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HomeMy WebLinkAbout0340 CEDAR STREET - Health 340 Cedar Street A = 131 — 013 -002 _ W. Barnstable TORN OF BARNSTABLE LOCATION -7� �! SEWAGE # - VILLAGE la - � ��" ASSESSOR'S MAP & LOT INSTALLER'S NAME & PH.ONE NO. . za�n SEPTIC,THINK CAPACITY LEACHING FACILITY:{ty (size) 3 NO. OF BEDROOMSPRIVATE WELL OR PUBLIC WATER BUILDER OR OWNERr DATE PERMIT ISSUED: - 0 4 DATE COMPLIANCE ISSUED: = f- VARIANCE GRANTED: Yes No �O r rr I w. •ti� c• 1 II O, Dater I Iq/G�l TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS Oit Mff NAME OF BUSINESS: &Al BUSINESS LOCATION: .10 eedc4 3� (.,e5r (x.m f46k /"A 04d INVENTORY MAILING ADDRESS: �90 eec(o St c,.e)f baFnffWc M14 0)66cP TOTAL AMOUNT: TELEPHONE NUMBER: �-O(P 367 ON CONTACT PERSON: _Sco! /kr'Giaad EMERGENCY CONTACT TELEPHONE NUMBER: " 3&Z 74f 3 MSDS ON SITE? TYPE OF BUSINESS: P/vr''bc` IAeaf;2 INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum L/ .,q,( ntifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) /on �*daulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials :No.. .............................. THE COMMONWEALTH OF MASSACHUSETTS AR® F E T .......... .. .. 6.................. Appliration for Uhipmal Workii Toutitrurtion aft it Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System . ........... . ...... .... ... ..... ....................... .................................................................................................. 1� �-_Address or Lot No. . ........................................... .................................................................................................. Owc Address -- ------------------------------------- -------------------------------------------------------------------------------------------------- FMI In ler Address TypOf Building Size Lot-----------------_--------Sq. feet U Dwelling—No. of Bedrooms........! .................................Expansion Attic Garbage Grinder 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria 04 Other fixtures .................................................................................................... Design Flow...........6, Q......................gallons per person per day. Total daily flow__.___._..C, 10,........................ g'-'a,1_1'o"n'_s". P4 Septic Tank—Liquid capacity/,5X- ..gallons Length................ Width.__..__......... Diameter-___________-__- Depth.............__. Disposal Trench—No..................... Width..._........._.___.. Total Length........._.._._..... Total leaching area....................sq. f t. Seepage Pit No--------------------- Diameter..._..__.__..._..... Depth below inlet............_....... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.__.__..........__.. Depth to ground water_.______.__._........-_. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.._____._........_.. Depth to ground water-______________-----__-. 04 ............................................................................................................................................................ 0 Description of Soil........................................................................................................................................................................ x U ...........................................1........................................................................................................................................................... ......................................................................................................................................................................................................... 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 IT'LL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in I-,L operation until a Certificate of Compliance has been sued by the board ca' health. ,.,Signed. ................. .... .. ...... Date .. ............ .6............... ............... Application Approved By.... ............. ........... . .... ........................................ Date Application Disapproved for the following reasons:............................................................................................................... ..................................................... . .................................................................................................................................. JfDate PermitNo... .... ------------------------------- Issued....................................................... 4�� Dsza � THE COMMONWEALTH OF MASSACHUSETTS ,�o ,TARD PF liration for rrmit - - ' - Application is hereby made for u Permit to Construct / ) or Repair ( ) an Individual Sewage Disposal . s CM ?;Q t�77- 7- ........... "_;.4.4.......................... .................................................................................................. Address or Lots" /er Address IVEler Address Other—Typeof Building ............................ No. of persons............................ Showers ( ) -- Cafeteria ( ) Otherfixtures ...................................................................................................................................................... Desio per person per day. Total daily Septic Tank—Liquid .gukxm Length................ Width................ Diameter---------------- Depth................Disposal ' Treuch--Nu .--------'- Widtb-------- Ivtu .--------- Total leaching area.------'---mq. fc � Seepage Pit No--------------------- Diaoeter------.- Depth b��mv �dc�---------' Iotu leaching area.................. ft. �� (�t6crDist�6odoobox ( ) Dosing tank ( ) ^~ Percolation Test Results Performed bv.......................................................................... Date........................................ 1.4 Test Pit No. l................noinutcsycrincb Depth of Teat Pit........... Depth to ground rrutcr-----_.,- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------__- -- ........................................... ......................................................- 0 Description u{ Soil_-__-'---------__'--_-----------------------_---_-..---_--------_---.---_------ ...................................................................................................................................................................................................... -----------'-----'------'-----------'----------'------'-----------''--'------'--' | U Nature of Repairs orAltcrudoom--Aoswecwkeouonlicuble-_------_-.---------_----------_------._. | ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TILE 5 of the State Sanitary` `Code— The undersigned fu;thec agrees not to place the system in operation until a Ccni6curm of Compliance has b S ----'.-- ...���-� '��&�` »*" A���� A�rm� D����� ' � �' /� .... ' � ^^ '`--^--` ��'+�^�'t-' --' - ' --------'-_-------__ u^= Application Disapproved for the following reasons:........................................................................ ..................................... - .......................................................... --__-----__-__-------_-__.--__----__—_'--__- / Permit No THE cOmMomvvEALr* or MAssAonussrrs � g ..&__. ��////l/�|/ THIS,ISI TOU CERJMFY, That the In/dividual Sewage Disposal System constructed or Repaired � has been installed in accordance with the provisions of TLIT11-f"', 5� , \ application for Disposal Works Construction Permit No------ 2__ dat( _/0--- ------_----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARAN EE T AT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................ .............................. -----'_-------------' | r*s CoMwomvvsAcr* or MAssAc*ussrrs BOARD ~~ ° ./ K /_,� ` ~ 2�o-L/-/---../-�^ ' ~------''� ----`�-------'' ............................... FEE........................ ---' 't/ � - ' toConstructConstruct �� )w� ����F in Individual Sewage Disposal System pp,/ica on or .... ...C,... Board of ealth /----------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS as shown on the li d f Disposal Works Constructio P mit No.K1._"­'./7­ ,,Da, d.... ... .. SECTION - SEWAGE ' -SEPTIC TANK- -"D"BOX- -LEACH TOP OF FDN --1�=��(MSL)• � YLNIc�L PNY uu�x.+FTACbt�. FDT�P DlSrswc.C: I l '�;,. O� lo{f. 4�uu0 wTP_E.. —a^= t=1¢-u7 n o WASNEDSTONE 1 e-l\. ��1 -�- -,� Z�q �.T.• \/ 4 1 '- 1 ' x ' OUT 1 1 '•• - _1 - Q , . , C) i! IZ..Z4. SEPTICG - 1�.(06 TANK ILC{- �I.o/ '-i=� \�\''t• ., 11 •\ �' ISD� I r,• /.: ELEV. ELEV. ELEV. ELEV. '11.31. /_11.20 A ELEV ELEV OF3 N _ Cy wn�'e•L WASHED TO E y TEST HOLE LOG . . 1, r_ r a a .rr. TEST -. - WITNE _:.:. __..,_,_;-• _ '.-.�.,. .- :':3': .., TEST OAT d- r_ �' _ BEDROOM HODS_ _ DESG r - s �_ T.H.s 1 :- ..,� T.H. 2• � - ;k - - .K.-:. tA . w EIEV. . :ELEV. . .r_» :e .,._ - + r.<_ A - _ a r• _ DISPO3.-R DISPOSER PERORATE- MIN/IN.' 3 t' "15� as toU(GAL/DAv) \� FLOW RATE& 3 9 a r ==-'� >3� =� ,_..�•• �;;-:je(eD.- .5 ' ::->.� -• - • ���.: r1.' SEPTICTANK...' (1 . - w SEPTIC TANK I E: - ,� REQ D SE T CTA S Z -:,,.�;-";'- CUE ._ ,--et.-... ,-4� vo :- ,-,-_ : F.: ...._ _._ .. w _. .x _ _ •�- �i� sr'. �i saw M • :,. ...,...,.. 1 •_ .. .:..._-- ;..- ♦ .... �: .-_.,:,, ...- ,_. s LEACH FACILITY :c +�17- SIDE WALL' ( I- - eG/D � _ �.. ^ S� :: '', - ?'`` C\ - ivr� // / •' '- .�` '�' 1_ :x: 3 - _ -- BOTTOM. :o x zo 4oc- 1t.c ) �:oo G/D ` ,{r>; Q � � '✓ :- f�7-/ 4., r r TOTAL:' b.`400 :'�s.T Cats( yauD 4 � _ SP O _ -- - - xi• '�C.+ Cs��i� -� a 9 _ li � _ �� .� 1 {�. ✓.,a D.a 'i. _ s 1 T 1 _ c - _•. 'F----; - �. 'tom. �Z --F�:-I. - 'Y." - � +•.. USE. LEACHING - ,c. .�:�•� -< �� i:,`�, � =� 3� _ �'� �/' _�• 1Z� CP !s � _ -.:3.--.., �,o � 3a.q•{i•.'.X ZC� �ht�-w.d�L` _ - ,-�.� - ..e<'. - Z .�+ a'�-r -:6 -.a ax \• .n { "1.- f_'..... .-- -` ATER.ENCOUNTEREO - _ ._:.. .",. '®r_... ....,...- ..•_. -. - - ..a t ,�._. -._x; • '+�-�-. Q-� ' -.,�: -�:�..< ):% -�.�. s•. -.,,- ....: .,-_...+ .,f:-.i--ti _-,*... 9. ]P..-i _..4.e ..._, .v #.:.. i-w+ �„5.:. .a.-r-; M-T�.yt'?.•-.(3"'.. Uy'__..x -� _ .. ..._. ...- c ...... .•: .� Y c `"sue.., ,Z+.'aG`�... -�..- x-r. R :5.:-^ .-S.a ..=T'r.F .'•�- ``� -u'� Wit... : +t ♦. - R'.T•.�'k • ...��'. .�-?" i�.: .a..:,m._ �..&.., h;.. ..9:_ �� 02"": ��:... ,\�� -IJ: x:F,^ ,. r#�'•. � G,.} �'1°'> ' NOTES- (UNLESS OTIiERWiSE NOTED) - :. ti .sa�: � ag '(/�), 3 ` \t "�4S' '�k- �` .�^'•v` Sc..i, �� r.,:''. •.Y. ,, •TO_ ' � ��� _' �.; .� �.'' •�i�i, - �' O G' 1- - � IFU►1DEt't�IVE . ,. ARNE �� @ `=x ...-».:^:.� - '�r, y�. 'Y.,�., _3.PIPEPITCH:M-PER FOOT _::.' .,r:.:. .� ,=:...,.;,:. �� ..._ �:. _ �+^_.. � - _ ".,-'�e` .�-a ''►4'.Q � - 7-::�- �:�:.r >:+.,_. =., ,.:.. � -." 5-ti O .. <��,;_. .._';,., --'r'a w. _=�` '�. _ \ .5�_'• - t`tom�"w. -4 j:Y""�c ':t,,�": 4.DESIGN IAADING FOR#L�PRE['AST lIN1T5.AASNO�=LD -• -14"•"-r*•� -.d.!•1-,c '�ARF1E'1! '- .-P...'.� - j s.T ?" �• u+�-" -�-=y � � � $ �-Z' ��� sy..s� >i �" s�-s` •'•u-.-r 4 c F:r', ti_ �.- , ALA - •r ».. :..�:c:DISTANCE AS.CERTIF D?: '{ \ C�`4'-�;cg '1 ..�,?:. t�- '.y :-.t,.,•rz ..r =. .. _74�a:'. 's- -x-f��^R: GROUND COVER OVERALL SEWAGE FACILITIES:(1)6. - - .. a i'.� w �n rx..:...4T ,x,:: :•rszc"*"'" .v. Io>v'+ `'-'vi- JOIN A .WATERTIGHT, •x .. '_.:. _#- ^>tx•'�.._r.,.` >'..:,.+'; -ti-,e 26348`-'. t:Y.PIPE TSIO D AMADE _ , .. _;-.< J:dANSTRUCTION OETAItS T06E ACCORDANCE WITH COMM.Of MA55.+��_ _ _ `~. _ F"" .>-� ;� }"•.. --:: ..:r,;r"'x'T .�:w.<;•:: .'.x'"�- v:` -y_��. }`"(-..c -�' i '-;��' •a.-..�•� �. E- .. y..;.�. .. a -r'�s�u :r$ ti., �07a2z a� �ct 3g says.* t' r•,_+ �: zs z �tw' STATE EN ! ^xF•'kS:ni :v 4_ .� - .:v-,t»s:v .a-, �-s:` =,a P-w�x.-.>.?�kr... ;.s3s` � :�� -3,:•�/'U tt •;.. � :-'ETA VIRONMENTAL�ODET TLE 3- -;Y,,,� ,trS--tf� :.._- - y^>:::-:•- � - .�,,�.- _ �Df N� - �-'k�.�S� ..,;,p.a- __ .�r� _ ..�.. _ .�--e.';rl',� _ i'�lTLlMINE iOLgT.OU of ao•IEcc3:; 'xQa9s^ ST T - 9 y0 -,r�';# _;� +.- �=gymya,- ���•F� .: v • �-�"+.�+,,.,y"�.-_.' «'.y.' •��-:. -si'.:';'.,__...�_.-F_ _ - - _ L -...� .•._..J � v ._.. _. .w ayy. ._'a•'1.. .:.. ..h.-.{.vi f.._� ..':F.I`.ti � �t ..aY.:�: 'Y ;.Y} 7v :A�.'-.•k'=..".c� '�F B � �.i yr :'�'3 /qC�� _a..y.1r ..tr'� �-�_.-�_ .i, ,w. ,s' r +�.� c.s're �. x>�+ :.�\w*-6T 't3PtE./•,ISTI��I':�" l./l/� � b - '� i•. ram`. �' vy_. �� '.<->•�:r.x,.�';}:*� -� _ --_ 'fin-,E.�..�: :e -/E" - { -s �. ',i �7C'7.`.. - ��. .i'! - Sr,• J ccr-„' .P OVAL ENGINEER '•-."��. •' ..E" .ra- i�.- -,.-.,. ,_-. : -�:. �,. ' .',...� �•_ :%.. �. � .x:'-'+' =. '.:.,: - S.- '¢:a 31 - .��T. *c �u' `s-'�- REF:'. r.y.� .��._ .__, 'f: ::' _�-.- � r.: .. �•$s._n ,.� .,,r-fy �..�1 s� :r.-+ •�ta;�-� rs�,••',." �. z'�. I. fir.. ':k "'_r•! .1 .:x, w` k.::fy++.• _ter,�..t '•1 :.�i : a-.. 1 '1 rY". �:• �- � �:�'`- , - _ .. _ ,, ,a �" down.ca a en ineeri Jon,..=-u�(-r or:, "r•_ a - 'a'`" v i '�., i r d.-, �1., a :.>,.': PREPAREDfOR -�_ a•`:_J ...r ,, .+ -_."s :.- -..-„•1,a;.:<�IVIL G NEE V... ".� _ -v -., _ D URVEYORS -- ,- •.'''.-. Q r rzt.- v% rJ..- ._" .::'- - . BOARD OF HEALTH L .�' -•� _ tAN(/SURVEYOR NTOUR (EXISTING('.""` ..'.MA .'Yermoulfl�- M REG. .! r>y.St: R '� S (PROPOSED)-O-O-O�- .. APPROVED GATE A ,_ ALE. .. p ,{ - DATE C - �4-� t � � LO`C AT IO�e& � � � SEWAGE PERMIT NO. Y .e VILLAGE Ce-Jo�v, ST- - 131 U 13-o0 � IN'STA LLER'S NAME _ i ADDRESS � IUILDER OR OWNER oy q rfdn Co pi ST DATE PERMIT ISSUED _as DATE COMPLIANCE ISSUED Z iN?r 'A Fps.. ............... _j THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH :7 P.W-N--------------------OF.....BARUSTaSQ11,.-----------.........---------------------- Appliration for Uispoiial Works Tomitrn.rtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .............................. Location-Address or Lot No. tMAV.................. Owner Address ac�u_tN `.............. Installer Address qq UType of Building Size Lot._ �Z_S__1......Sq. feet Dwelling—No. of Bedrooms.._..._..._...............................Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) A4 Other fixtures ----------------------------•--• . W Design Flow................55....................gallons per person per day. Total daily flow.._..3�3P_......._._.........._...._..gallons. t4 Septic Tank—Liquid capacity.`gOa._gallons Length._tS..... Width..-S..... Diameter________________ Depth_t ..... Disposal Trench—No. Width....?r®.......... Total Length....�o......... Total leaching area_. p�?........_sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `-' Percolation Test Results Performed by---9.-1`r_`_63i,f1L1 MR1 .........P .................. Date...'LA-Za l aTest Pit No. 1--- 2--.____minutes per inch Depth of Test Pit.... ?-o°_!...... Depth to ground water........7z.......... (i Test Pit No. 2................minutes per inch Depth of Test Pit-----L19........ Depth to ground water._.--_?Z��.__-_____ ----•---•---------------------------------------•-••----...........--------------•------•-•----_............................................................. 0 Description of Soil......C L.T_r.kn-----5 1.k:;? --- -----TV.f ...........0 v 7e-.)._k..........514T:.....!; i&J-1.°,-------------------------- U ----------5 Q 5.. _tidy 1 ------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------- ------------.----••------•-----. - U Nature of Repairs or Alterations—Answer when applicable_,.,_- s.�____---Id.........Q,l�..._,gt�,�»w.� 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 be ed by the board of health. A4K -- ------•-----•-•--•......................•--------- Ye... — 1 plication Approv ................ Date Application Disapproved th ollowing reasons---------------------------------••--------------------------------------------....-----•---.....-•-----•--•••-•• ............................•---------------------•------------•-•------.....----•---------•---........---------•----•----•••-•-•-•--•---•-•---•-•----•--•------•-------••-----•---••-•---•---•-•-----•- Date PermitNo......................................................... Issued_....................................................... Date No. .. ......._....._ F�a............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... ..................OF..........................._........... ApplirFatiun for Bisposal Works Tonstrnrtion amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ ....................................................- ......------.......------......------...--- Location_Address or Lot No. .................................................................................................. ..........--...................................................................................... Owner Address W Installer Address UType of Building Size Lot............................Sq. feet Dwelling—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 daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+' .--••-••••-•---•--------•-•-••---•-•••._.....••------•-----••----------------------•--.........•----......................................................... 0 Description of Soil........................................................................................................................................................................ x. w ------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------•- 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 b e ed by the board of health. pplicatiori pro y--- mate ... ................ . --..... ---------......... Date Application Disapproved th ollowing reasons:--•--••-••-•-••-•-••------•---•.............••••••-•---•.....•--•-••---•---•••••----•-•••-•............-------- .-•-•••----------••-•.......................I.....•..............•.......------......---•-.......................•...__.Date•.........---- PermitNo......................................................._ Issued_...........................................------------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH F .........................` .OF. ...... ` .................................. Trrtifiratr of TompliFank"r S IS TO RTIFY, That the Individual Sewage Disposal System constructed (--'"or Repaired ( ). b ;Z •---•---•--••------------------------•-----•-•------..........----------------------------••------••---------------•--•-••------....---------........--•-------•-••.Installer at .-. "" = -•----------------•----------------------••-------- -----------•--------------•----------------------------------------------------------------- has been installed in accordance with the provisions of T T F r �T e State Sanitary Code as described in the application for Disposal Works Construction Permit No.W-i. ..__..___.. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SA ISFACTORY. DATE..................................................... ............. Inspector-----...------......... THE COMMONWEALTH OF MASSACHUSETTS ............................. BOARD OF HEALTH r JAB �'/D_ �+G Not?..y.................. FEE..................... Tel,Permission�he r ed...... ? ,._.... to Construct ( or Rep r ( ) an Ind' ual Sewage at System. atNo................ .....�.....•--- ------------------• •-•-•-•--••- Street as shown on the application for Disposal Works Constructiot% Permit No._ -. ......... Dated.......................................... ............................................. DATE ...-•--- r{. Board of Health ✓✓ .....�-----•---•--------•-- --------------- , FORM 1255 A. M. SULKIN. INC.. BOSTON ... ..M1.. , ..,.IT'TT4T�FV',psp,Jy.:Li�k1f,4 '.`W1a. ,ITNPT11.r-. ... ._._ _ .. _._.y.... V f,� .. ' • SECTION - SEWAGE Cp - -Fri'" � ,' • .c . fddt lv� �-� SEPTIC TANK - - "D" BOX - -.LEACH TOP OF FDN r / ? ♦ �-�-� \ s \ . --?�=�- (MSL)# 'EGMmVG. ,A1•-1Y 4u-�.x�rTAt3+-.G. FdR- Oct, "2"OF 1i8T0 +/x" �1 OF Ki�j• ARou►. P >ww+t gyp - 1- i l=l4cA-3 A-P�o WASHED STONE Imo*•-io�� + IN- OUT- IN -OUT4;(N- - r `7 SEPT- -I•S2 I.do7- —TANK -1\•3-I T `l't.© 4'" 1' + \ \ ISO ELEV. ELEV. ELEV. , ELEV , + ELEV. ELEV. OF 3/4 pi3S62N.w WASHED STONE TEST HOLE LOG6 ?EST BYcaPSY - +�,o. H TEST DATE ! w=tL94 WITNESS DESIGN .BEDROOM HOUSE `, �' \ T.H. Ar 1 . -� I. T.H. # 2 /- - pC7" ELEV. OG3"-_ { ./ .. ELEV. NO ��. C.Z. DISPOSER DISPOSER c .p,tis._ Laa �y,u xas� PERC RATE MINJIN. i \ �- •' ,T� Tj~/9�/ / \ 3 ,ca 1 \\ FLOW RATE �J3f.� (GAL./DAY ) 4.a_____ SEPTIC TANK REQ'D SEPTIC TANK SIZE t�✓c.�G - `t , ��'� L r j \ \\ o:Yac. LEACH FACILITY SIDE WALL ( ? = G/D. �� tt - - � t o�• ��� �'':€ t,, ,� , .. BOTTOM ' x z-o 4 tea G JD. t, ` , vQ' .�a' �' �!• "_- ��/ L '.� 51I-r TOTAL �� 1 Mgt' \•-l0•�\~ y \\\ times E ,x � It ' tom► 1� t=1Y �USE: i� t f } ' LEACHING 1 Ca(.5 12t5" lvG�.� { ' 1J \ \ \ sI WATER ENCOUNTERED Z_o la �1 C t`t \ ♦ ' `�'_700 ZA, ANOTES: (UNLESS OTHERWISE NOTED) (AV 1t �* ; 1. DATUM (MSL) ' TAKEN FROM_-__S �yPuL�G __ QUADRANGLE MAP n� -•1�,yy " �et; IFjq`\ 1' 1, \ \ 2. MUNICIPAL WATER.....����.............- .._.. AVAILABLE i IFy(' r�'�l elo z 3.'PIPE PITCH: /•"PER FOOT CO 44 ♦I= Cr AKiI~tF W ♦v� ) l ,1 `G ♦ y- at 4. DESIGN LOADING'FOR ALL PRE-CAST UNITS: AASHO - , DISTANCE AS CERTIFIED t ♦ `�� p,Q$' ` B. MIN. GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. Off'^1 A ^`• � ��� - `~` 74�1 � •. t _ a v� , .-• 6.PIPE JOINTS SHALL BE MADE WATER TIGHT - � , CIVIL .•••"" _ 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. (,� SITE PLAN STATE ENVIRONMENTAL CODE TITLE S s ` f• 1k. -P:TLCM l•O,C Ki't' 0 F WE�cS ��ICQ•gr� c�T. Pf �R. Z n Lo+SST. r <q�_ T+'. ,, L CUS: • ` �♦�rC�`TJ r Q o rl - -- (f 7 c} j REG.PR ONAL ENGINEER REF: 14 doM Cd.Pe elt i eering,� , J - ��...... PREPARED FOR: CIVIL ENGINEER$ _--_-------- 'p 44 � -rJ LAND SURVEYORS O REG.LAND SURVEYOR • 1 0. � t ,�), _� BOARD OF HEALTH CONTOURS ----- - I SCALE- (EXISTING) (PROPOSED)—O�--O—O—O-• APPROVED DATE MA Yarmouth MA DATE