HomeMy WebLinkAbout0090 SMOKE VALLEY ROAD - Health 90 Smoke Valley
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No. J Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pplicatton for Mtsspogal 6pgtem Conelruction Permit
Application for a Permit to Construct( )Repair(k)Upgrade( )Abandon( ) O Complete System VIndividual Components
Location Address or Lot No. 4?0 $^a kr z ` A)_L£Y 1'j Owner's Name,Address and Tel.No.
A
M�f N/V/iVI— GvAssessor's Map/Parcel4 0Z3 G srto F ILF V .e,3 osr
Installer's Name,Address,and Tel.No. n r_a Designer's Name,Address and Tel.No.
5 6v-Y,4
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 gallons per day. Calculated daily flow gallons.
Plan Date 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) J7SOX k E e. /1 C- q fc-,T
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 is d by this Board of H th.
Signed Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. —0.3 Date Issued
No. ( V Z 3� y Fee J v�:.:/
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '✓
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
Rpphratton for Mtgogal *pMem Construction Permit
Application for a Permit to Construct( )Repair(k)Upgrade( )Abandon( ) El Complete System VIndividual Components
Location Address or Lot No. S m O k- V,4/ E FD Owner's Name,Address and Tel.No.
M 42411— /y/ I Al/l.lA/A Ai/4-1-/'9n1
Assessor's Map/ParcelQ 7 O 3 9,0 1N01-f'£ ,4 41_t V /0) 0 ST
Insta is N e,A dress,and Tel.No. Designer's Name,Address and Tel.No.
35_0 /01A- Si
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 gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title'
Size of Septic Tank Type of S.A.S.
Description of Soil
F
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 Certi`fi-.
cate of Compliance has been is ed by this Board of H94th.
Signed Date
Application Approved by Date
Application Disapproved for the following reasons a
Permit No. 'Z-37 Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS r
Certtftrate_of-Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( ) Repaired 'Upgraded ( )
Abandoned( )by
at �0�70�!t SAIL t $ has been constructed in accordance
with the provisionso Title 5 and the for Disposal System Construction Permit No. %l-" dated
Installer P9 > .(0,4yf O Designer
The issuance of this permit shalld.� not be construed as a guarantee that the sys,em will function as designe
Date ►P /?"i Inspector
` fl z��j-----------=---------------
No. Fee
r / �
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
'Wtopogal *pgtem Cow5trurtton Permit
Permission is hereby aanted to Construct( )Repair(V)Upgrade( )Abandon( )
System located at
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 thi e itol
Date: Approved by
V
LOCATION SEWAGE PERMIT NO.
VILLAGE
IINSTA LLER'S NAME i ADDRESS
al
Ho KLU i c:J%
e U I L 0 E R OR OWNER
McPhee Rs--soc-
ODATE PERMIT ISSUED l� _a _,33 .
DATE COMPLIANCE ISSUED
� »-
14 _ �
`�
V�
��° I
No..F3=��� _,ti Fss.`S�C�
. .............................
THE COMMONWEALTH OF MASSACHUSETTS
::.. 7BOARD %OF HEALTH b�
It-c. •aJ OF......�
App iration for Disposal Works Tnnstrnrtion ramit
Application is hereby made f a Permit to Construct � or Repair ( ) an Individual Sewage Disposal
•System a
Location-Address
- .11 -------------------------------------- >��...........�1 .a<.................._. �......�,�� . ------.........
W �1 �e.1-..................................... 0�-- Me hl� ddre;s fNrG .
a Installer '�
� Address Type of Building Size Lot_.9�- a.__�t.Y_J�_.0Sq. feet
.-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder �V&15
Other—a Type of Building g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures ....................................
�JVsWT------------------------------------
Design Flow....._.. ___ . .•---------............----
-- gallons per day. Total daily flow......._
W •- -ll� �3C�Y' er� �---P.......................
WSeptic Tank—Liquid capacity/........gallons Length................ Width....---......... Diameter-,--------------- Depth................
x Disposal Trench—No..................... Width......... Total Length................... Total leaching area....................sq. ft.
3 Seepage Pit No.......'�Z-..----;--. Di eter.--.....tV..... Depth below inlet..........c�_-_._ Total leaching area-._ .�sq. ft.
Z Other Distribution box (� Dosing ( )
'-' Percolation Test Results Performed by-----
--- f ....................... Date..... ��
-- ------------
Test Pit No. 1...............minutes per inch Depth of Test Pit...l���..... Depth to ground water.._-.._.__..._.--.
(z, Test Pit No. 2. ___ -minutes per inch Depth of Test Pit_? Pam--.". Depth to ground water-.>....
L� •
O Description of Soil-fv.-�.' � ........... � C.�_ ..� --- /.S--•-�----•--- � l�f ?..
rg�llj •
U -
W
UNature of Repairs or Alterations—Answer when applicable..................................................................................._.........--.
--------•---•-•----•-----------.•--...-•-------------------•---------•----------•--.------•--•--...--••-•------------------------•-•-------------•------...-------•-•-•---------------------------......
Agreement:
The undersigned agrees to install the aforedescri d Individual Sewage Disposal System in accordance with
the provisions•of iITLlE 5 of the State Sanitary Co e The dersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee i d by o of lth. l
ned --- ----•-------... - 1 ��v•1 s.--
Application APP -- ---- ----------•--•-----•--------------------- .------�----------- .•. . --? Y--�....
• ----•--•--.._.... Date
Application Disapprove the following reasons-----------------------------------------•---------------------•----------------•--------- ......................
.......................................................-----......------...-----•--------------••-------•--------...•••-•--•-•-•---•••-----•-••--•-••••------••-----•---•-------•-••----•----•.........
Date
PermitNo......................................................... Issued.......................................................
Date
h M
Na............. fff Fss............._.............
THE COMMONWEALTH OF MASSACHUSETTS
--� BOARD OF HEALTH
J
Applutt#inn for 0 spnstt1 Marks Tons#rurtiun IhIrmit
Application is hereby made f a Permit to Construct J�I .or Repair ( ) an Individual Sewage Disposal
System.—a"
Y � vitc� -- - .1 ....
Location-
.....{X .IL .. l!!.[llll. ddress... .............r t
JWW a1�P !'�. .5(. .....C�o..-.:Tx=_........ C,�]LG.. `F. �?.�S/���. y.:�ddr' % l .r.� ....
,.� .. --
Installer Address q
Type of Building Size Lot..99,e.3..2 0Sq. feet
Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder VotS
N Other—,Type T e of Building .... No. of persons............................ Showers — Cafeteria
a YP g ........ P ( ) ( )
a' Other tures ............................
d .... v�i+�f..........
Design Flow..._. . ... .....1l�gallons per er day. Total daily flow........
W 4F---.. ---•-------•--•--------...gallons. ,
AG Septic Tank Liquid capacity/....___.gallonc, Length................ Width................ Diameter................ Depth................
. Disposal Trench—NS...:................. Width 1,........ Total Length.............j....rTotal leaching area....................sq. ft.
Seepage Pit No..................... Di eter....... .... Depth below inlet............... Total leaching area... f . sq. ft.
Z Other Distribution box ( n Dosing
`4 Percolation Test Resin Performed by.: ... ...........•--•...................... .:...__.... Date--
afr-...
Test Pit No. I.�..�minutes per inch Depth of Test Pit...lr� ..... Depth to ground water.._..............e�
fs, Test Pit No. 2.........:------minutes per inch Depth of Test Pit..... .......... Depth to ground water...'.../.. ..
0 Descri tion of Soil.. .. . ..- ?!4!�f `{��,fo(C f.. �.�."/� ... Jdr l .........
s .P-•--.----.... .!. oT ....... '..........................................:
w ------------------------------------------------------------------------------------- ------............... .....----------.-.----.-..-------..-......................
-
V Nature of Repairs or Alterations—Answer;when applicable...............................................................................................
... ..--•-• .... ............................................................•--••---•--•--•--•--••------........................------------•-------------------.................--•---
Agreement:
The undersigned agrees to install the aforedescri d Individual Sewage Disposal System in accordance with
the-provisions of TITLE 5 of the State Sanitary Coe The tgUersigned further agrees not to place the system in
operation until a.Certificate of Compliance b d by hf, o o It
ApplicationApproved BY.A. .......................I.........................-• -•-_..... ..._.......---•----• ............
Date
Application-Disapproved for the following reasons:.........................•-..............................-----.........--•-...................--••-•--•..._....
. .............,. ........... ......_............................•... ..............................._... ......................... .Date
�..•..........
PermitNo.................................... .:.:::.._._...... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.................................. ..............................................
Trr ifirate of fan p ittnrr
T O-CERTIFY That the In ' i ual e e Di A System constructed ( ) or Repaired
1� y ( )
by-... ... s Her ..
at..................................................... ....• .
has been installed in accordance with the provisions of TI IJP V ie State Sanitary aS" s@i-i the
application for Disposal Works Construction.Permit No......................................... dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR AS A GUARANTEE THAT THE
SYSTEM WIL F TION SATISFACTORY.
F17
Inspector..:
DATE.....I ....T..Q ......................:........................ .... ... ......_... .......:............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH ,-
....... ................................OF..................................................................................... s
No.........:................. FEE........................
aispn � rkn Tons
#r n lernti#
Permissio reb ted.......: :............. . :.....,... ...------•----..--... ........
...
Y
to Cons or Rt' a ( �' i .Se gDfs '`. / tem
at No................. ..��..n .. ......... .... . -•••••--•.........._.....•-----._..................
- ............... .--------- --....--- --..... ......--r-----�- ----street:-------...
as shown on the application for Disposal Works Construction Permit .................. Dated..........................................
•.-•--•-•---- Board of Health
DATE... ..................:.
FORM 1255 A. M. SULKIN, INC., BOStON �`"'
20 FT MIN.
TOP OF FOUND,
EL
r ,
10 FT MIN.
d --CLEAN SAND
�J CONCRETE 4 SCH. 40 PVC
t COVERS
PITCH
PfPE- MIN. CONCRETE
1/8 PER FT. COVER
f 2 LAYER OF
k CAST IRON 12�k MAX. _ �
a kk t 1/$��- 1126' WASHED
PIPE - MIN. PITCH i J
.. y , .,.. 1/4 PER FT ! STONE
y 4 FLOW LINE
{ r3•,4 y ',, f, 10
L `
-
y _ MIN. r
EL,-_
EL.. =
DI ST EL. ,
LOCATION MAP J w BOX a a >
jf 3/4k'- 1 1/2uj
t WASHED STONE v �
t 6G
GAL PRECAST LEACHING- EL -'
'ov
—__ `
BASIN OR EQUIV.
N
r SEPT I C
x
TANK ! --------
r ,
{ EE k
GROUND WATER TABLE EL. =
PROFILE OF
SEWAGE DISPOSAL SYSTEM -Y
f t NOT TO SCALE
r l DESIGN CALCULATIONS
< ' SOIL TEST
f DUMBER OF BEDROOMS . _ . . . . . . . . . . . . . _ _ _ r S
GARBAGE V�DISPOSAL 'UNIT,. DATN'WITNESSED SOIL TESTT _EST _
f TOTAL ESTIMATED FLOWry , ', ERC ?{.AT1E7; AT - ' .... ,
GAL /BR./DAY x F� BR. ) r C N R � MIN,/INCH
r t
10
REQUIRED SEPTIC TANK CAPACITY.. "--,--- GAL OBSERVATION HOLE I OBSERVATION HOLE 2
ACTUAL SIZE OF SEPTIC TANK .-,----GAL. , . . L E-VAi ION ELEVATION
>'
LEACHING AREA REQUIREMENTS
!
SIDEWALL AREA GAL./S.F.
.>
BOTTOM AREA _ GAL IS F,
+:EACHING CAPACITY ( BOTTOM + SIDEWALL} GAL. t
:, 1•" d
1--
j
` f ! >V RESERVELEACHING CAPACITY .... _,... GAL.
LEAC iT M -
t ;
v
NOTES
I- ALL WORKMANSHIP AND MATERIALS SHALL CONFORM
TO D E 0 E TITLE 5 AND THE TOWN OF
RULES AND REGULATIONS FOR SUBSURFACE DISPOSAL
OF . SANITARY SEWAGE
2,COMPLIANCE WITH ZONING REGULATIONS SHALL BE
'. DETERMINED BY BUILDING INSPECTOR OR BUILDING BUILDING SETBACK REGULATIONS PER BUILDING
COMMISSIONER INSPECTOR OR BUILDING COMMISSIONER
�. MIN. FRONT SETBACK
'3.EXISTING AND FINAL GRADES SHALL REMAIN ;ESSENTIALLY -
THE SAME MIN REAR SETBACK
MIN. SIDE SETBACK
` APPROVED : BOARD OF HEALTH
DATE AGENT
�-
APPLICANT '
t v
rY
LEGEND
y SCALE DR syt DATE
i EXISTING SPOT ELEVATIONS OOxO
Joe NO APPD, BY REV.
x EXISTING CONTOUR - - - - -
�- FINAL ' SPOT ELEVATIONS 00.0
FINAL CONTOUR ----Loo R J 0 HEARN INC. DRAWING
~ SITE PLAN SOIL TEST LOCATION (�}
_-, ' REG. LAND 5t/RVEYORS- REIN. SAMlT,4R/AN•S NO,
1348 ROUTE 134 - R 0 BDX 1263
SCALE __ �- _._ EAST DEI'VNIS , MASS. OF . _..