HomeMy WebLinkAbout0127 MISTIC DRIVE - Health 127 MYSTIC DRIVE
MARSTONS MILLS
A = 079-049
J,�r b er 17 T 9 V � I
Date: b-7oT .�Za o2w_g
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: SLS)9 S �7tJT�?io� �Aj�T7 Q CK1R9 77bxL5
BUSINESS LOCATION: /2-7 IV162/c 29IVe-, /i HK5TaA)S /V///-f /y/9 02&0
MAILING ADDRESS: S9rrt nS mye Mail To:
TELEPHONE NUMBER: SW. V20• &6d //// Board of Health' Town of Barnstable
CONTACTPERSON: Aalsel� 7? TAyLc� P.O. Box 534
EMERGENCY CONTACT TELEPHONE NUMBER: J"eOg y f T�i L -- Hyannis, MA 02601
TYPEOFBUSINESS: 40
Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own
use? YES _�� NO
This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed
envelope for your convenience.
If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing
address:
ADDRESS:
TELEPHONE:
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health has determined that the following products exhibit toxic or hazardous character-
istics and must be registered regardless of volume. Please estimate the quantity beside the product that
you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS.
Quantity Quantity
Antifreeze(forgasoline orcoolant systems) Drain cleaners
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salt (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor oils Pesticides
NEW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet Fuel Photochemicals (Fixers)
Diesel fuel, kerosene, #2 heating oil NEW USED
Other petroleum products: grease, Photochemicals (Developer)
i
lubricants, gear oil NEW USED
Degreasers for engines and metal Printing ink
Degreasers for driveways & garages Wood preservatives (creosote)
Battery acid (electrolyte) Swimming pool chlorine
Rustproofers Lye or caustic soda
Car wash detergents Jewelry cleaners
Car waxes and polishes Leather dyes
Asphalt & roofing tar Fertilizers
3 yal Paints, varnishes, stains, dyes PCB's
/ Lacquer thinners Other chlorinated hydrocarbons,
v NEW USED (inc. carbon tetrachloride)
Paint & varnish removers, deglossers Any other products with "poison" labels
la Paint brush cleaners (including chloroform, formaldehyde,
Floor& furniture strippers hydrochloric acid, other acids)
Metal polishes
Laundry soil & stain removers Other products not listed which you feel
(including bleach) may be toxic or hazardous (please list):
Spot removers & cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
J
7 TOWN OF BARNSTABLE
LOC=:TION r c �r� I SEWAGE # !io -J,158
VILLAGE �,4�^s�o,v s �.�(S ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO /�( OiC/`S�/�/di
SEPTIC TANK CAPACITY . /060
LEACHING FACILITY:(type) FrPcaS u 0i)cr eK(size) /o0e —
r
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
. BUILDER OR OWNER e4 r
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No L/
i
6.A If
y
� a
.J t N
i
II
.. S
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 9F HEALTH
.. .....................OF.......
...../R,✓ f
Applirttttun for Disposal Works unshvdtun Errant
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at.• � - - - --.
........-•- :..... 0. .. ./..�Y� %�..... , ............... .....�......_..._........._....--.---
tio Addr s ...--.or Lot No.
.. --- ._ .....2� ............................._... ...............---•------.. .-•---...-----................................
1 .
W t....=.....-----:
......LeLC-!-!sy.ftwoo......................... ..1ra --1--- : dre�Llvc..k
a Installer Address
Type of Building 3 Ize Lot.1/4/'.1�.......Sq. feet
U Dwelling—No. of Bedrooms._._.. .__. .....Expansion Attic ( Garbage Grinder (�
Other—Type T e of Building r- No. of persons............................ Showers Cafeteria
Pa-� YP g -----1��r-�---•-•• P ( ) — ( )
a' Other fixtur
W Design Flow.._.._......5. ......................gallons per person per day. Total daily
•--- .- flow..,33•v-------•--•-------------- lons.
WSeptic Tank—Li uid ca acit /�_ lons Len .ZJ;L Width.�O.r.d.... Diameter................ De t.................
x Disposal Trench—No.___________________ Width___.....___.._.__... Total Length..:___... Total leaching area...._. __._ sq. ft.
Seepage Pit No. � .... Diameter./�------•---- Depth below inlet---- - Total leaching area--. ..sq. ft.
z Other Distribution box ( ) Dosing tank
!a Percolation Test Results Performed by...� �R ............................... Data�.��... ...__.........
Test Pit No. 1...... minutes per inch Depth of Test Pit._l.v....._.. Depth to ground water.................
(i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
...................................••---............----•---•-•--•----......._.......----•----------.........................................................
0 Description of Soil........................................................................................................................................................................
x
x ------------ -----------------------------------
-
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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has issu by board of health.. �+
Signed . ...... .
_ Date
Application Approved By...... .. ........................................ P. ....
..........- ------- ........._ mace•
Application Disapproved for the following reasons:..............................................................................................................
....................•--•-----•------.......------....----•-------•---.....-----•--------••--------------•.....--•------......---------------•----.....----•-•---...----•---------......•-•------....-•--
Date
PermitNo.. � - ....---- Issued-.....................................................
Date
r nn 0
No..qv�� .... Fizz_......._._....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD PF HEALTH
Allp ration for Disposal orks Tonstrur#ion Frrutit
Application is hereby made for a Permit to Construct ;�)�/or Repair ( ) an Individual Sewage Disposal
System at':
- --- -:.:.:.. �5 _...... .: ......................_-
........ ______........ .... ...............•-•--..................................._.._..........
�,, Location•Address or Lot
a•� '_ "�_._ . .r:"�� ..................... • ^^ ..��=g ...... ..
-.. ... '"• Address --------------
................ .......................... - .............. ........��^��,�
• .,_ Installer Address
Type of Building ize Lo,4/ feet
q.
U
Dwelling—No. of Bedrooms....-_ �_t.................................Expansion Attic Garbage Grinder
p, Other—Type of Building __ e''-"-----__-- No. of persons............................ Showers ( ) — Cafeteria
04 Other fixtures ..............:......_.........................
W Design Flow....... `." ............
.......gallons per person per day. Total daily flow ...............................gallons.
WSeptic Tank—Liquid capacity gallons, Length/,E'?.. s.... Widths.,. �...... Diameter................ Depth..______.._...
x Disposal Trench—No..................... WMh-2........_._.... Total Length.................... Total leaching area...................sq. ft.
Seepage Pit N6 "' ...... Diameter, ....I......... Depth below inlet.._.............. Total leaching area...
!�.....sq. ft.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed ................................. Dat ....................
s Pit No. 1.... :...:....minutes er inch Depth of Test Pit -. e
,.a Test � p p � �........... Depth to ground water.,.0...............
Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................
--••----•-------------------•-----............................----•----•-------------........_...............---•---------.....•-•-••--•••---••-••-•-...._...
ODescription of Soil......................•----------•------.......-----.....---•--.........------------.......-•-•------•--....------..._...__........_............._..---......-••••••----
x
M ------------------------------------------ --------------------------------------...........------- ---------------•------ ____--------_-_-____-______ ----------------------------
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 Sanitar Code—The u dersigned further agrees not to place the system in
operation until a Certificate of Compliance has i&dl o d_ health.
r
Signed- .......................................O ............................ ------------ •-
r at�•` �
ApplicationApproved By..........................................................................................I••••- ........................................
Date
Application Disapproved for the following reasons________________________________________________________________________________________________________________
---• _----•------ -----•-•------------•-•-•-----_-__-----___--.__-__-----•------------------Dau
O •----•--------
Permit No........... -- � ^ --
---------------------- Issued........................................................
Date
- 1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................OF , �✓ r '✓ ram`:".......................................
(Irdif iratr of Tomplittnrr
THIS 1, ,TO CERTI1F�,, That the individual Sewage Disposal System constructed ) or Repaired ( )
by---------------°�-�-'A'4A(�e...14W It. 1r�-:...................Installer-------------....-----------------•-----------------.
at. ......... `` ri d E.��ti.............. ------ t{{����}} --------
has been installed in accordance with the provisions of TITL..1�(�'of3 State Sanitary Coda� esZ�z'%ed in the
application for Disposal Works Construction Permit No......................................... dated..............._................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.........,�'��� � �W°�
-•---•-•-•--•---•-•------- -------•-----•-----•-----•------------- Inspector....-- - .. ---- -•--•-•---• -- --•---.......-----••--
THE COMMONWEALTH OF MASSACHUSETTS .
70.R9ARD O ,Qi /00
yQ-33 0 ............................. ..1I.��......O F............................................................................---......
No.- /...... FaE............�.......
Disposal orko Tonotruction rrnti#
Permission is h by granted--•-•-•.=�X-•`', f -----•-------------•-•-••---•--______--_--______-__---__--__....
to Construct �V�b p �'�a�In u0 Oem'lageoO&sp�osal System ?v 7
atNo.---•----•-----------•--......_..p----- -- ---------------------------------------------••----- -•••••----..........��:3-------•--...............--- f -
Street
as shown on the application for Disposal Works Construction Permit No........... Dated.......................................... .
_ ..........-----•••••...-••--•--• ..........................................................
DATE.... Board of Health
J .................•-.............•••--_..
FORM 1255 A. M. SULKIN, INC.. BOSTON
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QPPLICAWT ; 'SILVIA 1 5IILVIA .1W-,
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r sYA6J, MCHARO �*
No.,29733 "�3?j�_ �Ax7ER ,
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LEGEND TOP FNDN. AT EL, 33.9' SYSTEM_ PROFILE TEST HOLE LOGS
SEPTIC DESIGN: NOT ALLOWED ' --ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT T 1 SCALE)
100.0 PROPOSED SPOT ELEVATION (GARBAGE DISPOSER IS_- ) (WATERTIGHT) TO BAXTER & NYE
ACCESS (OVER WATERTIGHT ENGINEER:
DESIGN FLOW: 5_ BEDROOMS ( 110 .4,PD) = 550 GPD MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 32.1' WITNESS:
" �;, ---•..� 2% SLOPE REQUIRED OVER SYSTEM
100xO EXISTING SPOT ELEVATION USE A 550 GPD DESIGN FLOW : 27 87 I.
100 SEPTIC TANK: 550 GPD 2 = 1 1 �0 f RUN P PE LEVEL 2" DOUBLE WASHED PEASTONE DATE: /
PROPOSED CONTOUR (�) -.� 30.39 FOR FI3ST Z' ROUTE 2s
' USE A 1500 GALLON SEPTIC TANK (EXIST) EXIST. EXISTING 1500 /
+ -- PTI / 3' MAX. PERC. RATE _ < 2 MIN/INCH
100 EXISTING CONTOUR C4LLON SE C **
6771
!, LEACHING: TANK (H- 10 ) cns 29.1' CLASS I SOILS P# N�
SIDES: 2(47.5 + 10.83) 2 (.74) = 172 -- BAFFLE 28.32' �"� 28.15 C-1 C3 � ED O C I� O 0 MARa,PNO OR. 0��
_?.7.96' f� 0 CI 0 M Q CD 0 �3' AT SIDES LOCUS-�T
47.5 x 10.83 (.74) = 380 ----- ELEV.
BOTTOM: --- 6" CRUSHED STONE OR MECHANICAL 0 0 0 M � F 2:5 AT ENDS o
TOTAL: 748 S.F. Sat GPD COMPACTION. (15.221 [21) �$ 2' C7 a CO C� C7 CJ Cl 0 CI bo 251.96' p�� �'� 32.0'
DEPTH OF FLOW = 4' 1 1 0
USE (5) 500 GAL. LEACHING CHAMBERS ACME OR TEE SIZES: 10 ( o SLOPE) ( q sLo"'E> 3/4" TO 1 1/2" DOUBLE WASHED STONE LOAM &
_EQUAL) WITH 3 INLET DEPTH =STONE AT SIDES AHD 2.5' AT ENDS _ SUBSOIL
OUTLET DEPTH 14„
24" LOCATION MAP NOT TO SCALE
LEACHING 4'
FOUNDATION- EXIST. SEPTIC TANK - 93' -- D' BOX. 21' FACILITY 22'f ASSESSORS MAP 77 PARCEL_ 37-3
BOARD OF HEALTH I **UNK DOWN INVERT - VERIFY PRIOR TO COARSE SAND
h0`L' INSTA, LING ANY PORTION OF SEPTIC AND GRAVEL
MA SYSTE v1 22
APPROVED DATE I
/ GROUNDWATER EXPECTED AT ELEV. 4.0'f
_--4 MARQUAND Df ;IVE
\ 45.77
UTILITY j 5.67
-`` 120" 2 2.0'
CLUSTER i 4 7 4 09 �~
--- EL!=C TEL.CATV4 69 NO WATER ENCOUNTERED
5.54 i
461 R%s �45,55
ma3 GATE 45,1P LOT 3
LL `� 4 0$i, 45.03 3.8f ACRES
g�
° 3.06 NOTES:
�3 `''� 4 f 1 1. DATUM IS NGVD
ao. N�C) ,� 2. MUNICIPAL WATER IS EXISTING
44.80
39,4 , �� 4 . ELEc 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
\\ �`O 1 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 20
+3y.0 i (�
�'01 39 87 " VL METER I �1 5. PIPE JOINTS TO BE MADE WATERTIGHT.
BENCHMARK + 9. �rl? 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
CONCRETE BOUND � O � ti
ENVIRONMENTAL CODE TITLE V.
ELEV = 34.0' F-E �4.4 M r:+29.34
NGVD -31 ° 3 ,'s R� `' 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
_. F LOT F STAK
M
34.00 � / ;<% 31i.73 USED LINE ._ G.
, I ry _ _ _ _ __ R (zinc_ "CIP S TIL c\i4Tc-t,AI �_ ----
• a
_ I
38.24
9 COM TS "JIj f 0 B^'�
33 ti ,4R POI`•=EN I - `i_ -
� K3$.50 INSPECTION BY BOARD OF HEALTH AND PERMISSION OP7 AWED
+ act f/38.33 ' FROM BOARD OF HEALTH,
l ` +27,86
LOT 2 3 a6. •77 10, CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE
37.36 LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIE.\ F,fti'IOR
TO COMMENCEMENT OF WORK,
' - LOT 4
q 9 + 9. 5
t�35. 1 TITLE 5 SITE PLAN
4ee 4.39 34. 7
35,08
OF #165 MARQUAND DRIVE
-4 38.70 N _
+32 434.32 '1 IN THE TOWN OF: -
r 35.11�, 36.02 ro
SL EVE SE _R LINE FOR 0 31
,O' ITER IDE OF D (MARSTONS MILLS) BARNSTABI-E
f34.29 CROS tN NTH
TH WATERLINE
4.7 +36. 6 +38.69 `. +3 .7 r_ PREPARED FOR: DR. ARTHUR BERNSTEIN
Z 2�
34.31 i 7.8
33\+33.18 r \ 30 3�\ 0 30 60 90
irr 34_.-4-33.
P s
+r 33.76 LP --- "- 3�\
� SCALE: 1" = 30' DATE: JULY 31, 2001
-�;33. TH + 7.5
38'
32 33,02 0 ST LL 39
'1 ,a RET. AL
40
r/ it 32.46 5. +39,86
2.7.1 3.1.
i 39 `ZH Of M
\ i +38.59
3?,6 INV OUT 32. �8--
�� '"y �N
__-- � AFiNE N. cyGJ, ���P` A11NE
ELEV = 30.39' 37 aF OJALA
c� 30 Z i 36 f
c! CIVIL o _n A
�• �� 3S� +35.14 EXIST, SEPTIC o. 30792 0 26 04
O
' LOCATION FROM
EXIST. DWELL. INSTALLER'S ASBUILT SS �SQ� 7 PZ
/
�\ TF=33.9' A JALA, P. .S. DAT32-45
PROP. VENT (FINAL `, 31.73
PLACEMENT BY
CONTRACTOR WITH
HOMEOWNER) ,
LOT 3
off 508-362-4541
fox 508 362-9880
ry
down cape engineering, Inc.
CIVIL ENGINEERS
EW2 EW3 LAND SURVEYORS
-- +1 3
939 main st. yarmouth, ma 02675
0 1- 138 EW,
T - -