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HomeMy WebLinkAbout0355 LONG POND ROAD - Health 355 Long Pond Road Marstons Mills - - A = 028 104 — - _ r TOWN OF BARNSTABLE FL LOCATION S5` �cn�jpo�b dz�j: SEWAGE # �'®"i /.17 VILLAGE ���4�',P�D/�S' i?olZeS ASSESSOR'S;'MAP & LOTS � INSTALLER'S NAME&PHONE NO. ���� �F �d 7 7a9 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size)_ NO. OF BEDROOMS BUILDER OR OWNER -g ���G' PERMITDATE: —COMPLIANCE DATE: -off Separation Distance Between the: us g 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 4 G �9 S� � � o 8 /4 (/7 a C G �/ A TOWN OF BARNSTABLE �C LOCATION ` l�lPa , — SEWAGE # VILLAGE >.4�,PT�i�S' /LCS ASSESSOR'S MAP & LOT S 01 31 INSTALLER'S NAME&PHONE NO. l7 7 7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) r NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: / Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facilitywetlands exist ° Edge of Wetland and Leaching Facility (If any / Feet within 300 feet of leaching facility) Furnished by �€ c -29 CG No. �� r L Fee •==7 L�— �) THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[pprication for 3Digpoga1 bpgtem Construction 3permit Application for a Permit to Construct( )Repair( )Upgrade( Abandon( ) El Complete System El Individual Components Location Address or Lot No.3 r S' <oatvc>o b O Owner's Name,Address and Tel.No. Assessor'sMap/Parcel / - C Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building f,*r- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow S% gallons per day. Calculated daily flow �� gallons. Plan Date __ $Y—®�z Number of sheets Revision Date Title Size of Septic Tank o Z � r• -J Type of S.A.S. �J�r Description of Soil 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 y this Board of_Ialth. Signed J' _ Date Application Approved by Date Application Disapproved for the following rea dns Permit No. ��� '�� Date Issued --------------------------------------- <I . -'�xr No.���.� ,'"_�%/�i � �. Fee „'✓ �`- e THE COMMONWEALTH OF MASSACHUSETTS Enteredn computer: A( Yes \, PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEs MASSACHUSETTS 2pprication for Migaar bpgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade Abandon( ) O Complete System O Individual Components Location Address or Lot No..3 s" a�ooaqg:L,,,,,b O Owner's Name,Address and Tel.No. Assessor's.Map/Parcel !«Q. SO Installer's Name,Address,and Tel.No. �` Designer's Name,Address and Tel.No. '� L!"is►.► �'CBe+cr�it="' 9��-'o� o> Type of Building: + Dwelling ' No.of Bedrooms 3 Lot Si ze sq.ft. Garbage Grinder( ) Other Type of Building /tom j' No.oll'Persons Showers( ) Cafeteria( ) Other Fixtures . f Design Flow yc gallons per day: Calculated daily flow3 gallons. Plan Date .3--2 s/-o.7 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) ., 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 this Board or!f Ith. Signed Date i Application Approved by T Date '""%2 " Application Disapproved for the following reasons Permit No. Date Issued '' '"- --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded Abandoned( )by CT/^ e at e C h,Q -1; "37 _ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permi�l WO-/0"V4ated %7^' 02-4*1 -_ Installer �'i � �6 mil— Designer The issuance o s ermit shall not be construed as a guarantee that the syst m- ill function as dessig ed.. Date�G Z Inspector Vim', `/LV• /d�f'„ 1' ` --�y--`-----.�y------------------------------ 1 No. ii '9 �Vv �if / Fee -" THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Mi000l *potem Congtruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade�,X)Abandon( ) System located at 3 T 1- ,b 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 completed within three years of the date of this erMit. Date: .. n Approved bt �� TOWN OF BARNSTABLE ry Lo-r LOCATION � SEWAGE # � e VILLAGEA.-irs-ren 5 /,11,6- ASSESSOR'S MAP &' LOT - d INSTALLER'S NAME PHONE - SEPTIC TANK CAPACITY LEACHING FACILITY:( ype) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER_)Jurk- BUILDER. OR OWNER�fp� DATE PER MIT ISSUED: DATE COMPLIANCE ISSUED: ' VARIANCE GRANTED: Yes No a 0 ' s - No.'9�."y. Fes$.... .5�... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH o -.�........oF..... .,lJ:> ....................... Appfiration for Uiipnml Works Tonstrnrtiun Vanfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System alb. - Ee itA 6irL5 i •. - / Location-Address or Lot No Owner Address a ---------------------� t'" j�......----.C-a-!l.`£'_ .n.-•-----•--•------ ------........................-----...---••-----.......------......-----------•-•--............... Installer Address A dType of Building Size Lot......b'.Zi_!�-r.Sq. feet Dwelling—No. of Bedrooms....................�......._._.....__....Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures•-•..........:.....a_...........---•--------------•�--:�-------:----•----------•v---•-•-:----------;:�,��-----------------g--a�1on� ;9,._ allons Len h. _� .6 . Width.2�d_.-___ Diameter................ Depth_(i____.�._. w Design Flow...........5—........................g P P P , Y Y _ lions per person per day. Total daily flow----------- � i WSeptic Tank—Liquid capacrty/� g gt ,/_.r.... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------/---------- Diameter......./011.... Depth below inlet---,s6..f......... Total leaching area..................3sq. ft. Z Other Distribution box (ka_ Dosing tank ( ) aPercolation Test Result Performed by _--..• _�.................... Date....... _. __ _�. .... Test Pit No. 1...__2.....minutes per inch Depth of Test Pit...... Depth to ground water..00VL--. -_.. (s, Test Pit No. 2..-/-..Z ._minutes per inch. Depth of Test Pit-----/2 ..... Depth to ground water..!10._�.........._ -Aif -----------------------------------------------•----.-------i..............---•-- --- ......................................................... Description of Soil ! �' , C. )410 ,�! % 1. x �•`� �. �----72....- La -1-........ rid ..3_......._��� ._-�•-•-- fit'...... dt U Nature of Repairs or Alterations`Answer when applicable ._��._..____.(�_L...................... ...._........_.............. U P -------------------------------------------------•---------•------------------------•-•--....----•---------.....--------------------...----.....--------------------.........•---••--••••-••-••••••••••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITi I-E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Cer 'flea a of Compliance has been iAsued by the board of health. ? Signed ....... = C _...... . ...... --YD�/te � PPlica ion App oved BY---•.---•- ••-•-----•l.J�%N ...-••--•--------•--------------- r� Date pplication Disapproved for the following rg asons:------------•-------------------•---------------------...._...------------•---------------------------••......- ...............••••..........-••---._..............-•--•-••----•-••-•-•-•-•--••-•••-•---•.............•••••-----•----•--------•------•----------...•---•--•--•---•---•----•••---•••••--•--••---•--•-••-- ¢� Date PermitNo..... �?.. ' - •.......•................ Issued....................................................... Date J. NoA y.Tv Fps......j..s.` .._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -------...... 0 ........0F.... P.Slik6L�--------------••-------------------- ApplirFation for Disposal Works Tonstrnr#iun lbrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual SewageSewage)Disposal System �. ............... " ...................... .......................... -- ..----• ---------- Location-Address ®� or Lot N .. L..... 'fit U.Q........................................ "8..n ,....... 4 t l e .�. -----•--- ..... Owner Address W Installer Address 4 q d Type of Building Size Lot._.__.f•f-. 6-.----...-..---.--.S . feet U Dwelling—No.No. of Bedrooms............... _._..Ex Expansion Attic � g— ------------------------ p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........................n_ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------------•--------------•---•-••-'---------•--••--•--------•-------••--••- Desi Design ............'-_ 1011 W g .........................gallons per person per day. Total d >ly rflow._._......-- rr WSeptic Tank—Liquid capacity/_!,.=gallons Length./ :4..... Width. :':.... Diameter................ Depth............ x Disposal Trench—No. .................... Width.................... Total Length......._..�_.._... Total leaching area....................sq. ft. 3 Seepage Pit No....... .:........ Diameter.......1-4...... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (14, Dosing tank .�) '~ Percolation Test Results Performed by...b Xi ._.... ? ....................... Date....__ .___ ._.. Test Pit No. L.�° ._...minutes per inch Depth of Test Pit------ ....._.. Depth to ground water. ... fs, Test Pit No. 2__!�".L_._nunutes per inch Depth of Test Pit...../Z........ Depth to ground water........................ a ------ ---- O Description of Sold t9_--G t..... 'P.&M `�J J�;`- �: c:•�' Li:'':i E" V ..3........./Z J rn.,sc.�!�_._. Ld. °� r??f� tv� .r�.. '"� ....................................................tea ✓Fr'e���/ l�lG ...!•' 6z. <P,d6l!°'�....._ ` _�_- /! f/`�'Gss`t �°7f '�j, s/'u✓ �1 'J (a✓ �' iJ�Z... I�f .............................. 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 TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in M?Egsons: �- of Compliance has been issued by the board of health. Signed------------------------------•-------------•.......------...................-------- BY ..•..... -""�1...............•----•----------- ----•- - -�.. ..... Date ved for the following re sons:..................... ----.....-•---------------•-------------.....-•----------------•-•-----•------------------•-•--••--•---•---------•-------.....•.-----------------------------------------•---•-••-----..--•-••.........__ Permit No......1/.G._...�. -------------=--=--•-------------- Issued......................................................Date Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .l " �. ....OF......:.. ....................................................................... ....N S Trr#ifirFatr of Tontpliaanrr THIS IS TO CERTIFY, That the Individu Sewage Disposal System constructed ( or Repaired ( ) ---•----------------•-------•------•-------------------------------------------------------------- by ' ti!----..... ---........................... --------.... at----------bC !_-_� -5...Ck1�.-b----... �=�1�.....t`:{/r..Installez!.l.L.!!.._41!-................... �� has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_..1.7 � 4v -----------------•'----.. dated_......... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM'WILL- FUNCTION SATISFACTORY. DATE.............................................................•--•-•-'•----_..... Inspector.,................................................................................... HE-COMMONWEALTH OF MASSACHUSETTS j0s1S�'"j l'`} gz_�L _ {i.a,r BOARD .OF HEALTH / .....................OF.............................................. No.. Q. _.(_... FEE...`...`.................. Disposal orks Tnn#rnrtion ramit . Permission is hereby granted........................................ l���----------C vl.�..�...... .:------........----..............-•----- to Construct ( y�or Repair ( ) an Individual Sewage Disp�s�1 System at No. Aa........(..----.....j '-4. .- 1! ` ��r . Street. •-- as shown on the application for Disposal Works Construction Permit No,_f1�__�f� ated........ 1.................................G i_ j„ i� � Bo ra of Health DATE.----•••... v f FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS Department of Environmental Management/Division of Water Resources WATER WELL COMPLETION REPORT WELL LOCATION / Address City/Town G.S.Quadrangle Map Grid Location Owner ! Address ` ' A.1, i, r r 1, f r' �, �. ✓, r �,r r 2 J WELL USE CONSOLIDATED WELL Domestic❑` Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones Method Drilled rr! r *+r 1) From To J 2) From To Date Drilled I`— j 3) From To - 4) From To CASING Depth to Bedrock Length r2 Diameter Type I�l -? , /r UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing'Materials Feet below land surface .17"/ Sand: fine Q medium❑ coarse❑ Date measured - J' r• l07 Gravel: fine❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL .2 ! slot# r. length from to Yes El No Q" Split Screen (or 2nd screen) WATER QUALITY TESTS MADE Slot# length from to Chemical ❑' Biological ❑ Depth To Bedrock / PUMP TEST Drawdown / feet after pumping days f hours at GPM. How measured (,"T ' '701 M , /I Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To Cb M 1 n DRILLER h Firm Address % • r Y 1 I•+ - \ + City Registration No. 'Operator's Signature Please print riMy �W� L— — I A BOARD OF, HEALTH COPY 15M-2 84-176171 t-,T t GENERA 4., NO TES 5 # FFAlr-WV*L5 S PYIV AAE 'wA6%A 5 u6 fa. �-tGwr CL-A'? vo I V- 1017-CH A44, 4/1VC- 5 A VIA(I'AlUM OF C 0@ 0 (1) 0) 41N4,C,5S OTHERWISE SA46CIrIEP 41 0 0 0 3 J A44 R1,PE,5 7"0,41VP ,11v THE S ySrE,+f SyA 4. 4 41.4 SE,*077C Fi vj 0,' @ (D 0 C-) (1) .4NP 4,C,401INS Plr,,-5 SA�,4z4. Cul�jlj (D 0@0 CD @0 lExisr -x A WA�Al "�-OR W111IC"C-4 44C.24PING5 A- -4- (1) Q (D 0 00 0 a (D 0 �, " f V/L E7,� I , I i 5 RE100VC ,44.,4, 411V\51-11748k4C AIATCRIAi, ............ D 0 (D 0 (�D 0 Irl 0 (D Orr 23,N4,47)q 7.,-1E INVER7 46 54TIONS5 L,-Acl/1&6 P.r ,,roR 4 01.5r.4NCE OF 00003 ie"% 'ANP 6.4cA Flo kl WITAo' CkA Y-FREE: 1314NP -4NP 6;,f,4 VCk 1-1,4 V11V6 A FE41CM.4 7-10N T YPI"4 A945TRI4341 7/ON 3ok` ?t5)e � R,4776' Or Z Af1N417-,E,5* pc,�f, INCH OR 4,,r,55 BYO 7-0 6C,441E J 6 7,4�,4-tA"-'t-TA&.E90,4RP OF H6-AlrHAfdS-r "J") F. E-JiJc-0UkJ7 ICA ,' . 1-,c4 cl-�IN6 P/7- IVC)7-,C-. P15TR13UTION BOX ANC SEPTIC A NK NOT TO 6C,41-.,E e'C IVO T lcIE V 44',4�A/ 7H� d YS Te,4f/S NEAR Rr1Vr0 C4CR SEPTIC TANK eY T COMAkfT,0 .41YP OR10,11 M,VCA'r/4z IA16 AMeRIC,4N 1A:',CC,4S7- 0/'f F-,'ylZ1A1- P4fRC01,A'01V 94rE Z.1-9 �,' '-1-1-114t:-i-4 - 7 UIV4,ESS 07'HC,,f W1,5E N076-k7,,44k 5y,5r4_rAf IVOJI 70- ,5C4k,6-- SHA,,k .6E INsr,44,4,ep 11v 71IROOGHOU 7 60,4eP OF qE,44AR AC(f0lf'R4lVC4f-- WITY 771TLE Y 0ocTqES7,(7-e W,7.y Ez ec rRIC k*i, -,PE EN,GIN,f, %5.4NIURY COPE dN49 ,4NY 4OC,44, AMEC P-4 7-F -F4�9,6.PASP 5rcccl- RoP5 //v 7,ope� BOTTOM. c-r - Is -4 o-oo Psl rec r wlqle"091 AW y 'Ix Pl-k y NOTE ' ACCE55 MAO-101-E5 ro 5E,0771C TAN, l A ND LEACH IA16 P/7,5 T0 ,34 31114-T ZIP 70 Z-Zcy- -40 /Z 3,CZ-OW P C-,,eA,0,E IMSH GRAPE IN45H GRA Pe OY-EW 7 7, ,oRNA�H G,,f4PE FW/5,H &RAIDE OVEj2 y.E lor '147- 15ox 3 S 4 lec" C- 1-CAC,441A16 T­ - :14 X7 570N r 1 CIO 4T ,TO Be Z rVL 7E CS) 54Ep7`1C ;"ANC'( 0 1 11 0 Sr / t, 0 +tom 0 '411EACP/Alb /:'/,'7- 7-0 AE 1-,E 6 T-A.6)-,f- Pvorl L E TYPICAL 5EtVAC2 E NOT T06CAi-,E�- V. SECTION PARCE(, 4,A Oer 6, LOT3*3 LEA4 -,T-o'le- ��ejz.,A ZONING P/Isrg/cr �,A A PROP05,6� 4�-')C,4 TION 6)/c p :71 CoNroi j9,E6'16N CR17'EIFIA Uf YR /V BIER OF laepRooms ^5 r 1116RWIV,15 PER ZIEPROOM PROP0,5EP CONTOUR ROBEFrr PA Y r-215 E6ND OAA-LOMS ,�Wlf PERSON )OCR Exl,57- 5por ELcvAr1oN &--o m � D 2P -,e0,P0,5eP dR07- Ek 4� 44EACIWIIVG RE . VA r10N 6.,6) L-P C"... 77 4EACAv'1A(6 PC??C0.CA7-101V 7-EST m MONO.", & "Z. Tf Z H 4 e. 41 A50TTOM 5C,44,6 PATE' 4S NOTE© 7-0 TA 4. - 154" G P 'V ",?AWN 49P Y ASSESSORS MAP :I ) 7�i& PARCEL : TEST DOLE LOGS � �d'`� / FLOOD ZONE : SOIL EVALUATOR : SOT REFERENCE: -7 WITNESS :Jr �J/ � �- L7D� H. DATE : N7� I ; 00 PERCOLATION RATE : Miul Z 1 11 1 Z" _ Oj�lL IZ.I�1 �.� ..J TH- 1 TH-2 r 7r o -1� T `�' cam--( ��� C �1 41�i�.-4-1� -4---Um Lrn I�.`� 1 oQ 1 .s� '1 �b-�L It \ W _ LOCATION MAP Lq"I"5) ' �baI SEPTIC SYSTEM DESIGN FLOW ESTIMATE �� c, -. IW�rC 1 - ,...._ ...............------- ---- BEDROOMS AT GAL/DAY/BEDROOM - GAL/DAY SEPTIC TANK 33O GAL/DAY x 2 DAYS - J GAL USE �10 GALLON SEPT IC TANK L, 5j j �12� I2J►� b lo— �+ )CI SOIL ABSORPTION SYSTEM SIDE AREA: � , BOTTOM AREA: ' 0 = Z3O�g i5 1 � `y" 3 � SEPTIC SYSTEM SECTION ,� ! _fib 4k6 -- 2 35S,Z GAL . a li y SEPTIC TANK 'DAL AD SITE AND SEWAGE PLAN T PREPARED FOR : P SCALE : I DAV I D B . MASON R5 DATE : 3 �� DBC ENVIRONMENTAL DESIGNS W EAST SANDWICH . MA DATE HEALTH AGENT ( 508 ) 833- 2177 z