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HomeMy WebLinkAbout0082 WHEELER ROAD - Health 82 WHEELER RT --- A=103.107 A TOWN OF BARNSTABLE V LOCATION eS'� Lash ile C 013 SEWAGE # VILLAGE ASSESSOR'S MAP & LOT ID -IOC INSTALLER'S NAME&PHONE NO. /G �? J 8!JQ tC SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS _ BUILDER OR OWNER Cs PERMIT DATE: �y r�' COMPLIANCE DATE: 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 C. Rear 13 lt2 i e Q r i 4. d o ZV '7�& d TOWN OF BARNSTABLE LOCATION g/ ` P—lj SEWAGE # S VILLAGE e� f ��� ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �B07�rn SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �� '�"�� (size) ------------- NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: �-�J� COMPLIANCE DATE:_ 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) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by Feet No. �Fr Z v- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Apphratfon for Mizpoml *p!tem Construction Vertu Application for a Permit to Construct( )Repair( )Upgrade**-)Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.y W r'L v 1 97, Ik 04, Owner's Name,Address and Tel.No. Assessor's Map/Parcel 1 3 `O ? Gp ww�� Installer's Name,Adddrreess,and Tel.No. Designer's Name,Address and Tel.No. �d �5�2�-'�Yi1� \C.X� 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 14 qQ gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank , i S-% tOM AiOA Type of S.A.S. � Description of Soil 0 -e-12 4400 Nature of Repairs or Alterations(Answer when applicable) 4�3� 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 Environment a o and not to place the system in operation until a Certifi- cate of Compliance has beeB.L jaued by this G `�� Signed Date 07 Application Approved by e Date Application Disapproved for the following reasons Permit No. ® Date Issued No. � ry" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ),PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS � i Zipplication for Miopo!6a1 *pgtem Construction Permit, Application for a Permit to Construct( )Repair( )Upgrade'f_)Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./ a Cw eye. 1 r r ltil r( Owner's Name,Address and Tel.No. P.,F Assessor's Map/Parcel Installer's Name,Address,C _and Tel.No. Designer's Name,Address and Tel.No. 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 qn gallons per day. Calculated daily flow �"l gallons. Plan Date .'' Number of sheets Revision Date Title 17 7 r Size of Septic Tank 19: t sti lCJZrb Type of S.A.S. . 4L- N L Description of Soil �/4'-�—Q 1✓� ; �• d Nature of Repairs or Alterations(Answer when applicable) �(4--.51-4d G1 << <r ra 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 Environmenta o, and not to place the system in operation until a Certifi- cate of Compliance has bye" ' sued by this Signed `Date '�G 7 i Application Approved by Date „Application Disapproved for the following reasons � r Permit No. 9 , y0 3 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( ) Upgraded Abandoned( )by -,v—C,14 (f— at v r i QXA-0 . has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 0 3 dated . 7—/` 9 r Installer Designer The issuance of this ermit shall not be construed as a guarantee that the system `11 function as designed. Date Inspector . . " No. C yo-3 e_,--------------------------Fee Y-,�p..I_��____� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mitpogar *pgtem Con.5truction Permit Permission is hereby granted to Construct( )Re air )Upgrade(*PK)Abandon( ) System located at f00 Vh115 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 it. Date: 7 —1—9 r Approved by F� F 10/9/97 ` NOTICE: This Form Is To Be Used For the Repair Of Failed -' Septic Systems Only. T, CERTIFICATION OF SKETCH AND APPLICATION FOR A , M F ^i DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) rl s I hereby certify that the-application for disposal works construction permit signed by me dated 4-��o ` ` ,concerning the property located at a- w �e�'.i— meets all of the a Al following criteria: r There are no wetlands located within 100 feet of the proposed leaching facility { ry There are no private wells within 150 feet of the proposed septic system There is no increase in tlow and/or change in use proposed 4 There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted ' groundwater table elevation. _ Please complete the following: F, A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) c0t`i , r{ B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED:,. -. ' _.;. DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system:Also if the licensed Installer posesses a certified plot plan, this plan should be submitted]. s ' t q:health folder:sett i 6x 1 V III LOCATION$ SEWAGE PERMIT NO. VILLAGE Rt>TO tA U's INSTALLER'S NAME&rAjDDRESS to pc BUILD OR OWNE © DATE PERMIT ISSUED DATE COMPLIANCE ISSUE �20 �� f � •� �—� 99 s �o, OP a -' t �,� n � , �'o 0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........OF......................................................................................... Appliratiun for Dispaiial Works Ton,itr diun runtit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .O.E.7-...W1,EEIFL..# DQ..................................vlS ..... ,......................_.................. .................._......_......_... .. Location-Address r Lot No. Owner Address ©V' .......... .......: :... ! ,nJtclJ......................................................... 14 Installer Address Type of Building .� Size Lot..�Y.Y. ..........Sq. feet U Dwelling—No. of Bedrooms._...`.:1................ .....Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building No. of persons...b...................... Showers ( ) — Cafeteria ( ) dOther fi*tures ...........••••--••----•-------------------•----•----.......-•-•-----..................--••--........---..............................._•••••••-••-••• Design Flow...... _____________gallons per person per day. Total daily flow..........3al�........................gallons. WSeptic Tank—Li uid ca acityf Q® gallons Length............... Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area...................sq.ft. i 3 Seepage Pit No.................... Diameter...JA.......... Depth below inlet....�t_............ Total leaching area... .......sq. ft. Z Other Distribution box ( t/j Dosing tank ( ) 0 Percolation Test Results N Performed by......�y ......rv_i�oQ&.)............................... Date..... " '. ................... ,.a Test Pit No. 1 minutes per inch Depth of Test Pit...../:?n......... Depth to ground water....... :Q:......... f? Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ....---•-•-•-----------------------•----................................._..............................................-- .............. O Description of S oil....6- 1��f. 2.f Sv .SP!�................. eSl!LSD_..._&,Z L............................................................... ._. G. .. ....................•-•...••---._......----------•-........---...•-•--_......••----.................--•---------••-••...._..... 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue0y the board of health. c Signed... �J _...-•••...................................................... �_.......__......___-•---••- Application Approved By.. ................•--•-.......�J .. . ... _,...._..._.._ ............._.... l Date Application Disapproved for the following reasons:-•---••-•.................•----•-•-•-------•----.....---••----•--..........---•-----......................_-- 8.:�..���..�------------- _............._.....-•-•-----.......Issued............................................ nu--w------ - Permit No...... _ate • .. , � •`--•,r= _.,� q"r, __ „-•r.'v....-r •- .,ri.-: .r�-,..-..�,,.-.. 1 �i.. �'L.Y`'•i• .Y;.-�i�,..�'�s....-:yZ-^-.....-.,,,,'",S`. ... - No.ff THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. . _ . ........,...........OF......................................................................................... t Appliration for Biliposttl Vorks Cnonstrudion Permit Application is hereby made for a. Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 1A WECl le I�n s hl�t(, . ................... •Location•Address or Lot No. - ............. Owner j Address jE /VD ✓✓(c Installer Address Type of Building Size Lot..�y. $3...........Sq. feet V Dwelling—No. of Bedrooms......IX..................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type T e of Building ....... No. of ersons...b..................... Showers fs, YP g ------------------•-• P ( ) — Cafeteria ( ) 04 Other fixtures...:............................•-•-................ ... _ _.:. .. _ W Design Flow....... �..3'- .............gallons per person per day. Total daily flow..........��� : .._:..._...........gallons. WSeptic Tank—Liquid capacity.Mq� ?.gallons Length................ Width........:....... Diameter-........ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No..................... Diameter....R/......... Depth below inlet....(?............ Total leaching area..#!? ......sq. ft. Z• Other Distribution box ( v) Dosing tank ( ) ~" Percolation Test Results Performed by........................................................................... Date..... �f ':: t .--•--••••------.. '1 _ ..,.a Test Pit No. 11�._: ..minutes per inch Depth of Test Pit.....J:�......... Depth to ground water....... ......... fi Test Pit No. 2...............minutes per inch Depth of Test Pit.................... Depth to ground water................:....... 04 ............................................................................. . O Description of Soil....�°?.::3� Slait •-•...............•..................-•---......-•-...........•---••••----•...........-••••--••-•---------_... V ........ .....----•.........................e�-i. .....�5�...�.eo.........1_.6a,T 6N,o..�5c..:............................:...•..:-..---........................................ 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 TITLE 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....!-�!:l-&. -.............................................................. Application Approved B � ---•=- u .. Application Disapproved for the f ollouring reasons:...................... ---•..........................................•.----•-•---.....---.........-------__ ................................•--•--•--........----•---------•----•--.....•--•.....---.....---.......................................................-•••-••-•-•--•-•--.._....._......-••-•- --- Permit No.......8. ../. P _.:._.._..._ Issued--......................................._Dar_.._ aft THE COMMONWEALTH OF MASSACHUSETTS 7,�*%, /7" BOARD OF HEALTH l .................OF..... .. 5 ........................... la of irate of lZontphanrr �r THI S T CERTI Y, That t e Individual Se'Nvage Disposal System constructed ( ) or Repaired ( ) by........... ..ffJ. ..................---.----•-............ ......---..........---........---- .............................._ � Installer at....L'".d.!........�....•••..... .. - - .. /' �-f ,. ---••- .............................................. has been installed in accordance' with the provisions'of TITLE 5 of De State Sanitary Code ay descr' in the application for'Disposal Works Construction Permit No...{�'�"-�-� �._....... dated_......�j. �-. ...� • THE ISSUANCE, OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ""' �?�/ �X� Inspector........T.... DATE..... ......... -•.............•-•• ....................................------•--............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r...q?.N ......O F......../. .! -, - 5 i'... 42:!a%`''.`................. G 0 9 d.................. ar-�--- tE ............... Disposal ors Tonptru4ion rermit Permission is eby granted.......... .......d.... Y_s - ....!QA......................... ....................................... J�orto Construct ( or Repair n IndividI:rual Se, a Disposal tem /� ................... •... . ..................... Street as shown on the application for Disposal Works Construction Dated.......I/ ...2 ?/� ...... �,. . r Board of Health DATE................................... ... -•--..._...... FORM 1255 HOBBS iWARREN. INC.. PUBLISHERS - I � 1 FuCA < , /So. 9 / 95 T. f r O+ I �° , r { ire 2-07 Ab 07 ' Iona rjAt_• p f .:' L4rAGH ` �lfi r 1 Iva s n D L o_l' F� Z49N0 r�',Fr x sPr`T/3 �/4 �'6 S N =, 3 ti Y i ti -EE.DR'� u, NO 1` SE vry"r�FddCi!$1«Qy:�((�C�L�� !! �/ iT6 }'C+ T •i W i. I.N1fV t - �T1 6:f .LEG END r kWTINS: SPOT EL4VATLON 0,c0 CERTIFIED PLOT PLAN i d�rryy`+ A j ;pf1x1,9,TINQ_r"CONTOUR._—'. 0 —_— ; ' 1N1$HED 4gPOTtl,•ELEVATION. wT 7 Li%% 11101-SHED "CONTOUR 0 lq,4 IT S 7-o o/s_ lV/[ 1. #1 ;XOTfiY.Th location f any eacisting'�unde ound .sewer.age', IN wells`; or other tuttlit�es shown .on tri5 plan is` approx- . � Tel .. } mate only.;as determined from records and/or verbal. �ii�format' on: The confractor is x•esponsible for the verY'fcation q the existn;g locations in.,the field. SCALE, l��=SD r DATE ZONED? +4;OREDGE' ER/NG=.CQ /N�? fti ..._. CL'IENT ......._. I CERTIFY TN AT THE PROPOSED D 1 A V{ u 8.5 '13 v_ BUILDING SHOWN ON' THIS PLAN EDISTERE k v R 4I9TE 'ED a: JOB,NO.-�..----.- t r 6s CONFORMS TO THE ZONING LAWS; . CIVIL l:, ND r' , 1 �F.A to L6 DR.BY .. OF rzr✓ST. $ MAs N=STR`EET CN. EIY� '�' F U YAN N I S " SHEET.;�. OF D T E REG LAND SURVEYOR n a ; • 20 PT. MiN• E/TNER THE SEPT/C TANt�C OR /--=,A ///va P/T ARE 110RE THAIV /2"BE40PV /N JRA OEM f� 24�O/A M E TER COiyCR E T.E CO iiE'R SJIALL BE BROUGyT T0.4,TADE. ,XTRA CGNCRGTB �MlPVC P/ r/E.4vy CA ST /RON CO{/�R SN.RLL !3E USED 7 /N. PITCH EL. /G 2•0 COPIERS /'' �g"pEiQ FT /F/N OR/VEN/A y CO/VCRETE 2 M/N. _ E COVER CL EAN -SA/V O •A a % - •.. -'LAYER P Y.G P/FEE t /O D O o • o o AF /IB -'SIB �► M/N.P/rc/r GAL. o • • ► • , • • WA5HEO S701VE SEPTIC TANfC o/sT. o .. • • • . • . • • ,o d q"r'` BOX � • P c EFFECT/VE • o j a • • DEPTt1 • • 1 ; v o A1A5XED 570NE (. ° • • • / • • • •470 PRECA5T SAS94 73 GE I{ P/7 OR EQU/✓ l AlveA"'" Z,4 EYAT/oN S P!r cry c'�ca Tr a fT. D/AM.. ERT AT QU/LD/NG �np FT, Ii. !NL ET SEPT/C TANK- 9 7.� FT ✓� F7: O/A 1+�1. , C C IiVY sEE TABUl�1 TION, 1.-:.�, 1 QUTLET SEPT/.0 7ANK 97.6 FT. 1 97 g' FT. GROUND PVA7-,ER TABLE //V,(ET D/STR/BUj/ON BOX SECT/ON OF' ` 0U;rLE7-,,Dl 97.Z F7- /�LEr cEacN/wG o/T AFT. SELVAGE. OhSOOSA 1. SYS7r'EM TAQULATlDN , LEACH//VG p/T SCALE.. I4 ,,. DES/GN ;CRITERIA 10/At10nrs10N 8 FT NUMBER OF BEDROOMS 3 D/MENS/ON C. `� FT. /�17�✓i GAR6AGE DISPOSAL UNIT' N'O�YE` '" .' SOIL LOG; - , } . • . ,: � ,, TOTAL E3T/MATEd FLow_ 3 b. GqL: DAY SO/L TEST T.L�ST#2' "- •S /G TEST ' , 9��d ELEY 0A7'Lr OF /~/UMBER aF ,404cmima PITS !`FLLaf/ j' S/O�L.EACH/NG PER P/T ! SQ, PT. • I� 3 RESULTS,WIT/VESSEb BY NYC' BOTTOM!.Er4C!!/NG PER P/T 7$ $Q. FT L o M PEN COL AT/Oh! RATS M//1/�I TOTAL LEACH/NG AREA, 2t� PONCOl�7"/O N AA741 2 �MlNZ1;Ve t, RESER1iE LE.4G'Nl NG Ai4EA 6 6 SO. F7► a O l�µF 7 ROBE? SA- ? 4.l h "�f.E"•. •, A//1! .;9T� y.4NNl3,,M.45S , s L1.4` �SE}/► (r4�t!F.�/`F �pifTE.,;// /S �• I-`V Vrr'`R if.:��ii4 ',v 5�: 'finr Wi4TL°tf�' E' h h .!. 'L `y__ T{S•�s+�T �R�'r"_'" q•�...M^• i %//K9�/ :w � �- � �+ - f,',y; .�t•X. Jn ..4 �,�,�-.� 1,�tr'. d 1 .�,,.� `ta .•i 4 s;LJ i f 7 x.?l }I. ;r+;: ,:. ..,- .. .,e .. .. ,.a.>. .. ._ .-•'...a -,:,-. ..., tom., n. t ":',•z },r�F.w .e�... .-c 't.• 2E :'S' t -;?b� ." ...._ .. .r:R <. ,•.;. N +_.SY. .,..,„...., J.,..wt .. }'..��.t,. 1.v. �L;. ..1.. d..!} �Vp Pr ,y