HomeMy WebLinkAbout0394 MARSTONS LANE - Health 394 MARSTONS LANE
BARNSTABLE
A 349 097
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TOWN OF BARNSTABLE
LOCA fTON '3 Q r• Ak�:,r f!J ,j L vt SEWAGE # 40-
ILL�►GE "��1 rASSESSOR'S MAP & LOT
to
INSTALLER'S NAME'&PHONE NO:SEPTIC TANK CAPACITY 1 Xn i l _
r7 7—
LEACHING FACILITY*'(type) t",l`1 i 1 f%✓/c� {size)
-NO.OF BEDROOMS 4
''BUILDER OR OWNER ? �
{ 0 COMPLIANCE DATE:PERMIT DATE: Y . ,
Separation Distance Between the:
Maximum Adjusted Gro nidwater,Table to the Bottom of Leaching Facility Feet
Private Water Supply Welland 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: 9
within 300 feet of leaching facility), Feet
Furnished bya
t3 -
f
No."5 ��" �1--� Fee '✓ �`
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
es
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pplication for �3i!6poar *p6tem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. lea's Name,Address and Tel.No.
Assessor's Map/Parcel
f&
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
—/vq e- L e&r, I . I
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil ' �j�`� �'� "`G/ O l
Nature of Repairs or Alterations(Answer when applicable)
4.
4
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 Code and not to place the system in operation until a Certifi-
cate of Compliance has been issue by thi Boar ealth.
Signed Date
Application Approved b Date A-ILf 1 -0aC-�
Application Disapproved for the following reasons
Permit No. l`.. Date Issued 27 6-e
TOWN OF BARNSTABLE
LOCATION 3 Lj a Al, k i SEWAGE #
rr VILLAGE�A . SJ l./
e�-- ASSESSOR'S MAP & LO T
j INSTALLER'S NAME&PHONE NO.-Al I r-E L-tzt C`I
SEPTIC TANK CAPACITY 1 l tt)
LEACHING FACILITY: (type) "� t`l�! ��J f f' {size)
f NO.OF BEDROOMS
BUILDER OR OWNER
�. - �►
PERMITDATE: � l � ` COMPLIANCE DATE:. r.
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the.Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching.Facility (If any wells exist
on§ite: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
s j Furiushed:;by ,
777
Lb
p
1 ' ;i �,
1� No. f/ Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
'. es
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS
,,Zppfication for Die;p5ar *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. �lr Q/S CJ4S N � O�U�Crs,ame,Address and Tel.No.
Assessor'sMap/Pazcel 3y OG ? �p C� � (ems/ U
Installer's Name,Address,and Tel.No. % Designer's:Name,Address and Tel.No.
A-1 4c L
Type of Building: ,
Dwelling No.of Bedrooms t Lot Size sq.ft. Garbage Grinder( )
Other Type of Building f No.of Persons Showers( ) Cafeteria( )
Other Fixtures t.
Design Flow 3 3 gallons per day. Caiculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil �� ` " d %6 1 �-• �o u ^S e
Nature of Repairs or Alterations'(Answer when applicable) t Aecx_ `emu LT--
Date last inspected: E t � -� U f
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 Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Boardaf lIealth.
Signed �JJ Date G
Application Approved b _____d_, G�.rs�. �7 GTi'I/Z� Date
Application Disapproved for the following reasons
Permit No. G U`6 �� Date Issued 4/6
--------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS fig"
BARNSTABLE, MASSACHUSETTS r
Certificate of (Compliance
THIS IS TO CERTIFY that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded ( )
Abandoned( )by t Va
at has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit , U/,dated
Installer f Designer
The issuance of this permit shall riiot be c rued as a guarantee that thA�yystem.will function as�design 1d.'i
Date 1 Inspector
�r c p
1 / 5
--r--------------------------------------
No. -C J". , Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Migogar 6pgtem Congtructton Permit
Permission is hereby granted to Construct )Repair( )Upgrade )Abandon( )
System located at 3��{ a-e de
s1 o°I J L H t
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of thi 'eAlt. ,
Date: / �l� < �. G C� / Approved Z,,r,>�/
r ,
{ 1/6/99
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION.PERMIT (WITHOUT DESIGNED PLANS)
I, /4 , L e�` `� , hereby certify that the application for disposal works
construction permit signed by me dated l C� Gy , concerning the
property located.at 471/' n f' L" meets all of the
following criteria:
• This failed system is connected to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
(There are no wetlands within 100 feet of the proposed septic system
There are no private wells within 150 feet of the proposed septic system
` 'There is no increase in flow and/or change in use proposed
There are no variances requested or needed.
/The bottom of the proposed leaching facility will not be located less than five feet above the maximum
adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when
applicable]
• If the S.A.S.will be located with 250 feet of any vegetated 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:
A) Top of Ground Surface Elevation(using GIS information) d
B) G.W.Elevation +the MAX.High G.W. Adjustment.
DIFFERENCE BETWEEN A and B
SIGNED : DATE:
[Please Sketch proposed plan of system on back].
NOTICE
Based upon the above information,a repair permit will be issued for bedrooms maximum. No
additional bedrooms are authorized in the future without engineered septic system plans.
q:health folder:cert
4t,-
7C-24(
MiLl
` L-``` -CATION SEWAGE PERMIT NO.
VILLAGE
INSTALLER'S NAME i ADDRESS
S UI;LDER OR OWNER
DATE PERMIT ISSUED _
D AT, E COMPLIANCE ISSUED l��-
G
q {
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® �OF� HEALTH
Appliration for Uiipuiial Workii Tonstrurtion ramit
Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal ,
System at:
...................fib....&r:s job. _kc,Vae.................... ........ ................
-- ---
ocation-Address or Lot No.
....................................... -•------------------- •------------•--•--•-----------------------------•--
Owner Address
►Wa ........... == .. ------------------------------------------ --------•--------------'•'----•--.................................................................
Installer Address
dType of Building Size Lot....!-4srS..`I-X....Sq. feet
V Dwelling—No. of Bedrooms..............�.._.._...._._ .Expansion Attic ( ) Garbage Grinder ( )
U —
p., Other—Type of Building ............................ No, of persons............................ Showers ( ) Cafeteria ( )
Other fixtures .........................•----- .
W Design Flow..........ZIP....S-S..................gallons per person per day. Total daily flow.._.........� Q...................gallons.
WSeptic Tank—Liquid capacityfvS? gallons Length._.....g_.___. Width------,a----- Diameter................ Depth.... ......
x Disposal Trench—No. .................... Width ....... Total Length........._.......... Total leaching area....................sq. ft.
Seepage Pit No.............______-- Diameter....... Depth below inlet......17......... Total leaching area,279.:.7...sq. ft.
Z Other Distribution box ( ) Dosing tank
a Percolation Test Results Performed .......... Date.....
.......1.... ................
Test Pit No. I......:_......minutes per inch Depth of Test Pit.... ........ Depth to ground water/w-ojf_- ti ount��re®
Test Pit No. 2.......--&....minutes per inch Depth of Test Pit......tt?......... Depth to ground water./Vd._ne P o ,Ie.rrof�
x ----------------------••----------------------------
......-...-..... -----------------...--------------------------------------
--------------
O Description of Soil.......L�!PuCh._.xn.f_Cd ,.�rn....S.u!ad....�_�c_C!)e.-l-------•••••-••-•--•......-•-•-----•--'---'•. ---------------------------------
x
V -•------------------•--'-•----•--•-••'•---'---'•-•-•------------------------------------"-----•--...--------------....----•--•--•---••------•-----•-----------•-'--•••-•---•......•-••------••-•-•
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 iITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in y
oper ion until a Certificate of Compliance ha he Fen b the�j bbo health.D
D-to
Application Approved B .Z........................................................ ... .......... ... .....
y-----•-----_ ....................................................... ............••-- - ----�2pv736_S-----
Date
Application Disapproved for the following reasons:-------••------• --•------•••-•'•--••-•----•-•-----•-------•-•••---•---•••-•••••••--•-•-•...•-•.............•--
--••-•--••-'--'--------'-.....-•------'-------•-•-•-------------•'•-------............--•--••-'-----•---•.-•••-••--------•-•--'-•----•------------------•'--•--'----'----•-------'•--------••---•--•----.
Date
PermitNo.......................................................... Issued.......................................................
Date
• — - " ! �"`-"ter
No.....`.: .. :::......... FFs....:.......,a..............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OE HEALTH
`. ..V?...!!1...........OF.................� cA r,�•S a l>
ApplirFafion for D'tupoii al Workii Tomitrnrtion rruti#
Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal
Systemat: ... is l?S.....`..�'.?-..................... .... ........................................................
_-
Location Address or Lot No.
Ru s s e..l.l....__:.... ►�.So- ....................................... ..........--......................................................................................
Owner Address
.................. .............................................. ......................-••-----•-------•-.... ---------................................
Installer Address
Type of Building Size Lot..... ...Sq. feet
U g— _._..Expansion Attic age Grinder ( )( ) Garb Dwelling No. of Bedrooms.............. .................... —
'4 Other—T e of BuildingNo. of persons............................ Showers Cafeteria
04 Other-fixtures ................................. . _
W Design Flow...........*....4�..................gallons per person per day. Total daily flow............3..,3 U........_..........gallons.
WSeptic Tank—Liquid capacity.hOgP gallons Length.......?...... Width.......4�..... Diameter................ Depth.... .......
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No...........1-------- Diameter.......Y o_ Depth below inlet......'"......... Total leaching area.22 y.:.7...sq. ft.
Z Other Distribution box ( ) Dosing tank
'~ Percolation Test Results Performed by...... P. /3��'._.. :...FAtR!3. !�!K_........_ Date.....�1 ' 1�. ................
`�j Test Pit No. 1_.._..�..____minutes per inch Depth of Test Pit.....Ia._........ Depth to ground waterA! .e_._ZL.10yP1�'✓��
1TI Test Pit No. 2........Z....minutes per inch Depth of Test Pit------ . .......Depth to ground water.�V�%_°__Pt1/LPuvrl�r��u�
9 ---••-•-•••-------------•-----•-------------•-------------••-••....-------------•-------•--•---.............--------------...••------•------•------•---......
D Description of Soil------ /Puri ='•'-cd f'.V!......5.4"d..--a
x ��`!�C
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 TITI,L 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.
................................... . .......................
• .. ....................................................t
Date
Application Approved BY - -------- -------- --•-• -
Date
Application Disapproved for the following reasons-.............................----------------------------------------------...................................
-------------------------------------•---....-•-•--•---•-----------------...--•---......-------•--.....•-•••-------------------------•-•-----•-•-----•----------•--------•-------•------• ..............
Date
PermitNo......................................................... Issued.......................................................
Date
THE CONIMO:NWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................O F.....................................................................................
Trdifiratr of Tompli aurr
THIS IS--.TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
bY-----------------:.............................•----••---•_.....................------•--•--•---.. .__......-•---..............-•--...........--•-----.........---------•••-----•---------.....
r Installer
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code,as described in the
application for Disposal Works Construction Permit No-------x. >._ :: . :.... dated_------ .....:........................
THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE............. _ ...................................... Inspector........ ...a
THE COMMONWEALTH OF MASSACHUSETTS -:
BOARD OF HEALTH
No. ... :....:_ .,, FEE................ .
Disposal lVarkii Tronutrudion rrutit
Permission is hereby granted------ T'-::: KA✓L. ....------•-----------------••----•---•-•--------------......................................
to Construct ( ) or Repair ( ).,an Individual Sewage Disposal System
'. � - - --------------------------------------------••••••---- . --•••------•------.......
Street
as shown on the application for Disposal Works Construction Permit.No..................... Dated..........................................
ti . . _ -
•,., Board of.Health
DATE................ ......... ..........•--- -......--••••---•---•--•-•---
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
1�� w
SECTION.- SEWAGE',
' —SEPTIC TANK — — "D"BOX — — LEACH
TOP OF'FDN •,. �• y c ""
"2"O F t!8 T O• /z' e* .t•* 'KL ti 89 t: . y\ ... tee• i •.. ,,,. ,, ....,•ym.st..,,,, _
" WASHED STONE rT`
w _ 5 t./i(4.:1•. {.G' GCpVts.Q„ �.m ij,. I e _
• '' „�_. ` ,. ✓I 1.4.' Ertl �y,;��"�8"'�.�,r /.►.�
OUT- IN- `
OUT-
IN-
't (wG72 1Cv �2 —Tep
AIVIK -iCm.t�-1 `iCo..60 40 1.*` Z A/.
ELEV! e C'vr' Zj
ELEV.' ELEV; ELEV. Lo,O �`. F_, I .� �� 9 .
r '1103') "1Co,Zo '3.d' to.5'----�I ao' ice` �"r( `yti�` cry 2• �
.a ELEV. ELEV. .alO
Y. {2..00 13caTTOM-r-A.
IV ...
( EA.EN. OF 34"-142" II ,
WASHED STONE
ze
TEST. HOLE,-LOG, i
TEST BY v iP,P�o:lV4,N r-- � ,• Ak A;�` Cop /
WITNESS' c nw'
TEST DATE 13 DESIGN .. BEDROOM HOUSE 90; ^�"
T:H. # 1 T.H. # 2
1L ELEV; �� ELEV.
DISPOSER NO
DISPOSER , �' 0
LrtSAnnt' 4u s��� oo PERC RATE 3 MI'N/1N•
S
FLOW RATE ?,=,o (GAL./DAY)
- co" S'�•'� SEPTIC TANK 33.> (LS1= \ 2 S y
$ .T�4_Se. o .. �'• REO'D SEPTIC TANK SIZE I oeza? ' k¢
�IZ2— LEACH .FACILITY
w
SIDE WALL tr(L.S�4=1ri 1•0� (Z;Zy) 353.25 G/D.
et)4 �.. BOTTOM 'IT 12�2 L.-1 m �0.92) � ) 1.2-3 G/D
�.
sRNn 9(?w.p TOTAL 2.n19 .1m = 4CoCa..13. G�D. 1 ` �8 �`�� `�— a r+ .•
e_ USE: G71��C LEACHING ►�(T
4' -?G"Et' �G '(Z .S, C-�F'. D(b.
IVC WATER ENCOUNTERED
NOTES: (UNLESS OTHERWISE,NOTED)' J^41i
1. DATUM:(MSL) TAKEN FROM_.: - - tS- QUADRANGLE MAP
2.MUNICIPAL WATER __:. _ IJ��.-
--AVAILABLE
3. PIPE PITCH:Ys"PER FOOTS 44 AI � 4f >�QS
4.DESIGN LOADING FOR ALL PRE.-CAST UNITS`. AASHO-` - � to —Q---DISTANCE AS CERTIFIED ' f
5.MIN.GROUND COVER OVER ALL SEWAGE FAC1tITl'ES..(1) FT. C! ABNE H. S 4� ARNE
6•PIPE JOINTS SHALL BE MADE WATERTIGHT O�ALA t 'PLAN
7.CONSTRUCTION.DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. H. ''.4 I HEREBY CERTIFY THAT THE BUILDING ` SITE PLAN
CIVIL OJALA SHOWN THIS PLAN IS LOCATED ON THE
STATE ENVIRONMENTAL CODE TITtE$ L=-r Cs MA 'TQh! t.P•
No. 30792 26348 GROUND AS SHOWN HEREON &THAT IT LOCUS:
4. } v�kk£4 L. l OR ti7sFG' CONFORM TO THE ZONING BY LAWS OF THE
USE 14-2G PE•I(C'N WIFE R:£V�Q F�Sg.
� TOWN OF ,-
MA`( B£ £x+t C�'^y �, �fA �� PR �1 1 t31?i R WHEN•CONSTRUCTED. DATE REF: L•v"I' !�'
o�✓�:. cap e'n� neerill ° PREPARED FOR: u�SG4t_ G11 'vCSi`.1
' + CIVIL; ENGINEERS
r 7 ———
. LAND SURVEYORS _ -------- . .
v x BOARDbF'HEALTH REG. LAND OR SCALE
AND SURVEY �4
LE 2
(EXISTING) --- t ')3,esip,t4STfaiptrls4 MA ' 'Yarmouth&,Or1@ans,MA
CONTOURS o-o-0--o APPROVED OAt E
(PROPOSED)
pATE
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