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HomeMy WebLinkAbout0062 ENSIGN ROAD - Health 62-Ensign Rd : Centerville.. A= 147 - 055 SMEAD_ No. 2-153LOR UPC 12534 smead.com • Made in USA OCYCLO YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates"(. ost$40.00 for years). A business certificate ONLY REGISTERS.YOUR NAME in town [which you must do by M.G.L.-it does not give you permisst erate.) Business Certificates are available at the.Town Clerk's Office, 1 s`FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: Fill in please: �f t" APPLICANT'S YOUR NAME/S: yI "� '"' BUSINESS YOUR HOME ADDRESS: doc9 /U.5 I TELEPHONE # Home Telephone Number �Qf- q,9-0 • 06?/ NAME OF CORPORATION: �-,F-W LAA,'DSct j A-�(sue NAME OF NEW BUSINESS TYPE OF BUSINESS-6/UD-%Q /A-)u --, L c,�j,C- IS THIS A HOME OCCUPATION? YE NOZ AOORESS'OF BUSINESS MAP/PARCEL NUMBER ,z-1 7.— D (Assessing] When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE (� This individual has been informed of any permit requirements that pertain to this type of business. 7 Authorized Signature" COMMENTS: ti2'. BCWi:?O OF HEALTH -:-This individual has boen inform d of the permit requirements that pertain to this type of business. `J MUST COMPLY WITH ALL Authorized Signature** FVkZARDOUS MATERIALS REGULATION,; COMMENTS: `a CONSUMER'AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature' COMMENTS: w Date: 'y I aal TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: -rW L��ljSCRY'i.CJCs� BUSINESS LOCATION: led, .Eo\Ki Cc� QN-0' INVENTORY MAILING ADDRESS: 6,� 6/vStCak) � - TOTAL AMOUNT: TELEPHONE NUMBER: &08 - -?G 9 ,? /fof'tS CONTACT PERSON: , OHS h'). EMERGENCY CONTACT TELEPHONE NUMBER: �09' yoZd D 71 MSDS ON SITE? TYPE OF BUSINESS: .C '}iVDSC/9p J k)GLj INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners ® Automatic transmission fluid Q Disinfectants v Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants / otor Oils Pesticides ❑ NEW ❑ USED j (insecticides, herbicides, rodenticides) lS9 asoline, Jet fuel,Aviation gas Photochemicals (Fixers) iesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers C> Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison"labels (including chloroform,formaldehyde, 0 Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers Q (including bleach) Spot removers &cleaning fluids 0 (dry cleaners) ® Other cleaning solvents v Bug and tar removers Windshield wash W cc_e7 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials azardous Materials Inventory Sheet Checklist -'�/ Date _Physical Street Address-Check database to ensure it exists q/ Working Phone Number f/ Actual Amounts -( ie. gas being used to fuel machines, thinner to clean brushes all count as hazardous materials-no blanks) " Storage Information -location of storage, how long is storage for? If none, note that. Disposal Information -where and who? If none, note that. Applicant Signature - understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. No. . � ' r F91 00 00 THE COMWONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for Misspogal 6potem Conotruction Permit Application for a Permit to Construct( ) Repair kX) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 4 2 0—0 0 71 62 Ensign Rd, Centerville John & Robin Westlund Assessor'sMap/Parcel 147/55 62 Ensign Rd, Centerville Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco—Tech PO Box 1089 Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder PO) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 leach system to plans of Eco—Tech, #ETE-2745 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 He Si ed � J Date Application Approved b Date Application Disapproved by: Date for the following reasons Permit No. Date Issued mot...�:. ..Y. _ - _ _ J • _ ... v _ _ —'f�a'S • , � i' 1 No. _ Fee 00 00 Entered in computer: ' THE COMWONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for Dizpo$al 6potem Cowgtruction Permit Application for a Permit to Construct( ) Repair K) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 4 2 0—0 0 71 62 Ensign Rd, Centerville John & Robin Westlund Assessor'sMap/Parcel 147/55 62 Ensign Rd, Centerville Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco-Tech PO Box 1089 Centerville 43 Triangle Cir, Sandwich Type of Building: y Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (10) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil y¢� d Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 leach system to plans of Eco-Tech, #ETE-2745 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 He Si ed Date Application Approved b Date Application Disapproved by: Date for the following reasons Permit No. —'T Date Issued ----------------------------------------- - - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS WEstlund Certificate of Compliance. THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by Wm E Robinson Sr Septic Service at 62 Ensign Road, Centerville has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No. -OnQ -7 ^ycs dated /p!P/ Installer b »�r.�� Designer - #bedrooms Approved design flow f n1 3'ZJ•O gpd The issuance of this permit s a not be tt uedoas a guarantee that the system ill f�unctio as/designed I � Date Inspector/ 1J�11 .J �•e"C!ilXf _/l f/I t ---U— -----———— No. �X.J-7 5 v�-� \$,100.00 Westlund THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS / 'Wi5po5al Stem �lCon!5truction Permit d p Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon System located at 62 Ensign Road, Centerville 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 mus be completed within three years of the date of thi perm t. Date '� �� Approjed by lown -of---BarnAable Thomas:F--der,Director z Mm3re public-A ..s639• -� Thomas MiMt n,_Director 200 Main Stet;.$ MA.02401 Office: 508-862-�4644 Fax: 508-790-6304. Instaielr&1) xer Certffication Form Date: % Sewage Permi#1 [ 1, Assessor's MapWareell 4 7/5 5 ]designer: Eco-Tech 'l`ilStaHer: Wm E Robinson Sr Septic Address: - 43 Triangle Circle - - Address: .PO Box 1 089 .-Sandwich Centerville .. �.:. .(�' Wm"- E_ Robin-son .-Sr Septicwasissuedapemu#to:installa -� (date). (filer) septic system at.....62 Ensign Road, Centerville basei.on a design drawri-by - Ec=Tech 09-19-07 _ bated (designer) I certify that the septic-.ssystem referenced above was.installed substantially:according to the-design, which may_:.include.minorapproue€l.changes.such-as lateral relocation of the distribution-box andfor septic ta k.- I certify that--the septic system refereed-above was installed.with major changes (i.e. greater than._l0' lateral relocafm of the SAS or any kcal.relocation of any component of the-septic s ei�.}-but in act 3r<lahce wi is State=&IAc� Regulations: --Plan revision or certified-asfiuilt by designer to follow. - - H OF Mgssq ° DAVID eyGN er's Signature) COUGHANOWRcn No. 1093 - o T • �- - STE�� - � SgNITARIN (Designer's Signature) (A Designer's Stamp Here) PLEASE:.RETURN:.TO -BARNSTABLE PUBLIC IWALTH DINMON. -CERTMCATE OF COMPLIANCE WILL.NOT-BE--1SSEIED UNTIL BOTH IHIS FORM AND AS-BUMT CARD ARE RECEMD-BY THE BAP.14STABLE PUBLIC HEALTH Dr€rISION.-THANK YOU. Q_HealUSeptic/Designer Certif=ibn Form 3-26-04.dt R TOWN OF BARNSTABLE LOCATION �a� �N$((�/i! �Av�p SEWAGE# 2001-- $ V.J,'LLAGE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. �p WVsc�N�S��-ALL S'03—7)S--(7 SEPTIC TANK CAPACITY ,O LEACHING FACILITY:(type) 2/W4('w C—AtLE c, (size) ;Z9x(0 9Z. NO.OF BEDROOMS Ja LJ OWNER -,fo4eJ 4#D JJ �C—S��✓d✓D PERMIT DATE: � /�(�'2 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet s 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 o Nosy, Ps It 3 ,31 35f r r r � r -7 Town of Barnstable P 0 ; 3 Department of Regulatory Services Public Health Division Date k u�- 16 , Zed 7 63 a�� — 200 Main Street,Hyannis MA 02601 Date Scheduled Y; !a Time i 1 - Fee Pd. t d Soil Suitability Assessment for Sewage Disposal Performed.By:_V av i cry h"r , b5c Witnessed By: DO h LOCATION& GENERAL INFORMATION Location Address 6 Z t n 5 f qn R„K/ Owner's Name % RA j h We5HV kC4 � t� - ��E•1=P(s-�l_�.t� _ _ _. Address cv7 Ke,�o�h l�� I s s Ceyf�(�U'II e 1 1/y1 02-43 - Assessor's Map/Parcel: Engineer's Name , D�✓r NEW CONSTRUCTION REPAIR v Telephone# land Use R&5,1d e 11+I a Slopes(%) Surface Stones t w h e Distances from: Open Water Body t Do`" ft Possible Wet Area too ft Drinking Water Well L0b+ ft Drainage Way So+ ft Property Line �© + ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) — M GROUNDWATER ADJUSTMENT ��� EXISTING GROUNDWATER LEVEL ��r® BASED ON TOWN OF BARNSTABLE (D GIS DEPARTMENT RECORDS. TP z INDICATED GW 26.00 INDEX WELL SDW-253ZONE C - .�` i READING DATE AUGUST. 2007 READING 48.4 ADJUSTMENT 3.5 ADJUSTED GW 29.5 i Q C= I�iG1 �t�Wq1 � Parent material(geologic) S Depth to Bedrock. �D h� �, � rn Depth to Groundwater. Standing Water in Hole: N Weeping from Pit Face d h Estimated Seasonal High Groundwater x -q b oy e DETEATION FOR SEASONAL HIGH WATER TABLE Method Used: SEC G Dove— Depth Observed standing in obs.hole: _ __in. Depth to soil mottles: Depth to weeping from side of obs.hole: {n. Groundwater Adjustment fr. - _ Index.Well# - Reading Date: Index Well level,.e ms Adj.thetar Adj.Groundwater bevel PERCOLATION TEST DA__G'If�lb�Time P M Observation /!�1 Hole# Time at 9" Depth of Perc C 6 r 11 Time at 6" vi l ;I Start Pre-soak Time @ G'�a Time(9"4") _, _A End Pre-soak =N6 i Rate MinJlnch m P Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division, Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICIPERCFORM.DOC SOIL TEST LOG DATE OF TEST: SEPTEMBER 18, 2007 SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. WITNESSED BY: DONA;D DESMARAIS. HEALTH DEPT. PERC NUMBER: 11937 I i TEST PIT 1 NO PAARENOTUMAATERIA EPROGLACIRALD OUTWASH PERC AT 66 in - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 48.60 0-9 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE 9-40 B SANDY LOAM 10 YR 5/6 NONE FRIABLE 45.27 40-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 37.60 NO NCOUNTERED TEST PIT 2 PAARENTU MATERIAL: PROGLAC AL OUTWASH 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSEL ) MOTTLING 46.50 0-8 AP LOAMY SAND 10 YR 3/2 NONE FRIABLE 8-40 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 45.17 40-136 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 37.00 _ f DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. onsi en Flood Insurance Rate Man: Above 500 year flood boundary No— Yes V__ Within 500 year boundary No Yes Within 100 year flood boundary No V/, Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the 1 area proposed for the soil-absorption system? )-, If not,what is the depth of naturally occurring pervious material? ,.._..� Certification I certifyn N tw � .�S (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent SN OF*8 the required training,expertise and experience described in 3 10 CMR 15.017. sy0, i; �, C y�►.-_ f,5� L 5 C Date s�11 + 2-00 7 ��a DADVID ti�s� Signature o in COUGHANOWR s0�'!'C E N SE0 E V A L U P Q:\.SBpTIC�PERCFORM.DOC • oc?/...cl.d.5... v Fps.... . .. .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH � * ................ // J 4::..wirFatilau for DiivuaFal Works Towitrurtuau Prruat Application is hereby made for a Permit to Construct �\' or Repair ( ) an Individual Sewage Disposal System at: •.L,,c��ation- ddr s Lot No ----------------- R _���d / �. .._ 6 x---��_®_..._ "s'�U o ll -----••. --- Owner d ss ................... ••••-•-- • - .._.. •---_. W1 -•- Installer Address Type of Building Size Lot._9 7 .'7_170._Sq. feet U Dwelling—No. of Bedrooms............. __ 3......... .....Expansion Attic ( ) Garbage Grinder Other—Type of Building No. of persons............................ Showers G� yP g ---------------•------------ P ( ) — Cafeteria ( ) Q' Other fixtures ------------•-• ......•----•-•--•••••• - W Design Flow.................tj`7�-_--•-.___----gallons per person per day. Total daily flow......._7.1-Q............_....gallons. WSeptic Tank—Liquid capacitylDWgallons Length.............•.. Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area............._.....sq. ft. 3 Seepage Pit No..........1____-__.. Diameter____________________ Depth below inlet.................... Total leaching area....Z.�..�sq. ft. Z Other Distribution box (J(j Dosing tank 67-iettiwl, Percolation Test Results Performed by--_•.•___-____- ._.E ...•......... Date.....•.•�������. Test Pit No. 1 GCSf.____minutes per inch Depth of Test Pit...... Depth to ground water.._/ --- 0-4 44 Test Pit No. 2.T __..minutes per inch Depth of Test Pit___................. Depth to ground water____.��TQ �-�� a' --••-------------------------A.......--- ---- - -------•------•-• - -- - r ODescription of Soil...........................0 -1.....t-••-•� (���►••_ ... .................--Q-..-..."-------------.------.---------........__. w 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 I'1 TLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. _ Signed........J ----PXJ-15.c.42 --•-------------- --- /13-/ .�.. Date Application Approved By........... Date Application Disapproved for the following reasons:----••-•••••••-•-•---•••---••-•••••-•-------•-------•-••--••-•••--------•--••••••-••••................•••------. `---------------------------•-----------......_....---------------------------------------------------...--•----..•.....-------------------•--•-------------------------------------------------------- Date PermitNo......................................................... Issued---.................................................... Date FE$...3.b.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF �H►HEALTH, ....To.wx1_..........oF............... /�� �f ... ...1. A,'���_F_ ,�pliftratinn for Bisposal orks Ton st rn r tinn ramit Application is hereby made for a Permit to Construct A) or Repair ( ) an Individual Sewage Disposal System at: ,, . ,! , Location- ddre-- Lot ox _ -- r--• -'�- _.rilo ......�_A._....... ..j.... f... -_____-.j-'............ Owner W 5 C c/ V a ................................... .........Inst...a.11e..r.......... ------------------------- -----------------•---------•--- --------•---Addrressess- ----------- - ---- 1 � Q Type of Building Size Lot. _71._-__f__O_..Sq. feet Dwelling—No. of Bedrooms............. ..... ._._....___._..Expansion Attic ( ) Garbage Grinder (/> e of Building ............................ Showers a Other—T YP g ---------------------------_ No. of persons ( ) — Cafeteria ( ) QOther fixtures_..---------•-• -•-••••-•-•-......-•••••--••---•---•••---••-•-----•-••--•------•-•----............... :._........---•---- W Design Flow.................. 5...................gallons per person per day. Total daily flow........... f4 Septic Tank—Liquid capacity4999 gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No. ...............•... Width......._............ Total Length.................... Total leaching area............ _.._.sq. ft. Seepage Pit No........... Diameter.................... Depth below inlet.................... Total leaching area... _�C_ sq. ft. Z Other Distribution box (A Dosing tank (, W Percolation Test Results Performed by.................... .�!!�:...... ........._....�......._.........--------------- Date.......... __....._.. t5s u /f'._. Test Pit No. L... _ minutes per inch Depth of Test Pit......_'Zi..... Depth to ground water___.:................. (i Test Pit No. 2 7 _..minutesper inch Depth of Test Pit..... ............ Depth to ground water._.__ ''' w .............. Description ..............•_• .. ._ ........ 0. Dion of Soil............................•-••--. ° -•----- ....._-• -- -----' x -- U --•••-•......•-------•-----•----•---•------•-•-•---•-----...""-------------•--•---....r'.' t-ram' ......................................................... W ----------------------------•-------•---------------------.._...---------------------------•-----------------------------------------------------------------•--------------...........----•-...--_..... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ............................................... ----•-•-•---•--•-•---•--•---•-•-•.................••----•------•••-••--••••----••---•----•----•••--•-•--•••--------•----•-•--••--•-•....-----•---_..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TILT y g g P y 5 of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been •ssued by the board of health. ¢ - r' �` ,l Signed ------------ -� � :..._.. _...._ Application Approved By............ .. .................. .......... Date Application Disapproved for the following reasons-----------------------------------------------------------------------------................................. Date PermitNo........................................................... Issued_.................. ................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 1 HEALTH V. _ �± '.................. ✓/ (9rdifiratr of (luntplianrr THIS IS 0 CE TIFY, Tha. he d, i ual wage Disposal System constructed (An or Repaired ( ) y �,, l ns 11 ,,¢� -----•---•----.....--•--•-----------------•-----.._.....----•---••-•. has been installed in accordance with the provisions of TITLE rr h State Sanitary Code as described in the application for Disposal Works Construction Permit No.____�:`r{--- ----.----. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFA TORY. r DATE 1.. 1.I.C_}pQj....... Inspector.......................... j A W� ................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 40 CIS ..........J.. j<ir t'.............OF................. �/ .�. //....... ...... b No... . ........... FEE........................ ' �i����ttl nrk� �nn��ruan rrntt� Permission is hereby granted.................. .-1-------------------------- ._0 j. ._ . to Construct (.• �o} err� 5)!a�_ Vividp =.age Pis a S�y�st�rmf tJ / C !� I �`7 at 'No. •...............•--------.--•••------------•----••-••-•••........----••--••-------•-----•-•--•--•••-•-•-•--------•-_..... Street as shown on the application for Disposal Works Construction Perrpit- ......................Dated....... °�.............................. 1 ...............................--—±----------- -.-------•-•--•---•----.....----- DATE................ .� ._. ........ :...... t Board of th FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS i i L CATION I SEWAG PERMIT NO. 04 rl V4, LLAGE INSTALLER'S NAME i ADDRESS 0 p MAWS T-ns �!►1r IUILDEIII OR OWNER �r�PPn6r�►�r� DATE PERMIT ISSUED (7 DATE COMPLIANCE ISSUED 1tj F� t� �'yL r t.L:� E ALL ►.rA-ru2AL. cw Rff-AA,a i N u I C o PEST Ff-c m SKul.rlcr.l ETT:.1z%J" .vNLESS A QcrnCF vl� Pit., 'PEP 74S sT'A` e wErt.htiAS /tcT. m/, lFl.=ioo.00 i Q$ 'g F,►roe t,. 94:2 0,a cb *• ,%•'1 91.3 $NTMM-sa 51G.�.IKr,1ET .. ,•��H DF:/y�s 2VEQ. /3tiP ALB�Ft�. : A. o R 5 UUO S. F• o PFlsv Sl0NA- 10 LEGEND q.EXISTING SPOT ELEVATION .• OtiQ -�P��N '�'�� +•' � ;` CERTIFIED PLOT PLAN . EXISTING CONTOUR Co �-., f2c4 D FINISHED SPOT ELEVATION B9R o- , y :.` G ►..ITS \J i L.LLE7- FI N I S HED CONTOUR -----0-- IN .APPROVED$ BOARD OF HgALT "o sum• DATE AGENT SCALE, DATE; C09•og•5?1. C�.IF�IT.�,� �.�, 1 ELORE06E�`ENQ/NEER/N6 colIMF CERTIFY 'THAT THE PROPOSED REOISTERE E9ISTER ®® NQ! �� `3 SYILDING SHOWN ON THIS PLAN CIVIL LAND ^ CONFORMS TO THE ZONING LAWS E OINEE SURVEYOR RV Y DR.RY$ J.Q.e.`, pF 1 STA M S' 71Z MAIN -ST. .. CN.OY� P-.a d�� HYANNI3o MASS. SHEET!w. or, PATE CEO. LAND SURVEY R IV07'F /F E/TNGRE TANk OR 20 FT. M/N. LEACN/NG ?/T .4/lE MORE' TNA/V /2"QELOJVE /O PT. Mt'k GR/►OE,A 24"'O/AM ET.ER CONCRETI� CGYEJ✓r }f-- SNALL &,F BROIl6NT 7 GI�AOE.�flN EXTRA CONGR�TE ��qyY CAST be OW Co{/�R SHALL BE USEO MIN; P/TCN �L' 9$.a GOYERS �g"OERFT !F/N DR/VEy1/AY v 2%MIN. CO/VCRL�TE CO✓ER CL EAAI .SANG 04. _ 2'LAYER M N i GOt7 G11L D/ST. .s40 ,. . 11 r . w : .: ; > ►.•,� - . WASHED 5M E �4'Pt/r f7:, SEPT/C: .. TIiNK.. • r . ,• r r 9 . • r 1 r OtPTJ4l• • ► : ;Bay I, 00'Iff WASME0'.STDNE `,. • • • • • •. R•I t _•.. ..,.. t' Lr3• Y.F. G7.P s .. 1AIPIMNY AA R VAV4&0, t/JV)�,EA T A7 OI1**AA1 N6 L?�oo = . J+T. ? !/YGET� .�i'EPTI�"`"T•�lNIC '95; P�.r cnP m' 549 GPa •_ _IG JrX`AA4JNi �`+�.SEC7 tI ATIO/V ' OV71ET SEPTIC PANN 95•G. _/QT jNAAFr D/STR/� vr-*v V BOX�5 4 J .SWC"0Al QROI/NO ItG4TER TAa1tE' 0&/ZAE7D/3TR/9NTi►ON IJYL.ET-LFACNl/Kli P/T 95,0/ra► _ S►EyYA6E:.0lS/�IO�SAL S T/1 Ql!l..4TtO/Y. IV � !-0o? O/ML•N.V 0I1f JYUAl R O+F aEGsROD/yS 3 D1^1AW51W , 6 _fT. wRer.6. o�sPosr+ uw►/r o; S'D!L "Loa . TOTAL e'STI/► TEts FLO/4/ TES?' / • SO/! Ti1eSTE,�y /L iVUmB1aR aw Y tCM/ +. A. i G'K q3, AV." AATff OP SOIL. TEST w 4/OEA&ACMIN6 PER P/T 18� So ! RES//A.Ts IV/TNESSED d)'' dOT roM tEa,CM/NG PE14 P/T Sq FT. ' " — �' �t AERC®LI►TIOI✓ MATE / �5'S M/ INGIy" TOTAL 1G4CN/NG AMOA �l� S4 yr s�+85o►t. I A.JeCo AT R./ON ffTE j*Z M1 AF.f/JNCK R6SE�HYd'L.B�1CNlN6ARE/4 ?(ova SQ. 'FT.; • _ i OF P���o y�ss9�" qu o+ ► Lo'r C1, — E t�1 S I C�i.l .(�cam► L? JOkN !tom ALBERT : tic �AwtD Cr=i.tT`E �V F L Lam' No.ioy5 i EL DREDGE A.MCrhy"WIMM CQ,lNC. tST ��� g4.(a:�. �w1ATER' 71Z WA//Y Sr. �NosT v�ro� '"'��.al��/ Iy0GROt1NP kV,,4rrM, ENCOUNTERED I+YANN/s, Mass. ' R�c'�4 SUM wa`vv� ] GROijVo W-47—, '.P A7' EL.EI/. JOB No. �(023 SHEET 20F ; CONTOURS ___--�—•���— 3 LOCUS 42 - m EXISTING - - - - - - - 50 46 44 — — m MINIMAL GRADING PROPOSED 204 FtDED 1�48 LEGEND ; t EXISTING NE R RaPO BENCH MARK 66m0%� 29 FL X 10 F'L X 2 ft \ I I lase GALLON � I Ee POZE ELEVATION = 50.04 F GAS GATE49 LEACHING GALLERY SEPTIC TANK I RO c N BARNSTABLE GIS DATUM /�'� TP-1 LOT 6 --0 ® 1 I EXISTING LEACH \ 16 O AREA = 27790 _- +- PIT/CESSPOOL \ CENTERVILLE MA ' o� 2 -1 A 1' UTILITY POLE $ LOCUS MAP I NOT TO SCALE 50 � O 1 rP-2 22 ft O E m� - x TEST PIT ® D-BOX ❑ O �O � \ �\ LIfJ \`10 M I -� DECIDUOUS CONIFEROUS �p \A TREE Oo TREE 18-P 6-H 20-P d�b 16 M 18 P kn G �-r\ O \ -NUMBER REFERS TO DIAMETER IN ISO, ~Z Z O \ INCHES. LETTER DENOTES TYPE. _n\ - Z �. O-OAK M-MAPLE P-PINE C-CEDAR 7 GA TE 3 \ I I �3 I 18-P zZ 58 X � �NE \ i ATER \ DISTANCES O / _ TO LEACHING GALLERY I \ \ \ P� V I \ ALL DISTANCES ARE IN DECIMAL FEET NOT IN FEET AND INCHES. —� \ O 1 A I B 1 \ / \ 1 22.3 1 42.P I / 2 26.9 51.9 / 3 53.0 67849 48 % i 46 44 42/ 22377 FLOW PROFILE ALL PIPE ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS FLAN GARBAGE GRINDER EXPRESSED IN DECIMAL FEET NOT FEET AND INCHES. SCALE. 1 - 20 FL IS N 0 T ALLOWED — i n TOP OF FOUNDATION RAISE COVERS TO WITHIN SIX INCHES OF FINAL GRADE , WITH THIS DESIGN. ONE INSPECTION RISER FOR LEACHING GALLERY TO 20 0 20 40 EL = 49,51 +- WITHIN 3 INCHES OF FINAL GRADE AS INSPECTION PORT. 48.90 0 10 20 �G®a TE SEWAGE DISPOSAL SYSTEM PLAN 1ORKNp -TO SERVE EXISTING DWELLING /D-UOX a f t SCHEDULET40 B VC /3" DROP �l MAX AND TO PITCH AT EST. �OH� ROB OF IN WESTLIJND FLOW LINE 45.90 1/B In/ft MIN. 1m = 14. 62 ENSIGN ROAD 48" GAS�� PRECAST �ytNOFMgSS �y�Nur&4,9s 1995 �� CENTERVILLE. MA BAFFL E ? ? y 99MPROPERTY ADDRESS DRYWELL ti ® RA BOTTOM O DAVID GN o [)AVID ��, \45.92+- 6 i n LEACHING Z g`r a ASSESSORS MAP 14 7 PARCEL 5 5 ................. EXISTING STON 45.2E LEACHING GALLERY �. �' c�i D. 43 TRIANGLE CIRCLE EXISTING BASE COUGHANOWR �' COUGHANOWR EXISTING � 45.45 GALLERY � No. 1093 SANDWICH MA 02563 PLAN BOOK, 2J3 PAGE 28 EXISTING 45.15 43.15 5.00 ft + �F �� s ��CENS�� Q' SD8 364-mBJ4 DATE: SEPTEMBER .19, 2007 1080 GALLON (END VIEW) S01STe�N E PLO JOB BETE-2745 PAGE 1 OF 2 VERSION: SEPTIC TANK SEE DETAIL ON REVERSE I r �P SC THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED EXISTING 12 f t b) 15 ft 10 ft I b1 4 ft SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM DEPICTEPROPERTY INCLUDING ADJUSTED SEASONAL: 29.50 Sepie*bO- (q, �07 PLACE ENT OF ADDITIONS. SHHEREON. FOR ANYOEDS.FENCES OR SCHANGESOWIMMIING POOLS. OWNER HIGH GROUNDWATER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. i 1 SOIL TEST LOG } . A DESIGN CALCUL- ATIONS - DATE OF TEST: SEPTEMBER 18, 2007 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS WITNESSED BY: DONA:D DESMARAIS. HEALTH DEPT. USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL PERC NUMBER: 11937 CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) NO GROUNDWATER ENCOUNTERED DISTRIBUTION BOX: USE 3 OUTLET D-BOX. TEST PIT 1 PARENT MATERIAL: PROGLACIAL OUTWASH SOIL ABSORBTION SYSTEM: A 29 ft. x 10 ft. x 2 ft LEACHING GALLERY CAN LEACH PERC AT 66 in - 2 MIN/INCH IN C SOILS A6ot = ( 29 x 10 ) = 290 sf Asdw = ( 29 + 29 + 10 + 10 ) x 2 = 156 sf ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER At.ot = 446 sf (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING Vt 0.74 x 446 = 330.04 GPD 48.60 0-9 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE USE A 29 ft x 10 ft x 2 ft GALLERY. Vt = 330.04 GPD > 330 GPD REOUIRED 9-40 B SANDY LOAM 10 YR 5/6 NONE FRIABLE 45.27 40-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 37.60 A L L 1000 GALLON SEPTIC TANK NO GROUNDWATER ENCOUNTERED LEA CHIN G GALLERY Y DIMENSIONS AND DETAIL NOT TO TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH USE SHOREY PRECAST 500 GALLON NOT TO USE EXISTING H-10 LMT SCALE 2 MIN/INCH IN C SOILS LEACHING DRYWELL (H-10 LOADING) SCALE ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER CONSTRUCTION DETAIL ATPTIME OF INSTALLTIC TANK IS TO ATION MAND IPED S TO (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING BE EXAMINED FOR STRUCTURAL 48.50 DRYWELL UNIT STON INTEGRITY. INSTALL NEW PVC OUTLET 0-B Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE TEE EQUIPPED WITH A GAS BAFFLE. B-40 B LOAMY SAND 10 YR 5/6 NONE FRIABLE 29.0 f f 1 in 45.17 40-138 C MEDUIM SAND 10 YR 6/4 NONE LOOSE TAPER N 37.00 m o GROUNDWATER ADJUSTMENT 6.5 F- _1.4 Ft 1. 6.5 FL 4 Ft u- EXISTING GROUNDWATER LEVEL 29.0 ft BASED ON TOWN OF BARNSTABLE 1� GIS DEPARTMENT RECORDS. ' 6 A 1 INDICATED GW 26.00 INDEX WELL SDW-253 500 GALLON DRYWELL ZONE C DIMENSIONS AND DETAIL INLET OUTLET READING DATE AUGUST. 2007 COVER COVER READING 48.4 USE H-10 UNIT INSTALL ONE INSPECTION ADJUSTMENT 3.5 RISER TO WITHIN THREE 3 IN DROP ADJUSTED GW 29.5 INCHES OF FINAL GRADE —► /l - FLOW LINE AND INDICATE LOCATION FROM 10 In ]q TO ON AS-BUILT PLAN BUILDING 1- O-BOX 48 in LIQUID GAS LEVEL BAFFLE 33 NOTES o�0 00 00 I) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. a0000000000 ��p00 „` 00 moo 0o CROSS SECTION VIEW 2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED o00000 0 i�` FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. 102 5g 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS 1n OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. CROSS SECTION VIEW SEWAGE DISPOSAL SYSTEM PLAN 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED, AND FILLED. 2 in PEA13TONE 2 in PEASTONE 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST".IN PLACE. -TO SERVE EXISTING DWELLING a o 7) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION' OF LOW FLOW FIXTURES 24in JOHN AND ROBIN WESTLUND AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. 28 -1r2j,GRTi1°vEL DEPTH 1-112L,i n°vEL 26 81 SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING:` DO NOT in 62 ENSIGN ROAD CENTERVILLE, MA PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. '' 31 in 58 in 31 a Elr.O-TECH ENVIRONMENTAL 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE"ON A LEVEL 120 in STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH 43 TRIANGLE CIRCLE SANDWICH MA 02563, INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO. MINIMIZE UNEVEN SETTLING. FABRIC IN PLACE OF THE 2 in. PEASTONE LAYER SPECIFIED. ETE-27451 SEPTEMBER 19, 20071 1212