HomeMy WebLinkAbout0699 RACE LANE - Health 699 Race Lane
Marstons Mills
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HASTINGS,MN
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TOWN OF BARNSTABLE £'C
-2 �o0
LOCATION �99ffe``� �~' SEWAGE # oa� -
I
VILLAGE �i'IG'�l'7�' ��<<� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. J/may LE.6'o� / 7.7
SEPTIC TANK CAPACITY -'S"a o L7,4 _
LEACHING FACILITY: (type) (size)
NO. BEDROOMS -? c ,�s�BC"�✓
BUILDER OR OWNER
PERMIT DATE: e21-v 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 / Feet
within 300 feet of leaching facility)
Furnisbed by
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CERTIFIED
/Nc ; p P 7 y 1aoEs Mar crirr�Ii� LJVATION 6 R` �. . . . ,a!�' S?Z' W..
rCovb 2 v.vV- ('zawE N C 19 f¢s � ,. �30• /,�,�Jo . . .
SN'd4/�✓ U/v C��'►Al�/N/Ty ��fN�g'L/V'O- 2,s'UDO/ � . . . . . . . . ;�,C/A'1LWOD{�,f,�(�, �
PLAN AEFER�7V� R Sr. .
/!*d 1v,�.s rhitGs-B'.�ir ec�A'�i5�
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ICERTIFY THAT THE
! SHOwN ON THIS " 1!LrOCAT ON THE # +
DATE
PETITIONEA: RI�OItTQ11Q0
TOWN OF BARNSTABLE -C
LOCATION �9 9 Gf'�fG E ~' SEWAGE #
VILLAGE �lifGt'�l'7a' h��<<`� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. J/,,'1/ LG�Bot�'yl°' 77 �"070�
SEPTIC TANK CAPACITY /s--vo �A 1
LEACHING FACILITY: (type) /cE'Lt5 (size)
NO. OF BEDROOMS
/1F,�is,BC`�eJ
BUILDER OR OWNER
a
PERMIT DATE: CP "Z/—03 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 Feet
within 300 feet of leaching facility)
Furnished by
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3 P ovrE
A 4f 7
c o 0 b
�D 3Y .
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y fo o &
y'
No. C� Feet
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes
ZippYicatfon for 30tgpogal bpgtem Couttruction Permit
Application for a Permit to Construct( . )Repair( )Upgrade(k)Abandon( ) O Complete System O Individual Components
Location Address or Lot No. cif Gam' Z /3/yj Owner's Name,Address and Tel.No. /
Assessor's Map/Parcel / 3 9
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
(j 7
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building �c�s' No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3 o gallons per day. Calculated daily flow .3 gallons.
Plan Date S'r��—�.� 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 by this Board of Health.
Signe Date
Application Approved by LZnw I I Q Date
Application Disapproved for the following reasons
Permit No. DQ0 3 "` C� Date Issued 9-/ Z
� No. �"�J�u„� ,free,.`�v,�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
,3 �a Yes
v PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE S MASSACHUSETTS
r_g4 01pplication for Ztzp far *p.5tem Cow5truction Permit
Application for a Permit to Construct( )Repair( )Upgrade&)Abandon( ) El Complete System O Individual Components
Location Address or Lot No. aQif dre L�✓ /� Owner's Name,Address and Tel.No.
Assessor's Map/Parcel / 0 3
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
lT i Hj L F'�o��/r ,7 o o J d.d bii� CQ
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building /t'f f' No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow S< o• gallons per day. Calculated daily flow .3 gallons.
Plan Date Number of sheets / Revision Date
Title
Size of Septic Tank /1-0 0 C• Type of-S.A.S.
Description of Soil y
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
` Agreement: t
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 Board of Health.
Signed,--- _ Date
Application Approved by t._ Date f )r!f t-, 'c
Application Disapproved for the following reasons
Permit No. Q00 3 'S�C,� Date Issued `c.,
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded V)
Abandoned( )by (.Ti M L
at 4"9 9 e A- ,� /L Z - has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer c1io,, ' Designer_ gQ_41116 6'•
The issuance of this permit shall not be construed as a guarantee that the sy tem ill function as e igned./�
Date o3 Inspector
---------------------------------------
No. I fiG Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
'i!5 pogal 6wem Cougtruction Permit
Permission is hereby granted to Construct( )Repair( )Upgrade(>)Abandon( )
System located at 6"q 37
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 permit.
Date: _ ���/ri Approved by
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PA, OF
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MAP :
ASSESSORS �0. -' ' ,(^ -
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_ -_,I EST I t �L�� L0(3s
PARCEL : - `;�'7 _
FLOOD ZONE: /-/0% SOIL EVALUATOR- . +� �� , ,• NOTES:
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WITNESS : b-lv ►REFERENCE : DEe� DATE: AZD 1PERCOLATION RATE : � Z_ r41161, I 1) The installation shall comply with Title V and Town of Barnstable Board of
' ` l �� ? Health Regulations.
2) The installer shall verify the location of utilities, sewer inverts and septic
TH- I TH-2 components prior to installation.
3) All septic piping to be 4 inch Sch 40 PVC at 1/8" per foot.
4 Existin cess ools to be um d n
) g p p pe a d backfilled per Title V abandonment
Z p,,�l procedures.
5) This plan is not to be utilized for property line determination nor any other
purpose other than the proposed system installation.
LOCATION MAP LwIT�) 6) All septic components must meet Title V specifications.
7) Parking shall not be constructed over H10 septic components.
/ L ! 8) The property is bounded by property corners and property lines as depicted.
P P Y P
9) The property owner shall review design considerations to approve of total number
of bedrooms to be considered for design. Receipt of payment for the plan and
installation based on the plan shall be deemed approval 2 p pp oval of the number of
bedrooms.
SEPTIC: SYSTEM DESIGN
FLOW ESTIMATE 22
BEDROOMS AT//O GAL/DAY/BEDROOM - J?;0 GAL/DAY
SEPTIC TANK
330 GAL/DAY x 2 DAYS - GAL
USE I Edo GALLON SEPTIC TALK
SOIL ,AUSORPT I ON SYSTEM
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1 DE AREA: Zx. lJ '§- Z-�, X Z -A .�
o 6 v` E;OTTOM AREA: C 7-el C>\-I�A =
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Q .--5 �P T I . SYSTEM SECT ► N �► ,I ,�,�
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SEPTIC TANK
S 1 TE AND SEWAGE PLAN
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LOCAT 1 ON
PREPARED FOR :
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SCALE: l�tZO r
DAV I D B . MASON, ►25 DATE : 8
z DBC ENVIRONMENTAL DESIGNS
EAST SANDWICH . MA
3 DATE HEALTH AGENT ( 508 ) 833- 2177
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