HomeMy WebLinkAbout0179 CHUCKLES WAY - Health 179 CHUCKLES WAY, MARSIONS MILLS
A=101-126
TOWN OF BARNSTABLE / V
LOCATION /�!q doe 4/v Goo 4 SEWAGE # gb vZ yZ:'
VILLAGE AMU ASSESSOR'S MAP & LOT 113
INSTALLER'S NAME&PHONE NO. &/+k®li(; I-Q
SEPTIC TANK CAPACITY /SOOGG L/,
LEACHING FACILITY: (type) .!^yA`�L�i,ci�4�� (1� 1 (size) 7 X V J Jr
NO ROOMS_,,__
(]�D R OWNE
PERMITDATE: . iQ COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility / Fee,
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 �q-
within 300 feet of leaching facility) '/ Feet.
Furnished by
yA .
9 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
ZippYication for Zioogal bp!gtem Construction Permit
Application is hereby made for a Permit to Construct( k )or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. Own 's .Name,Addres�nd Tel No.
�fa�sFcr• %ll! -7-7 [ -6-"
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
�'jo✓f410k eortisE —7-71 - F3F7
V z —
I�
Type of Building:
Dwelling No.of Bedrooms 3 Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow a gallons per day. Calculated daily flow a gallons.
Plan Date Number of sheets Revision Date
Title
Description of Soil r c e- K,Y a k.. I
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 E vironm tal Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued t 's Bord f eal&,a�&,
Signed Date
Application Approved by
Application Disapproved for the following reasons
Permit No. 96 — d`W Date Issued ��
9 _ Vic) Fee
* �'*"_- _"COMMONWEALTH OF MASSACHUSETTS
N : PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
x �
2pprication for Di5pozal *pgtem Construction Permit
- i
Application is hereby made for.a Permit to Construct( K )or Repair( )an On-site Sewage Disposal System at:
Location Address or Lot No. Own is Name,Addres"j nd Tel.No.
/-79 c/(Iems tN�`� �zE �r /'riPrr6>-r'fI q-� �.
d ter % It s -7-7 / -GDO S
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
-r�rl'olol� % ('G, ;t '�7/ Siff /�a� . Carr F �
Type of Building:
Dwelling No.of Bedrooms 3 Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3 �' gallons per day. Calculated daily flow L C c gallons.
Plan' Date Number of sheets Revision Date
` Title
Description of Soil s e e a K c 4..
s
Nature of Repairs or Alterations(Answer when applicable)
Date last nspected: ,.-
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 E vironmee tal Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued bf this Boar d of ealtli/
Signed r - U244 j Date
Application Approved by-
Application r _
Disapproved for the following reasons
PermivNo. _ a yG Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS
l
Certificate of Compliance
THIS IS TO QRTIFY,that the On-site Sewage Disposal System installed�(_K/��or repaired/replaced( )on
by y'i`c� pt , for 1�o
has been constructed in accordance
with the provisions of Title 5 and the for Disposal S�stem Construction Permit No. q a2 �/0 dated I.
Use of this system is conditioned on compliance with the provisions set forth below:
VJ
d
No. L�Q Fee AO V
/ THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
wigogar *pgtem Construction Vermit
Permission is hereby granted to Gov /V /
to construct( repair( )an On-site Sewage System located at Lor4 5 75'
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.
I; Date: 7— 1 9-& Approved by
?
F
t;�u .'.. HOL , LOGS'
T.O.F, AT,:tL
(NOT '10 SCALE)
ACC
WATMOI-M;.�TO
:'!b,OVER.'TO WITHIN Ir Of',M, -MDF EER'
A ESS COVER
MINIM WITHIN ir� bF
nN �'GRAOE
-0
tA
2 WITNES,
r 0VER OVER PRECAST'' pim#3
X SLOPE OFOUtRFD,OVER ,SYSTI� , , �� "�. ;� I I" I , ,
S:
oi
I o
RVN' PI �LDU- a
DATE:
`,rFOR PPST 2*_
b
vll.
PERC, RAT
tLAS
L.�= SOILS P
TANI 2
K '(H l(Z)
7D &A.16
S
-:7 C7
SLOPO
�OR MECHANICAL -��O ftA
'r ,CRUSHED STONE`OR Al�
COMPACTIO (1 5.�21 121)
F FLOW
0 N'
7-
(i% SLOPE) (L% SLOPE)
fEC:SIZES.
i)EPTIA
INLET,
8.2,
. ..... 'LOCATIO
Y �MAP
OUn-ET DEPTH
-z
PARCEL
ASSESSOR$ MAP
LEACHING
FOUNDATION SEPIC TANK -BOX FACILITY.
FLOOD ZONE,
:'BUILDING ZONE-A
SETBACKS: FRONT
ry- e 5
SIDE
REAR
'PLAN REFERENCE:
-_+NOT ES:
1 DATUM. IS
2_ MUNICIPAL WATER
SEPTIC DESIGN: (CARWE DISPOSER IS
-1 TO 8 E':' 1 R FOOT_.
." MI N!M U.M, P IPF PJTCfl 8' PE
GPD
Gp
--BEDROOM D)
OW:
DESIGN FL
4. DESIGN . LOADING FOR ALL PRECAST UNITS- TO BE 'AASHO--�H.
A ::; GPD .DF_SIGN. FLOW PIPE JOINTS O BE MADE.� WATERTIGHT. ,
5'
GALLONS
TAN IN
SEPTIC K, GPD
6. 'CONSTRUCTION �DETAILS TO BE .,ACCORDANCE WITH .MASS.
ENVIRONMENTAL CODE TITLE V.'
S17
u A 15qe GALL-ON. SEPTIC TANK
'PROPOSED WORK -ONLY, AND NOT TO ,BE
7. THIS : PLAN IS: FOR '
LFJ�CHING:
USED FOR LOT LINE, STAKING,
-4 8. PIPE FOR SEPTIC -SYSTEM TO SCH. �46 4�. PVC,,
OR CONCEAL
E30TTOM:' GPD
EQ VITHOUT
COMPONENTS NOT TO' BE BACKFILLED
TO '' S. -5 127. AND,.P RMISSION �013TAI
6/ TAL: F. GPD
0
ARD',OF HEALTH ' E INEb
LTH.
S E
11 AND ' SEWAGE,
L.-V_ 1�__15
I THE TOWN
N OF:,
BOARD OF RVALTH
PREPARED FOR,
MA
APPROVED DAIS
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