPTH • • •+ • oo j
PRECA9 T SEEPAGE
x 2 s 4-1 6P�
. Pig -OR Epu/V. �.
¢MVBRT &AEVAT/GNS x 1.0 -S C-3PD 9(.1
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;ERT AT B!!/LD/NG 10 3.3 FT [� P. p. C SEE TABUL.ATl G7N>
/N LET .SEPTK' .Ti4/VK IT 3_I FT. '"�j'cP�Pftcrr,' G1 f7:_O/.4Jy. .
Ot/TLET SE®TIC TANK 1sZ_FT.
/N ET Dl$TR/�!/T/ON BOX oll.-7 SECT/ON aF ' GROUND. ! ►TER TABLE -
vnE 102 5 FT .SP;VAGE OIS4POSA L 5 S7'MM r
1"4LFT AXACN/NG p/T 102.3 FT.,. `T/Q�U,LATION I
LEACH//VG P/T v,1ye/vs/oa .A 2.2. XT
'a SCALE.: %s' � / -o o/�liHvs / t;8 (0 �T•
.N R TES/6 C ES D
/VLlMBER OF BEOROO/NS 3. D/ME'NS/ON
GARB aGED1sPOSAL 4/,V/r 0 SO//- LOG
TO A 4E5T/14A7-EO'-FLOW 0 64L. DA Y SOIL TEST */. SO/L TL�ST�#2
NUMBER Of LEACKING P/TS fI5�. E LEY_1 ,� OA TE O FS®/L� TEST
OC � �
2-7 ' 7--I
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/7' I S PT. ���P-^ t-oA M RE LTS IV/T/VESSED BY
QE Jot+t j JAca9 i I
S/DE L1'ACH//VG PER P 4� o _( s�-ror-�Ic- a��l�- SU €
6oTTOM 4Z4C/•//!VG PSR P/T �g So. AT. PERCOLAT/ON RATE / L1 ly/NrI/NCH t
2� I:- 3` ^^ 3 sa PIERCOLAY/O/V RATE A2 �+A� /y/N:f lNCH '
TOTAL LEACH//VG �4REA .SQ. FT. sPaD 2 Q
RESERVE LErgCNlN6 AREA 2� SQ.. FT. -
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OF Mqs �P\�H OF,y�Ss ISM wttlf� lLAntilD of�lhc�f�tP<Ll�, WATE4?F
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