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HomeMy WebLinkAbout0111 STONEY POINT ROAD - Health 111 STONEY POINT RD.,BARNSTABLE �. A=336.036 lm a ♦ o v� r V S , r • o r r f v � ter. • y � , e J • . i f V • n T : 6' TOWN OF BARNSTABLE LOCATION ��� ,;/ �o�v�,t � SEWAGE VILLAGEx,.tb2cv�5�^��P ASSESSOR'S' MAP & LOcT , p INSTALLER'S NAME & PHONE NO. 20 O SEPTIC TANK CAPACITY tD00 �ZL LEACHING FACILITYAtype) l fLNCLn (size) 3o"X y"X ` NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ��Gte cpczv_ef— DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ham' d-�i�'' --✓��� VARIANCE GRANTED: Yes No L .. aoa�q� !\v� �Z ri A R ASSESSORS MAP NO• :3 _ No.. .. c PARCEL No j>-'...tg::..T� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ApplirFation for Uhipati al Workg Ton rurtioaa Permit Application is hereby made for a Permit to Construct ( ) or Repair (,X ) an Individual Sewage Disposal System at: .1 L1_. Locatio Address or Lot No. 1�3 - L) 5111 . --- --------- ........................................ Owner Address W h'1tJf 7l ... iSla7lc/ . ......................•--•••-•--•-•-•---... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms........... .............. .....Expansion Attic ( ) Garbage Grinder ( ) Pk Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ -------------------- ----------------------------•----•.---•----------•----------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter-_._--_____-•-. Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by.......................................................................... Date--------"........................................ aTest 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........................ (� "-""•------"--"--------------------"""-"--------------"--...-"-""-"-----......................------......................................................... 0 Description of Soil".............................."-"---•--"""----"------------•-------"------•--""-----------------"---------"---"----"-"-"-""-----"""""-"-....--•-•-------............--- x UW --••---------------------•-•-------•-----•-------------•-•---------.......................................... ------------------------------------------------------- Nature of Repairs or Alterations—Answer when apyplicable.A__ t� �' _ _ _ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia c has been ' sued by the board of health. Signed `/ .....(.:to..................... Application Approved �`j� ....................'---' --------'----"----....--...............--"---'--'-----...... .....------'--"Date Application Disapproved for the following reasons- ----------------------------------------------------------------------------------------------------- ' ...""''---"-'-- '- '-. ...................----------------_-- Permit No. ...... ::.. � .-- Issued .......... .. f�� P"... e Dace No...._..-_ ....�.J THE COMMONWEALTH OF-MASSACH SETTS BOARD OF HEAL H0. JA ., r1� _....:...OF.- '-----••-•.................�_.........._ Alip trtttauaa fur Dau�ruli al urkii miva mila Prrmit, kApplication is hereby made for a Permit,to Construct ( ) or Rep it (X) an Individuaf Sewage Disposal , System at - --------- -- ---- - Locat oiy Address or Lot No. ............ 1 1 /:&------------------------------------------- ?�?2'..----.....-----...--------......----------•-------.....--•---.......--- Owner }� %Address a .......... ••••-- 5/............................... s </vQ.LL21c! _. Installer Address UType of Building 1 Size Lot____________________ _____Sq. feet I—I Dwelling—No. Hof Bedrooms........... ___________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ..............................No. of persons_________----------- -_-_____ Showers ( ) — Cafeteria ( ) d Other xtures .._.. ___________________________•-•--•-•--------•------•---------------- _............ W Design Flow........... ____............................gallons per person per day. '}Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width............::_- Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width_.................. Total Length.................... Total leaching area....................sq. ft. Seepage Pit Nb_____________________ Diameter.................... Depth below inlet.................... Total leaching area........_,........sq., ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.................................................................... ---•-• Date....................................... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •-•••-•--•--••••••--•-------••••--•••----••••••••-•-•-----••-•--•••-••-••-•••--•-•--....----•................................................................ 0 Description of Soil................................................................................................... ................................................................... --- --------------------------------------- •--------- •----------------------------- •---------- •------ •------------------------------------------------------------------------------ •--------------------- W -------------------------------------•------------------------------------------------------------------------ ----- - -----------------------------•------------------------•- Nattire or wer when U f ST2�'.1tJCtSns�T��fJ.�.l.�icab`�--�� - ._ .. : Agreement: \ f� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System Iin accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia has been sued by the board of health. SignedGhC --... ........................ ate Application Approved yam-.--..... F D Application Disapproved for the following reasons- ---- ----------- -- ------------- --- --- ...........-- ...................... ---------------------------------------------------------- ----....... ....----------......----------------------------------- --.....---...-... 011V Permit No. . .. � -- Issued --- � .-- x. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -------------J o� f ------ --------------- - Clertiftrate of Tompliana THIS IS TO CERTIFY, That ndividuaL�ewage Disposal System constructed ( ) or Repaired ( K ) by /vC�1ZZ4 a-ao.............................................................---- --------------------------------- m Ie� at /../../ ..... / �Cam------------------- . ...................................>------ -----.............................. has been installed in a Ordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No: .. .- --.f-- -� ---- dated ..--.. .. �-= THE ISSUANCE OF THIS CERTIFICATE SHAL .L NOT BE CONSTRI6D AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---------.I_e ...... ...( '':.... Inspec{or _ THE COMMONWEALTH OF MAST ACHUSETTS BOARD OF HEALTH ��. _�G t)C/L - ........ V.A0A1..0F..... ................................ No.. - �iu�uu�l� urku uaau#riun rraati# . Permission is hereby granted..........46��--- g j4ea.cle PJto Construct ( ) or Re-Pair ( a In�livi ual ewa a osal stem at No.•-•-•-•-••••-,,!_!.:l.-••-eh_T._. - • ....em:K— --- Z2.--- u1..!rx ... Street as shown on the application for isposal Works Construction Permit ...... Dated---4 .......................` f DATE_ Board of Heaifli / -----•--•---------------•-••• L FORM 1255 A.M.SULKIN CO. PIRRO'ELY ARY _ y� /VD 17 M a - i'.� r /�O T � � C �MM • vt �G�'1 J4 iC i� r IN 2�' �L TOP OF FOUNDATION a e 4 I ulfl ii4 �14L. MA9'E%rt/ - ;;' TO CONCRETE COVERS o BtyoAID`/ 8E`_ ee�04oVC,D / iD A2t�L/3Ct'D WifJf� " min,,. ccr�rN s�v0. Z4•'xso' r S ID&-pry ,�. 4 CAST IRON 12 MAX.. i OR SCHEDULE 40 n 4"SCHEDULE 40 P.V.C. (ONLY) 12"MIN. 7 3Gu}- '�� P.-V.C.PIPE• 'MIN: PIPE-MIN. vi PITCH 1/4"PER.FZ r LEACHING TRENCH (.I..REQUIRED) -' PITCH I/4"PER.FT 1/8"-I/2" WASHED STONE Lr o INVERT, . . . :'o EL........ . INVERT INVERT WASHED " "STONE SEPTIC TANK _ DIST. 3/4 —II/2 L.......... EL......... -- _ 6•• INVERT - BOX .P. .. ... GAL.. INVERT INVERT INVERT 1fa: EL.............. EL.......... EL.......... EL............ �• � 30 f ZI PROF1 LE OF a-.!. GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM TYPICAL CROSS SECTION SOIL LOG a.y NO SCAL� _ .�LEACH! I NG TRENCH � r . . . . . . . . . . NO SCALE' . TEST HOLE I TEST HOLE 2 ELEV. DESIGN DATA : =L_V. . . . .. . . . .. . . . . . . . . . . 12���M!N• �7A =�Tw- . , H ED IjWNSER OF BEDROOMS NE -OTAL EST!MAT ED FLOW . . . .`' '�.� . .. GALLONS/DAY d" ERf`vRATE� BOTTOM LEACHING AREA �Zd.. ... SO.ri./TRENCH PLASTIC PIPE �'- �' SIDE LEACHING AREA . . . . 1.70... . . SQ.FT./TRENCH L3/4=1 V2" GARBAGE DISPOSAL .��'v�=..I50% AREA INCREASE) WASHED TOTAL LEACHING STON AREA ?1.�... ..: SQ.FT.✓ L�" GO ` 2.4 —+-«--2 ! SG+� `•`�`�`.• � PERCOLATION RA—it . . . . ... . . . . . . . ... PER. INCH 48* 4 /yZ `\� !'or✓S LEACHING AREA PER PERCOLATION RATE ...... ... SQ.FT. I •i GROUND WATER TABLE APPROVED . . . . . . . . . . . . . .. BOARD OF HEALTH i3L' .WATER ENCOUNTERED DATE .. :. . . .. .. . . . . . . . . . . : WITNESSED BY : AGENT OR INSPECTOR _. . . .. . .. . . . . . . BOARD OF EAI_H La ENGINEER ENGINEER . . . . . . . . . . . . . . . . PETITIONER : sVJt6 r TOWN OF BARN TABLE LOCATION �l f c> c,y �-t. SEWAGE # VILLAGE �Q /D '' A� -.ASSESSOR'S MAP & L_OT2-. INSTALLER'S &PHONE NO. �� �%/� GelM, 77 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) ? NO. OF BEDROOMS 4 BUILDER OR OWNER �S�b�7yS f' ••� PERMIT DATE: ...` C-01,�COMPLIANCE DATE: 16, Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom ofleaching 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 feet of leaching facility) Feet Furnished by r s 4 r - • � 2 A, - aq T31 - [ 7'f AL As 3 -Ski� .y No. '" SLY Fee zg S1 THE COMMONWEALTH OF MASSACHUS TTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABL x ASSACHUSETTS 01pplication for Xkgo$al 6pelem �Conm Ltion Permit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �p r�� � [� Owner's c .N-aame,Address and Tel.No. SJi� r 1 Assessor's Map/Parce (/Il���� �(�` 31ry Rr- 6 no 4W&Aal" VA Installer's Name,A dress,and Tel.No. Designer's Name,Addre and Tel.No. Ro>�o�i � P O. pox 200 p��� >A cos 3�S- T�pe of Building: /�, Dwelling No.of Bedrooms Lot Size ��sq.ft. Garbage Grinder AA Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow "ILI 0 gallons per day. Calculated daily flow T�, gallons. Plan Date NO Number of sheets _Revision Date Title (f gto Size of Septic Tank Type of S.A.S.— ZW &A (6K O Description of Soil TDP5e1C& , S"r glxc' ` .+29 lima Nature of Repairs or Alterations(Answer when applicable) 11 � 4Rj5 SA g 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 is _ b this Board of a Signed Date Application Approved by ;- Z CZDate Application Disapproved for the following reasons Permit No. Date Issued No. Fee THE COMMONWEALTH OF MASSACHUS TT Entered in computer: ~PUBLIC HEALT,W VISION - TOWN OF BARNSTABL s.. ASSACHUSETTS letYeS,F. ° rication for Migponl *pgtem Coma ction Vermft`_ Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address andTel.No. 5USd�J &Z S,,,i i Assessor's Map/Parce C/l���V' � P/ !// �rv� _ aG/t/ Installer's Name,Address,and Tel.No. Designer's Name,Addre s and Tel.No. pz �'A y pros r o c C�°p5VOGTOU P a`• Po 2� Type of Building: /� Dwelling No.of Bedrooms _ Lot Size V� sq.ft. Garbage Grinder(/ A Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures/� Design Flow ly 0 gallons per day. Calculated daily flow ���� � gallons. Plan Date Number of sheets Revision Date Title s / Size of Septic Tank ? Type of S.A.S. 5Z'e 1! ES Des ription of Soil ?Q�SQWt- J AA sw;�e��.�ig lA Jc 5-) t.. Nature of Repairs or Alterations(Answer when applicable) Av S e �ywrc s v 620 ;� 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 iss (Oby this Board of a th. Signed _ —i• r Date Application Approved by fZ Date Application Disapproved for the following reasons Permit No. "' Date Issued ---------------------------------- THE COMMONWEALTH OF MASSACHUSETTS r BARNSTABLE, MASSACHUSETTS W Cift ificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (/[,)Upgraded( ' ) Abandoned( )by at Q has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 5 dated Installer G � �xT Designer - d�dl��- 40V S The issuance o this permit shall not be construed as a guarantee that the s s ill function as desigilep. Date Inspecto ---------------------------- — No. Fee F/ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migogaf *pgtem Congtruction Vertu Permission is hereby gran ed to Construct( Repair y 1 ' pgrade )Abandon( ) System located at 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 =peftit. ! Date: ��."" '�',i�''�-- 4F:!P Appro ed :y BY DATE 2 SHEET NO. OF CHCKD. BY DATE PROJECT NO. PROJECT �G�� Q Horsley&Witten,Inc. BOOK NO. I � { i 1�� i — - - - _ - a� to- 0:� f 4- - }. TOWN OF BARNSTABLE I.,QC?►_'i:'N SEWAGE # VILLAGE ASSESSOR'S MAP & LOT Jo � INSTALLER'S NAME 6t PHONE NO. SEPTIC TANK. CAPACITY /60 G LEACHING FACILITY-.(type) P1 (size) f NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNERL>1NN DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� C� 3 ' � 2 e = � i� qo I�To.... F.. t FRs... C3.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ;v. ................. ...............OF..... Applira#ion for Disposal Works Tonstrurtion ermit Application is hereby made for a Permit to Construct ( ) or Repair ( m") an Individual Sewage Disposal System �at: �^ O/ // J 7Zii�/G�j o,�p,. .. ......................12 .............l..d_Tif�. .^ hle!:7........................ .............1.._........_..................y�`5.. ..i:...................................... jLoca "on Address or Lot No. ..... .... ..._._. -�..��� d�................. ....................... ..................•----....._.........---- ----•------••----•-----.........----.............. Owner Address Installer Dwelling No. of Bedrooms.. Address U Type of Building Size Lot_-__-----••-•---•--_.-•-_.--Sq. feet a g— Expansion Attic ( ) Garbage-Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( + — Cafeteria ( ) Otherfixtures -------r................................................................................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length_............. Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width..................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water....................... f14 Test Pit No. 2................minutes per inch' Depth of Test Pit.................... Depth to ground water........................ P4 •--••-•....•----•------------•-•--•••-----•••••-•-•••.....-•••••....•--•.......................•----......................................................... Descriptionof Soil .....----•------------------------------••---------------------------------:.-------------------------------------•••-••••--........----•- U W x - -- ........ -•--•• ------------------- ----------------------------- U Nature of Repairs or Alterations—Answer when applicable.___—� _s�? __.11?1�� 1per>..................... ...- -•-••-•--•••-•-•--••••--••••----•-----•--...-•---•-•••-•••-•--••----------•-----•---•-----••-•-•----••-------•-•-•-••••---••-••-••-••-••-•.........-•-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL% 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. ...•... �y� ----•- Application Approved B /fiace - --------------------------------• - -•------•-•--- Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------------- ..........................................................,..........................e................................................................................................................... Date Permit No..__---_.8.2.11......�._L� ............. Issued_....................................................... Date yt f N40.........y:....:.!..`.!S` FRs....a-0....._.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................._.......................O F................................_.......--------................_._........_...----------- Apptira#ion for Uiipniial Works Tonstrnrtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................� ......:5' '..- .: ' ............................ ----...................... �o .� � - ....---- •- -----.... ... I Loca$io Address or Lot No. ......................_.�....,�..::.:...!_u�---------------------------------------------- ------------------------------------------ ------......---....-----........-----......... Owner Address � Installer Address U Type of Building Size -------- Ty feet Dwelling No. of Bedrooms.......::...................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures ------------------------------- -- --- --- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity..,.,.......gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i, Test Pit No. 2................niint}tes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •--•-••••--------------------------------•-•--•-----•-----------..........--•--••-----•--•-••-••----.......-................................................. 0 Description of Soil..............................................................................................----------------------------------------------------------------••....... x U ..........................................................,.............................................................................................................................................. ----•--------------------- ...................................................... ---------------------------------------- ----_---- ------ ,: U Nature of Repairs or Alterations—Answer when applicable... `.�':'rf!�.�.�___. 1P ��� ------------------------------------•------- i Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL i 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. Signed- �'_ -- /. C�. /%' r-- Date Application Approved By.............. ------------------------------- D --- c9.... Date Application Disapproved for the following reasons---------------•------------••------------------------------------------------------------------------------•.... ................................................................................I........................I.....................-----------------------------------------------------------------...._..•. Date PermitNo.•-•-•-.1 ------------ Issued......................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........er--.C<l(t.............OF.............i :-!.... ...a ........................ (rrfifirate of Toutpli anrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (>,.) by.............. le.t� i '""=.).......................................................................................................................................... Installer at..--.. ........ ..---------•--..-------------------------------•-------•-----------------------------------•---...----------- has been installed in accordance with -le provisions of '1'T '`" S of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.___ ........ dated----............................................ THE ISSUANCE OF THIS CgRTIFICATE $HALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... �,.'. .......................... Inspector...-•--••---•••I-A-0 ----•--- .......................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � �- ........... !. OF...... . . .............................................. ` ( s ,............... /. No.. .I..::.....1 T FEE.'a gtapnotal Workii T-Fnn#rndinn ernti Permission is hereby granted........ -IAr _A-..... - ..........-----------------------------•----------.....---------------......................... to Construct ( ) gr Repair (k an Individual Sewage Disposal Systen� atNo................... zsv :C ......... -----•-----•-------•------------------------------------------ Street t � r as shown on the application for Disposal Works Construction Permit No.__._-, �J Dated.......................................... .............................. LD---------------------------------------------------- Board of Health DATE-------•----..7,-(•t _ $-_!--...................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS The Town of Barnstable . Health Department 367 Main Street, Hyannis, MA 02601 M 1 Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health Date -- =- 7=p` ------- The onsite sewage disposal system located at -��Y=$ --�11_SYQII�b �_P1t�e@k�3Able _ 1 _ �2 was inspected on ---- ---- --- _---- and was found to be in compliance with the State Environmental Code, Title V. 7� Date t } ate' LO•CAT„ION SEWAG ERMIT NO. vie A c E 0 14- I N S T A LLER'S NAME V ADDRESS DEMOS Trucking & Bulldo%ing et Hyannis, Mass. 775-0828 BUILDER OR OWNER 77 c e DATE PERMIT ISSUED 9 -7r DAT E COMPLIANCE ISSUED a ,� ,ono No. F w ♦f-� ................... . THE COMMONWEALTH 'OF MASSACHUSETTS BOAR® OF HEALTH ...-�-----------------OF..... s-r - Appliration for Disposal Works Tonstrurtinn Prrmit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal S stem at: ---- ----------- ------c--oN � �Location-Address --- ------ r..Lo �r- T hav----- ----- ow . ... R. e Addres In alley Address Type of Building Size Lot__ �E. ....Sq. feet �-, Dwelling No. of Bedrooms.........: .......................Expansion Attic ( ) Garbage Grinder (SC) Other—T e.of Building No. of persons............................ Showers — a YP g ---------------------------• P ( ) Cafeteria ( ) dOther fixtures ------------------------------------------------•--•-.-------•-------------------------------------••-•----------------------•-------•...........---- w Design Flow..............5- - llons�per person per day. Total daily flow-----174-� ......................gallons. w Disposal Trench�No.--P--------------- Widt�-----------g.. ---------------- Width................ Diameter.--------------. Depth................ C4� Septic Tank�Li uid ca acity' _ a o s� Length Total Length.................... Total leaching area..__.__..._...__.___sq. ft. x e Seepage Pit No._.....-1............ Diameter.....(.q...__..... Depth bel i Total leaching area_.'�1-4P...sq. ft. Z Other Distribution box (X) Dosing ton1c�( ) G `_/.2-2 7- 9 7 CS Z �4,�PA��/ Percolation Test Results Performed by-_._.....11.�_��.t_l ..._l-! .`�. - Date_.. ,.a ------------- a Test Pit No. I__�S-Z......minutes per inch Depth of Test Pit----1_�....... Depth to ground water-Nor .4�!'C.= f=, Test Pit No. 2.................mini�t es per inch Depth of Test Pit.................... Depth to ground water........................ xa--- ---------= - ..---- o .- , Description of oil----3...7pr . s� .SD�� •.�.... �c> ... Zr x ---------------------------------------------------------------------------- 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 iIT,IZ 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. Signed_P� _ - •-- .... ✓��'.I D `� ate Application Approved By....—. ..f'�"" .. ... ... Date Application Disapproved for the following reasons----------------•--------------------------------------------•------------------------------------•-------••••--- ....-----•-----------------------------------•--•--------------------•-•--------••----••-••••-----....._..---•----------------------•--- -----------------.............................................. _/ Date Permit No.. .............•--•-•---••----•----_._.. Issue _`._....Date/....._ .-•--. M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF......�. :tZ0S.T.l- L-4.......... ApplirFatinn for Bispos al 1%rks Tnnstrur#inn Pumit Application is hereby made for a Permit to Construct (x)-or Repair ( ) an Individual Sewage Disposal S Stem at: Q T S7-0AJ /fc n< E' �iE 2N5 i �' f3LC• C ............. �.......................--.... . ........................................ ........ `......_.._..........---•--•-- -..------....._................--•-- Location-Address or Lot .... ....0 o...................... i O 7 T p. ._._......: ....._.. :.. . ?d�r��.../L 42� _ Addres /A�p /t.................................. /:. ..... 1. ��{ TUNC ... . .......... In�r taller Address Type of Building Size Lot...ze�.a?:..........Sq. feet Dwelling—XNo..of Bedrooms..........'.(.-....•......................Expansion Attic ( ) Garbage Grinder (k) Other—T e of Building ............... No. of persons.............._............ Showers — Cafeteria a' Other fixtures --------- ...................................................... W Design Flow....... per person per day. Total daily flow..... _ ``U..::.................gallons. WSeptic Tank X Liquid capacity 4S q.gallons Length................ Width................ Diameter__-_____.___-__- Depth................ Disposal Trench—NO............... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........I__---_____-. Diameter....(_-_r_.____ Depth bel°�w in t.___ _. Total leaching area__4.�_ .___sq. ft. Z Other Distribution box ()O Dosing tank ( ) Gu- / I . l�"z 9- 7 7 �8t-2- 6)SUA '-' Percolation Test Results Performed by......... .t.lt.!..ix m.....�.3.E_!13';.fL k.� Date--- ?.,?-"?.�.��_ _ Test Pit No. L .Z......minutes per inch Depth of Test Pit....f_OZ......... Depth to ground water..144;7_4�m— f� Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ ,...---•------ -. -- -- w ------------------------ ----------- •----•---- --. o __ Su-ODescription of( il .. 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 TITLE 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. Signed.. f !�! .��,T!.c?�4!.......... Z /�D 7 ........ a ate Application Approved By • � �- - ------------------ r I Date Application Disapproved for the following reasons---------------•--------•---•--•-----•---•-----------------------------------••--------------------._...-•----. -----•-•------•.............•------...................---.........---........----•-------..............................................................................-........................... Date PermitNo....................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Ag'.'1.........................0F.... .. .�.�L. .................._.............. CCrr#ifirtt#r of (�nnt�li�anrr THIS IS TO CE TIFIF, Tat e! vidual S Di osal System constructed OO or Repaired ( ) ( / �j� Ins er G Ci ----- f- �` ..... .at... jam' �rr,��.�� . has been installed.in accordance with the }provisions of T F 5 of The State Sanitary Code as described in the application for Disposal Works Constru• n Permit No.. ............... dated_-...,T_ ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. F DATEInspector ' ......... -•-•........................-••----:.._....._. ..................••-----•---•------•---------------....------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH O!N. .......................OF..--.....AI........._-Lu .s.rA Rl_L _Y� . No........�. .......... FEE---••................... 11W.Vos t1 Iforks Twnn#rnrtinn Permission is hereby granted..... ::._. :_- - � �_.. , --'�r •. -.:. to-Construct ()o( ) or Repair ( ) an Individual Sewage Disposal System '� ? ... �? _SX!QR4G ,.............................. at:No.... --•- Street as shown on the application for Disposal Works Construction P t No. .....�4_ Dated._3`'.ham'__.7:�........... ...---•- ...........................• Board of Health _ DATE..... " ._ ........ ....................... C!1 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ^ : l 'yw^y.,..:n M'n .w nn+.✓rn.ds,r:_:..-y..., n__.-�n-^._ram _ ,,,PAW+,y::x wn..•-. ,.+,.+nw>...,.a.-+++.:....,..,... _,-.._. w.,..xr-r .,,, .w.a,w. .. m..' ...;�,r . .,.. , .+.....w...,r :wv.......A-n.-«..+ero: rn.-.._».n��-+n,.at_..-✓i++r+•Ml.—.•:+�e+r.--,:aY-e....:.+�.i.a+.-._-,_..-.i-wr.-:y.........._:....-. -• ••:.m_-v.«-, �._'•.a , .a ,. ,> ,.,. __•-'^'__1. w-nn-✓n,••MF^*.M*,."r+.r„Y-a .+i....y,.p,... .+..+n..+ Y'F'^.'•Wrt`•;f""..v++•' .. .-.."_ - .. .. .. ..., ,. { ....w,..ww,r...�....yr.G+,.••,.•".._..-..r+.:..-..•..:..o,.:,,..e.d:Kw...+...,•.--.+..n+_..r.,..w.. _____"_�rw.�-...,i._.r..__w..,+er.,,u.�+..�»�.-s......._,..,: -. - .. J f L - - r , • dj t f t Totem - tt { a 'Qora Saw�o , -. 14 4 TQP OF F _ ..... , E ' QED t I 2� S L QPE OVER LEACHING AREA 6 , -18`� D lA. NC TE CC `ERS - �� ----__-: ; 7 _. - l8 t�lAs CONCRETE COVE r , 18' D I A CONCRETE 'EkY PING - - � ' 3 ki�� � t ►r C QV E R _ _ - V'WASPED STONES cl ¢ 1/3 'J } I - ICI .�e.V D/,9 W1 6ir S UMP b t 'l, v 4 _ .-. :._. .�1 I ' ii ; f T �• j,•' a,�." �Z 3 '� 14 Y4 y e n a .` SU r t. T S73 G ter✓p ci;::'�..r:? p n! /z/ 77 �.. /✓j '�fF. / i. ✓• t ; j' " - u �? f t f -�Ei '1 't. f. � ,�; � �• � � t � � v� .1 .�'+ ,( �?r �—•7 1.1/T�' 1�):4"�"�i�a...i.� b�,,..�' w'� s%�. i-- • 1 /✓ ©`J G A y,. i. 1 Y I P\!�- A.._._ .,' + 4�. I �'__•-• i 0 tt a S T l.n TA >'C — CAST. r.. � N WITH H 1 fn,P PL A.Cf� I INLi_ T AND 007 Er 7 PE TIr1 /j_i L.p N( ii " .� -�.;r 'a._.-'s_�d'✓✓��. � j t' (✓1/''S f `t. r� PRECAST LE/A HI 4, P�,T_ � SIZE : ?� a 3yij SYaTEM DESIGNED ED TO TOWN rJF BA!��1:��f`z� c�_ REGf LA7IONS r AND STAT T;'7? xZ' FC�R SUBSURFACE ISP %-A' F SEWAGE i i 1-:A L L PIPES SHALL RE 4C" PVC SEWER PIPES :� L t, 1F� S "HAL �L BE � L PED 14 PER FOOT MIN, EXCEPT � R L r Y FOR. THE FIRS` 2 FEET DCIT OF THE DB �— Sh'ALLSF LEVEL sE f.� T 1. GALA PF..R BR / — ' 3- DESIGN FLOW-4 BEDROOM`�' r� � �, 440 �,�� ��. r \ � � '�'°� /33' S E PT I C' TANK. SIZE : %� 2,v � _ 880.E A����USE /sow �� W f GARBAGE G tNt E R � L E AC t-11 .N: MaCE _ � �."G T i _ ..__ z-- , c s • , EFFEC TIV E A R EA SIDES :D E � : � � � 2 , - . � LL? �_. - - TOTAL FLOW " _ f�l �r?� �� �` r _ 3 r - TOTAL REGUIREC' FL V:!: 44o X 1. 6 W/ GARBAGE. 6RINLER RESERE FLOW a h r ) �.�. �.��.�. j„K1� � ,. 1�+;f � �� '7 � d . _. _. .. + R i6 �' L C7 �.'r►R�• n.! +..�t� a) ' a`� tie ' + It 1k' �e� . t " '•�' ,` t !c Y K _ __. _�. _ . �. _ ._ . _ _Y _ . ._r_. ._, . .. ._ z _ L0 IN IT•E So H N ._S_ mac._ °�- , +� ='��'� t< 6, 77o_A �,. Z1✓ t Y — —_- i}� t . 2&tj- - :: t k'' R'RIvS Tip�a i�.�G...._[_..aG.,Iii-IJIR./l�w+Q-trt,..•._.�c'J''V',�;.'�`'.�.k ...ice. ^- rye,,?� _._.. Q ,fit - CALLw, R _ N R2RJ jTF� L� r. r.� }y, I 4 a «� 1 s . ,� '*:�n:,K:.'•?et :.�^tn.,s.�.�S.r"�Jl4�4���r F.��J^�...c,+'� : ✓ yr , PROVIDE PRECAST CONCRETE EXTENSION 5"DiA.OUTLET(S) 4"SCHEDULE 40 PVC FINISH GRADE OVER LEACHING FIELD= GENERAL NOTES TOP OF FOUNDATION RISER WITH CONCRETE COVER TO WITHIN o REMOVABLE COVER SLOPE tc� /o 2 MIN. OVER SYSTEM ELEV.= 100.6 6"OF FINISH GRADE WHEN NECESSARY. FINISH GRADE OVER D-Box= 99.30' 2"LAYER OF 3/4"TO 1-1/2" DOUBLE WASHED STONE " 2 OF 118"TO 1/2"DOUBLE WASHED STONE FINISH GRADE @ FND. EL.= 99.5• FINISH GRADE OVER TANK EII 99.25' - -- -- --�--"- - -- ---- 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION 20"MIN.ACCESS COVER �- METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE (TYPICAL FOR 3) 36"MAX. 12"MIN. ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. --PROPOSED 4" n 2' 4"PERFORATED PVC PIPE 36" n n 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD SCHEDULE 40 PVC __. PROVIDE WATERTIGHT --- OF HEALTH AND THE DESIGN ENGINEER. 6" 3" 3"DROP MIN. 3" 9" JOINTS (TYP.) Q� C � 1 " 4"PVC IN FROM SLOPE PERFORATED AT 0.5°� 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL SEPTIC TANK 4" PVC OUT TO p 0 O O 0 0p BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. " -A - Match 14 LEACHING FACILITY 00 CAP ENDS �-� O 4. 4"SCHEDULE 40 PVC PERFORATED PVC PIPE SHALL BE USED Existing Match 12" Klatch Match � oo -� O o0 � 48�� OUTLET TEE Existing MIN. Existing Existing 00 O O O 2+ o� O INSIDE LEACHING TRENCHES OR LEACHING FIELDS. 12 7' - ► 6"CRUSHED STONE O CD © 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. � 'OVER MECHANICALLY �,,�Q O O COMPACTED BASE � �`-�` W O 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. EXISTING DISTRIBUTION BOX 381 4' 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED TO BE INSTALLED ON A LEVEL STABLE 5' PRIOR TO BACKFILLING WHEN SYSTEM IS NEARLY COMPLETE AND i BASE. FIRST TWO FEET OF OUTLET READY FOR INSPECTION. SYSTEM IS NOT TO BE BACKFILLED + PIPES TO BE LAID LEVEL. GROUND WATER ELEV.= 88.70 MIN. WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH - ----� EXISTING 1000 GALLON CONCRETE SEPTIC TANK CROSS SECTION VIEW AND DESIGN ENGINEER. LENGTH 8.5+ WIDTH 4.66+ DEPTH 5-66' TYPICAL TRENCH PROFILE TYPICAL TRENCH SECTION 8. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE DISTRIBUTION BOX DETAIL AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY SEPTIC TANK PROFILE TRENCH DETAILS DISCREPANCIES TO THE DESIGN ENGINEER. NOT TO SCALE NOT TO SCALE NOT TO SCALE 9. NON-SHRINK GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR --- - -- - - LEAVE ALL CONCRETE STRUCTURES IN ORDER TO PROVIDE WATER TIGHT SEALS. TEST PIT DATA 10. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS INSPECTOR; LOCATED UNDER PAVEMENT DRIVES OR TRAVELLED WAYS IN WHICH .; '`' •° CASE THEY SHALL WITHSTAND H-20 LOADING. SOIL EVALUATOR{ . EDWARD KELLEY ' - DATE: JULY 6, 1994 11. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND TEST PIT#: 2 FINES. 11,0 r .,�., ELEV TOP 99.70' 12. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND ► t _ UNSUITABLE MATERIAL BELOW TRENCH INVERT FOR AN AREA 5 FT.ON ALL SIDES ELEV WATER 8.70 8 + OF LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN .Y 10 •(\ "� "� PERC RATE_ < 2 MINlIN COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 115.00 Fnd w - ,w DEPTH OF PERC= In Coarse Sand 13. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES 226.61 ~ 9 ' s TEXTURAL CLASS: 1 FOUND IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO f 61 J 22.8' l _ CONTINUATION OF WORK. 111. . 4'00„ E _ t ,. '" P 0 99.70' 14. PROPOSED PROJECT IS LOCATED WITHIN: 11100' N 82 4 _ s `\ s ++ .� , ` r ASSESSORS MAP# 336 LOT# 36 „ Loam, FEMA FLOOD ZONE C Subsoil & 30.4' `�' �` ling , , +*1 Clay AS SHOWN ON COMMUNITY PANEL# 25 0001 0001 D Stone Drive !! "" *•" Existing 10"Around wog ,.� - 99 - - 4 * ► * '�, m OWNER OF RECORD: SUSAN L. NICKERSON Trench Strip-outs f Ban ; . 61 " ADDRESS: P.O. BOX200 96" 91.70' CUMMAQUID, MA 02637 Proposed 3' Extentioq To Existing Pip4 4 °h` O # . ,( I ,` Existing `~'���„N.) 15. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN 6"ABOVE ,E stirs Trench----� , r� ++#`"""4t Coarse INVERT OF TRENCH PIPE FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. r F !J / Ui x Q 4 ' Sand e © 16. ASSUMED ELEVATION OF 100 FEET MSL TAKEN FROM PK NAIL SET IN PAVEMENT. / P�opoied ( � Shed Trench % : / / rTt " Groundwater CD 01° Encountered w 132 88.70' o� rop LOCUS PLAN / Pr pose 5'Around / �, SCALE: 1"= 1000' T ench �rip-out/ / / 3s.0 / /� _ a ;=xispng 1006 / 1 / � a Gad Septic/Tank / �, ` 4,0 0 * DESIGN DATA ( Exijs'engRegved P / LEGEND To / - I Proposed / '2.r o r--t NUMBER OF BEDROOMS 4 ---- 1 5 EXISTING CONTOURS / O 4"PVC/ El= 100.0 (assumed) NUMBER OF PERSONS 4 / f / / / i 21.0' i PK Nail Set In Pave. DESIGN FLOW 110 GAL/DAY/BEDROOM TEST PIT LOCATION l ` ( / / = - ! TOTAL DESIGN FLOW 440 GAUDAY O ti 1 ) / { ri l O O O EXISTING 1000 GALLON SEPTIC TANK SEPTIC TANK: Demolish \ 4"SOLID SCHEDULE 40 PVC PIPE 1 112 Sty WIF ? USE EXISTING 1000 GALLON SEPTIC TANK [] DISTRIBUTION BOX Dwelling I Existing to Remain ` r LEACHING TRENCHES: a . SIDEWALL CAPACITY 1 \ I 2 X 40' (LENGTH +WIDTH)X 2' (DEPTH)= 160 SQ.FT. f' 160 SQ.FT.X .74 GAL/ .FT.= 118.4 GAL. LEACHINGIDAY A h \ Q SQ V\\Boulderl\; �Ic v BOTTOM CAPACITY Existing Water 381, 36' LENGTH) X 4' (WIDTH)= 144 SQ.FT. Stone 144 SQ.FT.X .74 GAUSQ.FT.= 106.5 GAL. LEACHING/DAY Drive/ I � TOTALS: TOTAL NUMBER OF TRENCHES 2 @ 36' LONG BY 4' WIDE 211 25\ z TOTAL LEACHING AREA 604 SQ.FT. 83�6�30' \N/ \ \ TOTAL LEACHING CAPACITY 446.9 GAL./DAY REV. DATE BY APP'D. DESCRIPTION r s APPROVED BY: I PROPOSED SEPTIC SYSTEM UPGRADE ;N Of 16 i PREPARED FOR: RESERVED FOR BOARD OF HEALTH USE ���a� o RICHHARD T SUSAN L. NICKERSON LHEUREU '^ LOCATED AT No. cs Edge of Pavement � `� '�� ad Lane O I i \i (40' Wide - private way) `� �E� �' 111 STONEY POINT ROAD Y � CUMMAQUID, MA 02637 APPROVED BY: SCALE: 1 INCH = 20 FT. DATE: FEBUARY 14, 1999 0 10 20 40 80 FEET PREPARED BY: IEt W �+ DAN SANTOS e� P.O. BOX 200 SITE PLAN °� ��, �,� ,, f. CUMMAQUID, MA 02637 508-375-0876 SCALE: 1"=20' _ I -�- �-- -- - -- --- A- -- Drawn By: JLC Designed By: DWS I Checked By:DWS