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HomeMy WebLinkAbout0372 RIVER ROAD - Health 372 River Road A = 060—004—002 Marstons Mills i n TOWN OF BARNSTABLE LOCATION J ® (Z% SEWAGE #a"i S" ','11sLAGE _ r 1 S ASSESSOR'S MAP & LOT Q D'00 q'oo�. INSTALLER'S NAME&PHONE NO. Ardulr3 cko sl- 3(Po'(0a-17 SEPTIC TANK CAPACITY 1500 LEACHING FACILITY: (type) POW I' PC (size) <IUA�60 NO.OF BEDROOMS 4 BUILDER OR OWNER`` I A' � /V f PERMITDATE: `Q t [0 I COMPLIANCE DATE: 1 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 A I 2, V5,7 -4 37 z Qt ver r t,�=3 � 3d•� f —2 146.3 i r No. V / O Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppliLation for Disposal *pstem Construftion Permit Application for a Permit to Construct( ) Repair(j() Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Or 60J "00 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 1 ,_/0, =j2K f _41 S: Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 91[is Br® ay� r_ E Type of Building: Dwelling No.of Bedrooms ZIA Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers J-) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank OW CQ)6K- Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ��er> 9Soo 9 Z I(ek a�� 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 Certificate of Compliance has been issued by this Board of Healt . Signedr Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. `�j 17 6 Date Issued /0, �D T�- No. Q l G/ '� Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' ✓ Yes PUBLIC.HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 9ppiication for -Disposal &_ pgPm Construction permit Application for a Permit to Construct( ) Repair X) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components 4? Location Address or Lot No. Q —O .1 Z Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 1 i c Lr� _41s Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: / Dwelling No.of Bedrooms ( Y Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons_.. Showers(A) Cafeteria( ) Other Fixtures Design Flow(min.required) ,� gpd Design flow provided gpd Plan Date '.✓ rivuinber o sheets Revision Date Title - r _ / --1 /�y Size of Septic Tank 1000 Cg)6K ~T pe If S:�A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) v "�'�,/l Q^a,( K I Soo R Date last inspected: ( t i / r Agreement: �` 1 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 Certificate of Compliance has been issued by this Board of Healt . Signed . Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ,�/, ( — / 7 Date Issued T --------------------------------------------------------------------------------------------------------------------------------------- �q--f, L �(,- THE COMMONWEALTH OF MASSACHUSETTS t s BARNSTABLE,MASSACHUSETTS 6A41l-h Certificate of Co pliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by A at 3 2 2ad has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. _7� dated Installer Designer #bedrooms Approved design flowi gpd The issuance of this pa it shall not be construed as a guarantee that the system wi fun tion as desi d. Date 1 Inspector rs 1 - ---------------------------------_------------------------------------------------------------------------------------------------------- No. ! k D ( -7 Fee w THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstrm Cons"I ttion 3permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at � and as described in the above Application for Disposal System Construction Permit. The applicant recognized 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 (� 10 Approved by I' U 1 r � , fLv � �� LOCATION SEWAGE PERMIT NO• 'VILLAGE s ons INSTALLER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DAT E COMPl1A'NCE ISSUED -�OJr�" AR A No.-RZ.�-� J ; +�_ y YmB. d..............._ � � / ✓ DWE COMMONWEALTH OF MASSACHUSETTS" by BOAR® OF HEALTH d -- -- '� �f......... ......OF �.�. � '�. liratiou for Uhipwial Works Towitrurttun Famit Application is hereby made for APermit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: BJECT TO9 APPROVAL 19 Location.Address �+� �JS`i+' ��� or Lot No. ......................f% =.....:>�= ...%�- 1: _ ..................�N � .�. �Ka _..f� ...... �.� Owner, �Address.- ddress � a ............................... ..................................�... c�� Jt' ....v: -----.....��..1..-.�..................---- Installer I Address Type of Building Size Lot..`?�_ ------Sq. feet U Dwelling—No. of Bedrooms...........�............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-----___..__--______-_______ Showers ( ) — Cafeteria ( ) a' Other fixtures ---------------------------------------------------------- d W Design Flow...............-W........................gallons per person per day. Total daily flow-______---_---15-3P..................gallons. WSeptic Tank—Liquid capacityi.0 _gallons Length Width_��! ".... Diameter________________ Depth... x Disposal Trench—No. .................... Width_.. __.. Total Length-----j rT. Total leaching area...- --....sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed b ._._ G ---------- Date_. -: 1 ...... 41 Test Pit No. 1-- w +.Y..?--minutes per inch Depth of Test Pit___._._ _ Depth to ground water......e..�............. Lt, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...... '........... ---------------------------------------------------------- ------------------•••---•--•••-••-••-----...----........----•-------•-•-•--••-.................. O Description of Soil......49.�� ���f ..,?` �3c� ��©/to "--•¢a"'-4>�ez6— . !a. x ----=`-----� „- _ ,s aQ �--4- ..-----._wart- ... ..�.... V 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 the provisions of'ITi p S of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. �j �/ _-Signed t .............................. :l'- :-f 3-1....91 Date Application Approved By__._._.� /1l< ,��. 2_--/_e... ......... .... Date Application Disapproved for the following reasons---------------------•-----------------------------------------•----------------••---------------------•--....... .............................................................................••---------••-••-----------•I---------•------------------------------------------------------------•----------------•------- Date PermitNo.......................................................... Issued_..................-.................................... Date e THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ..,HEALTH 4 .......0F...... -.i ................................... Appliration for Bhipasal Workii Cfnnstrnrtinn Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Locat on Address G� /+ or Lot No. i `—? .. .... 4 ........_� r" ..Le_. '<�r.[74:....W.......�I'A s&..-t_ .................. . ..... ............ ........_.. 6.... .. Owner a Address C a --•-../•�'2.�- ............ .mac:-4,�-� ............. !�'1Z+s �..........�?`/ S . � Installer Address Type of Building Size Lot...` 1-4� ....� yp g -Sig. feet �-- U Dwelling—No. of Bedrooms___..__..._.--�................ .Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ............................................. WDesign Flow.............. ......................gallons per person per day. Total daily flow..............:�K ..................gallons. 1:4 Septic Tank—Liquid capacityl.00 ..gallons Length._A?. ".. Width.-_if ... Diameter................ Depth_._4.0 Disposal Trench—No. .................... Width....h �°__.. Total Length......?P-E-_ Total leaching area... ?------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by....?' : .L:..! '%': 44. ._ f�-'�`� _____.____ Date._�`' .. .�`�' ........ a Test Pit No. 1.. r .�ffiinutes per inch Depth of Test Pit......... -- P P ----•----- Depth to ground water...... G ........ Test Pit No. 2................minutes per inch Depth of Test Pit.....?1.---_... Depth to ground water..__.__7....�.".... . ------------------------------------------------------------------------........•-------------------------------- ---------------------------------- 1,-Description of Soil-----•4„--7�4".........--Air---_¢`._•Strom-3o�t,.------7'-�' 0'--�0.�..Iz . ..S. i�-------------- -•--------•----- ---------------------------------•---•---•------------•--•----•-••--•----•--•-•-•----------•---------------...-------•-•-------••-•-----•-----•--••------•---•............•---••...... U Nature of Repairs or Alterations—Answer when applicable----___________________________________________________________________________________________ ----------------------------------------•••------------•----•-••-••--•--•-•••---••••--•-•-•---••••---•-----••---------------......--•-•---------••--------------------•---------•-•••--•••-----••-•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with f'I T/'1�+-� the provisions of :: . 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .... ........ Date Application Approved By............ ,art/.-. -.... �" ��e�......... Date Application Disapproved for the following reasons:............................................................................................................. ..•-------•--••------•------••---•-•-•--...----•--•--•••••-•----••--••------•--•---•-•--•-••-----...•••--I----------------•--•--••......-•-•••--••-•-•....-----------•----------••-•---••--•----......... Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH QSs s>...:...........O F..... .r ...................................... �rr�if irtt#r n� (t�lant�rli�nrr THIS IS TO CERTIFY, That the Individ Sewage i osa system constructed C ) or Repaired ( ) by--••---•-.._.. : _. ......._.. . - ...-•---- _--• --------------------------------- Installer � ` has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. -8+�__---4_1............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................................... -Z8- . ... Inspector.....-- _ A / THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �.............OF.... .• � ..,.,,,�'�. • ............................................. FEE.........3-0............ Dif1paSa r Tanstr i.a crnti Permission is hereby granted...... •-•-------------------------•-- .................................................... to Construct ( �or Repair ( ) an Indi idual Sewage Disposal System .p Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... -------------------------------------- DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 11PPLICATION FOR PERCOLATION TE ST AND OBSERVATION PITS LOCATION (yG'Z ���? - - NO VILLAGE APPLICANT FEE ADDRESS `v. TELEPHONE NO. 779-/:/( (Non-refundable. ENGINEER TELEPHONE NO.�7�-oases DATE SCHEDULED // - /lo (Applicant' s signature ASS$SSOR'S�bi & LOT NOS " . . . . f, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .a. . .•. . . . . . {�,� SOIL LOG / f SUB-DIVISION NAME���-i2,✓�� /Z�, DATE a� ��J �-TIME ( � EXPANSION AREA: YES NO �/�-�{. i tiJ ENGINEER . TOWN WATER PRIVATE WELL r;b Z4_ rt�4 BOARD OF HEA�Tf EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) . NOTES: La;/ > 4,,� 7 •)1 I �; C lr' v L,4 F_ I{zo.7,01 PERCOLATION RATE: < TEST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 2 4 5 2 s 3 3 4 2< 4 - 5 6 6 7 7 5 1'�> 9 9 10 10 11 11 12 12 13 4,4 13 '`�" 14 . 14 15 15 16 16 SUITABLE 'FOR SUB-SURFACE SEWAGE: LEACHING FIELD /LEACHING PITS LEACHING TRENCHES t/ UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: I NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION 1 )RIGINAL: COMPLETED IN ENTIRETY BY P. E. AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT TOP OF FOUNDATION,' ''' CONCRETE COVERS Zdj •,:, 4'CAST IRON 12"MAX. sAr PIPE OR 4"ORANGEBURG(OR EOUIV•) " it, EOUIV.)--MIN. PIPE-M1 12 MIN. 2e" PITCH i/4 PER.FT �' LEACHING FIELD (. .,.REQUIRED) � PITCH 1/4 PER.FT. .� 1/19 -1/2 WASHED STONE , + Ii'V€RT WASHED STONE re EL.. ?1r'r INVERT GIST. INVERT 3/ ,.; SEPTIC TANK 38�o EL.34r4¢ BOX EL......... %• INVERT /000 GAL. INVERT 'e' EL.3y,�L. """" "' 38.7 INVERT INVERT EL.......Z. 38.18 EL•3B.�o , Go . Ze •, PROR LE OF --Z.3z.w GROUND WATER TABLE SOIL LOG SEWAGE DISPOSAL SYSTEM TYPICAL CROSS SECTION NO SCALE LEACHING FIELD DATE !�fAR.9/.�1��. TIME .eet'-PP NO SCALE TEST HOLE I TEST HOLE 2 ELEV. ..3.7.44y. .. . . ELEV• 3B?!o. DESIGN DATA 1, I/8"'-I/z" „ 12 MIN. WASHED Lp NUMBER OF BEDROOMS `3. .. • STONE &A"f G sr x see-se,/G sue „ TOTAL ESTIMATED FLOW . . .330 . . .. GALLONS/DAY 4" RFOR ED �r �� Z co�►+�sc u~ BOTTOM LEACHING AREA .. S.Zo .. . SO.FT•/ FIELD. PLASTIC PIE pose. CoMts Ar L3/4"-I V2" Cn/4�¢3Er S0 GARBAGE DISPOSAL ..(50% AREA INCREASE) SASHED SA+vn Cs/l/11IE2 TOTAL LEACHING AREA 20. ... .'.. SOFT. 4' 4' 4• 4• fit' 60 v�•'r�a Cc" w4rtz a"F7 PERCOLATION RATE LZ4ss stlq,� stvr �'!�Y• PER.INCH ,ZG tR.7i•/ 6t.3t./ LEACHING AREA PER PERCOLATION RATE P.. SQ.FT. SAw.D GROUND WATER TABLE;,, , APPROVED . . . . . BOARD OF HEALTH KELLEY CO. I(, — - - - - - THOMA3 E. _ ._ "_ &t•. ,!- -/o WATER ENCOUNTERED ^- "` `' ENGINEERS—SURVEYORS DATE . 6 LO �DRIVE 34@ a' WITNESSED BY AGENT OR INSPECTOR So 't MA88. BFMAss E L ,W 26 �.°`, A !?,�.L Mvea . . Z BOARD OF HEALTH mTna tH ,`^,► ENGINEER C olic. 34269 231 Q� � w•a� n ,Iy, •!PAC s. �' 9 TAR �IONAI lk- U� PETITIONER ; / /n//S " /�fJSS,.. . , a supi , < I. �lArZs7v..iS /-JiCG s M,As - i /�' 8A Ti913G �I .e {I { I ; Ii �. _G'al N� tl C�"-.iti Q � A �II i a — II 0 T ICI s y f h Z G 1/_S M , f - o 8 / 1 3 l oV�C�oW L3oG / t ! { 1 1 : 1 7 � Z � a LoT � F � 1 / N w a = r of oV6- �E�4 d6 3 . �; I 34 AceeS _ vP .�. / V\ .O o . ' 7C Ac�zEfS o G ca / { 3 i ti O V&;OC.wWN 15' a. 1 1 / � t5 I 34- 13oG � a 1 ; / � t - r. Ls✓ w h/ o �J N" u f , o a i r p s S / o � \ .roP 3 o -r a . Zq z rly �n 1 o v a v Lti c v T 1,� .. a 3 S , A^ i u z , ® m Z 5 s. CIA Y n 0 1 , i 5 � N N 1 a O L r✓t 1 ziz C a 3 x aF t vr. x _ Z .. d;.....: ,�/ .� _: .. .... .. ....... -ice' / ... vpazr tf V 7�/ �,. >, hoGC' �L , .,-a%. . - A r _ G _ r _ vac- 1-2 i _ _ f III w N -- N_ Nord- Av_ I II s y��� 6Yaz� rn �— �, --,. I I �Y n. _.. 2L a ADD GiGGL u W TN G�x}� wi , )cgry fzo o S Env /fi'4� , v' 4 w w 4, __a.. 5 sus' hL�w Pry o.S S�t/ a � � o ra.9CG to , 41 , I_ F T , EL. 4Z.b 3 kEQUIV-� TOP OF FOUNDATION CONCRETECOVERS °CAST IRON 12t�MAX. IPE OR 4"ORANGEBURG(OREQUIV.) 12°MIN.-MIN. PLPE-M(TCH 1/4°PER.FT PITCH 1/4PER.FT. LEACHING FIELD (. ..REQUIRED) I/B I/2'� WASHED STONE trr �,• EL V9 S3„ INVERT INVERT WASHED rr . STONE e'4 SEPTIC TANK 9¢ 80X EL38�Q 3/4 -f1/2 EL je•.. . ,:. INVERT /000 GAL, INVERT 38.7 INVERT INVERT EL... .7. EL.39./8 EL's3B.io 42t •, � e�y� � - vr� Qw lot, ' PROF)LE OF s , all, GROUND nr Ez.3Z./o � eil e•e•.'!� GROUND WATER T8l��' G SEWAGE DISPOSAL SYSTEM TYPICAL CROSS SECTION � �D SOIL LO SCALE LEACH 1 NG FIELD DATE !MICA/,fV. TIME .//.00�. . NO NO SCALE �' F_ TEST HOLE I TEST HOLE 2 ELEV. ELEV. .38.�o DESIGN DATA i211MIN. 1 / /2" • 18- WASHED NUMBER OF BEDROOMS 3 STONE s'�C-Sei TOTAL ESTIMATED FLOW . . .'3I . . . GALLONS/DAY 4' Q' 4° RfOR ED �•. ` , Z ces� u~ 3eit. BOTTOM LEACHING AREA .. `rZ�.. . SQ.FT./ FIELD PLASTIC PIE it ---- 4or s.�•ivD t' Plitt. Co'*ms l"' .L3/4'_I ? SrM.O GARBAGE DISPOSAL!YWA . . (50% AREA INCREASE) WASHED CnA�¢36i' Sw+�� STONE G/�� TOTAL LEACHING AREA 'S'Zo. SQ.FT. ,�• `, 6 w4frv. � lot + uxroEy M PERCOLATION RATE s.?x/ .�'!!W PER.INCH Rd tr!•!I•/ $2 3Z. GE'Z' C'�aQs� LEACHING AREA PER PFRCOLATION RATE SQ.FT. SAw.D GROUND WATER TABLE;;,�, 94- 9L~ APPROVED . . . . .`, . . . . . . . .. BOARD OF HEALTH — — — — — — THOMAS E.KELLEY CO. a•32•/V.WATER ENCOUNTERED DATE . ENGINEERS—5URVEYOEB 3,46 LO l DRIVE OF11� AGENT OR INSPECTOR -" MASS. SS WITNESSED BY GoTw so � `` 26 � TH A P.4eiG Mv2. . . BOARD OF HEALTH �' . . . { C GG v� IfE 77-� 2 242684 e �O Kb+laz. E X2 PETITIONER / .q,�,v�s /yi9 SS, '�✓p <3 A s�ONA4 j l t � /ALA BA�NST I3G�- HJL}1257ri s />✓G.L S MASS - I; U cam; _!�•*,►,t� rz v�- ore. , u y Q A TE- �ZE�//A-Tro�v s � �y ��r�y S�q LE'►/GZ ->t- L a T pu �`. Dina Tz7-E , y s ' 8 s ' 3 7 . I z m 1 i 3 i 1 1 -17 1 � doG / � � ♦ 1 1 1 Z 1 o T. LoT . 1 �• a j ti N C- o � W A�E� _ ' Z.i� �1C2E31,19 SA f �� � t� � �/ t oYL /,3 ric2�5 4Ir- F v G�.o <�_ P y � G•7L o<1uzErs _ F 80 G ra / , k 3 _ � • ti / �C�o wn/ ; OV e / N I3oG QI ,i M s a � 1 a / i o b c' w r / A r � e Q¢ o V, tJ' : a � Oil C gal op > e r 1 r _ 10 1 , `J J _ f G"D -rz S _ 1 rh o i v 3 2 _ c d- n r O i 1 5 i i 1 o t r o If .. i 3 AD _x .y }Y ; u, c- v } s � r • ^ k IPa a 3 t x 1 0; m _ t u ✓ o . z -� o eL�/ z A 12 C G r WAY ._ N LC o ,9v� — — N rE- �/�� �� ra , a _,2G Mav�G-rD G LG L�isT'rnr 2 , _ 3 /NC/l 0 Al v_ .,