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HomeMy WebLinkAbout0022 DERBY DRIVE - Health 22 Derby drive 75�019 West Barnstable h 0 ASSESSOR'S MAP N&-,G `;k-\S PARCEL LOCATION SEWAGE PERMIT NO. VILLAGE ,Z,L xN ALL ER'S NAME i ADDRESS w S UILDER OR OWNER DATE PERMIT ISSUED DAT E CO_MPLIANCE ISSUED _ `o � �co. 3' v% No....�S.. FEs........... ...._ _ K THE COMMONWEALTH OF MASSACHUSETTS M BOARD- OF HEALTH .W:. .......:...OF... 51 5 C- ..................22 ,�l�t�ItrMftDlt �rir �t��tp�M� Dx�t� C��lt��rlxr#iuri �P�mtt Application`is hereby.made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at:....................:...... . ...7.D ••! y..a ... ...:..:. .�`� ....�_........................................ .. Location-Address c or Lot No. ......_..._. C__ ............................... .. ............................................... ........................ .------- e� f/A e � ..............•--------•-...... .�.. -----............-----••••-- ..--.......`---- i-_.._.t •---------------•-..........._ Install Address Type of Building Size Lot..` ...Sq. feet Dwelling—No. of Bedrooms...............a .__....................Expansion Attic Garbage Grinder ( ) `a Other=Type of Building No. of ersons............................ Showers — Cafeteria W Other fixtures ---............................... .............................. ._ d Design Flow...'....1.�.�.........-.. gallons pei persore ay. Total-dgily flow......... 5 ................gallons. Desi Septic Tank—Liquid ca acit . allons Len h i .. Width: _ c�.. Diameter............... q P Y g � - - - P �•-�.... x Disposal Trench—No.........::.......... Width.................... Total Length.................... Total leaching area..................._sq. ft. 3 Seepage Pit No........... ..... . Diameter....VZ�....... Depth below inlet..... .........Total leaching area_Z0:.1.sq. ft. Z►. .`Other Distribution box . Dosing tank,( ) a Percolation Test Results Performed by..._ t,a� [ ��.... f sl. ........ Date....` __ � ..... .4 . . Test'Pit No. 1...,.-.._ .....minutes per inch Depth of Test Pit...�. �ii.:.. Depth to ground water.. .._ f=, Test Pit No. 2...G_��....minutes per Inch Depth of Test Pit:...I.�,Lt�....... Depth to ground water...... . .............. - ----- ------- ------ -- ..............41.............. ...... n O Descriptio of fSoil. ` . 1 ... �. .re... ....•. ........ - � .� t -yv L od x .................��' TIZ C DrF. �-t .l . . .t... ... it c t 1. ......_ U Nature of Repairs or Alterations—Answer when applicable...................................................................................._.......... s ................•------•----•--•-•-----.............---.._..................------------•-------..............----•------------------------•---------•---•-••---------------....................... Agreement:' The, undersigned agrees to install the aforedescribed In idual Sewage Disposal System in accordance with } the provisions of LIT'LZ 5 of the State Sanitary d — 'rh id s ned further agrees not to place the ystem in operation until a Certificate of Compliance has a ed a of health. Signed --------.. ................... ... D e Application Approved By............... .... ... _ ZD e_ ., ........................... ...................Date Application Disapproved for the f l wing.reasons:.................•---••-•--..-....---.....--•-•---...............................-•-------••-................... ....................•-•................................................................................................................................................................................. 5 � � `..:J.6.�. sued Date Permit No . ........ ...... Issued....................._ Date..................... ..... No._.......... _............ THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH ........... c'PUE.................. . pfiration for Disposal Workii Tonstrurtinn rrrmit Application is hereby made for a Permit to Construct Og or Repair ( ) an Individual Sewage Disposal System at ......... ...��_�. :_ .v -:.._...: Ut`_A CC- -�'L. .......................... - -- -- Location-Address � or Lot No. l ......?. C t::: Via_'._.... `.:v ............ ...................................................... ............................... . WQj� !�..... .................................... Instal'-Z Address 1 Type of Building Size Lot._ j ?...Sq. feet a Dwelling—No. of Bedrooms.............. ............ Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building..........:.................. No, of persons............................ Showers ( ) — Cafeteria d Other fixtures w +� � cv ... Design Flow......... ._...... gallons per person per day. Total daily flow ............... . _.... gallons. Septic Tank—Liquid capacity gallons Length_ .._ _,. Width:. .... Diameter................ Depth&'. n.. x Disposal Trench—No. ......... ......... Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No.-.___.__.k.____.... Diameter.... Vic......... Depth below inlet....A:.........Total.leaching area_ l3sq. ft. Z Other Distribution box O Dosing tank ( ) An Percolation Test Results Performed by._._ ;�'? �`- ? ..................................... Date...'K ..Z�� :a...-. Test Pit No. I....,e.11 _minutes per inch Depth of Test Pit... �aLa ..__ Depth to ground water..��r�� G4 Test Pit No. 2...��Z__..minutes per inch Depth of Test Pit.... �?7...... Depth to ground wate ... ......... .............' .... ........ O Description of�tSoil.. (.... .�._�< ? *M..SP._ 1) `CAC ILL t)t�„�.�� .....IU�C.. �( ................ _ (a .....'`� ,. fir' ..... -- 4(n I1' ............................ �.. Nature of Repairs or Alterations—Answer when applicable.............................................................................................. .......-•....................................•--............_.--... ....---._.........------------------. --. ................................................ Agreement: The undersigned agrees to install the aforedescribed In ideal Sewage Disposal System in accordance with the provisions of T I A'IL 5 of the State Sanitary d — Th id s ned'further agrees not to place the ystem in operation until a Certificate of Compliance has a ed t e of health. . ,.. ` igned-_ .......................................... �-�4__NW , �_ 1 Da e Application Approved B � I .. ... ..ate Application Disapproved for the foIowing reasons---------------•--•----............--•---------..........--=-•------......----...---....... .... .............I..l1 ........-•--•••••-•-•............................................................•--•---....--•--•---.............------..................:------•----........---............................--•......... Date PermitNo...... 6 7•-•--------------------- Issued........................................................ Date .................... »..i.i.w.H...w w✓i6A».ems-..........................0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL oF. -.. . . .............................. Tntif iratr of Tuntplittnrr THIS I �CERTIFY That I livid age Disposal System constructed or Repaired ... .... ..r � y by w .:..................................... . .........._............................._ at, .�-' % has been installed in accordance with:the provisions of TI T LE j of The State Sanitary Code as described in the i 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.....................�.1._...... ............................................ Inspector.................................................................................... y_yam»��..»......«.aa....�..-+. ............rrnae.aa... ......,.............. . vn,�...+,a..�, THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ....................................... OF.�l: ..... .. .i� %~ � �... ............ Q 5 . /1_/- ,.'rl ` ,✓ .- .... S �� No...5.:....... .. FEE........................ MOVI 41 Works nstrnrtiun f amit i Permission is he y granted.,...� 13���-� -• =�%' ,� ��'1.. to Construct or Repair ) a ndtvidual Sew Dkspo�System c at No..•---•-.... ......_ :F-..1� ..--. --•---• Streetl as shown on the application for Disposal Works Construction PermitrNo ,� 5` 6�ated } "-¢..`.. ...... ............. Xt1� _ ._.......DATE........-•-•-1- - --=s------•-••....................__... a'd oritti�...�•. 1,..... .._.. a w SECTION - SEWAGE _. r SEPTIC TANK- _••D"BOX - . LEACH . TOP OF FO aQQ.;Q . {MSL)+r •.2..OF�raTO Vs" It WASHEDSTONETF . 1 OUT 11V•. OUT• IN. SEPTIC TANK � 3,t�a ELEV. ELEV. ELEV. I q `ELEV. L ELEV. ELEV. "CIIcO(� �� 4 `'� / i ^ OFi4^-Irk" , Y ' - WASHED STONE " 1 �( ` g`� SIZE KoLlT. TEST HOLE LOG P 40 17 � x 1�d =20l Np- ad TEST '64C 1,Lo WITNESS TEST DATE S BEDROOM HOUSE DESIGN /n T.H.- a .1 T.H. +� 2 �q __ ELEV.IO2,� ELEV. I�OIQ NO Lo uB 101 r P 2 DISPOSER DISPOSER I �� \ • _ �:; 1;# z` ° / � 'I LS IL 61'3 0 PERC RATE, MIN 33© L Gl,b�f " 3� F:COw RATE 330(GALJnAv.) --- LLO Coo �O1S t-P c SoM�, Airl 1�/ M JrI E: SEPTIC TANK 3 (1,51=: - ,1 OXI A C<`J REQ DSEPTIC TANK SIZE N1�{a t%I11 SI 'LEACH FACILITY 1. 5 SIDE WALL J277 - PI g BOTTOM 12 2 tt - 13, 1,0 I I I -.G/D. 1321j TOTAL � I 2 USE: LEACHING fl1 �l EFL I�E{'1'+-� x 12' f:� rJIA-N► , 1 �I� `! �' �' p _ 3 WATER ENCOUNTERED J, NO S: (UNLESS OTHERWISE NOT�EJD) 1.DATUM.IMSLU:TAKEN FRO �I`�1' GiUADRANGLE MAP t1A Of 2.MUNICIPAL WATER__ oVAILABLE \ / 3.PIPE PITCH:W PER FOOT 4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- r ( -44 a E 19• 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1)FT. LA . 6 PIPE jO1NTS SHALL BE MADE WATERTIGHT CIVIL 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. .q, NO 3r� STATE ENVIRONMENTAL CODE TITLE.S __ $ �_. /� �.O/ SITE - PLAN $. TvnS PL.y,,J Fot 2'l=87ti ."3 wCy�i, c5.-J�r a►�6 � ��b ' r C. E y LOCUS: -C I ' K��i� 1+1 Y_F/' H. REG.PROFESSIONAL ENGINEER O,JALA • REF• MZ6SId _ ®wo ca oI���Ig��j�OI�.. PREPARED FOR , �e.�. pus CIVIL ENGINEERS W LAND SURVEYORS BOARD OF HEALTH ��III RE LAND SURVEYOR /� CONTOURS (EXISTING)---- --•--• SCALE Imo' -I (PROPOSED)-O-O-O-O- APPROVED DATE MA ; DATE ��'-