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HomeMy WebLinkAbout0102 CARLSON LANE - Health z, �102 'CA , S0 110 033 WEST BARNSTABLE I o -LOCATION o� a SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME a ADDRESS B U I L D E R OR OWN ER DATE PERMIT ISSUED - DATE COMPLIANCE ISSUED — `����n �i, •.s, / , ,°s ,i / k JT , iy _ �_ *4d "�j� e,� „� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L6-ll1�t/. OF.... -•---------------------------------- ,'�' Appliration for Ui ipwgal Workii Cfoutitrurtion ramit i Id Application is hereby made for a Permit to Construct ('() or Repair ( ) an Individual Sewage Disposal i System at: Location-Address or Lot No. ------.JBOZ? - -SA !.... 4 Z.ree� ------&C................. .... ............................ .....--- W caner Address a Installer Address d Type of Building Size Lot_._-T4 L4 .... feet Dwelling—No. of Bedrooms___fQU-A............................Expansion Attic ( ) Garbage Grinder ( ). Other—T e of Building ---------------------------- No. of ersons___--__-------_-:-_--___-___ Showers — a Other—Type g p ( ) Cafeteria ( ) Otherfixtures --------------------------------------------------------------------------------------- ............................................................. W Design Flow..........&D................. .......gallons per person per day. Total daili flow-----441.o..........................gallons. WSeptic Tank—Liquid capacityl25.0__gallons Length.../P...... Width----.J�....... Diameter________________ Depth-_-514 x Disposal Trench—No. .................... Width_...._.............. Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.....2_______...... Diameter........ ._...... Depth below inlet.......Ce...... Total leaching area_._5A*99__....sq. it. Z Other Distribution box (X) Dosing tank ( ) 1105 EFFC_CT- Percolation Test Results Performed by.1--_b_Y_L._---EA4 JV'__ .. Q .e...... Date---''�" ,.� Test Pit No. 1..... .Z_minutes per inch Depth of Test Pit...../'�_-....... Depth to ground water14 E__C2VC4 vN%EQW Test Pit No. 2................minutes per inch Depth of Test Pit------- Depth to ground water_K9A?F_F,cN-aCIerJTE+EE_D ................---.......................................................................................................................................... 0 Description of Soil.._.#/.......6 4...k0,"4 .,.5j/Miid.1L------------------------- ¢Z-----------0-`i....... -----------------••-•----- UW ---------------- .......................--•----•--------•-------------------------------------- ------------------------...-----.3.-T.------4 t.-.......................... Nature of Repairs or Alterations-Answer when applicable.-.------------------------------ -=1- _____NlQ._.. A!vp................ ••--------------------------------------------------•-- -•---------------•--........------.......-•---•---...----------------------------•----------------------------------------.......--------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syste 'n accordance with the provisions of iITLU 5 of the State Sanitary Code— The undersi e urth agree of t place the in operation until a Certificate of Compliance has been issued by the b d of le ned.... J Application Approved BY •- ------•---•--•-----•--• - to ----------- ----------- Date Application Disapproved for the following reasons:......................... -----------•---••-------.....-----------------•---•-...--•---•-•----•••-•------_...._ --.......-•---------------------------------•---......-----------.....--------•---....---.....-------•---------------•-••-------•----•----------------•-••-------•----------•--•----------•------....: Date PermitNo......................................................... fssued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....=1=.111 ✓._................O,F.....,f s � 4 Alipliration for Bispu,i al Works Tonstrnrtinn Vrrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ........�L ......14............. �.i`v.0............... ................................. .............................................. Location-Address or Lot No. /,V..c................ ----- ............................................... 0 ner Address y----------------------------------- ....••----• ---...••--_.._...... n �IPe'4-`' Address ' Type of Building Size Lot_____'936 ....Sq. feet U Dwelling—No. of Bedrooms----164W 5:...........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------•-- -----•----•--•-•------------•-•-----.••-----------•-•••......--•------ ............................................................. Design Flow...........IJD.........................gallons per person per day. Total daily flow......:�'`�_�_..__.........._.__._....gallons. WSeptic Tank—Liquid'capacity.lz .gallons Length__-_/G_�__._.Width-_-__5_......_ Diameter---------------- Depth....�_. x Disposal Trench—No. .................... Width..__......_..____.__ Total Length.................... Total leaching area.........._.........sq. ft. Seepage Pit No._-___----.----____- Diameter........ ....... Depth below inlet........A......... Total leaching area....5:Z.....sq. ft. Z Other Distribution box ( )() Dosing tank ( ) _ /iv5- C-'FrFCT. '-' Percolation Test Results Performed by--- ------ Date.... 8 5. a Test Pit No. 1------<_',minutes per inch Depth of Test Pit....../4.___... Depth to ground water_NENE._6MC60N76426) LL, Test Pit No. 2................minutes per inch Depth of Test Pit--------/2..__.. Depth to ground water_A/cA�E_ N<1��1J%L-�E r7 a ---•--•----•-•--------------•-•---••••--•-••--•--•--••-•-----•-...------•---....••-•--------•-.....•.......................................................... 0 Description of Soil.....AI-.......C =` r 0Z----------a-` -•------ 1s01 L. w . �. ` f?G' ._ � Q_... ` fU ? L W �- C-----------------------------------------------------------------------------------•------------------------... --dr �r/t(n ....---------------------- U Nature of Repairs or Alterations—Answer when applicable.---------------------------------=1_Z_____144--� :5,441> --- ----------------------------------------•-----------------•--•--•-------------•-•-----•-•••--•••- Agreement: The undersigned agrees to install the aforedescribed Individual Sew e Disposal System in accordance with the provisions of TI'!Z- 5 of the State Sanitary Code— The un igned they a of to place the system in operation until a Certificate of Compliance has been issued by the boa �Health. -.� grred ----------- Application Approved B Z. Date Application Disapproved for the f vjl wing r asons-----------------•----------------------------------------------------------------------- ------ -------••--• -•----•--••---•-----.._•.............••--•---------------•--•---------•---------------•-•--••-------•-•----••••--•-----•-•-•---------••-•------••••-•----••--•---••-----•-•••-•-••---------•-----.....-- Date P� mit No......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF........................................................... ...................... Tnrtifiratr of Tompfianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or`Repaired ( ) by... ..... ------------------------------------------------------------------------------------------------------------------------------------------ Installer - ,. Installer at. : r has been installed in accordance with the provisions of TITIZ 5 of The State Sanitary Code as described in the ,application for Disposal Works Construction Permit No......................................... da.ted....._--- ..................................... THE ISSUANCE OF THIS CERTIFICATE SHALL.NOT BE CO STRUE® AS A GUARANTEE THAT THE SYSTEM WlkLz.FUNCTION SATISFACTORY. �- DATE................ Inspector• ` ---------.................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......OF..............................•-------............................................... NO % FEE.............1 Bispos.a1 nr� inn rnr ilan prmi Permissionis hereby granted.......... ................................................................................................ to Construct ( �,,or Repair ( an Indivi7l Sewage Disposal System at No........ 1l- Street as shown on the application for Disposal Works Construction Permit No_ ��.-_.­&Dated.......I--- _ �...._._ - DATE. Board of Health FORM 1255 HOBes_&,,WARREN, INC., PUBLISHERS Massachusetts Water Resources Commission/Division of Water Resources WATER WELL COMPLETION REPORT WELL LOCATION Address/.*"' �/ �-.J�l/,�..��/r•rm ��, �ri�,,.�: `'t— City/Town•It,0 r '/21..n G.S.Quadrangle Map Grid Location Owner... /r..�.IPI�..-� Address /WELL USE CONSOLIDATED WELL Domestic Q Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones METHOD DRILLED 1) From To Rotary(type)_Cable ❑ 2) From To Other 3) From To 4) From To CASING ,. Depth to Bedrock LengthAIAA /!%C Diameter Z Type AP/ty UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materially Feet below land surface ; Sand: fine,-Q•medium❑ coarse❑ Date measured Ct�t.I�Xy Gravel: fine❑ medium❑ coarse❑ Screen: 411 GRAVEL PACK WELL Sot#/- length c!'� from,,hn to/l P Yes [� No �. ' Split Screen(or 2nd screen) WATER QUALITY TESTS MADE Slot# length from to Chemical ❑f Biological Q' Depth To Bedrock PUMP TEST Drawdown feet after pumping days !f hours at /n GPM. How measured Recovery-' feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 DRILLER Firm L /r••in -�...n !7!A <<!M, N• o a f Address dl, r City Registration No! 101.'- Operator's Signeture Please print firmly 10M$l81-164843 SOIL LOG FL Er 84.4 No. 1 O NO. 2 eV 83. 7 I T E PLAN 4, 6 f-: WooO 2 0.Su�3ciIL `uU8So/L ` 3 n BC- 7 0 0 E�EV 60•b 4 r, o u 0 0 0 17 o • o .� TOP OF FOUNDATION El .: 6 ev • ♦ __ .._ •D• -_ MELT/UM ' ' • IN El o� D e 1. LI.C•I t_.i/.__.L. � Q 2•�J ( `Z l�clo{ eEjL 1 1 I N. 1. _g - 71.7 _u IM1. 2 COVER 1/8 3/8 WASHED STONE . .e E •�, IN.El�38 tIN.EL. '. I�`.*�J --- - ----- �„ °,' �' 12 i�� G/.•►TES[ • fi n, I N. E L,8Z,,'[8_ y •r �, , p p I D/B W/ 6 SUAItP a o ° , , ° 3/4 1 1/2 WASHED STONE 13 • 4 LIQUID LEVEL - . D ��w 70. 14 n `' Ie' i �• � ,) e J a e e o 0 ,{� �•, n ° • O' EFF. DEPTH�� h n =f PERC TEST 1 RESULTS r r• h . ! PRECAST SEPTIC TANK WITH o� ° ° PRECAST LEACHING PITS PERC RATE : CAST IN PLACE INLET AND u.�s n � � �. :., o �� {�,: �_MWHITNESSED BY : .T•� EL. 1_ _ NO SIZE : :Q-�_.= OUTLET T S PER TlTIE �,� I �F sna,,s- „�� ti�'` - 1 , s7 . c _ BOARD OF HEA;ITH SIZE `` 5� GA _ Err <— T-AJ, � ' �-- �. DIA � DATE : 4 — iz - � = IDIA P- 436Z I l � i PROFILE OF PROPOSED SEWAGE SYSTEM gX' SYSTEM DESIGNED BY THE TOWN OF REGULATIONS AND STATE 1 ITLE V FOR SUBSURFACE DISPOSAL OF SEWAGE . SCALE 114" - C 0 7.H• '�� N . B . 1 ALL PIPES SHALL BE SCHEDULE 40 P.V.C . SEWER PIPE 2 All PIPES SHALL. BE SLOPED 1, 4 , PER f00T EXCEPT FOR THE FIRST 2 FEET OUT OF THE Dill WHICH SHALL BE LEVEL Lv7 iz 8�� +� 9 3 . DESIGN FLOW BEDROOMS AT 110 GALDAY PER BR . GAL / DAY SEPTIC TANK SIZE ' _P X GAL 8h Ic.� 7- USE GAL . VV.' Gas_ GARBAGE DISPOSALAr -- - 4.� LEACHING SYSTEM . USE T' - O EFFECTIVE AREA S I X LIT r5x z.5� ro© .>Ac a� ��• ;. - _ BOTTOM � % TOTAL.. FLOW l_1_o � .�„[- Aly � � 7lf 101AL REQ 'D FLOW A--,� X !. _ _=__-44C> W/ ou; GARBAGE DISPOSAL RESERVE FLOW .� �Gs - 441D . _ = � �� GALI0AV __1N ,eFSE� VE _ REFERENCE PLANS : IPAV - - - - --- APPROVED BY : tiF L= 75.54' 3Akl'f57ArL. BOARD OF HEALTH E'=62.2Z SCALE; /"= 44 . DATE __ - - SITE AND SEWAGE PLAN PROPERTY OWNER : ��,r�� ��,��Fr,.��,s,��._______- _ __-- /r�t�Y F�krys f' i1A 9F +Kra F 0 RQ Post BEDROOM SINGLE FAMILY DWELLING DOM DATE . �-' 9, /9�r Aut DOYLE ASSOCIATES FALMOUTH , MASS . � aJ SOIL LOG Y) ! � E 8z¢ NO. 1 N 0. 2 --� 0 r SITE PLAN h. 4,2,;/y I , i� �' Y�G 4 �- " --- 5 TOP OF FOUNDATION El.: - ----- • c __, f/ yr -- -- . • -----: 10IN EL. • IN.Et. {' 2 COVER 1 8 3/8 D STONE u T / WASHED 12 •s IN.EI��''" L • IN.Et. • __ . ' fi • e v d s o • a IN. EI �9 �o . 0/8 W/ 6 SUMP o�ora• ,I o ,° - 3/4 1 1/2 WASHED STONE F �•¢ 13 L4' QUID LEVEL a • ( 14` ^ .'• i ` ° p °n NU h/A9-TEaQ D F iC�/ iv ERy . N 01 EFF. DEPTH , p ti i 5 PERC TEST RESULTS e ° onn,., • � c, v PRECAST SEPTIC TANK WITH °o a ' i • as PRECAST LEACHING PITS PERC RATE : __� '�'�• .ti CAST IN PLACE INLET AND 7� . ���� °., n 61 . ���,� r ff = ==o WHITNESSEO BY: =,��aN , El. NO.: 1_ SIZE . .:E .. OUTLET T'S PER TITLE Y �— I R S y�f -7Z `' A« BOARD OF HEATH SIZE . �/ i JSao r,9< < :.£ F ti � -i = DIA . -•�~ DATE: 4//2j8'S rt=ap Y & '- a �, 7 1- 4 + �EEo �- - �DIA. . 1 a ' y V' l , PROFILE OF PROPOSED SEWAGE SYSTEM _ SYSTEM DESIGNED BY THE TOWN OF '�"".':r,�6r' REGULATIONS AND 'f STATE TITLE, -Y FOR SUBSURFACE DISPOSAL OF SEWAGE . SCALE 1/4"= 1 ' 0" A r N .B . 1. ALL PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPE � t 2. ALL PIPES SHALL BE SLOPED 1/4" PER FOOT EXCEPT FOR THE FIRST 2 FEET OUT OF THE O /B WHICH SHALL BE LEVEL �' 3. OESISN FLOW 4 BEDROOMS AT 110 BALDAY PER BR. � OAL/DAY SEPTIC TANK SIZE 4'0 X _ �(�° SAL. �• 2s- ti X� USE GAL. W/ GARBAGE DISPOSAL ' LEACHING SYSTEM: USE Two <�; =� x -o FF Q�OT�`/ GE.4fN/ivr i T```, h/� / '—Q'" OF EFFECTIVE AREA SIDE ;aa �<- �zlpf,l � ; BOTTOM TOTAL FLOW ©- TOTAL REQ'0 FLOW 4¢0 X U = 4-�, W/ o�:T 8ARlABE DISPOSAL i RESERVE FLOW /,os- _ = � a �� GAL/DAY z, i i REFERENCE PLANS �Gv K 38`> � GF � p - _ � 78�,. Ste•-3�---'" _� APPROVED 'B` : BOARD OF HEALTH A •- DATE • PR PERT OWNER • ���� FT-� - _ SITE A ;. , :AN } O Y Ot M, `. ,� � w� - ''. 1'�R .1ivL�`f.�',4/ � ��`r•i�v'G- �,r�rt � oc.1,„ .� -sue© tipi4 S IEDR00M $11k�` V � LOT • / C/3 • "• DOW DATE r BOYLE A # 1'E ,, :iP . 1 SASS. x r P