HomeMy WebLinkAbout0101 BLACKTHORN ROAD - Health ���C� b��-e,�.�t�.v-yv�,�a o ���.
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
......_0F........r9rAs*PQ....................................
ApplirFation for Disposal Works ( omitrurtivaa Yrrmit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at:
✓� _ it.
� ..----•-... �1'�....................... s�------ ......4. `.c A----------------------
s ocati dd o t�A"o.
a � � ...........................................
----•-•-•.................... .e - _. -- -
-------------
Installer Address
Type of Building Size Lot.._. _. . Sq. feet
U Dwelling—No. of Bedrooms---- /_.P,-------------------Expansion Attic ( ) G rba�inder ( )
Other—T e of Building No. of persons............................ Showers
a YP g ---•-----------•------------ P ( )--- Cafeteria ( )
dOther fixtures ......•---•...-••-•••••••••••-----•-•-•--••-••--••--•-•---------•--
w Desi Flow........._ gallons per person er d Total ow
gn � ..................... � . ,� .._• �-----------•----------•----- dons.
WSeptic Tank—Liquid capacity Length�.6__ Width ...._ Diameter________________ Depth _i.
x Disposal Trench—_To..................... Width_ ....... Total Length..._... _ Total leaching area....._. .-_---_--•sq. ft.
Seepage Pit No..... ........... Diameter._._. __...__ Depth below inl ............. Total leaching areasq. ft.
Z Other Distribution box ( ) Dosing
Percolation Test Resul s Performed by-.. _ fst
__ lCt " : Date...... �V '
minutes per inch De h of it. -__7-Y../lDepth to ound water.._1V
Test Pit No. 1.. _t pground
fro Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
............. -----
Descrip 'o f Soil ..yIl �i,S�,I[
--- - ---- ----- ------------
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'TT
LE 5 of the State Sanitary Code— Th ndersigned furth agr s no o ace the s stem in
operation until a Certificate of Compliance has been is b the boar of he
Signed
• • .-- •-- .•••• ••.._.i...
• to
Application Approved BY ----•----------------•--•---....••---- ---• ---•-••-r- .�Weo
ate
Application Disapproved for the following reasons:...............................................................................................................
.........--•••-•••••--•••-••-•-••----••-•••--••-----••-•••••••-•-•••-.....-••-•-----------•--------••-•-.--•••••-•••-•-••-••----•••--•-••-•--•-•---------••••--•-•.............•-------••-•---•••---•---
nn �/ Date
PermitNo... S!. .7.� ----•-----•----•-------------. Issued.......................................................
Daze
0z
No.....JP�L-- J�90............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.....................................
j;.k.........OF.......
Aliptiration for Disposal Works Toustrurtion flunat
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
System at:
............. ......................ktkar.r ........... .......... ................. ---
i. d .. r I
No.bA............................. . vfii
k -q----- n r ; Add�To - - - 4�r. ....3.,/..... .4, K"' ee...............
Installer Address
Type of Building Size
Lot -- -- --- --------Sq. feet
�G�rba�geGrinder Dwelling—No. of Bedrooms---- ..................Expansion Attic
Other—Type of Building ............................ No. of persons................._...._._... Showers Cafeteria
Otherfixtpjes ..................................................................................................
Design Flow_..__..... _........................gallons per person per d T ..3 4y. Total}' POW. 9C.............................gallons.
Liquid capacity' gallons Len 4?
Septic Tank Length ...6 Widte!k!.... Diameter---------------- Depth.5.-!.7
Disposal Trench—'lo. ................... Width ....... Total Length I........ Total leaching area.....__ea..... sq ft.
. ....... Diameter-----ej--------
q.
Seepage Pit No...../...... ......... Depth below inlet.............. Total leaching ar;;S*];;;b;
z Other Distribution box Dosing tank ( ) - I
0-4 ----:V - . I..0,11.1.44-fr4c........Percolation Test Resuys Performed by. ..... Date...... /xic..........
Test Pit No. lA,..;L--rriinutes per inch er i of Test Fit.................... Depth to ground water--------------------
Test Pit No. 2................minutes per inch Depth of Test Pit............_____... Depth to ground water----------------------
--U0Des r 0%of So
il i ow 4QF-1.-1
---------
-- . -01------#-----------.............. 2
( . I
'------- .................................... ...................... . ,
........................................................................................................................................................................................................
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
................................................................m.....................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of'TIIL- 5 of the State Sanitary Code Thendersigned fl.11`07 agrees With no o pface the system in
b A6�
operation until a Certificate of Compliance has been is Ax the oa�rd,(of li
Signed.... . ....... ...=. ........................ ......... ....... ......
6 W..
Date
Application Approved By. -- .... . ..... Z a'l..............
Application Disapproved for the following reasons:................................................................................................................
..........................................................................................................................................................................................................
Date
PermitNo.-��1--------------------------------------------- Issued.......................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
-w.k,...............OF..... J.1.9.......................................
(Intifiratr of Tomphatirr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed �r Repaired
by------------ ....kaI6le°./................................................................................................................................................
_&Inst 11
at---- ......................................................
has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.-?&-%64.................. dated./�O-9/v'O'C5----------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. 15�7
.........................
DATE...... ..................... Inspector.....W't.. ----- .....y.....0.i--;....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............OF...... ... ................................... 00
FEE../64...........
No.... ��160 .........
Elisposal Varkv Tonstrurtion "prrutit
PermissionLor
'�r 4.1e, .1.
ereby granted...........U..LaA.el...... ........ . .... . ......T-------------------------------------------------------------------
to Construct Repair an Individual Sewage Disposal System
at No. <0-71-.S. 3-2---- 4-
'HI-4111...................................................................................
Street
as shown on the application for Disposal Works Construction PS54ut No..?10.74I& Dated9zvv7o......................
---------------
DATE..----/ -------------------- ------- Health
FORM 1255 HOBBS & WARREN. INC.. PJBLISHERS
3 � TOWN OF BARNSTABLE
LOCATION to —6 I1 CANk "!/'Lt- EWAGE #
VILLAGE Y4V'SJbl^ �r�! ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. T® �%__ S "e
SEPTIC'TANK CAPACITY 10(�)Q 94/.
LEACHING FACILITY:(type) lCQQ (�/'�� (size) 6 X NO. OF BEDROOMS Z PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER bc)L& e i
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
,s
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ill - S4AIP %6RA vel- -70
TOP OF FOUNDATI01Y El.: 9G2 Ec. 977
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2/ FINISHED G.-RAOE 9
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SAA&+
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o. IN Et 9� js .�' MIN. COVER 1Q
- � 1 � • ' r f IN t l 9_..a Ih ll 33 • i • , 1 , � •
2 COVER 8 WASHED STONE
IH E 93 t 1/8 S/
li l L r N G L. 2' ° . ' �• • ° • 1
..' 4, I 0/ 8 W/ 6 SUMP ' •' 3/4 1 1/2 WASHED STONE Fc �0U 1 :3
ll U 0 LEVEL • • e 4 O .vo Lt/� �
II E.�
° • • � • 9 EFF • tt
, • • • • e ' • p • J 1 ,
. . v _., -Wj 0 ° , b .• DEPTH •• • .. PERC T EST RESULTS
PRECAST SEPTIC TANK WITH • ' ♦ ` • ` PRECAST LEACHING PITS PERC RATE .
I CAST IN PLACE INLET AND EL• 89 0 `. °°• % / • G'.�iA !�/iT� g'EIr�E<77r/� WITNESSED " BY RAvL �AwO�,rrs
III I OUTLET T ' P R T I T i N O•• ._.. S II Z E■ ,DE�T�/ ,�ivD z ' o� srnv� BA�Pn/srABL
S E LE V z G ' Atc A,PouN/� BOARD 0 F. HEALTH
S I t E : /eoo G'A l l 0 N S --�--D I A `'+'-
. .. . .. �, ._ � O F STONE DATE: SE�rFr�,B�-� ✓.�', /990
C 8G LONG x s4 W 1 O E x s � - 0 E E P l Pervious % :DIA ALL AROUND P. No. 76113 '
Material
- -
E L. �a NOTE•' �t'E�'10!/E /i�IPEI//O�/S /�JAT�R/ALOJ4 /O' J
iVo •h/AT��P ENCOUNTE�P.E D ALL 'ACOVAID 77/E LE.4Ct//NG A/7 Alp 4e'pEEP '
o
I PROFILE . OF PROPOSED SEWAGE : SYSTEM COARSE, CLEAN SANS �� �t
SYSTEM - DESIGNED BY , TH[ TOWN OF ._ AARWS7ABZH REGULATIONS AND _ ` nG�G . L07, 332 m
•, � STATE TITLE V FOR SUBSURFACE DISPOSAL OF . SEWAGE . SCALx 1/4 - 1 0 27zZ2s
i
r (57LV,4-1AL N072F•.S Z
9
1. All PIPES SHALL BE SCHEDULE 40 P.V.C. FLOOD PLA/N z0/t/E C 45
L .V.C. SEWER PIPE ,3
i
►• ON F/R/9 P.9it/EL No. <<'G'OD/ 00/S' C
Z. All PIPES SHALL BE SLOPED 1/4 PER . FOOT EXCEPT FOR
D.grEo: AVGusT /9, /9r.�S � �
THE FIRST Z FEET OUT OF THE 018 WHICH SHALL BE LEVEL --
0 E S I G N FLOW ,� .BEDROOMS AT 110 GALDAY PER BR , . . GAL/ DAY
SEPTIC TANK ' SIZE 3. 2 IX /3' - ` 49s GAl ooj 939 tiK d�°a� $ 3 0
7000 CAL. W/__ovT GARBAGE DISPOSAL I Z'U S E < S
LEACHING SYSTEM : USE : w C,' DiA- ARECAS7- Lt_AC11/1V6: pir w/,z' 4f1511zw
ALL ,4RdUlVb 4ND 8 E'ffECT/IlE '16Ei"771 �G � ��x • � •�"'" .-- � ° — � '�• `�2, •2, �'�� � • W' -
� $�L.R dodo�1C �• � 90 Q`
\ p
EFFECTIVE AREA : SIDE EZ"A xis• zst'<s>(e>x s= cz8 ��+c/aA� 9oX\ ` \"'� aN r2. �SERT,craArA 1, p
B O T T O M �.,�= x�c . V'<s> 78 GAL%w
O
TOTAL. FLAW 7o GAG7DAY \ ,� /Dsd/G RI g• , ..
TOTAL REQ D _ FLOW 3__30.E X /0 33r� W/. GARBAGE DISPOSAL
Al
'.'•�9� '
RESERVE FLOW -700 - 330 t 376 GAL/ DAY..IN RESERVE •, IN
.. RE FEB E N C LAND COURT PL AN /Alo.. .?07s/ E sHEEr �3 E��=98 eo ��'O `� '� sr ,•'�G`a���
C PLANS . � 9
' APPROVED BY :
BOARD OF HEALTH h
-PROPERTY OWNER ; /LEEiI/ A" ,SAC& 1y l-Z�-.�
DATE
: P.4v6�1EivT NAA1 SC'ALf
_ SITE . ANC. S E WACE FLAN
OF�p``H Of Mks a p�,SH Mqs�
F O R : PR/ESTG Y FA/•f/G Y 72r UST
9 o�' JOHN q�yG 3 OFOROOM tINGLE FAMILY DWELLING
ROBERT cya � P..
e M• v DOYLE,111 ti L O T ; 3-�2 ,BLACk7/lORN OR/l/E
1 c DAVIDSON -a
y No.33389 0 SE,DTE�18Ei4 /�� /99D
.o .p No. 24500 I A t
�oF01 TE��°��� �q�E�/STEn�do� DOYLE ENGINEERING ASSOCIATES, I N C 0 R P'0 h A T F 0 Y
B:�Landers Road W. Falmouth, MA 02574 '
- i•IVM` .�yial aM ���Y�1%���r�.ra.��S..
SONAL Box 595"'•"530 Thomas `
t rs w Lrevl•fi rM
' �+r�.arr��r.ri M•�•w�.�a�il.7a• - - d1A�.•rr � . i '•e+GlVi•{
SOIL LOG
NO. 1 NO 2
SITE PLAN . AND 2
II !
a c3'YIBSd/L 3 '
_ Fc. s99 4
• - SAND %X)tAf/eL
c . 0 5
TOP OF FOUNDATItlN EL.• 9 ?... Ec. 677 a 6
7
I� INISH' ED � ��oiury ' • .' 6
+' R A G — 9
E ,,4Na s
IN )l
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r.�. MIN. COVER
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• 4- 2 COVER 1/8 3�/8 WASHED STONE I
.98 • ° • r
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IN It
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�.' O/ 8 iN! 6" SUMP IN El. 2• ' ' 3/4 1 1/2 WA SHED STONE
v 4 L I V I D LEVEL . e61 NO [,I/ArE'�4
. ' o• ° • ° ENG'OUNTFREI> ) A
v
•
a• r
e • • . 8 ° I
. EI�F 1 .I l
I ' + L � U. • e • 0 _
• � -r--;-*-J ' " " ' n ° ° , • • DEPTH ; �� ; PEaC TEST RESULTS
PRECAST SEPTIC TANK WITH • ; .' °, :; PRECAST LEACHING PITS PERC aAi 1 ZM/N//,ycf1
CAST IN PLACE INLET AND �(, 8¢9 • , °b NO ' SIzE• G'.d�A !�/i / 8'EFPErnv�' WITNESSED " BY PAvL tArvoE-,Ps
OUTLET T 'S PER TITLE V I , ....._.. r// ftivD z • O� sravE BAR�srslaL BOARD OF, HEALTH
Z G 2 Al L A�PDUND.
SIZE : /eod G A L L O N S ¢ .� .--D I A OF STONE DATE sEf7t-fiBf'R /3, /990
L 0 N G x s"'¢'. W 10 E x 32" 0 E E P ) ...._.r.. Pervious ,,
DIA ALL AROUND _ _. t P. Ale. 7G�3
Material
EL. 80.9 A-01 •• rPEMD!/E 1i'�I�E�E'li/4�/5' /1AT�R/AL �O/S /O' ►
No h/A7,RR Fil/C'OUN7�iPE lD ALL �AR,v I O 771E LEACH1,A1G �17 .4Alp ��1�eE� y' �
d01�'N 7V ELE;/A770A1 B9. 9 RE'i°LAC� hi�Y N-
IPROFIL. E OF PROPOSEDS SWAGE SYSTEM CdA::C-I XZEA/V SAND �
SYSTEM - DESIGNED - BY _ THE TOWN OF BARws ;4B��- REGULATIONS AND �� � \ SOT .332
STATE TITLE V FOR SUBSURFACE DISPOSAL OF SEWAGE SCALE j!4'w,, ' 0" 9°\� � Z7zZ2s� �
W
N . B • ZONiiv� P15rR1C r.. . 5�
1. All PIPES SHAH BE SCHEDULE 40 P.V.C. SEWER "LDOL? PLA//V 20/Y c •�s aEt/wEAr�� q� q2 W
W R w �13
! .. Ow .fYRrJ AWA1EL /Vo. M000/ 00/�" C
! 2. ALL PIPES SHALL BE SLOPED �1/4 PER . FOOT EXCEPT FOR
THE FIRST 2 FEET OUT OF THE O /B WHICH SHALL BE LEVEL , a
3. DESIGN FLOW .3.r BEDROOMS AT 110 GALDAY PER BR , GAL/ DAY � ,-y
SEPTIC TANK ' SIZE 3. 30 .X �5' 4,*5 CAI
USE /000 CAL. W 1, ovr
GARBAGE DISPOSAL
LEACHING SYSTEM USE': w (,' d/A' ARECA,5 T l_4Ac y1NG P/r w/2' of sro vim-
ALL +ROUND AND 8 �'FFECT/VE 2DS' 771 qG � `,�.,, I '�.r/ • _ �2. 2, '�'� � W' - \ o, Q
EFFECTIVE AREA : S10F a s��.P
2 7YJP 1! x e?5• ZTl"�5�($�x�5= Zg GAL/DAY ,Gac -r�• � � �
� \ w/t'of ' •° sE�is TAat- �
B O T T.O M n'R" ,�/o r 1r'(s�s x/O : 78 GAc%.4v
TOTAL. FLOW 704 P41-IPAY ,o"5,0
r o��L
TOTAL REQ'D FLOW 3� X /o WI. .T GARBAGE` DISPOSAL 9F8�
AESEAVE FLOW —-700 - 33o L s7� CAL/ DAY - _LEI RESERVE
REFERENCE P L AN S LAND COURT oz AN A/. �3o7S/ F S,-ve e J E�.=9B 00 •'
APPROVED , BY : 9�0
' BOARD OF HEALTH
PgvEi'7 NT NAA1 ,SCALE
DATE :-PROPERTY OWNER . f/LEEiI/ AND �,qC& ,V/I-L E,� SITE AND SEWA- GE ' PLAN
OF F O R : ,c/e L Y f:9�1/_Y 7i?UST
� H of M�a a�� �fgsf •
ROBERT gctiao� JOHN q�y� 3 BEDROOM SINGLE • FAMILY OWELLING
P.
M. bOYLE,rir y L T ; .3.32 ,8[ACkT/lORN •DR/(/E
o DAVIDSON y No.83889 I DA 1 E SZrP7E/ B-R /3j /990
No. 24500
�4 sC'STE�G ��"� . �q't'OSUE��yOQ �OYLE ENGINEFRING ASSOCIATES, INCORPORAtED y
Be Landers Road W. Falmouth, MA 02514
'srrr rr...wwdid,
.rirwii.Y'•'/:s .. - �p111NY�.r
n v' �ONAI Box — 5 Thomas
ow: -. - - ww..�M•:dlV+i✓r�.�w'a+�r�lki �..rr�r'�fir4N"-- r M 1 .rrr rn i _. _ •.4GNif- __ .