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HomeMy WebLinkAbout0081 KEVENEY LANE - Health LOCATION SEWAGE PERMIT NO. L VILLAGE I N S T A LLER'S NAME & ADDRESS tf Etalej�Lo 15r � - 8UILDER OR OWNER so- jiar DATE PERMIT ISSUED s DATE COMPLIANCE ISSUED �--- - ,J �� 'A o � �i ( � �� �_ ` � � ��— �, � � $ � O � 3 ` (� � �. ilk (� �� �. �a s a'_ a . = p .C. U` � -- _ .e` �, f� No. (%t/l/ 3Z Fee -7J_ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppYitation for Disposal 6pstem Construction i3ermit Application for a Permit to Construct( ) Repair(A Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 91 Ke j Ewc L-A• Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3 5S I O l t 6� 'J A K f�)Af�LA T3 v-b w N R d f e e ` P Installer's Name,Address,and Tel.No. $0$ - 11 ' a 6 ll Designer's Name,Address,and Tel.No. ROOv�T a �,w co. 3(p 3 14221 S, YA-f-IwTt� 0 2 Type of Building: 1 96: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder'( ) ' Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �. gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) r,,Sbk0 NEB D63 IN BoX w. l Ri a Aii6 (f ER- 6 c%w &&Abe Date last inspected: Agreement: The undersigned agrees to ensure the construction and mtenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environment od not to place the system in operation until a Certificate of Compliance has been issued by this Board of Signe d -b Date ��/ 9 Z Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ?,�M 3 — Date Issued V � r: � r - —_. - .,tip;' - , . ' _ _ 'q' ... — A t.h - ,. - ,•a '.T ^` • Y.���} �'"'. '' yif 6 t��t� '. ij•r',� mac' ' � No. �{� �4 Fee Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -`TOWN OF BARNSTABLE, MASSACHUSETTS : a ZippliLatIon for Disposal 6pstrm Construction Permit � Application for a Permit to Construct( ) Repair(A Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components . ' Location Address or Lot No. S t Kt V l.4 Ar Ownerr'ss jName,Address,and Tel.No. Assessor's Map/Parcel S O 12 � 'J R 1J 13��v w ~ ' � Ptr. ova ' (�W,1.�-�g. .� Installer's Name,Address,and Tel.No. 50$ -411 ' 9 911 Designer's'Name,Address,and Tel.No. r,+t!U•.LT Q wa (o- Type of Building: Dwelling No.of Bedrooms /V/�" Lot Size sq.ft. Garbage Grinder) Other Type of Building No.of Persons Showers O Cafeteria( ) Other Fixtures Design Flow(min.required) /�/��" gpd Design flow provided A11A gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 4.. z Nature of Repairs or Alterations(Answer when applicable) a 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<Cod a d not to place the system in operation until a Certificate of Compliance has been issued by this Board ealtlth. / f Signed ! 0 it, I Date Application Approved by _,..--�-"'""" � Date Application Disapproved by Date for the following reasons Permit No. 2— Date Issued � A i THE COMMONWEALTH OF MASSACHUSETTS _ ✓���r BARNSTABLE, MASSACHUSETTS - �� Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(: L-)__ Upgraded( ) Abandoned( )by ! � at + -c` has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �j Y3--dated Installer ,� ham'•/. Designer , y, � ' #bedrooms l�/11 A-- Approved design flow N//Q gpd The issuance of this permit shall not be construed as a guarantee that the system will function as/designed. � Date Z I / ( Inspector No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS t U Disposal 6pstr tt Construction Permit Permission is hereby granted to Construct( ) Repair( �' Upgrade( ) Abandon( ) System located at _A,,A and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed withinthree years of the date of this permit. 1 /� Date f �i� �.f Approved by ��' J. rroo , No..o..1— 1-.. Fx '::�d................ � . . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ----0co` -A)................OF..: 7C ................................. Appilration for Uhipilmd Workii Cfonitrurtion Frrutit Application is hereby made for a Permit to Construct ( ,-Y"or Repair ( ) an Individual Sewage Disposal Systemat: ...... ........_�...----•--- .................•-----•.........._----•- •-......... ... L......K � 1- - _ .. Location- ddress �c Lot No. ... .---...._ .....�.... .. ••--------�1!.—�t�i C, ........................ ,... w ez 1 _�Address................................. ---- a .....•••-•--•-•-••...•------•-•--•--...1 _.._ ........•-•------••-•-••--•---•..........._ ...•. Installer Address Type of Building -i Size Lot-__�__.�1�_ 0_Sq. feet Dwelling—No. of Bedrooms______________��..............Expansion Attic ( ) Garbage Grinder (44 ) '4 Other—Type of Building ............................ No. of persons............_............... Showers — Cafeteria dOther fixtures. ---------............................................................................................................................................. W Design Flow........•`~___-�..........................gallons per person per,day. Total ai17 flow.......... ......................gallons. Septic04 q p y gallons Length_____9________ Width_______________ Diameter_______________. Depth___5_____.-- D Disposal Trench Liquid ca aclt ;��'��idth_.__;r_�__.____.__ Total,Length.................... Total leaching area....................sq. ft. Seepage Pit No... �_____ Diameter....eEn 5..... Depth below inlet___:.(`........ Total leaching area__ZL7.___sq. ft. Z Other Distribution box (�� Dosing tank (w)� ! `-' Percolation Test Result Performed by- . �_.!' 1�__.____................�-rs._.. Date__.___ _�t � a 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........................ Pd -------------•-------•------.......................................................... O Description of Soil h••-•- _ �C 1 �1.4� /E '�'� C' .� r V ------------=5-!• -1f. _.._.__G.l.,,Zk. ........................................................................................ W ••••-•-----•---------------------•-•••--•••••-•••••----•-•---...•---•---•---------------.-.-------------•-----------------•----.._._.___------.._..------------------------•--••-•----••-•--•--••--•- VNature 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 TI'111- 5 of the State Sanitary Code— The undersigned further agrees not to place the system.in t ', operation until a Certificate of Compliance has been issued by the board of health. Sig ............ Z •D Application Approved BYIrthe ----- ------ -----------•---------------------------•---•--•-•---••-•--•----•--------• ----- - ---•---- .....-j------•--- Date Application Disapproved f following reasons-------------------•----------------------------------------------•---- -------------------••---e-------------- .................................•----------------------------------•------------------.....---._.......-•-••-••••••---•--•••-•--••-•-•••••••---•-•••-•-•••--•••---•-•-•-•-----••-•-••••••-••••••-•----- Date PermitNo...................................--................... Issued....................................................... Date NoJ-147-.. FEB.... .„............... THE COMMONWEALTH OF MASSACHUSETTS B H OAR® OF HEALTH TH L. .w..A�............. ...OF......r��.A.# .�_57. ..' A(-..0................. Appliratiun for Disposal Morks Tonstrurtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: _._, ................--.........----...... .. ................._......---..------..• ................................. .... 3.............................................. Location-Address or Lot No. !�u ------------------------------------------------- 1 EY .----... -`q-^.. -•-•---•--..............--- Owner Address ----•-•-••----•-------•----------------------- ---••--�vl aril U! S,S--------------- Installer Address 8 1 d Type of Building r-- Size Lot___________ ___J____._.___Sq. feet Dwelling—No. of Bedrooms....... --wd•-.•------::;;:......Expansion Attic ( ) Garbage Grinder ( ) pa,, Other—Type of Building ............................ No: of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .....................:........... . d --------------------------- ----------------------------------------------------------------------- W Design Flow................� ......_..........gallons per person per day. Total daily flow....... V.._....................gallons. WSeptic Tank—Liquid capacity/QQ_Q.gallons Length-----9....... Width....4........ Diameter________________ Depth....3 ...... x Disposal Trench—No. .................... Width.......�...._.__.__ Total Length.............I....... Total leaching area....................sq. ft. Seepage Pit No....aA.,-C... Diameter... ...... Depth below inlet....6._-......... Total leaching area.,9_1..7....sq. ft. Z Other Distribution box (L.-T Dosing tank ( ) Percolation Test Results Performed b IN.,..... ....... Date....... ..� ....-�.�,...... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to groun wate .._.>...1.5..._.. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....-.................. a ........................................... ------- O Description of Soil---4L.E-40.1 Pyle �r?/�l!1!'t........Jx4r .1.. ��`�' S 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 TITiZ 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 of health. ign --------------------•--......•-------•-------•-----•----•-......._......--------•---. Application Approved BYIte - --------------•-•-•-••--•--------•----•---•--.....................•---- --•-- 1' U. Date Application Disapproved fowing reasons:-------•------------------------------------•----------•-----------------------•----------..Da.---------....._ .......................................--------••-------------•---•..........----------••------........................................ ------------..................---•--........ -----....----- Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...........................................I......................................... Trrtifiratr of Toutpliatur, ,T TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ................ ..•-.. .:_...._•••-•------• r:. by--- ------ *' Installer at G - has been installed in accordance wit tl provisions of T r The State Sanitary -a ibed in the application for Disposal Works Co ruction Permit No......................................... d-ated_....-.......................................... THE ISS L �FCTION®F THeS CERTIFICATE SHALL N®T BE CONSTRUE® AS A.GUARANTEE THAT THE SYSTEM 19�1 SATISFACTORY. DATE l •-Zl .......... Inspector ---- . ------. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF..................................................................................... . No......................... FEE........................ iullu ku Tunotnu�iun rrmit a Permission Ire Permission granted-- .........••--.......---•-- ---------------------------------------------------------•-•------...................-•-•- to Construct nor. epair ( ) ldu evt a` > posal System at No ....... ................•----•............ ... --•-•••. .._..... --- .-- -•------- .................. Street ` i. as shown on the., pplication for Di os h s Construction Permit No......�.�r'" ated_. _.._ .....:......................... oard of Health DATE--------................................................. ................ FORM 125 HOBBS & WARREN. INC., PUBLISHERS a>� fli'r'1,.i(.`\ L I 1'l)i: � au' .i. 1Uil L' i Ali) 01. .,; LOCATION. y /U _ No. 112'- Y2 4 VILLAGE (' /& . -A-�. � DATE G APPLICANT,,, ©,z o y�> ,J FEE ADDRESS 51� woo��AU9 A�>` TELEPHONE NO. Zo1 2 (Non-refundable) �J - 3.5 3 ENGINEER '�e�w ,J �,� ;a�. �w� C,t ►.jr�sR�XTELEPHONE NO. ?v,-_Z-4 54 \ DATE SCHEDULED 61 Aallg:2 (Applicant' s signature) • • • • • • • o 0 0 0 0 0 • o • o 0 0 0 0 • e e • • • • o 0 0 • o • • • •.• • • • o • • • • • • • o • • • . o • • • • • • • • e • o • • • • • o • • o • • • • • SOIL LOG_ SUB-DIVISION NAME 135 , _ DATE \ \9 TIME EXPANSION AREA: YES NO ENGINEER `_ TOWN WATER PRIVATE WELL o AJ �,r Fo/2 BOARD OF HEALTH ja�iL1 5 EXCAVATOR SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test(-holes ) NOTES : o 7Z37, "0Z �,� �5 - 4'4 _, 30 T�sA- ��\e41 b 30. b t e ll foe 9�s SX f Q-A s-���s ccay PERCOLATION RATE: I '�/ h,i; L Z",��r,/i; (.t ll45t�LIe-LZ TEST HOLE NO: Z ELEVATION: TEST HOLE NO: ELEVATION:_ 'i 21 2 3 S t�� 3 i 5 5 6 6 g 8 Su cv� 10 10 11 Gee�,v 11 i 12 ti(F_J 12 13 13 t� iur, 14 1Ly2 14 15 �D 15 'i 16 Clv C auov r E 2 b � 16 � ' SUITABLE FOR SUB-SURFACE SEWAGE : LEACHING FIELDLEACHING .PITS _ LEACHING TRENCHES tUNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS : NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED. ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . E . AND RETURNED TO BOARD OF HEALTH ' COPY: RETAINED BY APPLICANT SECTION - SEWAGE - `h TOP OF FDN �/ -.SEPTIC TANK - - "D" BOX - - LEACH `f♦'' •'-�' ���1 '"'� I (MSL)# — "2"OF'%8TO 1h" 1 r � WASHED STONE ° - • M 1 r.l. LCVGF P_ t 40 , sEtTIC TAtiAK OUT- IN- OUT IN , .� ` 00, �-� � tt 1 Cj C Q G 0 W .1 SEPTIC ELEV. TANK ELEV. ELEV. 30 ELE ; rr C. 3e.\1 -T. ELEV. ELEV. ML�u C- f t..,X.._ t_1 1,14SUk i A Ll LE G AI _ � O\'Z �i `�l°`�rA-t il._1.:._ "�\ 16 e o L F=ALH W6 Ai_ -ri �o- oF�,^ 1v:" WASHEDSTONE Val1'1tr I! L r=AN E.G`AK5E ASlD. TEST HOLE LOG100 1 ? TEST BY Z. RE 12•.C-r(F•FORo 60•t{• I 1 (o-Z/ g� WITNESS IT t- TEST DATE DESIGN BEDROOM HOUSE T.H. 1 T.H. ELEV 34.1f ELEV. 33•4 -O�w` Sc>< `x�+� PERC RATE MIN/IN. NOS DISP ER SE?J�lE 3�4 3►.9 - 1 Slt_TY SAt.i� FLOW RATE ZZO (GAL./DAY ) SEPTIC TANK ZZO (I,S) k ,6(D a TEs T REO'D SEPTIC TANK SIZE �- _ o s r �4 LEACH FACILITY ' J Y �. °a `.�ToN XE13 ,= SIDE WALL 7T d.5 Ca (2,S 1 = CCCara G/D. + _ M I,G t O G -2 L. BOTTOM , G l._.C A-�,.1 TOTAL R^t`',lb '-f (g', USE: Qtidc LEACHING 19. ;. WATER ENCOUNTERED 17O op NOTES: (UNLESS OTHERWISE NOTED) ,>~en .R,� - ~ 9, 1. DATUM (MSL)+TAKEN FRO!? _!-t_t"' ritl �S QUADRANGLE MAP 2.MUNICIPAL WATER._________ / __.___--__AVAILABLE S•. '" ---•-------------- 3. PIPE PITCH: 1/4"PER FOOT + t 4. DESIGN LOADING FOR ALL PRE-CAST UNITS: AASHO- �- (� -44 ((� .IAPJ` +;fi �' ���' 5.MIN. GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. —Q—DISTANCE AS CERTIFIED �(�. 3d•A r 6. PIPE JOINTS SHALL BE MADE WATER TIGHT 0� � \ 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. A? 9 I HEREBY CERTIFY THAT THE BUILDING SITE f STATE ENVIRONMENTAL CODE TITLE 5 rh <�i.4 PLAN SHOWN ON THIS PLAN IS LOCATED ON THE ` 1 -2 �� ���� GROUND AS SHOWN HEREON&THAT IT LOCUS: `-mot! J AL � ' CONFORM TO THE ZONING BY LAWS OF THE c♦ i ------ ------- TOWN OF -_- _. � `- � REG.PROFESSIONAL ENGINEER ' WHEN CONSTRUCTED. DATE REF: , ..� 135 -3 t }WOW11 Cilpe englneerin PREPARED FOR: CIVIL ENGINEERS 'I-, 3&aq?D.1-Pp �Z /A E15T F I tj BOARD OF HEALTH LAND SURVEYORS REG.LAND SURVEYOR It 1,j01 I�44Z x 7 CCONTOURS (EXISTING) __'.-_"_"_.•• SCALE � F 1V ��T-�+'�.• r (PROPOSED)--0— APPROVED DATE MA Yarmouth&Orleans,MA DATED„—�1��