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HomeMy WebLinkAbout0028 BAY VIEW TERRACE - Health 28 Bay View Terrace Centerville A= 187-010 /// SMEAD® No.M6SLOR UPC IUU smssd.c m • Ysds In USA OIN Town of BaICl[Ilsta.➢ e p#_ / t3 41yI6 �IRE rbr ° )<Departmont of Regulatory Services �J-Public Health Divisioll Date l� rW111.8a 200 Main Street,Hyannis MA 02601 9 M l ol00• Go Date Scheduled_ D / Time _ Fee Pd. Soil Suitability Assessrizent for° Sewage Disposal /�}� A � Performed Dy:�>rk ' ' '�,A A°' s Witnessed By,: _� ILOCA]CI ON & GENERAL WCF ORNU7CION Location AddressT c 6A t ;el-) Owner's Namr C ✓I ' Address Assessor's Map/Parcel: �8��(� Engineer's Namc QW K- Col,�e NEW CONSTRUCTlOTd RCPr\1R Telephone It �`S U�J ?6a Land Use. V0:7 ..ems Slopes(o/a) I SurCace Shines Distance's Fran: Open Water Body rt Possible Wet Area r d fL Drinking Water Well _ t 1 ` t � Drainage Way rt Property Llne YJ Ft Other tt SJK11±,TCH' (StTrrt came,dimensions of lot,exact locations of lest(roles 8c perc tests,locnte wetlands-it, roxinul p y Lo;.holes) r;^j s 31w a' `1A } .M j4- +G .fc Parent material(gcologic)Ak Depth Lo Betb•ock Al Depth to Groundwater: Standing Water in}foie: Weeplltg 1)[im Pit NO, Cstimated Seasonal High Groundwater ]SET E' " R' 1\11,� �iA'�']CON FOR SEASONAL HIGH WATER TABLE Method Uscd: � Depth Observed standing in obs.hole: In. Depth lu SORiolll53; Iti, Depth to weeping from side of obs.hole_ I!], Cruuadwuter Adf usthtent Index Well A Reading Dale: Index Well level AdIJI,fllmi,- AaJ,C rowiclwater Uvel PERCO LA7CION TJCI ST N3ale Observation Hole iF Time at 9" 1 Depth of Perc _� Tltrip at 61' Stat[Pre-soak Ti`nre'@ _ Time(9`4') End Prc-soak Rate Min./Incll ro Site Suitability Assessment: Site Passed Silg'-Failed: Additional Testing Needed(Will) Original: Public Health Division VOSe-ry: Liort 171U1P Data'Po Be-ICotnpleted on Back------------ ***If percolation Lest is to be conducted wlLllill 100' of we dand, you (must filrslt Lsotily idle. Barnstablc Conservation Division at least one (1) week prior to begiglvAug. Q:\SCPTIC\PG1KCP0RM.D0C IDIlE7CROBSE V.ATI®I�T Depth fro �][®)C' + LOG —_— — m Soil Horizon ]Hole# Surface(in.) Sail Texture Soil Color (USDA).. Soil• Other (Mansell) Mottling (Structure,Stones;Boulders, Con isteGcy. %a' ra el �14 -Er—Er �-RERR U'AJLIO H®.14.IL; LOG Depth from Sail Horizon I-role ff 1— (USDA)Surface(in.) Soil Texture Soil Color —� Soil ---- ) Hansel!) MottlingOther ( sa (Structure,Stones, Boulders. A ? C nsis enc %Gravel Depth from Soil-Horizon LOG # Sirrfnce(in.� Soil Texture Soli Colo[ (USDA) Soil Other (Mons II G ) Mottling (,structure,Stones,Boulders. • Consistent. t3 ve ------------ ------------- Y.9'o n Il Dcplh fi'arn Soil Horizon g'®�` Hole#_ Surface(in.) Soil Texture Soil Color Solt (USDA) ., (Munsell Other Mottiing (Structure,Stones; Boulders, Consistent_ x Mood Insurance](fate Map, , Above 500 year flood boundary No Yes Wthin 500 year boundary No Yes. T� Within 100 year flood boundary No ll�e)ptB� m^�'1yTa��tr�@�y ��eusre�>ita���vao�s NQaterf�i Does at least four feet Of naturally occurring pervious material exist in all areas Observed thl-pughout the area proposed for the soil absorption system$ If not, what is the depth of naturally occurring l)ervlous marar1617 I certify that on A',� (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analy.;is was performed by me consistent with the u'ec)uired trai ertise and experience described in �M CMR 15.017. Signature 1 _ Dat6 Q:1S.F.P'TfC\PERCr0lZM.D0C No80.:.. �...... Fus.1 2. 00.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................... .awn...._.....OF.........Barnstable Appliratilan for E apoii al Workg Tomitrurtinn rantit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal ' System at: x a" . 28 Bay_View Terrace, Centerville --•....................../.. -------•----------•-----------------------------------•-•-- ........... ..••-•---•--•-...•••-•••••-•-----------•-......-•-•••--- Location-Address or Lo No. Dr. Austi . --••--••---•._...__.......----- --•--••---•--•-••---•......---...............---............................••••••....-•-•--•..... W A & B Cesspool Service 128 Bishops Terrace;ddY�yannis a ......................... ------....... Installer Address Type of Building( Size Lot____--•-_-----------------Sq. feet U Dwelling t—`r No. of Bedrooms...................... ................... Attic ( ) Garbage Grinder ( ) — p., Other—Type of Building ............................ No. of persons...__3_.._.____._..__.__.. Showers ( ) Cafeteria ( ) a' Other fixtures ..........................•----- • W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter----------------- Depth................ W 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........................................ Test Pit No. i................minutes per inch Depth of Test Pit.................... Depth to ground water_-___--___---------.---- (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ........... ----------------•-----•-------•----------------------------•------...................................................................... 0 Description of Soil.--••---------------Sand------------•-•---------.•..........---•-------•-------------------------------••-------------•-----------------------------------_••--- x c, .....................•-------•- ------------------------------------------------------------------- - ------ UNature of Repairs or Alterations—Answer when applicable.instal lati on of a 1,000. gallon stone leach..fit...�overflow�_r.....•-------------------------------------------------------------------------•-•---------------•----....------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T 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 h th. j Sign G�.r� - ----- ------- ----- ----- l.._.1�17�80------- �d� D i 1 - v 1 -- Application Approved By------... -----------� 7�-- Date Application Disapproved for the following reasons-----------------------------•----------------------------------------------•-----------------------------•-•--•- ••------------•..................•------------------------------------------------------•--••-------------------•------•----------------------------------------------- --•••--------•--•---•--------- / Date PermitNo....80 ............................................. Issued.-•--•-----...------...1..180 Date i. — No 80-„ F>l s. .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......-- - Town...... ....OF.........�axnstable........ .............. Appliration for Biipo,ial Worki Ton rurtion tirrmit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: Centerville----------•-••--------- --•••-----•-------•-----------•---------•...............•-------------•-...............---•------- Location-Address or Lot No. Dr. Austin 0'Ma1Zey„,,,,,,,,,,,,,,,,,,,,,,•---......--------------------- 2....-�..-View.Terracee..Centerville _.......... - ........._.. Owner Address W A & E Cesspool Service ____,_•_________________„..,_,___._..------ 128 _Bishops Terrace, Hyannis Installer Address Type of Building Size Lot............................Sq. feet Ua Garbage Grinder —No. of Bedrooms.......................3_ Ex ansion Attic ( ) p, Other—Type of Building ............................ No. of persons...._3_............__.__.. Showers ( ) — Cafeteria ( ) a 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........................................ 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........................ ------------------------------------•------------•-•--------------------..........----•---....----•-......................................................... 0 Description of Soil...................... and------------------.....----------...----------------------------------------------------------•-------------------...---•••------------. U •--------------------------------------------------------------------------------•--------------------------------------------------•---•--•----•-----------------------•------------------------------- W ------------------------------------=-•---•---••-----•--•----------•----------------•--•-•------------•-------•--------...-------------•--•-•-•-•---•--•--------•---------•--•-•--•---.....-•-----•-- UNature of Repairs or Alterations—Answer when applicable In tallat On_-of-• _-1,000-- 2llon__stOne_____--- packed-.-prm-rc,at..lea.ch.pJ.t...(-szxexnox)-=------•---••-----------------------------------------------..................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with T/'1'�-• the provisions of :f'1 T iE 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. f f , r L.It fP / `M - /�s. >�+ -1 L + ] �0 S" ed =:_._.... =----------------•--—_-f,� '�. ...... D te Application Approved By---•----•---•-- �'% ------------------------------- .-1 I Date Application Disapproved for the following reasons:_. ....... -•---------•---•--•------------------------------------------------------------------------------- ----------------•----•------•-- ------.... -----------------------------•----------------••-------•-•----•--•--•------------•------------•••--------------------------------•-•-----•-•---•----------- Date PermitNo.... ------------------------------•-------------. Issued......................W?1 9...........----- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................T.9X4..............OF........:...;�Amsuu.e.............................................. %-Enrtifiratr of ToanpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by A--&B Cesspool..Service-,---128,B ehope.Terrace-'---HYajan : ,.--1 ----92 04 ................. �...---- Installer at. _Bay-View_ errace,_-Centerville.,._02632--_-___.--------Dr,-_Austln__TM@'1 ,eyC..................................... 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-------- -_ ........... dated-----1117/80.-.-_--------_----_-- THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. _����•���� DATE--•----------- _.-.•,�.r--�=-1--�=�---------------- Inspector--- -:� ------- ------ --- �-................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable 80 .................................OF..................................................................................... .�aa� work$ PaBis A & Cessp ool Service, ops Terrace, Hyannis, MA 02601 Permissionis hereby granted.......................................................................--•------...•-•-•••••••--••-•---......................----............ to Construct ( ) or Repair (K ) an Individual Sewn e Disposal System at No..2S Bay View Terrace, Centerville t 024 2 Dr. Austin O'Malley___________________ Street as shown on the application for Disposal Works Construction Permit No 8Q-.e.:.......... Dated-----------i1W71 -----•------------------•----------••----------------------------------------------------................ DATE 1/17/OD Board of Health ----------•C. ... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NA E i ADDRESS R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED I' It �' 5s No. :�_l _.... Fizs......U`..:......... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE L H L,./ L... .....0 F..... .............. -......................... Appliration -fur Ui�ipuiittl Works Tatt.itrnrtivn Vrrntit Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal S stem at — --------- -- Location•Address ................•--- or Lot No. / Owner Address Installer Address U Type of Building Size Lot...-------------------------Sq. feet Dwelling—No. of Bedrooms-------- �..............................Expansion Attic (4) Garbage Grinder ( ) aOther—Type of Btl"i"Iding ---------------------------• No. of persons............ ---_---____.__ Showers Cafeteria ( ) PLO 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. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area-------.----------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-• Percolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. 1................minutes per inch Depth of "Pest Pit-_---_._ ---_____--- Depth to ground water..------.-------__-__--- L?. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_-__-._.._-___--__--__._ ------.----•------------------•--------•-----------•-----•------------------------------•------------•------_-------------- --•---•-•-------•-------...... 0 Description of Soil------------------------------------------------------------------------------------------------------------------------ ---•--•---- ----•------------------------------ x W ..........• ----------------- ------------------------------------------------------------------------•--•---- ••. ---------- -------------------------- --------- �'--- --------- Vf trs or Alterations—Anser when applicable_...... : x . 'z............... G f _.._._.. __P ......... .__.___. ---------------•------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een u d by the boa ealth. igned --•-------- •--------------=�'__--• j'v �i/?� ---• •- ,� ` ate Application Approved BY C��_"� 1 - e Application Disapproved for the following reasons:......................�--__------_.-___..__.__...__._...._-__•_--________--_____-__Dat _--___________ ---------•-------------------------•-•------------------------------•---•--------------•-----•-------•--------•---••-----•-----•-•-•---------------•--------•--•-------------•------. Date PermitNo........................................................ Issued..................... .................................. Date a THE COMMONWEALTH OF MASSACHUSETTS I'Z✓y --...OF........ .................................... . Appliratinn -fur Di5 mia1 lVorkii C uturitrurtion Vaunt , Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: _ Location-Address or Lot No. y........ J t v z -e-t.-vJ _1 --/----------------------------- ---------------------------------------------- dre 4 Owner Address Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms------------ ------------------------------Expansion Attic (moo) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons 4---.-.-.----- Showers Cafeteria Q' Other fixtures ------------------------------- -- d ---------- ------------- ••--------------------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic T;:nk—Liquid capacity------------gallons Length------_-------- -vVidth-------__----- Diameter-----.---------- Depth.-_.--_-.----- xDisposal 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 ( ) aPercolation Test Results Performed by------------------_- --------•-----------------•--..__ ---- Date...........-..-------------------------- a Test Pit No. 1................minutes per inch Depth of Test Pit..------------------ Depth to ground water...---- f� Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water...-..----_----------.-. a ------------------ ---------------------•------....----------------------------------•-•--------•--......................................................... 0 Description of Soil------------------------------------------------------------------------------------------------------------------------.----------•------------------------------------ x V ---------------------------------------------------------------•----------------------------•------------------------------------•-------........--------------------------------------•----------- W ...-------••------------------------- ---------------------------------------------------------------------------- x .......---- ------------------- - V N�ire of Rep irs or Alterations—Answer when applicable.-.-----..---�---.-_---a- ----------- -t----------�-.t%-- _- --.------ - 1------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een, u d b the boa of.l\iealth. Application Approved BY.......... . .... .� -� %'1 ------ -----------------_ -----..../-. ..-. ..-/ ._ Date Application Disapproved for the following reasons:............................ +._---...- ..................................................................... ----------------------------•----------------.........----------------------------------------------•--- -------------- Date PermitNo........................................................ Issued...................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O�F7 HEALTH P41OF.......... rr- if irate of TOri Phatta THI TO CERTIFY T he Individual Sewage Disposal System constructed ( ) or Repaired (� by .—.... ---•-- *erat ���' � ----- ------(...... -------; has been installed in accordance with the provisions o of 1e State Sanitary Cc7 described in the application for Disposal Works Construction Permit N :-_.�-1:.,5-_. dated.------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................................... ...................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS ' BOARD Oram.-HEALT 7 /� ..........OF..... ..- �1....-..... d----^ G No......................... FEE.----- ............... r ' i>Qat �rrutit Permission is hereby granted-•-- Gi 'n. ! =----------------------•--------••••---.---- to Construct ) or le pa ) dual e Disposa stem at No... . . ,- = --- .. A---- ------ Street, ' f ` as shown on the application for Disposal Works Constr ction Pe ]i o.-- - -._- -- D, ed... ...... oa$ -rd`of Health DATE---- r2 ''2 ------------------------------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS L &CATIONr ' / V/ EWAGE PERMIT NO. VI AG E INSTALLER'S NAME & ADDRESS B UI'LDf9 OR OWNER DATE PERMIT ISSUED �zl DAT E C 0 M P L I A N C E ISSUED � ' , ,�tugs U .. IL t