HomeMy WebLinkAbout0085 FAIRHAVEN LANE - Health 85 FAIRHAVEN LANE, MARSTON MILLS
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TOWN OF BARNSTABLE
LOCATION F��r�pyi_�s0 L,a•�� SEWAGE # 07 — 78G
VILLAGE �l,� Tor/S GLi�IS ASSESSOR'S MAP& LOT/tZ /6�
INSTALLER'S NAME&.PHONE NO. �17 -o s yy k�o G�`i d� s9r s
SEPTIC TANK CAPACITY l DOo A �
' LEACHING FACII.TTY: (type) (size) 2SA /3 2—SOo ;mot
r
NO.OF BEDROOMS
BUILDER OR OWNER
}: z_
PERMITDATE: 11-2 COMPLIANCE DATE: //-23-9Y
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
w t� ells exist
Private Water Supply Well and Lea
ching Fa
cility _
PP Y g tY (� Y
r K 3 on site or within 200 feet of leaching facility) Feet
=�k Y Edge of Wetland'and Leaching Facihty(If any wetlands exist
n within 300 feet'of'leaching facility)
Feet
Furnished by
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TOWN OF BARNSTABLE
LOCATION SEWAGE # 90— 78G
VILLAG ASSESSOR'S MAP & LOT/h'8"16-F
INSTALLER'S NAME&PHONE NO. zf7 -0 3 yrf ��oSe;,d� �� /3��•�S
SEPTIC TANK CAPACITY /000
LEACHING FACILITY: (type) /5 (size) 2SX /3
NO.OF BEDROOMS 2 p /
BUILDER OR OWNER
PERMITDATE: 1/—.22-%9 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the 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
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No. `� �(p
.: Fee '
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYication for Mie;ponl *p.5tem Congtructfon Permit
Application for a Permit to Construct pair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. $,- r4/;h.4 i11zW Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. L% �f—l����' Designer's Name,Address Tel.No.
ph 0.e, jym►A'a r
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) STj�`�
y/iT y °, 1arrT" 6Z2
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 by this l3oard of Health.
Signed Date ^ 2 —
Application Approved by i 12- F Date
Application Disapproved for the following reasons
Permit No. Date Issued
, Fee r '
s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.
PUBLIC HEALTH DIVISION - TOWN.OF BARNSTABLES MASSACHUSETTS
0(ppricatiou for &.gpozar *p!5tem Cougtruction Permit
k, Application for a Permit to Construct pair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. $ 441117,o V/=h Owner's Name,Address and Tel.No.
�flarSra%S 0*f1115_ Pliner 4;,ebGrvw,0•7
r• Assessor's Map/Parcel
11/3 - /S8 �r ash L0h�
Installer's Name,Address,and Tel.No. L/�7-1735/Q Designer's Name,Address an Tel.No.
Jost ph !,i ,C3,�rr�oS ✓osepy C7� l�.ar.-�os
Type of Building:
Dwelling No.of Bedrooms_ .. Lot Size sq.ft. Garbage Grinder( )
Other Type of Building '` No.of Persons Showers.( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S:•
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) ,a -00
46/454 �/ ' SryHi� 69i^r�i��� 2 " �i=_.r9 5-rar—
Ls
L
a
Date last inspected:
Agreement: r
The undersigned agrees to ensure the construction and maintenance of the afore described on-s to 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 by this Poard 9f Health. r
Signed Date 1! 2 2-2y
q,
Application Approved by ". Date //-2 -4 /
rt' A
Application Disapproved for the following reasonsowl
M
Permit No. Date Issued �_ .• -:.-,- -
1 --------------- ——————————————————— ---
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( 4-)-Repaired ( )Upgraded( )
Abandoned( )by ,j�,,s>✓,dGr ��� ,(�, �.. dS
at V,_=ly G.,w*f has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. -7 3 dated
Installer & -e l de Designer o ' 6, 1,2e- );Aaonok n n
The issuance of this permit sh not a to d as a guarantee that the sy •m. ill function s desi ned
Date Inspector
-- -- ---------------- --- —— ----
No. 7 d6 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
lwis ppaal *p.5tem Conoltruction Permit
Permission is hereby granted to Construct S impair( )Upgrade( )Abandon( )
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.
Provided:Construction must be completed within three years of the date of this pe t.
Date: Approved by
•v,h
't
1/6/99
NOTICE: This Form Is To Be Used For the Repair Of Failed
;Septic Systems Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERIMTT (WTTHOUT.DESIGNED PLANS)
I, hereby certify that the application for disposal works
construction permit signed by me dated //-�S-99 , concerting the
property located at 14 y" Lh, Vv, meets all of the
following criteria:
,4---The failed.system is connected to a residential dwelling only. There are ao commercial or business
uses associated with the dwelling.
The soil is cl;jssifled as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
There are no wetlands within 100 feet of the proposed septic system
�iThere are no private wells within 150 feet of the proposed septic system
There is no increase in flow and/or change in use proposed
4✓ere are no i-ariances requested or needed
C---'Fhe bottom of'the proposed leaching facility will not be located less than five feet above the
maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor
method when applicable]
• If the S.A.S. ME be located with 250 feet of any vegetated wetlands, the bottom of the proposed
leaching facih ty will not be located less than founeen(14) feet above the ma�cimutm adjusted
groundwater table elevation,
Please complete the following:
A) Top 01'Ground Surface EIevation(using GIS information) �8
B) G.W. ir.levatio ,
+the'WX. High G.W. Ad'
DIEFERF:�ICE B E Adjustment
E -N A and B
�y i4
SIGNED
(Sketch proposed'plan of DATE:
q:'uWu foide r cc" system on back].
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ii, - NOTE
�.. r . ASSWED LOT
PROrEC TION PEA
BYLAWS
agal
��►OF.
CERTIFIED PLOT PLAN
' ,Iwo LOT.•: 6 ' AI HAV IVE
' : . IN
SAA 5114AL96NASSA
SCAL.E� / =40" ®ATE15 20-86
W71". THAT Tier L
out i�#4Mt ®N TMte �I is 1 CA' �
EtiSTERE Rat9TEAEti1AftoN'. TDE $RoC AS.IN®I�t+� ' I
CIVIL -LAND ;.,i, .-.CoWoRM $ Tq THE ZotNIH® LAWS
(,4
I, EPI®IPiEER URYE�®N Doily!712 MAIN .
H YA IN K I S, MASS.. NMEE'�' '�!��. ®A C., RED. !!.AlNQ. $LaRVEow*
' •. . . .... •. .. ...,..�..•a:�..d:hr:ac.�.niGv..•JiYwZeab.t3C�i.%a.•'R.'a!Pr;LtxYa�raix:n?'.O�J:-:K•:.':r-.•:.' i'
116
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F H EA T"
/o�GJ
Appliration for Bi,spnsttl Vork5 Tnnitrnrtiun Prrutit
Application is hereby made for a Permit to Construct (4�'or Repair { ) an Individual Sewage Disposal
Systat���
/
....:!. .. . ----
No
-•----
Location-A.d.dr. ..... ..............
r
� -.---•-•-------•--- •---•• . . .Z.....
Qayner Address
............................................................
-----------------------------
lnstaller Address
Type of Building Size Lot_<.0;�(.L/......Sq. feet
U Dwelling—No. of Bedrooms......_ .Expansion Attic (A� Garbage Grinder 4e(�U
'4 Other—Type T e of Building No. of persons............................ Showers
t� YP g ------------------•-------•• P { ) — Cafeteria ( )
P4 Other fixtures .....................................
W Design Flow......... ..� gallons per person per day. Total dail flow.._......-3 C?..•_.._
g �---•----•------------------g P P P Y• Y .....................gallons.
W Septic Tank—Liquid capacity�0.b�allons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No---_---------------- Diameter.--................. Depth below inlet.................... Total leaching area........... ft.
Z Other Distribution box ( ) Dosing ty�•
'-' Percolation Test Results Performed by..-�t....cr � �..__. ��l ° �%%�. Date.._.._.. ,. _.. _ _
04 Test Pit No. I,W....minutes per inch Depth of`west Pi ... _ ____ _ Depth-fo ground water...
...
►-� ff
Test Pit No.��.r'k.minutes per inch Depth of Test Pit.../.. ._-...... Depth to ground water...
............••------- ----- ----- -•••--•-----•---•---------------.........................................................
x Description of Soil ...�.. sa'�....�ldl�Y.*1.�-- `S®f• ------------------•-----....-----...-----•-----•---------------•--........---------
v : ----------r..�_J----- ... ....
-------------- �._ r`-� Sa ---•-
U Nature 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'ITAU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee sued by the boar health.
Signed . . • -- ---••••••-- . ...........
..___.. e - _ ... to
Application Approved BY----•............•....••-•-• -.4 ...��......... ......... .`--'------------ ...... .2L
Date
Application Disapproved for the following reasons:..............................................................................................................-
--.....•--•---•.................•----•-•----•--------P•--••---------•--•...-••---------•--••------•......------------••--••• ---••-••.....•-•----•-•---•---.....-----•-••---••-•- ......._....
Date
Permit No........ q-34b-•--------------- Issued.......................................................
Date
r'
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9F HEAVTH,
....�.............. OF.....
Appliratiun for Uiuvuuttl Works Tonarur#ion Frrmi#
Application is hereby made for a Permit to Construct (4"f or Repair ( ) an Individual Sewage Disposal
Sy at
.- r+ �J
..... ... - - .. ........ .... . .•••• -•--•-
Location-Address ba
�47
,p� r o
' S7C0
- •- - ----� ... ._......---
..
*^ Oxvner Address
---......-_
Installer -
� Address
Type of Building Size Lot__ . . .- ......Sq. feet
Dwelling—No. of Bedrooms---.:�-----------------------------Expansion Attic (A01 Garbage Grinder '
a'4 Other—T e of Building . No. of persons............................ Showers
YP g ----------------•--•------- P ( ) — Cafeteria ( )
Other fixtures ... v -------------------------------------------
W Design Flow..........A. ................ ........gallons per person per day. Total daily flow..........731.-!P......................gallons.
WSeptic Tank—Liquid capacity t 6 allons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No....................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No-----------_-_--- Diameter.................... Depth below inlet.................... Total leaching area...,..... _.....s " ft.
z Other Distribution box ( ) Dosing tg )
'-' Percolation Test Results Performed b ...+=�= "�/ '.... �t �
►� Y _� , --- - --�4 Date.........
a Test Pit No 1 ...minutes per inch Depth of `T'est Pit. __. Depth"�o ground water
Test Pit No., ft -minutes per inch Depth of Test Pit. . .......... Depth to ground water':
•--f •... •-- : • ...................................................................................
O Description of Soil �,� .. t`��-'� � :�.�'-4�'•���
V ----------------------- f f r .""
W
---- •--- _..1.4-••••.. --- --••-••--•--•---••---•••-••-•-._.......•-•••------------------•---••._....
U Nature 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 TITALE 5 of the State Sanitary Code= The undersigned further agrees not to place the s stem in
operation until a Certificate of Compliance has beep issued-b the boardw health
P P Y
max= ---•---•• --- "`
Application Approved BY ti-:. .a..- -�------ "---- `:...... t /{ Zo
f"7 ............ •..... C-..
Date
Application Disapproved for the following reasons:..............................................................................................................
-
-----------------------------•---..........--•-----------.•...-------------•---•------------•----......--••................-•••••-•-•••-•-•-----•-•.-•-----•-••-••-••-•--•----••-•-----•..........-----
Date
Permit No........ •---•-- Issued..-------•--•-----_..
- ` Date............. .-._....._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......................� t ter" .............OF..... �'arr.s"
.. .... ........................
(9rrfif uttte of Tompliamr
THIS IS TO . RTIFY, That the Individual Sewage Disposal System constructed Repaired ( )
by - �zrs '.. f.�k�nd
-geInstaller
at....��_,......•..:�� �s�!mot✓" `L.__.�' 155)............
has been installed in accordance with the provisions of TIT r 5 of The State Sanitary Code as scrib d in the
fF
application for Disposal Works Construction Permit No............... ,��.`a"�. � dated.............: �.---a �„------.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU D AS A GUARANTEE THAT THE
SYSTEM 1 L FUN9TION SATISFACTORY.
DATE....... . C�'f� ..tom .....................--...................-- Inspector--•---I............................................................................
THE COMMONWEALTH OF MASSACHUSETTS
i BOARD OF HEALTH
f
No....:..
--....... FEE.... .... ...
Disposal Worksgonstru4ifn pami#
Permission is hereby granted =�.t��.�`?' ....... = ..............................................
to Constr ct or R air ( ) an,hild>vldual Sewage Disposal Syst - M
} �
Street
as shown on the application for Disposal Works Construction Permit No. _`n: Dated..... r � 1,�_...-.....•.-
.......................- :- A0 --.--.. _
Board of Health
DATE........................ ... ./6..........................
FORM 1255 A. M. S LKIN, INC., BOSTON
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LEGEND. - ... .�
EXISTING SPOT ELEVATION OAO CERTIFIED PLOT . PLAN
EXISTING CONTOUR --�- 0 —�
FINISHED SPOT ELEVATION LOT 97 77,,,;77177v 7>/.� vE
FINISHED CONTOUR ---- 0
NOTE: The location of any existing u dergi-o;nd sewerage, — ---
'wells, or other utilities shown on this plan is approx- IN
imate onlyas determined from records and/or verbal �t
informatin. .The contractor is responsible. for the
�� '�� 'r�� �� ASS*
�, / vi
verification of the existing locations in the field. SCALES / = �" GATE
ADREDGE ENG/KEER/NG CC' /N Gec- n!!S�'/ER
A ,° CLIENT.__....____ I CERTIFY THAT THE PROPOSED
EGISTERE REGISTEREp JOB NO. 8 5 BUILDING SHOWN ON THIS PLAN
CIVIL . LAND DR.BY� `.� ._:_ CONFORMS TO THE ZONING LAWS
INEER� R OF BARNSTABLE , MASS.
712 MAIN STREET, : CH,.BY j IZ. r3 . 5 l z 9(:=. %`' ---
HYANNIS, .MASS. / Z — - ----
MET-... OF ATE REG. LAND SURVEYOR
VOTE /F E/TNER THE SEPT/C TANk" OR
247 FT M/N. r'iEACHIivG P/T ARE MORE 7'NAN /2~BELON/ "
:7RAOE., Al 24'O/AM ETER CONCR'/FTE C'OYER'
SNA4L BE ,9ROUGNT TO 4,TAO.E.& EXTRA
CONCRETE' 4 PYC P/PE 01EAVyCoV =R .Sh�.4LL I3E USE1�
L• 9P.0 COVERS M/N. P/TCN !F/N OR/V,6WA Y
i
fi 2 M/N. CO/1/CRLrTE
i `_"o' 1 GRADE CC) VER
A / CL EAN SAND
�' „ L/QU/O LEVEL - ,; .w �, �•
S tlCb *LAYE_'R
CNED
.%axe _
PY.C. P/PE c �Q C9.-O o 0 0 ' 040r I8 -'TI8
b` MIN:P/TCII GAL. • o , f . . . . .• . e oAa
�4 p�R rT SEPT/C.. TANK D/sT. o e • • •'" • •. • • • • e , + jti/ASilFO STnNE:
BoX 0 Q o f f' 8'1 • • ••.• �•b� w
k v• Q • / fEFFECl"/VC r • • + 314 - f2
f - • a r • • pEPTi�I • •• ' • ♦ • H/ASHEO STGi1/E> -.:
-1 Ot . ! 4 • • • • .f ••♦ 1 �s o e
I/3 K /• - -377
s n; , • • • .• • • • • D •,a PAWCA57
.: .. O/VS PIT C.'p/ /. -4y0 :Gs�1I— A a �o r • • • � ► • • • ' s p P/7OR EQU/V._
/N�/eit"T LrLEt/AT/ _
/NYERT' AT BU/LD/NG X- `}S 0" F�- ` �3 �
INLET SEI0r/C TANK: S FT' /Z �. O/.4M C� E'TABULATJON} ,
OtlTLET SEPT/C T.�tFT.
!NLET D/STR/DUj/ON BOX 94 g &7 SECTIO OF GROUND Nr,4TER TABLE
N
OUTLETDISTR/,otITIOJ—aax 94 Ff
94.0 FT S,ffPVAGE 0/S'POSAL..SYS7�.46M A L
LEACHIIVG P!T T BU AT/ON
DES/GN`CRlTERlA - ,
StAt_ DIMENS/ON G FT /✓
NUMBER OF 6EORaOMS 3 , • ,.
GAR46A4GE O/SPOSAL UNIT_lVO Nfi, SOIL -LOG
TOTAL EST/N1fITED FLOsif 3"3 GA4./DAY �SOI L T4cST 01- SOIL TEST#,2• EST
NUMBER of L04Cf►l/v4 P/TS__- PATE OF SOIL TEST.=`
t S/OE LEACH/NG DER P/T L S/ sQ, RT / M Md�, 0 .
E G — l ' RESULT$ idITNErSSED dY� 2 '
16oTTOM L"94CN/NG.PER P/T //•� $Q, ,CZ d >3 yy� -:" PERCOLATION R.47E#J "t l+�I/1/r/JNCJ'1.
TOTAL LEACH/NG AREA Z(� SQ, FT.: S�/'3 S v►t PWeCOL-4TION RATE 2 M/IV. INCN
RE3FRtiELEAC'N/NGAR£-A Zl�4 SQ. FT _�
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CIF,+�e � � .. [Ffq,." Ns: ( GDT i9✓EN i2iVE .
• r4 \ ti
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P.LSERT C>v� ROB�Fa7 G►'J�1 RCS?OATS l/L_G
y r A. J s lLfYiS� S / $C
E3YE�G
` 1 tiio�sE I«� tea 1SsS? c S�4".✓v
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