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HomeMy WebLinkAbout0100 KNOWLTON LANE - Health �� v I.��v�Lf��,��,� 1�.�� f U�J��z/b6� _ � �� C _ TOWN OF BARNSTABLE ► 0� LOCATION /;n/rma(,j O IV LA N C"SEWAGE # VILLAGE I VIA G,7/iyS /f�//C IASESSOR'S MAP LOT R p9 Z0� C7 Y`/,� INSTALLER'S NAME & PHONE NO. Alt.c \SEPTIC TANK CAPACITY /p,ri n LEACHING FACILITY:(type) /0 00 G � (size) O NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER A/ / C_ I,u 1 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No -� 1� i m N� y� �i �j6 No.....Q ..1 C I Fsa............._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratinn for Dhipoal Works Tonotrur#inn rami# Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal S , ystem at: . 1 ....:.......1 p ..,.. .............. iL'`�� .Yu._. .. ../a' `L aN�.:"2.'/ L� --..._.... ..........- .. 1 Location- drefss � ., or o. N ............. .... -_... :•-JssaF ��'�'�J� =D�`� ...... , � Owner /g�a ess - /---- a Installer A ess-- !` `&T — �----S feet d Type of Building Size Lot.... ............... q. Dwelling—INo. of Bedrooms.._..._. .......:...... .. Expansion Attic ( ) ----------- p, Other—Type of Building ._._lever .......... No. of persons............................ Showers ( ) — Cafeteria ( ) G4 Other fixtures ---------------------------------------------- d .............. ...................... ..... W Design Flow............................................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. 3 Seepage Pit No--_---------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) - , Percolation Test Results Performed by... ....... ... - �J-.......... Date......_...5 ... .. _.. � ,� _ ,� 7 Test Pit No. 1_._j.. ....minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2.. .........minutes per inch Depth of Test Pit.................... Depth to ground water............. R+' --••---•--------------------- ........�......---- / 0 Description of Soil----------------------•-•---.....----.... �..... --•-- ----1O lir ..---.-= �... ----- -yr... W � . J?t -.-:, !z ---------------•-- UNature of Repairs or Alterations—Answer when applicable............................................................................................... ..............-......................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal em.in accordance with the provisions of iITLi4 5 of the State Sanitary C e The undersi her agre n to place the system in ` o ation until a Certificate of Compliance has been'i tied by the boar of healt Signed........... •. --- .. ... -•--------------- � . k- x,DatApplication Approved By----•------•....................••-••----.. . ... ..I...------ .... ._..._._......---- ----......--•---- •Date Application Disapproved for the following reasons........................................................................................................... ---------------•-- ------------------------- •..... .............................................................................................. Date PermitNo.......................................................- Issued.-------------------------------......---------......... Date No....................... Ficz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............../eU ......OF........... .. ...... ..................... Appliration for 13isposal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal .�tk ................. ...... Location-Addressor_.e............7F........... ................... 0 _i�22a�.......... ........... .......�.;vlw ZZ ,Z ........... ....... Installer Add ess Type of Building Size Lot_. ...Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Other—Type of Building ..... ......... No. of persons............................ Showers Cafeteria Otherfixtures ...................................................................................................................................................... Deflow_._____..._...._:.-... 1��.............gallons. sign Flow............................................gallons per person per day. Total daily flow........ Septic Tank—Liquid capacity...capacity...e gallons Length................ Width.........._..... Diameter.............._. Depth................ Disposal Trench—No..................... Width_._.........._._._.. Total Length._............._.__. Total leaching area...................sq. Seepage Pit No..................... Diameter._....._......._.... Depth below inlet_................... Total leaching area.................sq. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed by.__..._.....A&ZI .......... Date...........�1�Z Test Pit No. I....,--- minutes per inch Depth of Test Pit.................... Depth to ground water_........................ Test Pit No. 2_4.1...........minutesper inch Depth of Test Pit.................... Depth to ground water....................... ................................................7....................1�---------------------------- 0 Description of Soil.....................................................:f........................................................ ................................. --------------- --------"........................*------------ ........ --- ....... ---------- ................................................................................................................ .................. U Nature 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 T I T IE 5 of the State Sanitary Cgde—The undersigned-fur,.her agree�noi to place the system in er,ation unti a C been4ishued by the bd:�rd of healti, .,op Certificate of Compliance has h. Signed...........Z ......... ............. ...... ........... ..............1, ate Application Approved' By............................................j•...... ........ .............. Date Application Disapproved for the following reasons.().......................................................................................................---- . . .....................................................................................................................................................................................Date PermitNo....................................................... Issued..................................................... Date A. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................................OF......... .......... (Intifiratr of Toutphatta THIS IS TO CERTIFY, That the.Individual Sew t Di System constructed la- Disposal ( ') or Repaired aby ............. ........... k. ...I . dZ 4 .—..0.......................... .... -------- ............................... f Installer . VU? . . has been installed in accordance with the provisions of TITILE 5 of The State Sanitary Code aj describ-4 in. the application for Disposal Works Construction Permit No...... 6.-.100.J.......... dated............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SAT 1L JSFACTORY. � . DATE. ... ...... ...................................................... 1 c)4 THE COMMONWEALTH OF MASSACHUSETTS 0 q-A BOARD OF HEALTI� ............lk. ..............OF......... ................ Fn........ ........ Dispasal Permission is hereby granted.........V .................6 ......_._..--•t ...................................._---- to Construct (�`I or Repair ( ) an Individual Sewage Disposal System at No.............. ..........................( jj......................................... ....................... Street as shown'on the application for Disposal Works Construction Permit NA.............I.. Dated.......................................... ---------- ------I—------ --------I------------------------ ------ G L Board of Health DATE-------------�..... ............. ....................................!�2..1 -17 FORM 1255 A. M. SULKIN, INC., BOSTON _............_. .. ... _...... __.__�_ _ _.. ....__... . ..... __ { 2,F. ' Zohe- i • y3 SGo. S.F.. j o� ( 7' ' 04 I /s I SiJ� It W 1 g S U o° �1S' 3 o''c ' I 1 2-26.gg ' \ ©+ r2 i r I Ioo/ QeSEe��. / ram` 1 � l i s l-o'f" O ri I 1 i ¢ M `yX�1 - DsT3oX 1 �: Lo LEAu I �000 CAL. P;T 01, SaP7c,7ANk N 1 N e a N \ t i2 �l.►{0,0� 75 `N 43° 2,>' F-h 0,,/(�0" C y� leJ 'c/G Pr�JA,�e) L�►,e` • -OF DAVID P. � ocrwf *� 2 MAFfIANO �•i• dG o PAUL A..' �. :'CIVIL' LEVY � Na•31115 u No. 10617,: y' C7 S T o� LEGEND EXI' TI © SPOT ELEVATI ON 0 0 CERTIFIED PLOT PLAN EXI'ATINA CONTOUR--'- 0 -- _ FRISHED SPOT ELEVATION CONTOUR 0 FINIS�iED Neo / « M � /�Nou �oN L e JOIr�: The location of any existing underground sewerage, _ 4slls, or other utilities shown on tY.is plan is approx- imate only as determined from records and/or verbal information. The contractor is responsible for the ver7fication of-the existing locations in the field. SCALE I / = ��� DATE 1 '� LEVY & ELDREDGE ASSOCIATES, INC. CLIENT. ' fit,'/,, I CERTIFY THAT THE ` PROPOSED ENGINEERS-LANDSCAPE ARCHITECTS,, JOB NO. 1033 BUILDING SHOWN ON THIS PLAN F�LANNERS-LAND SURVEYORS !?O/�) CONFORMS TO THE Z© 1 0 LAWS DR.BY .___.. OF &Zr0%S4t. , P mA i 712 MAIN STREET CH: BY HYANN I S, MASS. SHEET OF 2 AWE R G. AN0 • SURVE OR'-- ?O FT. .M/N. /1(OTL� /F E/TNER THE SEPT/C TANK .OR k---- ZEACHIMO P/T ARE MORE 7NA1'/ /t"BELOW f' IO fi. MIA' 'sRAOE�A 24.0/.4M ETER CONCRETE COYE.P SWALL B.E BR0&oS. 7- TO 4RAOE.64 N E.Y7'RA .P/Pl r . .?4YJS GONCRCTE AITCN /vERVy C^ST/RON Co�I�R SHALL !3E USFsa co a 2 q• MIN. CG/VCRE'TE A • _ G ADE CO✓ER CLEAN -TA IV BACKF/LL /RON P/PE'fb -• e /MIN.P?C/1l 00 r7 ._ GAL. D/ST. o• i . . . . . • • . e •tee aF /8 -'�/B '/4 PER SEPTIC: 'TAAIX • • • • s WASHED S7t�NE BOX v. • • 8 • • • • • • .•• • o / r ss • • •EFFECT/VC.• ` , •� 3 4 , a••. _ /wE,2� • o • DEPTH • • • • WA5,►EO STONE o • • • • • • • 1 s e • rr3 rL o = I/i.o c%'y i o. • • . • o • • • • o�o PRECAST SZiBPAG£ 1 'T G•L EVATIONS r ��%/ ° • • • • • ' a o p/T OR EQUIV. ,WCA INYeRT AT DU/LD/NG FT. 6 D/AM. INLET Si ,9>77C TANK 3 Fr• _ �Z_ FT. PlAM. C SEE TABUL4TION� OUTLET SEPTIC TANK FT, r _ /INLET D/STR/DUT/ON BOX �3.9 P7 SECT/ON OF GROUND / ,47-,ER Ti4eLE OdTLETD/STR/B11T/ON.BAX �3 FT /NLET LEACHING PIT 73.5.. f•T SEJVAGE 015ROSAl- SYSTEM TAQULATlD/V L EACH/NG p/T F.T DR516A' CXITAFRIA . sc.�LE : %s" /= o" D/MENS/ON A 11f, FT. D/.►f.ENS/ON $ NUMBER DI=BEDROOMS 3 D/HENS/ON C V FT. GARBAGED/SPOSAI- UNIT Vet, SOIL LOG SD/1 TEST TOTAL E1T/N1A-7'Eb FLOW 33 0 c7.4 L.1DAy SOIL TEST Al SO/L T.C-"STO ,2' NUMBER OF 4E`•4CHllVG P/TS f^FLG°Y. 'I$•S --ELEY. Z Sl S/OE,C�ACH/NG PER P/T I�S .SQ, FT. � 7o toll t SaSaePl .DATE OF SOIL TEST R 2 P ESULTS *VIT/VESSED BY 41/N6 /yam cCL 6oTTOM L.EigGN/NG PL R P/T ��� S4. FT Tim COLAT/O/N IRATE At/ M/IV•//NCH TOTAL LEACH//YG AREA "Y SQ. FT, , G�°'y � A kC0L.4T/0N RATE j*Z %+JIN. INGN RESERI�ELEACN/NGAREA 2�_ 1_: Q. FT. 5 .n� =�3•S ��Q ��k'� DAVID gl na C r.,.v 4 MARIANO, Sei �5Y P'S7S3 o CIVIL v n..d.:v... ,�No.31115 ` .A9 *'GIST F'(v ,' Loy �Z /�ao4.D�`fOH LOLvc- 0 rsTE , s /• V . LEVY & ELDREDGE ASSOCIATES INC. L- I 7/2 MAIN ST. , HYRNn/IS, M,gSJ, ND C"ToONt7 Yt✓AT�'R fNCDUNTEREO � CL/ENT.:NcK..Ins DATE: � 7 L •: AT F(/ _ C+IPn/rIV/� L�%/fTF.Q F/