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HomeMy WebLinkAbout0058 MINTON LANE - Health 58 Minton Lane, W. Barn. A= 174-029 4 h 1 1 No. 4210 1/3 BLU ESSELTE 10% TOWN OF BARNSTABLE LOCAI710N 92K - �'`� �'� SEWAGE # q VJT 1LAGE 14-) r r.,.:5�A&fA ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. W— r' I I;a en 6- 86() i ynS gin `7 7.4 SEPTIC TANK CAPACITY 1 0cX) LEACHING FACILrrY: (type) 3 M fA)rQ./03,Zet3 (size) .;2 FQ 4- NO.OF BEDROOMS 3 BUILDER OR OWNER 7,e` 4'a I PERMITDATE: f0h `tk ) COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by Act ©F P j, a d� No. Fee $5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Migpogal *pgtem Construction 3perntit Application is hereby made for a Permit to Construct( )or Repair( x)an On-site Sewage Disposal System at: Location Address or Lot No. 58 Minton. Lane Owner's Name,Address and Tel.No. 4 2 8—7 948 Assessor's Map/Parcel vry W Barnstable Michael Z i t o l l a Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr Spt Sry P O Box 1089, Centerville, MA Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder( no Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable Title 5 Leaching system, D—box, and threestonepacked Cultex infiltrators. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this oaLd of Health Signed Date Application Approved by Date %- Kcf Application Disapproved for the following reasons Permit No. Date Issued f5 e f Fee$50.00 No., x C THE COMMONWEALTH OF MASSACHUSETTS 1 PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppYtcation for ;Digpogal *ps tem Congtruction Permit Application is hereby made for a Permit to Construct( )or Repair( X)an On-site Sewage Disposal System at: r Location Address or Lot No. 58 Minton-Lane Owner's Name,Address and Tel.No. 4 2 8-7 9 4 8 Assessor'sMap/Parcel� W Barnstable Michael Zitolla Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr Spt Sry P O Box 1089, Centerv&lle, MA Type of Building: Dwelling No of Bedrooms 3 Garbage Grinder( nq Other Type of Building No`. f Persops r� •�'� Showers( ) Cafeteria( ) Other Fixtures +` R Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil t Nature of Repairs or Alterations(Answer when at)plicable) Title 5 Leaching system, D-box, an three stonepacked CuI ex infiltrators. '[ Date AtOnspected: if Agreemenat: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate df Compliance has been issued by thisBoard of Health Signed Date "a1 Application Approved by DateOF Application Disapproved for the following reasons i Ij Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS/ BARNSTABLE, MASSACHUSETTS Zitolla Zertif irate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( x)on by Installer Wm E Robinson Sr Spt Sry at 58 Minton Ln W Barnstable has been constru ted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N dated 0 `" '''JE Date Inspector�,� � � J1 THE ISSUANCE OF THIS CERTIFICA E SHALL NOT BE CONSTRUEL'S A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. '. — '°o.--—^---------------.----------------Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,MASSACHUSETTS '} Zitolla ]igpool Opgtem Congtruction Vermit c Permission is hereby granted to to construct( )repair(X)an On-site Sewage System located at No.# 58 Minton Ln j W Barnstable uF WM E Robinson Sr Spt Srvo, Installer street and as described in the above Application for Disposal System Construction Permit. xF No. Date The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within three years of the date below. _� Date: �"�� �'� �� Approved b � Board of Health • TOWN OF BARN STABLE ::..::LOCATION • n•}an �—�1 — SEWAGE # 3. VILLAGE ��r ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. �J i i i M Ra b v�S Q►'1 �S 8�74 SEPTIC TANK CAPACITY Od0 LEACHING FACILITY: (type) J? f'Yl laxQ/h-► ZQ�� (size) NO.OF BEDROOMS .BUILDER OR OWNER Z e pBgMI I DATE: (7I _COMPLIANCE DATE::6:/— Separation Distance Between the: Feet :;Maximum Adjusted Groundwater Table and Bottom of Leaching Facility private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet Within 300 feet of leaching facility) :Furnished by 4► K� 3 0 �'� NOTICE: This f6rs t&tre used-for the reirof failed _ septrc sy5t oay _ .. C T MA` N QT' cETCI-ANWAP LICATION..Ef}R A H SAL WORKS CONSTRUCTIGN PERMIT(WITHQU-T DESIGNED PLANS) I ��E Robin Sr.'_h > s that-tle�aWfiuhon for.-disposat works _ consti€octi€t-permit signed by.me dated- ^ concer*g the property lacated at 59 Minton Ln W lkmdablei,l meets all oft�wing crxteriia: ^� 'There-are-ao wetlands withit 300'feet of-the propose(Iseptic, stem. `Themare=ne private-wells-witl -f .of-the pry septic-s)rstem. -The obmvett groundwater tablti-is> ect-or-gireater_below the-bottom o€.thc-leas =*ility. /�� * r��.a�i�er-ease-i�_ffow.aadfor_el�age-i��pr-eposed. There are' va riances-requested or heeded. UCENSE9 SEMC-SYSTEM RiSTA=IN-TE TOWN QR RARNSMABU NUM3ER GO (Attach-a sltiet .plau ofthe proposed systems.. Alsa if the licensed installer proposes a certifipation plot.plan,tlds:plm should be subn atted). (1 F7lr L 6"t'A"T ION WO SEWAGE PERMIT NO. 11 I-?- v�l LA C)� L-Cxve vrLLAGE INSTA LLER'S NAME a ADDRESS B U I L D E R OR OWN ER DATE PERMIT ISSUED -.- DATE COMPLIANCE ISSUED i � Lo L L ,.,No------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE LTH /7 ' Alip irFatinn for Disposal Works Tonotrnrtinn Vamit Application is hereby made for a Permit to Construct (L_I�or Repair ( ) an Individual Sewage Disposal System at . ....A�4 Z Q .,v `/'l r...... - . - -1.. f '�l�e. _ S................ t Location-Ad ss gr Lot .N �'�_C ..6r�" ucl......... .P........................... ------���.._ s�.�i.� l._�5....�'�r�.���.�-r-.11� Qwner i Address W �.J a.M.QZ---- �1'�5- �..1 ------------------------------ --------- `S�'`m ............................................ Installer Address / d Type of Building Size Lot._._`,,7'_�.)..C7YSq. feet aDwelling—No. of Bedrooms-------;I................................Expansion Attic ( ) Garbage Grinder p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ...............................•---••-••-•--- W Design Flow.... 0...Q.....gallons per person per day. Total daily flow......... ...................gallons. WSeptic Tank—Liquid capacityl. #?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. Other Distribution box ( ) Dosing tank ) �-�r Z Percolation Test Results Performed by...... _.l re'1P .. .'�.' {h1' .kno,Date__..��...1'. . aTest Pit No. 1_ ._..minutes per inch Depth of Te' Pit........ ........ Depth'; ground water.._ ._....._._........_. Test Pit No P_._minutes per inch Depth of Test Pit___-�_. ------- Depth to ground water./ �... y0A ......................................................... Description of Soil�'� r P 'k cf@ f .... -- vA--- ....... --------------------------------------------------------------------------------------------------------------------------------------••---------------------------...--•--..._•---•••••................ 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>provisons of J. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the b d of health. Signed � �a t------------------------- -•------------ •`' ff Date Application Approved By....... ............................ .. _... . Date Application Disapproved for t following reasons----------------------------------------------------------------------------------------------------------------- --•--•----------------------------------------------•--...•..---•-•---........-----------------•--.....---•••-•••-•--•...---------•--•---•------••--•-•--••--•--•--•-•••-•---••.....----•-•••-•---•-•••. Or Permit No. -................................................... Issued.. j .......0.....--Date Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliratiin for 11 ipwial Workii Tomitrnrtinn P&MU Application is hereby made for a Permit to Construct 41_/ or Repair ( ) an Individual Sewage Disposal System at f._.... .......... ..... lI._... _ s-- Location-Ad ess or Lot No. Lo Pwner Address ............................... ..............................5 to--------------------------------------------- Installer Address , J Type of Building Size Lot__"7. Sq. feet V ,t• --- Dwelling—No. of Bedrooms_......................................Expansion Attic. ( ) Garbage Grinder ( ) a4 Other—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( ) ' "3 Other fixtures ........ • --••...............•-----•.....-----•---••-......-•-•----------••••.._...---•-•---•--•-----•--.......--••-•-•----•-•-.......--------- W Design Flow.._ .�.._l' ......gallons per person per day. Total daily flow........,° .0....................gallons. WSeptic Tank—Liquid"capacityf... OV.0.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 taxk ) / '—' Percolation Test Results Performed b ...__J .. . :�:��. .. ��!1 ..ek-It2:" Date...' .'.tF.s� _ Y '� - ... -- -- - a Test Pit No41' .. .._.minutesperinch Depth of Tes _-_: Pit__ ' Depth`fo ground water..............Test Pit N .xg_._minutes per inch Depth of Test Pit.................... Depth to ground water _�a-._.__ ........... a .................................................... Description of Soil - ! ----------------------------------- ------ ----- x V �1 ......._.-•-----------------•--••------•------._......-•---•----•----•-••------•--•--------------•--•------•-•--•-------....----...---•--•-----•---•-•-•-•-•----•----------------•-•--•--•-----------... 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by theI .rd of health. - {/ . ._r k- t............................ .... ........".k"..Signed----� •�°--`'�"'�'"�'`-°' ��'--• �°�... - �- Date Application Approved By..... _'YN4 ..- ...... ®............................ ------. 3•i i . Date Application Disapproved for a following reasons:--.--••-------------------------•-------•--------------•----••------..... -;----------------------.-------.----- { ..........--•-•..................................•------•-•----•-•--•-••----..---• „ p - ........................ Date �y Permit No....'x,.5m.4.4. jj 11•. •---•--•--------------------•--. Issued.--•-,F-'.'--��w'��...................... Dare I.�AY THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 .................OF..../� + ."�'"t. .... s:. ./.. ......................... Tatifiratle of (Sam rlianrr TtLj,�_IS TO CERTIFY, That th Individual Sewage Disposal System constructed r Repaired ( ) by..---- P se s.. .. 1, ,* ' : --------------------------------------------------------------------------------------------------------------------------------- r *� Installer at � ----------------------------•-------------• has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.........� ------ .................................... Inspector-------- :. ._:. ....C............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HgEALT FEE �...... ......... Dispoal Vorkii Tnnstrnrtion amit Permission is ereby granted........................................................................................................................................------ to Construct ) Rep r ( )�I Indivirlu�J Sege Disposal System at No.. �� -- 0•/1 .. ....A.3_..--- �.Jf " Street a '• as shown on the:application for Disposal Works Construction ermit No._ S.".��i. Dated........ ............. ............... - ... .- - =�1 DATE-----._.-�cz�.-.'�._`"...�,J.............................................. oard of Health FORM 1255 A. M. SULKIN, INC., BOSTON IS'8 r6 � l ry It ,9 !?7" Z i • 43, 67.E SrF• � - IVQ 50 i . sow.-�� o o i 1 ..�3� p /j /� 5 SST Z / s OFM� CERTIFIED PLOT PLAN 02� A S �� s� .0t 0 7- 2 2. M//✓/O�J L ft NE R08ER f g" No.1095 O '4 R/ ..�..+ .r- N, SCALES /'�-- 40 DATES } LDREDGE ENGINEERING CQ /NG CLIENT -- I .CERTIFY THAT THE PROPOSED EGLSTERE REGISTERED JOB N0. g3 2v BUILDING SHOWN ON THIS PLAN } CONFORMS TO THE ZONING LAWS CIVIL LAND A '. AWE' MASS. ENGINEER R EY 712 MAIN STREET CH. BY HYANN 13, MASS. gHEET.�. OF - A E AWdEE LAND SURVEYOR 3 �O FT MlN.. NOTtC /I'� E•ITI� ,&m 7wzr SE'PT/G TANAC OR _ LE/SC/+I/iv6 Pfr ANE. MORE TNAM /i~EFLD , /O Pr M/k C-49AD&JI 14 4""01AM R71&M 4C0N4CR'W7'JF C140PO&AP. S,iVALL B'lr ,�.�Ovl6/ti/T Tb 6fflA0E.64,V EA"7"RA CONCI�tCTt 4¢"PVC P/Pd tiEAYY CAST/RO/fY CO{/,--R ,S/H.41L -SE USED EL/Z4.� COVERS MJN_ P/TCN /FIN DR/VEJt/AY e i PJW FT. % MIN.2 2 N.- C�NCRL�•TE ` A CG KER CLEAN, .SANG • . . 8AC/CF/LL LIiqU/D.LEVEL - r. .�..•,•' 2 LAYER PZ MIN.P/TCW / OO GAL. • • . .�. • •• • A ��� WASH" 57ONE YAWT. •P&M 1 . SEPTIC TANK D/ST. . . . off• • a EOX v t • y� 8t • e •• ' ••• '* �✓` 7�-x !_0 7£s i s. • • • t�• • •• • ► ..t' PRECASTSEEA4GE INVERT �L�YAT/GWS 1��7 cst Pia c�ry s4 g �sL/yet y •e • • • t • • • • . s O/7.0 EAU/✓. . s :off 0 2��/dSMbs h/YERT AT.Q1//LD/NG I l G .d FT Corr. D�IAM. IAfLET ,.SEPrtC T.4/VK / S•S FT,. /D FT, C�SEE»4S1lLATJow� Dt/7LET SEPTIC 7A' NAM *AtLET D/STR/BUTION BOX l!S .C7 SECT/ON OF GROUND IIGgTER T/t�FLE F OtlTZETD/3TR/BIl7•/OIY T• /IVLET t:'.•AC/IIA W I=/T I )SEJVAGE O/SAP"A A. SYSTWM 7/1�tJJ4�TIDN 1 L�ACfd/NG o/T g, T , D.ESISIV CR/TERI/4 D/t1.Hvd/o�I 8 NUMBER OF 49L=Lwooms 3 D/M�1/1/S/ON C FT. /'���✓ ' R®.4GE D/SPOSIlL UNIT K°NE SOIL LOG TOTAL &-57M'i�TEG'FLAH/ . 3:3o G.4t./Di4y' SOIL TEST _/1E/ ` S.O/L TEST 2 .�101d. TEST mumaze OF 4eACXINlr P/7S fFLEY. !/¢•9 ELEY, PATE OF SOIL TEST S/3 yZ�3 -; S/DE 44A CHI NG PER P/7-Z M 5a PT. ' RESULTS iV/TNESSED OOT'rOM 464CNING PER P/T 2 PI $Q. FT. Lost /�'f gERCOlAT/O!V RATAF At/ �::--r AfJAVl NEN TOTAL LEACH/NG AREA Z!o 6 Sip. FT. l�j?C0LA.7/ON RAVE 1-2 t '4-"�I N�/NCN i Q RESERVE ZZACRI NG AREA G 5Q. F T. /O ^, c- �� -Z-a 7- L, -/ / n c ��SEY Of Po►, s'c ��� DF MASS9 -r 1�A ✓E L ��!3 C {.R / r� 'yi Oy �AC��N T ���LL �. ROBERT- �m p� ALBE ELDRE o m Nb.10951 O MA/A, .5 NYANN/3, MASS- �E� s Np'.gUR'}� - �FSSlONAI NO GRONNI� YYATE'I� ENCO[JNTERL�O CL/FNT: DATE' 7..ZD/� GIC0UVo y .a TER AT EL.-i!. G2c iaol3rzr- � JOB. /1A0 •z:o �,yEJFT�-O>� z-