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HomeMy WebLinkAbout0179 BRIDLE PATH - Health 179 MARSTONS MILLS - r AsBuilt Page 1 of 1 F TOWN OF BARNSTABLE L ATION 17 d /^I e A4 SEWAGE# W VILLAGE-- ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY aGU GAL LEACHING FACILITY: (type) ��� (size) Id NO.OF BEDROOMS 3 BUILDER OR OWNER PERMTTDATE:. 3 COMPLIANCE DATE: Separation Distance Between the: �` Maximum Adjusted Groundwatet Table and Bottom of Leaching Facility y t Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) ,q Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Rear 7 d;2;2 43` � 0 R 1�Ic http://issgl2/intranet/propdata/prebuilt.aspx?mappar=125055&seq=1 5/30/2012 TOWN OF BARNSTABLE LOCATION o A; SEWAGE# 4f VILLAGE A4V,,3/0 3 141115 ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. Q®� � � ®��� ��-�✓=�1 SEPTIC TANK CAPACITY 1,100 Gt L i LEACHING FACILITY: (type) e_> �l �J/eu!' (size) 6 X/d NO.OF BEDROOMS BUILDER OR OWNER PERMPTDATE: 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 Rear �, 3 r' 0 y yf y�f !Uc No. �" ! —7 / Fee THE COMMONWEALTH OF MASSACHUSETTS f ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pprfcation for Mitpogal bp.5tem Construction Permit Application is hereby made for a Permit to Construct( )or Repair(4n On-site Sewage Disposal System at: Location Address or �N Owner Name,�ddress and Tel.No. �/° Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 7 Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder(A09 Other Type of Building If:6 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 6522 gallons. Plan Date 3�4/ y Number of sheets Z_ Revision Date Title Description of Soil Ge ea//aP) Nature of Repairs or Alterations(Answer when applicable) CX L57/0 5Y57`�i� �•�/ Z%o s �r�� 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 thi oaKbf lth ` Signed Date /zl Application Approved by Application Disapproved for the following reasons Permit No. / y Y� Date Issued 3 —&P/ —Pe ——————————————————————————————————————— No. Fee o t G.ViEUMMONWEALTH OF MASSACHUS61" PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppYication for 3M!5pozal *pgtem Construction Permit Application is hereby made for a Permit to Construct( )or Repair(4n On-site Sewage Disposal System at: Location Address or t No. Owner' Name, ddress and Tel.No. f�Zey4k,G,y/'s Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. too/y'dLd i Gor�s�i"uc7�i®" 7 Type of Building: Dwelling No.of Bedrooms `3 Garbage Grinder( 0 Other Type of Building YfXx re No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /D P' gallons per day. Calculated daily flow 322 gallons. Plan Date 3 Number of sheets L Revision Date Title Description of Soil - CP 4LIke e. 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 o f lth. l Signed thi Date Application Appr6ved by Application Disapproved for the following reasons PP PP Permit No. / ` Date Issued 3 -,21 Z 6 u • THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the Op-s' Sewage Disposal System installed )or repaired/replaced( on �l o � 6 for r Z h' ly S Y � as s een constructed in accords ce' with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 dated �� Use of this system is conditioned on compliance with the provisions set forth below: No., / A� �Q 197 0 — Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po5ar *pgtem Congtruction Permit Permission is hereby granted to construct( )repair( aln On-site Sewage System located at 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. All construction must be completed within two years of the date below. Date: ��— � � _ 9 � Approved by CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I, &fIT L)- 6rrG%�&reby certify that the application for disposal works construction permit signed by me dated 'J 1Z/l�� , concerning the property located at 1?? �/'�a' /� a�� meets all of the following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. SIGNED : DATE: 3k LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. rl,A i • e , 'clr � �: �y,p P �j ��i11',f r ,'" op cxq ti - ;' .T 1 :�; t r r>*Gt r •�T qy r E t� .Jr�� nJ-f �! rs. ♦1' 411 t,, .. " 1, ? �TFr r.;{gi �''jr�+ .E �.. i t, e \is`v'• ,c 71y� Tr/► r Y VI t •ti 1t'' � f t r '^,�� n:iti y ,r � , �t1i �i :;i' i, ,•r ;" rqStJn•'4` , Vi •(ifs. v'.'1 I ;' .., i.�e h o /`/ 1ft�tIV 'xi w � iv- OF 9f ss4� CERTIFIED PLOT PLAN L 1 LEGEND ;-' �'` , r ► a Exl TINA SPOT ELEVATION 0�0.;; . sEf�T''' E l INO CONTOUR .0 o gUNIKIS x �9 S-PnT ELEVATION IN FINISHED CONTOUR 0AS L�A �f o.22isP�o��� ®PHI klS SS APPROVED ' BOARD OF HEATH �fss�ONA1.ISTS � r/ make,A I`l# a SCALE 1 = `yG DATE r AGENT ,PATE iERING CO. IN , CLIEN4-41`rk� 1 CERTIFY THAT THE PROPOSE LORED_�_ENGINE _ �7G9 e' BUILDINO SHOWN ON THIS PLAN ` REaIgTEREO JOB NO. _--- - - 'CONFORMS TO THE ZONING LAWS EGISTERE LAND CIVIL RVEYOR OR-By _ �1 Y--' OF BARNSTABLE , MA �° ENO.LNEER SU t _ 712 MAIN ST• CH' BY REG LAND SURVEYO �r `33 NO. MAIN ST' HYANNIS, MASS. SHEET—L OF 2' DATE S0. YARMOUTH, MASS. ---- -- --- --- --- ---= .------........._....-... .- Board of Healt •-.P._.. -.. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS A 0 L-' /F E/7-H-5 >O FT. M//V. _--- -.- -- .--_� n ' r�iCN/NG P/T .4RE /70RF THA SELO/w CO"S"' - - - ram•_. -- --�/� .;;kAOE, fa 24 "O/AM E=TER CD/VC• BE a A?0UG H T TO ':;,TA •E y l ��•• CONCRETE 4' �vL' P/PE i /-,SEA✓Y CA 5T /RO/v C o✓ER S.H�I L Z- tJE �/S FV chv Io P/TCN G10 R F ,• - - A -- - - - - G RA o E � C v . "E=� _L� C L EA,ti' _5,-�/V.� I 4' CA57 IRON PIPE lib OQG GAL. 0 ° - 1 • • • • • • 1 • ° c W,4bHED S7r/vE i Tr N V/TCN M/ D K • • • • • • • • 1 1 c/•� y ; PER P"T. TANK 'box • , • B • r • a • 1 % • o I � • � �. r • • UEfTH • • • •�� ,, .. .•s•r;5r1EC .S.T✓,4•E j I ?. -� �.! li - —� - t: r • • • • • • • • ► `_c ;�_ _.ti - rat= J T SEEPAG E I o r '� P/7 c:R QiJ/V __`. - .. 1 J • n � r 1 ■ • • • • • • 16 a o; ;,I: /NIiePCT ELE✓/�T/DNS _ � : ci /N✓ERT AT QU/L.D/NG 7.�' O FT_'`' f0 FT. U/fiM G SEE T.tliaL �T:CN ; INLET SENT/C TA/VK SS S FT - — �— ^`X\ OCJTLET. .SENT/C TANK .'��- :, FT GRO:/Nu nV<!TER •a9LE `a� FTINLET!J/STR/BVT/ON BOX _95'O CyTL ETD 1STR%B SECT/JN 4F Y;TEMAE -TUL.ATIOAI' FT f a 5HW ` LE EA NG P/ T z - _ / �N A LALE D/HENS/ON 8 _.fo _ FT. f UES/GIV CK/TER/A a 4� 3 D/HENS/ON C _ y__ F T �// �► i N4110"f9ER OF l&EURoJM-5 _ _ _. SDI z- LOG G..4Re.4GE 0/SPU�AL lJiv/T _ $OIL TEST - - i #/ - SOIL TESTg0�2 /C! ]$ ❑ TOTAL EST/MATED FLov�.'� 3.� G.4L../DAB' �4/L TEST ,VUM8Eje 0.4r 4GE f+/TS_ �—_ �^=LE✓. AG EL4Fk:_. OATS JF SOIL TEST _ _ L-- — I S/OE LLaAGH/Ni PEK PIT _ISM -S..� FT. or, RESULTS /''//TNESSED �Y�' �w ?I ��/ s �G2 -,m CO L AT/O/V RRTE #/ .1 I_► S .- M//V�IN-GH__'� BUTTUM LEACHING f'EK P/T- Q $Q. FT �f• pERcpL_AT/ON RATE Air 2 -.- M."N. •'/%✓GN ! TOTAL LEACH11WZr AREA -SQ.. fT. i O�_SQ. F !! 2Y R '•SI• Sa/1 i A` �'S N DF t� �� -- - - t LcSERiiE T. ER g'EAC'N/NG ARCH • 4v I �� RO ss' n ---t i I T �G f, Qs..Ss LI`1 va RUNIKIS ::4 _-_- ?-1.-f e �" s / "• / �/ l i -o A NO.221 62 Q s �0�FSG!sr�N���``�� EL DREDGE EN6r/N.EER/NG Co,/NG: C) '' GM • SC .'� QN�1LE 712 Mflrr t :` !•>, d „4, NYAAITZ MASS. SO_-Y/•RML7/TNr Ms1.aS_ 1 4T&or E/vC�C�t✓?E;:E,G ..Ilse �: '# t .� GRb uNC� 1-ti�TER_,AT EL�✓ .lp0 IVD-.ZP� SNEE7 �. x '� - - ----- --- r. ' - '- - . _ '• c•.'s•.,-'. fsii...l-��:•_•1•:.� ___• •: .Y., "�i d: :z t��'9i..S i LO•CATI/I/ON SEWAGE PERMIT NO. I� LLAGE x/a,re,.<I-lws INSTA LLER'S NAME & ADDRESS B U It DE R OR OWNER DA T E PERMIT ISSUED � ' � DATE COMPLIANCE ISSUED i� i 'S�3 �� _��i �� � � LL'� . . t �f� �; r �! 3� ,,;.� ,��� K fF y_- : .i '79 No........14 _.._ .�_.. '* "FSS............................. THE COMMONWEALTH OF MASSACHUSETTS BOA HEALTH ..-1. .../L,l`.............OF.......... �.../q..�N�...� .l..f(�.:� �............ ,� lirni�an for Diipuiial Works Tunitrnrtiun rantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal S stem at r*ocaln ddra�!'.I...kill',............ ................................. a.................................................... o . .S....-S--L -�ip4ky-........ - t . �'�' .. . :._..r Y :N tel:i Owner Addr a ................................................... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms_.�-----------------------------•--_--____Expansion Attic ( ) Garbage Grinder ( ) ..... No. of p-, Other—Type of Building �__ ._...._.____ persons...... ............... Showers ( ) — Cafeteria ( ) a Other fixt rest..--........•_.__ ---.•--•- - W Design Flow....................., .............. gallons per person per day. Total da' y flow---------3.XJ-......................gallon. W Septic Tank!-Liquid capacityli.4__gallons Length... ....... Width.. . ........ Diameter---------- ------ Depth............... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area_2-6.6.......sq. ft. Seepage Pit No...................t__.. Diameter........()...... Depth below inlet.....4........... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing t, ( ) Percolation Test Results Performed by._-L.l._�_ - ..� -$-.I �: .......___•.................•__ Date__��._�,2_ __.__.. a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ a Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground x ' .- ... >> ................... -----water.-._.____-___----- -_-___. •-•--• --- -......----•-••............. --o•---..---- pp O ---------------------------- Description Description of S it _ 4. .... -------------------------•------------•--•----•--- • ----•------•......--•--••-----••. - . W -•-•--••••---------------------•-•-•--------•-•--••---•• ----------- ....... 0 Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------_.................. ____ Agreement: The undersigned agrees to install the atorede bed Individual Sewage Disposal System in accordance with the provisions of iITL� 5 of the State Sanitary od — The undersigned further agrees not to place the system in . operation until a Certificate of Compliance has ee.......n i sued by the7oalth............... . ......................... . S;iprt ----•--------------Date _._ Application Approved B llll PP PP Y Date Application Disapproved for the following reasons----------------•-----------•--------•-------------------------•--------........................................ ..............••-•--•-----•--------------....--•-------------------------••------------.....----------------------•-------------------------------------------------------------------------------- Date Permit No................................................... ....... Issued....................................................... Date �l No.- •-1 S`e -- F�$.. ............... THE COMMONWEALTH OF MASSACHUSETTS } BOA F HEALTH ............OF...............L� .t ...9f ... ....<.----------------------- Appliratilan for whipoal Works Tomtrurtiun Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ' System a� -'�.?-� ..a • #=.._1.: .1.'_� 1 �t . ?a_ /i a.e. ;........... ....................._ .. -. ----------------•-....................... . ----~•� L'ocatio Address or ( U �/ f tj oZ U n`� I rI i nr _ o� - Owner Addr s -� U.. - .................................................... y •--�:... --1`,:-.:. .•-•...-- - ► Installer Address QType of Building Size Lot............................Sq. feet U Dwelling—No:-of Bedrooms.........�-�_.___._..___ Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building 1 No. of persons....... ________________ Showers — Cafeteria P, Other fixtures -----•-------------------------- - W Design Flow............................................gallons per person per day. Total da'y flow........ ..5-..................._gallons. * Septic Tank—Liquid capacity............gallons Length.___.-6....... Width____ `..... Diameter________________ Depth................ xDisposal Trench—No. ..............._ ... Width.................... Total Length.................... Total leaching area4_..--------- ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosi, tI ( ) r Percolation Test Results Performed by..........i`..u-__,�_ _1_ ._ Date__ .....1_..: ...�..._... o Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W ..................................-............... ................................................. -------------•-- ` >, O !..... '`''�' Description of ih... :. ! - '--•-•.•.- - = �f... y n�......4�-ram--°---- - -------- ---------•------•-....-•------------•----------- W ------------•--•------------••-•-----•------•----•----•--•-•---•--------•---•--•-••••---•-••--•--•-•-------•--....--•--..... UNature of Repairs or Alterations—Answer when applicable--------------------------------- ----------------------------------------------------------- •------------------------------ ...... •------------------------------------------------------------------------------- •------ Agreement: The undersigned agrees to install the aforede 'bed Individual Sewage Disposal System in accordance with the provisions of TITTIE S of the State Sanitary od — The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha been ' sued by the lth. / Sid........ / � ............................."'. ----D•. ....... ... ate Application Approved By..... Date _=.. ::, f .. • .------------------------------- -•--••-•••----•----- --•----------•--- Application Disapproved for the following reasons:.........................--•------------------------------•-----------------------------------•---------------- -•--........--•----------------------•------.._.._....-------•---•----- --- ............. Date PermitNo......................................................... Issued......................-----------•------------••---•-- Date THE COMMONWEALTH OF MASSACHUSETTS BOF HEALTH f.� .a ... .......OF.... .... ....r.,r ... ..... %................... Trtifiratr of Tantlrfialta TH IS TO CERY, That the Individual Sewage Disposal System constructed (�or Repaired ( ) by....------- - ......... . ..............••• --••----------..................••-•---•-•------------..........---•-•--...............--••••-••------ "^"„1 Installer �+ S+" � l { at...... ._.. J. '� - has been installed in accordance with the provisions of TkTIE, j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..?...-___-/� �.............. dated.....� _..y`:�� "_............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANT "THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 'DATE ..........................................•--•-----......--•-•--...-•----•---•- Ins,pector-------------•-•---------------------------- , -•--------••-----...---•--•_•--�----- l THE COMMONWEALTH OF MASSACHUSETTS BO OF HEALTH s n � ..I.. .. ?............OF....:....:.. .:...........9L........" ... 1 ......................... r �IAv � N ............�S�f'�... FEE.... .s.......... �i��r �t1 n�k� �nn��tUan �erntit Permission is hereby granted. .-�:..........'-=-•------•-••••--•-•------•-•----•-----------------•--••••--•--......................... to Construct �_) or Repair ) anIndividu.1,Sew ge Disposal System atNo...... ........¢--•--�-1- .-.I.5o.----..:.. ----•-......--••------ Street as shown on the application for Disposal Works Construction Be No a_...._._. Dated.._"!]�'..`��:_��............... �f . , �f' ----------------------------------- Board of--ea Hl s` DATE............. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - �F r•+•r.+c... c >tt a�..Y 9"• �. y '{ ._ a 1` - 9;..t .�—Y °'b',t,. .* � t e 1 ',�VA��-� ,, .' ��> .. yt.. /._1 `. f,�. 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