HomeMy WebLinkAbout0010 AMELIA WAY - Health 5.1
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ELIA WAY, MARSTONS MILLS
9-031 -001
i
f TOWN OF.BARNSTABLE
LOCATION j - SEWAGE #_
�r S
VILLAGE_lItlt�:614 ,04(11 ASSESSOR'S MAP & LOTS ) .
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY IF
LEACHING
LEACHING FACILITY: (type)—'9w a (size)
NO.OF BEDROOMS
BUILDER—OR OWNER - -+
PERMITDATE: 3 -17 - 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) Feet
Furnished by
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Dia v
to
. -2 7
/d ' TOWN OF BARNSTABLE
LOCATION " �3 / t�lrs� �`�+ Udn/ � SEWAGE#
VILLAGE /J �` ASSESSOR'S MAP&LOT, 1.
INSTALLER'S NAME&PHONE NO. !/-2en �r/r.Z:
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMTTDATE: 17 '11� 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(N any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
y� o �,o
c� ASSESSORS MAP NO: / Ll q
PARCEL N0: .3/ _ d d / FEB
.... dd .
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABL.E
Allp ira#ion for UhnVotial Workii Tomitrurtion Permit
Application is hereby made for a Permit to Construct ( �r Repair ( ) an Individual Sewage Disposal
System at:
......... ....�/Y.."�T. �._------ c�—!
�lddress or Lot No.
------------ -----
a • / Ad res
.. G- --•••- .....!. �e.��� ...................
Installer Address
U Type of Building Size Lot__ '. ..�3,,7 Sq. feet
Dwelling— No. of Bedrooms______ _ ____________ -__--.----Expansion Attic ( ) Gar age Grinder ( )
a Other—Type of Buildiu _._g�' No. of persons............................ Showers ( ) — Cafeteria ( )
______:
Q' Other fixtures ----------------------------------
W Design Flow......... .5........................gallons per person per day. Total daily flow-----------... ..>.._�.....______._____gallons.
WSeptic Tank—Liquid capacit/W gallons Length----c4_...... Width.....-��__..... Diameter.--------------- DepthX
x Disposal Trench—No. .................... Width_____...__--.-.--_- Total Length.--_-_._-._____-____ Total leaching area_...._...._.__......sq. ft.
Seepage Pit No----/.............. Diameter._.-./�?�..._. Depth below inlet---�k_.�.....__.. Total leaching area_.__X
Z Other Distribution box Dosing tank
'-' Percolation Test Results Performed by.�-�G c. Date._ ...Z. ���.._.._..
Test Pit No. 1 nmutes per inch Depth of Test Pit/-5/ 4.... Depth to grounfwater.......r
(s, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........
.------•-------.
-------------------------------------------------------------------------------i -----.-_.�l_._.._.... --------------••----
0 Description of Soil_.. ` .._�1 �`.Cf __. �"�.�,/
x
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 TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the
system in operation until a Certificate of Co anc as been issued by the boa of health.
.. .................!�-q/
Slgned ... - - .//
,, Date
Application.Approved By ---- _. . 't''... .............. l��f.. .... .... .Date �.�
/ --------------
Dace
Application Disapproved for the following rearonr: ...........................
... ..... :' -------------------------------------------------------------------------------- -------------------
----------------------------------------------------------------------------------...._...----------------...........I--- ----------------------------------------------------------------- -- -.._......----------------------------
^�VV5 Dace
Permit No- -- ----- -----------------------------------.........----.... Issued ---------------.j.. .f.?__3 5
Uare
/v
No.....�� -�, 'f _ , _ __ _ �j,l _ f' n FEs.... bD
THE COMMONWEALTH OF -MASSACHUSETTS
BOAR® OF HEALTH
-
_ " TOWN OF BARNSTABLE
ApplirFatinaa for Div.-,Vvii al Workii Tomitrnrtinn ramif
Application is hereby made for a Permit to Construct ( V1 or Repair ( ) an Individual Sewage Disposal
System at:
/
. te.f C
-••--.....-... _.._... -- ..
_-- Locatj9�c- address ��`- or Lot No.
.' /_ ..._.......-'__'K ........... _____ __________________________ 4_.........._..............................................
....................L_Y::!�:5..
W .. Q C.. �� Ad res
,.� ---......-•.............. ........ .....��'¢.���•�S ��.3
---•------------•--•------•------------
Installer Address
d Type of Building Size Lot__.'_ .._&.3,7.Sq. feet
Dwelling—No. of Bedrooms.___-_ ........ ------------------Expansion Attic ( ) Garbage Grinder ( )
04 Other—Type of Building ...._____ 41,4 4.t No. of persons---------------------------- Showers ( ) — Cafeteria ( )
a
d Other fixtures --------------------------------------------------------------------------------------- -----------------------------................................ -
W Design Flow......._...5- 5........................gallons per person per day. Total daily flow--------- ................................gallons.
WSeptic Tank-Liquid capa6ty/V_0 gallons Length._._....... Width----- Diameter._..---------- DepthX_....._....--
x Disposal Trench—No. .................... Width.................... Total Length-------------------- Total leaching area....................sq. ft.
Seepage Pit No..../_............ Diameter.....lc Depth below inlet...lo_........... Total leaching area-,��'7',7...sq-€t.
z ,Other Distribution box ( Dosing tank ( )
'-' Percolation Test Results Performed by. _ G G max? ... z........ Date._ Z.�T..._._.-.
Test Pit No. 1.�2minutes per inch Depth of Test Pit/yy- Depth to group water.
GXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---------._----_---.---.
Description of Soil... ... /'`c' � -J G --•--•--...----•---- ------------••-•--•...............
x
w
---- ---------------------------------------------------------------------------------------------------------- .....-••-•-----------------•••-
U Nature of Repairs or Alterations—Answer when applicable--------------------------......................................................................
I le.
--------•-------------------------------------- ----------------------------------------------•-•-••••------•-------------------•---------------------------•--••---•----------•----•---•••-•-......-•-'
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Comp.ant as been issued by the board of health.
Si ned .. ............. .. ...... - ------------ ... ' /�
g ....... ...........................
�r t Date
Application.Approved By ----- - -----L�'� -- -��--- ---------------------------------------------------�� ---------------- .__... -I� . -j
/ Dace .��
Application Disapproved for the following reasons:
Date
Permit No. ......--..g :..��� r
Issued .................. ........ .7_S
�� � Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Cer#tftrate of C omplinure
4��ERT VTThat the- ividual Sewage D osal System constructed ( V ) or Repaired ( )
by ..� - (%.. �7-------------------------- -----..---------.-------_..----....._...--------------- -----
`,�/ 1—aller -/(
at ..... ....._.....--........-� ... ...._._.. - .... ...,...-.'.................._----------_--------------------........-------..- -------------------------------
has been installed in accordance with the provisions of TITLE 5 of The State Environmental 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 THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...... ................. ..._..----------------- --------- Inspector ---- ----------- .--- ------_.....----------_ -----....--------
i.
THE COMMONWEALTH OF MASSACHUSETTS
S _ BOARD OF HEALTH
IT -
WN OF BARNSTABLE
No.....�.............. FEE...�lf .......
Permission is erebYg .ranted.... ------. �-,c .. ------------------------------------
to Cons tr t ( ) or Repair ( ) an Individual Sewage Dis osal System,
at No... L :...... LGrGt --------------------------
Street
as shown on the application for Disposal Works Construction Permit No.-9s-yy'Dated---- ..........
.......................................... ---------------- .............................................
Board of Health
DATE................................................................................
FORM 36508 HOBBS R WARREN,INC..PUBLISHERS -
TEST HOLE LOG
DATE:_SEAT
TEST BY:WELLER&ASSOC.
WITNESS: . _—7,o 5
PERC RATE:
77, 71
Al
I
U \ t?oposeD s t
----�-
c� rnw42� _ \�
1 �
DESIGN DATA
DAILY FLOW:-63)/3�r�.?: '>
SEPTIC TANK: 33c>__.- x 150%=
cas--s'�7c T +dC
LEACHING FACILITY:
USE: :6�J
CAPACITY:
SIDEWALL %98, x = %7/ z
BOTTOM: 78 S,r /. o
TOTAL:_...
J .
PIPE TO BE LAID 2"LAYER OF 3/8"PEASTONE
LEVEL FOR 2''OUT OF OVER 3/4"-1 1/2" WASHED
DISTRIBUTION 3OX STONE ALL AROUND
TOT?OF FOUND.
/ 10" 14" --- -
9--
ALL PIPE TO BE 4"DL4.SCH 40 PVC Z' Cv'
RAISE ALL APPLICABLE MANHOLE
COVERS TO WITHIN 6" OF FINISH
GRADE
THIS SYSTEM IS NOT DESIGNED FOR
THE USE OF A GARBAGE DISPOSAL
SEWAGE SYSTEM PROFILE
SCALE: 1"=10'
GENERAL NOTES
1. CONTRACTOR TO BE RESPONSIBLE FOR THE
SITE-SEWAGE PLANLOCATION OF ALL UTILITIES,ABOVE AND
/,,.
b.' UNDER GROUND,PRIOR TO ANY CONSTRUCTION
FOR
. t 1049, OR EXCAVATION.
2. INSTALLATION OF SEPTIC SYSTEM TO BE IN
COMPLIANCE WITH 310 CMR 15.00: TITLE V.
PREPARED FOR -
�TN 0r R''�A'Pp 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY
,� }�,j/,t�C ,�jU/C.t�//,✓C7 - //./G ��°�`` �� �'� LINE DETERMINATION.
SCALE:j s �(/o7"E� DATE: 99s _ (V S¢ '��1;''�'
Nil�
-
WEE]LER & ASSOCIATES
P. O. BOX 119 YARMOlUTHPORT, MA. 02675
(508) 362-8131 APPROVED BY:
VEST HOLE LOG
DATE: sE,oT zz,
TEST BY:WELLER&ASSOC.
WITNESS:
PERC RATE:
y/
o
--75
voiL
N ;y,� n7. / 6 - /o /�i5'7U2 tJ cc�i..lT= v
aQ�poseo rt �. ,
3�6 37 s i
o l zs`s!- `sue DESIGN DATA
DAILY
SEPTIC TANK:-
..=33 0 x 150%= yes
7,
LEACHING FACILITY:
+ USE:
CAPACITY:
SIDEWALL:/9,5,
BOTTOM-' A 76r,5
TOTAL
PIPE TO BE LAID 2"LAYER OF 31V PEASTONE
LEVEL FOR 2' OUT OF OVER 3/4"-1 1/2" WASHED
DISTRIBUTION BOX STONE ALL AROUND
TOP OF FOUND.
@ EL, .a`v
/ 10" 14„
ALL PIPE TO BE 4"DIA.SCH 40 PVC
RAISE A cam'LL APPLICABLE MANHOLE �
COVERS TO WITHIN 6" OF FINISH
GRADE
THIS SYSTEM IS NOT DESIGNED FOR
THE USE OF A GARBAGE DISPOSAL
SEWAGE SYSTEM PROFILE
SCALE: 1"=10'
" 4
}. GENERAL NOTES
1. CONTRACTOR TO BE RESPONSIBLE FOR THE
SITE-SEWAGE PLAN LOCATION OF ALL UTILITIES,ABOVE AND
FOR
UNDER GROUND,PRIOR TO ANY CONSTRUCTION
OR EXCAVATION.
Go T- �3 c�9yTh'i�.STfaBGc-'S 3 �
2. INSTALLATION OF SEPTIC SYSTEM TO BE IN
PREPARED FOR COMPLIANCE WITH 310 CMR 15.00: TITLE V.
04f0 of At",11" 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY
LINE DETERMINATION.
SCALE:: S.: /o7Eo . DATE: R�
WELLER & ASSOCIATES
L.rr�
P. 0 BOX 119 YARMOUT'HPORT, MA. 02675 -
(508) 362-8131 APPROVED BY