HomeMy WebLinkAbout0009 APPALOOSA WAY - Health paloos-a `flay
11arsto-is Mills
A s-i,74 Oat UZI
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TOWN OF BARNSTABLE
LOCATION SEWAGE 5Z5;e
✓vif�I
VILLAGE _ ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO. /e ms moo✓5' S-ot 7 a s f 3 c 2-
SEPTIC TANK CAPACITY (5 00 s 1
LEACHING FACILITY: (type)(30 S'd,' el-v 41 5&�,2 f (size)3z X f x X
NO.OF BEDROOMS
BUILDER OR OWNER J® 4 N 2,4024 /.5,
PERMITDATE: 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
i r
AC/ c, /r �
,f
No. �07 Fee
_ / - ', O
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ZIpprication for Migaal bpgtem Conarwrtion Permit
dal Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) 0 Complete System El Individual Components
Location Address or Lot No. lx3 ��j�y c� Owner's Name,Address and Tel.No.
�01 Assessor's Map/Parcel /
C_�r -#JiL AA,
Installer's Name,Address,and Tel.No. Designer's Name
l A�ss anted Tel.��
�7 -/ z& 7 S__
Type of Building:
Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( ®
Other Type of Building No.of Persons. Showers( ) Cafeteria( )
Other Fixtures
Design Flow f `/yo gallons per day. Calculated daily flow Y°'}�D gallons.
Plan Date Number of sheets r Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil �_,
Nature of Repairs or Alterations(Answer when applicable)
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 issued by this Board of Health. _
Signed a� Date 4' TU aZ
Application Approved by M/• Date 112.0 v
Application Disapproved for the following reasons
Permit No. vu — Date Issued 01u U
————---———————————————————————————————
r I.
�0P l Fee I 0 ` + /
' ': s'1 y U
No. x
`�1y_ • THE COMMONWEALTH OF MASSACHUSETTS �4� es
J .; Entered in computer: Yes
✓
- PUBLIC HEALTH-DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Z[ppricatiWfor°Migpogaf 6p5tem COAt ittiou Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
r l Location Address or Lot No.�,F
100s,-- Owner's Name,Address and Tel.No.
UO' Assessor's Map/Parcel
M
Installer's Name,Address,and Tel.No. Designer's Name ddress and Tel.No.
kle ffer- -d 49}0G
Type of Building: `
Dwelling No.of Bedrooms� - Lot Size 23 sq.ft. Garbage Grinder( /I40
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
' Design Flow gallons per day. Calculated daily flow VY69 gallons.
`!'Ian Date Number of sheets / Revision Date
Title
x:
Size of Septic Tank Type of S.A.S.
Description of Soil
a
Nature of Repairs or Alterations(Answer when applicable)
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 issued by this Board of He Ith. i
Signed a _.X Date
Application Approved by Date aG &
Application Disapproved for the following reasons
Permit No. 0;- 'I/1 t� Date Issued q V U ;?
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CEP FYI that the On-site Sewage Disposal System Constructed( /)Repaired( )Upgraded( )
Abandoned( )by cy-i/ ��---i
at NO 0 4 k aD_s- (.J . has been constructed i accordance
with the provisions of��Title 5 and the o Disposal System Construction Permit No. a Uu]—yZ V dated ) u 011
1
Installer 1—h GkL-e y m,p s Designer_____�
The issuance of/this/permit shall not be construed as a guarantee tha(the syste �i i�nclion as designed.
Date / r7 �4 Inspector
---------------------------------------
No. Duo ;t—7), / Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Miopooar /bpgtem Con!6truction Permit
Permission is hereby granted to Construct(✓)R pair( )Upgrade( )Abandon( )
System located at W94
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:_ 1.2 old 2 Approved by /A4 4v-
L
TOWN OF BARNSTABLE
LOCATION SEWAGE # 0 :t
VILLAGE (t/4-2 7- 941?1 5'i4J 't ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO.A'd e fil
SEPTIC TANK CAPACITY e5e;'C' -5 r
LEACHING FACILITY: (type)-W 5 t)o.C/ o�, 5��,� c (sizeQZ X !'3 X 4X.
•• NO.OF BEDROOMS
\ i
BUILDER OR OWNER Ja 4,u 2-
PERMITDATE: 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
goy
9-r C
4Q Q
A ..
-J
TEST HOLE LOG
p+ i lu DATE:'D" t�y SOIL EVALUATOR:
WITNESS:.,/,..
PERC RATE:_.-. Z -J/i(/,//�/�
4 per: -470
w�
e
�1
DESIGN DATA
DAILY FLOW: (0//BDRMS. x 110 GPD = 7 TO GPD
SEPTIC TANK: yZD GPD x 200% =880 GPD
USE:/.SO p GALLON PRECAST SEPTIC TANK
LEACHING FACILITY:
USE:=(;_3r_ j xQiSll ��" �oo� �a�IIU�CL.S
CAPACITY:
S IDEWALL:-_ 93 X Z X D,2X_ /,32.r
BOTTOM:=_ :./3.x33.SXo•7y= 3z z3
TOTAL ;
OF MAS '
.' DANIEL E.
STEVEN ':sN �� F,RAh/IAN
R e!:• m 'Ci
vi1 (,
c10N�ca POFGISTE��
S/ONAL E v
NOTES:
1. ALL PIPE TO BE 4" DIA. SCH 40 PVC.
2. PIPE TO BE LAID LEVEL FOR 2' OUT OF DISTRIBUTION
BOX.
3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN
6" OF FINISH GRADE.
4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A
GARBAGE DISPOSAL.
5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED
li ON 'A 6" LAYER OF STONE.
Ii 6. INSTALL GAS BAFFLE IN OUTLET TEE.
2" LAYER OF 3/8" PEASTONE OVER
-----------=-= ;4"-lW' DOUBLE WAS}® STONE
-------------------` ALL AROUND
TOP OF FOUND.
@ ELEV.I&I, :::.:__::_ :�::::::: ��Z•7
.o l , o / 3, 3 �)o.o
6
::::::::::: /,23.2S /�Z.o Co.
/7�00
SEPTIC SYSTEM PROFILE
SITE SEWAGE PLAN
FOR GENERAL NOTES
f�,�ja/9L oos,� lvh'Y GJ. SNfTi9,C3G r 1. CONTRACTOR TO BE RESPONSIBLE POR THE LOCATION
OF ALL UTILITIES, ABOVE AND UNDERGROUND, PRIOR
TO ANY EXCAVATION OR CONSTRUCTION.
PREPARED FOR 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH
310 CMR 15. 00: TITLE V.
3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE
— DETERMINATION.
DATE :-JEyaTS Zoo"Z SCALE : 1" = Zo
4. ALL DISTURBED AREAS TO LOWMED AND SEEDED.
5. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY
WELLER & ASSOCIATES REQUIRED INSPECTIONS.
1645 FALMOUTH RD. - SUITE 4C P.O. BOX 417
CENTERVILLE, MA 02632
TEL: (508) 775-0735 FAX: (508) 775-0754 APPROVED BY: _ _ _
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