HomeMy WebLinkAbout0014 GREAT HILL DRIVE - Health 14 Great Hill Drive
A- 173 - 084
Centerville
1lle � Z
IN
UPC 12543
Now 53 LOR
HASTING6,MN
j
No. ��� ` Fee 40
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye—�!
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitation for Disposal 6pstrin Construction Vermit
Application for a Permit to Construct( ) Repair(%Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. /// C."-ec x Wt Vte Owner's Name,Address,and Tel.No.
CCl�-rd ail J,e �
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
A T1,zi fCJcn3^' -rNC sD�j-No� S�5 r-— I'ver,Af-j �,✓�(S
Type of Building:
Dwelling No.of Bedrooms .3 Lot Size .4*'j r70 sq.ft. Garbage Grinder( )
Other Type of Building -��S��Pn�f/c/ No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 3C) gpd Design flow provided 3 5l ,o 7 gpd
Plan Date y-2 ct-I C_ Number of sheets 2 Revision Date
Title
Size of Septic Tank 15 X/ni-jnj. Type of S.A.S. a 'TOO 9A(117nl /-A r,•n,�!P�f Lt//f�LJ'5 fO�
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) L Aseu) C7 t,qox &aC] ;t, 5"d0 G►Cell��)
C1AWti�0'f�S w l¢-LI N ° S�G nS 'e
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.
Signed - Date
Application Approved by Date 6 n_Yr/l(D
Application Disapproved by Date
for the following reasons
Permit No.A Q 1 Date Issued '� .
kkkk f
" o �.�.
o l �� � l � � s _:..�;� Fee--1—6 `
a THE COMMONWEALTH OF MASSACHUSETTS Entered in/mpufer.'tYe
PUBLIC HEALTH"DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplicatlon for Disposal *pstem Construction Permit
Application for a Permit to Construct( ) Repair(Upgrade( ) ,Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.. /// G✓mot #1 I V� Owner's Name,Address,and Tel.No.
Ce,Vi-r✓viI)-C
Assessor's Map/Parcel / _ q 5 U
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
`Dao:z,IG s A i J =NC SOg-NO�-)/S-S r✓ INt�t�v�^�J ( j✓��J
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size �/ f'Jo sq.ft. Garbage Grinder( )
Other Type of Building 4t+,;Zd ✓//C l No.of Persons Showers( Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 gpd Design flow provided 3 4--1 , 7 gpd
.r
Plan Date L-1 -2 - [_ Number of sheets Z. Revision Date
Title '
Size of Septic Tank C X Type of S.A.S. a 5 00 y 15 FO(vc
Description of Soil
Nature of 1R�epairs or Alterations(Answer when applicable) -(ky tc, �� �„oy�,. ) Gjc)Y -AA)C) SCY��nGe�� nl
CGGMbOr(% W t� tl N SfQ/41e
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
1 -
Compliance has been issued by this Board of Health.
Signed �j�� Date
Application Approved by ( Date `j-!9 i� +
Application Disapproved by l Date
for the following reasons ..
Permit No. �p - (��p 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( )
Abandoned( )by i 1 it,
at /</ G/pa! �r/� 2 o r ✓J J Y has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 0 (i- j dated (, f f
Installer T)2uJe A 1IrA,.%r') I&)c Designer ,�,��,�,r �,�, L, l C1,-c
.,
#bedrooms Approved design flown gpd
The issuances jof this permit shall not be construed as a guarantee that the system will c o as des
i ed.
Date C 4l5 -I C. Inspector
v• o
------------------"---------------------------------------------------------------------------------------------------------------------
No. a o�(y " 1 a to Fee (Da
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Disposal *pstem Const rtlon Permit
Permission is hereby granted to Construct( ) -�Reppaa+ir(� Upgrade( ) Abandon( )
System located at
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:Construction must be completed within three years of the date of this permit.
Date li CO Approved by `YWW ') ,t-V-4--u/(-,,— YS
IJ G - -,—a �v��or `�
Town of Barnstable
Regulatory Services
4 Richard'V'. Scali,Interim Director
. n�excrnw.r_ •
Public Health Division
038. .
t Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508770.076304
Installer&Designer Certification Form
Date: (, Sewage Permit#?��r—1c (o Assessor's Map\Parcel ?
Designer: 11 yvc�:;y, - .: r.� ivc�:-ems t Y. L Installer 17 I7 0 v-W n (" C
Address: i Z i, , Cam:s st- . \Cj K-r-A Address:
r � a lie 1N k 4s �j _f��e►� keN�'I Lt t4A-r2-6`16--,
On was issued a permit to install a
d, date) (installer)
septic system at � . ` Deli '
based on a design drawn by
(address)
pe+ � °� i✓.n t-e t: t�t,' dated
(designer)
V Nk. ri,4 s V, only awl e eel S c1" ( l a3 j 9-ao 6c'Aw '
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. Strip out (if required) was inspected and the soils
were found satisfactory..
I certify that the septic system referenced above :was. installed with major changes (i.e.
greater than 10' 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
certified as-built by designer to follow. Strip out (if required)was inspected and the soils
were found satisfactory.
I certify that be system referenced above was constructed in co liance with the terms
of the 11A approval letters (if applicable)
PETER T:
staller's Signature), M civic j
No. 35109
AEGIs�E ° ��
(Designer's Signature) (Affix Desigi Here)
PLEASE RETURN TO..BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL, BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
QASeptic\Designq Certification Form Rev 8-14-13Am
TOWN OF BARNSTABLE
LOCATION �P \` /� / SEWAGE#
VILLAGE C_A„►¢-err % 11`� ASSESSOppR'S MAP&PARCEL/73-089
INSTALLER'S NAME&PHONE NO. ICE I �IVC,
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) 2 H-*20 L%n9GeAf1Dr4 (size) /2,51AZS °2_._
NO.OF BEDROOMS
OWNER EI I-,e �
PERMIT DATE:�g (� COMPLIANCE DATE:
Separation Distance Between the: ✓SOON 2i�"s
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Perc- 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 yS,
�e A 3�GK
AoO--.z3,�
--38 r�
Town of Barnstable P# 5�'(, _
Department of Regulatory Services
UAMSTABLM Public Health Division Date _
grFoa 200 Main Sheet,Hyannis MA 02601 -
I.IA .
Date Scheduled 1-2 Time S 0 d C1`�
me Pd, ---
Soil Suitability ,;
ty As�wssment o>r Sew!Witnessed
e �isp loscal
Performed By: YL-�! i�tC. � i $ L -!S>�f Z By:
LOCATION & GENERAL INFORMATION
Location Address Owner's Name�� �-��.�-�.�i--i';I �,-� :.3-E�l�y �► a k-,
Address 1 S� ( (, ':"nz/11, !Z '4
Assessor's Map/Parcel: I -7 3--U S Engineer's Nam ;
NEW CONSTRUC ION REPAIR Tele hone# S. � T
Land Use GLS;c�i��tZ Slopes(%) -Z- Surface Stones No-Q.
Distances from: Open Water Body ft Possible Wet Area �/' �'
ft Drinking Water Well �'t 5�� ft
Drainage Way j ft Property Line !0 -�~ ft Other
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes)
_ l
Parent material(geologic)
Depth tO Bed brock
Depth to Groundwater: Standing Water in Hole: lv A_ Weeping from Pit Fttce
j Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: - - ,in, Depth to soli mottles; in,
Depth to weeping from side of obs.hole: Oroundwater Adjustment-____ft.
Index Well## Reading Date: Index Well level,„- Ad,l,factor w _„�,� Adj,Grounthvater JAvel a
PERCOLATION TEST Data , 'rime
Cbservadon
Hole# � _7 J Time at0" /Z Z��
j Depth of Perc ��cr Time at G"
:Oj
C
Start Pre-soak Time Q _ Time ff'4')
End Pre-soak /Z°%) 6
Rate Min./Inch
Site Suitability Assessment: Site Passed r> Site Failed: Additional Testing Needed(Y/N)
I
Original: Public Health Division Observation Vole Data To Be Completed on Back------------
I
*'1`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.
:\SEPTICPERCFORM.DOC
DEEP.OBSERVATION MOLE LOG Dole #
Depth from Soil Horizon Soil Texture Sdil Color Soil Other
urface(in.) {USDA) (Munsell) Mottling '(Structure,Stones,Boulders,
_ Consistency}%Gravels,.,___
'(It
j _7l C-4 » �.wQ Z,S�I' G/ 7 "Z�, �:j •4 �9 C, 6
c
Jac�+sz
DEEP OBSERVATION HOLE, ]LOG Hole# z-
epth front Soil Horizon Soil Texture Soil Color Soil Other
Surface(in,) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
conslatengy �o rave
Cj 2 t3 F1 C L _ ---
Crvj— V i ,r A l�`y ;c;`s o.a
DEEP OBSERVATION HOLE LOG Hole# F -
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.,Boulders.
Consistency. o Grave
Z.. —
�- r--5
I).EEP OBSERVATION HOLIE LOG. Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
Consistency,56 Qray�g
C. Ste; ^CA 1�' �►'L-4/`1
i
• i
Flood Insurance Rate Map:
Above 500 year flood boundary No _ _ Yes_ a
Within 500 year boundary No_ Yes _.
Within 100 year flood boundary No Yes
Det)th of Naturally Occurring Pervlous Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? _Jj�.J
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on it (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 with
the required trav)i ,experdse and experience described in 310 CMR 15.017,
Signature —� � --- Date
Q;\S.E PTIC-PERC FO R M.D O C
a Town of Barnstable P#_ �3
Department of Regulatory Services
8TABV, : Public Health Division Date 3'
MASI
200 Main Street,Hyannis MA 02601
N rE0 hut" �► "C
Date Scheduled' )--2- rTime e
r_ Pd. as
Soil Suitability Assessment for Sew ,r a Disposal
Performed By; Witnessed By:
LOCATION& GENERAL INFORMATION
Location Address iq / �� Owner's Name
Addre yss � s
f2�
�� /�
j e-��+� t� M� o Z_(r
J Assessor's Map/Parcel: [Z 3—0 �1, Engineer's Name . Z
NEW CONST,,RR�UCTION REPAIR Telephone# Sd�y-77 s—?�.
Land Use t�-S i JC,hu,( Slopes(%) -Z Surface Stones 6J®"e
Distances from: Open Water Body MA- ft Possible Wet Area tit��
ft Drinking Water Well7 ft
Drainage Way /�IA- ft Property Line iv ft Other
ft
d� r
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes)
2 t p +7 i
S
�Tv
Parent material(geologic) (?C kc-rC ( of r``^ %.'- Depth to Bedroc . A /
Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face T
Estimated Seasonal High Groundwater ?I 3$ f
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: a in, Depth to soil mottles: In,
Depth to weeping from side of obs.hole: _ e in, Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level .__ Adj,factor Adj.droundwater level
PERCOLATION TEST bate . 'aim°_
Observation Z l
Hole# 'I ime at h"
Depth of Perc 1/ Time at d"
Start Pre-soak Time @ .� S,1LtcA Time(9"-d")
End Pre-soak �� a,^P_ Ca,A S t S`ftA r'''`Q j j0-4-f-C
Rate MinAnch.
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)_
Original: Public Health Division Observiition 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:ISEPTICIPERCFORM.DOC
I
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones-Boulders.
,
on i tenc ravel
`;� o._� • �� ems. �ayt2`11z
ZOO
9-3®
•i P!1
• ' I
DEEP OBSERVATION HOLE LOG Hole# Z—
Depth from Soil Horizon I i.
Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Cons' en % ravel
v A Ls >ay�yl.7_-
3 . s o
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture _Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%G e
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,
Flood Insurance Rate Map:
Above 500 year flood boundary No _ Yes -
Within 500 year boundary No Yes
Within 100 year flood boundary No=, Yes .
Denth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious iaterial exist in all areas observed throughout the
area proposed for the soil absorption system? �
If not,what is the depth of naturally occurring pervious material? --
Certification
I certify that on 11 (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 with
the required training,expertise and experience described in 3 10 CMR 15.017.
Signature Date
Q:\.SEPTICIPERCFORM.DOC
Town ®f Barnstable
Department of Regulatory Services
]Public :health 6
• 8ARN8TABr.0 : Division Date
' 0rfn a`b� 200 Main Sheet,Hyannis MA 02601
Date Scheduled JI-2 1 Time
e Pd,
'ySoil Suitability Asg essment or e
j!.6 �j,,
Performed By: �C?.I� to l L � t -(�;`f �j
Witnessed By: ;v.
LOCATION & G•ENERAL INFORMATION -�
Location Address Owner's Name�9 Grp-(:.���•�-}-i t��,�' `�,-•
Address 15 5- ( -e ( �, �-,z s, f�
P_
(f'
[;; QNSTRUCTION
or's Map/Paecel: i .3 6 �, Engineer's Name
C REPAIR 7L Telephone P
Land Use rZ,_ti;c ✓\.1`c C."(
Slopes(90) Z- Surface Stones
Distances from: Open Water Body ft Possible Wet Area �f!a• ft Drinking Water Well'rL 1 S� ft
Drainage Way �1)f ft Property Line lO -S f ft Other �`
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes)
d ;� Z
1___�)tA�
Parent material(geologic) 1VL611 nt•ee Depth to Bedrock
Depth to(3rpundwater: Standing Water in Hole: Weeping Prom Pit Pttoe ��'i--
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: ---In, Depth to soil mottlt?m: in,
Depth to weeping from side of obs.hole: in, Groundwater Adjustment..._.- �.--ft
Index Well# Reading Date: Index well level", Adl,rAo or- Adj,Crvundwater Level
PERCOLATION TEST bntu �rtme
Observation
Hole# �' 'y Ti J Z 1 2 V
Time at 4 �e
Depth of Perc )
P `��f�c j � Time at G,�
i
Start Pre-soak Time @ 1 2 11 03 _ Time(911•6")
End Pre-soak Z;)
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Hginal: 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.
'\SBPTICiPERCFORM.DOC V? V'
' I
DEEP.OBSERVATION HOLE LOG Hole#—J
epth from Soil Horizon Soil Texture Soil Color Soil Other
urface(in.) (USDA) (Munsell) Mottling '(Structure,Stones;1oulders,
Consistency,%
'(ffe
A Z"'"� fig �' (?+�— 7 � 12• >/ C,Q b b lr.a �.>I C>(.4,, t
a'
DEEP OBSERVATION HOLD, LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
urface(ia.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsi en % ravel)
L
r' sv+��f 17 —- /va; �v. ► r C/ E��" v t r A43 ice`.' SC o tr-S
DEEP OBSERVATION HOLE LOG Hole# , 3
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
_ Consistency,%Gravel)
3o dcs C. C 5 toysi�
a
7
DEEP OBSERVATION HOLE LOG. Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones, Boulders,
Conal (enc ° ra
0 IL
93�
L��� f �2_ t^-� r�- S rg•,� `�`
i
Flood Insurance Rate Mal?:
Above 500 year food boundary. No.— Yes
Within 500 year boundary No— Yes
Within li)0 year Hood boundary No � Yes
Det)th of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring.pervious tnatetial exist in all areas observed throughout the
area proposed for the soil absorption system?
If not, what is the depth of naturally occurring pervious material?
i
Certification ,� '
I certify that on tl 1 c�� S�(date).I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above.analysis was performed by consistent with
the required trait}i ,.expertise and experience described in 310 CSYM 15.017,
Date
Signature
Q:�,SEnlC-\PERCFORM.DOC
— — 73'9-- ----
4T 2 9-1"4 47'2 — — 23'-- -- 8'11 ---- —9-3 -- 14'3
711 11'6 — 37 3'3 68
VP
/remove window a d install a 6068
/ slider withside lig is
--- 17'8 -----
�► -- ......... —
5Lro
N -- -- -
�b r- 1
r I
�-
i � l
BATH
8'3 8'36'3
I O
I �
KITCHEbv -
497 x 12' ] CLOSET ----g- ---
�r SH
5 4 z2.74
o =4'1 ns' — '2'—
io N
n —
4r c M - --
c� I SH / M
Nu)
::::..... I [—
�5�. N N GARAGE N
remove small wall on the left /f 137 x 23'6
17'8
1'4' d �\ ,�, -- - ------- --
dinning room l
`c living room 12'4 x 1 V\\ I
O
_ I I
L
— — '24'10- 4'10 6'7 - 8'6 2'6 32 5'11 311 41 —5LIVT14
�ir�R A18' sq ft 13' � 9'3 -- --6'
11"-3--- 14'3—� .
-- —73'9-- — — —�
wanes coating half all the way a
around 4
Remove closet ar�d walls Take two F
W.
railings from oak ' Y Ur G' �0.
wood floor oak allover 1 `(/� 1 (�� y�
new windows all around I ® rM'
Keep pantry and duct chase.
Widen the pass threw to four feet. ,,-
i
Bed r m #1
Closet
UP
Bathroom
Closet
�Y
' Bedroom #2
_ � G
------------
� I
Garage
LIVING AREA
1230 sq ft
73'9
4'7"2 9'1"4 4'7"2 23' -8'11 j. 9'3 14'3
19'5 — —3'7 '3 5'8—
6'
/remove window and install a 6068
slider with side lights
17'8
...._........._....._.__._.
::::::::::::::::::_ ..............................:
N 1,22 I o I Oo o
BATH
F _ -
8'3 -.9'3
I �
KITCHEN
497 x 23'4 CLOSET 9'
v SH 5'4 r2 7a —4'1 = 2
00
`v SH °' Cl) c�
CM - CV CV
N ... -:_ GARAGE
� CV
remove small wall-on the left r 137 x 23'6
'v
1r8 �w`)
1'4... -------------------;
living room up
I
LMNGSH=A
-------------------I
4'10 8'4 4'10 67 8'6 2'6 3'2 5111 3'11 4'1 — 5'2- 6'11"3 7'3'5
18' 1T7 LIVI 18 AREA 13' --9'3I 14'3
1 44 sq ft
73'9 r
wanes coating half wall all the way
a round
Remove closet and walls�ake two
railings from oak
wood floor oak allover
new windows all around
Keep pantry and duct chase.
Widen the pass threw to four feet.
• V
I
t 73'9
4'7" — 9-2 4�6"4 10'2"1 9'27 — 12'6 9'3 -- 14'3
8'10"7-
(— 10'2"1 i
F" 8'10"7 —
r - M
N L 7 C�
M OCN
N
r� V'
Cco
bo
00
13'57 UP- 11'10
N^ ao
------—18'-------- — ----32'3 -- -- 9'3— ------ 14'3-- --�
LIVIN73,9AREA -
' 1566 sq ft
TOWN OF BARNSTABLE
SEWAGE#
;;LOCATION
E ASSESSOR'S MAP &LOT l'7�-
VILLAG
!1STALLER'S NAME&PHONE N0.
ex;S4 000
t: SEPTIC TANK CAPACITY ' X I
(size)
w NG FACILITY: (type) I
No.OF BEDROOMS
: GUILDER OR OWNER
Tor. 17- °
I'
COMPLIANCE
ERMITDATE DATE'
`Separation Distance Between the: Feet -
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility
8 ty an wells exist
Private Water Supply Well and Leaching Facili (If Y Feet
on site or within 200 feet of leaching facility)
exist
Edge of Wetland and Leaching Facility(If any Feet
within 300 feet of leaching facility)
`Furnished by _.- _ --- --
3 �i =o - �
0 J*D;)
N . �!i 1 Fee
! 1
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
�tpliration for 33io o at bpeum Conotruction Permit
A li tign Fra Permit to Construct Re air U rade )Abandon( ) Com lete S stem ❑Individual Com onents
PP � � ( ) P ( Pg ( � P Y P
Locatio ; ddress r Lot o. A q G g-e,.� t,.M Dr{� Owner's Name,Address and Tel.No.
GfTrt= dd 1� `
Assessors Map/Parce O —T—OVA
}N� (
Installer's Name,Address,and Tel.No. —7 g,_p(o g'(f Designer's Name,Address and Tel.No.
�,r.>-Cis P SAP-I �.
2 c � V-o� ,W,go. s x, mob e�-FS
i
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 —.!:R'1 gallons.
Plan Date i Z —q 7 Number of sheets Revision Date
Title G OA1�7-
Size of Septic Tank '!5LKt Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) =r&_1 �t cJ/',,— Cq ICY t
4 O h- !b q 11 U — c
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 a not to place the system in operation until a Certifi-
cate of Compliance has bee of Health. \
Signed Date `Q
Application Approved b / Date
Application Disapproved for the following reasons
Permit No. �7-710 Date Issued
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in compute
Yes
PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE, MASSACHUSETTS
01,ppYication for Mi.5po5ar *p5tem Construction Permit
APPhktignfor a Permit to Construct Repair(�Xpgrade Abandon Com lete System ❑Individual Components
Locati�%ress qG e eHT L I t`, Ori j J Owner's Name,Address and Tel.No.
Asses, Ma
1-7
Installer's Name,Address,and Tel.No" g'(f Designer's Name,Address and Tel.No.
' *` \D-C A P 6: S t_P �%t c_
2 U jc�"4 t r<o A� 1\ Ar +O`D QY-kS
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 _53Z) gallons per day. Calculated daily flow __lR. gallons.
Plan Date 12--1 i -q _ Number of sheets Revision Date
Title C.
Size of Septic Tank `ZKi b a Type of S.A.S. 41
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) =r•-%-AA j-c�✓�" l�'' �r4 rDC 1 1 �,-
,� of- 51'0z•( y- l�l�� ►tic � v�c�7'!�
127 YS r- +6- - D ore-e)
Date last inspected;,, "' l� f _r +
yx
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordandwith the provisions of Title 5 of the Environmental Code an. ;not to place the system in operation until a Certifi-
cate of Compliance has bee rOF6fl ,Health. \\
Signed Date
Application Approved b Date 2 /5
Application Disapproved for V010as ns
ri
Permit No. _ 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�
Abandoned( )by t O-C A e E S(a,P-'t
at W G-�C,26cQ: 44 t l 1 pa c',JQ- .0 e h'C't`�pit �`�- has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. - 1 Z) dated 5 /
Installer T Designer
The issuance of this permit shall not be construed as a guarantee that the system Will f n as designed.
Date g`�,--_/ l Inspector f
-------7---—�------------------------------/l—
No. ( V Fee (/
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
r Miopooar Opztem '_ ngtruction Permit
Permission is hereby granted to Construct( )Repair(✓)Upgrade( )Abandon( )
System located at C
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: ConstT-9/5-7
ion must be completed within three years df the date of thispermit.
Date: l �� `Approved
TOWN OF BARNSTABLE
LOCATION N C rznp "nflH I rlf i,JC SEWAGE # 7
VILLAGE ASSESSOR'S MAP & LOT l'�.�-DS ii
INSTALLER'S NAME&PHONE NO. M MA Csi-2-- 7a-O G 81
SEPTIC TANK CAPACITY eN;S-414-
LEACHING FACILITY: (type) y" i A-�+'' �PcA ,r S (size)
NO.OF BEDROOMS
BUILDER OR OWNER MCIhr��"�
PERMIT DATE: 'a- ' 9 7 COMPLIANCE DATE: )2. 17 7 1
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
within 300 feet of leaching facility) Feet
Furnished by
l-
c
CQa�j e ;; L�
t`COX, CST
Pl-
J
LOCATION I _ SEWAGE PERMIT NO.
VILLAGE
I N S T A LLER'S NAME i ADDRESS
RA
e U I L D E R OR OWNER
� cue P-IA'b �t<
Gew C' ae
DATE PERMIT ISSUED Rq
DAT E COMPLIANCE ISSUED �Il/
Lot 3
1019/97
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)
hereby certify that the application for disposal works
construction permit signed by me dated y1 9 -J`7 , concerning the
property located at_ I�( -� '�J��t ����� ����`�'r`�► - meets all of the
following criteria:
.There are no wetlands located within Io0 feet of the proposed leaching facility
There are no private wells within 150 feet of the proposed septic system
, •/There is no increase in now and/or change in use proposed
There are no variances requested or needed.
•�f the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the
(/
proposed leaching facility will agi be located less than fourteen(14)feet above the maximum adjusted
P P
groundwater table elevation.
Please complete the following: q
A)Top of Ground Elevation(according to the Engineering Division G.I.S.reap) -/
B)Observed Groundwater Table Elevation(according to Health Division well map)
y �
,i
SIGO
DATE: ( 2- — 9—I�
LICENSED SEPTIC SYSTEM I ALLER 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]. Y
q:health folder:cert
���' s
,: .�
r``�.. ., a � �.... r ... � `
�Y 1 ���
F; _...... � '
Q
- ..
4
_5!: ♦�
.n `}
1
1+
. LEGEND Great Sand ,
N Hill Dr Hill Rd
BENCHMARK
OUTSIDE COR./BOTT. STEP cBdh I -- 98 -- EXISTING CONTOUR ® op,K �RE� Longb°
EL.=102.02 x 100.98 EXISTING SPOT GRADE
o -$EXISTING S.A.S. H. OVERHEAD WIRES LOCUS Capn Cros y Rd
e-°j�p0„ E 5 I TO BE ABANDONED G Pen Ln
EXISTING GAS SERVICE °�
N 4 52 12,sj'1 W �EXISTING WATER SERVICE `° ,,ti�ra,,,
r n
97,91 .�o� 166•p2 �'-o I c �a °° o osr �n9 ON
1 /r"' , TEST PIT a ode`
CATCH BASI
\ a 4 o
97.50 TP-3 +102.9 BENCHMARK O wo „ Mosth
CBdh 100.50 100.70 TP{'i4' I rc 4 v
100.96 GO
::" + .1 R6CK96.54 �' ,�► OU ROP' EXISTING SEPTIC TANK
97.45 100.04 x 100.76
98.95 2p . 103,72 ! TOP OF TANK, EL.=101.41 LOCUS MAP
3:r 0f4c� 101,42 ® INV.(OUT)=100.08E NOT TO SCALE
100.61 BM co
3. 102.02 , I L"I04. OLD LEACH PIT
' 03
-+ _ 103.49 ABANDONED
.:.. w 1_ 0.89 N.N c� 1 r3
99.29 �� DECK �' 1 �, N� GENERAL NOTES:
I :::: _ 102.86 + v'
o ION �. CL
t� -� \_V O 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL•��� - �. O, I BOARD OF HEALTH AND THE DESIGN ENGINEER.
-+i1 1.97
99,87 x �O� 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
x 1o1.5a OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
L. 101.07
11�-11 96,31 00 \ x 101,50 +30.
I01.27 m LOCAL RULES AND REGULATIONS.
x�,92 � x . ,99.23:� BRZ. d � � � 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
o ;� �\ ✓ 100 �K WAY -1 +'1o1.as DESIGN ENGINEER.
00
CD G WP \ 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
r-- ° N \\ P °' 4 c _ FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
j� GARAGE 100.13 ENGINEER BEFORE CONSTRUCTION CONTINUES.
D_ J 98,35:+•`.':.99,6'', :^''i .' x 100.91 n\ +100.73
/ 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM.
73
73
1� G s6.54 pR 10\,68 _��f- 99, `- - 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
.: �RpVEL 99:3099,+ HEALTH FORTHE CTOR PROP�R IOWNER TO NSPECTIONS DTIFY THE URING CONSTRUCTCAL ION.
OF
98.56
99.26 7. WATER SUPPLIED BY TOWN WATER SERVICE.
8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
C•f ' �� 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
\ 96.30 TP-1 & TP-2 HAD INSUFFICIENT /
95.22 \ \ � lv AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
95.76 SUITABLE SOILS TO 11.5 FT. a 4V DIRECTED BY THE APPROVING AUTHORITIES.
\ ^ �% 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
a \ �./�o ,`�\ THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
1 94,80 _-__ --/� A:, ,\�o�O���„�, �a CONSTRUCTION.
GS 95,49 i 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
�y �p� IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
LOT 37 / `� s __ REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
- N \ / 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
43,570 ±SF�f Qd GxS94.35 / 4 i�& INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL.
PARgEL---I-D. � / -�VT�� / OO+NOy /,\A 1 n 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
Q• `r IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
ex
PLA
N ADD SOILS
LOGS, 6P 1 6 1 & TP-2 (SHEET 2)
o PETER T. x 94.38 �PcJE
M CIVIL "' / G
1 INP V'f
PROPOSED SEPTIC SYSTEM UPGRADE PLAN
No. 35109 RP �
Fcis1���° �,�� 68 'V91.91 14 GREAT HILL DRIVE, CENTERVILLE, MA
Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
of P OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO.
�1�� 59 edge O PJ
ELLETSON, JEFFREY E Engineering Works, Inc. 1"=30' P.T.M. 136-16
l :00' 155 FIVE CORNERS ROAD
93,09 'D'2 CENTERVILLE MA 02632 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0.
,
90.6 (508) 477-5313 4/29/16 P.T.M.
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL:99.00
SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE
INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S.
AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX PROPOSED S.A.S. SOIL LOG
PROVIDE ACCESS TO GRADE OVER OUTLET COVER INSTALL WATERTIGHT RISER & PROVIDE TWO ACCESS MANHOLES TO WITHIN 3"
T.O.F.=102.5t
COVER SET TO 6" OF GRADE OF FINISH GRADE FOR INSPECTION PURPOSES SOIL EVALUATOR: PETER 1McENTEEI PE(SE#1542)
F.G. EL.=101.5t F.G. EL-101.9t F.G. EL.=102.Ot F.G. EL.=102.0t WITNESS: DAVID STANTON R.S. HEALTH AGENT
ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH
MAINTAIN 29b GRADE (MIN.) OVER S.A.S.
100.9 q O 99.5 0"
SANDY LOAM FILL
L = 35' L = 5' 99.9 10YR 4/2 12„ 97.8 A 20"
® S=1% (MIN.) ® S=1% (MIN.) B SANDY LOAM
4"SCH40 PVC 4"SCH40 PVC
10YR 4/2
s SANDY LOAM g7 2 / 28'
io"I aN $ as 10YR 5/6
14" s aaaa0ae 97.9 36" B
NNaaaNa C1 LOAMY SAND
EXISTING as" LIQUID 10YR 5/8
LEVEL 4' 4.8' 4' COARSE SAND 95.5 48"
GASADAFFlE INV.=99.17 PROPOSED INV.=99.00 10YR 6/4 C1
INV.=100.08 D-BOX EFFECTIVE WIDTH = 12.8' 94 4 78" COARSE SAND
• " ' ' " ' INV.=98.50
EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS C2 1OYR 6/4
SURROUNDED WITH STONE AS SHOWN SILT LOAM 94.0 66"
SY 5/3 C2
H-10 RATED SILT LOAM
5Y 5/3
TOP CONC. ELEV.=99.3t 89.4 138" 88.0 138"
BREAKOUT ELEV.=99.00
INV. ELEV.=98.50 ease UNSUFFIECIENT SUITABLE SOILS ENCOUNTERED
NOTES: ease
aBaaa NaNaa
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE Naas eases
INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=96.50
4' 2 X 8.5'=17.0' 4'
2 D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' MIN. OF NATURALLY OCCURRING ELEV. TP-3 DEPTH ELEy. TP-4 DEPTH
ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL EFFECTIVE LENGTH = 25.0' 0" 0"
5' MIN. ABOVE GROUNDWATER 102.1 q 101.5 q
STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). LEACHING SYSTEM SECTION SANDY LOAM SANDY LOAM
3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTT. OF TP-4, EL.=90.0 - 101.4 10YR 4/2 8" 100.8 10YR 4/2 81,
4) CONTRACTOR SHALL INSPECT EFFLUENT FILTER ON 3/4" To 1-1/2" DOUBLE B B
OUTLET TEE AND REPLACE IF NECESSARY. WASHED STONE LOAMY SAND LOAMY SAND
10YR 5/8 10YR 5/8 24"
99.6 30" 99.5
3" LAYER OF 1/8" TO 1/2" C1 C1
SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE COARSE SAND COARSE SAND
(OR APPROVED FILTER FABRIC) 10YR 6/4 10YR 6/4
97.1 60" 97.5 48"
C2 C2 PERC
DESIGN CRITERIA 46/64"
FINE SAND FINE SAND
NUMBER OF BEDROOMS: 3 m 2.5Y 5/3 2.5Y 5/3
SOIL TEXTURAL CLASS: CLASS I
DESIGN PERCOLATION RATE: <5 MIN/IN n EXISTING\ so.s 138" 90.0 138"
(0.74 GPD/SF LOADING RATE) a HOUSE(#14) NO GROUNDWATER, PERC RATE: 3 MIN./IN.
DAILY FLOW: 330 GPD c� BRZ. T.O.F.=102.5±
^� WAY
DESIGN FLOW: 330 GPD
GARBAGE GRINDER: NO
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF S iv
74 GPD/SF DECK S ��b4'9\cmS•
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 9 - 96• u��'�
PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS
USE 2-500 GALLON LEACHING CHAMBERS IN SERIES PROP. S.A. PROPOSED SEPTIC SYSTEM UPGRADE PLAN
SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES co
--- A 14 GREAT HILL DRIVE, CENTERVILLE, MA
�-25'--I
SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632
BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. SEPTIC LAYOUT Engineering by: SCALE DRAWN JOB. NO.
TOTAL AREA:..............................................................471.2 S.F. Engineering Works, Inc. NTS P.T.M. 136-16
DESIGN FLOW PROVIDED: 0.74 GPD/SF(471 .2 SF) = 348.7 GPD 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO.
(508) 477-5313 4/29/16 P.T.M. 2 Of 2