HomeMy WebLinkAbout0059 TREELINE DRIVE - Health CD LtD-- i Qr7- 0057 - M L tS
r -
0
No.. .F-.. t I V4 ®9 r005 Fizz.... 1�:.4��........
THE,COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
A <T 2.'.3 ...................OF.......`. c. .................................. P774
_4
Appliration for 11ispn.ial Works Tomitrurtion ramit
Application is heree�by nadde fqj a Permit to Cor/�s/truct l�or Repair ( ) an Individual Sewage Disposal
Sys+ at: C,OTui! /"//I 1/I��//S
......................., . .......�..---••-•-••••-••--�............. 4 .. -- ----------- l.. .1......_------
..
Loca' n.- res or Lot
x2 ..wner _�.. .------------------------- ?
O :. v __. :t4:�I: l�' C3.st�
Address
W
Installer Address
Type of Building Size Lot_._.._ .............Sq. feet
Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' Other fixtures ...................................
W Design Flow.................. -�..................gallons per person per ..
day. Total_gaily flow------- _.'I •-•.._._....._._..gallons.
WSeptic Tank—Liquid capacityk? gallons Lengthf:� h.. Width::1-�..tP Diameter---------------- Depth.'--_V1..
x Disposal Trench—No. .................... Width..l.....�.._..._.. Total Length.......... Total leaching area....................sq. ft. I
2-Seepage Pit No.__....j............ Diameter.._�.Q._ 1...__ Depth below inlet...CaLO.''-.... Total leaching area..71�_j. v'
Z Other Distribution box ( A-� Dosi,, tan )
~' Percolation Test Results Performed by._. 1.Ca l 4L►. �.... Date. -----------
Test
W _}` }
,.l Pit No. 1......��. ......minutes per inch Depth of Test Pit--- .._. Depth to ground watered
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
- -----------------------------------•.-------r•----•-•- ---•-- -------------------.----- -•••--•---------g----�----1---.---
0 Description of Soil...... ------tA� fum. �
x
U -•-••--•.....•----•••--•--••-•••.............••-•--.....------•---•-----------•••---•------•-•----•-•-•-•---•--•--• --------••-------••---------•---•••••-•-------------•--•-------------•-•------•--•--
W
----•-----------------------------------------------------r•--•-•--•---•-•----•-•------•••••-••-••---•••--•-••-•-------------------•--------•-----•-----•-•-------------•--•-•-----......-•--•-•..--••--
U Nature of Repairs or Alterations—Answer when applicable................................................................................................
------------r---..................................................................................................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of iITU,, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue by the boar of health.
Signed•... .......... ---•-•6 a g�
Application Approved
By.......... .........
...... Date
Application Disapproved for the following reasons:................................................................................................................
--•...........................•-•-•----...... -•---------•....•..-------•----------•------•--•-----•---..._...---...------------------------------------------------. --•-------------------•--•--•-----
C� �+ Date
mitNo.......�1..� ...................... Issued_.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
7-4 I
__T�_I.-J.....`. t r .�. M
Apfiration for Disposal luork,5 Tomitrnrtion Prrutit
Application is hereby made for a Permit to Construct (4-1"or Repair ( ) an Individual Sewage Disposal
System at:
......................... ............................ ................. -M1 ,
Locati n-,Mdresq or Lot
. :..-•- ................. ��: lr<: 7_ : �a� � k4 Flo. 4 z�`f t
.
W Owner Address
Installer 1 Address
U Type of Building Size Lot....... feet
1-1 Dwellings `.'No. of Bedrooms............... .._..........•..._..._...._Expansion Attic ( ) Garbage Grinder ( )
a Other—T e of Building a YP g -•-------------•---••------- No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures •--•-•......•-••-•......•--•--•_._ ..- -•-••--••....--•••-......•--------•----------
W Design Flow.................................., .gallons per person per day. Total_gaily flow.._...._....._... . ..........._...._gallons.
`a f f
WSeptic Tank—Liquid'capacityj.��.''� .gallons Length!U`'"... Widths`�..._.. Diameter................ Depth:�_.`.7��_..
x Disposal Trench—No..................... Width..I.....F_.......... Total Length.........'........... Total leaching area....................sq. ft.
2- Seepage Pit No...... ............. Diameter...RQ_-0..... Depth below inlet..z'�,_i�'I...... Total leaching area..--!
z Other Distribution box ( 4--) Dosi tank( ) !
Percolation Test Results Performed by.�_ _d' ...k ! f- k :. 4?!- ! J u e E #
r Cti 1�. -1.•--�''� Date••-•---- -•-•-.....
Test Pit No. L__..�_n.....minutes per inch Depth of Test Pit---!.-'"-�-___4?... Depth to ground j t °
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit-----_.............. Depth to ground water............_...........
W .................................s_..__... s........-_..............._........r^7_......"•-....._..
�-�- •--•----•- 1
D Description of Soil......0.4.... 4T. (a �s ! `�- ......
� ••--••••••--•••--...••--.......••••..............................•-•••---•-••--•-•••-•--•--.....-••-._..._....--•-•-••-----••-•-•-•-•-•-----•---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'ITL1� 5 of the State Sanitary Code—The undersigned further a es not to place the system in
operation until a Certificate of Compliance has been issued by the board of�.......
al .
Signed ••----..... y/sf ... �.
^� Date
Application Approved BY-b - J� '`"."" j .��
-------
.........................................
Application Disapproved for the following reasons:-------•--..•--•..............•-•-•••---••••••-•-•-----••-•••-----•-••-••-••----•--•......--•-----•••-•--••-••••-
................................. .....•-•------•--.•-----•••••-•••---•--•--•-----•-•-•--•---•...--•--••--•-•----•----•---•--•••...••--•••-•-•-••-•••-----••-••••••-------•-•-----•----------------
Date
Permit No./_.._-_......��
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
(9rdifirtt#r of T antplianrr
THI J1 �RTI'% T t the Individual Sewage Disposal System construgted ( ) or Repaired
.. ( )
by...... j ....... ----------- •'�`
n� ( ,� Instal r
at ----------------T-------------------------- s.. -L l--- ------ --•----------•-----------------------------------------------------------------------
has been installed in accordance with the provisions of-TIT-T 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit -__ ,_(R__:111.................. dated_..._.__-_.-.-._-_.----__-_---__-------___-----.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE.--
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............................a�a..` I 1 ......................... Inspector....---• ? •---•---- --••-•••--•...•---------••-------•-•-•---
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
,ale A+ `-A L,.�.
...................OF.........................._. .
Di T al nrkii Tnni#rnr�ilan rrnti#
PerUpia5ion is hereby grante ••- --.--•---•......*'......--•-•-•-••--------------------------•----------------•---•---••------•-•........--••---•-•--.
to Constru t,(a.-or Sewage Disposal System
atNo................................................................i 1�'°...:. ..{ `
Street`--
as shown on the application for Disposal Works Construction Pere-r#1p�'�............... Dated..........................................
---Board-----H---------------•-•----•--------•---•----•--•---•--
oard of ealth
DATE................................................................................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
APPLICATION FOR PER(:OLATION TEST AND OBSERVATION rn's
le
B 4!
UA
1�ILLAG !: ` r-
i3 �4
APPLICANT d � /. j'1'.� (Theo Constuction C.o. Inc. ) [�EE
• —� (Non-refundable)
ADDRESS ; 34 Great Pond Drive, S. =Qut1TBL PIIONB NO. 778-2700
,..�� (ARO. ng. Inc.. )
ENC3LNEBR . /�/ TBLBPIIONB NO. 540-0354 ' ?
DATE SCJIEDULED
(Applicant's Signature)
............. ...........................................
.......
...........................................................................................
ASSESSUEZ"9 MAP 6 LOT NO:
SOIL LOO ,
SUB-DIVISION NAME 41 `�'�""�err/eS PATH Vl � �� l��il'16iB 11:18 A.M.
EXPANSION AREA:,YES X NO Bob Raymond, ARC) Eng. Inc ENGINEER-
"TOWN.WATER x _ PRIVATE WELL Edward Barry -HOARD OF HEALTH
Then .nnstriirtjon Co: Inc_ EXCAVAJOR
SK13TQJIt.,(Street name, etc., dlrnenslons of lot,.exact locatky of tfstar�.�
locate wetlands In proximity to test holes) 3 L: .
• NOTBS:-42'' ----TREELWE9WE___ R.
3 N 6S 29'07 E C24
15 158.29
`z r-
I I� m
6 I5
N CDLOT 13 N CD
N .
N W . p
o 44382. t S,F. -
• O cn F► cn
W W
' 2 min/inch' N 61'29'07'E
ULATION RATE.-:; _ i 4 176.91
BOLE NU r ELEVATION. TEST MULE NO: ELEVATION:
1
3 i 3
4 4
5 5 — --
•� 7 -
E3 �� 8
9 �''^ 9 -
11. 11
12 SAND 12
13 13 i
14 14 i
15
• 15 '
16 16 .
ABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD _ LEACIIING PITS X
LEACIIINO TRENCIIES��
ITABLE FOR SUB-SURFACE S WAGE. REASONS:
E14GINE12RING PLANS BUST SNOW. NUHHER. ASSIGNED ON PERC TEST APPLICATION
INAL: COl,j 1:t 'EU ZN TJIIE'I'Y BY P. E. ANU RETURNED TO BOARD OF IIEALTII
= �•
RETAINED BY APPLICANT
TOWN OF BARNSTABLE 640- I��
o
LOCATION / /0`'� 1`!/?� ��'1u-Pi SEWAGE
VILLAGE,A�6 ®wS I ASSESSOR'S MA & LOTj
INSTALLER'S NAME & PHONE NO.S eV® T40 8�� �7
SEPTIC TANK CAPACITY ®�
LEACHING FACILITYAtype) ! (size)
NO. OF BEDROOMS / PRIVATE WELL O PUBLIC WATER
BUILDER OR OWNER eo
DATE PERMIT ISSUED: /
h/
DATE COMPLIANCE ISSUED: 1 .1
qj
VARIANCE GRANTED: Yes No `�
4�,
RK
dW.
qV
7
W. NN171TVIV, � 11 1 1!7,�, � *ftv**�
Rt r
r
Ora
t Ntra y
WHIM 10011
N
1"P; OWN! 1 11,11,711 7
lion
�4-M
!KS0;Sk Z
vf,PRA-4,
5"k
ZT-4, ow-`A�
'7'4 1411
y�,',M7 V�4
P -low PT
'77 1, _77 A- _J
7,
Rt
41 Zt7
7W�
W VA P on- -jT
zi
_gpu q.
too
WK Py vr� ..
q,
'10 u
V,
�:o
0,
4?
T! 77Z�,7
Apr
40,
At- at-EVATTOW5 M
�NAQ!Tarf 0, XT
A 1 7 G"m
-b� �T
A , "A
4�
TV
N
0
'A 4
Uhh k0l,,L"
A- wy N 4�01W WWI,
44,M
pp nn > A,, -
T
Nov.1
0102 LOAN
ALL--.-171"PES IT-Or.-AND N H 7
J,Y4
E,,$TB7EP1 qHM
Too �xxjfy, lott.v.ot- X� nj7y �
4'(
_4
N�, lit"
W,
P-0- "AN Z,
4 .6L D Pt9JjTf "o
-MEDIUM 4�, 1
<
-1 1 1. . i J., 0
�9-
4
N�
V
4
#HEN
I"
WAYS. 4 '.
n Tr
GS
z- o 0 o 'a 0 0i C,
-T,
T
a
0,c�o ax--4 C) 0 0, C� 0 KIAUVE AILL� Pj StA TAR-1., V 1AL PEN'
J W. f NV�RT E L VA T 0 N H� LEACHJ
WAVE 0 C 5 0. i
4, bf�TANIC AINlY 434C,
J -11
k�f' 4t
To A zoo'TA
F�,EEF_. SAN
TYPICAL DISTRIBUTION BOX.:, f d WO CAJ
N G,: -tRC�CATIION
r-, Tf,
WEL
4 C&
-017
BIT yX
7' TT,) "Or 0 1 NU ES: PIE
ivo , ,, 1 1 � � ,Say '10,
TOWN OF BARNSTA
T
J
*07Z 1STR16UT10N-9,)X,ANb 1500 8LE.
(E
'NOT I-r1l ED W H EN T��
L-EACH0467 131
_T 00, E'QQ�_
-D SEPTIC TANK,BY
�r NOVAT�R�--E_N�bUNTE�ED GAL REIN�ORCE
A(C
M� ' PRECAS
tCAL 1500 -L.. SEP1 107ANK TYPtCAL
Q!, MAIM TYP GA 'uti
7 u!"11 S, g1TPeRYV1SP"V0TF_0 ALt -sys'TtAK-1�c"WIP, tEr4l"!,-, �
zu
-:4
AA2r 11) z1*0 1
Aw All
STIAV14 TV PSTALt- R' E, T rfTL
AN lit; GATH1 AND,��
OF J HE;
T -ED THROUGHOUT WIT
wqre-, 1ANKS, REINFORC
RULES'"161 I _ x .
1'ek �Mwky t,Ppi-Y
Pa -,)F- ,E'ALTH ELFCTRIC WELDED WIPE Vk)I TH 71/�7'
130T-
4*14i EERING INC. IN TOR-a
T `�10174 Y Emai
064-t -V
01 , : �, - n " .
ARNSTA Z -BOA 24
r
vivo
ON 40F
EI`4GIN
EbABEINXID STF-EL PODS
t4i APO
Iffi: N r 1 k E
�' - - A
in" �v TOYM CON RE TE If 4XXYD PS E TEST -4ct S,�eEl ARM
't F_
PU,
"T
-A
VW"Ift 'rO 6 T rG
1,;�q
X
cc M-
50' JOW Alf-A
T",Ar,
x
,wtt,�,U'P ta
g
"N �:"w Z�V,I taw
A ",Mwx�
A� 4Q t�
oil
v
"W" f0:1
no All 401� "FREETINE"DRIVE 10.� An�o W
WAR
POF
-000-4 tin 14 07."1
1-o6�
-wft
TOA
P71
is ON zoo
�A
shoo PQ M
ELEV� 661+00
NEP REA
P
11�4
'IGRADE� ; �. , - - ��" -
fINISH' PAtr_-
FINISH,
'PADE T01k
'07
FINISP G A
ELEV 49+00 V
E.LEV.ed+oo_ , ELE 58+50 U,
L EA CHIPYG
EXiST GRUJINH) 'v
4A
SWR�^ rAVK g,
LEI
J
IV _j
54+90, mr�,-54?73 %v
INW!55,+85
L
"r ;7t
'01
�5+10
10 -
NV=55+3 __j (50( EART Box
-'ROPOSED
it
iN
01001001 w W
DWETWNG
F MONO
J
`4
nv
INAK 54450
0j.-
j
v�
.7,
r%
'E' TEM PROM IT
_W�7 " i I ; ,L�' 14�,5
-V GAL TEMAG
"I"A sly x"PW y P
z
j
0,
'�010.0010- 1 AV ."n TV ""S
46,
qf
j.V "7
9OWL77
LOT� 13
%7 t,
1'9,
7
Ar�
7
7
AP ,r
12114 - r �40
WQ " !"r�,: 11 .10 ;4� >� 1 v) � A
_92�Sf
�!:j �'p
T
0I
Ain X,
7
t* il,4�
1A
T
NAM
W
VA.".Q,:0,10
Myl
-AK
77
%
X
PST
1 hT lips
vo
WO 2 1 yt it!;;pp
'IN
x
too , 7. i,!�
Idly I an M
>A% 404 at W,A J,.
'7�
A, QW1,
7 7
it
Its A.- 1.01
0 j- Q.
WWI,
VA!
A
i1w
-A
7,
ZAN .'-'PC RM:ft
Its 70
K",
A
lit
W- MV0
&
M
E
V
x
"AS 1K too
�V�T A�QW W401i
lit;;V0 n �44 0, R :OF
"':
4�
KA
G,
7P�
,0,t��
A7
I"
IMAM>
Q :11 N1 07
too E
Y�
Y
Q.L
J'N
iiEk
L
VA
1E ft 1P IM
,MUM
rV Rr
Mow gg a 1. QQ,_
F
111,P iE,,
IM4,1;"T V.,
10T I 6-Y k t'U
W 2
3 E 11)
Y you
<
Jll�
n.7 A whM
Py
k:7-,h
70 M" - u
..........
tc "fp
pig
'24 Gk.11;
�:4!2
-PQ
1 On-A 4 M *18TRUCT-ON t
qV"_j"rx , , - 6
K A
lit.
My WIN
V
'Al
0; r ' �i
701
IWO ji V py play `7
is 'Wr
'Alt
My 0, 0, -K
S E WE'R
QW1000"T"Qu-00 &W."Y A % 'OL
'y
$
f��.'FALi QIJTH
D-U T 1A A' 664 0'
Q
A,
WWI w;= f
y put
47
1z
To
*& A
PAY BY h ydc
0 EW �1.87:_ 314
PL
,7 A 4.^4 4_4xk-
"17
Mir
av
0.
tA
412 SAN AN"&T,
q1 0
MOYAN no z Ott j
JV
0,4 if&
AA
�JUNE 12'
i y
-.ecrf Oki
V1
518'
4
ILI,
7 gpd,x,2? �733.
Ay
K
KOO
j
`77
t Mot"
All