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HomeMy WebLinkAbout0160 COACHMAN LANE - Health 160 COACHMAN LANE Marstons Mills A = 151 — 130 No.....S1�-._....... Fps. ........_............... THE COMMONWEALTH OF MASSACHUSETTS K, BOAR® OF HEALTH ----mac., Xa -------------------oF..... `. .c . � ......................... Appliratinn for Uiipn,ial Works Tomitrnrtiun rumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...��.Acr ..............)..�at_ �J..------ ------ ------------- L a'on-Address �r Lot No. .-..- . �+-O�w1ner Address ---_.... E�_C.la........r.Yl✓L[..............................•-------_..... . '.X� YA-R."_b7 . Installer Address U Type of Building Size LAS;5_79---Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (-) p,, Other—Type of Building ............................ No. of persons............................ Showers (—) — Cafeteria (—) P4 Other fixtures ..--••--------•-------••-••-•-------••. • •• •••. W Design Flow..........�_l.(2).......................gallons per person per day. Total daily flow.. ...._ -�: -----------------------dons. R: Septic Tank—Liquid ca.pacity.1.0Q.�llons Length 83 Width, (z5.. Diameter.J.2...... Depth_G......._. 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 ( ) )_4 Percolation Test Results Performed by.......................................... Date ---N -- ---.... Test Pit No. 1---- .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........................ .... .............. .. ---_-------._..--- 0 Description o So'I_.US � = r'�-- �= Q ft-d... U Nature of Repairs or Alterations—Answer when applicable._-______________________________________________________________________________••-•--------__. --------•-----------------------------------•--••-•-----•---------•----•-•-•---•------•---------------••---.....•••-•----•---•••-----•----••------••---•--••-•-•----•-•---•-------•-••--...........-•--. Agreement: J 1.v {?. CD e-S 59,,n, The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI11,E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be iss _ by h oar of ealth. Signed......... •. -•. ---•--• ` -- .. - ate Application Approved By.............................................. ---•-• •--- --- . --•--•......J .�� ate Application Disapproved for the following reasons-............................................................... .................. .......................... Date PermitNo......................................................... Issued...................- ................................ Dattee n\ i ODepartment of Environmental Management/Division of Water Resources + WATER WELL COMPLETION REPORT / WELL LOCATION Address City/Town 60 rti Yw G.S..Quadrangle Map Grid Location > Owner .r Address H J /']Fr rI '' on Al/P., -�r 7"i'l (�Y/ 4,,`1-4 A WELL USE CONSOLIDATED WELL Domestic Qf Public ❑ Industrial ❑ Type of Water-bearing.Rock- Other Water-bearing Zones 1) From—To- Method Drilled h'�it t J 2).From .To Date Drilled � � 3)From To 4) From To CASING Depth to Bedrock Length 120' Diameter Type A e?s 4i f" UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface / /. Sand: fine❑ medium©/coarse®Z Date measured 1 0— 19- P19 Gravel: fine❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL Slot# /0 length 3lfrom to Yes ❑ No ❑v Split Screen (or 2nd screen) WATER QUALITY TESTS MADE Slog length from to ,r Chemical J Biological ❑ Depth To Bedrock PUMP TEST n Drawdown w/ feet after pumping-• days hours at / =GPM. How measured_/ln lnof fh iA Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 ci m C �^ DRILLER pp m Firmra/o /t lA to 11 �frt�//1C1 o Address l�o A k 8/lt) City Registration No. /44 v it perator's Signature Please print firmly BOARD OF HEALTH COPY 2SM to•ss•sol101 .. 4L- 1(Db TOWN OF BARNSTABLE LOCATION kor 4� SEWAGE # S -VILLAGE ASSESSOR'S MAP & LOT/51'-43d iI-- INSTALLER'S NAME PHONE NO. �//� ��►,� �,C1 y ��p _�®/ 7— nSEPTIC TANK CAPACITY /`eyp �/ .(=EACHING FACILITY:(type) (size) �X i z- NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER G,k-// BUILDER OR OWNER �� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: -Z Iz"it VARIANCE GRANTED: Yes No f Wall � t _moo xfr 1� p f OIO A G I Fl 4 A) ' 7 s v No......................... Fes$.......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t ...................OF...... '. � ►. '.. ............................ Applirution for DhipusFal Works Tonstrurtion rautit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............... ------ ....... .............. ..............................................................n Address .. or Lot No. : �....... .............. ...•.................-_..... Owner Address W Installer Address d Type of Building Size Lot ► - 79..Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder PL4 Other—Type of Building ............................ No. of persons............................ Showers (—) — Cafeteria A4 Othe fixtures ............................ . w Design Flow_._.__....._�.Q.......................gallons per person per day. Total daily flow__. gallons. g g P P P, Y Y WSeptic Tank—Liquid capacity.' j�llons Length_,S..-��-?_�_. Width.`-..•j" . Diameter....�L. 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 ( ) aPercolation Test Results Performed by.......................................... Date..................... j��_ __ Test Pit No. 1-_-''!minutes per inch Depth of Test Pit...�:J+A...... Depth to ground water.....' Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth }to ground water........................ O Description o So'1 � ='. . t c �.,r� .��`?=�....... ��.. �!-_.�����! �Z ---...... ........................_ `: �' P'^ v .........c� I c --------�`--.... ...---- . .az.---�.��.:..�.��F.:._...... ----�-"----t v�-`mac`-�-----�-=•---•--- --_�-� �=--�--'---•------='-�-------�- -�J=� sz;.,-- --------------------•----------------------------•------- UNature 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 TIT .rW. y g g p y of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the board of health. Signed................."..................................................................... ................................ D'.te Application Approved BY----•-----------------------------------------•-�T'}------- ,--�------t-.�.--.�`r-.�"---;C_'�--- I J/ late Application Disapproved for the following reasons:--- ••••---•••.........--•--••••••••••••-•••-•-••---•••••-••-••---•--------•-••--•---••••-•-•--•••--......•---- ---•--••-•••--•-•••••---••..........-•••••••--•-•--...-•-•--•------••-••....--•-•-.......-•••••••-----•----•••••••-•--••----•••••••-••••••-•••-••••••-••••------•••-•--------------••••---••--•••••--•-- a Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS � , _ BOARD OF HEALTH r _ ;.7:.. . c�.................OF...... -� .h ............---------......................... �rr�ifirtt#r ,af �laut�littnr�e I THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (K) or Repaired ( ) by � :..{-1•, n ,�- o.;: !----------------•---------................--•---••---••. Installer at- ilk_...........•......, ... f{;;:"r= =� == :'--•------.=t•� t............................... has been installed in accordance with the provisions of TIT�gI&E 5 of The State Sanitary Code.as described in the application for Disposal Works Construction Permit No..... ? '.a f_ ........... dated_...__ r._ _......I__�.. ............... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.---•---•--•.........................1.�.. Inspector. 1 A - 15 f _3 Q THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......�LDUM.0.........OF...................................................................�s.'1:....... , IVTO....` (�.-._�f.�I� -- FEE.....?.............. Dispoal Workii %Ta$no#r uan rrutit Permission is hereby granted...................... .......... to Construct ( y� or Repair ( ) an Individual Sewage Disposal System at No. L=d _•..... ...!+ A..1!�..._.. ..............lm. ".)..j.--------...1�=; c 'ram Street ' as shown on the application for Disposal Works Construction Permit No. 'p..ILcI; . Dated.......!.! = 4 Board of Health V -�. DATE....... 6�--------� Lam.--•- ................. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 20 FT MIN. TOP OF FOUND. EL. _ _'--- 10 FT MIN. ti CONCRETE 4 SCH. 40 PVC -----CLEAN CLEAN SAND COVERS • ( PIPE CH r__CNCRETE 18 PER FT = COVER 2" LAYER OF - •= 4 CAST IRON l `r PIPE - MIN. PITCI' 12 MAX -` I 1/8"- 112" WASHED 1/4" PER FT �__ STONE I o -� FLOW LINE EL = Liilo MIN. ----- � `c� - `t D / r` h � t EL EL. 1 - - DiST EL:: Z 6 i nq p J) ,e. ,., LOCATION MAP �`� , � BOX �n�� � _ �a0;�re� 3/4 - 1 1/2 -� WASHED STONE 0 o n nFsne'ARD C I=EA 8 t :1J V d GO VV�IY VFas;iVJ 3 ----- --- GAL. PRECAST LEACHING �o" U _ LOT€3 `� � BASIN OR EQUIV. SEPTIC i 6.0' TANK �6 4 c>(�, >l j ;gat BO TT OM�OF TEST HOLE EL, PROFILE OF GROUND WATER TABLE( EL SEWAGE DISPOSAL SYSTEM - i + - NOT TO SCALE DESIGN CALCULATIONS SOIL TEST ' - - ! -- — - NUMBER OF BEDROOMS .. . r y r 4.- — -, " _____ DATE OF SOIL TEST _ GARBAGE DISPOSAL UNIT.. . -. —_ r TOT --- WITNESSED BY �._....�_ _ ESTIMATED FLOW PERCOLATION RATE J - MIN./INCH G f ) GAL /DAY AL AL.. /BR., DAY x � `eft. REQUIRED e,PTIC TANK CAPACITY _ GAL OBSERVATION HOLE I OBSERVATION HOLE 2 AVTUAL SIZE OF SEPTIC TANK... _GAz. ,—ELEVATION = r-ELEVAa ION = ,Jjf 32iA PIT L ARE REQUIREMENTS L GAL.I i A S r. SIOEWAL .F. - BOTTOM AREA2 GAL./S.F f, � ( BOTTOM SIDE WA CITYLEACHING CSPA 395i5 GAL j i t.E 2 (114)(6) (4) (2.0 , 3,14 (6)$ (0.83) " I l 395.5 I NG RESERVE LEACH CAPACITY GAL. 2 (3.14) (6) (4) (2.0) + 3.14 (6)2 (0.$3) }� j i e - I c-lacl G A I Y I W ep_:L . r1 k. NOTES 7 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.Q. E TITLE 5 AND THE TOWN OF - 4 Ie I ' x RULES AND REGULATIONS FOR SUBSURFACE DISPOSAL ' SOIL TEST # P-3726 1 OF SANITARY SE WAGE 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 12 OF FINISHED GRADE. 3. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY MIN. FRONT SETBACK - THE SAME. I MIN, REAR SETBACK 1 i 4. NO DETERMINATION HAS BEEN MADE BY THIS OFFICE AS TO r r MIN SIDE SETBACK COMPLIANCE WITH TOWN ZONING REGULATIONS. OWNER/APPLICANT _ i fir ,.- IS TO 06TAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. APPROVED BOARD OF HEALTH DATE AGENT �*+ PROJECT LOCATION APPLICANT { s iO I i LEGEND SCALE' DR. BY 0AiE EXISTING SPOT ELEVATIONS OOxO �Np�; '� � EXiSTp'NG EV CONTOUR - _ _ _ _ _ - - _ _ 1~'qa ';., x- JOB NO APPD. BY R � r 00- �� , t� i C. T RICHARf? ? /� RICHARD f FINAL POT ELEVA IONS OO.Q] �5� FINAL CONTOUR -----100 Q O'HJARN o-� l I JAA4 R J. UfHEARIV, /IVC. DRAWING f SITE PLAIN SOIL TEST LOCATION No. 27P7i �� t `;; I REG. LAND SURVEYORS- REG. SAN/rAR/ANS N O. i Y �F�s RF�.,�TE� ¢' t 1 35 ROUTE l3 4 — UN/T 2 �oNAz tea© ^i�t;i '� SOU7N GENN/S , MASS. OF I X