HomeMy WebLinkAbout0027 BERNARD CIRCLE - Health 27 BERNARD CIRCLE
CENTERVILLE
A= 147-028
SA
NoC._...�.43 ` °J�a
HASTINGS, MN
Tormer� 4oud e
ll'
a
TOWN OF BARNSTABLE
LOCATION�.� (3��R-N04 A Cyr L�e- SEWAGE#
VILLAGE 2i-� �'�V�1` ASSSESSOR'S MAP&LOT �.
INSTALLER'S NAME&PHONE NO. C�Cniee C c A
SEPTIC TANK CAPACITY 0)0.5'�k'- l V r4 r / l d �y✓� �, e
LEACHING FACILITY:(type) )"I-G (ef (size)
NO.OF BEDROOMS 13
BUILDER OR OWNER
PERMIT DATE: COMPLIANCE DATE: gIly o
Separation Distance Between the:
i
Maximum Adjusted Groundwater Table and Bottom of Leaching 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
of
A3 39 - ri
fh C-k-
!1 J Iei
V2)A,
►��= 3, "
eciT
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftphtation for Misposal *pBtem ConstrUttion Permit
Application for a Permit to Construct( ) Repair(a Upgrade( ) Abandon( ) omplete System ❑Individual Components
Location Address or Lot No. 27 / i�snl� C� Owner's Name Address'and Tel.No. i W'-7�G= 7S'�Q
L er ce"I rL��l/a' fuCe�cf'd<rso�
Assessor's Map/Parcel /y1-_ -Zr a r =,W/
Inst)ler's Name Address,and Tel.No. s '���" Designer's Name,Address and Tel.No.
o4rox)A FW Cam Co�/s' iv'G 9 e evr�c� �rafi<,`te cr`i ec�G4rfe6r
.� GGeSf G'dOi'J�'i`C/Q� B�e� oB'B�j
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size j d o o sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) ZY;3cr gpd Design flow provided Fya 7- gpd
Plan Date Number Number of sheets Revision Date
Title
Size of Septic Tank /o®d Type of S.A.S.deg
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) G!S G P&tx 4 krgg --h Bar
!t.�-d-1�• /-�5�/s�il.�Lt)��r� �r�` rCvsC,l �7�ii?C 1"—I t9�� �� Jt! �� �iY� ��
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 Certificate of
Compliance has been issued by this Board of Health.
Signe Date
Application Approved by Date .L�
Application Disapproved by Date
for the following reasons
Permit No.En'�'- Date Issued
y^a y_ IN h n'r'aa...0.�..r. .. ... -. r• +-.T s...r#fE .. ,-, g�-. �.r• _•': ,_ „ .t'€r 7r'�'w rytif.+4.'(�,( !ti J��.•A,%,. . i.. - +;,'F;#��' "'�.V'•r'.
E NA
TM 'a,
s>, / # Fee
THE COMMONWEALTH,OF MASSACHUSETTS, Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN`OF BARNSTABLE, MASSACHUSETTS
ftplidtlon• for ]Disposal Opstetn Construction Permit i
Application for a Permit to Construct( ) Repair(a Upgrade( ) Abandon( ) G/Omplete System ❑Individual Components
Location Address or Lot No. y> 45&1aaiq✓ C o'i`. Owner's Name,Address,and Tel.No. ,Cad--r96 793'�
16.1 S/ CC �ilri l/o %w ew. es='F ee r wrt
Assessor's Map/Parcel ?r ram"""""V Ci•':
.:: Ins ler's Name,Address,and Tel.No. f'� 7?s' �'� Designer's Name,Address,and Tel.No.sbv0-'Yr';"
o�/ CcrRr �oc/flOa��'G 9�reirYcy
/il L�+!,ff C/ofA�'i•+/� /�e� /."'�s'+�f/�/,�!
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size d-o'o sq.ft. Garbage Grinder{ ) j
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) _-�3Q gpd Design flow provided :1 +� gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank /pod Type of S.A.S ' 1;
Description of Soil
f Nature of Repairs or Alterations Answer when applicable)
t r,�/t�SJ6G// y/lr cd ro ri:� �li.e.� �'��a.�.r s;,'....+►+'. ..t °yxe� ,�/r/� //'/�-
Date last inspected:
Agreement:
x
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 Certificate of
Compliance has been issued by this Board of Health.
Signs C Date
s Application Approved by Date
Application Disapproved by Date
R for-the following reasons
d -
`Permit No.-- '' Date Issued
R jr J ,1� THE COMMONWEALTH,OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliaure
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(O-K Upgraded( )
Abandoned( )by'e5Z/ r n �'ey co e� �s�vsJ L'�.^i .
_ at �► /3 /� ' "has b�en'constructed in accordance
e4: �►idr�sr� , l
with the provisions of Title 5 and the for Disposal System Construction Permit No-. (PO dated -
Installer �'' " Designer
#bedrooms `y Approved design flo gpd
The issuance of tUs p it shall not be construed as a guarantee that the system wi� cti as designs .
Date 1 l 2 d Ins ector
P
�S l "
rjV Fee /
THE COMMONWEALTH OF MASSACHUSETTS r
PUBLIC HEALTH DIVISION- BARNSTABLE, MASSACHUSETTS.
Nsposal *pstem Construction Vermit
Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( )
System located at T /�;•ors>c�-r.0� Cr',; radr�z�i`ui%/.•�
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Constructl*on must becompleted within three years of the date of this permit.
Date Approved by
Town, of Barns able
of SHE Pp�
iy� ti Regulatory Services
(�. Richard"V.Scali,Inter1m,D reor',
nnitxsrnsi,e, � ct.
Public Health;I?tvision'
t639. �$
�°pTev MAC' Thomas McKean, Direckoi-
200 MAIM Street,'Hyannis,MA 02603
Office: 508-862-4644 Fliv, 08-79M3i74
Installer&Designer Certification,Form
Date: 03 I �/ ` Sewae Permit#. ++
�,g ;moo o> z64 Assessor s"lVlap\Parcel .� ,I��O Z
C Cis•+ee
Designer: 1 ,�e� n JCxjCt L.S Installer. � �c� �-p �_e Svc
Address: )Z W1 Cry--,:i IZd_ Address:' 3S0 �'t,g�vv
MAq
(fin ?O_ ���v � e �7J� issued a permit to instal] a
(date) (installer)
septic system at T7 based on a design drawn by
(address)
i
l Cn r n eel✓1q Nc 'Zts• f� tiC dated' G
f
� __... (designer) — -
i
c6rti.fy that the.septic systern referenced above was:installed.substantially`aceordiit;to
the desig , w ich may include minor,approved changes such:as lateral relocation of the>
4 distribution box and/or septic tank. Strip out (if requlied) wasinspected,and the soils
were found.satisfactory.
' I certify that the septic system referenced above was installed with.major or changes i e
greater than 10'lateral relocation of the'S:,�S or any vertteatre'ocatio.n of an'0oinpo lettt,
of the septic syst.efn) but in accordance with State &Local Regulation.s. Plan revision or
certified as-built by designer.to follow. Strip.otit.(if -i✓9lii I d) was inspector and'tltesoiis
-
were found satisfactory.
I certify that lie system referenced above was:constructed m with the terms
of the l\A approval,letters (ifappli:cabte). pus
AM
t sl-
(Tnsia ler's S.gi�ature) C1VIl
�6.35'109.
fl15SE
(Designer's Signature) (Afiix;Designe ere}
M PLEASE RETURN TO BA.tt�IS'fAC3L.i PUI3"LiC'H'EALTH DIVISION. CERTIFICATE
OF COMPLI.ANC.E WILL NOT BE ISSUED UNTIL �BOT.H THIS FORM AND AS
BUILT CARD ARE RECEIVED.BY 'rHE BARNSTABLE PU13LFC HEALTT-I DIVISION:
THANK YOU
Q:'Su1;0 0 signer Ceilificatiou Fornt Reu 8-14-11doe
Engineers note:This certification is!roiled to an as-built inspection of.system remponon! as installed.•prior to backfill:'The
engineei did not supervise construction o:the sysiem.The in taller assumes responsibility for all materials,workmanship,backtilling
io specified grades v lh proper compaction and setting risers;covers as shown on f idesign plan..
f
Fee C
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Rpp ication for 30igpozar *pftem Com6truction Permit
Application for a Permit to Construct( )Repair( )Upgrade )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. a'7 ,et N;A_rd_C—Q o-c r Owner's Name,,Address and Tel.No.
Assessor's Map/Parcel i?V_ 4.1�'e a r S"4�)
I kb- �d f
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
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 17330 gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank _45�,r S;ry A YTDL7 .S60T`C Type of S.A.S. C O�.c s'SSc U(IS
Description of Soil -A-V— S ADO
Nature of Repairs or Alterations(Answer when applicable) �� �` �2C i Sf t
S-- oflu,ae jVq
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 bW
sits
Signed Date
Application Approved by c Date
Application Disapproved for the following reasons
Permit No. —04_9�_ Date Issued 7
n
/��• - .� � -.- .may.. -_ ai a. "- n, •, _.Y 6. _. ..�. �• `.
f
v. NCB I'(/ / _ Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: f
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Rpolicatton for M.5po!5al *pgtem Construction permit
Application for a Permit to Construct( )Repair( )Upgrade Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.�-'7 ��N ,rQ—eC rr ' \Owner's Name,Address and Tel.No.
Assessor's Map/Parcel -� -er C.r.S tnL)
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
e✓
Type of Building: If N
r v t
Dwelling No.of Bedrooms :Z1 Lot SiCe .- Sq. ft. Garbage Grinder( )
f Other Type of Building `� No. of Person s(•V` Showers Cafeteria
t. ( ) ( )
Other Fixtures A �
._
i
Design Flow gallons per day. Calculated daily flow �3 S9 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank rr. S Type of S.A.S. l-� 5�1� rc. rg_c r ,�.�ji -�(?"�tp f?
/n� c
Description of Soil fNL I S Atit Q
Nature of Repairs or Alterations(Answer when applicable) < =V-(;\- t*- en-(StZYr�'1
ZX --,7 t( S lS.t S cc v t� t1
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 is
Signed A Date — 3U
Application Approved by e Date a�
Application,Disapproved for the following reas ns ,
'+ 1
Permit No. d Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired ( )Upgraded()t(Q
Abandoned( )by &`O--CIA OC S t_Po
at !al jr,.-,0 e---. c, to G.'C-_(JTf_V_AR has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.� 0-eedated 7 �`
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date ,ter Inspector
o. QQ'''�/
J ° 7�� � Fee .��� ..►/
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Mi5pogal *potem Cott.5truction Vermit
Permission is hereby granted to Construct( 4epair( )Upgrade(X-)Abandon( )
System located at '?s'Z
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 this it. .
Date:_- 7 �—9� Approved by
J � 1
TOWN OF BARNSTABLE
LOCATION ` ,�3 C441ARD. SEWAGE # 9 Y
VILLAGE + 1LnA1L- ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. { n�r
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER /fit Cn
P
PERMITDATE: 4i Jty COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well 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
r7 C,
� *
� ,�
. � ��_�...................
THE oomMowvvsAcrH or mAssAo*ussrra ^ '
���~��� ���� ���� HEALTH �
������" "�� �,"
�� �F �~��������������
----- ------ _
� Appfiration for Di~
Application is hereby made for a Permit, to Construct or Repair an Individual Sewage Disposal
System at
� � - o �� N�
Yr
----------------------
ss
c= L� -----
--_"���e�u���--'��� '��--_________________ _________._______________________________________.
z"��,, Aa/=�
TyycofBu�6��-' w �� Size I.ot-/'����I{�----'Sq. feet
Dwelling—No. o� B�dr0000,---���----_-------'Eoyuo i ( ) Garbage Grinder (y«)
04 Other—Type of Building ............................ No. of persons.--»�—!-------------- 6hm,cry ( ) -- Cafeteria ( )
P4Other fixtures ------------------------------------------------------------------------------------------------------------------------------------------------------
Design Flow............................................gallons per person per day. Total daily flow.........-s..3.42-----.---' .
1:4 Septic Tank—Liquid capacitvZP.Ov-�ak�os WidthD ---------------- Depth
Disposal %���G--I�u --��---_' \��16~�5��.---' Iota �co�tb.'��..--..... Total leaching area-.��,10 .'--ag ft.
Seepage Pit No--------------------- Diaoue1er------- Depth below inlet.................... Total leaching area.--------ag. ft.
Z Other Distribution box Dosing tank
~~
�.Iczcolutioo Test Results Icoroy-.- ��.-.� � �1--'--------------'
Test Pit No. -oioutcspcci�h Dcnib of Test P�.'''��. . ''' Depth to ground nn�r------------------------
Test
-
Pit �o. 2'"��� -o�out�y��r inch }cnt� of Test ��..��-"-_-- Depth to cr0006 waterZu -.--_
............. _._-.---_.--__--___ ........................................................
� 0 . of
_-_- ---''
---_---'---------------.------.-------_-------.-__-._.--_--_--_.-----_.--_-------..
j
Nature of Repairs or AJterutioou--Aus=c, wbco applicable-.---'-----------------.------------_-
-------------''-------''-'------------'--''-'-----------'-'-'''-----'---'---'---'------
agrcement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions
y �I�provisions7- 5 of the State Sanitary Code—The undersigned further agrees not to place He system in
operation notJ u Certificate of Compliance has been 1o» 6b the board f
Signed` ------__--'-' �_'_'-~~....
...............Pate
.................
Application Approved B !-- --'------------ -���'�������-----
. Date
Application Disapproved for the following reasons:.............................................................................................................
--'---'--------
"=°
�
'
Permit
Date
' `
No.- .' •- �: f ,.. Fps...._ ...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...........OF.................. / IY-.s" ./ „-----•-
Appliratinn fur Dispaa al Works7) or
C�nn '�trurtion ami#
Application is hereby made for a Permit to Construct ( Repair ( ) an Individual Sewage Disposal
Syst at V4 . .......Ot..... ................drf.�I.VZ—F& ................................
Locati n-Address or Lot No.
- r- :.. ... . ?11±' f.'.......lar!_. ., . .. .....................................................-............................................
caner -------------•----------•-•---- Address ^
a '. ..... ....1 ...............................
Ins` er',, _ Size Lot__C
Address
g _..'�}.-;d0�?---•-----Sq. feet U Type of Building � '
U Dwelling—No. of Bedrooms........ _____________________________Expansion &ic ( ) Garbage Grinder (Na)
4 Other—Type e of Building _ No. of ersons.._._. Showers
Ga YP g --------------------------- P --------------- ( ) — Cafeteria ( )
alOther fixtures ................._....................................................................................................................................
W Design Flow............................................gallons per person per day. Total daily flow-------'" " _t+ .....................gallons.
W Septic T9XV-01—
iquid capacity/._.gallons rLength________________ Width._.__..________. Diameter:_.-.--.___._._. De th___________...--
Disposal No------/__________ Width_/&...________• Total Length_.4�4r........ Total leaching area...4�!&.....sq. ft.
Seepage Pit No_____________________ Diameter.................... Depth below inlet.....:.............. Total leaching area..................sq. ft.
Z Other Distribution box (+.-15 Dosing tank ( )
~' Percolation Test Results Performed by------P'___._.V4>V_WV4A1.g.................................... Date....3 >0*45.
,a Test Pit No. I...C,_�t .__.minutes per inch Depth of Test Pit....ft?.......... Depth to ground water____9............:...
44
(i Test Pit No. 2_,-_.r-r__.minutes per inch Depth of Test Pit._6 ... Depth to ground water_ ..____________________4.,
............. .............:.. ------•--......._•--••- ------
41
Description of Soil. ..! _....L_. ...�� � +I _.. ________ _.. l✓ ... ••-
x
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 TTTLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
w-< operation until a Certificate of Compliance has been iss �.d by the board of 1 lth. '
Signed fly . ...........:.• �� _
.............................
to
Application Approved BY - -----• -
� .
Date
.. +Application Disapproved for the following reasons---------------------------------------------------------------•-•----------.•.-------------------------------•--
.....-•..-•---••------•---•-•---------------•------•--------------••------...-----------....------------------------------------•------------•---•-•--------------==------------------------------_..._.. -
�^ Date -
Permit No. Issued --n� -----------------------•--•----
c--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
F
..........OF...... I NS' .. .........................
(5rdifiratr of Tomplianrr h
THIS S,'Q CER Y, at the. Individual Sewage Disposal System constructed (� ) or Repaired ( )
1......._!�' -• !_:1_A.r ----- - l Y f _ � `�!�'- —
has been installed in accordance with the r isions of 'r -LE 5 of The State SanitaryCode as described in the
application for Disposad Works Construction Permit No.��__���'_ �__________. da.ted ---___________-___-________________________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON UE®-AS A GUARANTEE THAT THE
'SYSTEM:! WILL FUNCTION SATISF CTORY.
r
DATI: I= .}::'_r ... ----------.. Inspector �.�r_ ...................................
* THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH y
..... --59�Ul--Y.............OF.......� f►` ` /T. r .r.......... 3
No.......... ....,, 1 ;> FEE._.......
Permission is hereby granted......... ...!"'... ......... ______ ____ "-
to Construct ( lyf"Repair ( ) an Individual Sewage Disp al System
at No.-••••••-•-G v `e?,tLl =I& `s1% , Yt�s�FG '"
Street
as shown on the application for Disposal Works Construction rmit No.................. Dated----------------------------*.........
at d______:____-__________-_____-_.__-._._
�.,.
�• �} /� (r� Boar f Health
DATE. c,�C/ d-(�
FORM.1-1255 HOBBS & WARREN. INC., PUBLISHERS `
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' Y-4 LEGEND -
�`�N-°F�'Qs�� CERTIFIED PL T PLAN l I~XIST•ING SPOT ELEVATION O,<0 �.� Q
'EXISTING "CONTOUR — 0 �ROSERT �\
'FIINISHED. .SPOT• ELEVATION
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fiN1SHED, CONTOUR ® -- x r •,
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- PATEt AGENT SCALE . m 3G DATE P-�/�f_ _
lt�bOtb�GE. EIVG'IMEERIIVG CO IlVd.:) --'- —��
CLIENT I CERTIFY, THAT THE.-PROPOSED
.f IfEGISTERE(� 'REGISTERED<I JOB N0. GGZI BUILDING SHOIAtPI ON THIS PLAN
fi , a CIVlL r I LAND CONFORMS TO .THE ZONING LAWS
Af5
ENGINEERS,) '._[-SURVEYOR j DR. BY -- OF BARNS-TABL E MASS.
3•?:�iC'° MAiN ST, 712 MAIN cT CH. BY :-=---------'- �/YAT
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SO.vYARMOIr rH, MASS. HYANN(S, MASS SHEET. ._ OF _ " , ;
IE REG. LAND SURVEYOR,
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LD,
L 0 C TI0N toNR SEWAGE PERMIT NO-
i�
VILLAGE
1— 0—izt;�-A
INSTA LLER'S NAME i ADDRESS
3 UILDE R OR OWNER
DA T E PERMIT ISSUED o
DATE COMPLIANCE ISSUED -_�•, �
� G
13 '
b i, C7
10/9/97
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
ENGINEERED PLANS)
I
I, < &� o.�eS , hereby certify that the application for disposal works
construction permit signed by me dated (0—30 9 , concerning the
property located at meets all of the
following criteria:
v• There are no wetlands located within 100 feet of the proposed leachingfacility
ty
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.
If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the
proposed leaching facility will=be located less than fourteen(14)feet above the maximum adjusted
groundwater table elevation.
Please complete the following:
A)Top of Ground Elevation(according to the Engineering Division G.I.S.map)
B)Observed Groundwater Table Elevation(according to Health Division well map) `3 0
� I
SIGNED : DATE: 1�-3o cj�
LICENSED SEP IC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
[Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan,
this plan should be submitted].
q:health folder:cert
Z
. ..
U
I
A
Town of Barnstable
Department of Health, Safety, and Environmental Services
�°"M`A� Public Health Division
61639. 367 Main Street, Hyannis MA 02601
Office: 508-790-6265 Thomas A.McKean
FAX: 508-775-3344 Director of Public Health
December 2, 1996
Mr. &Mrs Bruce McPherson
37 Bernanrd Circle
Centerville, MA 02632
NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.00 THE STATE
ENVIRONMENTAL CODE TITLE V: MINIMUM REOUHLEMENTS FOR THE
SUBSURFACE DISPOSAL OF SANITARY SEWAGE, AND 105 CMR 410.00
STATE SANITARY CODE H - MINIMUM STANDARDS OF FITNESS FOR
HUMAN HABITATION.
The property owned by you located at 37 Bernard Circle, Centerville listed as Parcel 028
on Assessor's Map 147 was inspected on November 29, 1996 by Jerome Dunning, Health
Inspector for the Town of Barnstable, because of a complaint. The.following violation of
310 CMR 15.00, the State Environmental Code, Minimum Requirements for the
Subsurface Disposal of Sanitary Sewage and 105 CMR 410.00 State Sanitary Code
H- Minimum Standards of Fitness for Human Habitation was observed:
REGULATION 310 CMR 15.02 (207) AND 105 CMR 410.300:
Overflowing sewage onto the ground. This violation is a serious public health hazard.
1) You are directed to hire a licensed septage hauler to pump the overflowing cesspool
within twenty-four(24) hours of receipt of this letter.
2) You are also directed to keep the on-site sewage disposal system pumped as many
times as necessary to keep from overflowing onto the ground.
3) You are further directed to contact and hire a licensed Disposal Works Installer within
seven (7) days of receipt of this letter in order to repair this system or connect to town
sewer.
You may request a hearing before the Board of Health if written petition requesting same
is received within seven (7) days after the date the order is served.
Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with
an order shall constitute a separate violation.
PE R O T BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
t ,
NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.00 THE STATE
ENVIRONMENTAL CODE TITLE V• MINIMUM REQUIREMENTS FOR THE
SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND 105 CMR 410.00
STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR
HUMAN HABITATION.
The property owned by you located at Z
listed as Parcel 01ff on Assessor's Map IY 7 , was inspected on
�!-1�96 ► 199 ► b 17 , Health Inspector
for the own of Barnstal because o a complaint. The
following violations of 310 CMR 15.000, the State
Environmental Code, Minimum Requirements for the Subsurface
Disposal of Sanitary Sewage and 105 CMR 410.00 State
Sanitary Code II - Minimum Standards of Fitness for Human
Habitation were observed:
REGULATION 310 CMR 15.02 (207) AND 105 CMR 410.300:
Overflowing sewage onto the ground. This violation is a
serious public health hazard.
1) You are directed to hire a licensed septage hauler to
pump the overflowing cesspool within twenty-four (24) hours
of receipt of this letter.
2) You . are also directed to keep the on-site sewage
disposal system pumped as many times as necessary to keep
from overflowing onto the ground.
3) You are further directed to contact and hire a licensed
Disposal Works Installer .within seven (7) days of receipt of
this letter in order to repair the system.
You may request a hearing before the Board of Health if
written petition requesting same is received within seven
(7) days after the date the order is served.
Non-compliance could result in a fine of up to $500.00.
Each day's failure to comply with an order shall constitute
a separate violation.
PUR ORDRR OR THE BOARD OP HEALTH
Thomas A. McKean
Director of Public Health
TOWN OF BARNSTABLE
LOCATION -3 7 Cfi SEWAGE #
VILLAGE 9=:-:U ^" ASSESSOR'S MAP & LOT I Y 7 O
INSTALLER'S NAME&PHONE NO. 1ZgZn f'
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER /��G TP NM
PERMIT DATE: w-"-a30 "? COMPLIANCE DATE: ET
Separation Distance Between the:
' Maximum Adjusted Groundwater Table and Bottom of Leaching 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 Feet
within 300 feet of leaching facility)
Furnished by
1
i
r, +
-.f LEGEND _
APPROXIMATE LOCATIONS OF APPROX/MATE LOCATION OF EXISTING S.A.S. ''� �'' '
PREVIOUSLY ABANDONED S.A.S.s (PER TOWN RECORDS) -- 38 -- EXISTING CONTOUR
(PER TOWN RECORDS) TO BE ABADONED IN PLACE x 30.98 EXISTING SPOT GRADE
37.3 PROPOSED SPOT GRADEa� ji'� •�`
PS 252-L'G 32 -W EXISTING WATER SERVICE
Jr �mt �� `: ! �4\ %! g
• ++ 6, -G EXISTING GAS SERVICE
N 30 00 �W
106.31' -0.H.W.- OVERHEAD WIRES
I - ` Q27 Bemard Circle'/ii\,% ;
\ 93.05 --_-- -__,� cV PARTIAL STRIPOUT OF UNSUITABLE TEST PIT i i•.� ;fir �:• �
I SOILS ASSOCIATE,WITH OLD S.A.S. `y% ` '.:- ` i^
\9 I 12 BENCHMARK
ED PROPOSED S.A.S. \.�; h\ `../\\\ j ``,
\ 92,34 ------C--- `O, 13' x 35' LEACHING FIELD `ti "S �`'w '`ti
\ \ �•�,`. -O':i�:`� W/2 DISTRIBUTION LINES
\ 9 3.5 4 r
\ 9P.63A.
k.
62
PROPOSED x �� 1 i 93,98` f I \ �: �y' LOCUS MAP
PUMP CHAMBER ` �; 6:26
1.
�. -
��� GENERAL NOTES:
0
93,27 \ � ;.� 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF
95.27 x 96.67 HEALTH AND THE DESIGN ENGINEER.
EXIST. SEPTIC TANK x 93,7 � BENCHMARK 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE
(TO REMAIN) \ j� \ 3,86 ORANGE DOT ON CONC. PAD STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES
Q0 EL.=36.60 AND REGULATIONS.
TOP, EL.=92.39 \ DECK 93.63 x '96.85 2
INV.(OUT), EL.91.04t x B BM M 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO
INSPECTION AND APPROVAL BY THE BOARD OF HEALTH & DESIGN ENGINEER.
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM
�p THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER
97.49 \ BEFORE CONSTRUCTION CONTINUES.
O. �0 EX/ST#2ING O. �, 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM.
O /�+ HO F.=10 Z7� 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE
/ \ T.O.F.=101.5t
� . x 16 CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR
\ CELLAR FLOOR EL.=94.Ot `J 96 x' 97,6 PROPER INSPECTIONS DURING CONSTRUCTION.
98.10 J x 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
97,99 8. THERE ARE NO PRIVATE ABUTTING WELLS WITHIN 150' OF THE PROPOSED S.A.S.
RET.WALL 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS SHOWN ON
x RET.WgLLS 97,43 THE PLAN OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES.
99,71 x 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY LOCATIONS
98.48 �\. x 0.5 OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION.
98,04;: 0' 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS BENEATH
AND FOR 5' ON ALL SIDES OF THE THE S.A.S. AND REPLACE WITH CLEAN SAND
\ 97,54 : ,�'.. AS SPECIFIED IN 310 CMR 255(3).
\.
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INSPECTED BY
o�P PETER T. .`PAVED: ' :; LOT 51qq A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL.
r^ 15,000 ±SF 13. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED EXISTING SEPTIC
McENTEE ti \ 97 8 47.4 ...`...." \_ SYSTEM COMPONENTS NOT SHOWN ON THE PLAN.
CIVIL c7
No. 35109 R/VEWAY; 14. CONTRACTOR SHALL TAKE ALL NECESSARY PRECAUTIONS TO MAINTAIN THE
98 75 STABILITY OF ADJACENT STRUCTURES.
o� Sj�RE� Q `L : .:;.• ., '+ \ 15. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
/� IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
99.05
UPED Oz,l� 106.31' LOCUS: PARCEL ID: 147-028
S 1'3�00" E
102.57 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
101,36 100.19 1 99,18 27 BERNARD .CIRCLE, CENTERVILLE, MA
98.38 \ Prepared for: Cape Cod Septic Services, 350 Main St, W. Yarmouth, MA 02673
BERNARD CIRCLE Engineering ri SCALE DRAWN JOB. NO.
OWNER OF RECORD � 98,39 S-� En meerin Works, Inc. 1��=20' P.T.M. 228-20
MCPHERSON, BRUCE G & SHARON �l \ 9• 9
37 BERNARD CIRCLE 12 West Crossfield Road, Forestdole, MA 02644 DATE
• CHECKED SHEET N0.
CENTERVILLE, MA 02632 k (508) 477-5313 8/8/20 P.T.M. 1 Of 3
i
''►' EXISTING SEPTIC TANK & NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE <93.3
PROPOSED PUMP CHAMBER FOR A DISTANCE OF 15' AROUND THE
PROVIDE RISERS & COVERS AS DESCRIBED: PERIMETER OF THE S.A.S.
1) INLET COVER SET TO 6" OF GRADE. PROPOSED D—BOX
2) 20" OUTLET COVER SET TO GRADE
MANHOLE COVER SHALL BE SECURED INSTALL WATERTIGHT RISER & PROPOSED S.A.S.
TO PREVENT UNAUTHORIZED ACCESS. COVER SET TO 6" OF GRADE INSTALL INSPECTION PORT
F.G. EL.=93.3t F.G. EL.=94.3 to 96.5t
PROVIDE ENOUGH WIRE F.G. EL.=94.St
F.G. EL.=93.3(EXISTING) MAINTAIN 2% GRADE (MIN.) OVER S.A.S.
SLACK TO REMOVE PUMP
DIAM INSPECTION PORT,
L m 8'MAX 13' x 35' LEACHING FIELD W/2-4" PERFOR.ATED IN S.A.S., SOLID
L = 20' '• E.
40 �OcKs @'scri% (MIN,)SCH 40 PERF. PVC DISTRIBUTION LINES SET ABOVE SWITHIN WITH
OSCREW
CAP
S=i% (MIN.) TOP EL.=91.84 2 F NHRU6F DS
4"SCH40 PVC pROVIDA pL�BEND CAPPED ENDS
s
. . .. . � :. 6" EFF.DEPTH
WIll �e INV. EL.=92.80(END)
14„ I'p^ INV.=93.06 I SLOPE OF PERF. PIPE = 0.5% I EXISTING
INV.=93.23 ,
PROPOSED D—BOX 35' EFFECTIVE LENGTH
HOUSE/ 27)
ADD INV.=90.75 3 OUTLETS (MIN.) SOIL ABSORPTION SYSTEM (PROFILE) T.O.F.=101.5 EFFLUENT 2 FLOATS
FILTER INV.=90.50t INV.=92.98 /
EXISTING BOTT. EL.=86.2 BACK OF NO E
SEPTIC TANK 1000 GALLON MONOLITHIC
[(FIEINV.=91.04t PUMP CHAMBER (H-10 RATED) ESTABLISH VEGETATIVE COVER
LDEXISTING
VERIFY) (See Pump Detail, Sheet 3) DECK
FINISH GRADE iD p ��o' Mffu
NOTES: EL.=94.3 to 96.5t� d ,yCj•
1) PUMP CHAMBER & D—BOX SHALL BE SET LEVEL AND TRUE .;.;, APPROVED N
TO GRADE ON A MECHANICALLY COMPACTED 6" CRUSHED BREAKOUT ELEV.=93.33 FILTER FABRIC
n.: r'
STONE
ASE, AS SPECIFIED IN
CMR
2 NSTALLBINLET & OUTLET TEES ASOREQUIRED 221(2) ���� ` /\
BOTTOM ELEV.=92.30 3/4"-1 1/2" DOUBLE 0,%
3) MAX. COVER OVER SEPTIC TANK, D—BOX & S.A.S. SHALL BE 36". WASHED STONE % �♦
5' MIN. SEPARATION TO G.W. 3.5 6' "3.5' %
4) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR AND 4' OF NATURALLY � N
TO CONSTRUCTION. 13' EFFECTIVE WIDTH p
OCCURRING PERVIOUS SOILS � .p
5) EFFLUENT FILTER SHALL BE INSTALLED ON OUTLET SOIL ABSORPTION SYSTEM (,SECTION) O %
TEE AS MANUFACTURED BY ZABEL OR EQUAL. FILTER EST. HIGH G.W. EL: 85.8 _ ; t11�
SHALL BE INSPECTED AND CLEANED ANNUALLY, OR AS
REQUIRED TO PREVENT SEAGE BACK UP. SEPTIC SYSTEM PROFILE ma`s%%
% 0
SOIL LOG
DESIGN CRITERIA DATE: JULY 31, 2020 (REF# TPT-20-153
SOIL EVALUATOR: PETER McENTEE SE#1542
NUMBER OF BEDROOMS: 3 (AS PERMITTED) WITNESS: DAVID STANTON IRS HEALTH AGENT
SOIL TEXTURAL CLASS: CLASS I ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH
DESIGN PERCOLATION RATE: <2 MIN/IN 96.0 A 0" 96.1 AY: 0"
DAILY FLOW: 330 GPD
LOAMY SAND LOAMY SAND
DESIGN FLOW: 330 GPD 95.5 B 6" 95.6 B; 6"
GARBAGE GRINDER: NO LOAMY SAND LOAMY SAND
LEACHING AREA REQUIRED: 330 GPD = 445.9 SF 10YR 5/8 10YR 5/8 S.A.S. LAYOUT
(. ) 93.5 C1 30" 93.4 C1 32"
.74 GPD/SF MED. SAND MED. SAND
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 2.5Y 6/6 2.5Y 6/6
PROPOSED PUMP CHAMBER: 1000 GALLON CAPACITY, H-10 89.5 78" 89 C2
.8 76"
PROPOSED D—BOX: 1 INLET, 3 OUTLET (MIN.), H-10 C FINE SAND FINE SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN
INSTALL AN 13' x 35' LEACH FIELD 2.5Y 7/3 2.5Y 7/3 27 BERNARD CIRCLE, CENTERVILLE, MA
SIDEWALL AREA: NOT APPLICABLE 87.0 HIGH G.W. _ 108" 87.0 I HIGH G.W. _ 109" Prepared for: Cape Cod Septic Services, 350 Main St, W. Yarmouth, MA 02673
BOTTOM AREA: 13' x 35' = 455 S.F. REDOX REDOX
85.7 STDG. G.W. _ 127" 85.8 STDG. G.W. — 128" Engineering by: SCALE DRAWN JOB. N0.
TOTAL AREA:.....................................455 S.F. 84.5 138" 84.6 138' 9i 9
En neerin Works, Inc. N.T.S. P.T.M. 228-20
LEACHING CAPACITY = 0.74 GPD/SF x 455 SF 336.7 GPD PERC RATE: <2 MIN./IN. 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
ESTIMATED HIGH GW, EL.=87.0 (508) 477-5313 8/8/20 P.T.M. 2 of 3
NEMA 4 JUNCTION BOX CORROSION RESISTANT
PROVIDE WATERTIGHT CONCRETE RISER WITH & LIQUID-TIGHT CABLE CONNECTORS SUPPORTED
SECURED FRAME & COVER TO GRADE BY 1-1/4" PVC CONDUIT. JOINTS TO BE MADE
WATERTIGHT. USE SJE RHOMBUS-JB PLUGGER
OR EQUAL. PROVIDE ENOUGH WIRE
SLACK TO REMOVE PUMP
INSTALL 1' PVC CONDUIT TO HOUSE FOR WIRING
HOISTING CABLE 7x19 STAINLESS STEEL WITH WATERTIGHT JOINTS. WIRE HIGH WATER ALARM
1/8" DIAMETER. / 1,760 LB. STRENGTH. FLOAT TO SJE RHOMBUS TANK ALERT XT ALARM PANEL
PROVIDE ENOUGH WIRE ON CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP.
SLACK TO REMOVE PUMP
INV.(IN)=90.75 2" BALL VALVE (FIELD ADJUST FOR 20 GPM RATE) DOSING & STORAGE REQUIREMENTS
(INSTALL QUICK DISCONNECT FOR EASY REMOVAL)
2"SCH. 40 DISCHARGE (THROUGH RISER-SEE PROFILE) DESIGN FLOW: 330 GPD
ALARM ON EL: 87.70 2" 90' ELBOW W/ 1/4" WEEP HOLE DOSING REQUIRED: 4 CYCLES/DAY (SAND)
PUMP ON EL: 87.45 FOR SELF-DRAINING FORCE MAIN 330 _ 4 = 82.5 GALLONS/CYCLE
BOTTOM OF PUMP OFF EL: 87.12 15" 12,> � 2" SWING CHECK VALVE DISTANCE REQUIRED BETWEEN PUMP
PUMP CHAMBER 1 8" 2" SCH. 40 PVC DISCHARGE PIPE ON AND PUMP OFF FLOATS:
ELEV.= 86.2 ADDITIONAL 3/16" VENT HOLE (MIN.) ABOVE PUMP FLANGE 82.5 GAL/CYCLE - 250 GAL/FT = 0.33 FT/CYCLE (SAY 4")
PROVIDE 2 FLOATS: 3" (TO PREVENT PREMATURE PUMP BURNOUT) STORAGE REQUIRED ABOVE WORKING LEVEL: 330 GALLONS
FLOAT NO.1: PUMP ON/OFF-SJ RHOMBUS (PROVIDED WITH PUMP) STORAGE PROVIDED:
FLOAT NO.2: ALARM ACTIVATION FLOAT-PROVIDED WITH ALARM PANEL LIBERTY LE40 SERIES PUMP .4 H.P. 115 V INV.(IN) EL: 90.75 - PUMP ON EL: 87.45 = 3.30'
(ON SEPARATE CIRCUIT FROM PUMP SPECIFIED) WITH 2" DISCHARGE, OR EQUAL
STORAGE PROVIDED = 3.30' x 250 GAL/FT = 825.0 GALLONS
PUMP AND ACCESSORIES AVAILABLE AT:
CAPE COD WINWATER WORKS CO., HYANNIS, MA. (508) 862-0166
NOTE: APPROVED ALTERNATE MAY BE SUBSTITUTED.
PUMP DETAIL
4" TOP 24" DIA. COVERS
(TYP.)
o - a �8'-3-1/2'
INLET OUTLET — T-I— — —I-F — BUOYANCY CALCULATIONS
I I 1 I
5' 3 1/2 33" A I i I i i I A
5' 5 1/2"� I I i i 1 I 1000 GALLON MONOLITHIC PUMP CHAMBER
54-1/2" 48" 51-1/2" I I
REINFORCING RIB LIQUID 3" _ I I _ BOTTOM OF UNIT EL.= 86.2
LEVEL I \ �1 I I \ I HIGH GROUNDWATER EL.=87.0
1 3 BUOYANCY FORCE PER FOOT OF DEPTH:
I I I I 8.3' x 5.5' x 1' x 62.4 lbs./cu.ft. = 2848.6 lbs.
_ LI— _ _I MAX. DISPLACEMENT = 87.00 - 86.20 = 0.8'
9'-1/2" I MAX. UPLIFT PRESSURE = 0.8' X 2848.6 Ibs/ft = 2278.9 lbs.
CROSS SECTION A-A 4" KNOCKOUTS PLAN VIEW WEIGHT OF UNIT EMPTY = 8,338 lbs.
(TYP.) 8,338 Ibs > 2279 lbs O.K.
SPECIFICATIONS
1.) CONCRETE 4,000 PSI AFTER 28 DAYS.
2.) CONSTRUCTION CONFORMS TO DEP TITLE V REcS.310 CMR SECTION 15.226. PROPOSED SEPTIC SYSTEM UPGRADE PLAN
3.) REINFORCEMENT PER ASTM C1227-93. APPROXIMATE WEIGHT =8,380 LBS 27 BERNARD CIRCLE, C
4.) PROVIDE POLYMER COATING ENTERVILLE, MA
Prepared for: Cape Cod Septic Services, 350 Main St, W. Yarmouth, MA C
APPROVED ALTERNATE MAY BE USED.
1000 GALLON MONOLITHIC PUMP CHAMBER f Engineering by: SCALE DRAWN JOB.
WIGGIN PRECAST CORP MODEL¢#1000MONTH Engineering Works, Inc. N.T.S. P.T.M. 228-
12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEE
(508) 477-5313 8/8/20 P.T.M. 3 C