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HomeMy WebLinkAbout0008 RUSSELLS PATH - Health 40, T+ g RussellsjPat, �, ks � r ` k 1Vlars{ons Mills; A'✓y�020. �9�S���wE.'`X;yi !ap}4 q,� f+ t j �/ < J , s TOWN OF BARNSTABLE LOCATION kQT 70 tee,]5 ptqT H SEWAGE # 76 ' 61 VILLAGE M4vsi,4nj Miis ASSESSOR'S MAP & LOT ��P- j INSTALLER'S NAME & PHONE NO. Otte Coco Scgj\cc SEPTIC TANK CAPACITY- N.mcj ' LEACHING FACILITY:(type) �Cecas'T QouDa p-%�T (size) (,c)o (S(A\ I NO. OF BEDROOMS PRIVATE WELL R BUILDER OR OWNER �C evom e g DATE PERMIT ISSUED: 1Q - \®- "-ZG DATE . COMPLIANCE ISSUED: VARIANCE GRANTED: Yes Noz �I r /. J A� b�• �, �`" /, � � 16'� 6 �ti we11 No... .. .� j. . THE COMMONWEALTH OF MASSACHUSETTS BOARD H ......................OF.... '.. l....... .................................... Appliration for Disposal Works -nnstrnr#iun Frrmit Application is.hereby m ade a an Individual Sewage Disposal de for a Permit to Construct ( or Repair ( ) System a � AZ .... ..........- - ...... .... ...... .... -- ----.........-----........._1. . -... Location-Address or Lot No. ..... .. ...................................... ..... ... ......................- _ .. ..------ W ......Address I staller Address D UType of Building Size Lot.'��.s3V...................Sq. feet Dwelling—No. of Bedroomlaz .Expansion Attic Garbage Grinder W� Other—Type e of Buildin ..._.._.. No. of persons............................ Showers Cafeteria A4 yP g --- - P ( ) ( ) a' Other fixt d .................•-----------------------------•--------------------------------- ------- •--•-•-------------------------- W Design Flow------------- ______-•.-•---......----gallons per person. er ay. Total daily_..__�?30...._...............__.__._- Ions. W Septic Tank—Liquid'capacitY��...gallons Length_�!.Z.... WidtQ........ Diameter................ Depth._.__.__.. x Disposal Trench—No. .............. Width.................... Total Length........._.....__._ Total leaching area........ ........sq. ft. Seepage Pit No...Q� _--_.- ameter....��... Depth below inlet............._. Total leaching area. Z_ ....sq. ft. Z Other Distribution box ( G. 0... . '-' Percolation Test Results Perfor Date.. a Test Pit No. L.21.,.......minutes of Test Pit...J. .......... Depth to ground water....------_.__.......... Test Pit No. 2................minutes of Test Pit.................... Depth to ground water........................ P4 -------- ----------------------••------..............------------........---•--...............-•......................................................... 0 Description of Soil........................................................................................................................................................................ x V ................•...................................................•••••••--............•-------......._...........•-----•--•--........---•-•-----•••......•••-•.....---•.....-••••---•................. W ••---------------------•--------•----•-•---•--•-•----•-•-•----------•--•--••---•---•-------•-••------------•-•----------••----------.....--••-•---•---••-•-•--•-•-•...........0...._..._.........•---•- 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 TLITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the ste in operation until a Certificate of Compliance b ha eel 'ssued e board of health. / SignI r.7w .: ...----- --.................. �A••-�' . . ......_.... Dat Application Approved By.................... ...... --- -••• •-- ...... 6 -----Da e Application Disapproved for the following reason,: ........................................................................................... --------------------------------------------------------•------•--------------.............................-..............-................•........................................................... Date PermitNo...........................•.....................__.... Issued-.....................................................-- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD A H ApplirFation for Disposal Works Tonstrnrtinn rumit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: —� i Location-Address or Lot No. �... ... .....................fi ..........• -----------___----------___........ ............._..........................-_...-- ._ -,_ Address a �=�t _......s.5-E. '---•......................... ....•-••-•"---""-"---------•-•----......_.............:................_.._._..................... ✓✓ © 6� staller Address Type of Building Size Lot_!s.....................Sq. feet Dwelling—No. of Bedroom ........................................Expansion Attic 416) Garbage Grinder ((/a) Other—T e of Building +C No. of persons____________________________ Showers — Cafeteria dOther fixti�es ---"-----"----"-"-"•""""---"""--•""•-""""""--•-"--"--"""-""-"-""---"""---"---•"--•"-----""--"""...---•"-......"-"-"-""-._..__._...""--•••••......__.. W Design Flow.__...____._�?__5________________________gallons per person per day. Total daily�ow____-�D__...__...........___.___.___gallons. / t S c WSeptic Tank—Liquid capacity .....gallons Length. ______.____ Width.I._..._._... Diameter________________ Depth_ _____._.. x Disposal Trench—Now................. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._ ........ ameter...�rl'�_..... Depth bplow inlet...... Total leaching area.�� _.__.._.sq. ft. Z Other Distribution box (✓ Dosing ( ' / �// Percolation Test Results Performed _______________ Date____ aTest Pit No. I A�..-.........minutes r in epth of Test Pit...l�_____ Depth to ground water_._tq! (i Test Pit No. 2................minutes er Depth of Test Pit.................... Depth to ground water......................... --------------------------------..................-......................................................................................................... 0 Description of Soil....................................................................................................................................................................... V .-----------------------------------•------"----------------.--"....._..._..--•---•--•------••--------"-""------"------..._..----...-•--------•--....------------------••-••-•--•••---•••-•••"•-"•"••"""- 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 TITU 5 of the State Sanitary Code— The undersigned further agrees not to place the yste in operation until a Certificate of Compliance ha been issued/bthe board of health. Sig - l!✓�:✓:.......................•"..--...-•----"---------•-----------.. y .�:..._.... f at. Application A lication Approved B _--"••""---"-"----- ----- �1 _.f �[� "-- ... "PP PP Y - j ate"',Application Disapproved for the following reaso� Date PermitNo......................................................... Issued.....................................................- Date THE COMMONWEALTH OF MASSACHUSETTS BOAR HE L . ../` ..........................OF. .......gDOF a�. : ..... ....-....................-• rtifir tr of Tomplianrr TH S 0 RTI , That e Ind: e 'a_e Disposal System constructed ( or Repaired ( ) by 1� 1 .,_ •' _,.. —Installer at"""""" .... -' ' -:_�-fi�r:.:.:.. _.._�_ ?_1_.._ c:_.:-'- -------------------"-........_..---•--..............------"---"---- haF been inialled in accordance V th the provisions of TITL 5 of The State Sanitary Cod as de?cri?s in the application for Disposal Works Construction Permit No.____ ._ _ ___ _ dated__..___ -y_� I PP P �C .//. 'No--------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector............................................................ DESIGNING IRI-ff-US i•-SUPERVISE INSTALLATION AND CERTIFY IN WRITING -Z THE COMMONWEALTH OF MASSACHUSETTS'.0 bYzJEM WAS INSTALLED IN STRICT ACCORDANCE TO PLAN. BOARDOF HVT6 , G' `�........................OF._ � � ... -•----•------------•-----------....._...._............ No......................... FEE........................ 6 5_Fa -To trnrtinn rrmtt Permission is eby grante - ll o_ f ..............."""....... -"---•""""--- ..................................... to Construct r R, air ( an Indw,� ual stem __f,/f/1_[�� Street as shown on the application for Disposal Works Construction Permit N .___.__71........... Dated__________________________________________ Y ..................._..___._...___.._. r__ r------------------------------------------------------- { —^rO l 1 )Board of Health DATE. ( " - F0R�'_1 1P_7 5 A. M. SULKIN, INC., BOSTON �J �l n\ y artment of Environmental Management/Division of Wa esources `. WATER WELL COMPLETION REP WELLLL LOCATION Address /W / �/(� lx.�S�S1�e/lS City/Town � ^Qi" m/1 y J er�I G.S.Quadrangle Map Grid Location Owner r Address J0 hil cS WELL USE CONSOLIDATED WELL Domestic Lrl�'/ Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones Method Drilled 1) From To 2) From To Date Drilled 3) From Tc 4) From To CASING t� Depth to Bedrock Length Diameter tV Type P1&-S -i C, UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surfs a 7 Sand: fioe gl-m—edium arse❑ Date measured 11,2,q6 Gravel: fine❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL Slot# 11) length J/from—to— Yes ❑ No Split Screen (or 2nd screen) WATER QPLITY TESTS MADE Slog length from to Chemical '1—L/ Biological ❑ Depth To Bedrock PUMP TEST Drawdown _feet after pumping—days Al hours at GPM. How measure Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 m DRILLER m Firm / r A, r o Address ` City Registration No. �perator'�ignature I-1 ease panIfirm OUSTOMER COPY 25M-10-85-807101 T � • � FP � _ Dom' T ,Lod 7/ TIy 83 -16% 4R a 1 04 . ' k1 s aX sr SIR f 4I r � i /25.00 I p1r I Q I I i o I 49 LI) & o o � \31 ( '^ ( � o n N( . .. il•s sg "' ar DJ p V) �av�R�ys 4" SCA kip p a OHN z JACO®I UPPERCAPE ENGINEEkING No. 814 . Zti - I. P.O. BOX 616 Es'-SANDWICH, MA :025 7 EALl�\ 362-6281 - TOP OF FOUNDATION ' • CONCRETE COVER .,` CONCRETE COVERS •4"CAST IRON 12 MAX. u •.'�•mm7r • !OR.SCHEDULE 40 W MAX. • 'P.V,C. PIPE . s 4„SCHEDULE 40 P.V.C.(ONLY} .. ••� PITCH 1/4"PER.FT. PIPE- MIN.. ' LEACH PITCH 1/4"P.ER.FT. •e PIT. PRECAST �� •e INVERT �o, iY r: PET OR G EL..F/,•R', INVERT INVERT ? t SEPTIC TANK EL:. .,. . .. DIST. EL..9: . / >= . . O, y. o w < EQUIV. '�• EI.SQ,7,,,,; .:•/PUQ., GAL. INVERT INVERT w :�: 3/4"TOIV,, BOX • EL�f.9.: •• w •.! �' EL.VAQ •• U.cc) WASHED w STONE PROR LE OF R6UNY WATER TABLE v/•s SEWAGE DISPOSAL SYSTEM NO SCALE ITN Z: SOIL LOG WITNESSED BY: DATE e. ��.�e�!`��I�IME....,. , .,/��P M�,� L:J(l•. . . . . :BOARD OF HEALTH } TEST HOLE .I, TEST HOSE •2 ll04�l. ��a/pe. L=�IG On/�C�ENGINEER EL-E,V..S/,FCa... . . ELEV.. .... 77 Z' DESIGN DATA : NUMBER OF BEDROOMS. . ., . . . . . . . . . . . j TOTAL ESTIMATED FLOW , r3. ,Q , . . GALLONS/DAY �7&D 0AAN BOTTOM LEACHING AREA .113 . . . . S.Q.FT./PIT ' SAA/D SIDE LEACHING AREA . . .����. . . . . SQ.FT./PIT f i 1 GARBAGE DISPOSAL . . : '. ..(50% AREA INCREASE) TOTAL LEACHING AREA . aG . . . . . SQ.FT PERCOLATION RATE /Crss '. . . . 'MIN/INCH e%V 3�'g�' LEACHING AREA PER PERCO.tAT10N RATE .. SQ.FT. .4V.WATER . ENCOUNTERED NUMBER OF LEACHING 1` . ,OlfZ_ . i APPROVED . .. . . . . . . . . . 130ARD OF HEALTH Z'Q . . .��!Y //,3 . Q77,�dl, ;Z•7F�i`/ . .�-z�«<��:�SOS<`.C?s 37,E ,S,/!�Y� DATE. . . . . . . . . • .AGENT-.-'OR. INSPECTOR. ►ate �1d OF R4 •. oe O • o J. OB •. a ¢Y /.vga1 E.5• UPPERCAPE-ENGtNEERtN $ o yJ . � r. .74 , . A�44�.d. �`h -- G P.O. BOX 616 E. SANDWICH, MA 02537 4NATAR� PETITIONER' 362_6281 '°P► qz- oz" /CIAO 1-16rO C'7 1,1Z6W 7o Lod"ag. Z-Z�6- OAK. I- V5. f 10 12-,L Pw ewv--f-Tv 6-,_;a,97 7-5 rtz 6 A172C, 7 7-16A IYP 90A 16 S . C . 0000 ------- 701,19 '50 �� 5 7�- 1 Cn-A ss SOU ,