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HomeMy WebLinkAbout0091 OLDE HOMESTEAD DRIVE - Health 91 OLDE HOMESTEAD'' Cw`Z I. MILLS - A=043-052.009 r j� j TOWN OF BARN TABLE L ATION ! D/42e /Y t�5 �Q� , SEWAGE # fyl—3 � J VUTAGE /47/!9/`D5�V11,5 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO �Df��� � Gar�s�` 7714", s%' SEPTIC TANK CAPACITY \ / 1 LEACHING FACILITY: (type) (size) q x NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: r` Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility 6 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 32 O 31 ti No. 9 `� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYicatiori for Migpoe;ar bpotem Conotruction permit Application is hereby made for a Permit to Construct( )or Repair( (/)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel �� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Li Dwelling No.of Bedrooms Garbage Grinder( � Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow l�� gallons per day. Calculated daily flow gallons. Plan Date /e— _Number of sheets Revision Date Title Description of Soil Nature of Repaiq or Alterations(Answer when applicable �/:� l � Ire22- r //— e /„®% 3 Q L1� ✓mac✓ 6111, 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 Cert_+fi- Cate of Compliance has been issued b t Boar f He th. ATZ4�� Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. I 3 6-0 Date Issued JL No. ',. Fee d .THE COMMONWEALTH OF MASSACHUSETTS p PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Of6pool bpgtem Congtruction 3dermit Application is hereby made for a Permit to Construct( )or Repair( /an On-site Sewage Disposal System at: t Location Address or Lot No. Owner's Name,Address and Tel.No. 4J1'1 .5�P Assessor's Map/Parcel Or. fQ v ''Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 74 Type of Building: Dwelling No.of Bedrooms Garbage Grinder V_44Q Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow J/t7 gallons per day. Calculated daily flow 63 3D gallons. Plan Date �40 - Number of sheets / Revision Date Title Description`.of Soil ' Nature of Repairs or Alterations(Answer when applicable) / i 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 Enviromm ntal Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. .•- p Signed Date 3 Application Approved by ;4 '; r _ Date eP Application Disapproved for the following reasons Permit No. Date Issued - . -- ------------ - - -- f -- - --==---- THE COMMONWEALTH OF MASSACHUSETTS 3 BARNSTABLE, MASSACHUSETTS 1 Certificate of Compliance { THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(✓l on by Installer at 9?a/4,42 4,We5 0&r sl`eo.0 .li/,// S has been constructed in accordance with the provisions Title 5 and the for isposal System Constructi n rmit No. . - 3 6 d dated �+ Date--, Ins �'ir rov P / I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. ---------------------------------------- No. ^� G ©"l 3 "��� •®�� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Oigpogai *pgtem Congtruction Permit Permission is hereby granted r -14' !��� l I ':21 /%��'r/•efr/' to construct( )repair( wfan On-site Sewage System located at No.# S Plyi street and as described in the above Application for Disposal System Construction Permit. - o. Date 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 three years of the date below. Date: roved A PP b Y Board of Health CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS] (, Aeiwr,)� VAVA-1,,' eby certify that the application for disposal works IIM construction permit signed by me dated -71YI ?r , concerning the property located at 9/0�,� ® � �°�� meets all of the following criteria: f//There arc no tictlands within 300 feet of the proposed septic system Y T re are no private wells within 150 rect of the proposed septic system Tv,observed groandiviter fable is 14 feet or greater below the bottom of the leaching facility Irl Th a is no increase in flow and/or change in use proposed Z There are no variances requested or needed. �l SIGNED : DATE: c� LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed system. Also irthe licensed installer posesses a certified plot plan, (his plan should be submiltedl. x R** ,s fix,,, x ". 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YO.43AY179 ONV7 03Y31S193y. a0j 441. 4�yF�• � '� � }, J t �'�M�N�'mMr +wnae>�1� , xw�..hww�r .. y. � • .. � j Q�S . rs 4Y :F y w �'�9��.ka %� �.s :} =s, �i A:P"���t�kth9' a'a ✓ u1 3' ����� �n^�Sx'�t r�Swt.ass ��.��" •. p ''`��r=�f*�.w+'...arMis!^g"•+-'+n*w'.w+1a .:w a.+w.....:ws.� ... 7 ,' �Y�11�M O� �mw - Zc xR. r.i c ;sue A 'ray#q g �/ 1 # 3 Aaas� &`F 'ice)8'I�Fa59xy M�-b -!c• {aL�%�y�r�� ) r � 1 { Ifs ,, s -70 Ir qq..s r WW i v N -dn►el doo wk2 voalIr o to 44 -1 / �i - -.•a .T x,g r,.i�q ��ruk�.�F i�ga4�-r '�i:sr��.'�;�4�'°t-E� ..<• •a �� ;�, S ;e .. . 0101 ,5�fp� Mi H4 `y N `q+�sRjypyy�y ' �; '�� �� ������'� `t ..y�����'i QT�h �+f„ �iJ'• Y:- �'� ,lv � �+f�..+'ti�?''s}.1��e:I.. x � eAfta '13kktatai't m+ Ftt r • %^ y'a "�fs ^'GpSY } •/•-«'' 1R' 'S3 >kx'°a [5" a• ,y e hl Ff.• 'y �`..,� 'rrfi/Yea y. *A :Y� a �..• � �0/.•133HS �^ .a _.. .. -__ .�:�,...�a_:�� r., :•��fit ��.�} ...N d 7d 3116 4 � WAJT z' i� 4 a y t 3 7 3 f . 4. . ...��.+'^+,i.1sw.��nv�rr•aa 1°.�$ r. ^Mrr%t WFi?l..'.,�"WI`a�".+�w?v .,,. ., •�� : - ' - a � 3 TOWN OF BARNSTABLE LOCATION IL SEWAGE # "1 VILLAGE ffl KILLS ASSESSOR'S MAP & LOT °`► 3 f INSTALLER'S NAME & PHONE NO. � I c' �. 771 r- SEPTIC TANK CAPACITY ��bbr QQ I Bros LEACHING FACILITY:(type) �, �1. i.�' (size) . GpJ NO. OF BEDROOMS �� PRIVATE WELL O UBLIC WATER �UILDER OR OWNER 26M' m DATE PERMIT ISSUED: DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No (� er V h c THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Va'o')........OF....... rJ�9R�t/s7i9 .. Appliratiou for Disposal Warks Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct ( ✓S or Repair ( ) an Individual Sewage Disposal System at:, �T 4Lo�t1i�on�-A'ddff Uw,55 RB L 2 x"� S'74N5 hi,�LS .....3a...... .--------------------------- ..._...----•-...... : .......... � . ress� �� �e����c39Y-• w Q_.. --- -------•---- --}°-Q�d5---. . ------------------ ,q ��'/v s r �j...... ....... ....•............------....---•--•-- Installer Address s r� Type of Building Size Lot......... feet U Dwelling—No. of Bedrooms.............3_.._._._.____ .___.Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------•• - Design Flow_________________✓�-.�...................gallons per person�er day. Total daily flow....�3Q......____..__ _ gal W Ions. P4 Septic Tank—Liquid*capacity/AV---gallons Length__ _.r Width................ Diameter---------------- Depth................ Disposal Trench—No......... ..... Width.................... Total Length....... .___y j_... Total leaching area ----- ........sq. ft. Seepage Pit No Diameter:.....-....... Depth below inlet... .. ......... Total leaching area_ . ......sq. ft. Z Other Distribution box (d) Dosing tank ( ) Percolation Test Results Performed by__ ! _ t� _.__._.______________________ Date...�r.. .`.� .......__. a Test Pit No. 1..__.Z-_____minutes er inch Depth of Test Pit-__-_ :? Depth to round water_____''_______________ � P P '------------- P g (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W' ------•-.-------•--------------•--------------------------------------------•-----------_------------ Description of Soil--------------------��s 7� l `--e7-al?j 121La.--------------------------•-------•-------------------------•-••----------.. V ............................................. Z•......1Z------... N.. •--•-------••---...-•-------------------•--------------------------..: W ---­------------------------ -••._....-----------...--------••---•••---••--•----•----•...-••••••••---•••••••••------•-----••--•--••••••••-••--•-----------•-•-•------•-------•----•---•--••••-•-...._. U Nature of Repairs or Alterations—Answer when applicable___________________________________________________•----__________-___-_-_-___-____-__-----_--. .---••-•••••-••---•••••••••-•---•-•-•••••-•••••-••••----•--•------------•-------•--••-----------••--•......-••••----------•-•---••••-••-••-•---•----••••-•---•-•••--•--••-•--------•••--.........•-••-•. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with th rovisions of i�'� : of the Stat itary Code— The undersigned further agrees not to place the system in er tion until Cc '•cate of Compl' has been issued by the board of health. Signed.............'ram' `-/ l��( 6 Date lication Approved By................................................ --••••• --••.•• •----------•-------•- --•---...�d ..--- - Date Application Disapproved for the following reasons:.... •---•--------------•--•-----------------------------------------------•---•---. --•-•••••-••-••••••••-••••.....•--------•••.............•••••-----•••-•---••----•-•-------••-•.......•-•----•-•-•----•-•----••••-•••-••-•-•-•--•••••----•---------------•••----••...•---------•..... Date PermitNo......................................................... Issued_....................................................... Date i Y r �y J • i `� 6 - II43 S as No................_....... FIms..........................._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratinn for Uiipusal Works Towitrnrtiun ramit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: ----•-•-••--•--••......... .....••-•-•-•--••---- ---••-•-•---•-------•---••---• --•-••------•--•------•-•• •---- ---••--•--- -----••-•-•- _ Lo atia -Address OWr q A doss Installer Address go UType of Building Size Lot__________ S_______________ q. feet Dwelling—No. of Bedrooms............:.3..........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building&l.!lJ ?f No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ...-•-------•••----------------- W Design Flow................ ............................ per person per. day. Total daily flow___::3 ......._.....................gallons. WSeptic Tank—Liquid capacit/!W!....gallons Length. TL9... Width................ Diameter................ Depth................ x Disposal Trench—N?o. .................... Width.................... Total Length.._.._L_............ Total leaching area -----------------sq. ft. Seepage Pit No-------- .____ ____ Diameter..... Depth below inlet_..1.•3.......... Total leaching area _.......sq. ft. Other Distribution box (J ) Dosing tank ( ) aPercolation Test Results Performed by.__. _ _... 1 .............................. Date...................................... ,4 Test Pit No. 1....�k-------minutes per inch Depth of Test Pit.... ........ Depth to ground water------................ rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ......................... ..------------------••--- .. Description of Soil ��' ;...... .....�G;liJ1�J�IIL._-------•-- x . VW ------------------------•--•-•----------------------------•-----•---------------•--•-•--•••••-••----•---------•--••-----•---•••------••---------•--••---•------•--------•--------•----••---:....-•-- Nature of Repairs or Alterations—Answer when applicable............................................................................... .`............. .......--••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 91ircatioln ovisons of T-`__E j of the Stat nitary Code— The undersigned further agrees not to place the system in tion until Ce Ticate of Comp' e has been issued bbyf the board of health. /' (JC`J Signed-------- _+/T4`-' 47/...---------•-•------•------•----------------- -`� �` �.....-- ------- --- �� Z a$ ApprovedBy.................................................. •••• --------------------•------- ---------- -Date Application Disapproved for the following reasons:---- . ------••-•----•----•••-••-•-•---•---•----•-••-.....-•-••------••--------------------------•--......--••- ••---••-•••---•--••-•---....•---•----•--•---•--••-------••-•-------------------•-.........-•--•-.......•. Date PermitNo....................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ktVI/.........OF........�'-3..di ...........- %rrfifiratr of TnmpiiFanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( } by.. -=:-J_... ---•.........................................•--------•-••-----•-----..................-----------....•..........---....------.......------------ Install at__ ^p_ ......3,2�-------� 1� ------' �*�t� I........ 1 � 7''Gl� /IT&L �a --- ---------------------- has been instailed in accordance with the provisions of T i T i E j of The State Sanitary Cod as de lc ibed in the application for Disposal Works Construction Permit No.3... ................ dated-__-`�-/_.Z_�-��_C_..., ........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. ` DATE..................Z..". .. .................................. Inspector......, �D.. . .------------ ........................ A = � � VVV vvv THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 157 3 ...........................................OF............-•-'• -• ••• ............•-•.....••••........• ................................ — NTO.....•-•---......q•.. FEE..... Disjum al Worho %T11nofr ion rrmi# r Permission is hereby granted =. ......_ ---------•-------------•............•-•••--••-•----------•------•-•----•....---•----........----•-••--•....••.._.... to Construct (V) or Repair ( ) an Individual Sew�ge Disposal System _ at N'o....l l...... n _..... It Street43 1 C) Z 8 as shown on the application for Disposal Works Construction Permit No.............:....... Dated......... ... _.. .6.. .................................... ----- -------------------------------------------------------------- & - ��` �� a,�+ ?� BoaTi'of Healt)i 1 E...?? . .._.- _. " ---- �� FOFM 1255 HOB S & WARREN, INC., PUBLISHERS d � { d i I SITE PL A tN SHEET l OF 2 SCALE: / = _4-0' f . 2�1 w I v. %lo )OoD.C�AL: 5�� TA(rez NS IdUII /�� \ p1 v, Al Good P� V-01V4 A t-4V WILLIAM o M. 3 WARWICK ^ ?, Na.'19771 Z, fCtSTER``���` Al REGISTERED LAND SURVEYOR FOR-M a Lod` ,' o�Dr� �� flD DQ iZaN E M A c5, /y1 i Lul, PLAN .REF.AA P4 PA ? O I7ci DATE I�-ZC,:� BENCH MARK DATUM-IcILg Nl ATUAA WM: M. WARW/CK 8 ASSOC., INC. =-DOMESTIC WATER SOURCE-TVwXf 1e A? 'C-;L, 80X 80/ - NORTH FALMOUTH FLOOD ZONE. N0Q' NIk�ArZ C�� MASS. 02556 - (617) 563-2638 ' LEACHING SAS/N SECT/ON NOT TO SCALE 24C./.MH COVER EARTH FILL BRICK AND MORTAR COURSES AS REO D• TO BRING 4„ i 4"' —ti = _ COVERT, TO* GRADE INLET +B FLOW LINE_PIPE y TO% WASHED PEA SrONE FREE OF IRONS, '':T;; FINES AND •DUST /N PI ACE I 6' �� '. q '• OPENING WITH 4%B" 3Y4„ TO I%2"WASHED CRUSHED STONE FREE OF % OUTER DIAMETER IRONS, FINES AND DUST IN PLACE ANO 1414"INS/DE .'. DIAMETER I. CONCRETE TO BE 4000 PSI 28 DAYS L„EFAcu0 , rrr •2. REINFORCED WITH 6"x 6" NO. 6 GA. W.W.M. x ' 3. 2�AND 4' SECTIONS ARE AVAILABLE FOR r / GREATER DEPTH REQUIREMENTS M/N' -6° ?ZI --� 4. NUMBER OF PITS REQUIRED v�JC EFFECT/VE DIAMETER NOTE: EXCAVATE TO ELEVATION OR (NOT TO EXCEED 3 TIMES- EFFECTIVE DEPTH) LOWER AS REQUIRED `TO REMOVE ALL WArER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE TYPICAL ' PROF/LE EXCAVATED MATERIAL WITH 'CLEAN GRAVEL TO DESIGNED GRADE. IB'STD. LT. WGr, C.I. MH COVER 4"C./.PIPE 4"BIT FIBER PIPE DWELLING FLOW LINE TIGHT.✓DINT OUTLET LEVEL -,r o o TO FIRST ✓OINr Ud ,v /q' p 1 10 09 1 p� C./. TEE 2,2 ` I I.0 1 0 0 1 1 111 000 00 1 I 1 1 ,STD. PRECAST CONC.TA D/ST. BOX TO BE ' It 000100 1 1 1 I AL.SEPTIC NK �' p 1 1 t fool O O D 1 1/NSTALLEO.ON LEVEL, STABLE BASE I '1 000 00 1,1 I a NSEPr/C TANK jT0•BE 1 11 100 00 1 1 1 INSTALLED ON LEVEL, I It 100100 1 It STABLE BASE. i 1 1 10 0 00 0 1 1 1 ' LEACHING BASINI I 10 BASE rO BE LEVEL 1 1 11001001 I ga � SOIL AND PERC. DATA P 5'S'v fv PERC. RATE 0 MIN. /IN. „ TEST PIT NO. I TEST PIT NO. O 0 2 TEST BY: 1-�gL-C> � ' . fiop5ol(.1sU �L WITNESSED. BY: M m GAQ ; TEST PIT OR. EL. ��� D DATE: "'" �� (Z' el. e4. D W A11"C"�•• DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM, DISPOSAL SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST..TOTAL DAILY EFFL3�o GPD. PRECAST REINFORCED CONCRETE. UNITS. SEPTIC TANK 100" GAL, ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE SIDEWALL -AREAL:GAL./SQ.FT. TO REVISED TITLE *5 OF THE STATE ENVIRONMENTAL CODE, MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA �• GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY I , 1977, LEACHING REQUIREDOSQ..FT., ANY CHANGES TO THIS PLAN MUST .BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. �Q.FT. AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES I/4" / FT. UNLESS INDICATED OTHERWISE. OF Aq l L A SYS TEM SEWAGE D/SPOS ` MARTIN yu�Prl+w o E• :; FOR; GJ I D pJ U ( Lr P I J-) C-2 Co . .� La MORAN T 32 dLDE 123417 pp, Ss�0 -A- UAL EN rora� SCALE AS INDICATED DATE ' WM M. WARWICK 8 ASSOC., INC. 80X 801 -- 'NORTH fAL MOUTH :. PROFESSIONAL ENGINEER MASS. OZ556 - (617/ 56,E-2638