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