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HomeMy WebLinkAbout0091 ALLYN LANE - Health 51 ALLYN LANE A = 258 -074 Barnstable -4 -- -�- No... /. G10 3 .,__. _. Fps..J. ......._ THE COMMONWEALTH!OF'MASSACHUSETTS g� BOARD OF HEALTH 0` --.._................................OF...... .... ApphrFation for Uaspniai I rk Tunilrnrtann a mit ) or Re-pair anIndividual Sew age DisposalApplication is hereby made for a Permit to Construct y y . / Location-Add s or Lot No. .. Owper Address Installer Address +� Type of Building �( Size Lot_...-...._�OD©-------Sq. feet Dwelling—No. of Bedrooms..............{.............................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. ofpersons—......................... Showers — Cafeteria Q' Other fixtures ............................................. Design Flow............................................gallons per person per day. Total daily flow......... _.0._........._............gallons. WSeptic Tank—Liquid capacityl...aSOgallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... WiJE.V ____....._._........ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......----------- Diameter... -___- Depth below inlet....4._.......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosin� tank ) aPercolation Test Results Performed by.7S��S�• �ir�.aai�..................................... Date.411 /X71............. Test Pit No. 1.....�....minutes per inch Depth of Test Pit....�.a_...__... Depth to ground water........................ Gx Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... ------------------- - l�_a.%........ �1 -- 0 Descry tion of Soil....--.6.L4_�._... U �..........i----------- --------- ------------------------- -------•-----------------------------------------•--------------------•------------------------------------.....•------------ W 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 TIT:LL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ssued by the oard of health. Signed - �l1!t •-- .............'-. �_ D e Application Approved By... .....e---- -------------------------------- -----.j� . �l Date Application Disapproved for the following reasons:.............................................................................................................. --------------------•------•-•----•------....._....----------.....---•-------------------•-•--------•-•---•-----•----•---------•-•--•--•---•------•------••••---•--------•--••••------•••------...._.._. Date PermitNo......................................................... Issued....................................................... it No... s !4 FEs.. ......... THE COMMONWEALTH-OF'MASSACHUSETTS__. BOARD OF HEALTH ••.....................................--.OF.......................................................................................... Appfiraatiun for Disposal Mirkp Tonstrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Syst at . .. VN_L o.: . . 1.13 ............................ ....... ... - - ....... .... ---........ Location Add s or Lot o Ow er Address Installer Address + Type of Building Size Lot /Q6B.......Sq. feet U Dwelling—No. of Bedrooms.___.......____________________________Expansion Attic ( ) Garbage, Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria GI Other fixtures --------•------------------------•-•-•-•--_.._. W Design Flow............................................gallons per person per day. Total daily flow......... 04 Septic..Tank—Liquid capacity P?gallons Length________________ Width................ Diameter................ Depth................ W Disposal_Trench No. Width___�I __._._.___ Total Length __ ... _..____ Total leaching area..................sq. ft. x Seepage Pit No _. . Diameter__ ..t.�S _._ Depth below inlet .. .............. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosi tank �+ ) aPercolation Test Results ` Performed by �` "1 allt_2_Qt��i..............! ..__________________ Date.��m/ _____________ Test Pit No. 1....?___....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........................ RS •---------xW t_ i a,, 7 I 1•.............•-- Description of Soil_.. .it► ' ..........................{ --------•-•----------••------- --• ---- -------------•------------- --------------------------- ............................................................. .........-............................................................................................................................................................................................. UNature of Repairs or Alterations—Answer when applicable............................................................................................... Y., v Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1_ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the oard of health Signed � . - ..... *� 10 D e Application Approved By.._ e_•1> - ................................... --- / .. . - . Application Disapproved for the following reasons-----------------------------•-------•-------------------------•-------------•--•-----------••-•--•---•--•------ ...._._._..••-•--•------•-•••-••••-----•------•--•----•------------------------•-----------._..__......--•••--•••-------•--•--•-...............................-....................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..... �.....•.. ............OF......... r'►t.. ......:. C-5rrtif irate of ToutpliFaurr THIS IS. TO CERTIFY, That the Individual Sewage Disposal System constructed (II-ror Repaired ( ) by f Installer .. ( - 4s ,;-�- at ----=--- ------- �` a�-....... �S+-a-. lA l[!`"�, r Gl Y 1�1, -.1 -if� `s.. has been installed in accordance with tl e provisions of TIT-1-, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No. _A,-)__5.W ............ dated.--•-------------------------------------------• THE ISSUANC OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIK FUN CTION SATISFACTORY. DATE.... ---•-- Inspect THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Q ............OF...- �� W �xw�; ..................................... N '! FEE.17 ............ Disposal Works Tumtrttrtiun rrrmit Permissionis hereby granted.............................................................................................................................................. to Construct r Repair ( ) an Individual Sewage D sposal System ' Street PP P G-"....... _.. . as shown on the application for Disposal Works Construction Permit No._____ ��.. .___ Dated_____- f �,- -....,.. - -- --•••••••---••-••----••-••-•- r oar DATE.....••-•• `--•------•---------------------------------•----•-•-------• Bd of t FORM 1255 HOBBS & WARREN, INC., PUBLISHERS • I SECTION SEWAGE - SEPjtC TANK - "D" BOX - - LEACH P/ r• �� (MSL)* -2-OF I1sT0'/z„ ✓ > �� j a� ' tt WASHED STONE OUTIN- IN O, IN- --- - f y � 5t � �� SEPTIC d t w? ! _ � ' Pr• .D�T p 3Z '�. '"ti. \ TANK 1.44tbv Y.�•In //� 1�h� `` li t-' '` �. ELEV: ELEV. ELEV. ELEV. / Cl?, I f�74 ELEV. ELEV, J` r - j FAA f{Ctt• r SIT' F�z r..+"r-.C>G't✓1 _I WASHED STONE TEST MOLE LOG TEST BY�WT.S'�1�►sk.�. �"- `;�• t�..x?. cEta.�`i4 ±� f _ cY�� .}L!.`.) "" ^- ---- I t i WITNESS TEST DATE L`1 ' ) + '_` 11- 'DESIGN �—BEDROOM HOUSE T.H. 1 ) T.H. # 2 }�.Gz ELEV. wry` k� ELEV. NO _ ... __ ) J� I DISPOSER DISPOSER �` PERC RATE _ _ MIN IN _ _ I__ -`- � `� -- _'" '^.- FLOW RATE'/ (oAt DfA i _*��d SEPTIC TANK � ► S - - - T -• '"-`• ',• J. - - - ' REO'D SEPTIC TANK Sl.f_Er© I -- — c �.� �a . "L"1�tl�tw5, R� 3 ,•C4 LEACH FACILITY F'1 i tvf SIDE WALL / �7 Y (1.�,�►} _ ` r G/D. BOTTOMC?. 4 G/D. � .t pl.r.> I�� TOTAL G I USE - _ Tt/C� . LEA(:HENG .?!�[7 WATER ENCOUNTERED •— - I - ei2"+a �: , sJl A{ 1'"C� (,/f.� �� �!'7•QQ •'J ti ` `w✓ 4 1" �`.'s.. •�5" •-.wj ti„�YJ� '/��r �`.. '�' ` NOTES: (UNLESS OTHERWISE NOTED) �:rlG , ,r/� 1. DATUM(MSL)L TAKEN F'R<<M f S��Nr//s _.....-,_.__QUADRANGLE MAP ✓Y"V1,,1er Zoj-..e 6sxA• � r(J v• ~ 2.MUNICIPAL WATER _3. PIPE PITCH: '/."PER FOOT J /tJ r a' `+',d� •°� r 4.DESIGN LOADING FOR ALL PRE-CAST UNITS: AASHO -_._ 1� r ._ 44 �g4 f ---�----DISTANCE AS�CERTIFIED `" ,y �I( 4fi�!��o 5. MIN,GROUND COVER OVER ALL SEWAGE FACILITIES. (1) Ffi. f ` ,fit } � . 6.PIPE JOINTS SHALL BE MADE WATER TIGHT {r- tl' iilaaaI - -' 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. -' U t I HEREBY CERTIFY THAT THE BUILDING SITE PLAN STATE ENV I RONMENTAL CODE TITLE 5, r�1t338 '{,� SHOWN ON THIS PLAN IS LOCATED ON THE ZL .o ! LOCUS:, GROUND AS SHOWN HEREON &THAT ITS_... I CONFORM TO THE ZONING BY LAWS OF THE .. �I t•.. TOWN OF . - F - -- - RE —­ WHENG. cENG INEE�2 CONSTRUCTED. DATE -___ I I REF' W06dn Cope .e/Ig'i/!@erIIIj PREPARED FOR: CIVIL ENGINEERS - LAND SURVEYORS BOARD OF HEALTH REG. LAND SURVEYOR I CONTOURS (F_XISTING)---------•--- SCALE,�.I Yarmouth&Orleans,MA ' 3� (PROPOSED) -0-0-0-0-- APPROVED r DATE — —_. MA DATE