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HomeMy WebLinkAbout0021 CROCKER ROAD - Health 21 CROCKER,?O�W.BARNSTABLE A = 109 042 o o TOWN OF BARNSTABLE !� LOCATION !L®c. r --5'Znt SEWAGE # VILLAVE lil ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. /W 4b 64402 e > Yt SEPTIC TANK CAPACITY n LEACHING FACIL=: (type) dV 41712 YI i 0 (size) NO.OF BEDROOMS p, BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: L✓ 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 r � _. �. , ,. , . - _ � - . � � e. �3 C 1 } {.� �� }A R Ci � � �� f.�.z.`� J� a?.�' _� e . `,� t .. e, ., !'r Page: 1 E CERTIFICATE OF ANALYSIS ' Barnstable County Health Laboratory ty Report Prepared For Report Dated: 05/01/2000 McKenna,Edward &Susan Order Number: G0005735 Edward McKenna P O Box 957 Barnstable, MA 02630 Laboratory ID#: 0005735-01 Description: Water-Drinking Water sample#: 05735 Sampling Location: 21 Crocker Rd.,West Barnstable Collected: 04j262000 Collected by: Edward McKe 109/42 Received: 04272000 Routine ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates 1.1 mg/L 10 EPA 300.0 04/27/2000 LAB: Metals Copper 0.4 mg/L 1.3 SM 311113 04/28/2000 Iron <0.1 mg/L 0.3 SM 3111B 04/28/2000 Sodium 19 mg/L 20 SM 3111B 04/28/2000 LAB: Microbiology Total Coliform Absent P/A Absent P/A 04/27/2000 LAB: Physical Chemistry Conductance 163 umohs/cm EPA 120.1 04/27/2000 pH 6.1 pH-units EPA 150.1 04/27/2000 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. Approved By: r- (Labdirector) f C11- 10 Superior Court House, PO. Boa 427, Barnstable, MA 02630 Ph: 508-375-6605 No. Fee C_T THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for Mir o Y *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) El Complete System �NJndividual Components Location Address or Lot No. 'ZZ 4-0 CAC_.._ cv( Owner's Name,Address and Tel.No. Assessor's Map/Parcel f f Q90—O _ InstalleerrA's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 1 0(- sw(�C \ S \Ou\S 5r( \ __ 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 gallons per day. Calculated daily flow J ss gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. �v Description of Soil Cl Pr25-e 9 Nature of Repairs or Alterations(Answer when applicable) 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 h en issue y d o Signed Date Application Approved by Date y/ Application Disapproved for the ollowtng reasons Permit No. a04o— ­2_� Date Issued No. 101 Fee '- ` ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MA S ACHUSETTS 0[pplication for ;Mfgpogal *pgtem Congtructfon Permit; '' Application for a Permit to Construct( )Repair(grade( )Abandon( ) El Complete System XIndividual Components Location Address or Lot No. ­Z fp c—V-.•- S t Owner's Name,Address and Tel.No. Assessor's Map/Parcel I Cf"0 l-4 p`'-` '�� �• �.-- �" �� p ' ' Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. `o 1 CiY( C 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 �3y gallons per day. Calculated daily flow 3 k-kc, gallons. Plan Date Number of sheets Revision Date Title �� Size of Septic Tank �' s�i`rt ��` 4�. Type of S.A.S. " k` Description of Soil O IR a'0 " S rV,0 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: 1. 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 Envirbnmental Code and not to place the system in operation until a Certifi- cate of Compliance hasfieen issued by this'B�d. -- --"- ` - � L/ _/� {"j 7 "� ��U Signed i Date Application Approved by _ Date �✓ -�a y Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTItf,tjkat the On- ite Sewage Disposal System Constructed( )Repaired( )Upgraded(� Abandoned( )by �- at - G OC-9_F-- k__ T�(—c - (AJ-60WS has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. -c.�Lo dated j Installer i Designer ,^, 6'_ The issuance of this perrmahr hall,n t ae ons ed as a guarantee that the s to VVill u ction as desrgneq-1 � �� ��/�Date -I l GL/ Inspector G /� 1 �. 9 ' t �- - f U v_�- -------------- No. o'er" Z�© Fee c_i� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 30fgpoga[ bpgtem Congtr ctfon permit Permission is hereby granted to Construct( )Repair( )Upgrade Abandon( ) System located at 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 this permit. Y Date: Approved by C4, xj r — TOWN OF BARNSTABLE s LOCATION �. n �� SEWAGE # 1 b` i VILLAGE � r3 r n ! A �!e . ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 4.I' 202 e >s r^- r C SEPTIC TANK CAPACITY f LEACHING FACILITY: (type) 1,114 zlZ %7'r'�'f. (size) f/ 5 NO.OF BEDROOMS m BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: IZI(20 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 I 4-� - l L F+ I I: 1 ;I r 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, e _, hereby certify that the application for disposal works construction permit signed by me dated �'�r 761V , concerning the property located at o�� 6 O CA(� 571-1 �c meets all of the following criteria: VThis failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. ( The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system J• There are no private wells within 150 feet of the proposed septic system eThere is no increase in flow and/or change in use proposed here are no variances requested or needed. G/ The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] If the S.A,S.will be located with 250 feet of any vegetated 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: A) Top of Ground Surface Elevation(using GIS information) /00 B) G.W. Elevation ;Z5, +the MAX.High G.W.Adjustment.`7"? _ DIFFERENCE BETWEEN A and SIGNED : DATE: "+' C) � [Please Sketch p sed plan of s on back]. NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert X LOCATION ��`'`'�� � fe SEWAGE PERMIT NO. 1 PO C r �I" VILLAGE '1 5 / INST LLER'S NAME a ADDRESS TX o R UILDItR OR OWNER i DATE PERMIT ISSUED -� , - s DATE COMPLIANCE ISSIIED r a� \ AV IT W Fxs..... � THE COMMONWEALTH OF MASSACHUSETTS �. 40 /BOARD OF HEALTH ................OF.. •-•--......................... Appl ration for Disposal Works Tunu1.rurtiun rrrutit v, Application is hereby made for a Permit to Construct (k ) or Repair ( ) an Individual Sewage Disposal Systemat: - ..... ......... - -- -- ....................... -- ddress .............. or Lot No. ..................•--- / :, ..._-..RA) :V ... Owner Address W ........-•-•...............................................•---•--••--•.....--•-••......•---•-. ••--•••-•--•••.................................••.... .....-••-•---••- ►'� Installer Address Type of Building 3 Size Lot.,,...t........1.............Sq. feet ,., Dwelling—No. of Bedrooms.•..........................................Expansion Attic (U�) Garbage Grinder (1J0) 04 Other—T e.of Building •... No. of persons............................ Showers — Cafeteria PaOther fixtures ----•...._...--•--------•-•----•---•------------------.--••--•----•---------------....------......----•-------•-----------.._.........-•--••-••.••.... d Design Flow.......JZOgallons per person per day. Total daily flow........3--,3 D.......... .........gallons. WSeptic Tank—Liquid capacity./O.0_gallons Length.6..--�a.-.. Width.Y.:..q/'. Diameter................ Depth-.. x Disposal Trench—No/..................... Width....................Total Length.................... Total leaching area.._......--........sq. ft. 3 Seepage Pit NO.........!-......... Diameter...1.Z..�..... Depth below inlet......1.1........ Total leaching area..210:_sq..ft. Z Other Distribution box ( (/f Dosing tank ) �2 Percolation Test Results Performed b ........ Date....... ......`................................ ,.a Test Pit No. l.K.2-....minutes per inch Depth of Test Pit.......6C....... Depth to ground water._ .'2....�� Test Pit No. 2....<..=.minutes per inch Depth of Test Pit.......L ..... Depth to ground water....:Ave......_.er• v O Description of Soil----•-.....f-!°1.......-•_..�.....�°�� Tp P e S vb Sol-�--------��--- - ---2...................... V T _ 6'ii - V"i - . _9 ......... --•7.1.j6=.----•--mac �------- - -- -- -- --- `Z..-------------------�--------...?'b�'�---�-cgs.m�.4-------3-G-.._..._.��:--------�..�-�V�1rrJ 44 V Nature of Repairs or Alterations—Answer when applicable....................:...........:...........................................................•-•• -•--••--•---------•-----------------------------•--•-----....-----------.._..---------•--.........---•-----•-------•------------.......--•--...........------•---................----•--••••••-•••...... Agreement: undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the rovi io s TITLE 5 of the State Sanitary Code The undersigned further agrees not to place the system in ope at u ti a Certificat f pliance has been issued by the board of health. Signed. - Date.... - App ication Approved By.....---•--••• • . ••-- ...... . ........_-•---•...•-------------- - ....... " ' .—. Date Application Disapproved for the f o wing reasons------------------•------------....------•-----------.....----•----•----••--•--•--......•••...........:......... ..................................•. L......__.. ..._.......... Date PermitNo.---. --------------- -- Issued......................................................... Date 001 Fxs.... _...� .... •• e Y THE COMMONWEALTH OF-MASSACHUSETTS �• z t BOARD OF' HEALTH f : Appliration far Disposal Works Toustrurtinfilphrmit Application is hereby made for a Permit to Construct (/,� ) or�"Repaii ( ) an Individual Sewage Disposal System at �� - - .... ..� ..... ....--_.... _ .................................................... - -- - - - -----_. .... ......... ._. C.. ✓L�c�lahku� ress....._!.�!_l.� /ic _ ... -- --•-•--.. ........ Lot No............ ......................... . ....._... _... tOwner ', dress Ad ..... - ti Installer 1 Address Q� f Type of Building Size Lot__ .... ..........Sq. feet Dwelling-No. of Bedrooms___.... _P�_____________ _____________Expansion Attic (06) Garbage Grinder (00) p, Other—Type of Building ____________________________ No. of persons............................ Showers ( ) = Cafeteria ( ) Otherfixtures 4 •------------------------ ..... -- ••-••----•-•-- •-_.._......-•-•-•---•----......._......•---•--••--••-••----• W Design Flow.......J �-5....... ._.gallons per person per day. Total daily flow.......-3_�6_________________________gallons. Septic Tank—Liquid capacity 10 __gallons Length c�__�-___. Width y e A~_ Diameter________________ Depth__. Disposal Trench '�To Width_ ____. Total Length___._.. . Total leaching area...................sq. ft. Seepage Pit_No.......__.�-__-____: Diameter___�.2_�_._.. Depth below inlet..... Total leaching area__`�_t% _rTsq. ft. Z Other Distribution box (�/ Dosing tank ( ) e v .. � Percolation Test Results Performed by_______________l`�r�. f-?..�� `Y�'v_....�N�::_:___ ;Date .................................`.. a Test.Pit No l_.<1 minutes per inch Depth of Test Pit.......65l.-.._.:__ Depth to ground.,' round w Test Pit No 2__ .. ._minutes per inch. Depth of Test Pit....... _2.•.... Depth to ground water '_._P ......... z c> ' ------ to 73 Description of Sail .........1 ........ ...... .., .__ . 14-42 Wv " ':'r! l"..,_ d.�.�r- 1->• .. .. ........... ..:__.._.,_ C?f SjU/ S ly! L 3 Cs F 4✓�✓ . . U' Nature of Repairs or Alterations—Answer when applicable...................................................... ..Y_ ^. _ Agreement: `t P The undersign d agrees to.a install the aforedescribed Individual Sewage Disposal System in;accordance with the prov`sioys i I!aJ 5'of the State Sanitary Code— The undersigned further agrees not to place the system.in operation until-a Certificate' f pliance has been issued by th board of health..' 0-11r4 �" Date -• ' APPlication Approved BY_' '�►.: Date Application Disapproved for the.fo` wing reasons ------..............-•••-----_.._ -------------------------- ..........................-••••••-- .............. 7_. 3.... N:._......._...........----._......__................... ._. _.... Date L Permit No.__.. _. .�. 9....................... Issued.......................fi�tt`" ..- _-:_-- ----._--- c Dated ._+.-r.l+�.� .+,�,...:,�.•.+_r'-...� .i.-.:-+— '!-- �.�—._._�-+....ram-...�o.._/ Y THE COMMONWEALTH OF MASSACHUSETTS " �( tt { 7 BOARD OF ' HEALTH .............. ..........OF.. ...... ............._.................. ........ �....l'...... G� r Bier#ifirtt#r of Tomplittnrr HIS 7S TO That'the Individual Sewage 'Disposal System''constructed ( ), or Repaired'(_)'• ....---•...................................... ..... --.... ...................... - - Installer G o , �cir o� .r9 ,P.✓s��.9L.� at .._. _ =- ;has been installed in accordance with the provisions of TIME, 5 of The State Sanitary Code as described in the . f' application for Disposal Works Construction Permit No: _____. . ____.._ dated................................................ 4 a i THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® ASA GUARANTEE THAT THE 4 �IYSTEM WILL FUNCTION SATISFACTORY.;. 4 r r ' DATE. g ..............................................' ' :,.i Inspector_---- ..................... `• •. .__..--•-•-............ ., ..,.r•.+�:....... .._,. ^:rL...{4.+. ...F�.._....nK �.c' ro�.'.'a. ._..:«.•.._.wLcro:...:}b-,.L•�vCs�.-iL•A it�,. � '� +Y:'- Y':.:_ .'.•*r.!-T.' °E '.4� .:'� '.vr.F.:M F'Aa+�f' .3' u,M1 :•.t �.r.L`r . arx �,Q_ _ m ._ __ -�-`1 � - .-. THE COMMONWEALTH OF MASSACHUSETTS -BOARD OF HEALTH No..: OR: `FEE.. Ca �. 1� Tuns#rwtiot Permit a as Permission is hereby granted_-• ..,---•wC ?...___ •...______________ to,Construrt � )Aor and Individual Sewage Disposal Syste � `�`! `� �� t� y_(.� __ ................................... at No - - ----_ .�..__._.. - � '9 r Street "is, on the a lication for Dis osal Works Construction Permi No1$7�7�__ Dated.................. �...a_�:.. ..._.... PP P z V . .. �� a, of Health DATL.:'r r -.5 -_cD Sp0'5 Or,__►... ................... ! r � n - _ , 4 • .,,. . ..: ... . 20 FT. . MIN. , _. . .. . . a . p ,.�k. TOP , OF _FOUND. ....... .. - r_.. -' - a a :. .-, - . T. .. . .�. , , : �``� l0 F L. MIN. . : _ CR T. .: ..:CON E E ,� { 4 COVERS SCH, 40 PVC V 'CLEAN SAND ' n. PIPE- MIN. PITCH ,, CONCRETE , a R.; .. t/8 PER FT:` _ _ _ COVER LAYER 4 CAST tRON 12 MAX. 18 .. 12 A HED . PIPE- MIN. PITCH _ � � / / W S :. ! 4 PER ,,AFT STONE G - / FLOW LINE z I0 ",rip : , •.� EL.- �5.. - EL. S.0 w D1 ST. EL= w LOCATION MAP , a e a' > BOX _ WASHED STONE 'd go U- o oD o 0 PRECAST LEACHING GAL. EL.= t) '0 BASIN OR EQUIV. SEPT I C 6.0 TANK D %,, PROFI BOTTOM OF TEST HOLE OR USGS• PROBABLE WATER TABLE EL. = P',, V� ,�10 LE OF ATTABLE( � GROUND WATER / I � EL. - e oc- SEWAGE DISPOSAL SYSTEM NOT TO ` SCALE DESIGN CALCULATIONS SOIL TEST C ;> / Qti� NUMBER OF BEDROOMS .. ... ., _ } '1 i / DATE OF SOIL TEST 3 3 GARBAGE DISPOSAL UNIT. NO J E t r 1 C < WITNESSED B Y ., TF n , c.�.�v...(•.� ;I _.; • . TOTAL ESTIMATED ,FLOW BR.,) ^ PERCOLATION RATE_4� IN./INCH GAL /BR./DAY x BR. u GAL./DAY SEPTIC TANK CAPACITY..:..:...... { 5 GAL. OBSERVATION HOLE .i_ OBSERVATION HOLEE 2REQUIRED �, ACTUAL SIZE OF SEPTIC TANK....._.. GAL. LEVATION < ELEVATION {{` �, 1 LEACHING AREA REQUIREMENTS n r' t J C ?C F 5 ,L ,, - ,K �L (��1+' ,, 1' 1 !J�)T /{]/r , ..Xzio � SfDEWALL` AREA — 'GAL./S.F. i C`P¢y, c�3 r~c err BOTTOM AREA I .D GAL./S.F.3 to jLEACHING CAPACITY ( BOTTOM +' SIDEWALL). GAL. 140 M I ` C`L F AA1 EL',t��M l/� r w t tiA�. .lii7 r� l I1.L rn F:1�1® r,�. RESERVE LEACHING CAPACITY......,.............. D GAL. 9 r D UM Ccr1R c i {r A F. a ; , NOTES wF K / r L�,l�4 `T OP4F /T r, o �t l� I. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM E'LE V, 10 .00 A.rr)S7A ,_ o ..� poCla TO D.E;0.E. TITLE . 5 AND THE TOWN OF B c P> r ► _ '� ,,- ,, << I _ t L +T SST ( ASSUME -= s 1 `.0 R[ `.� RULES AND` REGULATIONS FOR SUBSURFACE DISPOSAL r _ 1, ! v E E P OV 0 1 C. p V8 A OF SANITARY SEWAGE (1 1 )2 D►� � 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO v � r7, -�- -- t� sl!) h-'" LE AGk-� ( J .E -,r _. ti r WITHIN . 12" OF FINISHED `GRADE. 1� ` , t 1 i lqn .i � >..\ EXISTING AND FINAL GRADES SHALL, REMAIN ESSENTIALLY ��` � - � l / 3 E G L E 3 � T O•: �-,c, 1 C_' O MIN. FRONT SETBACK J ------ - 7 THE .SAME< IN. REAR SETBACK` T 4. NO 'DETERMINATION HAS BEEN MADE BY THIS OFFICE AS TO C f, 7 MIN. SIDE SETBACK 3 COMPLIANCE WITH TOWN ZONING REGULATIONS. OWNER/APPLICANT APPROVED _ BOARD OF HEALTH IS TO OBTAIN SUCH .DETERMINATION FROM APPROPRIATE AUTHORITY. ` 1 (' DATE AGENT ALL TflPO6RAPHY , W E' L AJND � � P�f� I �CA`� i�N , n _i ,ig PROJECT LOCATION: r E_�`StlTtkla A0 PRCSF�._SE; ARE FROM 3 ,- A . PROPOSES 'PLDT PLAN 3Y EL1)PEP6;E r -- . EA1 61MEERIAI� INC . JOB 832 w - APPLICANT QQ 9-2 2 83 I A L.. LEGEND 4 I DR. BY, DATE: a —_ EXISTING SPOT ELEVATIONS �M u . . OOXO �S�Of ls' (YHEA Sq P P Fn.. J0� � � c1r A D. BY REV.-. , No. 27 cn z� _ ..,/ 9 EXISTING CONTOUR 00 �+ � r r., _a .•• < FINAL SPOT ELEVAT]ONS 0 ST .� >, ..w , f s g JAMES •. + _,• ,' PU cry � : A ,- ;,� I o p HEAR CN,.. F NAL CONTOUR fn07 a R. fDHE,4R1V 1IVC. DRAWING p1o.69 q 7 _ - : SOIL TEST LOCATION r . . t- .. RfG,, ..LAND :.SURVEYORS FEG. SANlTAR/ANS , c NO. SITE : PLAN ISS ,35 ROUTE !34 UNIT 2 Its sourH oENNes MAss.. OF ry »:' '.'.is - . -. '- •• a. ..'. '., .. .. ._. t -