HomeMy WebLinkAbout0049 EVERGREEN DRIVE - Health MOL sTo- s
TOWN OF BARNSTABLE#1
-�l
LOCATION : _, - SEWAGE #
VILLAGE ,%iv&m had ASSESSOR'S MAP & LOT 163-I41-
INSTALLER'S NAME & PHONE �NO.�)
SEPTIC TANK CAPACITY %� ..
G
LEACHING FACILITY:(type) 95 (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
—a
VARIANCE GRANTED: Yes No
: � N
r
/FEB AV.4.7..........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
Appliratilan for Di"aoal Workii Tomtrnr#iun Famit
Application is hereby made for a Permit to Construct (�r Repair ( ) an Individual Sewage Disposal
System at:
...... ---i q?E---- --------------
--- .................................................................r ^..,....n.....................
Location-Address
...................................... ...............--
Address /Installer Address
Type of Building Size Lot...f�R.: _Sq. feet
Dwelling—No. of Bedrooms_.__.._.__..'_________________________Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures --------------------•--.__-. _
W Design Flow................ .. .......... .a___gallons per person per day. Total daily
-.. ow__...........4'0.._ ......_.....gallons.
WSeptic Tank—Liquid ca acit .j.5 allons Len �h.f � Width..�.'2'- Diameter................ De th. �7y x Disposal Trench—N ............ Width.................... Total Length............ .. Total leaching area___________________sq. ft.
Pit No..I.__.Z_... Diameter........ 644 0 De th below inlet.; .n Total leaching area.-- s ft.
Seepage �- P --- g .J` ._.... q.
Z Other Distribution box Dosin nk
aPercolation Test Results Performed by... -. - v______.. _..� ----------------------------------------
Test Pit No. 1...Z........minutes per inch Depth of Test Pit-------- .7 Depth to ground water----
Test Pit No. 2.__..2_.......minutes per inch Depth of.Test Pit...........13.. Depth to ground water........................
.................. -..----.-.--.--.-.----.._.............
3
O Description of Soil& ....'' �� �y o/G _�.. - s�tJ�._. /' ..
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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliant ;as been is e y t e and of health.
Signed --- ----- --- -- - --------- -------------------- ---------- -----------------D-- ------------------
are
Application Approved BY ------..1 -_-- --- �.'`�---------------------------------------------------------------------------- --- 3=
Date
Application Disapproved for the following reasons: ................................... ........................... ... .---...----------------------.-----------------
------------------------------------
Dale
Permit No. ....... -/-------
............................ Issued ---- ------------------------------------ -- .....-------------
Dace
low 2> 4,
CN ......................I ............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratiou for Di"vgal Works Tomitrurtiou Vantit
Application is hereby made for a Permit to Construct ( or Repair an Individual Sewage Disposal
1>
System at:
I- ..............A4..,o.t---------------------K7...........-----------------"-------------
Locaiiot-Address or Lot 0
L;��.....
--r-----------------------------------------
...............
....................... ...... ............... .....................................................ss..... ........ ............
df staiier Addre..
Type of Building Size Lot............................Sq. feet
U
Dwelling—No. of Bedrooms_____________ Expansion Attic Garbage Grinder
.......... -------------------------
91.4 Other—Type of Building ............................ No. of persons_____..___________.__._.._.. Showers Cafeteria
Otherfixtures .......................................................................................................................................................
Design Flow_____________,'__�' ....... per person per day. Total daily flow------------ --------gallons.
1:4 Septic Tank—Liquid capacity../,5�X.gallons Length--- Width 7-7-
Diameter__
-- ---------- Depth__._.7.//
Disposal Trench—No_ .................... Width______.__._.____.___ Totaf Length..____.____.____.___ Total leaching area....................sq. f t.
Seepage Pit No.-.-/---n�---Z..... Diameter.......... 'Depth below inlet..e...
6- r� -r7.(j.... Total leaching area----, ft.
Z Other Distribution box Dosing tank
Z1,
Percolation Test Results/"- Performed by.._... (5 -31atii
�T 7 Jz;,;X7c?� - -----------------------------------
Test Pit No. 1.... _________minutes perinch Depth of Test �it........ Depth to ground water_._._..._._ -----
2 Depth to ground water____
fLl Test Pit No. 2.... .......minutes per inch Depth of Test Pit-_..__......�-5
P4 .............................................................................................................................................................
0 Description of Soil.o..L.::2......
W ............... .........
U ---------
------ --------------- ---------------------- -----------
.......................................................... .............................................................................................................................................
�i
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
........................................................................................................................................................................................................
Agreement: Ir"
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance'i2has been issue;d"!y the board of health.'
Signe ...
Application Approved By I%.- �d Dale
.. ...................................
------- ------ ------------------ ......... -----/...
Dan,
Application Disapproved for the following reasons: ..........................................-----------------------.....................................................-------------
--.-----------.------------------...--------------.......------------------------.---.......----------.......................................................................... ...................... ....................................
Date
PermitNo- ------- .........5. 11.......................... Issued ---------..........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of Complianve
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired
by........................... ........a1i..... ....................................................I................................................................................................
Installer
at ............................ '"-----------n
has been installed in acc rdance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No- ----------7-/,:...; -L/ dated ...............................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
.. f ...... Inspector..............DATE..........................
............... ..................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No..... TOWN OF BARNSTABLE FEE---..kn.........
Dispowd Work.5 T11notrudiatt 't"Irrmit
Permission is hereby granted--------- Vzo -elle,......................................................................
to Construct ( >� or Repair ( ) an inAm':1--,-2i----Sewage Disposal System
at No.- 4eT---1--,-�---;?,—.-; ---y ------------------------i...r.bl I Street
- 1k I. . ..............................................*.....................................................
as shown on the appli tion r Disposal Works Constructiod:-P-'ermit No.71=.-.qnY 411//ated
:-�------------
--------------
Board of Health
DATE-------------- .......................................
FORM 36508 HOBBS&WARREN.INC.,PUBLISHERS
•
,
SEPTIC SYSTEM .PROFILE SOILS LO
G
ST-FLOOR
FiR � n
. , L FIN. GRADE OVER FIN. GRADE OVER
ELEVATION FIN: GRADE FIN. GRADE OVER • _ PERCOLATION TEST
_ AT HOUSE SEPTIC TANK'
DIST. BOX LEACHING PITS
-,I,. t o
-�x^.op of TEST HOLE I TEST HOLE
FOUNDATION 2
u
T R.,•.
ELEVATION
„� . . Z
7 _ 0 ELEV. _ ter''� da ELEV. _ ;o. 5
' •• , .. ,_ - • ,LEVELiNG RING TO WITHIN 2 of I/8fTO I/2
,
TOPSOIL & '"l�r;.'r�� f �• ,
<. 'v;. I " OF FINISH GRADE I/
INVERT at �.,�, 2 2
:. , .. WASHED PEASTONE SUBSOIL •
FOUNDATION , , I
.�"„/� .
•.rh•,t. �11 , ,. . , �stl.o�?•:ritp..r..o — P o••:D:a .p, 'y 1.
ELEVATION �/.
J
Z • ; ✓ w - � .. •. � �'�' ram-` �.�, .:, �• -
-�
., .D.0 i _ P' a �} �.% , 7 r ..• ,., c}.'r,.,e:, :..r•- ':� 11 ` :'__
_
, r
14
PRECAST,` C.I. OR P.V.C. TEES ,o y
DIST. BOX 3/4
100 GALLON To
0 N G I-I/z
v.. •e
.. . SEPTIC TANK
H-IO
WASHED
G... _
T FLOOR : :v :. ; TO BE SET ON A R SHED , . , n�:.lr , , +;
BASEMEN F - H 10 LOADING C U
_ . .
.�.. .,. .. , ,.. e p' C
ELEVATION _ _ � .,. 3 ..... >, . . LEVEL '8 STABLE l •,� PRECAST:..
,c ?
STONE
0-77.7 BASE
r - { ACME DB-3 OR LEACHING PIT
APPROVED EQUAL )
9
TO BE SET ON A LEVEL AND STABLE BASE H —IO LOADINr•.
( ACME ST-1500 OR APPROVED EQUAL )
( Pro file not to scale I ;
6,_O,r 2,_0.,
101-01,
PERCOLATION RATE: c2 MIN./INCH
TESTS BY : `
EFFECTIVE DIAMETER
TO BE SET ON A LEVEL AND STABLE BASE.
B WITNESSED Y
( ACME 1000 GAL LEACH PIT OR APP'D EQUAL ) ~ �� ��
, �.. BOARD OF HEALTH.
....,
DATE .
DESIGN DATA
WATER ENCOUNTERED AT NONE
--'--- -----_ NUMBER OF BEDROOMS
G.P.D./BEDROOM IIO G.P.D.
GENERAL NOTES
I FLOW �.� - G.P.D.
p TOTAL DAILY
GARBAGE 'DISPOSAL NO �-
4k -> 1. ELEVATIONS BASED UPON ASSUMED DATUM.
LEACHING REQUIRED � :__. G.P.D.
I 11099 G.P.D.. 2. ELEVATIONS AND LOCATIONS SHOWN ON THIS PLAN
LEACHING PROVIDED
ARE NOT TO CHANGE WITHOUT WRITTEN APPROVAL
OF THE ENGINEER AND THE TOWN HEALTH AGENT.
- r, _ f l_,f5 3. ALL SYSTEM COMPONENTS ARE TO BE INSTALLED IN
SIDEWALL AREA '7 0 S.F. x 2.5 G.P.D.
7 , , , Win. IT S. C. TITLE V AND LOCAL HEALTH
- BOTTOM AREA _ � - :,., �.F.; x' L0 - �'=� G.P.D. ACCORDANCE WITH E.
1
TOTAL PROVIDED :;f� S:F RULES AND REGULATIONS.
+4•0~ _ � _.,:.,� G.P.D.
) - . G.P.D. 4 ALL PIPES ARE TO BE CAST IRON OR P.V.C. SCH. 40.
i r -. >-440 G.P.D.
5 THE BOARD OF HEALTH AND/OR ENGINEER TO BE
c� NOTIFIED WHEN SYSTEM IS COMPLETELY INSTALLED
,,� NOTE. EXCAVATE TO EL OR LOWER AS SOIL -
Pr � �t INSPECTION.
4 I r ___ _ _ _ .�_ i =,t REMOVE ALL TOPSOIL SUBSOIL AND, READY FOR
`. •d :>�D>~'�r~,1 c->;.e��.f._ CONDITIONS REQUIRE TO
OR OTHER UNSUITABLE MATERIAL BENEATH THE G. NORTH ARROW IS NOT TO BE USED FOR SOLAR
CLAY
__a •o INLET INVERT OF THE LEACHING PIT FOR A DISTANCE ORIENTATION.
a r� o' ., 5, 0 7. WHEN COMPONENTS ARE SET SUCH THAT THE TOP
OF 10 AROUND THE PIT AND BACKFfLL WITH CLEAN
OF STRUCTURE IS GREATER THAN 4' BELOW FINISH
I SAND HAVING A PERC. RATE OF 2 MIN./INCH iN PLACE.
_ • _ GRADE, HEAVY-TOP OR 'H-20 LOAD UNITS SHALL BE
� (w; 1 � .�. ., _ e,: - REQUIRED.
,. : LEGEND
q ,A
•
EXISTING SPOT ELEV. . 23. 50 EXISTING CONTOUR 24
�+ _ • PROPOSED SPOT ELEV. 24. 75 REV BY DATE DESCRIPTION
. "• • '-, �_ '": �i - .�k�o°%l . ter 1! \ '
r PROPOSED CONTOUR 26'
TEST HOLE
PROPOSED SEWAGE DISPOSAL SYSTEM
u
3 EVER
L01 C REE N _DRIVE
r� - 9
1.•. _ . _
BAR 1�1 S 1�
T A LE t�1A.
__ APPLICANT: 1=� �I
rr
e
a
•1.
ADDRESS: ' �
' 4
ENGINEER:
NORMAN GROSSMAN, P.E.
._ • _ POINT ROAD'
EVER Cc RE�1�.1 DR1UE. 226 HOLLY
r RNINPGDISTRICT FLOOD ZONE ELEVATION
CENTERVILLE, MA.
SEC PCL LOT HSE SCALE DATE DWN. BY / CK'D BY PLAN NO. "
PLAN REFERENCE:
,f AS NO 12-; 1:''r t+ JTH / NG H- -2
BARNST. CNTY. REG. LGG 12�3d SITE PLAN-- SCALE I