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HomeMy WebLinkAbout0086 WOOD DUCK ROAD - Health 66 Wood Duck Road Marstons Mills 030 117 3 TOWN OF BARNSTABLE LOCATION &rYk bQc VA, SEWAGE # `IWq-�1S/� VFi.LAGE Mar i tn,05 M i It S ASSESSOR'S MAP & LOT C g O INSTALLER'S NAME&PHONE NO. GCI 9 `l CaAS .6TOR�I'7C.3593 SEPTIC TANK CAPACITY tODO LEACHING FACILITY: (type) 2'—SU0 Q Wla^ (\Ncm� J#ize) i x a e i. NO.OF BEDROOMS 3 BUILDER"OR OWNER WilliOMe PERMIT DATE: ^ .a d'' COMPLIANCE DATE: It I 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 12: y f y � I IA i _ No. 1Y, w Fee THE COMMONWEALTH OF MAq$ACHUSETTS Entered in computer: Yes PUBLIC I4EALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for ]Dig;pozal *pgtem Cow6truction Permit Application for a Permit to Construct( epair )Upgrade( )Abandon( ) i�?Complete System ❑Individual Components Location Address or Lot No.n ) Owner's�e,Addres and T 1.No. ��Jo0 dtlCwU� h� W111m1C� Y Ithll RO Assessor's Map/Parcel 6 0 �Vrs .s �l,ll Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 7 g 1— S t IDa t3 li••oL�4rrt �prs�A�.�-r�,n•+ Cx-\\7A- Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building ✓' -T-J2 No.of Persons Showers( ) Cafeteria( ) Other Fixtures 352 Design Flow gallons per day. Calculated daily flow 3 gallons. Plan Date 61 ?,'3 Number of sheets DYV, Revision Date Title Size of Septic Tank l 6,:,_0 C-R-AL Oij Type of S.A.S. 2 SO G>v_toJ],r-.�tf1�S t 3-+25 Description of Soil Nature of Repairs or Alterations(Answer when applicable) SFr, f�A 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 issued by this oard of Health. 90 Si ed Date 3 Application Approved y Date Application Disapproved for the following reasons s� Permit No. "`'� C2 Date Issued No. '"''y Fee O / THE COMMONWEALTH OF MASPAGF#14SETTS Entered in computer: ✓ PUBLIC HE TLA H DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes Application for Miopogar *pgtem Construction Permit Application for a Permit to Construct( )'R pe�atr )Upgrade( )Abandon( ) fl Complete System El Individual Components Location Address or Lot Neo. Owner's Name,Address and Tel'No. n Z�b VW�fit !X(�G�tti• ��hlJt �1'�1Hm I�`"C� '` Assessor's Map/Parcel �1 C6 L X ', C-S0 t�! ml% C c Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. -2'6 1 - S g r . 1113 C.�VA•� 10c,.3 3 U)i S•`I�,r.h��-1�. M -► w. agut" ?S-3�13 G3 ,sc, Type of Building: ° Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( ) Other,, Type of Building S!P)Z No. of Persons Showers( ) Cafeteria( ) Other Fixtures `lib a�v� .I? Design Flow gallons per day. Calculated daily flow - �352 Ji 3� � gallons. Plan Date b, 2 ,/23 Number of sheets 0 M Revision Date Title Size of Septic Tank I S 61 ri4&z-1 Type of S.A.S. � GJQ G W=L,.J _-,ALAS ►3�25 I Description of Soil se f r 11 Nature of Repairs or Alterations(Answer when applicable) Sl.r- 'PI-AX 1 1 Date last inspected: / k Agreement: f The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system n 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 issued by this Board of Health. S' ed Date Application ApproveAy Date Application Disapproved for the following reasons Permit No. _41 u P Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(mac)Repaire Upgraded( ) Abandoned( )by NyLIGU'f C_.as fitL"_-1)0" �r�n oJn at 5S1_ t�[_ ,2ztQ i ��-a�.n '���� ha been constructed i 'accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated o t Installer r L)- Designer . The issuance of s pe- 't sh ll not be construed as a guarantee that the sy e wilikK n a designed Date / V Inspector I 1 --_-------------- -- —----------------- �f No. 7 Fee�.— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Miopogal 6 Mem �tCongtruction Permit Permission is hereby granted to Construct( Repair( )Upgrade( `)Abandon( ) System located at �fo �oo >r ]�,r Sj:mj:� Ai�S 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:Constructio m�us/t be completed within three years of the ate of this • it. Date:_ y��`f Approve y • Town of Barnstable �pFIWE r y Regulatory Services P Thomas F. Geiler,Director • s�eivsras�e, • q$RNAM Public Health Division rFp' A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: SEPT 2 2004 Designer: ✓""�lr"� " ` Installer: � a 0 Address: . py0 -I �l Address: On was issued a permit to install a (date) A �(installer) �j — septic system at �'�'� V)eoy-) ,dUCk, mil- based on a design drawn by A j� (address) I �1 elo, M . `i`�1�' P� dated (designer) _ 1-certifythat the septic s stem referenced above was installed substantial) accordingto the design, which may include minor approved changes such as lateral relocation of he distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any v ' on of any component of the septic system)but in accordance with State �' Plan�revision or certified as-built by designer to follow. o=� DARpp W�REN tip, U BEY[ No. 11 0 0 (Installer's Si e) s T SNIT AF0' \ (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH 'THIS FORM AND AS- BUILT-CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form TOWN OF BARNSTABLE LOCATION �t� wn ��c c�� SEWAGE # 2QQY—�/S/� VILLAGE M,Qr S 6ffi ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. Vvf i 4 k+ l C OM , 77C.35-93 SEPTIC TANK CAPACITY 10©O CLS.1; LEACHING FACILITY: (type\ 1-6'06 QMla^ (1namj#ize) NO. OF BEDROOMS 3 BUILDER OR OWNER W i It iA 2 PERMITDATE: a COMPLIANCE DATE: of 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 s Cc ,4°8z ,SIZE - 1.-V 1 � � ti GENERAL FOUNDATION NOTES: Xl CONCRETE FOOTINGS TO BE MN. ! ! e ! 3.®F61 N20DAYS �11L FOOTINGS SHALL REST ON UNDNNF® SOL MCEV T—NOTED 4tNCONE.FOINDATI F Will PDEPTRHT ® SYNHREIN ORDS'FOOfINOOEPTHL BANG SHALL BE MIN.4NT .Wj-Oik SHALL BE BELOWGRADE NO -1?DN.ANCHOR BOLTSCIM%Sd NO MOVE THAN,T FROM OOIINERS `! GENERAL FLOOR RAN NOTES: -T-TY ROIAH CEILING HEIGHT.SGOO O wPmp l� �,» ImNa, tom) FLOOR a_ GHEOHTTOMATMEISETTNR �Maeo.OWM ALL E(T.R.O. 4ANDOW B\L HEIGHTSTO MATEN EOBIK, -CLOSET SHELVES A POLES BYGC. ' C �LLL INTHi011 FlNIBI®TO BEBHFCIHf BY C QM6F R RED a I R PRI INTTOSESHER I BYNIOCA. N tll LL.M PRIMER COATS AND CZFINISH COATS ON ALL WLLti4El081RFACES,am E%iERJOR OONSTRIICIION E%CEPT 8 WHERE OTHERWISE NOTED -VA WITH P O .m.AT ALL NEW INTERIOR WALLS IRlE8.9 OTHERWISE NOTED. -NATIRAI.UQRNG REED FOR ALL HABITABLE ® \OCLLPIIO ROOMS 4ALL HABITABLE\OCQPIED ROOMB NAIL HAVE m EXT.GLA3q OF NOTL®THAN NF TOTALFLOORAREA JNEW EXTERIOR X EROR GAZING SHALL NOT ENMED S Ns 6 ��r•�. j f1EW E]Gm BIKED GROW WAL NOT W CLO /`/`/( AH,TL OF COI®/m OR098wAW FFOes QG. AREA ALL AT=ACCESS NGELH SMALL BE MN W•SD•W/A CLENLHEIGHTOFTO• {ACTH BATH\TOILET ROOM LNMI.GE IORAPPEON)I LIXW/Hf PAN\ CORRESPOOINGQICINORA4O LETAN0 FIRST FLOOR PLAN �() TuBmmwrROmJ *� �« � � IiT'ALE 1a'-,V' J INSTALLED ByHGM CIID EY OWNERANo .ALL NEW FLARmq FDOUREB TO BE SELECTED HT QNEIFAND INSTALL®BY GCn all NEW N16ILQ/AN0 E]LTEiIOR DOQi8T0 E 8l3ECim BY OWNFR AIOINSfALLEO fW \ IN _ J '•}• J/LW W\OOW$ NI MUFACNRE AND STYLE uF L W1N tip nxwt� roBESEIE OCT®BNYOWNSR-BFEC roBE EMIALTO ARVEY- NYL I)MIBLE NLNO. DUAL PANE ARGONFILLED LOW E 411N1MUM REQUIRED P=LATKft �mr eliow oa We,TeowITABLEe,m.,- PREEQIRfIV6 APPRGM7Q a A EXPOSE Ao�vm�m I FLODNP RSS CAnNM U•G]SpA,O r———1 r———I1 WALLS: R,SD}SEXTECQi WALLS) I I I I I I SHEETSPECIFICHM I ALLLN MENS� A TKOOLFOFF NEW uNLE88 OTHERWISE S�PE I WALLS Addrdon to me v ley I I i I Rooklence 66 wood Duck Road MamtGnS Mills,MA 02646 I I II 1 L———J L---J I llI or. I AOQALTONII7E tN .N: �. v INOIlQ GC TO PRICE REPLACEMENT OF AMbb—W OnO . I FABTNO MIOONB YIfIH NEW TD MATd ND&ffiM= tmGSN BITE aPEcroAATCH NEW eF,HNW.u10me.oN11 I —————————————— — ISSUED C-(%ON LEGEND FOR AT.f 20x-W-Va FOUNDATION PLAN FwaPerm w 9ut A.sltNHn NIO,E FOLROATIDN QMBIBONB 'm"'m"""" ��e Al .1 AREro,;AOE DFCANfAE' T�TYP. LOCATION SEWAGE PERMIT NO. V 11 L A G EZ I N S T A LLER'S NAME & ADDRESS II t e UILDER ._ OR OWNER DATE PERMIT ISSUEDze '' DAT E COMPLIANCE ISSUED i I :��, �� a3 �s ,-� llsd, � _ _ -__ -- 7 - No.5ff- Fss... ,fi .. O— THE COMMONWEALTH',"OF MASSACHUSETTS BOARD, OF HEALTH 10_1^411.................. oF....&. ST'A,13Uf.-----=----------------------------...----- . Appliration for Disposal Works Tonstrurtinn Prrutit Application is hereby made fora Permit to Construct (V or Repair ( ) an Individual Sewage Disposal System at: ................______.......... .. .•---•--.-••--...•---...-•.......... .....................�....... ...i - :.......-•- ..Locati A ress or Lot No. ..-- ).... Owner............................ - ......_... . _............ .......... ...-• Address... -............-..... a ........ ,o.1 n......----•---•.....---•---------------------------------------•- ---...----------.._....---•----------------...........------------•---..........------•----------- Installer Address Type of Building Size Lot.... �t?.a9..._Sq. feet aDwelling—No. of Bedrooms........... ............................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type of Building ____________________________ No, of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures --------------•-•----------------- _... W Design Flow......... .l.l ........gallons per person per day. Total daily flow........33.Q-_,_................ ons. WSeptic Tank—Liquid*capacity_12vlWallons Length__ �_(�_ Width__ _�Q_ Diamete _ __ __._ Depth__________ xDisposal Trench— o..................... Width............ -Total Length.................... �a..:_..........:Total leaching area.................... ft. 3 Seepage Pit No........I............ Diameter....J_2....... Depth below inlet....:......... Total leaching area :8-__sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation-Test Results Performed by___- ____. 11Z .................. Date........................................ ._. Depth to ground water._ _. n ,,•a Test Pit No. 1_4_l...minutes per inch Depth of Test Pit.._��..__ ep gr �.-,:�?---- (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -•----•--' -----------••--------••------••-----•-•------------- O Description of Soil..... ---...C09....�__A�- ---•-•--� --r rr... I i.... .............. �-�1 ..... As_*.----•=------------------------------------------------------ ---------------------------------------•-----------------------------------...--------------------------------....--------- -----•-...--------- = VNature 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 iITL2 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. Signe �1 ............................ -•-•-------- - ••-•-•-..DtY.---._........Y ._a:.-•---•--•-_----- ... ........ •.....q G7 Application Approved B . • Date Application Disapproved for the following reasons:-------•------•-------------------------••----•-----------------------•-----._.....----------•r--------------- .....__--•••----•---...._••-••---•--•------...---••.................•---:•--•-------•--.....-;--•-•- .................. -•------------------------------------•------------ Date 44 Permit No........?...1. 2.5._•:-............... Issued_..............---------L_6-----R-L•---- Date •- r THE COMMONWEALTH±OF MASSACHUSETTS BOARD OF HEALTH ' 74:+.`�....................OF... .�••�...13T��+•54r =------•---•--------........................ Appliration for Disposal Works Tonstrudion Permit Application,ivhereby made for a Permit to Construct (V ) or Repair ( ) an Individual Sewage Disposal System at ................___................ .._ .................-----.......---------- --�•-�`-------�..... .a_• ................. .:------....-- p� �( Q Locati -A ress or Lot No. .......::-;s:.�/s e ,':..........�..�..... J v................................. ......................................................Address ...................................-...... W = - ' .............. Installer Address �� tTypenof Building Size Lot............:..............Sq. feet U Dwelling—No. of Bedrooms..........:�............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Ga Design Flow fixtures •. ......:..:.."dons ' er, erson. er da W gn '�•1) g P P y. Total daily-flow...._.. .--...................gallons. W Septic Tank—Liquid ca.pacity./Q� gallons Length .. _ Width..'_J_..._ Diamete .. Depth x Disposal Trench—No..................... Width.7................. Total Length.....................Total leaching area....................sq. ft. 3 Seepage Pit No.-.--_..I------------ .Diameter....1.2 ....... Depth below inlet.............. Total leaching area2J.Q%5..sq.yft. � Z Other Distribution box ( ) Dosing tank ( ) ° *r Percolation Test Results Performed by............d1" ?. .................. Date.................................. ,aa Test Pit No. 1_.5-�...Z___minutes' per inch. Depth of Test Plt` � :...... Depth to ground water..>.- 4'..._.. f� Test Pit No. 2................minutes per inch Depth of Test Pit...................:-Depth to ground water........................ . - ------ --V........ .--- ..._. ...--•---. oDescription of Soil...... _ 4.? =`- -.. ------.....6 .---.. ._.... !I`....................... lam - �' x .............................c� !D........---•........................................... v ............ - ---- W --•--•••---•------•-•---------••--•----•••-•---••--••-••-•---•••-•--------•-••-•-••••-••-•••-•-••-•-----•-•-•••-•••••-----------•••---•••-----••••-•••-••••--•••-...-----•--•-••-•••.................... F VNature of Repairs or Alterations—Answer when applicable............................................................................................... --......---•---------------•----------------•---------...-----------------------•--.....-•---........••---•...._--•••--•••--••. •--------------------------....--------............---•.....::.. Agreement: >j The undersigned agrees to install the aforedescribed Individual Sewage Disposal,:System in accordance with the provisions of TITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system'in operation until a Certificate of Compliance:rhas be n issued by the board of health. ' ---------------- D't ......._.... 2 .......... .Application Approved By .......................... -------r ------ -= Date :. . Application Disapproved for the following reasons-------------------------•---•-------•-----------•----•-•-----•----------------------....._...•-•--...... �- .............................................•-------- ••-•--..............-•--••-•---•.......... . .........I.,................................................................... Date Permit No......... � ........ Issued-------------------------------... ..._...------- - -------------- ----•--- -...--•--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` ......OF..................................................................................... Tn#ifirat a if Tomptittnrr , fHIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed Y" or Repaired ( ) rl,_ is /e %" Installer has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No--------- dated.....- .............................�> THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ ................................ Inspectors ,- .�n.b -rh.................................... THE COMMONWEALTH OF MASSACHUSETTS ,-�-- BOARD OF HEALTH t �Z .......................OF..... �rnSC - C<............•..-...-...................._......... ?jp.v� No......................... FEE........................ Disposal Works Tuntrnr#uan Permit Permission is hereby granted_.. -LSO............ . ------------=•-------------•-------------------................----= to Construct ( or Repair O � In idual Sewage Disposal„System �nn�.� yy atNo......L.•�4-....�-•--•-• .. ................. . . , -f > - ----- Street as shown on the application for Disposal Works Construction Permit No.. ._� -L Dated.......................................... . .... 6n z H, Board of Health DATE.............. -------------•------------•---------•---- i I ASSESSORS MAP : �D PARCEL : tt� TEST HOLE; LAGS �: 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH SOIL EVALUATOR .2Me\je� R S, CSe, THIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF ' FLOOD ZONE : J p WITNESS NOT ul w r �wJ�BLZ, BOARD OF HEALTH REGULATIONS. D , REFERENCE: �X_L�G° DATE: 2 1U3 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, PERCOLATION R Ti : Zrn� Intl 1� I1.5 SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO C L A55 I SOIL,, t,_rX9-:-6-)y t_L'36'_ INSTALLATION. �'� TH- 1 J. t, 9D,7Q TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION —'-1 ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE S � IC��� 2 DETERMINATION. 19S S,kO D 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "It FOOT. (UNLESS LORM I�!�sl� I t� SPECIFIED OTHERWISE) LOCATION MAP 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A C� S�Lr � S� A GARBAGE DISPOSAL, �'� LvAM ,�jy 6 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) CURSE. MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON C1 S'f�N Z. ' 1� 4=�� 7C� A BASE OF 6"OF CRUSHED STONE. _ ?) rXt577�LeAc�F DT T R o E PvmPrr D CJ2u3ff_Ed No (�W a�3S�ie-tr�b. g v KNbwtl I,1T�e ID . W�IAI lo'dOD �ln1C. a�. TIC S IL&WIV„J P,JVA-� w . 6 WhA) /S61 or- P�o���+iNc SE SYSTEM DESIGN z* p. __ urvs 5 o r �b FLOW ES7 I MATE ��BEDtaOOMS AT J:0 GAL/DAY/BEDROOM • :�,�GAL/DAY //• /UO Voikt tAl(_'FS �A -TiL Q—ToGA)n) 1`( Lpirw SEPTIC TANK 1 �J / / GAI JDAY x 2 DAYS D GAL / (Ao7L- ' l l l USE 10079 GALLON SEPTIC TANK-eAISP ° � q� r�-� 1 �t / SOIL ABSORPT I ON SYSTEM C r l .1. I / V76W .P T /1•t Lx 13 w X 2 SIDE AREA:.=-5)ZI-jt3 Llk2,c 0.2!f — /12 .'-/8 Tar=� 43 F / BCT70y AREA: �S� 1s a. ?y 2yd.so ti y i f�A''� _ — ' / �' SEPT i C' SYSTEM �3��� +� q� EM SECTION k, : or r — gZ el, ° " i / 7b 4 hs c p-A [� / "Q7uble lvbshe 5f v,� — D-sox �f3,5o r ;L 7z -iE I,� UD GAL �6r7 Wake�esf' a �L �/I"cl2lF�� SEPTIC TANK (�or �veJneS�s� ua.60 if �L 78 7b 7 r j z / �C.E�+`�tTZO/�� EXl sC j NGI .Y_ wush�Q sl�� �.SS 79.V5— SITE AND SEWAGE PLAN so DAFT N ` E R N LOCATION : FG WOOD 1Juc� INo. 1140 10 493-70nl S MILLS /1/1 S�NCTAR\ PREPARED FOR 0 M � W �v � � DARREN M. MEYER, R.S. 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