HomeMy WebLinkAbout0111 KETTLEHOLE ROAD - Health 111 KETTLEHOLE ROAD, W.BARNSTABLE
BITTERSWEET LANDSCAPING
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L6+ qs' - Ke4+lt- We Rd
LOCATION SEWAGE PERMIT NO.
VILLAGE (� ►�� k cp
IN TA LLER'S NAME i ADDRESS
8UILDER OR OWNER
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED /� T
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—LOCATION
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VILLAGE ; Y> � ASSESSOR'S MAP & LOT �Il
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) /:��wk4l F
z (size) b
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER&
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: 51j&L
VARIANCE GRANTED: Yes Io
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NOW
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DaNiOA
No. ............. FEic...... .....................
THE COMMONWEALTH OF MASSACHUSETTS
D � ��ell, BOARD OF HEALTH
.................OF. G.Q.Irf.?SAU.�le
Appliration for Btopviial Works Tomitrurtion ramit
Application is hereby made for a Permit to Construct � or Repair an Individual Sewage Disposal
System
............ at: .. iZ M0.............................. .
1.� Location L r Lo
0.
. ......................... _I. ......
YfAle... Aaaa.- !. --------------------------
Owner Address
.................................................................................................. ..............................................i...................................................
Installer Address
Type of Building Size Lott. ......Sq. feet
Dwelling—No. of Bedro
U oms............/ .....................Expansion Attic Gar age Grinder (4
Other—Type of Building ............................ No. of persons_-__________-__-_-__-__-___- Showers Cafeteria'�_
Otherfixtures ........................................................................ .............................................................................
Design Flow...............5S.....................gal ons per person pey day. Total daily flow------------�1.410....................go I S.
"Z 9 Septic Tank—Liquid capacityl2.60-gallons Length._/O:-.�P.. Width-5.,70.... Diameter________________ -De
—No......./........... Width___10.............. Total Length....31.q....... Total leaching area..... -76....sq. ft.
Disposal Trench :?�
Seepage Pit No_____________________ Diameter________-___-___..__ Depth below inlet.....__.........._.. Total leaching area..................sq. f t.
'T'
Z Other Distribution box Dosin ta
64 Percolation Test Results Performed by-Ock _rhaa..... -
as Test Pit No. I A4.-Z.....minutes per inch Depth of Test Pit------:YJ-co----_--_--- Date... -Z.... Depth to ground -------
rZ4 Test Pit No. 2Z 2-------minutesper inch Depth of Test Pit........)��..... Depth to ground top- - -----I-------
P4 0
....... ............ ...Z.......................................................-.
--------- -
Description of 1 - - YAA ............... ........ ---
L
--------------------------
.. .....
................................................-.-.-.-.-.-.-........................................................................................... .......................... ..... --- ...
U .........................................
.. -- --------
Nature of Repairs or Alterations—Answer when applicable................................ ........ ..........
.............................................................................................................................................................. A L Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TL I Ti LZ 5 of the State Sanitary Code e undersigned further agrees not to place the system in
operation until a Certificate of Compliance has-been i y ther(11 eal
---------_------------- - ---------------------------------------
Si ed. We -----------
y............... /D
ApplicationApproved B P. ....................................................................................... ....... . ..................
Date
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Application Disa:p ed r e following reasons:................................................................................................................
. ... .........................................................................................................................................................
Date
---------------------------- ------ -
PermitNo......................................................... Issued.......................................................
Date
- t
No..r� _ !.7 Fss......r .............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
r. �n................OF.......G.ozns_� ..We
Appliraation for DispatiFal Work.6 Ta niArnrtiun Famit
Application is hereby made for a Permit to Construct `+< or Repair ( ) an Individual Sewage Disposal
System at:
............. ................. ..'=�`--.... ------.. ...__....--------------------:.-.......:__
Location-Ac3�d s or L
l_f't'�....................•---• �1 �r C .. :. r Y
Owner Address 'V
W
PQ Installer Address
Type of Building Size Lot 4_12X ......Sq. feet
Dwelling—No. of Bedrooms...........
.................................Expansion;Attic (� •Fj Garbage Grinder Q4D)
a Other—Type of Building ____________________________ No. of persons
__..___.,:._ ............. Showers ( ) — Cafeteria ( )
Q' Other fixtures -----------•-••-••-----------•-- ... .
.tll :_._.....-•-•------....................................
WDesign Flow______________ _ ________EE.__.._..____gallons per person peI day. Total daily flow..........V ------..____.____.__:gallo s.
44 Septic Tank—Liquid capacityt-� I_gallons ength._/C,.�_-:�__ Width.5_'Q.._. Diameter________________ De�th._ :%s*
Disposal Trench—'No......./_........... Width.../a.......... Total Length.......J............. Total leaching area__._.,5�6....sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) §
aPercolation Test Results Performed by. - lsf3 _..i. _b10>__.Ca_______________ Date-__ :f_�__�'_ _1_.,&2
minutes er inch Depth of Test Pit.._..._:" _ De th to round water_._._._ _�__________ .Test Pit No. 1� _.::_..___ P P --- P g �- -
Gz, Test Pit No. 2_Z_ __._.minutes per inch Depth of Test Pit__.__.__J��__..... Depth to gr _____________________
x �• __._..__... _ = OF
D Description of Soil--- f ` r °�-••-- Y1' ' v' �c, CCiG'e_;5�_,'��i_VIQ
XL' •-------------
w ..._..--- •--•----••------•---•--•------------••••--•-• ---- �- -----•L ------------
x ---------------------------------------------------------------------------------------------------------------------------------------•--•- •- --••- -• -•-•-•• ---•-------
,�
U Nature of Repairs or Alterations—Answer when applicable-------_............................ ___ _ ........... ..............
Agreement: �OldAL E
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System In accordance with
the provisions of TIT11 5 of the State Sanitary Code e undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been i y the oarW
eal
X/ ` .....
/ at
ApplicationApproved R.. . .. •_ .... ---••----------------•-----...------._...-••••--.........--_------ _.. t--------•------
DateApplication Disapp llowing reasons-----------------------------•---------------------------------------•---------•----------------------•-•---_...
............................ ....... -...-•---•---•-------•--•-•--•-•-------........
---------••---•---
Date
PermitNo......................................................... Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
_ BOARD OF HEALTH
..........................................OF........ 2 ..................................._
C9rdifiraatr of Tuntpliaatta
THIS IS TO CERTIFY, That t� ndivid 1 Sewage Disposal System constructed (� or Repaired ( )
b '' -•---------------•--.....------....:.....-•---•--••-----•---..._...............----•-•-----
4-
-/ ns, Iler
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Cod asscribed in'the
application for Disposal Works Construction Permit No._ ___________________ dated_ •.o ..,__c'__?z,...__.___.___.____.__
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-------•--•---- -----•-----•••-------- 1-1 Inspector.... I "....................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
a/ .............O .............OF..:.._...,864_�A�klie....--•------......__...---•--......_..: FEE.. !
Disposal Ivor %fit
Donntrnrt' unfit
Permission is herebyranted.....................••-f/__�-'-----•---- -----------------...-----•-----••----........--•--.......----
g �����
to Construct ( ) or Repair (• ) an Individual Sewage Disposal System
atNo......................./-`,..... ................ s ;... -•.••-
Street
as shown on the application for Disposal Works Construction Permit No________________/,. Dd:Bah
DATE................................................................................
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
Date: 7 7b
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAMEOFBUSINESS: L�iSW� L0_KksC_!L1_Ri PA
BUSINESS LOCATION:_ lit Cu.
MAILING ADDRESS: 13T l.� • �s b�.NLQ. s 2CaL 9 Mail To:
TELEPHONE NUMBER:� o ) 3(.2 r q7 7 Board of Health
Town of Barnstable
CONTACT PERSON: P.O. Box 534
EMERGENCY CONTACT TELEPHONE NUMBER: L Oo ^ %U -- 160 Hyannis, MA 02601
TYPEOFBUSINESS:
Does your firm store any of the toxLP10-0
azardous materials listed below, either for sale or for you own
use? YES NO
This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed
envelope for your convenience.
If you answered YES above, please indicate if the materials are stored at a site other than your mailing
address:
ADDRESS:
TELEPHONE:
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health has determined that the following products exhibit toxic or hazardous character-
istics and must be registered regardless of volume. Please estimate the quantity beside the product that
you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS.
Quantity Quantity
Antifreeze(for gasoline orcoolant systems) Drain cleaners
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salt (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor oils Pesticides
NEW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet Fuel Photochemicals (Fixers)
Diesel fuel, kerosene, #2 heating oil NEW USED
Other petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil NEW USED
Degreasers for engines and metal Printing ink
Degreasers for driveways & garages Wood preservatives (creosote)
Battery acid (electrolyte) Swimming pool chlorine,
Rustproofers Lye or caustic soda
Car wash detergents Jewelry cleaners
Car waxes and polishes Leather dyes
Asphalt & roofing tar Fertilizers
Paints, varnishes, stains, dyes PCB's
Lacquer thinners Other chlorinated hydrocarbons,
NEW USED (inc. carbon tetrachloride)
Paint & varnish removers, deglossers Any other products with "poison" labels
Paint brush cleaners
(including chloroform, formaldehyde,
Floor & furniture strippers hydrochloric acid, other acids)
Metal polishes
Laundry soil & stain removers Other products not listed which you feel
(including bleach) may be toxic or hazardous (please list):
Spot removers & cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
nsYair ---•f ,
MH Cover-to within PRECAST SEPTIC TANK
/2"of Finish Grode ' Oo r r0 SCALE 1
z�
COVER AfA7,!RiAL /2`/Mlh'.
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'
A
4c IV
NOTE /F THE LIOU/O DEPTH OF THE SEPTIC TANK /S
--�„ 5`FEET, THE OUT LET TEE SHALL EXTEND /9 " SOIL LOGS
` BELOW THE FLOW LINE TP I T. P. Z T.P. 3 TP. 4
��. `D 1 1 .7 1 r Ii�� z F ° / t i'r.� :✓ ,J~ .�L SV1!—X;1 SVQI/`
�.,! �c�•,ne �x�,�t,�,� r� T G.. C..J'.'r G�:�'`i Cam. ;J{� . ..4 . •? i- � �' - _ /C1�.0
G
G , 1
-�— N/}�Vr �C_y_,_)C. a�USUvs / '� ' !/__.- / ! �jl +U, SGf}L mneAlvv mFU}U` i
' ' JGCSe60
GY1g �hL
r
C) -�
- O / PERCOLATION RATE OF L z MINUTES / INCH.
'RESENT DURING TESTS 4 i�—r f
AGENT
• '
x. use
SEC RON THRU SYSTEM
(NOT ro SCALE)
/L 0, a o - _. - -- �— M H Cover to within /2 "of Finish Grade
N/:I/_ _ r _ -//i. = rr _//r_.rr r/r/ern.
(r_J // /
i\ -T 1 L E r O L E 1�. �J .L y, 4"0 C r a,. sch. 40
PVC _1=
- - . - —j — -- —(
- - )�7 �,, SCh 4c:•PVC
`v T
_ 7 0 S L�7 C] C7 Q
SEPTIC TANK
/02•c)
(MIN) �Q. -�Oc)_
i
PROPOSED FLOW LINE GRADES BENCH MARK DESIGN CRITERIA
INV. AT FOUNDATION j()7 �25If �,; > . _,� *c-�� BEDROOM DWELLING AT PROPOSED SANITARY SYSTEM
INV INTO SEPTIC TANIr .I //0- .� ;c���.c- , � ,- ,t,�;•��� G.P.B.D. = G PD _ SOT 7'
IN OUT OFSEPT/C TANK DRAWN FOR f Xenv)eA cj 1YA1;r �) [?t
INV. INTO D/ST. BOX
INv our OF DIST. .BOX Iw•�, i,> r ,.•;� A �� %(Zx ?,11 r �,Y x1�� 1 /-7C� �. VAUTR/NOT B WEBBY CO. Cof1NTY RD. PLYMPTON, MASS.
I NV INTO LEACHING ?r. r (.�. .; O ,
GW.4WN BY r G. (-f� : `/ -- SHEET PLAN NO.
BOTTOM OF LEACHING r},G,�.,�,r /C�,�� �c .� /o •x 3y - ?WATER TABLE y'o ��. CHECKED
y /Sib
APPROVED BY
- PLAN DATE SCALE