Loading...
HomeMy WebLinkAbout0043 BRALEY JENKINS ROAD - Health BRALEY JENKINS RD. CENT ERVILLE A 171 150 UPC 12534 (I- Da No.?15LLOR 'ti, .HASTINGS,UN F , No. --- U4 309, Fee !61 — y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 2pplication for ;Dizpool *Vztem Contruction Permit Application for a Permit to Construct( . )Repair( )Upgrade�bandon( ) El Complete System ❑Individual Components Location Address or Lot No. N Owners Name,Address and Tel.No. y3 3r� �J �e��Sys ' euyeme, D).ssq,1r� Assessor's Map/Parcel 13 1 It 5-6 Y3 Boo, (,e:z ,T�v,,�,HS Installer's Name,Address and Tel.No. Designer's Name,Address and Tel.No. t�IJTOtZ� Y"LK1J+A oa./ i;t�lylneCvc (.-Ivy/KS skteoaCif rd (1 (2dps Type of Building:5 iol`e 'in (y Dwelling No.of Bedrooms�� Lot Size 15400 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 'Y�o gallons per day. Calculated daily flow 3 3 3' ..gallons. Plan Date (o - - 6 S: Number of sheets a Revision Date. Title Size of Septic Tank (�� Type of S.A.S. lS (6, Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the constructi -atr-m-aintena o the afore described on-site sewage disposal system in accordance with the provisions of Title 5.of the nvironmental Code d not to place the system in operation until a Certifi- cate of Compliance has been issued is oard Signed Date b _ a S- o Application Approved by Date Application Disapproved for th folio g re sons Permit No. a Oc.S_-3ug Date Issued 6.-30-'- -- ——— ----- -- --m - v P U IS-- , ad ��- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yew PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES M# SACHUSETTS } 01pprication for Mioo�al *raem' Coin,5tructio! Permit Application for a Permit to Construct( )`Repair,('' )Upgrade( Z-�bandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. S Owner's Name,Address and Tel._No. Assessor's Map/Parcel (-� 1 /5, Installer's Name,Addressr d Tel.Not. Designer's Name,Address and Tel.No. / JT0(Le f YCC P J,4T10 -j '�. EVIc�{✓�P<°'�°'�y („k�✓KS e 1 J Type of Building: S wl j�e G 11,(y u�� "�3/y Dwelling No.of Bedrooms � Lot Size si60-0 sq.ft. Garbage Grinder( ); Other Type of Building-- No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3,3Ci gallons per day. Calculated daily flow 3 3 3' gallons. Plan Date 6o - 5 - o!;- Number of sheets o1 Revision Date. Title Size of Septic Tank / � Type of S.A.S. t',_4 1 l6. 'k 5L Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to.ensure the construction an'�enance o the afore described on-site sewage disposal system in accordance with the provisions`of Title 5 of theEfnvironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b -tlss'Board o a•1tli. Signedf7 Date - Application Approved by � Date Application Disapproved for the o11ow' g rea ons Permit No. a Oas'-34 - Date Issued 6 '30 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired ( )Upgraded( "� Abandoned( )by ?A 5T"LdLL 4 ,ems aJ A TI o-J 111 1�- at L43 1�k\e! 2y►ff(vr5 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. .260 S-3Q&dated -3 0 Installer k` "-�S co2(_ !�Xc v4- yva Cl .&v Designer The issuance of this ermit shall not be construed as a guarantee that the s, stem vyil 1 function tigned. Date_ - - Inspector -- ~ ---- ------------------------ No. a s 0-5——go o Fee d e THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migoof *pgtem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( 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•ye'ars of the date of th(is� rmi;. r �) Date: 6 � 3.G " 0� Approved by i1,v�_ r Town of Barnstable Regulatory Services Thomas F. Geiler, Director SAWMANX Public Health Division a � Thomas McKean, Director —� --.— � 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: (0-,30"6) Sewage Permit# °LCO.S Assessor's MaplParcel t 7) —I S� Designer: Installer: Ra,�, Address: —4F . Address: qL, 4 I CJ`zCe On (0 _30 _b5 PA5rC26 E�V�Wwas issued a permit to install a (date) (installer) septic stem at 4 3 13t^c" 1-e JF11 U.%►sPJ_p y based on a design drawn by (address) C-enjev,^1 Lq Re k/-7<, In1 e �rt , dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than I t}' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. plan revision or ertified as by designer to follow. OF M,tss�c yG , PETER T. (Installers Signature) c McENTEE N c.� CIVIL No.W09� �Q A90F 9FGtSTEPO�\'�� FSSIONA (Designer's Signature) (Affix Designer's Stamp here) PLEASE RFTURN TO 84RNSTABLE PUBLIC IIE�,IIH ITIVISION CERTIFICA'[E OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RKCEjVI:D BY THE I3A1dNSTABLE PUBLIC HEALTH IIIVISION, THANK YOU, Q:Health/Septic/Designer Certification Form 3-26-04.doc TOWN OF BARNSTABLE LOCATION 'Of/3 AAL.44, Jr,, &I" SEWAGE # yf--70 ' VILLAGE CQ�-T�� L3L�s ASSESSOR'S MAP & LOT`��' INSTALLER'S NAME&PHONE NO. ll-4yTo.a,c SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 1A•FS —4 (size) fD,' x 37. 3 NO. OF BEDROOMS 3 BUILDER OR OWNER P v.2 0 L7 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on 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 A-3 f y A-y Q-y v�.y 3 0ti9C 13 � 9/f 6103 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM hereby certify that the engineered plan signed by me dated �D �� ,concerning the property located at -C-cJ4!j meets AM of the following criteria: • This tailed system is connected to a residential dwelling only. There are.no commercial or business uses associated with the dwelling. e The soil is classified as CLASS I and the percolation rate is less than or equal to S minutes per inch. The applicant may use historical data to conclude this fact or may conduct deep test holes and percolation tests at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. e The bottom of the proposed leaching facility will-be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table usin the Frimptor method when applicable] 2 (�AJ oPlease complete the following: � A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation ��+adjustment for high G.W. D F'FERENCE BETWEEN A and B SIGNED : DATE: �cl- .0 NoTIC1E Based upon the above information, a repair permit will be issued for bedrooms ` maximum.. No additional bedrooms are authorized in,the future without engineered septic systems plans. q:'Seytic�pa+ccxemp doc Cape Cod Commission: USGS Well Data-May 2005 Page 1 of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties, the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources ice. The water level measurements shown below are taken monthly from United States Geological Survey (USGS)observation wells and compiled during the last week of each month. They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to be used with Technical )Bulletin 92-001 to predict high groundwater levels, For your convenience,we've also provided links to USGS national and state data. See the last colnr,in in the table and the footnotes below. To see what's happening in real time at a separate well in Brewster, visit the USGS site: U Q..S 41463007001490.1NIA.-:BMVV_22_BREWSTER,MA For further information about any of the data or links on this page, please contact Hydrologist.Gabrielle Belfit at the Commission offices(508-362-3828). May 2005 USGS Site Water Record Record Departure from Number**** Location WeH No. Level* gb�. Low* Average" (links to USGS Monthly Overall national water-level database) AIN Barnstable 230 21.6 20.5 26.6 1.2 2.0 413956070164301.Barnstable ��� 21.9 20.5 28.6 1.8 2.6 4141 5407016500.1 Brewster B1V�W 21 8.3 6.9 13.6 1.4 1.9 414518070020301_ Chatham CGW 138 21.2 20.9 26.6 1.9 2.8 414100070011101 RRashpee NIIW 29 6.4 5.6 10.0 1.2 2.1 41352507029.1.904 Sandwich SDI 45.8 45.8 48.2EEI 1.4 4144.18070241.601_ Sandwich SD�V 48.8 45.8 55.1 0.8 1.4 414124070265901 Truro TSW $9 10.9 10.2 13.0 0.S 1.1 420206070045901 r --��------sr-----r--yr------,r----ter-- http://www.capecodcommission.org/wells.htm 6/22/2005 0 4 Table 6. Potential crater-level rise, in feet,, for " use with index well Sandwich RDW-252 WATER ZONE A ZONE B ZONE C ZONE D LEVEL 4-%-•9, 'ram S 45.9 0.0 0.0 0.0 0.0 46.0 0.1 0.2 0.2 0.3 46.1 0.2 0.3 0.4 0.5 46.2 0.3 0.5 0.6 0.8 46.3 0.4 0.6 0.8 1.0 46.4 0.5 0.8 1.0 1.3 46.5 0.6 0.9 1.2 1.5 46.6 0.7 1.1 1.4 1.8 46.7 0.8 1.2 1.6 2.0 46.8 0.9 1.4 1.8 2.3 46.9 1.0 1.5 2.0 2.5 47.0 1.1 1.7 2.2 2.8 47.1 1.2 1.8 2.4 3.0 47.2 1.3. 2.0 2.6 3.3 47.3 1.4 2.1 2.8 3.5 47.4 1.5 2.3 3.0 3.8 47.5 1.6 2.4 3.2 4.0 47.6 1.7 2.6 3.4 4.3 47.7 1.8 2.7 3.6 4.5 47.8 1.9 2 .9 3.8 4.8 47. 9 2.0 3.0 4.0 5.0 48.0 2.1 3.2 4.2 5.3 48.1 2.2 3.3 4.4 5.5 48.2 2.3 3.5 4.6 5.8 48.3 2.4 3.6 4.8 6.0 48.4 2.5 3.8 5.0 6.3 48.5 2.6 3.9 5.2 6.5 48. 6 2.7 4.1 5.4 6.8 48.7 2.8 4.2 5.6 7.0 48.8 2.9 4.4 5.8 7.3 48. 9 3.0 4.5 6.0 7.5 49.0 3.1 4.7 6.2 7.8 49. 1 3.2 4.8 6.4 8.0 49.2 3.3 5.0 6.6 8.3 49.3 3.4 5.1 6.8 8.5 Replaces Table 6 in cape Cod Commission Technical Bulletin 92-001 Page 1 December 16, 1992 . TOWN OF BARNSTABLE / LOCATION SEWAGE # A VILLAGE 41 l F.r /// / ASSESSOR'S MAP & LOT i i INSTALLER'S NAME&PHONE NO. /Y//iV C g2 y. .C'462 SEPTIC TANK CAPACITY /.Bd O LEACHING FACILITY: (type) lze,A7aleC (size) NO. OF BEDROOMS -� BUILDER OR OWNER i PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist i 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 i 13 1• � �9 ---- } No. �y n Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: e PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS b Zpplitation for 33igo5af *pgtem Construction 30ertnit Application for a Permit to Construct( )Repair Grade( )Abandon( ) O Complete System Zlfn vidual Components Location Address or Lot No. 3 f� /��� K!S Owner's Name,Address and Tel.No. Assessor's Map/Parcel CS�ra v k � �s l -6,O Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. fAT �� l/l/��✓ SV c G�.lz(/l G Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No, of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow ��5 gallons. Plan Date Number of sheets Revision Date Title Size of Septic TankfSY (5=3 Type of S.A.S. d Cr�— Description of Soil A[j _Vn. S&V�,o Nature of Repairs or Alterations(Answer when applicable) F 4C I* t—/z. Gv f Gc� 4 VW 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 En ' onmental Code and not to place the system in operation until a Certifi- cate of Compliance has b B igned Date - Application Approved by Date 61 'ZI,0,Z) Application Disapproved for the fol owing reasons Permit No. Date Issued ;;1 2 �zl ' Y i t No. �'°` , Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ?' e PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS c, 0ppYication for Mizpool *raem (Construction Permit Application for a Permit to Construct( )Repair(�)Upgrade( )Abandon( ) ElComplete System Mndividual Components Location Address or Lot No. /'9 ey Eta/ IYU S Owner's Name,Address and Tel.No. Assessor's Map/Parcel '"`) 1 _ ,'S O VIA 4_5 U Installer's Name,Address,and/Tel-No. Designer's Name,Address and Tel.No. MC C)-C p c, vL vt t S Type of Building: Dwelling No.of Bedrooms _ Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures c, Design Flow gallons per day. Calculated daily flow `( 1 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank n r 5��`' ype of S.A.S. Cat 0!� C Description of Soil Nature of Repairs orAlte atio s(Answer when applicable) ?��-c-� A-A diF� E�tc�S l i�C t a kA r CC, c�c ;`f i GL _ l Gc. L(1 SQ.,.- Gc- 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 E,rwironmerytal Code and not to place the system in operation until a Certifi- cate of Compliance has en iss'"ue3 by d. "ealth. - �# Signed i Date Application Approved by Date .- �� '•� Application Disapproved for the following reasons I Permit No. 7 A•'Lo Date Issued �w --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFYAha the On-si e_Sewage D''s-�osal System Constructed( )Repaired( )Upgraded(� Abandoned( )by J —C f} Fat 6 OcA w�, L 5 0T• has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permitels1 dated Installer Designer ,-, Al The issuance of this penAt s all r}ot be�co�ns�trued as a guarantee that the s stem will function as designed. Date Inspector i !%l. t �//i � •ll�� --- -------------------------------- self, No. �f�' Fee ' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwigpooat bpgtem (Construction Permit Permission is hereby granted to Con`s�s�(_�Rep ' ( )U grade( )Abandon( ) System located at �1 S `,—\ V Y�-V`� C-cn.`T'r 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 t s'"permit. -- Date: Approved by✓ f f . \ 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)_ ✓ , hereby certify that the application for disposal works construction permit signed by me dated �—�-/,— , concerning the property located at `? r/o.l� meets all of the following criteria: '�• This failed system is connected to a residential dwelling only. There are no commercial or business /uses associated with the dwelling. The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. Z- There are no wetlands within 100 feet of the proposed septic system • Where are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed v There are no variances requested or needed. �he bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when �Ifthe icable] • S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation (using GIS information) B) G.W. Elevation 3 +the MAX. High G.W.Adjustment 3 _ DIFFERENCE BETWEEN A �U r SIGNED : \ DATE: " [Please Sketch p d plan of syst on bac NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert �� ��� � . � F ,� 0 _ . ,, _ ..�: , - a TOWN OF BARNSTABLE LOCATION SEWAGE # ©'�✓ " r' VILLAGE _ .li>L' r ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. /YJ/ C g- SEPTIC TANK CAPACITY /.BO 0 LEACHING FACILITY: (type) /�t/�%/T,�sl�"o/l C' (size) NO.OF BEDROOMS' -� BUILDER OR OWNER PERMI'TDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on 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 fidaK �3 I •� r. fIJ `/3 1 f12 13 2--q--7 113 '133�3 No........6....3..9-Y FRic............................. ).THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH D �C-�/``. ......OF......, /iE�i 7_ 44,C...............................1trFatiou fur Did nsal Workii Tomit urtiun 1hrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..... .__. A................. Location-Add s or Lot No. Owner Address Installer Address Type of Building Size Lot----.P_.C252 .Sq. feet Dwelling—No. of Bedrooms........... .............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building Al e� ! No. of-persons..........-___•-_--____ Showers ( ) -Cafeteria ( ) Q' Other fixtures -----------------------------------------------'--'--'"------ -•---------- W Design Flow......................�.........._____gallons per person per day. Total daily flow----_.._._3w� ..____.-._.____gallons. WSe tiTnan u� Iquid capacity�d gallons Length.4:t'9:... Width...l5.-r"�__.r._ Diameter_/ . Depth.._tom% No. _,__:-t.......... Width...._....<......... Total Length.......2&...... Total leaching area...... 4-?----sq. ft. Seepage Pit No....... Diameter.._........_...... Depth below inlet.._....--`....... Total leaching area.........:"_-_sq. ft. Z Other Distribution box ( K Dosing tank ( ) ~' Percolation Test Results Performed by._..l.VWA,-.�G_....-6 4111144%.................. Date.....klUIF Y`P........._.. ,aa Test Pit No. 1 ._._ ......minutes per inch Depth of Test Pit.;...//"...... Depth to ground water......//............. fi Test Pit No. 2.ALA- _minutes per inch Depth of Test.Pit-----/!.**...... Depth to ground water.....1 ®wle___. 9 ----'-/.--------------- ---'-----'------ "--- ---"•----'--'-'-------------'--'-------le z....................................................... O Description of Soil �� Z�� �� Vim. ----------- ---_- �' - �:✓ _ .!_1 x 2� P f W -------------------- --------------------------------------- ------------------------------------------------------------------------------ UNature 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 p p ------------------------'__ ealt o eration.until a Certificate of Compliance has bee ssu Si ne '- ed he oard of h V Date Application Approved By.................................. -' . 1!- _:---- . •--.......-•-"-• Date Application Disapproved for the following re ns:................................................................................................................ ----•-•••-•-'...-'-•'-•-------'------•--......--•'•-"------------'--------------•------ •--------------- -------- ---------------------------------------------------------------------•------- Date PermitNo......................•-••--•••-.............-•----...... Issued....................................................... Date RmE.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD- OF HEALTH ............. .........................OF...................-----....._.......... Appliration for Diopooal Vork.5 Tonitrnrtion ranfit n� Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_ _ - ---- •-- •--...... ................... -...... Location•Address or Lot No. .....--•------•...................................•---------...................................... ................................................................................................. Owner Address W Installer Address UType of Building Size Lot............................Sq. feet �., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Otherfixtures ......--•----------------------------------•-------------•-•------. ••----------._................----•-------------------......-••••---------------- 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 ( ) aPercolation Test Results Performed by.....................................................=.................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fi, 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 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 bee Ks'ued by.the board of healt -- -------------------------------- Application Approved By.................................. = Y_ s-...............�.......---- --------�-t�°t-- Date Application Disapproved for the following re' ns:-----••••-•---•--•-••••-•------•-•-•---••---•-••.........--•-••--•-••---•-•---•--•-••--•---•---••---•--......._ -•--•••-----•-----•------------------••-••---•-------•••--•-•-------•--••••---••--•-......_..•----••--••---•---•-••--....•------••-•----••-••------••-•-------•-•--••--•-•--•••-----•••••••----...••---- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................OF...................................................................................... CIrrtifirab of Tomphanrr THIS IS TO CERTIFY, That the ndivi�lt}al Sewage Disposal System constructed ( or Repaired ( ) b . .... ------•-•-•-•............ L-n—.................... ...................................................... - -------- staller ---- at C"P J..........i��............................................................................ .... ......................................................................... has been installed in accordance with the provisions of T T 5 o T tate Sanitary Code as desc i d in the application for Disposal Works Construction Permit No------- __ __�_. _ ...... dated_...._q. ."L..�... 54._._._.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUA ANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................•-•-------....--•--••---.........--•------•---••---• Inspector.......................=..................................... W-PERVISE DESIGNING ENGINEER M�S�.. ISO INSTALLATION AND CERTIFY IN TFt'.ICT' THE COMMONWEALTH OF MASSACHUS.F,T�SSYSTEM WAS INSTALLEC IN sTR: BOARD OF HEALTH 11PDANCE TO PLAN ...........................................OF..................................................................................... / 3 FEE........................ Dinpooa1Yg ornrtion unfit �Permission is hereb ranted----•----------Tor -----�"��!----------------------------------•-•-----•------------------....---------.....------•---•-••---..._.. to Construct or R air an Individu Sewa Dis al S ems . P Y Zr1 h r treet 2 J as shown on the application for Disposal Works Construction Permit No... ated ._.{_ ........................... lY • .......................................... ••-•-- ^-z IG�LQ� Boar of Health DATE...... = -----•- —G7---•--------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS • ZD►J� l�G .zc' F9, J`ACT- p' SETBACKS eo O ,,�C I ,hey 99 $, 90 /�� M Ll 1Q-r � tN ojr M,4J A DFlygs PAUL O DAVID P. yG o LEVY N Z MARIANO �, No. I0617, � v CIVIL No.31115�� �e✓ fi E T !y' = -�� G 90� GIST P tv S— LEGEND EXISTING SPOT ELEVATION OAO EXISTING CONTOUR --- O --- CERTIFIED PLOT PLAN FINISHED SPOT ELEVATION [ -� FINISHED CONTOUR O Gr-iV TEkU%LLC- NOTE: The location of any existing underg;-ound sewerage, wells, or other utilities shown on tYis plan is approx- IN imate only as determined from records and/or verbal A ,\� tl•� !� 1 �,1 .\ tt�+ a information. The contractor is responsible for the verification of the existing locations in the field. SCALE, /""Sa DATE 13,dZ&A LEVY & ELDREDGE ASSOCIATES, INC. CLIENT. ram ' I CERTIFY THAT THE PROPOSED If ENGINEERS-LANDSCAPE ARCHITECTS JOB NO. ///0 BUILDING SHOWN ON THIS PLAN ?( PLANNERS-LAND SURVEYORS o CONFORMS TO THE ZON NO LAWS DR.BY OF BARNS , MA ! 712 MAIN STREET CH. By �'`+'L ' HYANNIS, MARS. SHEET_LOF 2, ATE JR4G. LAND SURVE R ' i zo fT htzm &W7E : !F Th/E SFPT/C TAWK !& /4?aRE 10 FTM/N. . 7'HAAl /Z INCHES f3E40JA/ �/2.40f, A F4-- J)VCN D/AMETr CONC/7ETE COyE,P SHA/.L q"PYC E/PE a,E,gR0V QWHT To G,"JP S BAN FX7?TA N=AYY L 11 .O - LRETE M/N. /�+TGH CAST IRON CDYER,Sj"ALL DE V SED sF Jiv "'•' DMIV49kVA (-X FLOi-vd/I PtUSOR © OR ZW/✓ALENT,GAZ4&R ES TO 8,,A'fUA/NECT.E�O CL.EAN SA/VO s SCHEDULE 40 '_t •' 4 N Q c d a ot= IGOO GAL :.; Ia p CQ �? t.; O�SGH.4R'c'-e L/NE N.P/TCN -,u-=PT/C TA NK d is T. `__•�-.�_•• _.�a :;:T-•...,,: ��•� 'K: '� E�.95- l F-9.3,E L-EACOM4. GAL-LE4r 8 W�saeo S7ZWE R v - m V GL 14 w CALL sJD� = 9� X Z, S = z o r°v SECTJOw uF GRovwo AVATSf TAeL E EciW 9/./ 8�►rra+H: /�(o x/.o = / S Co �P p .�EWi4GE OlSPDSAG_1S.XSTEM_ L_ - _T•4 BUL_.4T!D/� .wsr r. TQTIrt[. 3 9 Co X R 3- - /rT q�.� CAAAUTY'r G�P.D. � .SG4LE : Y4. �/=.D'• .D/.M�/1lsION B �T: /ITT. ¢ FT /�T 50/L 7&5'T. DIMENSION C Z4 Fr. PA7,EOFS011. T-FST 8/z71B� soil_ Accro� d LL TEST ! SO/t T1e<ST�K 2 RESULTS T/VES'S'ED BY - IK/Nf , , , pER1GU' LAT1aW RATE f/Z M/N.�/MCX. O'Z�L J°P L o ' Tr�yso,L 5uBsw L CLG14N OES/G/Y C&i7Z- 'A S.gNO KVMQER OF QEpROOMJ , 3 _, Z/L�-//' •` ' RQA« a"L.a YES t 6A O AG!/N T E O/SP S - • o s I dc� c rot. o v -s wN�dSTarE Em/yATto FLow 33o 6ALa/A4Y BOTTOMdEAC#V/*VG.ARAM 5 gaNO FCT/DN TO TA L. .AI WA z5Z 547.FT SrALF: /4a �._O., RtSXt E AREA SQ,:FT - warms' /Z� �LPaw �l•5 Y ArD 6ROUN0 N/Ar&N EN /YTERED /NVER; ELC-VAr. ONS � GRavNO jS/ATER AT EL�v. �gssq LOT 278 "Z4 </5 6ol/ErL , o DAVID P. �'g /Nf/E/PT AT BU/LD/KG f?'60 F.S. c CFwmeyla-C /?IA _ X MARIANO N /NLE7SEPT�C TANK FT n CIVIL ' OUTLET.SEP"C TANK 97 Z pT, ,Q No.31115 //VLET p/SrJVAUTioN Bo 77,o ter. ELDREDGE ASSOCIATES, INC. 9° ��� T6 our[E�'r ots7x/suTio�rOwc 96.8 jXT, 7/Z MA/NST. M�ANN/S MASS. ��s�o INLET FLOM�D//�FUSo/C 96•4 F7 CL1ZA ✓ �'' VAT&: /7 2fo OF L- ' Permit I:ur.iher: [.� A FT a tf. Ji rOmPleted by II I G!i GROUND.-WAI ER, ;.LEVEL: COMPUTAT I ON 7. Site Location: Gd9Ze> lO'✓�'2L /�1.f4�j ��'4L `JW-1 S Lot No. Zw f Owner: ..`Addr.ess: Gov G.•, i'h•t�✓ s j _ _ Y Contractor: Address: Notes: ---.—`.------- STEP 1 Measure depth to water table to nearest 1/10 . ft. . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . .. date STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A) Appropriate index well . . . . . . . . . . . . B) Water-level range zone I_ STEP' 3 Using monthly report"Current Water- Resources Conditions" --- determine current depth to 12s,oa water level for index well . . 8 8 `--- --. ... ._/ w mo y r STEP 4 Using Table of Water-level Adjustments for index well (STOP ?.A) , current dt-pth to water level for index well (STEP 3) , ,and water-level zone (STEP 2B) determine water-level adjustment . . . STEP 5 E!,tir►ate depth to high water - by subtracting the water- level adjustment (STEP 4) fro►n measured depth to water r level at site (STEP 1) �r LEVY& ELDREDGE ASSOCIATES, INC. ENGINEERS-LANDSCAPE ARCHITECTS-PLANNERS LAND SURVEYORS 669 WEST MAIN STREET CENTERVILLE,MASSACHUSETTS 02632 L (617)775-2244 December 12, 1986 Barnstable Town Offices Board of Health 361 Main Street Hyannis, Ma. 02601 RE: Lot 278 Lazarus Lovell Rd. , Centerville Dear Sir, The subsurface sewage disposal system on the above mentioned lot, was inspected on November 26 , 1986. I hereby certify that the system has been installed conforming to plans dated September 17, 1986. Very truly yours, LEVY & ELDREDGE ASSOCIATES, INC. David P. Mariano, P. E. #1110 cc: Barnstable Holding Co. DPM/lld LOCATION A r 7 '��GE PERMIT NO. ORA oZ 2 Z VILLAGE 0� vim. • INSTALLER'S NAME&ADDRESS BUILDER OR OWNER �- DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �� �� 2 CEza EEC TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY ZL LEACHING FACILITY:(type) :g (size) e- NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No LEGEND c`'e a tiP'^ Cd J'r • - 6 p�' `— gg PROPOSED CONTOUR 3d $� 99 PROPOSED SPOT GRADE `� c �4 �o PL, — -10s ? _ ---- EXISTING CONTOUR i 1. 101.4-=' EXISTING SPOT GRADE P ` EXI5TING 5EPTIC TANK EXI5TIN6 S.A.S. Benchmark Set TO BE PUMPED, RUPTURED TEST PIT Paz>� U ea AND PILIED WITH SAND TO BE ABANDONED - L_e f t cor, bulkhead p iWd EXISTING WATER SERVICE or` k era ' E1,=101,31 (Assumed) ea s� N 27°05'38," E >T^c .«. : d� 150.00' "�' c2 r _ � a r — �a LOCUS ",,�'r rr� �: ...... ....... •�� C TAN -- LOCUS MAP N.T.S. F _...._.... ...._.. .... ...._ .._ .... � SIDE OF HOUSE Y' rw vJ rt y k� �^ " Deox D � I I� GENERAL NOTES: 177,=.^'1 17i 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SEWER r I ';' ' " ,I BOARD OF HEALTH AND THE DESIGN ENGINEER. INV:=99.1J 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS �..:..:. OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE EXISTING �. ,. 00P {i� CA Q LOCAL RULES AND REGULATIONS. BEDROOM a �, L.;: I W 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLEO PRIOR r HOUSE 043� ,...: I v r TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE TOF=102,36 I rn1 _ r � DESIGN ENGINEER. Wi 7 I' ;" I tU ,z (Assumed) , �.:•:- (P Q ______ 4. ANY CONDIT►ONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 41 I I-- FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN CONTINUES, PROPOSED S.A.S. I ENGINEER BEFORE CONSTRUCTION CONT L---------------J 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. ' 1 29.8' 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF LOT 27-2 f I. .:... :;..: =� �^ THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 15,000.0± S'r ; 10 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 0 34t AC, r ENT 10.8' y 7. WATER SUPPLY PROVIDED BY TOWN WATER MAIN. tZI ,, LAYOUT arks " Map 171 �. i N 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. Parcel 1 SO `"- � 9. AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A k t ti�a' t CONDITION ACCEPTABLE TO THE OWNER. `` 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE THE s' p 120.00 LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. p. S 27005'38" .W 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). . ...... r` 12, THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. CP S ROAD PETER E G� PROPOSED SEPTIC SYSTEM UPGRADE BRAL E Y JENKIN g McENTEE d No,IVIL 43 BRALEY JENKINS ROAD, CENTERVILLE, MA o R£C/STE`�`������ Prepared for: Eugene Dussoult, 43 Braley Jenkins Rd, Centerville, MA Engineering by: Surveying by: SCALE DRAWN JOB. NO. EIVIneedngler& Terry A. Warner PLS 1"=20' P•T•M• 172-05 12 West Crossfield Rood 22 Long Rood Forestdole, MA 02644 Horwich, MA 02645 DATE CHECKED SHEET NO. (508) 477-5313 (508) 432-8309 6/29/05 P,T,M, 1 of 2 i s € NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH SHALLFOR A D STDANCE OF 5''TAROUND THE 1 ELEV. TOP PERIMETER OF THE S.A.S. VENT FOUNDATION FINISH GRADE: 102.Ot (Existing) a F.G. EL.100.8t F.G. EL.100.6t F.G. EL.101.0t =102.36t FMAX. COVER OVER S.A.S. = 36" MAINTAIN 2% MIN SLOPE OVER LEACHING AREA e' s a INSTALL RISERS W/ COVERS TO WITHIN L = 26' 6" OF FINISHED GRADE, AS REQUIRED PROVIDE A 2'X2' PATIO BLOCK SPLASH PAD RESTING ON A 2' THICK BED 4" SCH 40 PVC L — 42' OF 3/4'-1 1/2' DOUBLE WASHED STONE FOR AN INLET SPLASH PAD L —4 I� �• 6; ' .e• � 4" SCH 40 PVC 4" SCH 40 PVC @ S= 2% (MIN.) 10° 14" @ S= 1% (MIN.) e' @ S= 1% (MIN.) 6' EFF, PROP❑SED INV. EL.=97.64 DEPTH j a 1500 GALLON INV.EL=98.23 SEPTIC TANK INV. EL.=97.81 j INV.ELEV.=97,60 3' S UNITS AT 6.25'/UNIT m 31.25' 3' INV,EL=98.48 EFFECTIVE LENGTH = 37.3' 1 INSTALL INLET & OUTLET TEES GAS BAFFLE TO BE INSTALLED ON USE 1 ROW OF 5—STANDARD INFILTRATOR CHAMBERS (H-20) IN TIE IN TO SEWER OUTLET TEE AS MANUFACTURED BY SERIES SURROUNDED W/STONE TO FOR A 10.8' X 37.3' S.A.S. OUTSIDE HOUSE TUF—TITE, ZABEL, OR EQUAL INV.=99.00 SEPTIC TANK & D—BOX SHALL BE SET LEVEL AND TRUE TO ,SOIL ABSORPTION SYSTEM (PRQFLLE) GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED "r'=' STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 1 2' LAYER OF SEPTIC SYSTEM PROFILE BREAKOUT ELEV.=98.1 WASHED S DONE OUBLE N.T,S, BOTTOM ELEV.=97.02 3/4'-1 1/2' DOUBLE WASHED STONE 4' 2.8' 4' 5' MIN, ABOVE BOTTOM OF EFF,WIDTH=10,8' T,P, EXCAVATII7N OR G,W, (3) 5" DIA.OUTLETS H----J--� ��2, HIGH G,W, EL 91.$ 1 SOIL ABSORPTION SYSTEM (,SECTION) it , 10'-6" SOIL LOG rars, _ n� `- Mq 15,5' _ 6' ` S 3 — 20" Oio. Covers DATE: JUNE 16, 2005 DESIGN CRITERIA 2' SOIL EVALUATOR: PETER T. MCENTEE P.E. PETER T, H-10 LOADING / NUMBER OF BEDROOMS: 3 BEDROOMS � MCENTEE D--BOX 5'-8" IC NOT WITNESSED SOIL TEXTURAL CLASS: CLASS I " CIVIL 0 O Krs. DESIGN PERCOLATION RATE: <5 MIN/IN No, 35109 Elev. TP Depth DAILY FLOW: 330 G.P.D, Off/ G1S5f��� _ 98.3 0.1 DESIGN FLOW: 330 G.P.D. (MIN REQ'D) \ FILL GARBAGE GRINDER: NO Top View 100.5 C 3' PROPOSED SEPTIC TANK: 1500 GAL. CAPACITY 1 DLO 0 0 0 0 0 0 0 0 0 0 (3) 4" PIPE SEALS (TYP.) LEACHING AREA REQUIRED: (330) = 445.9 S.F, I O Q O 0 0 0 0 O p 0 0 0 0 0 0000a000 00000000 4" .74 �-- 28�--I I---28„-- I I L USE 1 ROW OF 5 STANDARD INFILTRATOR UNITS p SHOWN FOR AN SAS HAVING THE DIMENSIONS: 37.3' X 10.8'. Closed End Plate Open End Plate MED. SAND 10YR 6/6 SIDEWALL AREA: 2(10.8'+37.3') x 0.5' = 48.1 S.F. BOTTOM AREA: 37,3' x 10.8' = 402.8 S.F, 2 5'-8" 4'-7' 48" Liquid Level 4'-4" TOTAL AREA: 450.9 S.F. '2„ i DESIGN FLOW PROVIDED: 0.74(450,9 S.F.) = 333.7 G.P.D. J 4„ 3„ f 6 75 I�--34"ow 91.8 STDG• D G.W. _ 108" FPrepared ROPOSED SEPTIC SYSTEM UPGRADE -1 —yi ADJUSTED G. — �.25'' RALEY JENKINS ROAD, CENTERVILLE, MA �jde View End View Sect/on � 90,e t20" r STANDING G.W. ® tas" or: Eugene Dussault, 43 Braley Jenkins Rd, Centerville, MA STANDARD INFILTRATORS, H-20 LOADING 1500 GALLON CAPACITY, H-10 LOADING PERC RATE <2 MIN/IN. ("C" HORIZON) Engineering by: Surveying by: SCALE DRAWN JOB. NO. INFILTRATOR CHAMBERS S.A.S. LAYOUT G.W. ADJUSTMENT 0' (ZONE D) Eng/needngWorkr' Terry A. Werner PLS N.T.S. P.T.M. 172-05 K,.c. INDEX WELL: SDW 252—MAY 2005 12 West Crossfield Road 22 Long Road A (INDEX WELL AT RECORD HIGH) Forestdale, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. (508) 477-5313 (508) 432-8309 6/29/05 P.T.M. 2 Of 2 i