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HomeMy WebLinkAbout1811 SOUTH COUNTY ROAD - Health 1811 SOUTH COUNTY'Roa � MARSTONS MILLS _ A = 098 023 005 IAA Q kIV l f: - - TOWN OF BARNSTABLE C C,� LOCATION SEWAGE # VII.LAGE 1�J14 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITYj�dc> LEACHING FACILrI Y:.(type). 61 �.x (size) NO. OF BEDROOMS__ L� BUILDER OR OWNER p PERMITDATE:_ =�-�J- f� COMPLIANCE DATE: '7 —I q 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 within 300 feet of leaching facility) Feet Furnished by • N �_ #, Ilk Chi J r �' QLEK — 4 ��.T ��ASCN�E�T . PT � Plyv�l►. yq ,- 14 gxs co �w' Fbrn E v EvrA art 4 oj\ TOWN OF BARNSTABLE LOCATION 00,J sTV SEWAGE # —Z37 I'I VILLAGE mye o S M i-,L r ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ��1v LEACHING FACILITY: (type)AVY f'�/.•'� •��f size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: 171k Separation Distance Between the: t MaximumAdjusted Groundwater Table and Bottom of Leaching Facility 16 ff- 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) 13 2-e Feet Furnished by J>otc>,-� 1 43, 3d i I i TOWN OF BARNSTABLE C-:, ` G LOCATION SEWAGE # r a- J VILLAGE h4 < th 1.114 ASSESSOR'S MAP & LOT 1 a' 1, INSTALLER'S NAME&PHONE NO. R 90 (O! SEPTIC TANK CAPACITY cc,,;, LEACHING FACILITY: (type) n'Luv (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: mom= —COMPLIANCE DATE: "7 �► 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 within 300 feet of leaching facility) Feet urnished b F y f; j s r c r wu . No. a��17 i l � �ZJ �CJ � Fee THE COMMONWEALTH OF'MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppYication for MsSpogal *pOtem (Construction permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) AComplete System O Individual Components Location Address or Lot No. 1F/I Saul» (Uri Owner's Name,Address and Tel.No. 7z0 Assessor's Map/Parcel !f Q C /y01�t 16 hl1L `a Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 3�� jz,��_M` mocttEa ggg—� L,>-) COPCF /t &A.) Cr yitkA%W� Type of Building: Dwelling No.of Bedrooms Lot Size+02�1�4 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow AO gallons per day. Calculated daily flow gallons. Plan Date `�a&Aq`? Number of sheets , Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 19S �G9 c 3Se 061 S/72F IL !�,:EIJ464E ?Zdi 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 issuo by this Board of Health. Signed Date S Z 5)J.? Application Approved by Date Application Disapproved for the following reasons a Permit No. 9 r6 - -2,zT7Date Issued fir} P v_^... ,.c:..s..:., -..w.R ? r ** yi ",.4 .j•..�' ...i '- wn :ti. zgg.-d1:3 4" No. Fee ' :. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF YARNSTABLE, MASSACHUSETTS 01pphcatton for Migo al *p tem Con.5tructton Vermtt Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) [Complete System ❑,hidrvt al Components Location Address or Lot No. - U Owner's Name,Address and Tel.No. _ Map/Parcel / ,f r/�c-e- P4��� Assessor's x /� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 3 9-,,.FfPlf� M`m,C ue 0 ggg-��I iol �J>U,>a C11pe-Z�7�0t1_�e* 47 Type of Building: / Dwelling No.of Bedrooms 6 ` Lot Size':`o�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 rlo Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil `f7C—S�"72/3c'� p/4f $/ 7Z= 4- 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 E, 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 issue_q by this Board of Health. / \ Signed Date /Z 5 �/ ti. Application Approved by Date /5 t Application Disapproved for the following reasons Permit No. I Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS /. y Certtftcate of Compliance THIS IS TO CE IFY, that t e On-site Sewage Disposal System Constructed( ) Repaired( )Upgraded( ) Abandoned( )by C.b l,_>" f 11 r ' at n t has been constructed in accordance with the provisions of Title 5 and the for isposal System Construction Permit No. dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date :7 ` q Inspector No. - 2J — -------- -----------Fee x,,r , THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migozal *,Pmem Con5tructton Vermtt ` Permission is hereby granted to Construct( ")Repair(7 ) pgrade( )Abandon( ) System located att)i. '+ r 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: Approved by Town of Barnstable P# Department of Health,Safety,and Environmental Services V Public Health Division Date_ t— 7 cl, 367 Main Street,Hyannis MA 02601 II BARNIMAerK D rasa jft6 A Date Scheduled 1Jy7 Time lo?"1040 Fee Pd. ��yp Soil Suitability Assessment for Sewage Disposal Performed By: �%ET.l�.✓ R, /��LL /4.S'. Witnessed By: .FXg/ /�[//✓i✓//1/�S��A�(/V(L���'S� o'r- 1V1kq4rq LOCATION &`GENERAL'INFORMATION Location Address bV7y'(4 Mc Sr e�OJTfI i Owner'sName,.TOEL D gVl r Co uVV UUvey Ro'g Z) t Address Assessor's Map/Parcel: Engineer's Name S j�T�(p n/I�, SAP 9Y �4aeq zX-s' NEW CONSTRU&ION REPAIR Telephone# (S o8) -(n3to 7 Land Use Rai oE../TgG Slopes(%) 2 Surface Stones /✓G�✓E F'u�t.C.� rrs�%���s'✓P�� Distances from: Open Water Body /GD t ft Possible Wet Area 1,e4o ft Drinking Water Well ft Drainage Way /✓oif4 ft Property Line 30 ft Other - ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) " �. C. �'.h�✓ Zo o 7o a e610T 1 6 , J ti 772.9S, ' J Parent material(geologic) Der 1 ;>:h.CAi.✓ 04P, Depth to Bedrock Depth to Groundwater: Standing Water in Hole:` i✓O Weeping from Pit Face !✓O/1�� Estimated Seasonal High Groundwater , t `DETERMINATION TiOR.SEASONAL HIGH WATER TABLE * Method Used: t/.S6rS — rr-�/,774i��Q Depth Observed standing in obs.hole --/✓bey✓_ in. Depth to soil mottles: /✓owE in. Depth to weeping from side of obs.hole: P✓oNf.. in. Groundwater Adjustment ft. Index Well#.4,p W Reading Date:_ Index Well level, Adj.factor Adj.Groundwater Level_ 2S3 Za.+rE.� :'PERCOLATION TEST vate ,/t&7 Time 100 F j'R�sa.9.�- z9�.9L �.✓ Observation �/YJi�✓d ',1; Hole# 2 Time at 9' >' Depth of Perc .cS Time at-V Start Pre-soak Time @ /2'/G7 Time(9"-6") End Pre-soak '/ Rate Min./Inch _ M n/ e Site Suitability Assessment: Site Passed V' :' Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back—� Copy: Applicant DEEP OBSERVATION MLE LOG....... Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° o - y p ORGA.vi L 7 s R 4513 1*W 7sy��'3 /3" T--,4,-60 /eO'' DEEP OBSERVATION'HOLE LOG `Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ConsistencX.° 0 -4 Sa g�� �s✓oy�9^?�o yfz 9/3 DEEP OBSERVATION HOLE LOG . Hole# Depth from Soil Ilorizon Soil'l'cxture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ° Gravel) DEEP OBSERVATION HOLE LOG ' . ..Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % Y Flood Insurance Rate Map: 2.Spgo/ 00/8D Above 500 year flood boundary No_ Yes k�-' 4601,4 A/IN/(r 4;�F/9 7' �L����j�iEi►-) Within 500 year boundary No_ Yes Within 100 year flood boundary No— Yes Deptli;of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the areaproposed for the soil absorption system? X/C If not,what is the depth of naturally occurring pervious material? Certification I certify that on // ��%y (date)I•have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature -�� S3Y� Date .�/s , . SEPTIC 'PROFILE E 7 T.O.F. AT EL X o ( TO sc / •, ACCESS COVER TO WITHIN � MIN.OF , GRATE ,. f ACCESS COVER (WAATF.R'1 GMT) TO FNGINEER: / y t:UNER OVER PRECAST 1 _�l4 v �� � of WITHt� � O� � GRADE zz �IEcwrRED Sri WITNESS: �. . � .�.s �.�., - GATE 7 Rune PIPE LEM! 2^ O( E�L� WASHED PEA STONE z s•o FIRST 2' A c ERC RATE d ,. JOB# 41 PROPOSED MAX. GALLON SE nc '' -r--r -+tom _ d fi� CLASS Sty LS P TANK (H GAS 0 0 o o 0 o i 1 o ;f SLOPE) d CRUSHED STONE OR MECHANICALd TAS o o � o . ,^o110 0 o i�� �o � �.k � ELEV. -ELEV. � -? COMP (15.221 [2D C d I � rN DEPTH Of FLOW _ `2- SLOPE t ( --1�& APE) (--,.t — _ d TEE sIz>ts: 4- _ � INLET' DEPTH P lA , ia __�___ _ '„ ( 1 0 T, —* 3/4" TO 1 /2" PaOtJHt_ AuA° is S•G ¢, 1 __" ' -- ot�T DEE*tr+ __ ...�.__..... � �� � � �.� LOCATION '� SCALE a J 37 c. . LEACH , \ �_ . .. ___ ___ ASSESSORS MAP �b PARCEL 2 ' OUNDATION--- Zo SEPTIC TANK D SOX a r` - �`ACILST` � _ � 11 A$ 2 ra h or P z�.?, ZONING ,DISTRICT: fZ � N �\ - YARD SETBACKS: FRONT - j� -- - SIDE = REAR �� ;'� ;� PI.At� REF. ELUOPr? ZONE: �,: '� 1 � � ,.,.,,� t 111 � _.,,��!° �� �,F'�"a:: W �-�' �r;.tea' � .L,i`P 's"1 c�%a t •p � : or u SEPTIC GES`GN: c.a�cF -lspo p is �-' 1 . DATUM ,S f Aim- � A•. U' r,�;`�-„" _._:.. ._._ { _,._..._..�—.t�.._'_..�..��. �, •;� . C. �al.� FLOW: �'9 �—„EO�°.��aa f�:� ! i 4� ���d _... �... 4.'-c-.�^,a�7✓ .t t��.�t�i�`..., R ., ,`!„. t_ w v 1 "1 1 8 ` F 11 fie.�7 w b.)•A.f rs.t, , , V+S , ,..,1,9 D} '"0" B {�, ^ -v`` '°•;'1 5..,1 r SEPTICr� F P SIC: _w ,#` C wri yam_ ,�"t10-t Mt ,x TANK: 1 _ y , P lhc� SE r� "TM'" GAh 1 G" S 'IC TANK r. ,�c r� �' t� s�^,A, � �v C: ±CTIGI CA ? v AC�J, wi t!(TP? r _.. C'� MASS. p r Pi � : (.N`�r`?F'C3N ,E N t�` `�O�' '!�'_c �y,�.4.�' 1 � � `! .�v ..._.. �- � !a 4 ,, .r1 "' ` �'`_�� . :_r �, 7. T�i S 4�"�,N $:S�r-�`'-`' �,��.r�p+C'aED �'C?RK ^tiI�Y AND �.'OT ?J BE US C R _1 f �,�F S7,AX1Nk G. '� v ', '° —= — '' — PI 'C O' SEP C � T :'+f TO . 40-4 I S.F. < � �t S�P� PVC. Srf GPD COMPONENT�d � � C') " F—r-' OP. (�(�N}('EFZ,`..ED TM1 1 HOV M TS T��? #M Sx�CKd ���_ w �..-..:...- I ,7t 5�„1�F t ?", t r t r r' — -.._• NSPEC-90N By � DAR[l) O HEALT r�,NG PF -dM�5.> � N C8TAINFO . 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