HomeMy WebLinkAbout0777 RACE LANE - Health EA
RACE LN. , MARSTONS MILLS
103 020 002 ,--- -
TOWN OF BARNSTABLE ��
LOCA' ION 777 LN. SEWAGE # elo �
VILLAGE_ M8112—ONS ASSESSOR'S MAP & LOT W Q�W;
INSTALLER'S NAME&PHONE NO. Q'lO7TG—
SEPTIC TANK CAPACITY /00 0
LEACHING FACILITY: (type) a SCO GAuoa/ (size) 13'A04
NO.OF BEDROOMS_ _
BUILDER OR OWNER C6KL CcbP62
P RMITDATE: I"7-00 COMPLIANCE DATE: --QR-00
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
y� r
Il"�l 6 r
� a
11
a Sao GBH Lc�i9Cl G'k/� S
��STUXE
No. Fee 0
. THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
application for Mtgonl 6pztem Construction Permit
Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.777 A&,65—L Jj/ 7W� Owner's Name,Address and Tel.No. 61%L C pqP40,
Assessor's Map/Parcel /O 06�pI�5 '76' SAny S L/I
C, an
Installer's Name,Address,and Tel.No./,�a ip1i�[1��� Designer's Name,Address and Tel.No.
ao`Tf�C�-67W CIA,
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 _ ?30 gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank /ell- Type of S.A.S.Q .'SOD Ca, j��H
Description of Soil 0-6 a/0!^31t1 6"— 3K"'s66-50 1_ L6 a AW 6004LV�1h
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 Enviro mental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issue this o h.
Signed A Date
Application Approved by Date
t.
Application Disapproved for the following reasons
Permit No. Date Issued �� Gn
1 No. /.�' " ' Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH-DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pprication for 33i5poof *p.5tem Construction Permit
Application for a Permit to Construct-( )Repair(1/)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.777 PA-6 L.A/ tWrC.,1-1S (Owner's Name,Address and Tel.No. 61b& C C<VQ,::�k
Assessor's Map/Pa'rcel aif-
C. Rtrl �
Installer's Name,Address,and Tel.No.pp joy/�c/0T7j/_ i Designer s Name,Address and Tel.No.
E) L!
;07W--C TOP CIA
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
r
Other Type of Building No. of Persons Showers( ) Cafeteria( ).
Other Fixtures
Design Flow?LD gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank /1)00 Type of S.A.S.Q'1 D 6A, l&N CMM
Description of Soil 0-6 N L o(:m tS��-,3��S(IA5oI L �(�� l��F t��U�1 y SA/`/(,7
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 Enviro mental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issuedbj this B d of
Signed 'fi' Date I Z - GGo
'Application Approved by ` Date /
Application,Disapproved for the following reasons
Permit No. �� L�Fl Date Issued
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Comphance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired(V)Upgraded( )
Abandoned( )by / IqqoTy
at M-Z LL S has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.l00 dated /^ 77'' Ze0-z>
Installer I?t_TAa Y07y-- Designer G 4/
The issuance of this permit shall not be construed as a guarantee that the system will"funtcctio/nt,as designed.Date , Inspector 1) 1j/t/i�it/_Ar.rq%o, _i
------------------------ -------
No.6Z� 'g 49 / 1 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
XDi5po!6a1 *pgtem Construction Permit
Permission is hereby granted to Construct( )Repair( 1Upgrade( )Abandon( )
System located at 77 lQl« L4/. MAUI- 11!j /)I L1 .:5-
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 this2667hit.
Date: f�"' r' f Approved by .7
r
1/6r99
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 PERtiIIT (WITHOUT DESIGNED PLANS)
I, 1119 V0 hereby certify that the application for disposal works
construction permit signed by me dated L/—,-Zpc,p concerning the
property located at :2 ZZ a6nc - Z-V, meets all of the
following criteria:
" • The failed system is canner ed to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
J• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
�1• There are no wetlands within 100 Feet of the proposed septic system
J• There are no private wells within 150 feet of the proposed septic system
V• There is no increase in flow and/or change in use proposed
U• There are no variant= requested or needed.
J• The bottom of the proposed leaching facility will not be located less than five feet above the
ma..dmum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimntor
method when applicable]
J. If the S.A.S. will be located with'_50 feet of any vegetated wetlands, the bottom of the proposed
leaching facility will not be located less than fourteen(14) feet above the maximum adjured
groundwater table elevation,
Please complete the following:
• A) Too of Ground Surface BIe•iation(using GIS information)
B) G.W. EIevation F~ah G.W. Adjurment . _ �a
D Fr—ERE N CE B Ei WEE N A and B
SIGNED : DATE.
(Sketch proposed plan of s rsem on backl.
q:4cahh folder.cec
}. a
SOO 6ALtoH LW
PzT
TOWN OF BARNSTABLE
' LOCATION 77 LAI. SEWAGE # &i_D/<
VILLAGE 1'1'1AU ONS M-LLL5' ASSESSOR'S MAP & LOT .
INSTALLER'S NAME&PHONE NO. PRIAN
SEPTIC TANK CAPACITY /OO O
LEACHING FACILITY: (type) a 500 GAuv/'/ (size) 17'A-24 '
NO.OF BEDROOMS
BUILDER OR OWNER C,96L CcoP62
PERMITDATE: I"7-00 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
i
i
j
S2WwHyZ�irk?7 H&77JJ-9 005 lr'
1l �NiIL N,�'1'tH9
L O VAT ION SEWAGE PERMIT NO.
VILLAGE
K0606" %ryj s ups
INSaA LLER'S NAME i ADDRESS
BUILDER OR OWNER
' c, -
DATE PERMIT ISSUED cod-= 3U _ �g
DATE COMPLIANCE ISSUED
• J
S
46v -b
2 �
.000
O A
S I
0
No.6r '�" Fxs......', .............
��
THE COMMONWEALTH Pll-`MASS ACHUSETTS
/ BOARD ®F HEALTH
............... .. --��...._....OF.........KA,...... 9-- . ............................
Appliration for Uhip aal lUorkg Tonutrnrtion rumit
Application is hereby made for a Permit to Construct X or Repair ( ) an Individual Sewage Disposal
.SysfieT at: ��q
�. � Locatimi-Ad ssor
1�.. `!. `�' N ��
Q �ry® -•-- Address
a — W ► 1t1 Address
T of BuuiiYn �� Size Lot-"-- ��� S feet
U YP g --- -a�• -�..--•�-• q•
Dwelling=No. of Bedrooms...__.................................Expansion Attic ( ) Garbage Grinder ( )
P4 Other—Type of Building No. of persons............................ Showers —,Cafeteria
Q' Other fixtures -------------------------------- -
d ------------- ------------------------.--------
W Design .Flow............................................gallons per person per day. Total daily flow---------- ................gallons.
WSeptic Tank—Liquid*capacity�,!&®Ogallons Length—............. Width___-___--__-__ Diameter---------------- Depth................
x Disposal Trench—No--------------------- Width_ ................ Total Length.................... Total leaching area--- ._________....sq. ft.
Seepage Pit No.__----�------------ Diameter _ _ Depth below inlet.................... Total leaching area ..sgh ft.
Z Other Distribution box XDosin&tank ( ) �„ l
'~ Percolation Test Results Performed by.._, _d r -.--__ � �► p__.__._._. Date___._....._. V-------- _________
Test Pit No. 1------�..minutes per inch Depth of Test Pit... ' " _ Depth to ground water...9Ay-A.__...
GZ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
•--•----------------------------------a.....................................................................................................................
O Description of
cW, Soil .. � ? �
R,� L
� -----------------------------------------------••-------------------
- - -- P 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 AITL is 5 of the State Sanitary Code—The undersigned fur.-ther.agrees not to place the system in
operation until a Certificate of Compliance has been issued by fh4,.,board of health.
----------------_.
Date
��;.� .._..... --------• -•'--®- �
... ...
_
Application Approved BY-----.
IC
Date
Application Disapproved for the following reasons:........`..........-•------------------------------------------- .............................................
-•------------------•----.....---------------------------------------------------•---•-----•--w........................................................................................................
Permit No--------------------------------------------------------- Issued_.jKI Y I 7 �.
Date
_ ;r
d�
Fim...... *No-6)
-..�--
THE COMMONWEALTH OF_MASSACHUSETTS
4� BOARD OF HEALTH
« ........OF........ . . ..
Applirttf pan for UhiposFal Workii Tomitrurtion "(rrnti#
Application is hereby made for a Permit to Construct or Repair ( } an Individual Sewage Disposal
System at
�p
I ocat 6n-Address or "
nae
---A-04jau- -- --
T i �*, Size t Sq. feet
H Dwelling—No. of Bed rooms.__...._ ...........................Expansion'Attie ( )' ar agrder ( )
—
p.l Other—Type of Building _,_----------_--_---_. No. of persons.............................Showers ( ) Cafeteria ( )
....
Other fixtures .............••--------- `
W Design Flow............................................gallons per person per day. Total daily flow__...... : -_.. gallons.
WSeptic Tank—Liquid capacit}' allons Length ............. Width _ Diamet r__-.._. Depth................
x Disposal Trench No: idth__._ :,_. _.,.Total Length :.:.._..._. Total leaching area...................sq. ft.
Seepage Pit No '':.. Diamete Depth'below`inlet ..:::. ... Total Ieaching area .sq. ft.
Z Other Distribution lox using.tank'(
Percolation Test Resul Performed by_ :' f .:... r Date_: " _: _
`7 A _---
a ,Test Pit No. L_...II} } mirlues per,mch r epF� oA,: , t it__� ,g�. _ epth to ground ter.. --
+
Test Pit No. 2.`;...__.___._minutes per ineh Depth,of Test Pit.................... Depth to ground water............. ........
R-I' = ... f
-------- ----- . ------------------•---
D Description of l � :
--------------- ----
wr''� , 'Ii1 _ ..._
-
',:U Nature of Repairs or terations—Answe en.aFplicable -------k- - - -------------------------------------------........... ----------------�'
_. ......................................... :: ... ..._ ..._.. :. .............................................. ..._.........._-_._..._..............._...
'Agreement:
' The undersigned agrees'-to install the aforedescribed Individual .Sewage Disposal System in accordance with
the rovisions of TIT .;.,.
p 5 of the State Sanitary Code—,.The undersigned fu"' er agrees not to place the system-in'.
operation until a Certificate of Compliance has been issued,by,the board o health. J'
rg igned. �ij wp!. .
Application Approved by_
� '0 �
Date
Application.Disapproved for the following reasons:_ '" � :---.__
„ •,.
Date ti
PermitNo................................�: •-------- Issued: .•---••----------------••---••-....................
r Date
THE COMMONWEALTH OF MASSAtRL`U5EtTTS sty
BOARD O R HEALTH
.............................OF.........,;.' ...... ..':. ......:
,
(9rdifirtttr oaf Toutpli"t
THIS IS TO CERTIFY, That the kd,vidual Sewage Disposal System constructed ) or Repaired ( )
by Y. . I - .._ ...........
,;,- --------- ---�----------------------- ---
has been installed in accordance with the provisions of T r' j o6�, he State Sanitary Code as descried in the
OF
application for Disposal Works Construction Permit No... _. ""' hh .. dated--.. _ __ ._- +r
THE ISSUANCE OF THISf CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE,,
SYSTEM WILL FUNCTION SATISFACTORY: t
. l
DATE._•-•...............•....... .. Inspector.....---•----------- J
THE COMMONWEALTH OF MASSACHUSETTS
BQAR.D OF EALTH <,
I� ...........
�
Q�� ............. ...................... OF......... ..:,. .....��'��± _�` .:..... ..... �
a. No....................... FEE. ...... ...
Permissi ' hereby granted-------qA,
�. --kl!..._ ......................................................
to Construct or air ( a I vidual'Se gage Qii�sposal er2tt jj
,, Street
%
as shown on the application for Disposal Works Construction P No:_ _. .... . .....
Board of Health
DATE > -"" ...............................................
��
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS "
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LEGEND
EXISTING 'SPOT ELEVATION OX0 CER.TIFI,ED PLOT PLAM `
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EXISTING COWTO;VR' _ _ - 0 LOT / ZZ 7;�,4-e�
FINISHED SPOT =ELEVATION 0.0 ' r
-.FINISHED--CONTOU-R- - O--- 1A-7z-T2-t��1lS-
IN
.APPROVED BOARD OF, HEALTH
1A g h 5` A.4 o 9, ASS*
DATE AGENT. --- SCALE- I 40 DATES 512-/78
LDREDGE ENGINEERING CO. ING�
CLIEA-TCc_.�!�rh�'- I CERTIFY THAT THE PROPOSED
EGISTERE REGISTERED 7e90 BUILDING SHOWN, ON THIS PLAN {
=N B:.
CIVIL LAND CONFORMS TO THE ZONING LAWS
ENGINEER SURVEYOR DR._BY _A�^ • OF BARNSTABLE ; MASS/A
•
33 NO MAIN- ST. 712 MAIN ST CH. BY ' �'T'•O / ' `
SO.i YARMOUTH,, MASS. HYANNIS, MASS. SHEET OF Z »DATE REG. LAND SURVEY®R
? _ E/TNER ?'NE SEPT/C TAN/C OR
• O 'FT. M//i/. /�lOTLC /F
- L,E�tG,�//ivG P/T ARE � MORE Tfl.9N /2�♦EELOW
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swAPLL SFr BROUtaRT: ro 4mAz4. �'A1v ,EXTRA
CONCRPTE 4 P✓C P/PP E,4VY CAST //PON CO{/EI� SHALL !3E USEL7
0 CDI/E/PaS� M/N. PITCH
*;TADS co VEfz CLEAN SAND
• � BACkF/LL
4"CAST ' .a... 2 LAYER
/RON P/P� < P,00
/UO tI GAL. 0 9�o I ••• • •. � • o • I =e �04� - � //8
SCPT/C TANX DIST, o eD d q l�{�ASHFD 571�NE
o r► I e • • • • • • I I n
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e DEPTH • • I o �
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lNl��'RT �LEf/AT/OId/S o r`o` t .e i op 0 o I o o P/T DR.E4[U/v
INY♦ERT AT BU/LD/NCy jt6.0 FT -
6 s-T 91,4M. s -
/NL ET SEPT/C TANK 9 5•S FT, D_ F7 U/fa M _� C SEE TA�ULATION>
ouTLET SEPT/C TANK 95,3 FTC' .
s o GROUND W,4TER TABLE _
" /NLET D/STR/BUT/ON BOX 9 FT. - • ~ � - ---
g O UTLET D/STR/BIiT/DIY BOX FT = SECT/ON O F = r
/NLETSEEPAC�E Pi T 9 4-5FT _ SElfJ,4 GE O/aS'/,DSA L SYSTE/'?
1.EACf1//VG - �/T e TigQlJLAT t
/DIV
E5/G/►/ CR/TER/A Y SCALE : %a" _ /o o" _ o/MENS/ON A FT.
A14W,9ER OF 6EDR00/+�IS _
D/HENS/ON C�_FT.
-G�+Reo.aZv/SPOSA� uv/r_ SO/L LOG SO/L TEST'
. 7-,aT,4L, &_-rrIM,4TED FLOK/ O G.44.1DAY SOIL TEST p*/ SO/L TES r*,E
TS • *.�- L • �7 F'w"O.ER OFSEEF46E P/ A DATE OF SOIL TEST
10E LEACH/NG PER P/T 17,9 $Q 0-7 p 'z`
,L o 1RE5ULT5 N/17-/VE5S6•D BY /z,P, 13 v Al,f cI S
BOTTOM LE>*ICl//NG PLtR P/T �g $Q•. FT. Sv8 3 0!L PL`-RCOLAT/ON I@ATE ! a-•C
r.44 LEACH/NG AREA Zto 6
RE5ERVELE4CNIA16ARE/ b $Q FT. C`�y
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rn $Co q r✓O �a + `jt '.!Iq
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