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Home My WebLink About0059 COLONIAL WAY - Health l (;ULONIA�V�AY;�3A1Z1�S'1'A13L1: A=237.053 r e l , o ° o TOWN OF BARNSTABLE G LOCATION �� sG SEWAGE # VEELAGE ASSESSOR'S & LOT Z 3 7—OS-3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY f LEACHING FACILITY: (type) (size) NO.OF BEDROOMS R-OR OWNER PERMITDATE: ?--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) 8_ �� Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 Feet le==e Furnished byi ` " , � 6 aZQ No. 7 �d ! FEE " COMMONWEX611 ®F MASSAC14USETTS 1 $ Board of Health, �� MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for.a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) - ❑Complete System ❑Individual Components Location � OZM� �rhS ,j� Owner's Name Map/Parcel# 427 Address aAL,,�Zvftv Lot# - Telephone# Installer's Name Designer's Name Address _ Address Telephone# Telephone# Type of Building /49 Lot Size sq.ft. Dwelling-No.of Bedrooms 13 Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) .3D gpd Calculated design flow Design flow provided gPd Plan: Date Number of sheets Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TPTL.E 5 and further afire to not to place a system' operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date I ' - 4 �.,wt•,.�.rl�t.y: �✓a--- ,-..,�.r.,ty- .v+�•'y-1'�.-..iiar._weK,c 1;"a J .:3:_r. iw. •.r..+}�hA"`wa✓..y'�t7.MtiJ+^`e•rn�v�"1T....,.'V`.w..Fwvl`�%it.•'y��r_��- No. / d� FEE " Common1 y t�Il.'0�v M S^ CuV^ ETTS r {A � Board of Health, , MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair( ) Upgrade( Abandon( - ❑Complete System ❑Individual Components Location Gt►'rnS �,j Owner's Name Map/Parcel# -Z J 7 Address ad Lot# Telephone# Installer's Name Designer's Name Address 5 /� / _ Address Telephone# 1) - O Telephone# Type of Building _,C _ Lot Size sq.ft. Dwelling-No.of Bedrooms .3 Garbage grinder ( ) 0 er-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures F A Design Flow (min.required) -33D gpd Calculated design flow Design flow provided gpd Plan: Date Number of sheets Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS ___ . The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agreeg to not to place e�system' operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date 17 ay✓ r No FEE COMMO V'V'LALT14 OF MASSAL_.HUSETTS y" Board of Health, er'_` kid" t MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) Acomplete System The undersigned //hereby certifyye that the Sewage Disposal System; Constructed O,Repaired ( ),Upgraded ( ),Abandoned ( ) by: at ✓�/ CO 1CM c.� Lt/4"7 �3C�.h f IbGG. 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. dated — -2oo. Approved Design Flow 3 (gpd) Installer q,{ ' Designer: Inspector: ^ Date: 7 / d The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. FEE .-70 r — COMMONWEALTH LTH OF 1'�/llASSA,CHl_ SETTS Board of Health, UGC-�'r9J �/J� MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) UpgradeX) Abandon( ) an individual sewage disposal system at _,579 &A,-► k as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this ermtt. All local conditions must be met. form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date /�/_/4 Board of Health +�C/� i 10/9/97 i I NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. i CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) hereby certify that the application for disposal works construction permit signed by me dated 7 — f , concerning the property located at q meets all of the following criteria: /There are no wetlands located within 100 feet of the proposed leaching facility ( ere are no private wells within 150 feet of the proposed septic system 7re is no increase in flow and/or change in use proposed There are no variances requested or needed. Ifthe proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: _ T S� A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) . B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED: DATE: 7 — q LICEN ED EPT SYSTEM INSTALLER THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert TOWN OF BARNSTABLE LOCATION �9 - ,Q �� i� SEWAGE # C� VILLAGE- — ASSESSOR'S MAP & LOT Z 3 7—OS-2 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY i o a` LEACHING FACILITY: (type) (size) 5 �3C7 NO.OF BEDROOMS -W4EL -0R OWNER PERMITDATE: '1� / !�( COMPLIANCE DATE: 7 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 fee f 1 acility / /tIVt Feet Furnished by C .. U. - ?O i LOCATION SEWAGE PERMIT NO. VItLAGE INSTA/lILLER'S NAME / & ADDRESS 611 Ile- B U IL DE R ' OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED j/- 2-7 - � f' t .r `�( �\ i _ �'� � -� �: ._ -�.; No"...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -----....OF...........iC:�? 'tt� -------------- �s Appliratinn for 1is�rusa1 ut arks Tonstrnrtinn rril - Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...Cot, o n�'E,9 t, �✓4r..,.... �9 RN _574)3L r_ ji�D ....--•-- Lo ation-Address or Lot No. r ..1 t. :...... a^�'4`�� ............................I 2 .... ......V 5 ---jD� M�S...,..:....fl�4 S- ' ... ... NrT ...................................... .-•-•••--•--•......•........................ Installer17 Address 30 �O� Q Type of Buildin Size Lot----- P1.................Sq. Zed U Dwelling-No. of Bedrooms____..................................Expansion Attic ( ) Garbage Grinder (N8) '� Other—T e of Building g � ..._..... No. of persons_______ ________________ Showers (,2) — Cafeteria ( ) a' Other fixtures ________________ ___________ _ Q . . alllo s - Len h................erdaWidth-- d ily flow alls. W Design Flow._ ...---- g P P P day—Total daily flow............................................]dons. WSeptic Tank Liquid capacity.r?g gt ,.......__ Diameter________________ Depth................ gallons per person per a ota x Disposal Trench—No.r -.-----•--------_- Width...............:.. Total Length___...5.........._.. Total leaching area....................sq. ft. Seepage Pit.No._6!w _.__.. Diameter... --------- Depth below inlet __�6 ........ Total leaching area.:�-0�...sq. ft. Z Other Distribution box (V/ Dosing�a ( ) �� C �' - 7 ~' Percolation Test Results Performed by...__. _ :_ ..)_ a n..................................... Date...f+,. .:7.7-.t-......... a a Test Pit No. 1..4.6._._minutes per inch Depth of Test Pit------1.-3....... Depth to ground water________________________ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a r .......................... ; _ ..... . ..........•... O Description of Soil---••-. .2.�. . � ...... 1 - ,l iP -2arJf c tm�� x U W --------------------------------------••-------•-....--•------------•-----•------------------------=---------------------------...-------------------------•----------------------------------•---••••- UNature of Repairs or Alterations—.Atlswer when applicable_________________________________________________________•____-.--__-____-.-___---------------. P Agreement: The undersigned agrees to installrthe aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI 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 y the board o health. igd --•••...........4.....S ---- -----•------------ Date Application Approved By........ 1:� l yel -.2.�_- _u_-_.. -....... li Date Application Disapproved for the following reasons------------------•-------•-••--•-------•----------------------------------------•---•••-•-••-•-•---------....... f ate C PermitNo......................................................... Issued.....-------------v Hale --•--•----=- --------- J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `r.......0F........... Appltra#ion for 11ispati at Works Tonstrur#ion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 04'4 ..._.....__....... .- - - --------�-•---..... ••-•----• ..................... Lo anon-Addre r� .�*� / or Lot No� jpI O ne 4 y., dd ess Installer Address �QD q Type of Buildin Size Lot.... ..... .........S feet f.., Dwelling No. of.Bedrooms ____......................Expansion�Attic ( ) Garbage Grinder (ldt� Other—Type of Building ........ No. of persons_ ________________________ Showers Cafeteria ( ) dQ f Other fixtures ----- ----- " lions per person per day. Total daily flow............: --•••• ......................................... Design Flow__________ ._ gallons P P P y y W -----------------------•----- Ions. WSeptic Tank I Liquid capacity. !'_gallons Length................ Width_............... Diameter____.'.__-____:__ Depth................ x Disposal Trench No .................... Width _.__...__._....... Total Length.._._..._ .... Total leaching area....................sq. ft. Seepage Pit No Depth below inlet __� g area...' ft. �� ___..: Diameter :____ ._. Total leaching area._. Z Other Distribution box ( Dosing a '-4 Percolation Test Results Performed b .► .s )_J ae► ..................................... Date:._ -R_ _ a y . ,--a Test Pit No. I.. .. .._.minutes per inch Depth of Test Pit______ .;r.__.:_ Depth to ground water.-.......... ......,__. f� - fsf Test Pit No. 2...........;:-._minutes per inch),Depth of Test Pit.................... Depth to ground water........................ cs -- .... .... .. D Description of Soil 41(_ ss --,.•-•1 `•- U ._....•.------•---•-• ------------------- ............ --.... ........-•-••--•----------. .•. ...-- .----.----- W . 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 TITIL 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 board health . Signed.. ----- ------ -- ................................ Date Application Approved By------. w........................... :* .e2_-.. '!...... � w/ Date Application Disapproved for the following reasons-------------"----•-----•---•----------------------------------•---•...------.=--•---•-•-•-•--••------•----•-- ....................•---------•-••----------•---------•-----..._..--•••----•------•-•---•------•---•-••--------•----•----•-•-•---•••---............................................................... Date Permit No.......................... :. Issued___.._.._...._.._._..__._...___._: --•-•------•-----... -----------•- ----------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i"' 4 (9rdifiratr of Tontplianrr T1ftS IS TO CERTIA Th e Individual Sewage Disposal System constructed ( or Repaired ( ) by... at .� st has been installed in accordance with the provisions of T j of The State anitary Code as described in the application for Disposal Works Construction Permit No .._ 7_dated a 'a d 4, THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM-WILL FUNCTION SA SFACTORY. 7 �� DATE........... ---.::.�._7...•'-•-•�.. .�.---••---•-------- Inspector ---•.................................... ......_....-•------------•-•--- 1 r;,• THE COMMONWEALTH OF•MASSACHUSETTS x BOARD F HEALTH f i .. ri .......of.::. ...; :. 1. ................ . N ................ FEE.., .. ....... Mops Works on union pamit Permission is hereby granted•---- � , d: ! --r.. to Constru . (. . epa�( ) a I.Td dual r e rs Osal ys r t 01 ••-• I Street as shown on the application for Disposal Works Construction Perms o. Bated.....- .2 _..`rt ` .�._.... _. . <., ................... "hoard of Healt DATE--- l FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS F711 o F 20 ico4o, /p<T ^ 4" SCI-1 40 CLEAN SAND I Ec = io/• a CONCRETE PVC PIPE CONCRETE COVERS COVER MIN. PITCH- yB"PER FT. 27;M/n/ 12"1WAX. PITCH E FLOW ? L/NE 2F LAYER 4" T CA S %RN - 0 O 1 o Y /;T o o W ° o Y8 f2,� .• PIPE- /VJ/Al. DIST. o ) H/,4SHED STONE P/TCN "P,ER FT BOX o 3 f4„ ... ° V Q WASHED STONE a /000 GAL. o ° �0 P �' PRECAST LEACHING SEPTIC ° ° W ° ° P1T OR EEQUIV, 0 TANK j = SFr INVERT ELEVATIONS /SFr ��A / . `'� M ice/ 1,AIVERT AT BUILDING 98, OFT. " 1NLET SEPTIC TANK 97. 7 FT. GROUND WATER TABLE OUTLET SEPTIC TANK (:-�P7. FT. SECTION OF INLET DISTRIBUTION ,BOX -26 .7 FT. SEWAGE DISPOSAL SYSTEM OUTLET DISTRIBUTION BOX 6- FT. NOT TO SCALE INL ET LEACHING P/T �q.-;o FT. SOIL TEST DESIGN CALCULATIONS DATE OF SOIL TEST 6 z ,2 ' 3 WITNESSED BY �.D � � P /�� . P`tH OF M NUMBER OF BEDROOMS PERCOLATION RATE_— M/N. /NCH. As 9�, `1N OF Mgs GARBAGE DISPOSAL UNT/ . . . . . . . . . . . . . . . . . . Nel SI DEWALL AREA � GAL.IS.F �� RICHARD �''�; � 7-0 TAL E S T/MA T ED FLOW. . . . . . . . . . . .. . . . . . . .. ._ .3 3 o GALI DA, BOTTOM AR FA • 7/ GAL f S.F. ' O'HEAR jgMES JAMESN" p &{CHARD 'o,� �-- GAL/BR/DAY X • 3 R IO_ $ HEAR y . y I ELEVAT/ON ,pFNo. 694 o 1 zA N JI PEQUIRED SEPTIC TANK CAPACITY. .. .... . 4.9 s GA4. T0Psoic! sli L. l3soic T R ' ACTUA SIZE' O NK SU F SEPTIC TA _ _ Zy • T TO. BE /A/STAL LED. . . . . . . . . . . . . . /U 0 0 GAL.' L EA C1411VG P%T(S) I- fD�T DIAME TER ��'�� T d' '9. ! o c oN Ac f.:/�9 y REQU/RFD LEACHING AREA . . . . . . . . . . . . . . . .. . . . Z�3,� S.F• � � � i FT. EFFECTIVE DEPTH Ti2,gc�c �rlr�isT.9>r3L.4 AMASS. ACTUAL LEAC:-1//v0 AREA Z 6 7• a S.F. . . . . . . . . . . .. ... . Wo FT, EFl•=EC T/VE DEPTH RICNARD. J. O�NEARN,R.L.S.,R.S. f T. RESERVE LE•�4Cf-,Il/VG A/4EA z�0 '7 S.F. WEST 9DENNISJ MAIN S MASS. JO.6 No•0 6 S P-V, AT /Z C'OUNTF2ED DATE: ,j1 SHEET 2 OF Z t 1 LOT 9 O' 10T Cos �1 / p F,)T i p r 63 ' t I Q m LOT 7 ALL WORKM/aNSH I h AND MA TER//PL S \ � S/-/.9LL ,BE /A/ _,4CCORD.4NCE 1,V/7-/-/--- � �\ PR0V/S/OHS OF D. E. Q. E. TITLE S \ Ah/0 7-1-1,E _701,/N OF _ f3ARNsT,9l3L E f?ULES ,q/VD REGULAR TONS FOR - - SUQSURF.9CE D/SpOS/aL OF - A OF lrks�s - P�ZH 0Ff�qS a� _ RICHARD JA,MES RICHARD V, 11 o O'HEARN c JAMES 3 K,. 27971 H 1 LE. GE ND O'HEARN No. 694 FCISTti-� EXISTING SPOT ELEVATIOAIS 0,0 �eGisi �' yG EXISTING CONTOUR - - - O- - - SU FINI SI,'ED SPOT ELEVATIONS O SA. j \\ F•/NISHED CONTOUR O APP.f?O!/F_D = BOARD OF HEALTH CERTIFIED PLOT PLAN /N f�3,gRIv sr��F , MASS S. DATE AGENT (ID RTIFY THAT THE PROP05 ED RICHARD J. O't• ,4R/V,R.L.S., R. S. NG SI-lOWN ON Tq15 PLAN /9/ /CIA/N ST (RTE. 28� CONFORMS TO TPE ZONING - LAWS WEST DENNIS, MASS . n/STAi3Gti DATE' O 2 SCALE= / 40 vvc /JO. 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