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HomeMy WebLinkAbout1541 SERVICE ROAD - Health 1541 SE17V ( E RX}Ip► �'�.,`�u ��, r"; }i WEST BA C, ' RNSTABLE __n A 174 004 001. I V w 4y 50. 6r, / / . 6p i 0 I {.�r+ Ln P 1 Q rz' 80 TV M, _ _ TP-CD 2 B� 06 z� EL 55,00 10 At T te, '...s.e ..ter,., •�- 4 :-row 1:1 134. 64 WA�f R TOWN OF BARNSTABLE eT LOCATION ���� 3 //�, 9AC SEWAGE # VILLAGE YV, 5dJM5-Ad�`e— ASSESSOR'S MAP /& LOT/ 'OO -00 INSTALLER'S NAME&PHONE NO./—/h»G7�� �i e� �O�1tf�G /'•5 SEPTIC TANK CAPACITY /✓oo q on cos- $33-7770 LEACHING FACILITY: (type) ruc�,4size) 4 Aa 2/ NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: q _0 1 COMPLIANCE DATE,: U 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 4�1 T5 A Tm lah�, V iS 1�-13®x 32,5 Charts ber 3$00' - 1� • Fox iatnL 1�1�5 Cha�b�r 1D-Ibo-A 4-I. o Cham 6 er 4ry i T'� %may TOWN OF BARNSTABLE LOCATION O 3 f SEWAGE # 20o) - 2-2 l� VILLAGE K/ 1'3d*- 1S-ACID ASSESSOR'S MAP & LOT 'OU -GU INSTALLER'S NAME&PHONE NO. C != B �ifP_ (r4M-/MC tlY"5 SEPTIC TANK CAPACITY /✓�oo q on 508- 1933-7770 LEACHING FACILITY: (type) fz "A- A size) O© � NO. OF BEDROOMS BUILDER OR OWNER -�����^'� PERMIT DATE: q _0? G COMPLIANCE DATE: U 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 i { A �.oTamL TaKk 1)-130)4 Ch&m ber 3b,a' - _ � Fox T a $ �k. � 5 � Cl�a►M 6er 'D-�50X �I o Ghaw�6 er 45,o' /6-` FEE ® Board of Health,C9 {'Z j',dc , MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application a Permit t Construct( Repair( ) Upgrade( Abandon( - gl'Complete System ❑Individual Components J' seQv ti C R 09 Owner's Name �,� d�d nt Location 1 Map/Parcel# 1 7 — Address f� �W(� S Nlil i'lY74 S'_ Lot# Telephone# _ Z-1 Q Installer's Name � � C; Designer's Name C^$j jbt'_ LS bJ V 15 L3 1pNV VAf Address Address '306 01- Telephone# Telephone# ._ Type of Building Lot Size 7 PfC, sq.ft. Dwelling-No.of Bedrooms Garbage grinder (J4 0 Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures ,�{{ Design Flow(min..required) `P ® gpd Calculated design flow Design flow provided gpd Plan: Date / �� / 0 1 Number of sheet " Revision Date /+ P Ad, , Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of FAial"&ie-n 88 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersi agrees to in a above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further afire t n t o place a in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date L(o r 760 1 f,OBE K G . goLL EE ` pinlN�4 CUE. 5( fly. C oNj-r Z+'�Z.T<'vrG S' {.L .C�. Inspections No.( f"' FEE 9NMONWEALT14 OF MASSAC14USETTS Board of Health, C3_�. , NIA. APPLICATION FOR DISPOSAL S YSTE CONSTRUCTION PERMIT ApplicationPermit t Construct(vRepairO O O Upgrade Abandon - Complete System ❑Individual Components s 'ti Location C Owner's Name twi Lon n l�`7✓dam Map/Parcel# 7 - Address 00 W W I°1t c) S T, )A 0 orb i Lot# 3 Telephone# Installer's Name C. hlj&A `0AC Designer's Name CA %^ Address Address 30ra OU FLYM Telephone# Telephone# Type of Building Lot Size , !� �L sq.ft. Dwelling-No.of Bedrooms 4. Garbage grinder( Q Other-Type of Building ,- {...- No.of persons Showers ( ),Cafeteria ( )yk Other Fixtures',, Design Flow(min.required) T' 4-d gpd Calculated design flow Design flow provided gpd Plan: Date 2 ZD/ 1 _I ;-_ Number of sheets Revision Date ,! TitlepLAU S�wlM! G //++7EWy- "pe,51 a bi orf;' A PROQ®SLP Description of Soil(s) )le r-n V vlsopp5ttq 1 Q Soil Evaluator Form No. Name of Soil Evaluators Date of i DESCRIPTION OF REPAIRS OR ALTERATIONS �. 'The undersiowd agrees to in the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees tdd n�t to plac e s in operation until a Certificate of Compliance has been issued by the Board of Health.' 'Signed L Date �F,A 2(o Ot I �,.E "� p cud s.i M ctrii-r-IT;yr)rt s j.t c:� Inspectior_s f No. wr -4 � i ' FEE 1r Board of Health, !( to 5 u ld 6MA. CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) XComplete System The undersign/.fed hereby certi t th Sewage Dispp4 ,System;; Constructed Repaired ( ),Upgraded ( ),Abandoned O by: or,,- at Or 3, 'Sell 6/IC1%"� . • C�10,� I GG• r�-1 li ra;Cf has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No.'xr C dated /l 2 61 . Approved Design.Flow 7G (gpd) Installer •- 1 On c � p- Designer: Inspector: !� Date: !J h A f The issuance of this permit shall not be construed as a guarantee that th system will function as designed. No.. FEE 6D Board of Health, f,to(Q MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT 4 Permission is hereby granted to; Construct( `Re'pair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at l. o��jl/Cp ,�� ul Q� ��°n S¢a ' as described in the application-for' _ Disposal System Construction Permit No.9W -04R L , dated . Provided: Construction shall be completed within three years of the date of this ermip All loc �condifi�ins must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health ncuNowl, A; ; Top o� Gov►- D�r�o� t� ou-r'L -r TEf SOIL TEST PIT DATA INk"-SAt ELEVA TIONS. T.P. -i o o T.P. 2 GRND. ELF% 83. GAND. ELEV OD IFd. 'R; AT BUILDING I +50 G.M. ELEV. G. M. ELEV. -r- 5i INb 5W,`" IN A T SEPTIC TANK IN FP OUT A T SEPTIC TANK 8 ,0.0 ACCESS COVERS MUST BE.VITHIN 6 " OF`FINISH GRADE. F)iJ*R G ' -b BROWN JN,:R; ZN AT DIST. BOX - 7 INDICATES I.54 0VC-' V, 5•A'.S • PERC. TEST INc.:Af' our AT DrsT. Box ,-7o SAND go:7o EL- 814 MIN. 2' OF '' CoB�Lf.S INV��R7� IN AT S.�4,S, . 60- D ` ® �n0 ��. BOT;0A' OF S.4.S 8� l• 4' MIN: 5 INDICATES �A�ED GA�U'VDMATEA LIOUID I ` MASHED STONE 5AM¢ OBSr� --- !.0 D ,_ � OBSERVED MtiU/ AOJ�` i ti DEPTH GROUNOMA TEA 5OD GADUNOMATER 10 a�DO DB X :y N �k ` 3/4 J `1/2 DIA. p F1N , ST , r.-. MASHED STONE - O g SEPTIC TANK 1O '7 S 5O INDICATES SEPTIC TAAK 6 D-BOX TO BE SET ON A �- !d TEST PIT 6' BED OF COMPACTED GYWVSS W STONE. CONTRACTOR TO HATER TEST D�OX TO `� .SfrI�M LEVELNlESS. LOT. l 5f Acres i DATE• TEST BY.' ALL C�'�f e J L)V.0�Y Co l4 ejU L-rA lv T J WITNESSED BY.' S. VUNNING PERC. RATE 2 MIN./ rN. hl Me'D� DESIGN CRITERIA.' DESIGN FL 0!✓.• 4 �{� GENERAL _4: BEDROOM D*RLING 9 110 6AL/17AY PER BEDROOM 1. THIS PL,;,V IS FOR THE DESIGN AND 2.! EQUALS 44-6 6ALS. PEA DAY. CONSTP, " 101Y OF THE SEMAGE DISPOSAL '.OX r. � SEPU�TANK A Q I ED.' Gft)>sD�4 3 n FACILIT' _ D P. ALL CON � UCTION METHODS, MATERIALS AND I)' F MAIN , ;E FOR THE SEPTIC SYSTEM SHALL GPD X:�OOX = _8$0 GAL 3S� BOARD Of ..HEAL TH REGULA TIONSI TL E 5 AND LOCAL SEPTIC TANK PROVIDED.' eA 900 GAL. UIAED 3. ALL SEPI. ;� SYSTEM COMPONc-N7 SUBJECT TO SIZE OF LEACHING FACILITY AE0 7 VEHICLE .�.2ADING (I.E. UNDER DRIVENAYS, ETC.) _ \ SHALL BE+;DESIGNED TO MITHSTAND H-20 LOADING. DESIGN PEAC. RATE MINUTES/INm 3� 4. ALL SE''F: PIPE SHALL BE SCHEDULE 40 OR 440 GALLONS PER DAY rl APPROVS0 100AL. r BEFORE S);,APTING CONSTRUCTION CALL DIGS SIIE OF LEACHING FACILITY PAl7VIDED.' �Ov�Z- 50b CiAcLLO>J CF}�' -�»`i Co"CR� \ 1-800-3r c -4944 FOR L OCATION OF. SAFE i \ \ 3 8 UNDEAGAOG'•✓D UTILITIES. g S DEti'ALL © S.F. X 8. DATUM IS •��: ,ti �.n 3 .. ,�i0.l7ETEA�►i fn r 1.oN HAS BAN , A�j� n., T� .,. 3:. :._., �`I ;!� r: TJTAL S S..r. �- SPA a \ - MITH DEFO RESTRICTIONS OR ZONING REGULATIONS. IT SHALL 7EWIN THE OMNER'S RESPONS. 6Il.ITY TO � .,...; !,. .F9 . . , � � `� •. VARIANCESi ETC. FOR THIS FOJECT. OB AIN AL. R,_OUTAED PERMITS, SPECIAL PERMITS, 6 8. IT SHALL A ? �': THE OWNERS RESPONSIBIL I Y TO HAVE TA"' T ROPOSED DYELLING FOUNDATION DESIGNED T�' ACCOUNT FOR THE EXISTING GRADE 1 / t AND SOIL r�j i 9� TTONS AT THE LOCATION OF THE / / 1 50 PROPOSED c,L7 DIG. REVISIONS: �Z N0. DA TE REVISIO,V big l�lAjq � 50 5o 2 ' 62 � � � �� 7 �.� 7 o top T� C O N 5�F',t)l C.i 10 >� 6� T� e— .7 0 Asa qD o �► ~ �•�` LOWS LL.ILU 1 p 4 ?&PP oo M ✓ ` YJl3 ' EL 65,00 i OFMASS�o PLAN SHOWING THE DESIGN OF A PROPOSED 1 _ ✓ � G PAUL R. N�+ 1y G SUBSURFACE SEPTIC DISPOSAL SYSTEM 1 90 _ z RYLL - 6 No.32448 � LOT 3, SERVICE ROAD, BARNSTABLE, MA r F,0g0/ T� PFJL v v RCS / 5: ► ,�'l4 r; 2, z '' ��%P�1 SCALE 1 " = 30 ' FEBRUARY 20, 2001 4 ... ,_,.,•_-� �_ A+ CANAL LAND SURVEYING 306 OLD PL YMOUTH ROAD• SAGAMORE BEACH, MA agar = 3 — — — — 2l23. 0) ° ` 2-��,•-�� PROLIECT NUMBER Os 024 DA TE PRO 0 AL L=NGI EEf7 CI V DA TE PROFESSIONAL LAW SUR YO T'ow t� .134. 64 \�/aYti4Z