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HomeMy WebLinkAbout4289 MAIN ST./RTE 6A(BARN.) - Health 4289 Main Street - Bamstable A= 350-005 0 � n o � i a + 1 o � ° u o �� TOWN OF BARNSTABLE LOCATION 4X 17 4;,1 �" (off} SEWAGE # 9j' • �-Yd VILLAGE C,vJ"v kVtS ASSESSOR'S MAP & LOT 3 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) P/ 7- (size) NO. OF BEDROOMS S PRIVATE WELL OR PUBLIC WATER PuvS"c (B:U:2ILDER>R OWNER DATE PERMIT ISSUED: _/ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r Pl� 2fs ` 7 � D , � f , � 1 Ill 0/� THE COMMONWEALTH OF MASSACHUSETTS U, /BOARD OF HEALTH J V.C^.. ^�..............OF........1 2!"J T C_ ....... Appliration for Dhgvoii al Vorkg TnniTan iun rruti# Application is hereby made for a Permit to Construct ( ) or Repair Individual Sewage Disposal System at L at, dress or Lot No. W ���!✓� caner ��✓ • e ��1�i' 1� ddr �... Installer Address dType of Building Size Lot.Z�1..................Sq. feet -40 U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (I aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures ------------------------------------�3 t�"l� W Design Flow----------------I ---- Dgallons per Son e>Ddfyy. Total da���ow----•-------..�� ©............ga�lons�• WSeptic Tank—Liquid capacity.�.._._._.gallons LengthI�....__---- Width.4..e..... Diameter................ Depth.G...f.._.. x Disposal Trench—No-••-------------•---- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......2--_--- iameter..........e.... Depth below inlet....... ......_. Total leaching area_.. g ja Pet/--sq-• r Ct-L Z Other Distribution box ( Dosing to ) rr -- //_ ��.A-- g .....W-t-�' � � Date .� ...... ... '7 a Percolation Test Results Performed by-_......_ � (f---- 6� Test Pit"No. 1_ ........minutes per inch Depth of Test Pit.11i..._...jr.. Depth to ground water.....7.._1....___. Test Pit No. 2---_.---.Z---minutes per inch Depth of Test Pit.I.Y-Y....... Depth to ground water.__7__..f R+ ................... --------------•----- r,..... ..._._..... —! �v •��3Soi�/ � �B 3� •tc i;y �'--i c. L Est 9�0 Descriti n of Soil.OF ................... ............... •------------._.... ---•-------------- •-- 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 TLITI 1E 5 of the State Sanitary C The undersigned further agrees not to place the system in operation until a Certificate of Compliance h b sued by the board of--health. Si •--•- -Q •----•• --------------- ...._.__... � � e Application Approved By.... ..... ............... . .. .. .... ....... - U Date -! - Application Disapproved for the following reasons---------------••-----------...--•-----------•-------•-••----•-•-•-----------•---------------•---...•-•••.••••- •••...--•------•-•--•--•••--•••••••-•................•--•--•••-••••-•••••-••-••-•--••..._...-•••••-•••--•.......•-----•--............-••--------....---•-•-•----•--•-•--•----•-------- ................. Date ----•-•------- Permit No..-?.. . ------ -----------•--• Issued....................................................... Date FzZ THE COMMONWEALTH, OF MASSACHUSETTS .......... BOARD OF HEALTH .................. ........................0F........ Appliration for Disposal Works Tonstr lot' rumit Application is hereby made for a Permit to Construct or Repair Tan Individual Sewage Disposal System at- � 0-)/ -, Z a�5 --,,'-'� ­9 (;-�'C." , 4> ............................. .............................................. ........................... ? LID a ot rre _A �A S o ... ................................. .......... Ownet "Add;;&,,' �~' a"P�k .... .................................................................... . ...................................................................... ........ Installer Address Type of Building Size Lot..........'..............Sq. feet U —No. of Bedrooms............................................Expansion 5 Attic ( ) _ o Dwelling Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P4 Other fixtures ..................................../ ... .... ............... ......................... .< ........................ ... . ..... Design Flow................ ...............gallons per pen= per day. Totalsily,flow................E... .....................gallonA. W 0 . 6 1/ , 154 Septic Tank—Liquid capacity..�..-.�_....?gallons Length Width.. (9..... Diameter---........._... Depth................ Disposal Trench—No..................... Width.................... Total Length......._.. ... Total leaching area...................sq. ft. Seepage Pit No........---.2............ Diameter..........S--0.... Depth below inlet........ .... Total leaching area.jL-2,L/..sq--4r Z n box (L4' Dosing tank- Other Distribution Percolation Test Results., Performed by..... 6'.-<..,................. Date..........I.............................4:, Test Pit No. 1..�'....-.-.minutes per inch Depth of Test Pit... ------ Depth to ground water....... Test Pit No. 2...�-.I-minutes per inch Depth of Test ........ Depth to ground water....7?.... ................... ..................................... ................2FY- 0 Descri�ti?n of Soil..C�.:LZ&..... ............. ........................... _V U ... ................................................. C 7-/ 4- ................."........ ..................................... -------- ----------------------------- -;7c,,0e -/ ca ,-/' — r> .............................. ........................................................ ...............................................................�2!................. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Systemin accordance with the provisions of T I T 1Zj 5 of the State Sanitary Code-, The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b sued by the board of health. .................... . . ... .... ......... Si ............ .... / Application Approved By..... .............................. ........ ......................... --------- /�Date Application Disapproved for the following reasons:..........................................................................................................--- ....................................................................................................................................................................................................... Date PermitNo._`Z�... ........................... Issued..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR D6 OF HEALTH - .......... .. ...OF.... _6 .... ../.. 6 Z1_6 ..................... (Infifirair of Toutphaurr THIS IS-TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by................. ......................................................................................................................................................... n 7tjer ..... A2�2L) r .....at.. Y/9' 7_11---- .........i.. .. ....... .... ........ ... ...................................... has been installed in accordance with the provisions of TITS 5 oj. /T, a to Sanitary Cod/a ..ed in the application for Disposal Works Construction Permit No..... date ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................... .....TA.................... Inspector------------...... t ----•------•------•---•-•-•-••--......_......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT-H ...........7 M/.....OF.....6)A'k6j.tZ�,', .............. No.. Fzz........................ Disposal Works Tonstrurtion Vernfit Permissionis hereby grant 1w---------------------------------------------I......................................................................................... to Construct air an.I i�ual S Di �q Sy Z7 p at No.. .,Z. Rep n ',v a e ispo ....... ... ......?� ............ Street as shown on the appli7tion for Disposal Works Constru ermit No.... ... ?Dated...._.. ........... ........ ................................................... Board of Health DATE........ �........................................ FORM 1255 A. M. SULKIN, INC., BOSTON APPLICATION FOR PEROOLATION TEST AND OBSERVATION PITS LOCATICY:$ NO. �n a 0 VILLAGE G? v r DATE 18� \APPLICANT FEE ' � �� ,,// (Non-refundable) Z ADDRESS s c�� no )lre TELEPHONE NO. ENGINEER.. NO. �s���� DATE SCHEDULED (Applicants Signature ............................................................................................................................................................ ASSESSOR"S MAP & LOT NO: SOIL LOG - SUB-DIVISION NAME DATE Pie �j , `J� . TIME EXPANSION AREA:-YES NO / ��U ��cO°� ENGINEER TOWN.WATER PRIVATE WELL w^�"J�' — BOARD OF HEALTH EXCAVATOR SKETCH: (Street name, etc., dimensions of lot,.exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES: 9 ��cis z ,ear r l� Z 3 Cat s ri•v s ys7b-" o .J �-�— ti 7 rr Z vs ION RATE: � 2 .»-� ,..� �-�` • . ^OLAT — - T HOLE 140: ' ELEVATION: TEST HOLE NO: ELEVATION: 2 2 3 3 4 Q,r,-�i it2 4 5 7 �-L 6 6 7 7 e 8 Ccgr 8 of 9 10 10 11 S 12 12 13 13 1 14 14 15 15 16 16 :TABLE FOR- SUB—SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES ;UITABLE FOR SUB-SURFACE SEWAGE. REASONS: 'E: ENGINEEFRING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION -GINAL: COMPLETED IN ENTIRETY BY P. E. ANA RETURNED TO BOARD OF HEALTH +y: RETAINED BY APPLICANT •� *, TOP of FOUND. 20 FT. MIN. SOIL TEST EL, x IQ�— 10 FT. MIN. DATE OF SOIL TEST WITNESSED BY 7 CONCRETE 4 SCH. 40 PyC PIPE CLEAN SAND PERCOLATION RATE Z MIN. INCH COVERS MIN. PITCH I/8� PER FT. OBSERVATION HOLE I OBSERVATION HOLE 2 I T CONCRETE " ELEV. _ W s ELEV.= 9 ? 4�� CASR N PIPE 12 COVERS 2 LAYER OF (OR RO MIN. 1/8"- 1/2" WASHED � 0 T� {;�r�s'� � � 0 PITCH 1/4 PER FT. STONE ,� i8 s 71LJ ' - FLOW LINE 10 .r•.,• .. N tl 9 6 G c.•4 c•y c EL = �.d MIN �' . EL.= cr.�•� ma's�.. EL = K7 p LEVEL EL.= DIST. EL = • o o w I -' WATER AT L% EL.= 7 AWATER AT y EL.= go BOX Z 3/4"- 1 1/2" p •o° `T � o 0 GALLON WASHED STONE 4 ,10041 o o' o r- DESIGN CALCULATIONS U.SEPTIC TANK PRECAST w v El.= y 3 LEACHING NUMBER OF BEDROOMS I BASIN OR EQUIV. i6 1 I UNIT ( 6 DIAM. TOTAL ESTIMATED DISPOSAL LOW �o \� SEWAGE DISPOSAL SYSTEM PROFILE ( 116;' GAL./BR./DAY x >' SR.) s G ./DAY REQUIRED SEPTIC TANK CAPACITY GAL. NOT TO SCALE ACTUAL SIZE OF SEPTIC TANK GAL. BOTTOM OF TEST HOLE OR USGS PR08ABLE WATER TABLE EL.= 7g LEACHING AREA REQUIREMENTS OBSERVED WATER TABLE t / / ) EL.- StDEWALL AREA tAL./S.F. Pe a1 9� 7 /?cL vruS '� � .t Ce. ,3'/`s' , c/2,r1 '0Z,E�oc� -- BOTTOM AREA { GAL./SF �U :� ®�k^`1 ` F Zca••-► v^�o 2. Fv. A rh ur-1 o f /� ' �O ^- LEACHING CAPACITY ( BOTTOM t SIDEWALL) GAL. c �3 L�r/tr/In�l �i �s ?�(3. tKa '�xYX1.U�t(3 itxZXfxYx,' _} 7 Eh •STr�/G SV-A''T°C F'gC e- �7—, I�4 ce TO 5e, \` LEGEND RESERVE LEACHING CAPACITY I GAL Ate'-•-- � � � i4--�� j,�A c K�"�G.L �= D AL Q �.� r� �z�� t-v .f lets �v 6F �e -7'•r ra - EXISTING SPOT ELEVATION OOxO `� ( � - -- -00---- , EXISTING CONTOUR c tt� F lZc .-7 7-p a,� .�+ /�.'c�'r(/`�3 �/a-� �c' ,2�1"cX t f ,r<'.F-' r.tI-L �.._� i s t� r� /R-,a d� �.✓�';L �-�,r� FINAL SPOT ELEVATION ® `• FINAL CONTOUR NOTES: • I. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO O.E.O.E. SOIL TEST LOCATION rr k PIZ ,a S TITLE 5 ANO THE TOWN OF , A '- -'s � RULES AND v�.____.�. UTILITY POLE -4 REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. TOWN WATER W ===W 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO .J CATCH BASIN WITHIN 12" OF FINISHED GRADE . 3• EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME. 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H- 10 LOADING UNLESS THEY ARE UNDER OR IV �� /ti• �� `� WITHIN 10 FT OF DRIVES OR PARKING AREAS. H-20 LOADING �? 'j 5 SHALL BE USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING. S. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. 6• NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER /APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. APPROVED : BOARD OF HEALTH Y i DATE AGENT 9K G PROJECT UJCAT"s L T 3 v r 1 \ APPLICANT _ ti , F ROBIN W WIECOX ; e ! ) PRO LAND SURVEYnR _ SET UCKET ROAD \ ' L, Q 385-64T8 SOUTH OENNIS, MASS 02660 rxnlE _ 20 f 1 l 6'> 9 REV. REIN. L or 2 g. .L+ LOCATION MAP ra N0' Ol.7f�- O SHEET OF /