HomeMy WebLinkAbout0153 BLACKTHORN ROAD - Health c� G-v
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LOCATION SEWAGE PERMIT NO.
c KI-rHvp-N
VILLAGE
INSTALLER'S NAME & ADDRESS
C o 14/y
B U It D E R OR OWNER
DATE PERaIIT ISSUED _ � P&I7-7
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DATE COMPLIANCE ISSUED f�� ��/ 77
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THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN...-oF.......BARNSTABLE
---- ---------------------------------------------••-�..-•••-
Appliration for Disposal Works Tnnstrnrtinn Frrutit
Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal
System at:
Blackthorn Road-• Marstons Mills 445 A—
...............•----......._............--------......-------•-•......._....---------------------- ---•-•-----..........•--•-------------------------•----------------------..._.._...............---
Location-Address or Lot No.
�. ��_.._1Z�, 1 .1?rc._ r...►�..2. �c .t�............ ........ia_�.s.......�'. .-•--�'`�,�1�^r�r. t._..-•-----------•---------•---
Owner Address
........................................................
Installer Address 20000
d Type of Building Size Lot_____..._.__!______________Sq. 'feet
aDwelling—No. of Bedrooms___________________..___.__.____.___.__.___.Expansion Attic ( ) Garbage Grinder ( )
p� Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
a Other fixtures _..
W Design Flow...........110.........................gallons per bdr,. per day. Total daily flow................33-D_._..__...._::.:::.__gallons.
94 Septic Tank—Liquid capacity10Q Q__gallons Length_Q.'-0"__ Width..'_-_1.0"Diameter_.._.'"'-____. Depth_5.'_:.4L"_.
W Disposal Trench—No_____________________ Width.................... Total Length----_............... Total leaching area....................sq. ft.
Seepage Pit No...... ------------- Diameter....1Q_..___.___ Depth below inlet.... Total leaching area____._3_40_...sq. ft.
Z Other Distribution box ( X) Dosing tank ( )
Percolation Test Results Performed by-_CaPe...CO-d---5urXey___ Q315.111 cant]Sate_-__$/917.7__________________.
Test Pit No. 1....2_.........minutes per inch Depth of Test Pit.......U'_.__. Depth to ground water.....n-
(i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.. OF At
--------------------- --
O - S Q a a t J. ✓ Es•► ROB
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Descr>ption of Soi1J. • ------•---------•- • ..............-
E�,
/ 1 ----
U ._.___.__�__. _ i� __ ._ ..__ _ _____ ____................._______ 0 � y
W ......................- -:-2°+�•---__ ._._ --------- - •A'-•--•- - - --...------ -------------•---••-•---------..._._..----•--•• ......
--
UNature of Repairs or Alterations—Answer when plicable------_...............................................................
--------•-------------------•--••-----...-•-•---•-•------------•--•-•---•--•---------•--...........----•----..._---•------------------•--------•••---•--••••--••-••--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accord > it 7
the provisions of TIT?.��: 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.
t
Sined. ? ` -------------------------------------•------------- ---•----------•--------••----•--
Date
Application Approved BY { ---• 44.4. 1 �
Date----•------._
Application Disapproved for the following reasons______________________
....-----•-----------------------------------•---------•-------------------------------------------••-----•••----•------------------•--•-------•--•----------------------•----------•--••-••------------
Date
PermitNo......................................................... Issued_.......................................................
Date
Ficz..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
4N.
........... .....
..TOM....OF.......BAM. ST.".LE..................................................
......
Appliration for Uhipasal Warks Tonstrurtion Vamit
Applicatioi",is hereby made for a Permit to Construct (X) or Repair an Individual Sewage Disposal
System at:
.... •
.........................................445.. ................................. ................
Location-Address or Lot No.
.. ........
......./4
.......... ...... ...............................
Owner� Address
.40..j.4.Pj........................................................ .......................... ---
Installer Xydle"ss`n".
Type of Building Size Lot------2,0_y.0Q.0-----Sq. feet
Dwelling—No. of Bedrooms-------------------3_---------_--------Expansion Attic Garbage Grinder ( )
Other—Type of Building ............................ No. of persons____._.__.________.._.__.... Showers Cafeteria ( )
Otherfixtures --------_---__------ .......................................................................................
Design Flow..........110L.........................gallons per,:-- __'_1
bdr,-.per day. Total daily flow...........jn330....................gallons.
Septic Tank—Liquid*capacitylOLO.O..gallons I�ength'8'.!._6!!.. Width-4_t_.j.G)1Diameter..... ...... DepthS.1-4.1'
Disposal Trench—No..................... Width............__._._.. Total Length.................... Total leaching area....................sq. f t.
Seepage Pit No.....I-------------- Diameter....LV........ Depth below inlet...6.jL............ 116tal leaching area-------340...sq. f t.
Z Other Distribution box ( x) Dosing tank ( )
Percolation Test Results Performed by.-Cape--Cod---Guxvey---Gen-subtantpate....&/.9./.-j.7...................
Test Pit No. I...2..........minutes per inch Depth of Test Pit-------1.2.jL..... Depth to ground water.....norm__-
Test Pit No. 2................minutes per inch Depth of Test Pit..._..........._.... Depth to ground wate
I F 414.(,
.... ------- -------------------- ....... -------------------
40 /44
0 Description of i ------
... ...... ......... ................. ROBERT (P
U ..... . ................ 0*- ------F------------
�C' 11 X
W 4....Ix% .... Ex.......DAYLOR.......1111-P.. ....... .�.t;t �
.....................44 .1L..... .. - - -------------------------..................
U Nature of Repairs or Alterations—Answer when pplicable............................................................. .
.,p No. 41
. ... 237..
........
.......................... ............................................................................................................................... . ....... .
Agreement-Al'-.1"
The undersigned 'agrees to install:the aforedescribed Individual Sewage Disposal System in acc >tl
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-V657rd of health.
S%' ned....- .Z.A.11-L,
..................................................... ............... ..........
D;�
Application Approved By..... -.r 7
........... -------------------------------- .................................
Date
Application Disapproved for the following reasons:.................................................................................................................
........................................................................................................................................................................................................
Date
PermitNo................. Issued......................................... ...........
Date
1.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OA HEALTH
OFllfto*-�. ............................................. .............. ............................... ...............
Tlrrtffirat� of timp'liaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed dr--Repaired
by----------P4 .............................I.......................................................................................................................................
Installer
at.-- .............. k-11-------------------------------------------------------------------------------
has been installed in accordance with the provisions of T, of.1he State Sanitary C�de is cdi'e�'bed in the
application for Disposal Works Construction Permit No..... 7_7.............. dated-------- ...............
THE ISSUANCE OF THIS CERTIFICATE SHALL4fNOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SAT!$FACTORY.
DATE------......, ...........1.,,7 I.Z',e.2 ......... Inspector... ...........................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD QF,
,�HEALTH
_77 V'15 4*1Pftn
...........................................OF................j%W..................V.............................................
No.......................... FEE........................
Permission is hereby granted-.--. ---------------------------------------------------------------------------------------------------------------
to Construct (y, ) or Repair an, Individual Sewage Disposal System
.......IL
at No. 4-w� ........P JA............Aw.....tJ124fl-....5-.�................................. ---*------------"-------
Street 77
as shown on the application for Disposal Works Construction Permit
0 ......................................
...................... IV e.
..............................................................
DATE.......................................... ................................. Board of Health
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
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/ 2".PEAS TONE-LOAM a FILL 12"MAX. -
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BOX I;, e p p OD •I / G.
2♦"MIN.
�el*N. 1000
I� , � � 1000— GAL. 1) 0 e I
GAL. � ''° PRECAST OR o ° .I `SA
SEPTIC 6'I� o • BLOCK ° D°
TANK ��',�• p SEEPAGE PIT °° U 0
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20' MINIMUM o,°°• �0
FOUNDATION I
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7JO47- T� Si&euJ I�-4�� I �IW' WASHED STONE --1/`1
TONE I �28.8
Noca.nYu•C.
S I`bWN ht E O� W.OS L.oc-DTbT> i3y '9" ACTH,e� I SCALE I'�S
Id- $�{z+�tY. off A- ,s_ I9ZZ A N'
N�.. r: 10 PQRC. PATQ >< ��a�� z,.,..�/„✓
Cw•F ims TD TGe Zoa, ley I�� cF 76 , TEST BY : •� G3 .�✓f" �c1 tl„t ti
1 u a F 1 A b � /►t Ac�C..a� TOWN INSPECTOR: /5t004. .1 s,e fesEl/
BACKHOE OPERATOR :
sS �abiST L,QND Sv �YoC TEST MADE ON 9 77
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ELEVATION SCHEDULE
PROPOSED SITE PLAN
I. INV. AT FOUNDATION
2. INV. INTO SEPTIC TANK - IN
•3. 1 NV. OUT OF SEPTIC TANK _ 7 LoT 496' 1V,9RS TONS MleZ S, ^9
4. INV. INTO DISTRIBUTION BOX = 13'&' Z 7 SCALE: I ZO' sepr 1977
5. 1 NV. OUT OF DISTRIBUTION 90X 13a. SO C 7 a
6. —INV INTO SEEPAGE PIT = 138. 00 CAPE COD SURVEY CONSULTANTS
.: _ /3L. 00 ROUTE 132
T. BOTTOM OF PIT - HYANNIS,MASS.
A DIVISION BOlTON aunver CQNIBULTANTB, INC.
8. BOTTOM OF STONE LAYER = 3L.O O