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HomeMy WebLinkAbout0065 CLOVER LANE - Health Oq-7 OI0/009 7F� o-, 5 1-,?n L ,z � ICI i TOWN OF BARNSTABLE LOCATION SEWAGE # ( -, 6 VILLAGE_ ASSESSOR'S MAP, LO'�© INSTALLER'S NAME & PHONE NO. > '����� ��i e ®SEPTIC TANK CAPACITY 1 ®LEACHING FACILITY:(type) ��7— �� . (size) hX Id i dNO. OF BEDROOMS PATE WE OR PUBLIC WATER BUILDER OR OWNER 'Iss e)14.6&Z5 DATE PERMIT ISSUED: 50 99 DATE COMPLIANCE ISSUED: 7"s J ZZ 'VARIANCE GRANTED: Yes No 1,5 A-C K �= .p f-cct 61 -o 33 No../.�:'.��.0 Fss... ✓.�.1.�...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiun for UispuuFal Worko Tuntrnr#iun ranfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..L1 e..................... Location-Addre or Lot No. !{ s' ! p�?!�CV •_••----•••-- -----••--------------•••---•---•-••--............-•---•-..._......-•-•-•-•••-••---•......._---••-- Owner / Address ......... . ........o," ..... .............................. Installer Address UType of Building Size Lot_____ ....Sq. feet Dwelling—No. of Bedrooms_______________.......................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria dOther fixtures ...........................................•-.................................... ----•-------•••-•---•------------•----------._......._•---......---• W Design Flow............./1_9.....................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........................................ Test Pit No. 1__G_mutes per inch Depth of Test Pit____________________ Depth to ground water.. _:__._____._.. rl, Test Pit No. 2.............___minutes per inch Depth of.Test Pit...:................ Depth to ground water.................... a -•••-•--•--•••-•----•--•••-•••-•-•-••••-••-•-------------------•---••----•------•-•-••---•-•••-•--••......................................................... CDescription of Soil........................................................................................................................................................................ x V ....•-•-----------•-••-•-•----------•---------------------------------------•-•--•••-----•-•-------••---------•-•••••--•--•••----------•--•--•-------•-•---••._..--••-•--•....------•---•--•._..._..--•- •----•-•--•------------------•-••-----------•-•----••--••---------------._...._.__.__._._..----•--•-- ....... ----•- - -----• •------ k.._.. U Nature of Repairs or Alterations—A*swer when a livable.__ �_ __________ ..�_ sL�Yt.__.�____.___._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code he u rsi f th r agrees not t pl cthe system in operation until a Certificate of Complian s b _ C � Signed - -- ^ ! ---... . . �'--.. . . LG'-- g -. . y-... ---�-e Application Approved By .... ------------------------------------ G4 . te Application Disapproved for the fo owing reasons- ----------------------- --- ------------ ----------------------------- -- -------------------- ------------------------- ....................................................... ---- -------------------------------------------------- - - Dace PermitNo. //..-=-�..Q.�------------------------- Issued ...... ------..-........--....-----------...-------- ------------ i Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD ,OF HEALTH TOWN OF BARNSTABLE Applirttfion for llhipas al Workii Tomitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) ari� Individual Sewage Disposal System at: ..... .......................................... . ..........-•----............................ Location-Address or Lot No. --• ..... ...... s= . . ................................ ..........-...................................................................................... Owner �y / Address Installer Address UType of Building Size Lot._...'7_:j------- feet t-I Dwelling—No. of Bedrooms...............J.......................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Building No. of persons............................ Showers YP g ---------------------------- P ( )--- Cafeteria ( ) Otherfixtures ------------------------------------------------------•--•------------•-•-• ••••••--•------••--•--•-•-•.......••_... -•••.----- W Design Flow............./1T .......................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 ( ) i Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1.....-_.2`=-minutes per inch Depth of Test Pit.................... Depth to ground water._...'_ ............ P� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 •---•------------------------------------------------------•---•--------.........-----------•.••••••......................................................... 0 Description of Soil........................................................... .... ----------------------------------------------------------------------------...----.....----------------- U P p P ��> - "� ...•.....--- Nature of Repairs or Alterations—A,saver when a�licable !�� � F _�' _ �► �*4!� � !!;, of l- X1 .6tr'1_I{l.?- ��.�' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code/—The undersign d fufthe agrees not to place the system in operation until a Certificate of Compliance has bee-1 isu�db he jb`o �p�� Signed -I/�r-.x f%.. i --:./... ��-----���—-- ----- Application Approved By ...................Q '�f �.� ��.--�'- — t ............................................. te Application Disapproved for the fo owing reasons- ------------------------------------------------------------------------------------------------------------------------------•Y ----------------------------------------------------------------------------------------------....................................--------------------------------------------------------- -------------- ------------ -- ----------------- Permit . -------------------------- Issued ----------- ----- ------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE CIer#tfira e of (10mytia cee THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( -I./) or Repaired ( ) by------------ -e- -7-7 1------------------- 4 �..t% ?� .............------------.-. ..---------... ---------------------------------.--------- Insmller at ....../-T---------- ---- � �� 7 � >- ��� ------vL'l L ....................................... has been installed in accordance with the provisions of TITLE 5 o�The State Environmental Code as described in the application for Disposal Works Construction Permit No. -.----.-XX- --�.... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........ /' .. Inspector G /. ... v THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.... �, � F TOWN OF BARNSTABLE FEE......IU.... Difivlag al nr n Tonitrnrtion ami# 1 Permission is hereby granted...........]?;A...... .................................... a to Construct Q<)' or Repair ( ) an Individual Sewage Disposal System atNo.........G..e:2T--.S---- ........... •Q?............ ------------------------------•----••------------------•-•-•----------..............--- Street �J as shown on the application for-Disposal Works Construction Permit No._,C _. h Dated.......................................... ......--•-•-•..............•-.........---------------------------•--------•---------•-----•._.........._ Board of Health DATE.......-•----••--•---•-------------•----.................................._... FORM 36508 HOBBS h WARREN.INC.,PUBLISHERS SECTION - SEWAGEj (O 1 -SEPTIC TANK - I -"O"80X - S I -LEACH TOP 0 FT. `-' (MSU• WASHED i STONE ^ . � ate© - - :� •, �,� IN• OUT- N. Ski 1 OUT• IN• ` �'Z r g ,�2 1 /SEPTIC 1 l� TAN K ELEV. ELEV. \aaL ELEV. g7 ELEV. ELEV. Cad 7 ! �, OFIA -11h WASHED STONE TEST HOLE LOG TEST BY. MGt�E�I.1 �U'V•F-f•, �`� \ ` ti� .h 1 TESTDATE I WITNESS BEDROOM HOUSE _ DESIGN � T.H. s 3 / T.H. .�G ELEV. 1(D.tD ELEV. NO I, GZ DISPOSER ISPOSER MIN/IN OP PERC RATE . FLOW RATE {GAL./DAY) SEPTIC TANK . (�,�= I�OCZ2,0 REQ 0 SEPTIC TANK SIZE CI D r LEACH FACILITY ` /Y/"., /.. \ 4151(�Zq� SIDE WALL s 3770 2•SJ q.2, G/D. BOTTOM JO 2r � t.0 l - �� G/D. ` �+ TOTAL =s 5F = ESL _�zG-�L� l�(p USE: LEACHING WATER ENCOUNTERED NOTES. (UNLESS OTHERWISE NOTED) 1.OATUM(MSL)_TAKEN FAOM `+` �~I QUAORAIVGLE MAP 2.MUNICIPAL WATER `7 }.- AVAILABLE OF �'o I1 -ra^ ✓c - �' 3.PIPE PITCH:w-PER FOOT a-OESIGN LOAOING FOR ALL PRECAST UNITS:AASHO- 5.MIN.GROUND COVER OVER ALLSEWAGE FACILITIES: (1) FT. (✓ 44 ARhE 6.PIPE JOINTS SHALL BE MADE WATER TIGHT cz �IALA 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. CIV1L H 1 SIDG' iSl + '_'?`" -- SITE PLAN STATE E14VIRONMEN"TAL CODE TITLE 5 '-y \ µo. ,K I RE1 ` IS 1 ��`t -.: Locus: d�FR _I �i�t: ` . ������ � U►.lE �t'A•Kl►�1C� �E s c Ea��, —— — ^. �-:�, l ��-���M�L,i_.S(v�,n ca,K�-v,��` ��L�• REG. SIONA ENGINE—ER I -J+� OJA = ✓�IV 7'� _,f.� REF: n'7. tdown cap e en • eerIn �^ ^Y PREPARED FOR:_ `�✓' �� _ f- CIVIL ENGINEERS t LAND SURVEYORS -- - - BOARD OF HEALTH , 1iZ'Q w�.�. REG.LAND SURVEYWR n i - q Co CONTOURS (EXISTING)------------- APPROVED DATE MA ���.1/A SCALE-L== DATE (PROPOSED)--O-o-� r - —